Introduction

The Maritime Labour Convention 2006 has defined standards for medical care ashore as a requirement for states party to the convention. Nowadays, medical care available to seafarers differs substantially between ports: In some ports private practices are tailored to serve the needs of seafarers and shipping- managements, others have governmental port health services including clinical care, but there are also ports where seafarers need to be referred to the general medical system of the port city. The Maritime Labour Convention 2006 requires that shore-based medical facilities for treating seafarers should be adequate for the purposes and their doctors, dentists and other medical personnel should be properly qualified. Globally, it is up to the local agent or fleet managers, who are medical lay-persons, to coordinate medical care. In case of serious incidents, government agencies of the flag state or insurance companies may take over. The company’s priority will not only be on quality but on the availability, cost and timeliness of the service chosen. Also, the company’s priority may be for acute care to assure fitness for duty rather than prevention or rehabilitation.

Experts in maritime health agree that despite there being no regulatory body which oversees the quality and appropriateness of port medicine globally, doctors who perform port maritime medicine need specific knowledge and skills. It is not a specialty in medicine; but it requires knowledge of several medical specialities.

General practice, occupational medicine and tropical medicine are the most important. Medical practice in a port to serve the individual seafarer as well as the companies involved in shipping, calls for a particular style of organization.

This text gives suggestions about the basic characteristics of an ideal port medical clinic. Seafarers are among the most isolated people on the planet regarding access to medical care, both in case of emergency and for primary health care. On a large, slow vessel in the middle of the Pacific Ocean, a seaman may be several days away from qualified medical services.

Health care on board may be organized with fully equipped hospitals, full and up to date medical chests, well-trained officers and telemedical support. It can, however, never offer more than basic medical treatment.

Evacuation by helicopters are spectacular and sometimes get the news headlines but they are exceptions and the range of a helicopter is limited.

Many seafarers remain on board worried and afraid, longing to get professional assistance as soon as possible. The majority of cases are first seen by a physician on arrival in port. These port physicians and port clinics have to meet certain criteria in order to assist seafarers in an appropriate way. A port clinic has to be the easiest way for a seafarer to get medical help on arrival in a port. It has to be nearby and should be easy to access.

The seafarer has to find help there for any medical problem or related request he might have. This implies a well-organized referral system to all kinds of specialized consultations and care, but also the facilities and skills to assist in questions on fitness for duty, vaccinations and other work related health issues.