In 2011 439 pirate attacks were reported to the International Maritime Bureau (1). These included 45 hijackings with 802 hostages taken. Eight crew were killed and 42 were injured. The incidence and nature of mid to long term health effects and the number of psychologically traumatised crew members are unknown. While piracy in general has attracted considerable media and public attention over the last ten years, little or nothing has been published about its medical implications.

The aim of this chapter is to outline the medical aspects, to give an assessment of the impact that acts of piracy might have on seafarers’ health, as well as to give those involved - be they medical professionals, ship crew or others responsible in such situations - advice on the medical implications of an attack and how to prepare for this possibility and to respond during and after an act of violence. Chapter 17 considers responses to the mental trauma arising from piracy in parallel with other mental and psychological traumas that may affect a seafarer.

A general introduction into piracy can be found in Dr. Baniela’s appendix to this chapter.