Textbook of Maritime Medicine

The liberalization of the labour market, also in the shipping industry, was found to weaken collective bargaining, minimum wages and safety of work.

Ship owners were the beneficiaries of the process of globalization. they are now able to operate their ships at lower labour costs than before. But for seafarers in many countries, globalization was a mixed blessing. They can now look for employment on ships operated under various flags. But for many of them, conditions and safety of work and the care for their health have generally deteriorated.

On ships flying flags of industrialized countries, there is job security for crews and the health care for them is fairly well organized. Seafarers are regularly examined by doctors, their medical expenses are fully covered by insurance, and strong trade unions protect their social security and fight for honest wages.

Yet, during the last two decades, a large number of ships of industrialized countries have been re-flagged and operated under so called “flags of convenience” (FOC).

Seafarers of any nationality can be employed on such ships. They come from developing countries or from newly independent countries, in which the previously efficient government operated health services have disintegrated.

Their contracts are usually for short periods of time, often for one or two voyages only.

Low registration fees, low or no taxes, and freedom to employ cheap labour are the motivating factors behind a ship owner’s decision to “flag out”.

In 2000, there were 30 FOC countries, including Bolivia (having no access to sea), Bahamas, Cambodia, Cyprus, Lebanon, Liberia, Malta, Panama and.

FOC registers have poor safety and training standards. In many cases these registers are not even run from the country concerned. Once a ship is registered under a FOC, the ship owners then recruit the cheapest labour they can find, pay minimum wages and cut costs by lowering standards of living and working conditions of the crew. The home countries of the crew can do little to protect them because the rules that apply on board ships are often those of the country of registration. As a result, most FOC seafarers are not members of a trade union.

The international organizations as ILO, WHO, IMO, and the ITF have done

much to introduce legislation protecting the safety of work, health and wellbeing of international seafarers, fishermen and other maritime workers. More about that is written in the next two chapters of this book.

Particularly WHO has done a lot, supporting many initiatives and activities of maritime health services in various countries, training and disseminating knowledge of health problems of seafarers.

In 1972, WHO designated one research centre (Institute of Maritime Medicine in Gdynia) as their global reference centre for maritime medicine. Since that time, several WHO Collaborating Centers were designated, in Hamburg, Esbjerg, Bergen. Similar centers in other countries ( Ukraine, Russia, Vietnam, Japan, Lithuania, Spain) joined in these activities. International Symposia on Maritime Medicine have been conducted since the first one organized in 1963, and the health care workers from many countries who belong to the International Maritime Health Association (IMHA) regularly exchange experiences. Scientific maritime medicine journals are published in Poland, Japan, Spain, China and Ukraine. International WHO postgraduate maritime occupational health training courses for doctors were conducted in Gdynia.