Textbook of Maritime Medicine

Introduction

In recent years, introduction of modern technologies on board of merchant seafaring has been associated with reduced crews and increased workload. The shortening of turn-around times has resulted in decreased ship’s stay in the port and consequently minimized the crews’ social contacts (1). The problem of social isolation is often underemphasized by policy makers and practitioners in maritime sector (2).

Until now, only few studies dealing with the isolation of seafarers exist. To compare the risk of social isolation among seafarers with that of general populations, researchers face the problem of the healthy worker effect in seafaring.

11.6.1   Causes of isolation

During time of contract seafarers are confined to their vessel both during working time or leisure time. In consequence, they are separated from their families, friends and their social context for long-lasting times. There are considerable differences in the duration of shipboard stay (in months) between European and Not-European seafarers. Several studies revealed an average assignment from 3 to 6 months for European seamen and from 6 to 9 months in Non-European ones (3,4). Some seafarers reported on shipboard stay of more than 12 months. Consequently, several seamen feel confined on board a ship.

The social network, however, is important to compensate job-related stress and to speak with familiar persons about unpleasant experiences. The absence of family and friendship networks causes a distinctly lack of social and emotional support and makes the seamen more vulnerable.

Sometimes, seafarers have to cope with absence from home at times of family crisis or social unrests in their homeland. In these cases seafarers suffer from the fact that they cannot influence the circumstances at home and they feel helpless and isolated. Especially traumatic events on shore like bereavement or a break-up of relationships increase the feeling of isolation on the vessel. In such situations many seafarers often did not receive support from their colleagues since emotional issues are normally not picked out as a central theme and close friendships are quite rare at sea (2,3). Several seamen avoid discussion about private topics in order to maintain appropriate social distance.

Shipboard isolation considerably depends also on the social structure, especially on the leadership and the team spirit in the crew. The kind of leadership influences the atmosphere on board substantially; an extreme authoritarian leadership style can cause either opposition or servility (latter predominantly among low-qualified crew members). In contrast, sincerely interest and support of the subordinates allow for a faithful interaction and counteracts seafarer’s isolation on board.

Since seafarers have no influence on the choice of their companions they have to arrange with them although they might be very different. The crew is continuously changing during a voyage owing to the seamen’s different time of embarkation/ disembarkation. Thus, it is difficult to build up the faithful atmosphere aboard. Nowadays, crews normally consist of many different nationalities of different religious and cultural background. Reflecting this, different needs, values and expectations exist (6). Although multinational crews do not necessarily lead to isolation the often observed communication problems on board may cause isolation (2).

According to the Maritime Labour Convention (7) the ship owners’ and seafarers’ organizations concerned should take account, without discrimination, of the interests of seafarers having differing and distinctive cultural, religious and social practices, and may permit fairly applied variations in respect of the recommended shipboard standard of accommodation and recreational facilities.

Further, seafarers are among the most isolated demographic working groups in the world in concern of access to medical care, both in emergency situations and for primary health care. As the physical demands and health requirements in seafaring are rigorous and the job market appears competitive many seafarers are reluctant to seek medical help neither on board ship nor during their short stay in port even when they are feeling ill. In addition to this, several seafarers - especially Asiatic ones with short-term contracts - fear to lose their job if they become ill so that some of them dissimulate their symptoms. Those persons are at risk to develop chronic and serious health disorders. These developments emphasize the problem of lack of faith and of social isolation on board. In worst cases severe isolation can lead to despair, depression and finally to suicide.

11.6.2   Remedies of isolation

As long duration of shipboard stay aggravates isolation and homesickness it should be generally intended to reduce the seafarers’ assignment on board.

Modern technologies enable seafarers during their stay at sea to be in continuous contact to their social network at home. Further, the social isolation can possibly be reduced by the use of available seafarers’ welfare services and facilities ashore in accordance with the ILO Recommendation No. 173 and Maritime Labour Convention (7).

Telecommunication

Since separation from their social network normally lasted for a long time telecommunication (via telephone and internet) becomes increasingly important. Thus, the ship-to-shore telephone facilities should be made available to seafarers at reasonable charge. Telephone cards are often offered in the ports or the possibilities of telecommunication in seafarers’ welfare centers are used provided that the ship’s stay in the port is long enough to leave the vessel. The Maritime Labour Convention (2006) highlights that effort should be given to ensuring that the forwarding of seafarers’ mail is as reliable and expeditious as possible. It is further important to guarantee the privacy of the messages so that seafarers can contact their families without reservation.

In spite of decreasing costs for communication technology in the last years some seafarers still invest a lot of money monthly for telecommunication. This is especially a problem of the lower ranks with less financial resources. Further, an access to email is sometimes denied especially to the lower ranks (2).

Social contacts on board

Sometimes, the living situation on board is anonymous in spite of the limited living space on the vessel. By organizing social events, such as sport activities, regularly common dinners or exercise competitions the crew meets together und can better know each other; this may be a chance to militate against social isolation. Further, it is advantageous to provide daily new bulletins, video-recordings of major sports and news events worldwide with private access to all seafarers (2).

Additionally, a sufficient offer of communal space such as recreation rooms is important for the crew’s interaction (see chapter 6.7). The vessels should provide enough social and mess facilities to inspirit seafarers for communication. In contrast, a total bans of alcohol, whilst required for ship safety, may impact the shipboard social interaction.

Further, families should be allowed, if possible, to visit seafarers when their ship stay in port and also consideration should be given to permit spouses to accompany seafarers on occasional voyages (Maritime Labour Convention 2006). Absence from home for many months has a psycho-social impact on both, seafarers and their families (8).

Social contacts in the port

The shore leave provides the opportunity for a change in routine and allows seafarers to engage in activities which they are denied at sea. In the ports the seamen can socialize with their companions in a relatively normal environment. Furthermore, seafarers who have particular problems on board, such as feeling of isolation, can seek help from a local port welfare service.

Port welfare service/ facility

Seafarers suffering from isolation may find suitable advice by an impartial welfare worker. There are many common welfare services in the ports which can be visited. According to ILO Recommendation No. 173 shore leave should be granted as soon as possible after arrival in port and an adequate transport to and from dock areas has to be provided. The ports shall ensure that shore-based welfare facilities are easily accessible for the use of all seafarers, irrespective of nationality, race, colour, sex, religion, political opinion or social origin (Maritime Labour Convention 2006).

The port welfare facilities are important points of contact - a kind of second home outside of their common working and living place on board. It facilitates the seamen to meet other seamen of the same country of origin, same culture, same religion, speaking the same language and being exposed to a similar situation on board. These circumstances facilitate good understanding and a worthwhile and sincere exchange of meanings and feelings.

Seafarers often appreciate the “visit of a friendly face” with whom they can discuss their worries and personal issues. The welfare worker also often arranges telephone calls home, post letters, and he provides and exchanges newsletters, books and magazines. Also the Maritime Labour Convention 2006 (7) recommends taking measures designed to expedite the free circulation among ships, central supply agencies and welfare establishments of welfare materials such as films, books, newspapers and sports equipment.

In case of strong feeling of isolation professional help may be needed and the welfare services can arrange psychological advice.

Pastoral care

Pastoral care normally comprises religious and personal services as well as the provision of more general advice about the leisure time possibilities in the near of the port. The pastoral ship visitor is often perceived as “a friendly expert” informing about the different faiths and denominations in the port. Many seamen find a refuge in their faith which often helps to successfully deal with their feeling of isolation.

Seafarer’s health counseling

Several contact points for seafarer’s health counseling are established to solve the problem of lacking trust in effective help on board and social isolation. According to Maritime Labour Convention (2006) each member state signed this convention shall ensure that seafarers on board ships in its territory who are in need of immediate medical care are given access to the member’s medical facilities on shore. The medical advice provided free of charge to seafarers should not be limited to treatment of sick or injured seafarers but also include measures of a preventive character such as health promotion and health education programs.

The seafarer’s health counseling offers confidential and anonymous health service. Seafarers have the opportunity to seek for medical advice without requirement to involve the shipmaster and/ or the agent. The health counselor is normally a medical doctor well- knowing the special problems of seafarers related to their job. He is able to focus on the most important health issues among seamen (such as skin problems, sexually transmitted diseases, lower back pain or social isolation) und can give worthwhile medical advice.

Conclusions

Current developments in the maritime industry subjects the seamen to an increase of individual work load, to a long stay on board and to a long-lasting separation from their social network at home. Considering the restricted social contacts during the short stay in the ports the seamen are at risk to suffer from social isolation. Some studies reveal a high rate of suicides among certain groups of seamen which maybe an implication of strong isolation in seafaring (9,10).

In total, there is a need to enhance the possibilities for telecommunication at home and to improve the leisure time activities during the stay on board as well as in the port in order to promote the seafarers’ contacts with their colleagues (see chapter 18.1).

References

1. Kaheveci E. Fast turnaround ships and their impact on crews. Seafarers Int Res Centre, Cardiff University: Cardiff. 1999

2. Sampson H, Thomas M. The social isolation of seafarers: causes, effects, and remedies. Int Marit Health. 2003; 54(1-4):58-67

3. Oldenburg M, Jensen H-J, Latza U, Baur X. Coronary risks among seafarers aboard German-flagged ships. Int Arch Occup Environ Health 81; 2008: 735-41

4. Jensen OC, Sørensen JF, Thomas M, Canals ML, Nikolic N, Hu Y. Working conditions in international seafaring. Occup  Med (Lond). 2006 Sep; 56(6):393-7. Epub 2006 Jun 27

5 .Oldenburg M, Jensen H-J, Latza U, Baur X. Seafaring stressors aboard merchant and passenger ships. Int J Public Health 54; 2009:1-10

6. Knudsen F. 'If you are a good leader, I am a good follower'. Working and leisure relationships between Danish and Filipino seafarers on board Danish ships. Research Unit of Maritime Medicine 2004. 117 s. ISBN 87-90866-09-6

7. Maritime Labour Convention 2006: http://www.ilo.org/wcmsp5/groups/public/---ed_norm/---normes/documents/normativeinstrument/wcms_090250.pdf

8. Ulven A, Omdal K, Herløv-Nielsen H, Irgens A, Dahl E . Seafarers' wives and intermittent husbands-social and psychological impact of a subgroup of Norwegian seafarers' work schedule on their families. Int Marit Health. 2007;58(1-4):115-28

9. Mayhew C. Work-related traumatic deaths of British and Australian seafarers: what are the causes and how can they be prevented? Seafarers InternatRoberts S, Marlow P. Traumatic work related mortality among seafarers employed in British merchant shipping, 1976-2002. Occup Environ Med. 2005 Mar;62(3):172-80ional Research Centre; Cardiff University: Cardiff, 1999

10. Roberts S, Marlow P. Traumatic work related mortality among seafarers employed in British merchant shipping, 1976-2002. Occup Environ Med. 2005 Mar;62(3):172-80