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LP 11/2020 Managing Sudden Illness Onboard during COVID-19

2020-02-16

Since the outbreak of the novel coronavirus, seafarers of Chinese citizenship have been restricted in terms of disembarkation, as well as getting treatment and replacement. For those experiencing sudden illness, even it’s not related to the virus, immediate and effective treatment is not always availble considering the global outbreak. The Club has recently collaborated with lawyers and one of its Members to settle a case where an outbound seafarer was sent for treatment, and this article is prepared to summarise the case for future reference.

I. Seafarer treatment during COVID-19

The Club has been informed of situations where sick and wounded seafarers are having difficulties getting treatment due to port regulations on preventing the spread of the virus. Some port health departments have demanded sick and injured seafarers to be quarantined on board, and some have required shipowner warranties on the fact that no COVID-19 symptoms were spotted on board. In extreme cases, Chinese seafarers are denied of disembarkation in some ports and they will have to deviate to other countries for treatment.

Regardless of the difficulties, the Club and its Members have been putting “saving lives” as the top priority when handling such cases. Liaising with local health department, customs and immigration authorities for timely disembarkation approval then becomes very important for getting the seafarers treated. This case is such an example where resources are reasonably and rapidly allocated through efficient teamwork so that medical help was provided without delay.  

II. Case briefing

In the evening of 2 Feburary 2020, the Club received a report from its Member that a seafarer suddenly fell ill during the voyage. The symptoms were swelling and bulging in the right lower body with a strong sense of falling. The seafarer experienced great pain as soon as he stood up and could hardly carry out his routine work.

Based on the information provided on board and clinical manifestations, the Member informed the sick crew member that he had been initially diagnosed with hernia and had no symptoms such as fever and cough. The Member decided to arrange disembarkation and treatment in hospital for him as soon as possible and according to the lawyers’ advice, an early surgery will be necessary if hernia is confirmed, or the crew member might be in danger as an incarcerated hernia can lead to serious consequences such as intestinal obstruction and intestinal necrosis with a possibility of septic shock and even loss of life.

III. Case handling

Determining the port of disembarkation:

The planned ports of call were Singapore, Sungai Udang of Malaysia and Bataan, Indonesia. Therefore, Singapore became the first choice. However, according to local correspondent, the Maritime and Port Authority of Singapore (MPA) has been requiring strict quarantine process since 1 February 2020 for ships that have called at Chinese ports within the last 2 weeks, including but not limited to the mandatory submission of Maritime Daclaration of Health, body temperature testing, quarantine of unwell crew members and disallowing entry/transfer for visitors with recent travel history to mainland China.

Knowing that it’s unlikely for the sick seafarer to disembark in Singapore, the Club reached out to correspondents in neighbouring countries like Malaysia and Vietnam. It turned out that strict control measures were also taken elsewhere and disembarkation would be allowed only with approval from health and immigration authorities.

Given all this, the Member then decided to try to have the sick crew member disembarked in Singapore as strict rules are implemented in all nearby ports.

Coordinating all parties involved:

1. As the ship proceeds to Singapore, the Member asked Embassy of China in Singapore for help, who agreed to assist in the negotiation with local authorities.

2. The Singapore immigration authority replied that a diagnostic statement by the ship physician is required to prove the authenticity of the incident. As per the suggestion of the Club and the lawyer health team that emphasis should be put on describing the symtoms and the severe consequences that the crew may suffer without timely treatment, the Member completed the statement and issued it to the authority.

3. After obtaining the approval of the immigration authority, the owner was informed that the sick crew member would not be granted access to medical aids without permission of the port health department. The ship had gone through the quarantine process in the early morning of 4 February 2020 as it arrived at the port, but no permission was issued and the ship had to wait at the anchorage for further notice. The Club then reached out to local agent and correspondent and after several rounds of communication obtained the approval at 11:00 a.m. the same day. A small boat was arranged later by the agent to pick up the sick crew member.

4. By the time this article is completed, this crew member was effectively treated in a hospital in Singapore and has been back to work on board the ship.

IV. Advice to Members

At a time when the pandemic continues to escalate and strict control measures are taken in most ports, the usual process for managing sudden illness on board ships has been challenged. It’s predictable that more cases of restricted crew disembarkation will take place in the near future. P&I Clubs and its Members will have to quickly and tactically respond to the situation, complying with international conventions and local regulations.

1. Report immediately to the Club with detailed information upon occurrence of such incidents to make the best of available resources, including the Club, overseas offices, local agents and correspondents. And with efforts of different parties and assistance of the Embassy, establish effective communication to facilitate the best possible option of helping the injured and sick crew.

2. Identify whether the country of the ship’s port of call is a member to the Maritime Labour Convention, 2006 (MLC 2006). If yes, it’s recommended to invoke Clause 2 and 3 of Guideline B4.1.3 Medical Care Ashore of MLC 2006 when applying crew disembarkation to the local authorities.

    “2. Measures should be taken to ensure that seafarers have access when in port to:

     (a) outpatient treatment for sickness and injury;

     (b) hospitalization when necessary; and

     (c) facilities for dental treatment, especially in cases of emergency.

     3. Suitable measures should be taken to facilitate the treatment of seafarers suffering from disease. In particular, seafarers should be promptly admitted to clinics and hospitals ashore, without difficulty and irrespective of nationality or religious belief, and, whenever possible, arrangements should be made to ensure, when necessary, continuation of treatment to supplement the medical facilities available to them.”

3. It will be prudent for the ship to be aware of the control measures at its ports of call, especially those targeting at crew disembarkation and treatment ashore. If such documents as diagnostic statement and ship physician statement are required, the Owner should consult qualified experts for issuance.

4. Maximum efforts of the Member should be devoted to getting the sick/injured crew member treated and the Club will provide all necessary assistance. Yet if unfortunately, the application for medical care shore is denied by the maritime authority despite the efforts, the Member should be prepared for deviation for the safety of the seafarer.

For further consultation, please contact your manager at the Club.

 

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