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1. On M E C A


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Why was the course of Advanced Medical Care for Mariners establshed?

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1. On M E C A

  1. 1. IMO Resolution on “Training & Qualification” ILO Convention on “Health Protection & Medical Care of Seafarers” On Medical Care Course
  3. 3. “ TRAINING AND QUALIFICATION OF PERSONS IN CHARGE OF MEDICAL CARE ABOARD SHIP” <ul><li>RESOLUTION A.438 (XI) </li></ul><ul><li>Adopted on 15 November 1978 </li></ul><ul><li>Inter-Governmental Maritime Consultative Organization (presently International Maritime Organization) </li></ul>
  4. 4. CONSIDERATIONS <ul><li>RESOLUTION A.438 </li></ul>
  5. 5. Paragraph 1 <ul><li>Considering the serious dangers to human life and safety when sickness and accidents occur and are not properly treated owing to the </li></ul><ul><li>limited medical training of personnel aboard ships at sea. </li></ul>
  6. 6. Paragraph 4 <ul><li>Recognizing the many ships which do not carry doctors are often in an isolated situation at sea where reliance must be placed upon the medical training of those on board.” </li></ul>
  7. 7. Paragraph 5 <ul><li>Desiring to improve the level of safety in such ships by establishing a reasonable minimum standard of theoretical and practical medical training beyond first aid level for persons placed in charge of medical care aboard ships at sea as part of their regular duties. </li></ul>
  8. 8. RECOMMENDATIONS <ul><li>RESOLUTION A.438 </li></ul>
  9. 9. #1 <ul><li>That ships engaged in voyages of more than 600 [nm] in length </li></ul><ul><li>Is more than 200 [nm] from a place of safety </li></ul><ul><li>Do not carry a doctor </li></ul><ul><li>“… [must] carry at least one person who has satisfactorily completed a course of more advanced training in medical care.” </li></ul>
  10. 10. #2 <ul><li>“ The advanced medical training… be provided by a specified program, of appropriate content and number of hours, in practical and theoretical medical training beyond the level of first aid;” </li></ul>
  11. 11. MECA’S GOAL <ul><li>“… enable candidates to participate effectively in coordinated schemes for medical assistance on ships at sea and to provide the sick or injured with a satisfactory standard of medical care while they remain on board.” </li></ul>
  12. 12. HEALTH PROTECTION AND MEDICAL CARE FOR SEAFARERS <ul><li>ILO Convention (No. 164) </li></ul><ul><li>Geneva, 8 October 1987 </li></ul>
  13. 13. To Whom? <ul><li>Article 1, No. 1 </li></ul><ul><ul><li>“… applies to every seagoing ship… publicly or privately owned, which is registered in the Territory of any Member … and… is ordinarily engaged in commercial maritime navigation </li></ul></ul>
  14. 14. For the Purpose of… <ul><li>Article 4, A </li></ul><ul><ul><li>Ensuring “the application to seafarers of any general provisions on occupational health protection and medical care relevant to the seafaring profession, as well as of special provisions peculiar to work on board.” </li></ul></ul><ul><li>Article 4, B </li></ul><ul><ul><li>Providing seafarers with health protection and medical care as comparable as… workers ashore.” </li></ul></ul>
  15. 15. Considerations <ul><li>Article 4, c </li></ul><ul><ul><li>“… the right to visit a doctor without delay in ports of call where practicable.” </li></ul></ul><ul><li>Article 4, d </li></ul><ul><ul><li>“… provided free of charge to seafarers.” </li></ul></ul><ul><li>Article 4, e </li></ul><ul><ul><li>“… not limited to sick and injured… (also) measures of preventive in character…that devote to…health promotion and … education.” </li></ul></ul>
  16. 16. Article 5 Medicine Chest <ul><li>“ Every ship…shall be required to carry a medicine chest.” That shall be… </li></ul><ul><ul><li>Prescribed by a competent authority </li></ul></ul><ul><ul><li>Based on the most recent editions of IMGS and the “List of Essential Drugs” by WHO </li></ul></ul><ul><ul><li>Maintained and inspected at intervals, not exceeding 12 months… </li></ul></ul><ul><ul><li>Medicines are listed and labeled with generic names in addition to any brand names, expiry dates, and storage conditions. </li></ul></ul>
  17. 17. <ul><li>When the drug is not available… </li></ul><ul><ul><li>In case of emergency, and the medicine prescribed by qualified healthcare providers are not available, the shipowner shall take all needed steps to obtain it as soon as possible. </li></ul></ul>
  18. 18. Article 6 Medical Guide <ul><li>Every ship shall be required to carry a medical guide adopted by competent authority </li></ul><ul><li>It will… </li></ul><ul><ul><li>Explain how the medicines are to be used and </li></ul></ul><ul><ul><li>Designed to enable non-medical persons to care the sick and injured on-board with and without medical advice by radio or satellite communication </li></ul></ul>
  19. 19. Article 7 Medical Advice <ul><li>The competent authority shall ensure the availability medical advice 24/7 by radio or satellite communications </li></ul><ul><li>Communications shall be free of charge </li></ul><ul><li>The requesting seafarer shall be instructed on the use of the ship’s medical guide </li></ul>
  20. 20. Article 12 Medical Reports <ul><li>A standard medical report shall be adopted by the competent authority as a model for ship’s doctors, masters, or persons in charge of medical care on-board and hospitals or doctors ashore </li></ul><ul><li>The info contained shall be kept strictly confidential and shall be used for no other purpose than to facilitate treatment. </li></ul>
  21. 21. Standards of training, certification and watchkeeping
  22. 22. Standard of Competence <ul><li>Section A-VI/4 </li></ul><ul><li>4. Every seafarer who is designated to take charge of medical care on board ship shall be required to demonstrate the competence to undertake the tasks, duties, and responsibilities listed… </li></ul><ul><li>5. The level of knowledge of the subjects listed…shall be sufficient to enable the designated seafarer to take immediate effective action in the case of accidents or illness likely to occur on board ship. </li></ul>
  23. 23. Standard of Competence <ul><li>Section A-VI/4 </li></ul><ul><li>6. Every candidate for certification under the provisions of regulation VI/4, par 2 shall be required to provide evidence that the required standard of competence has been achieved in accordance with the methods for demonstrating competence and the criteria for evaluating competence tabulated… </li></ul>
  24. 24. Knowledge and Understanding <ul><li>Care of Casualty involving: </li></ul><ul><ul><li>Head and spinal injuries </li></ul></ul><ul><ul><li>Injuries of the ear, nose, throat, and eyes </li></ul></ul><ul><ul><li>External and internal bleeding </li></ul></ul><ul><ul><li>Burns, scalds, and frostbite </li></ul></ul><ul><ul><li>Fractures, dislocations, and muscular injuries </li></ul></ul><ul><ul><li>Wounds, wound healing, and infection </li></ul></ul><ul><ul><li>Pain relief </li></ul></ul><ul><ul><li>Techniques of sewing and clamping </li></ul></ul><ul><ul><li>Management of acute abdominal conditions </li></ul></ul><ul><ul><li>Minor surgical treatments </li></ul></ul><ul><ul><li>Dressing and bandaging </li></ul></ul>
  25. 25. Knowledge & Understanding <ul><li>Diseases, including: </li></ul><ul><ul><li>Medical conditions and emergencies </li></ul></ul><ul><ul><li>Sexually transmitted diseases </li></ul></ul><ul><ul><li>Tropical and infectious diseases </li></ul></ul><ul><li>Alcohol and drug abuse </li></ul><ul><li>Dental </li></ul><ul><li>Gynecology, pregnancy and childbirth </li></ul><ul><li>Medical care of Rescued Persons </li></ul><ul><li>Death at Sea </li></ul><ul><li>Hygiene </li></ul><ul><li>Disease Prevention, including: </li></ul><ul><ul><li>Disinfection, disinfestation, de-ratting </li></ul></ul><ul><ul><li>Vaccinations </li></ul></ul>
  26. 26. Knowledge & Understanding <ul><li>Keeping Records and copies of applicable regulations </li></ul><ul><ul><li>Keeping medical records </li></ul></ul><ul><ul><li>International and National Maritime Medical Regulations </li></ul></ul><ul><li>External Assistance, including: </li></ul><ul><ul><li>Radio medical advice </li></ul></ul><ul><ul><li>Transportation of the ill and injured, including helicopter evacuation </li></ul></ul><ul><ul><li>Medical care of sick seafarers involving cooperation with port health authorities or outpatient wards in port </li></ul></ul>
  27. 27. End