Seaways Conference Report by Deirdre Lane, FNI, MSc, Master Mariner.
On 7 October, the Nautical Institute Ireland Branch and the Irish Institute of Master Mariners held their long-awaited Seafarer Wellness Conference, postponed for over two years due to COVID. It was great to finally meet face to face in familiar surroundings at the National Maritime College of Ireland (NMCI) in Cork to discuss an issue that has been brought to the fore by COVID 19 and the resulting crew change crisis.
Alison Kay, Trinity College Dublin on “Human Factors”.
Our first speaker of the day, Alison, spoke about how modern life creates problems that can be exacerbated by conditions at sea, such as reduced social opportunities and reduced shore leave, and advocated that “the human factor is fundamental to successful operations in safety critical systems”. Toolkits such as mindfulness and healthy eating are needed to approach wellbeing, but there also needs to be a systematic approach to seafarers’ wellbeing that includes one’s own team/watch, the ship, the organisation, radiating out to the industry and regulators.
Dr. Nebojša Nikolić, International Maritime Health Foundation (IMHF) on “Consensus on STCW Medical Training”
Dr Nebojša spoke about the need for consensus on learning outcomes and competencies to be used in the medical training of seafarers and argued that the low number of actual medical incidents on board and the lack of medical expertise can be addressed by a mandatory course with a refresher every 5 years, including logged drills and exercises at a shore-based training centre, in addition to extending medical training to engineers. It is planned that the Norwegian Maritime Authority will propose a consensus document on learning outcomes to the IMO MSC, which will be used to design new model medical courses. Dr Nebojša called for feedback from seafarers if they feel they can help the expert panel. More information on the IMHF and the journal is available at https://journals.viamedica.pl/international_maritime_health
Captain John Dolan, The Standard Club on “How major insurers responded during COVID”.
Captain Dolan gave an interesting insight into how the major insurers responded during COVID. John set the scene with a strong focus on the seafarer, including crew metrics of 1.89 million seafarers on some 74,000 ships with a need for more officers and diversity. He described the talent in the shipping industry, the need for more supply chain professionals and how seafarers are at the heart of the business. He described the early days of COVID as “chaos”, with general confusion about the scale of the situation, fear of the unknown, quarantine, port and state paralysis and the crew change crisis. John described the difficulty of getting clear answers to their members at this time.
An internal COVID team was set up and the group initially met every day, with a port tracker providing data and frequent updates throughout the day. John described the high levels of anxiety on board during COVID and how it had an extraordinary impact on seafarers. He concluded by encouraging seafarers to take part in the Seafarers Happiness Index survey as an opportunity to share how they feel about working at sea. https://www.happyatsea.org/survey/
Our expert chairman Captain James Robinson DSM, FNI (also NI Past President) actively encouraged Q&A from all attendees, young and old, and then dismissed us for a well-timed smoko, while conference organiser NMCI lecturer Captain Bill Kavanagh FNI struggled with the technology to get our next speaker live from her ship in an F8 in the North Sea!
Captain Áine Hyde AFNI, Master Dive Support Vessel, on “Ship Operations and wellness”.
We were joined by video conference with Capt. Hyde, live from her ship in transit in the North Sea, for a question and answer style interview with Capt. Bill Kavanagh. Áine gave us an important insight into ship operations and wellbeing from “the pointy end”, describing life on board her ship with 118 people, including a multinational crew of British, Dutch, Filipino, Latvian, Polish, South African and Irish, with 4 of the 118 being female. Bill asked how the seafarers on board were coping with COVID and Áine explained that it’s not over yet and that being on a dive support vessel they have to be extra careful as it’s a higher risk because they have to put divers into a saturation chamber. They still have to do a PCR test before they go on board and they still have to quarantine if they have COVID. Bill asked what’s important to seafarers and we were pleased to hear that a variety of good, fresh food is still high on the list and a great morale booster. Wi-Fi and connectivity are also high on the list of priorities these days. A good rotation of time on and time off and good money with reliable crew changes are also high on the list. Excessive paperwork can still be an issue, an example being the Maritime Declaration of Health, where the form is not standardised and it is not clear exactly what is required.
Dr. Fiona O’ Halloran, Munster Technological University, on “Diet and Nutrition”.
Dr O’ Halloran spoke about how diet and lifestyle are a major risk factor for non-communicable diseases (NCDs) and a priority area for maritime health. The four main types are cardiovascular disease, cancer, chronic respiratory disease and diabetes. Environmental risk factors include air pollution, weather changes and sunlight, while medical risk factors include stress and obesity. She emphasised that good food doesn’t necessarily mean good nutrition and that ship’s chefs need to have a concept of good nutrition and optimise the food supply on board. Dr O’Halloran highlighted the e Health ship project (2017-2021), which found that seafarers are at a higher risk of becoming overweight than the general population, with diet being a key influencing factor. Eating habits at sea were found to be generally unhealthy, with a preference for energy-dense, sugary, fatty and salty foods, putting seafarers at high risk of type 2 diabetes. It was also found that there is a lack of research on diet and nutrition in Irish Maritime studies, and that more research is needed on the effects of being on board versus being at home. Fiona concluded that while the signals are being read, further action and intervention is needed.
Joan Dineen, Munster Technological University on “Fitness”.
Participants were introduced to the importance of fitness, with the key message being that it doesn’t matter what you do, as long as you move, because the human genome has evolved to support a physically active lifestyle. A sedentary lifestyle (sitting in a chair) doesn’t maintain the metabolic demands and muscle loading required for good health. Lack of exercise can lead to chronic diseases such as coronary heart disease, high blood pressure and type 2 diabetes. We all need 30 minutes of exercise 5 days a week, which can include a brisk walk at a pace where you can talk but not sing. Joan broke down the different components of fitness as speed, agility, reaction time, strength, balance and co-ordination. When it comes to fitness, seafarers need to choose one of the components of fitness and set short and long term, relevant and time bound goals. Exercise is medicine and as seafarers we need to think about our ship and what we can do while we are on board. We can set up step challenges, organise team or watch challenges or go to a local park run if you can get ashore. We can also use fitness apps that suit our own needs, find out what works for you and remember that “any exercise is better than no exercise and do exercise that you enjoy”!
Captain Nick Bourke, Port of Cork, on “Seafarer Supports in the Port of Cork”.
Captain Bourke gave the Ports and Harbours perspective on seafarers’ wellness by highlighting some of the seafarers’ support in the Port of Cork. Nick spoke passionately about the issues affecting seafarers, “the forgotten workforce”, including remote ports and harbours with few facilities, long public transport journeys, access to internet and data, language, currency, isolation, paranoia of “outsiders” and worst of all the misuse of ISPS to restrict shore leave! Nick highlighted Cork’s advantages for seafarers, including a cruise terminal and city berths with easy access to the city, a safe place to go ashore, public transport, a seafarers’ mission and the popular Port of Cork Wi-Fi project. Nick then went on to describe Port of Cork’s forward-thinking COVID vaccination campaign, where they used their relationship as part of the Inter-Agency Emergency Management Office to work with the local Health Service Executive to develop a plan to issue Medical ID numbers, which resulted in Cork being the first port in Ireland to offer COVID 19 vaccinations to seafarers. They also worked on a communications plan to get buy-in from local ship’s agents. Captain Bourke urged us all to think “Seafarer and don’t accept the status quo”. Share information about how and what seafarers have access to in the vicinity, find out what seafarers want and provide facilities where appropriate.
Nautical Institute President Captain André LeGoubin.
After a break for lunch, we received a recorded video message from our President, who was unable to attend the conference as he was at sea. Captain LeGoubin described how we don’t listen to each other and how we should try to identify any seafarers who may be having an emotionally difficult time and desperately need to talk. He also talked about how the expectations of the next generation are different and how senior seafarers need to adapt. He concluded by encouraging our younger seafarers, our leaders of tomorrow, to speak up and “tell us what you need”.
Dr. Claire Pekcan, Safe Marine on “Fatigue and health in the maritime Industry.”
Dr Pekcan began by describing how internally a central clock controls many small clocks in our system and that’s why we need 7-8 hours of good quality sleep. The level of alertness required for shipboard operations when tired can be stressful. Claire urged seafarers not to underestimate the risks of heavy workloads, which can lead to immeasurable cellular damage and chronic fatigue. The consequences of chronic fatigue for seafarers include death by suicide, obesity and cognitive impairment leading to accidents and chronic disease. Claire described the case of an Australian coal carrier at anchor for 6 months where crew changes were not permitted and the Captain and Chief Engineer’s sign offs were 307 days overdue! Claire highlighted the need to balance commerce and compassion and asked, “Are we getting it wrong? Shipowners can make managers aware of the safety implications of their actions, invest in human factors training for personnel, monitor emotional wellbeing and implement fatigue risk management to allow recovery from stressful events. Claire urged seafarers not to think about things over and over again, but to seek out people who make them feel good, and not to engage in “if only” thinking, but to tell themselves that they can’t control everything. Claire concluded by saying that we need to look at contract lengths and balance them with the demands and pressures of the job, a one size fits all approach does not work.
Paul Mc Carthy, Munster Technological University on “Counselling in the National Maritime College of Ireland the word form over the horizon”.
Paul’s opening slide proudly highlighted that the National Maritime College of Ireland was the first college in the world to join ISWAN in 2019. When Paul arrived at NMCI, he conducted a needs assessment which identified issues such as bullying, stress management and resilience training. Paul described typical maritime specific stressors, including life on board, noise and vibration. Steps to managing stress at sea include calm breathing, resilience and basic assertiveness skills including how to say no to inappropriate requests. Paul then shared with us some unacceptable feedback from students returning from sea, such as a captain’s contempt for a cadet by speaking negatively about the cadet to others on board in a different language (which the cadet understood); and negative comments about a cadet’s body size: “the captain barely disguised his contempt for me”. Students described seafaring as a demanding, high-risk and stressful occupation that doesn’t compare with land-based jobs. Other problems included isolation, homesickness, relationship difficulties and cultural issues. Paul urged the industry to continue to promote mental health awareness before students go to sea and to have an official mental health module rather than relying on the goodwill of lecturers to include the topic.
Simon Grainge, ISWAN on “Improving the mental wellbeing of seafarers”.
Simon began by describing the International Seafarer and Welfare Assistance Network (ISWAN) and how it works with stakeholders on mental health awareness training at sea, social interaction issues and the Seafarers International Relief Fund. He also highlighted some of ISWAN’s publications, including “Mentally Healthy Ships” and “Arrested and detained ships, and abandoned seafarers”. ISWAN also has bespoke helplines for yacht crews, shipowners, unions and a counselling service, which handled around 16,833 calls and messages in 2021. Paul described how the simple things at sea matter, such as contact with family, shore leave, welfare facilities, living space, pay, food, keeping fit, interaction with others and workload. Common trends include COVID, the war in Ukraine, sexual assault and harassment, abandonment, fatigue, mental health and suicide. It advised companies and ships to identify mental health risks and implement policies, reduce the stigma and negative consequences of seeking help, and establish effective support and response mechanisms.
Dr. Chris Haughton, Haughton Maritime on “The development of a standard for mental health
Chris engaged us all in an interactive session that started with everyone writing the word “me” in the middle of a page, then participants had to analyse what we do with our time by dividing the circle into segments such as work, non-work etc. to help us all discover what’s going on in our “world” and what we feel we can do about it. We each reflected on our findings with our neighbours and it was interesting to note the considerable size of the segment allocated to work compared to non-work! Dr Haughton went on to highlight the Merchant Navy Training Board publication “A standard for Seafarers’ Mental Health Awareness and Wellbeing Training”. The aim of the book is to help seafarers and to provide a recognised benchmark and light touch standard. Learning outcomes include being able to describe different types and causes of poor mental health, recognising changes in behaviour, avoiding judgement and stigmatisation and actions to promote wellbeing awareness”.
Dr. Imogen Stilz, Shell Medical Advisor on “Healthy people at Sea”.
Dr Stilz described how to connect the dots for healthy people working at sea, starting with pre-embarkation and the medical examination of seafarers. The next step is “joining the ship” and the legal requirement for the captain to have medical information, as well as ensuring that there is adequate health support on board and a sufficient supply of medication for the duration of the voyage. Staying healthy ‘on board’ is the next step, including lifestyle, nutrition, exercise and dental hygiene. Chronic conditions need to be managed and ships need mental health and wellbeing ambassadors. Dr Imogen highlighted the importance of social connections on board and the connection to home. Ships also need to meet legal and regulatory requirements for on-board drug control, drug and alcohol testing. “At home you need a healthy home life with good nutrition, exercise and healthy habits, you also need to recharge, have access to healthcare and look after yourself and others. For healthy people at sea, we need fair and transparent employer processes, procedures and Key Performance Indicators. Employers need to provide the right facilities, a safe environment, safe systems, seafarers’ wellbeing programmes, confidential employee support and psychological safety, and finally, seafarers need to be empowered to own and manage their own health.
In conclusion, the Chairman, Captain James Robinson, noted that this was the first conference of its kind in Ireland and that the conference materials provided further opportunities for action to help all seafarers.