Merchant Shipping Act, 1951 (Act No. 57 of 1951)RegulationsMerchant Shipping (Eyesight and Medical Examination) Regulations, 2004AnnexesAnnex 1 : Guidance on medical examination of seafarers (Regulation 3)Section 1 : General Introduction |
| (1) | Seafaring is a potentially hazardous occupation which calls for a high standard of health and fitness in those entering or re-entering the industry. A satisfactory standard of continuing good health is necessary for serving seafarers throughout their career because of the high inherent risks of the occupation. It is better, therefore, at an initial examination, to exclude an applicant if there is any doubt about his or her continuing fitness. Flexibility should be exercised only during examinations for retention. |
| (2) | These medical and visual standards give guidance on health criteria to be met. Allowance should be made for the inevitable impairment of health that time and change bring, so that a reasonably fit seafarer can, if he or she wishes it, continue at sea until the approved age or retirement. Firm recommendations have been made to exclude those suffering from medical conditions considered to be incompatible with continued seafaring. |
| (3) | It is clearly impossible to encompass within the standards specific advice on every medical condition. However, as a general rule the medical examiner should be satisfied in each case that no disease or defect is present which could either be aggravated by working at sea or represent an unacceptable health risk to the individual seafarer, other crew members or the safety of the ship. |
| (4) | Apart from the purely medical aspects, the occupational background should be considered especially in cases where there is doubt. It is necessary to emphasise that a ship is not only a place of work requiring attention throughout the day and night, but also a temporary home in which the crew must eat, sleep and find recreation. Most important of all is the need to adjust to each other, often for long periods, during a voyage. Although much is done to ameliorate living and working conditions, certain inherent characteristics remain. A crew is a closed community living in a ship that is seldom quiet or still. Individual eating habits and tastes cannot easily be met; facilities for physical exercise are limited; forced ventilation systems are used; the tedium of routine can easily become oppressive in the absence of normal diversion enjoyed by those ashore. An inability to fit in, or unwillingness to take responsibility, or to accept a reasonable measure of necessary discipline, could impair the safe and efficient working of the ship. |
| (5) | Very few merchant ships carry doctors. Acute illness or injury is dealt with by designated ship's officers whose training is limited to first aid or medical aid treatment. It should be borne in mind that a crew complement is carefully adjusted in terms of its size. Sickness can burden other crew members or even impair the efficient working of a ship. The examining doctor should therefore be satisfied that no condition is present which is likely to cause trouble during a voyage and no treatment is being followed which might cause worrying side effects. It would be an unsafe practice to allow seafaring with any known medical condition where the possibility of serious exacerbation requiring expert treatment could occur as a calculated risk. |
| (6) | The absence of doctors in most ships means that seafarers will not be able readily to consult a doctor or obtain special treatment until the next port call. Ship turnaround in ports is often very rapid allowing no time for necessary investigation subsequent to consultation with a doctor. The standard of medical practice abroad vanes and facilities, which we in this country would regard as necessary, may not be available at smaller, remote ports. It is doubtful that it is even wise to permit seafaring if the loss of a necessary medicament could precipitate the rapid deterioration of a condition. |
| (7) | It should be remembered that some trades will require that seafarers spend lengthy periods in tropical climates. Furthermore, most seafarers will need to join and leave ships by air travel. They should, therefore, be free from any condition which precludes air travel, eg. Pneumothorax and conditions which predispose to barotrauma. |
| (8) | Where medication is acceptable for serving seafarers, arrangements should be made for a reserve stock of the prescribed drugs to be held in a safe place, with the agreement of the ship's master. |
| (9) | Article 4 of ILO Convention No. 73 states that "when prescribing the nature of the examination, due regard shall be had to the age of the person to be examined and the nature of the duties to be performed". In addition, Article 3 of the Convention states that a serving seafarer should have a medical certificate "attesting to his fitness for the work for which he is to be employed at sea". In reaching a conclusion, the attending doctor should therefore consider any medical conditions present, the age and experience of the seafarer, the specific work on which he or she will be employed and the trade in which he or she will be engaged (where known). If a seafarer is found to be unfit to continue in his or her present capacity because he or she does not meet the full unrestricted sea service category, a restricted service certificate may be issued stating the restrictions applicable. |
| (10) | The standards are framed to provide the maximum flexibility in their interpretation compatible with the paramount importance of maintaining the safety of vessels at sea, the safe performance of the serving seafarer's duties while, at the same time, protecting his or her health. Conditions not specified in the standards, which interfere with job requirements, should be assessed in the light of the general principle outlined above. |
| (11) | It may be necessary on occasion and, with the seafarer's consent, for the doctor to consult the general practitioner. When it is necessary to consult with other doctors the usual ethical considerations will apply, but it should be clearly understood that the decision on fitness in accordance with the required medical standard, rests with the initial examining doctor, subject to the medical appeal process. |
| (12) | Full clinical notes should be kept of any detailed medical examination and be retained for at least six years. |
| (13) | Reference should be made to the ILO and IMO Guidelines on the medical examinations of seafarers as published in the Code. |
[Section (13) inserted by Section No. 10(a) of the Merchant Shipping (Eyesight and Medical Examination) Amendment Regulations, 2015