Post-piracy care for seafarers guidelines
Today piracy has become a serious problem in maritime security. The threat of an attack, fight with the pirates and especially captivity cause psycho-emotional stress, lead to a breach of psychosomatic health and a threat to the lives of seafarers.
Збережено в:
| Дата: | 2011 |
|---|---|
| Автор: | |
| Формат: | Стаття |
| Мова: | English |
| Опубліковано: |
Фізико-хімічний інститут ім. О.В. Богатського НАН України
2011
|
| Назва видання: | Актуальні проблеми транспортної медицини |
| Теми: | |
| Онлайн доступ: | http://dspace.nbuv.gov.ua/handle/123456789/136562 |
| Теги: |
Додати тег
Немає тегів, Будьте першим, хто поставить тег для цього запису!
|
| Назва журналу: | Digital Library of Periodicals of National Academy of Sciences of Ukraine |
| Цитувати: | Post-piracy care for seafarers guidelines / Oliver Brewer // Актуальні проблеми транспортної медицини. — 2011. — № 3 (25). — С. 49-54. — англ. |
Репозитарії
Digital Library of Periodicals of National Academy of Sciences of Ukraine| id |
irk-123456789-136562 |
|---|---|
| record_format |
dspace |
| spelling |
irk-123456789-1365622018-06-17T03:07:09Z Post-piracy care for seafarers guidelines Brewer, Oliver Материалы 11 Международного симпозиума по морской медицине Today piracy has become a serious problem in maritime security. The threat of an attack, fight with the pirates and especially captivity cause psycho-emotional stress, lead to a breach of psychosomatic health and a threat to the lives of seafarers. В даний час піратство стало серйозною проблемою в безпеці морськогосудноплавства. Загроза нападу, сутички з піратами і особливо перебування в полоні викликають психоемоційний стрес, призводять до порушення психосоматичного здоров’я і єзагрозою для життяморяків. Вирішенню цих важливих проблем присвячена ця стаття. В настоящее время пиратство стало серьёзной проблемой в безопасности морского судоходства. Угроза нападения, схватки с пиратами и особенно пребывание в плену вызывают психоэмоциональный стресс, приводят к нарушению психосоматического здоровья и являются угрозой для жизни моряков. Решению этих важных проблем посвящена настоящая статья. 2011 Article Post-piracy care for seafarers guidelines / Oliver Brewer // Актуальні проблеми транспортної медицини. — 2011. — № 3 (25). — С. 49-54. — англ. 1818-9385 http://dspace.nbuv.gov.ua/handle/123456789/136562 347.799.1 en Актуальні проблеми транспортної медицини Фізико-хімічний інститут ім. О.В. Богатського НАН України |
| institution |
Digital Library of Periodicals of National Academy of Sciences of Ukraine |
| collection |
DSpace DC |
| language |
English |
| topic |
Материалы 11 Международного симпозиума по морской медицине Материалы 11 Международного симпозиума по морской медицине |
| spellingShingle |
Материалы 11 Международного симпозиума по морской медицине Материалы 11 Международного симпозиума по морской медицине Brewer, Oliver Post-piracy care for seafarers guidelines Актуальні проблеми транспортної медицини |
| description |
Today piracy has become a serious problem in maritime security. The threat of an attack, fight with the pirates and especially captivity cause psycho-emotional stress, lead to a breach of psychosomatic health and a threat to the lives of seafarers. |
| format |
Article |
| author |
Brewer, Oliver |
| author_facet |
Brewer, Oliver |
| author_sort |
Brewer, Oliver |
| title |
Post-piracy care for seafarers guidelines |
| title_short |
Post-piracy care for seafarers guidelines |
| title_full |
Post-piracy care for seafarers guidelines |
| title_fullStr |
Post-piracy care for seafarers guidelines |
| title_full_unstemmed |
Post-piracy care for seafarers guidelines |
| title_sort |
post-piracy care for seafarers guidelines |
| publisher |
Фізико-хімічний інститут ім. О.В. Богатського НАН України |
| publishDate |
2011 |
| topic_facet |
Материалы 11 Международного симпозиума по морской медицине |
| url |
http://dspace.nbuv.gov.ua/handle/123456789/136562 |
| citation_txt |
Post-piracy care for seafarers guidelines / Oliver Brewer // Актуальні проблеми транспортної медицини. — 2011. — № 3 (25). — С. 49-54. — англ. |
| series |
Актуальні проблеми транспортної медицини |
| work_keys_str_mv |
AT breweroliver postpiracycareforseafarersguidelines |
| first_indexed |
2025-07-10T01:39:08Z |
| last_indexed |
2025-07-10T01:39:08Z |
| _version_ |
1837222121820913664 |
| fulltext |
ACTUAL PROBLEMS OF TRANSPORT MEDICINE �#3 (25), 2011
АКТУАЛЬНЫЕ ПРОБЛЕМЫ ТРАНСПОРТНОЙ МЕДИЦИНЫ � № 3 (25), 2011 г.
49
В настоящее время пиратство стало серьёзной проблемой в безопасности
морского судоходства. Угроза нападения, схватки с пиратами и особенно пребыва�
ние в плену вызывают психоэмоциональный стресс, приводят к нарушению психосо�
матического здоровья и являются угрозой для жизни моряков. Не случайно эта про�
блема вынесена в отдельный раздел программы Симпозиума.
Материалов по медико�психологической профилактике и реабилитации явно
недостаточно. Поэтому мы публикуем в порядке обсуждения материалы, любезно
предоставленные сотрудниками The Seamen’s Church Institute, выражаем нашим кол�
легам и особенно Оливеру Брюеру (Oliver Brewer) глубокую признательность и ждём
комментариев, замечаний и предложений по этой проблеме.
Редакция журнала «Актуальные проблемы транспортной медицины»
Today piracy has become a serious problem in maritime security. The threat of an
attack, fight with the pirates and especially captivity cause psycho�emotional stress, lead
to a breach of psychosomatic health and a threat to the lives of seafarers. No coincidence
that this problem is placed in a separate section at the program of the Symposium.
Materials for medical and psychological rehabilitation and prevention is not enough.
Therefore, we are publishing in order of discussion material, courtesy of members of The
Seamen’s Church Institute, we express to our colleagues and especially Oliver Brewer deep
gratitude and look forward to comments, observations and suggestions on this issue.
The editors of the journal “Actual Problems of Transport Medicine”
Preamble
The following guidelines provide a
general structure to care for seafarers
following a piracy incident. These
guidelines emerge from a study currently
underway at the Seamen’s Church Institute
(SCI) designed to develop
recommendations for clinical assessment
and intervention. SCI welcomes comments
from interested parties as it develops
specific guidelines to address the mental
health impact of piracy on seafarers. This
document addresses a continuum—from
transiting high�risk areas without incident
to prolonged captivity of seafarers.
1. Anticipating the possibility of
piracy
Piracy threatens 21st�century
seafarers. While most piracy incidents are
thought to take place around the Horn of
Africa, piracy remains problematic on the
west coast of Africa, the Indian Ocean, and
throughout the South East Asian
archipelago. Although the adherence to
УДК 347.799.1
POST�PIRACY CARE FOR SEAFARERS
GUIDELINES
Oliver Brewer
Center for Seafarers’ Rights the Seamen’s Church Institute
Today piracy has become a serious problem in maritime security. The threat of an
attack, fight with the pirates and especially captivity cause psycho�emotional stress, lead
to a breach of psychosomatic health and a threat to the lives of seafarers.
Key words: mental health of seafarers, piracy, psycho�emotional stress
АКТУАЛЬНЫЕ ПРОБЛЕМЫ ТРАНСПОРТНОЙ МЕДИЦИНЫ � № 3 (22), 2011 г.
50
ACTUAL PROBLEMS OF TRANSPORT MEDICINE �#3 (25), 2011
Best Management Practices (BMP),
presence of Group Transits via EUNAVFOR
and national naval escorts through the Gulf
of Aden have reduced risk of attacks,
pirates remain unpredictably capable of
attacking and hijacking vessels throughout
the whole high�risk area as defined in BMP.
Because of this, all maritime industry
stakeholders should take preparatory steps
to protect the well�being of their crews at
sea, from stress management techniques
to coping with prolonged captivity.
1.1. Maintenance of accurate
medical information
Shipowners should maintain accurate
health records for their crews. Complete
medical records include results of the most
recent physical examination and details
about any medical condition that could
worsen at sea. This includes any
medication�dependent condition or
physical ailment that could deteriorate in a
high�stress setting like captivity. A detailed
history should provide information about
prior surgeries, immunizations, allergies,
family medical history, and complete
personal history, including information
about prior illnesses and major life events
(e.g., marriages, divorces, death of loved
ones). This information facilitates
immediate and follow�up medical planning
for release of a captive seafarer.
1.2. Anticipatory training
Seafarers should develop appropriate
instincts and survival skills necessary to
contend with captivity. Seafarers gain
mental confidence through drills aboard
vessels that practice deterrence
techniques. Seafarers should be trained in
basic captive survival skills that anticipate
their interaction with hostile pirates.
Cultural sensitivity training to avoid
offending and angering the pirates should
be included. Anticipating crew isolation or
group adhesion issues can strengthen
morale during prolonged captivity. Most
importantly, seafarers should understand
known intimidation tactics used by pirates,
including 1) providing frightening
misinformation about family members; 2)
suggesting that ship owners will neglect
them; 3) physical abuse; 4) death threats
or mock executions; 5) psychological
tactics aimed at isolating or dividing crew
or breaking crew morale, increasing crew
desperation, and thus pressuring ransom
negotiations.
2. At the first news of a piracy
incident
News of a piracy incident can induce
panic among all involved. Clear and reliable
lines of communication between the vessel
and its stakeholders and between
stakeholders and the families of the crew
pay huge dividends in managing palpable
anxiety and distracting rumors. Therefore,
regular briefings become critical from the
first sign of a problem. While respecting
confidential negotiations, clarifying even
partially known information regarding crew
location and conditions builds trust among
ship management, media, and family
members.
2.1. Working with crewmembers’
families
Families should be notified
immediately of an incident to avoid their
finding out first from potentially intrusive
news outlets. After the first contact,
families should be updated by telephone,
if possible, or by email at intervals no
greater than 24 hours—even if nothing has
progressed. Shipowners should also
prepare relatives for the possibility that
pirates, as part of their intimidation tactics,
will contact them. Families should be
instructed to refrain from making
statements to the press about the situation,
since publicity may impede effective
negotiation and prolong captivity of loved
ones. Further, the seafarers’ dependents
should be reassured that they will continue
receiving compensation from the
shipowners according to contract
provisions.
3. When a crew is being held
When pirates hold a vessel captive,
often little can be done directly to address
the needs of the crew. While negotiations
ACTUAL PROBLEMS OF TRANSPORT MEDICINE �#3 (25), 2011
АКТУАЛЬНЫЕ ПРОБЛЕМЫ ТРАНСПОРТНОЙ МЕДИЦИНЫ � № 3 (25), 2011 г.
51
are underway, however, several procedures
can begin.
3.1. Preparing for the crew’s release
Individual crewmember potential
needs should be identified before release.
This information should be solicited from
the crewmember’s medical records and
family members. Importantly, this includes
anticipating pre�existing conditions that
might worsen under captivity. Examples
include:
• Conditions that require medication that
may run out during captivity
• Conditions that worsen under stress,
including but not limited to: cardiac
problems, including histories of
arrhythmias, heart attacks [myocardial
infarctions]; stroke; asthma,
emphysema, or chronic bronchitis;
anxiety disorders; post�traumatic
stress disorder.
Anticipating possible medical issues
among crewmembers based on their
medical history facilitates preparation for
their release.
3.2. Providing timely information to
the crew’s families
As stated in 2.1, families should be
updated on a daily basis. Families should
be provided a named point�of�contact who
remains available to them by email and
telephone. Much like the owners of
hijacked vessels and others with vested
interests, families of crewmembers may
feel powerless and afraid. Unlike those
involved in negotiating, however, families
have no access to current information.
Allying with families enhances their ability
to assist with recovery that might be
needed by providing supportive home
environments, helping to identify delayed
symptoms from captivity, and helping to
link crewmembers with appropriate
caregivers (medical centers, behavioral
health clinics).
Families should be asked to maintain
confidentiality of all information shared and
not to disclose details to the media.
Families should be encouraged to
report attempts by pirates to communicate
with them, and families should be
encouraged not to respond to these
overtures.
3.3. Anticipating the seafarer’s
potential needs
While most seafarers are protected by
their natural resilience from debilitating
post�captivity side effects, ship operators
should anticipate that crewmembers may
need follow�up care. In the midst of a
hostage situation, ship operators and
insurance companies can identify qualified
professionals in the seafarer’s home
community who can provide care as
needed. Contact information for available
and properly trained and licensed medical
doctors and mental health professionals
(psychologists, psychiatrists, social
workers, licensed counselors) should be
maintained. These professionals should be
placed on standby for possible treatment.
These services, when required, should be
covered as part of the standard medical
follow�up offered to the seafarer.
4. When release is imminent
4.1. Preparations
Plans should be made to inform
families immediately after seafarers are
released. Families should be encouraged
to respect the confidentiality of
negotiations and be prepared for the
possibility of modifications to any timetable
provided. Preparations should be made for
crewmembers to be provided with
telephones as close to release as possible
to talk with loved ones.
4.2. Debriefing protocol
Debriefing should include appropriate
company, military, and medical interviews.
Immediate medical triage evaluates
apparent illness/injury and future risk for
conditions that could impede a
crewmember’s ability to return to work or
pose a risk to life. An evaluation that
conforms to established standards should
be made. (The M.I.N.I., for example,
provides suitable measure of emotional
functioning that could be used for this
АКТУАЛЬНЫЕ ПРОБЛЕМЫ ТРАНСПОРТНОЙ МЕДИЦИНЫ � № 3 (22), 2011 г.
52
ACTUAL PROBLEMS OF TRANSPORT MEDICINE �#3 (25), 2011
purpose.) Evaluations should be performed
by licensed medical doctors or allied health
professionals (e.g., nurses) qualified to
conduct assessments.
5. When the crew has been released
5.1. Medical assessment
Evaluation should be made as soon
as possible. Ideally, this should precede
any debriefing. Information that
government/military personnel receive
from a detainee will be less accurate if
disclosed in the context of significant
medical or psychological distress. Qualified
medical or allied health professionals (e.g.,
nurses, social workers) should conduct
assessments. A written summary of the
assessment, describing the seafarer’s
physical and emotional state, should be
translated into the seafarer’s native
language by a competent medical
translator and given to the crewmember to
take home to his local medical providers.
Also, the seafarer should receive an up�to�
date list of professionals and facilities near
the seafarer’s home capable of providing
follow�up assessment and care as needed.
The seafarer’s personal medical
information should be treated as protected
and private. No other stakeholders,
including the agency funding the
assessment, should be allowed access to
this information. This policy should be
extended to all of the seafarer’s
confidential health information. Medical
data required to determine fitness for
employment should be gathered in a
separate medical evaluation, also at
company expense.
5.2. Repatriation
Following release, crew should be
sent back to home countries as soon as
possible after being cleared for travel.
When crewmembers cannot leave the point
of disembarkation for more than three
days, efforts should be made to facilitate
family travel to that point to expedite
reunification. Families should be briefed
about the status of their family
crewmember in a culturally appropriate
manner. Families and crewmembers should
be equipped with a list of symptoms [see
Appendix A] to watch for in the seafarer.
They should also be provided with the
contact information for professionals
available to provide treatment for any
symptoms that might occur.
6. When the crew is to return to duty
6.1. Symptom presentation timeline
Symptoms do not always occur
immediately after a traumatic event. Post�
traumatic and other emotional symptoms
can present themselves when an individual
returns to a setting similar to the original
incident. Seafarers should be trained to
recognize warning signs of symptoms and
be furnished with the contact information
of professionals who could be contacted
privately if needed while at sea or expected
ports of call.
6.2. Follow�up assessments
Physical and psychological
assessments should be conducted three
months after release from captivity. If the
seafarer has returned to sea during this
time, the assessment should be conducted
as soon as practicable at a port of call or
immediately following the end of the
contract. Both crewmembers and insurers
benefit from engaging trained, licensed
mental health professionals to conduct
assessments. In regions where these
clinicians are not available, evaluations can
be conducted via phone or Internet
(Several assessments have online forms
that have been translated into many
languages.)
Concluding remarks
As our research continues, the Center
for Seafarers’ Rights at SCI will update
guidelines where appropriate. If you have
questions or desire consultation, refer to
the contact information below.
APPENDIX A
The following, non�exhaustive list of
symptoms could suggest the presence of
psychological distress. After release from
captivity and prior to returning home,
ACTUAL PROBLEMS OF TRANSPORT MEDICINE �#3 (25), 2011
АКТУАЛЬНЫЕ ПРОБЛЕМЫ ТРАНСПОРТНОЙ МЕДИЦИНЫ � № 3 (25), 2011 г.
53
seafarers and their families, should be
furnished with this list and instructions to
connect with local healthcare professionals
should any of the following present and
persist [from Derogatis, 1993]:
1. NERVOUSNESS OR SHAKINESS INSIDE
2. FAINTNESS OR DIZZINESS
3. THE IDEA THAT SOMEONE ELSE CAN
CONTROL YOUR THOUGHTS
4. FEELING OTHERS ARE TO BLAME FOR
MOST OF YOUR TROUBLES
5. TROUBLE REMEMBERING THINGS
6. FEELING EASILY ANNOYED OR
IRRITATED
7. PAINS IN HEART OR CHEST
8. FEELING AFRAID IN OPEN SPACES
9. THOUGHTS OF ENDING YOUR LIFE
10. FEELING THAT MOST PEOPLE
CANNOT BE TRUSTED
11. POOR APPETITE
12. SUDDENLY SCARED FOR NO REASON
13. TEMPER OUTBURSTS THAT YOU
COULD NOT CONTROL
14. FEELING LONELY EVEN WHEN YOU ARE
WITH PEOPLE
15. FEELING BLOCKED IN GETTING
THINGS DONE
16. FEELING LONELY
17. FEELING BLUE
18. FEELING NO INTEREST IN THINGS
19. FEELING FEARFUL
20. YOUR FEELINGS BEING EASILY HURT
21. FEELING THAT PEOPLE ARE
UNFRIENDLY OR DISLIKE YOU
22. FEELING INFERIOR TO OTHERS
23. NAUSEA OR UPSET STOMACH
24. FEELING THAT YOU ARE WATCHED OR
TALKED ABOUT BY OTHERS
25. TROUBLE FALLING ASLEEP
26. HAVING TO CHECK AND DOUBLE
CHECK WHAT YOU DO
27. DIFFICULTY IN MAKING DECISIONS
28. FEELING AFRAID TO TRAVEL ON
BUSES, SUBWAYS, OR TRAINS
29. TROUBLE GETTING YOUR BREATH
30. HOT OR COLD SPELLS
31. HAVING TO AVOID CERTAIN THINGS,
PLACES, OR ACTIVITIES BECAUSE
THEY FRIGHTEN YOU
32. YOUR MIND GOING BLANK
33. NUMBNESS OR TINGLING IN PARTS
OF YOUR BODY
34. THE IDEA THAT YOU SHOULD BE
PUNISHED FOR YOUR SINS
35. FEELING HOPELESS ABOUT THE
FUTURE
36. TROUBLE CONCENTRATING
37. FEELING WEAK IN PARTS OF YOUR
BODY
38. FEELING TENSE OR KEYED UP
39. THOUGHTS OF DEATH OR DYING
40. HAVING URGES TO BEAT, INJURE, OR
HARM SOMEONE
41. HAVING URGES TO BREAK OR SMASH
THINGS
42. FEELING VERY SELF�CONSCIOUS
WITH OTHERS
43. FEELING UNEASY IN CROWDS
44. NEVER FEELING CLOSE TO ANOTHER
PERSON
45. SPELLS OF TERROR OR PANIC
46. GETTING INTO FREQUENT
ARGUMENTS
47. FEELING NERVOUS WHEN YOU ARE
LEFT ALONE
48. FEELING OTHERS NOT GIVING YOU
PROPER CREDIT FOR YOUR
ACHIEVEMENTS
49. FEELING SO RESTLESS YOU COULD
NOT SIT STILL
50. FEELINGS OF WORTHLESSNESS
51. FEELING THAT PEOPLE WILL TAKE
ADVANTAGE OF YOU IF YOU LET THEM
52. FEELINGS OF GUILT
53. THE IDEA THAT SOMETHING IS
WRONG WITH YOUR MIND
АКТУАЛЬНЫЕ ПРОБЛЕМЫ ТРАНСПОРТНОЙ МЕДИЦИНЫ � № 3 (22), 2011 г.
54
ACTUAL PROBLEMS OF TRANSPORT MEDICINE �#3 (25), 2011
Резюме
РЕКОМЕНДАЦИИ ПО МЕДИКО�
ПСИХОЛОГИЧЕСКОЙ ПРОФИЛАКТИКЕ
И РЕАБИЛИТАЦИИ МОРЯКОВ В СВЯЗИ
С ПРОБЛЕМОЙ ПИРАТСТВА
Оливер Брюер
В настоящее время пиратство ста�
ло серьёзной проблемой в безопаснос�
ти морского судоходства. Угроза напа�
дения, схватки с пиратами и особенно
пребывание в плену вызывают психо�
эмоциональный стресс, приводят к на�
рушению психосоматического здоровья
и являются угрозой для жизни моряков.
Решению этих важных проблем посвя�
щена настоящая статья.
Ключевые слова: психическое здоровье
моряков, пираты, психоэмоциональный
стресс
Резюме
РЕКОМЕНДАЦІЇ ЩОДО МЕДИКО�
ПСИХОЛОГІЧНОЇ ПРОФІЛАКТИКИ ТА
РЕАБІЛІТАЦІЇ МОРЯКІВ У ЗВ’ЯЗКУ З
ПРОБЛЕМОЮ ПІРАТСТВА
Олівер Брюер
В даний час піратство стало серй�
озною проблемою в безпеці морського�
судноплавства. Загроза нападу, сутички
з піратами і особливо перебування в по�
лоні викликають психоемоційний стрес,
призводять до порушення психосома�
тичного здоров’я і є загрозою для життя�
моряків. Вирішенню цих важливих про�
блем присвячена ця стаття.
Ключові слова: психичне здоров’я
моряків, пірати, психоемоційний стрес
Впервые поступила в редакцию 22.08.2011 г.
Рекомендована к печати на заседании
редакционной коллегии после рецензирования
In the pathogenesis of viral diseas�
es the interaction of virus with the cell
has not been sufficiently studied. The
main point here is the virus intervention
into a healthy cell with a mandatory
deproteinization of the virus. However,
deproteinization of viruses is still poorly
understood. This firstly refers to the
УДК 616.921.5
PROTEOLYTIC THEORY OF PATHOGENESIS OF INFLUENZA AND
IMPROVEMENT OF ITS TREATMENT
Valentina A. Divocha, Anatoly I. Gozhenko, Vasily N. Mikhalchuk
Experimental and Clinical Pathology Laboratory, Ukraine Scientific�Research
Institute of Transport Medicine, e�mail: divocha09@ukr.net
A new theory of grippe pathogenesis with the use of proteinase�inhibitory system has
been offered. It has been established that purification and concentration of grippe viruses
by different methods did not release the virus from the cellular enzymes. When the
experimental animals have been infected with grippe virus, we have observed misbalance
in enzyme�inhibitory balance took place, especially during first hours after infection. Six
isoforms of trypsin�like proteinases were obtained from the lungs of healthy mice.
Antiproteinase immune sera have been isolated from these 6 isoforms which served to treat
the experimental animals. It was antiserum to the third isoform that has prevented the
experimental animals mortality. From the industrial wastes of gamma�globin manufacture
the inhibitors of protein�like proteinases have been extracted which prevented the white
mice’s mortality in 80% of cases. Endogenous inhibitors of human blood proteinases are
prospective in producing anti�influenza drugs for humans.
Key words: influenza, trypsin proteinase inhibitors, proteases, antiviral drugs.
|