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MARITIME HEALTH PROGRAMME

The Marine Social Institute (MSI), as a National Public Management Entity, is responsible for the Social Security of sea workers and is in charge of protecting their social, health and labour interests. In 1983, it set up the Maritime Health Service with the aim of developing and putting into practice a programme of integral preventive medical care. This affords on board, or when in a foreign port, medical attention to seafarers. It offers specific medical care resources that replace the health measures available for the rest of the population. This programme is called the MARITIME HEALTH PROGRAMME (MHP).

The MHP carries out its activities on two levels:

1. PREVENTIVE:
   


• Obligatory medical check ups Anterior to setting sail.
• Specific courses on Health Training for seafarers.
• Vaccination campaigns.
• Epidemiological studies and prevention campaigns for pathologies at risk for seafarers.
• On board health-hygiene conditions controls and check ups of medical kits.
All these activities mainly take place in the National Maritime Health Centres.


2. MEDICAL CARE:

This attempts to provide medical attention that effectively substitutes that provided by any other health centre, with the distinction in the way and place it is carried out and using the methods available. These are those that exist on board or in a foreign port and are much more limited than those that exist in mainland health centres.

The following centres provide this:

• Spanish radio-medical centre
• Foreign medical care centres
• "Esperanza del Mar" Hospital Ship
• Northern Tuna Coast Health ship (SANIMAR)

To aid in health control and medical assistance for seafarers when requested, there is the HEALTH DATABASE, in which the medical records of everyone who has attended a centre are kept. The medical records that appear in the database can be consulted from any Maritime Health Centre that has a computer connected to the Central Computer, which quickly lets you know the medical history of the patient.

The NATIONAL MARITIME HEALTH CENTRES mainly have a preventive character and are distributed throughout the Spanish coast.

There were 35 centres open in 2000, where the following activities were carried out:

1. Medical check ups before setting sail.
   Periodical, obligatory and completely free.
2. Courses in Health Training.
   All courses are both theoretical and practical, using audiovisual materials, examples, and anatomical mannequins to practice, and student manuals designed especially for the course. There are different levels with different contents and complexity.
3. Prevention campaigns and health dissemination campaigns:
   AIDS, Malaria etc.
4. Vaccination campaigns.
   Mainly tetanus, flu, hepatitis B and information about vaccines for international trips.
5. Control of on board Health-Hygiene and check-up of medical kits.
   According to the conditions stated in R.D. 258/1999 (see Chapter 5, MEDICAL KIT ON BOARD).
   
6. Collection of data and surveys.
   For the elaboration of epidemiological studies that serve as a basis for subsequent prevention and health dissemination campaigns.

The SPANISH RADIO-MEDICAL CENTRE is a free service located in Madrid and functions 24 hours a day all year round (see Chapter 4, LONG DISTANCE MEDICAL ASSISSTANCE).

The "ESPERANZA DEL MAR" HOSPITAL SHIP has given health and logistical support to fleets sailing in the Canary-Sahara area since 1982.

The health support offered is:

• Radio-medical Consultation.
• Out-patient consultation.
• Displacement of health personnel to ships.
• On board hospitalisation.
• Minor surgical intervention.
• Evacuation of patients to port.

In addition, it offers logistical and social support.

The NORTHERN TUNA COAST HEALTH SHIP (SANIMAR), has offered medical assistance in the Northern Tuna Coast during the summer months since 1990. It offers the same health and logistical support as the "Esperanza del Mar" hospital ship.

The FOREIGN HEALTH-CARE CENTRES are located in those foreign ports where the Spanish fleet is important for fishing boats.

Currently there are 6 centres:

• Dakar (Senegal)
• Luanda (Angola)
• Mombasa (Kenya) - Mahe (Seychelles)
• Nouadhibou (Mauritania)
• Walvis Bay (Namibia)
• Abidjan (Ivory Coast)

They offer medical assistance to Spanish crewmembers, with the limitations imposed by the country where they are based.