During the 2024 SAFETY4SEA Manila Forum, Dr. Christian Angelo P. Lubaton, Medical Director, Nordic Medical Clinic, presented ways that a holistic approach to crew welfare can be fostered.
We need to design a healthy lifestyle for our seafarers that aligns with the World Health Organization’s holistic definition of health, which views health as multifaceted, encompassing physical, mental, and social well-being—not merely the absence of disease or infirmity.
In my holistic practice, I view each person as a whole. Each individual has a body, experiences emotions, misses family, feels fatigue, and holds personal beliefs—whether or not those beliefs align with ours. Everything is interconnected, and everyone is connected.
Designing a healthy lifestyle is a deliberate and intentional process; it doesn’t happen naturally. It requires effort, investment, and, in some cases, political will. While internal motivation is essential, it’s ultimately the lifestyle design that determines long-term success or failure.
Consider, for example, the concept of choice architecture. I once went to a convenience store intending to buy only water, but as I reached the checkout counter, a display of colorful M&M’s caught my eye. Even though I hadn’t planned to buy them, their enticing packaging and nostalgic appeal led me to make an impulsive purchase. This illustrates how a store’s layout and design can influence our decisions. So, what kind of choice architecture exists onboard for our seafarers? What options are presented to them? The environments we inhabit significantly shape the decisions we make
Scientific studies show that urban areas with numerous fast-food outlets tend to have higher BMIs among their populations. High BMI is linked to increased cases of hypertension, diabetes, and chronic illnesses. This pattern is consistent across various countries and regions, highlighting the significant impact of environmental design on health.
Reflecting on my experiences aboard different vessels, it often feels like the food offerings mirror fast food—quick and convenient. While rice is a staple for energy, many meals are fried, limiting healthy options. This brings up important questions about the design of meal planning on ships. How are chief cooks and stewards trained? Can they prepare nutritious meals despite diverse crew nationalities? Are the provisions and budget per person per day sufficient to support healthy eating?
For instance, hypertension among Danish seafarers is a multifaceted issue, but one notable factor is noise. Many seafarers report getting only 4 to 6 hours of sleep due to constant noise, which negatively impacts their blood pressure. Proper sleep is crucial for maintaining healthy blood pressure levels, emphasizing the need for a well-designed living and working environment onboard to promote overall health and well-being. A person who’s going on board after months of rest is very highly motivated but over time 6 months 7 months it can the motivation can go down.
Overall, a healthy lifestyle for seafarers should be intrinsically motivated, yet it can be greatly influenced by lifestyle design both onshore and onboard.
Best practices on shore and onboard
- Fast & efficient pre-employment medical service: An online, automated system allows seafarers to book and schedule their pre-employment medical examination (PEME) with ease. All tests are completed within 2-4 hours, with results available the same day and sent directly to the seafarer.
- Health education with maritime doctors, explanation of results: Within 24 hours of completing their PEME, seafarers receive a call from an NMC doctor to discuss their results. This approach empowers seafarers to take an active role in managing their health.
- Access to follow-ups and continuous care: Repeat tests, specialized dental x-rays, and additional chest x-ray views are available at NMC at no additional cost for clients. Follow-ups with doctors are also accessible at no expense, ensuring ongoing support for seafarer.
Involvement of Family
One of our best practices with a major customer involves engaging the family in crew seminars, discussing family values, financial literacy, health, and wellness. This investment in family involvement is crucial, especially for Filipinos, where health decisions are typically made by the spouse, not the father. Influencing the maternal side to manage health decisions and not update the seafarer husband hourly about home events 1,000 miles away is very helpful. Empowering the family means taking care of the seafarer.
Additional Best Practices
- Continuous training for cooks while ashore: to enhance their knowledge and skills in preparing healthy, delicious meals for diverse nationalities onboard, moving away from a ‘fast-food’ approach.
- Crew travel is optimized: appropriate planning, shorter layovers, trying to prevent fatigue before seafarers even assume their role onboard, while keeping costs in check.
Access while on the ship
- Vessel visits: Going to where the seafarers are, seeing their environment and actual practices while they are onboard vessels. Creating opportunities for Health Education in the relevant environment.
- Access to professionals: 24/7 Access for any Medical or Mental Health concern. Includes Psycho-Spiritual support: Mental Health Support, Counselling with Psychologist, access to Priests, etc.
Ship design and psychological safety good provisions
The design of the ship plays a crucial role in promoting psychological safety and overall well-being among the crew. This includes ensuring that there are budget allocations for good provisions that offer a variety of healthy food options onboard, favoring nutritious meals over fast food.
Additionally, psychological safety is prioritized in toolbox meetings, where discussions about mental health and well-being are included in the agenda. Furthermore, the ship’s design facilitates crew health by providing access to exercise and recreational activities, as well as creating environments conducive to restful sleep. Together, these elements contribute to a supportive and healthy atmosphere for all crew members
The views presented are only those of the author and do not necessarily reflect those of SAFETY4SEA and are for information sharing and discussion purposes only.
Above article is a transcript from Dr. Christian Angelo P. Lubaton’s presentation during the 2024 SAFETY4SEA Manila Forum with minor edits for clarification purposes.
Explore more by watching the video presentation here below
