Following a recent roundtable with Rowland Raikes, Medical Rescue International, Markus McMillin, Claims Executive at UK P&I Club, discusses the varying circumstances surrounding medical repatriation of seafarers, and the related challenges and associated costs.
Medical repatriation is the transportation, home or to another medical facility, of a seafarer following an accident or illness when medical personnel and/or equipment are required for the journey. The two main themes that need to be thought about when discussing medical repatriation are the welfare of the patient and control of the costs.
The medical condition of the seafarer will determine whether repatriation is possible and this decision is based on advice from a number of parties. These include the treating doctors, but also doctors that specialise in the particular area of concern for the seafarer. It must also be taken into consideration whether the prognosis is for short or long term treatment and where appropriate medical facilities are available.
Depending on the seafarer’s medical needs, there are a number of medical repatriation methods, including road and a variety of types of air travel from commercial flights to air ambulance. Air ambulances are commonly used in the most serious cases, yet costs can differ greatly. For instance, an air ambulance from Dar Es Salaam to Johannesburg costs approximately $20,000, but one from New Jersey to Manila can be almost $200,000.
There are a number of parties involved in the medical repatriation of a seafarer and managing the advice, recommendations, and concerns of all these parties can be a challenging task that can be affected by international political relations in some cases. Additionally, there is an economic motivation to medically repatriate seafarers, provided it is done safely with no harm to the seafarer. Medical costs of overnight intensive care units can swing widely. It could be as low as US$2,000 a night in Vietnam to US$21,500 a night in New York. Medical repatriation costs can also vary significantly depending upon the needs of the seafarer.
The challenges to a successful medical repatriation can be numerous, with some of the more common hurdles being:
- Family involvement can complicate the seafarer’s treatment and repatriation process
- The seafarer’s condition if not as described, can be in a worse state than initially disclosed
- The seafarer cannot obtain medical clearance to travel
- Obtaining commercial airline tickets for seats which will accommodate both seafarer and escort
- The commercial airline refuses the patient either prior to arrival or upon arrival at the airport due to their medical condition
- The seafarer’s condition deteriorates during repatriation
There are a vast number of considerations involved in performing medical repatriations. Some cases can remain simple and inexpensive while others can become complicated and costly depending on the illness and injury involved. In these cases, engaging the services of companies that specialise in medical repatriations can assist with streamlining the process, ensuring the welfare of seafarers and help reduce costs.