Introduction
Seafarers, facilitating 60–70% of global trade value and 80–90% in volume, hold crucial roles. Amid COVID-19, trade dipped, but reliance on essential goods persisted. These goods, vital for low and middle-income economies, were delivered by numerous cross-border workers, including hundreds of thousands of international seafarers. Recognizing their pivotal contribution is essential for global economic stability.International seafarers, often engaged in shift work at sea for contracts up to 11 months, frequently traverse borders. Excluding the cruise industry, a standard vessel accommodates 20–30 seafarers. In 2020, globally, an estimated 1,892,720 seafarers served on internationally trading merchant ships. This figure included 857,540 ranking officers and 1,035,180 ratings managed by them. Leading in the supply of seafarers on merchant ships were the Philippines, Russia, Indonesia, China, and India. Recognizing their significant numbers and diverse roles is crucial for understanding the maritime workforce landscape.
COVID-19 travel restrictions swiftly altered seafarers' lives, notably through the crew change crisis. By October 2020, the International Transport Workers’ Federation reported a staggering 400,000 seafarers stranded on prolonged contracts at sea, with thousands unemployed at home, awaiting relief. Simultaneously, seafarers' essential right to access shores in port, crucial for "health and well-being," was essentially suspended. Acknowledging these challenges is vital for addressing the unique hardships faced by the maritime workforce during the pandemic.
Seafarers, residing uniquely at sea and playing a vital role in the supply chain, possessed established rights that warranted consideration amid COVID-19 restrictions. However, both port state authorities and onboard approaches often overlooked their distinctive circumstances. Vaccination, a proven solution for the general population, should logically have been extended to seafarers. Regrettably, various obstacles impeded seafarers' access to vaccines, as detailed in this Viewpoint. Recognizing these challenges is essential for ensuring equitable healthcare for this integral global workforce.
Life at sea's challenges complicated vaccination approaches compared to land. Unpredictable ship schedules, influenced by weather and maritime factors, hindered advance vaccination appointments. Limited internet access and toll-free numbers at sea exacerbated the issue. Recognition of vaccinations, including COVID-19 passports, posed a problem, lacking international acknowledgment for seafarers. Port states issued diverse information on sanitary and vaccination certifications, complicating the recognition of various vaccines. Understanding these unique hurdles is crucial for tailoring effective vaccination strategies for seafarers.
Notably, a lack of centralized coordination among port states and international agencies hindered effective resolution of these challenges. Instead, seafarer vaccination and documentation were handled provisionally by diverse stakeholders. Access to healthcare is not only vital for fairness and equality but also pivotal for seafarers' work capability. Unfortunately, most seafarers were not prioritized for vaccination, and the process of securing and certifying vaccinations proved challenging, even when vaccines were readily available. Recognizing the importance of seafarers' health is crucial for establishing more equitable and efficient healthcare systems for this essential workforce.
Impact on health
Amidst social isolation, hazardous work conditions, fatigue, and restricted healthcare access, seafarers already faced health challenges. The diverse obstacles introduced by the COVID-19 pandemic likely exacerbated the already high stress levels in maritime workplaces, intensifying existing issues and introducing new ones. Recognizing and addressing these cumulative challenges is crucial for safeguarding the well-being of seafarers, whose work conditions inherently pose health risks.
Reports from the industry and recent studies indicate that seafarers, amidst the crew change crisis, experienced heightened levels of anxiety, panic attacks, depression, loneliness, frustration, fatigue, burnout, and suicidal thoughts compared to pre-crisis conditions. The pandemic correlated with increased symptoms of depression and anxiety among seafarers. Notably, the extension of contracts and holding higher ranks were particularly significant factors contributing to the development of mental health disorders. Seafarers also faced discouragement in their daily work, perceiving apathy from external sources. Recognizing and addressing these mental health challenges is essential for prioritizing the well-being of seafarers in the maritime industry.
In a 2021 online survey of 817 seafarers, over 75% of respondents listed being vaccinated or prioritized for vaccination as significantly beneficial for their mental health. This ranked second only to the importance of "contact with family" and "timely crew change." However, despite the recognized positive impact, only 31% reported having been vaccinated against SARS-CoV-2. This underscores the gap between the perceived benefits of vaccination for mental health and the actual vaccination rates among seafarers. Addressing this disconnection is crucial for promoting both the mental well-being and overall health of the maritime workforce.
Seafarers encountered distorted job security and health incentives while seeking vaccines in various countries. In 2021, ship managers highlighted instances where seafarers who had already received the Sputnik or Sinovac vaccines sought additional vaccinations, including both initial doses and boosters, from other locations. This highlights a complex scenario where the choice of vaccines and potential gaps in recognition created challenges for seafarers, impacting both their employment status and health considerations. Addressing these issues is essential for fostering a more streamlined and equitable vaccination process for the maritime workforce.
Resources for COVID-19 vaccines
During the COVID-19 pandemic, seafarers faced numerous challenges in accessing vaccinations, prompting creative and grassroots solutions. Ship managers, labor groups, and welfare organizations engaged in advocacy, urging governments to reserve vaccine supplies for seafarers. However, the absence of centralized coordination resulted in incomplete and anecdotal records of seafarer vaccinations globally.
To bridge the accessibility gap, partnerships between seafarers' unions, port-based welfare services, and non-profit chaplaincies emerged. These collaborations utilized local health services, organized transportation to vaccination clinics, and even converted seafarers' centers into vaccination hubs. The International Christian Maritime Association (ICMA) and its North American region (NAMMA) maintained an online list of vaccination programs for seafarers, highlighting the lack of a central authority for tracking.
Recognizing the need for international coordination, maritime stakeholders, including 850 organizations, signed the Neptune Declaration on Seafarer Wellbeing and Crew Change in January 2021. The declaration emphasized seafarers as key workers, advocating for their priority access to vaccines and the implementation of health protocols. The Seafarer Vaccination Taskforce, organized by the International Chamber of Shipping (ICS) and International Maritime Health Association (IMHA), produced a Roadmap for Vaccination of International Seafarers, garnering industry-wide support.
Successful lobbying efforts resulted in the IMO designating seafarers as key workers in October 2021. In February 2022, global organizations, including WHO, IMO, International Labour Organization, and UN Conference on Trade and Development, called for continued collaboration on seafarer vaccination. Seafarer welfare boards played a crucial role in coordinating vaccination efforts in countries with these boards, such as the UK, Australia, Canada, and several European nations.
By June 2022, NAMMA reported over 250,000 seafarer vaccinations, facilitated by partnerships in North America, Europe, Panama, Australia, Singapore, and India. The situation improved as seafarers at home gained reliable access to national vaccination programs. A Global Maritime Forum survey in July 2023 indicated a significant increase in onboard seafarer vaccinations, reaching 97%. However, challenges persisted, with disparities in vaccination recognition and concerns about consistency.
Throughout the crew change crisis, the concept of seafarers as key workers was inconsistently adopted by maritime governments, highlighting the need for sustained international collaboration to ensure the health and well-being of this essential workforce.
Conclusion
Both before and after the onset of COVID-19, international stakeholders consistently emphasized the need for coordinated prioritization of seafarers' health and crew change. Seafarers' entitlements to medical care, shore leave, and repatriation are safeguarded by maritime law. As early as September 2020, the IMO's Maritime Safety Council advocated recognizing seafarers as key workers and prioritizing their access to health care and travel. Similarly, the WHO SAGE, in the same month, identified transportation workers as essential and a priority group. In February 2022, a coalition of UN agencies echoed these sentiments, calling for the designation of seafarers as key workers to facilitate crew change, prioritize vaccination, and exempt them from strict entry conditions based solely on COVID-19 vaccination status.
Despite these calls, public health responses during the height of the pandemic lacked the coordinated prioritization necessary for seafarers. Testing and vaccination for seafarers were delayed, impacting both the efficiency of the supply chain and the health of seafarers. Future pandemics demand a coherent framework that acknowledges the role of seafarers and upholds international agreements protecting them. Standardized and more accommodating approaches are essential for seafarers' access to vaccinations, recognized documentation, and travel.
Achieving these goals could involve closer cooperation between governments and maritime stakeholders, potentially through the establishment of seafarer welfare boards where they do not currently exist, as recommended by the Maritime Labour Convention, 2006. Improved communication between public health agencies and those overseeing transportation, trade, and maritime affairs is also crucial. Centralized international agencies should play a larger role in safeguarding seafarers' access to healthcare and safe travel, potentially implementing an international vaccination certification system dedicated to international workers.
While individual maritime stakeholders have made significant contributions during the pandemic and crew change crisis, addressing seafarer health requires international collaboration. For effective disease prevention among seafarers, a larger-scale and more reliable provision of healthcare is imperative, complementing recommendations and local initiatives. Ongoing efforts by organizations such as the ICS and its partners, along with the commitment of seafarer welfare boards and port-level partnerships, demonstrate a collective commitment to addressing seafarer health on an international scale.
