Caring for Seafarers Affected by Piracy The Rev. David M. Rider
President and ExecuAve Director The Seamen’s Church InsAtute of NY & NJ Hamburg, Germany 21 August, 2011
What happens to seafarers after a pirate attack? • Have they conAnued their seagoing careers? • Are they ﬁt to work on ships • Do they need conAnuing medical care? • Do they receive adequate medical care?
October 2008 ICMA Resolution 1. Undertake a comprehensive study on the effects of piracy on seafarers and families; 2. Develop international guidelines on caring for seafarers affected by piracy; and 3. Establish a piracy resource and assistance center for seafarer and shipowners.
ICMA Focus on Seafarers • ICMA’s 2008 resoluAon and 2009 IMO submission idenAﬁed scant aVenAon paid to piracy’s eﬀects on seafarers. • In past year mariAme stakeholders began developing policies addressing seafarers’ health • But, no empirical research available to support policies!
Focus on Seafarers • There are no mental health clinical studies published in the scienAﬁc literature on seafarers • Since 1950, there have been fewer than ﬁve studies published in the scienAﬁc literature on the impact of “disasters at sea,” but none have studied piracy
SCI’s Clinical Study •
Partner with Mt. Sinai School of Medicine and NY Psychoanalytic Institute
Produce descriptive data on seafarers
Better define the impact of piracy on seafarers
Develop a system to assess trauma and intervene, where needed
Develop an international network to ensure quality of care, including delivery and follow-up
Clinical Study Design – Describe the normal and clinical seafarer populaAons • Fieldwork in Port Newark • Interviews with seafarers by phone, Skype, and email • Interviews with industry representaAves
– Review literature on trauma assessment and treatment • Summarize relevant literature • Develop guidelines for assessment and intervenAon for the industry and the internaAonal community
SCI Study Status • Completed initial stage of benchmark interviews • August 2011 Updated Guidelines (Version 3) • Developing international network of mental health and health professionals • Interviewing seafarers affected by pirates
Piracy’s Impact on Seafarers Pirate tactics – InAmidaAng seafarers – InAmidaAng seafarers’ families – Exorbitant ransom demands – Pirates’ drug abuse – InﬁghAng among pirates – Divide and conquer – Crew versus oﬃcers – Mental and physical torture
Guidelines on Caring for Seafarers v3 • Guidance on mental caring for seafarers’ mental health Before sailing in pirate waters At the ﬁrst news of a piracy incident While hostage When release imminent When crew is released When crew is to return to duty
Important Considerations • IdenAfying crew needs for Ame of release, such as medical condiAons • CommunicaAng with all involved parAes, parAcularly with the crew’s families • ReuniAng crew with family as soon as possible aber release • Medical evaluaAons, including psychiatric assessment, upon release, before returning to sea, with monitoring on ﬁrst voyage back • Including cultural factors in treatment plans
New Informational Cards • Assessments Why assess? When assess? Assessment techniques
• Debrieﬁng Why debrief? Should you debrief? Debrieﬁng techniques?
Mandatory Assessments? SAgmas of mental health care Employability Cultural factors Assessment quality Voluntary mental health assessment Mandatory assessment and treatment – Could remove sAgma – Must be geared toward returning seafarers to work and disability beneﬁts for those who cannot
Medical Care and Confidentiality Seafarers encounter complex privacy issues between rights to privacy and ship owner’s ﬁtness for duty determinaAon Ship owner has duty to provide medical care, but who determines trauma diagnosis and treatment plan? Trauma symptoms may be immediate or delayed Seafarers may fear employer prejudice if “impaired” Guidelines 3.0 recommend privacy boundary between treatment and ﬁtness for duty exam New guidelines stress need for immediate triage and treatment plan when seafarer returns home
Local Port Chaplains Serve Piracy Survivors Port chaplains encounter many seafarer stressors Chaplains follow seafarer’s lead in sharing piracy experience via empathic listening Chaplains respect unique story of what seafarer experienced without prior bias about pirate capAvity Chaplains understand cross-‐cultural dynamics of suﬀering and sharing pain Chaplains may react diﬀerently if one seafarer or enAre crew in port was impacted Chaplains support seafarer’s need for healing and reconciliaAon
Closing Thoughts Need access to seafarers for study Need for internaAonal cooperaAon between psychologists (clinical and academics), as well as seafarer welfare providers More descripAve and qualitaAve research needed The importance of psychologist parAcipaAon in piracy response planning Trained port chaplains are valuable resources