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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  


QUESTIONS?

www.seamenschurch.org   csr@seamenschurch.org  


Caring for Seafarers Affected by Piracy