Hamburg,  Germany  21  August,  2011  

Caring for Seafarers Affected by Piracy

The  Rev.  David  M.  Rider  President  and  ExecuAve  Director  

The  Seamen’s  Church  InsAtute  of  NY  &  NJ  

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?  

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.

October 2008 ICMA Resolution

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