Necessity of correction actions to PEME program in the Ukraine
The growth trend of reproduction of Ukrainian seagoing labour force and the growth of seafarers’ mental illnesses declared itself at the duration of employment on the ship requires to take correction action in to the existing PEME scheme in the Ukraine. The importance and necessity of such actions to be taken is illustrated by the recent cases which occurred within the first half of 2009 and which were handled by Azovlloyd P&I Service Ltd.
In the first case, some 24 days after joining his ship a heavy mental disorder of seafarer declared itself. His psychological state was rapidly being aggravated (his reticence and apathy noticed on the initial stage transformed to persecution complex and suicidal mania). In 2 days the crewmember jumped out overboard and consequently he drowned. In the result of investigation it was found that mental disorder in this particular case had a pre-employment nature. Nevertheless it does not stop the family from claiming the dearth compensation. The total costs incurred including dearth compensation claimed by the family amounted to approx. 110 000 USD.
In the second recent case, the mental disorder of seafarer declared itself in four month of his service on the ship. Aggressivity, loss of reason, danger to the social well being of other on board featured his behavior. The seafarer was hospitalized on an emergency basis and then he was repatriated under the medical escort of the doctor and officer and ambulance with the special psychiatric brigade. After one and a half month in-patient treatment in the mental hospital the seafarer claimed sick pays and disability compensation threatening legal actions against Owners. In the course of investigation it was found that mental disorder of this seafarer has a genetic inheritance (his brother suffers mental disease with the deep severity). The seafarer is on the psychiatrical record book in the mental hospital more than 7 years. He underwent periodically medical treatment in the mental hospital.
In both cases there were no events/circumstances on ships where they served that lead to much stress.
At the same time both of above seafarers underwent successfully their PEME (pre-employment medical examination) prior to join the vessel.
Our deep examination of PEME procedure in various clinics including Club’s approved clinics shew that none of clinics performs psychiatric examination and/or psychological test in the course of PEME at all. At the best case, if PEME form includes “psychological test” section (worth to note that in the most medical form such section is absent) , a neurologist (not a psychiatrist) performs the assessment of the psychological state of the examinee via routine short conversation with him instead of performing physical examination and/or psychological test by accepted standards. PEME system in the Ukraine on the part of psychiatric examination requires urgent correction actions. The illustrative evidence of necessity of correction actions to the existing PEME program is the fact that seafarer described in the second case above in two weeks after discharging from the mental hospital was employed to serve on the ship again via the manning agent situated in Sevastopol.
Ukrainian mental health legislation gives good grounds for such correction actions.
Under Resolution Nbr 1465 of Ukrainian Cabinet of Ministers dd 27/09/2000 with further amendments “On compulsory initial and periodical psychiatric examinations and list of medical psychiatric contraindications to some kinds of professions which can be a danger to this individual or to the people around” and under The Order of Minister of Health Nbr. 12 dd 17/01/2002 “On the performance of compulsory initial and periodical psychiatric examinations” seafarer must undergo the initial psychiatric examination before to start his sea-going activity and then periodical psychiatric examinations each two years. Such psychiatric examinations must be performed by the psychiatrist at the state-owned specialized psychiatric clinics. In case symptoms of mental disease are found in the course of examination or an examinee suffered from mental disorder in the past or the latter disagrees with the outcomes of examination the examinee must undergo supplementary psychiatric examination in the hospital. After any above medical examination the examinee gets Medical Certificate on compulsory initial and periodic psychiatric examination of the approved standard form (Nbr.122-1/o). This Certificate reflects outcomes of psychiatric examination of the examinee and contraindications to seagoing service, if any.
We suggest the following format of the correction actions to the existing PEME program in the Ukraine:
1. The Club should alter the existing PEME program establishing the Rule that each seafarer-examinee must submit to his PEME the updated Medical Certificate on compulsory initial and periodic psychiatric examination under the form Nbr. 122-1/0 (hereinafter Certificate) adopted under the Order of Minister of Health Nbr. 12 dd 17/01/2002 “On the performance of compulsory initial and periodical psychiatric examinations”
2. The above Certificate should attached to PEME Certificate and should form an integrate part of it as well as Drug /Alcohol test report
3. Any seafarer should undergo the psychiatric examination prior to each PEME and each time submit to his/her PEME the updated Certificate with the exception of seafarer is continuously employed by the same Shipowners. In later case 2 years validity of Certificate envisaged by the above Regulation can be accepted.
4. The PEME medical form must have “psychological test” section irrespective of availability of psychiatrist in the team of PEME clinic.
The above alteration to PEME program would fully correspond to the Ukrainian law and in particular, to the mental health legislation. The implementation of the above correction actions will protect Members/Clubs from employment of people who are suffering from mental disorders and to save significant expenditure and to avoid substantial financial losses.
Azovlloyd P&I Service Ltd