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Guest Blog - NeurodiversAtSea

This month’s Guest Blog is from Dan and James, who have kindly shared their amazing story about the creation of NeurodiversAtSea in 2022 and we’re very excited to be able to highlight their work in this area.

We’re also delighted to announce that they’ve welcomed Anya to the team and are actively looking for more volunteers to support this unique organisation.


But firstly, did you know?

  • Up to 1 in 7 (over 15%) of people in the UK are Neurodivergent.
  • In 2021, just 21.6% of UK adults on the autism spectrum were reported to be in employment. 
  • Neurodivergent employees at JPMorgan Chase were reported to be up to 48% more productive than their neurotypical colleagues.
  • After 3 to 6 months, Neurodivergnt employees at JPMorgan Chase were working at speeds that typical employees needed 3 years to reach - while being more productive!


Dan Smith and James Stockbridge first met way back in 2014 when they started their cadetships at nautical college in Southampton and they’ve been firm friends ever since. 


Dan (27) hails from the North West and currently works as Mate on a harbour tug in the UK, but has an offshore background, and has worked in the dredging and RoRo sectors. James (39), is originally from Devon but now lives in Berkshire and has just completed an offshore role in the North Sea as Chief Mate. 


They’re both passionate about Neurodivergence for some very personal reasons. Dan was diagnosed with Autism at an early age and so has first hand experience of the struggles that the community faces, because he’s faced them himself. He understands how utterly soul destroying it can be when you’re singled out because you’re ‘different’, bullied because of who you are, discriminated against and generally mistreated. He recalls feeling upset and confused growing up - to the point of sitting in bed in tears and asking ‘why?’. Much of his motivation to make a difference is to stop anyone else having to experience the same.


Being Autistic means his experience of life has been… different to those without a neurodivergence. Sadly, most of that experience was negative; growing up in a world that wasn’t designed for people like him. It’s much the same working in the maritime industry and he’s found it difficult to even just do his job, because of a lack of understanding in the industry leading to discrimination. That said, he has noticed positive signs of change creeping in very slowly.


For James, it’s been finding out that some of the things he’s had to come to terms with personally are neurodivergent and actually a ‘thing!’ For him, this brought the realisation that on looking outward, his profession is rich in neurodivergent people. Yet the neurodivergent characteristics that made someone a brilliant seafarer were, for no good reason, socially and professionally limiting at the same time.  We have oceans of talent and human potential available to us, but far too much of it is still wasted.


James is horrified at this sheer waste of talent and human potential, though he agrees with Dan that being ‘different’ is both a blessing and a curse as a seafarer. On one hand he’s met brilliant seafarers who benefit hugely from neurodivergent traits - from hyperfocus to enhanced spatial awareness, creativity and numeracy. But on the other hand, many of these same seafarers struggle to progress; whether to get a ticket, to master a new IT system, or even basic presentation skills. These are the people who struggled without the right support, or only minimal support and understanding, to get them over the line.


He has encountered seafarers who have faced disciplinary action, been kicked out, and possibly black listed, purely because of neurodivergent traits - which are just the result of their brains working a bit differently. In many of these cases, knowledge, understanding and leadership could have resulted in better, safer and happier outcomes. 


While neither of the team have formal training in neurodiversity, their expertise comes from personal experience which could be considered to be even more relevant and important. Dan told us that his personal experience is in some ways better, but other ways worse. This ‘lived experience’ of being Autistic provides first hand knowledge of what the condition can be like and how it can affect someone. Some of his closest friends are neurodivergent which has been extremely helpful in expanding his own working knowledge and understanding how SpLDs or ADHD affect people day to day in the real world. 


James states he’s a seafarer first and foremost. His knowledge of neurodiversity from experience has been supplemented by study and guidance from others in the sector and he has some legal training. He believes that if you have the responsibility of a leadership role for seafarers today, then a sound understanding of neurodiversity and neurodivergent individuals is a practical and moral necessity.

The concept of NeurodiversAtSea happened as the result of a frustrating experience with a potential employer. Afterwards Dan realised that this was going to keep happening unless something changed. He was faced with a tough decision between staying in the industry and fighting to make that change happen, or leave and retrain for a job in IT!

After much internal debate, which he describes as “a scene that in my head looked like Mel Gibson’s ‘freedom’ speech from Braveheart’, he decided the only option was to fight the good fight!


So, the NeurodiversAtSea website was created (https://www.neurodiversatsea.org/index.html), together with the help of some friends who also have lived experience of Neurodiverse conditions. Then, he called James to ask how to take the concept from a website to a material change in the industry and they decided on the next steps. The NeurodiversAtSea charity.


Their aim is to help seafarers, their employers and managers to do the right thing. To shine a light on the positives and benefits that a neurodivergent workforce can bring, and to find simple, inexpensive ways to get the very best from the brilliantly neurodiverse talent within the seafaring profession. The neurodivergent community does exist and has as much right to be here, and be happy and successful, as everyone else.


NeurodiversAtSea has multiple audiences across the industry and the aim is to reach as many people as possible from ‘bottom plates to boardrooms’. Starting at the shop floor, seafarers have to live and work together which means an understanding of each other is essential. By and large, we’re pretty good at this. Seafarers are generally tolerant and understanding, curious and mostly respectful of each other. But we can and should be better at it. Our audience is those who work on deck or in the engine room, leaders, managers, ashore and afloat. It’s managers and policy makers; Masters, DPA, Auditors and commercial leaders.  We need more and better tools to understand, lead and manage effectively in light of what we now know about neurodivergence. In the maritime context these tools reside in ISM structures. 


It isn’t just from a practical perspective of increasing awareness and starting a change. The team has noted that crucially, you never know where you’ll find a potential ally. It’s been humbling in many ways to find that there ARE allies out there; people who want to drive change. Not just for their own good, or to further their own name, but genuinely for the betterment of everyone. 


Both Dan and James have been shocked at the journey experienced by other neurodivergent seafarers. Discrimination exists at every stage of the process from recruitment to promotion, through performance reviews to examination and treatment on board. Some seafarers have been found in crisis as a direct result of discrimination. Some have left the profession, or appear to have been blacklisted. For others, it has resulted in them being unable to meet their professional potential. Subsequent investigation often shows that these individuals have been exhibiting neurodivergent characteristics.


As a profession and as colleagues, we try to do the right thing. But so many of our efforts can seem ineffective or feel like theatre… how many videos promoting the latest buzzword do we have to watch? The fact that one fifth of the population's brains work differently - neurodivergent - is not a buzzword or an agenda. It’s a fact. This demands urgent, practical and evidence-based intervention. 


This doesn't mean we can sugar coat things and say that neurodivergence doesn’t, hasn’t or won’t cause issues at sea. However, the caveat is that those issues are most likely caused by a lack of understanding. 


Seafarers are robustly tolerant, mostly pretty respectful and have a very particular sense of humour! They are very practical, and quite rightly suspicious of agenda’s, jargon and bulls**t!! But, there is still capability for misunderstanding when it comes to neurodivergence. Let’s use the simple example of someone not making eye contact. Does this make them aloof? Unfocused? Rude or ignorant? Following a cultural norm? Or could they be exhibiting a neurodivergent trait? 


The reality could be an autistic person struggling to look someone in the eye, even though they are fully focused on the conversation and the task at hand. There are countless other cases of simple misunderstanding like this stacking up to the point where it can cause major issues. It’s easy to see how this can lead to significant misunderstanding, especially in a confined environment. This is what we’re keen to change. Thankfully we’ve found plenty of people who are willing to help by starting the conversation. Sadly we’ve also come across numerous others who believe that “neurodivergent people shouldn’t be at sea; period”


There are still far too few positive stories, but we can see the beginnings of change. As a result of ISM, we as a profession have the means to hold ourselves accountable in doing the right thing, and get better at what we do. People are beginning to understand that different brains are more than OK, they can be an advantage at sea and in other work environments. Progress is slow but change is happening and we’re working on a way to highlight the positive stories we’ve found, so watch this space!


As a relatively new organisation, the reception has been very reassuring and a little humbling. The team has received support from a whole range of professionals from around the world, which has been absolutely fantastic. In particular, Dan and James love the fact that so far, everyone has approached them with their own stories of neurodivergence, whether that be their own neurodivergent difference or that of someone they know. It seems that everyone has a personal story to tell and is united in the need to change the industry. The most unexpected thing they’ve noted is the joy of people reaching out to say that they no longer feel alone, because through NeurodiversAtSea, they’ve learned that there are other neurodivergent people out there on the ocean. They quite rightly take great pride in this. 


It’s difficult to describe a typical day at NeurodiversAtSea as no two days are the same! Because everyone has busy working lives at sea, plus family commitments, we have to make the most of the limited time we have, which can lead to a fairly uncommon approach to managing things! Our way is to allow each person to do the work they excel at, so we get the most accomplished in the least amount of time.

Tasks could include working through our research and whitepaper (more on that later!), maintaining and updating the website, working on top secret projects, planning, research, or doing PR and outreach to further the aims of the charity. Some of this includes daily time to directly engage with the community members who have contacted the team directly. We’re bringing in some brilliant new talent, and recently welcomed Anya to the team. The next phase will be canvassing industry leaders for their commitment. 


We’re all aware of the increase in adults discovering that they are neurodiverse later in life and the team fully supports this. But if you are looking for a diagnosis, their advice is to research the process thoroughly and think about what you want from it first – whether it’s support, answers, closure or something else. 


In the UK there are a number of routes and you may be able to take through occupational health, or through the NHS. If you’re lucky enough to have the funds, a private health route could be open to you. But, the team reiterated that even if you still can’t get a diagnosis, it’s important to remember that you’re still valid, you still matter and you’re still seen. Plus, you can contact the NeurodiversAtSea team directly for more information and support.


Research was mentioned earlier, and the team is about to publish their first White Paper. The evidential backdrop is fascinating, though of variable quality. For example, there is evidence that certain social and professional groups are particularly neurodiverse or value neurodivergence.


There’s evidence that employers who harness neurodivergent talent reap spectacular rewards in terms of productivity and creativity. On the other hand, some neurodivergent groups face statistically dire social outcomes. 


We started our research with open minds and with an eye towards straightforward problem solving. We wanted to test hypotheses that there are neurodivergent seafarers who face significant social and professional hurdles, and who are discriminated against - right from initial entry, through underemployment, to promotion prospects. Sadly, we now have the evidence to support each hypothesis. But on the positive side, we have a strong evidence base which we can use to start doing something about it, whether that’s changing individual empowerment, company policy or regulatory intervention.


In some way the results were even worse than expected. But that actually fills the team with hope. It provides a firm starting point. It has provided evidence that there is a problem, and this understanding will help to focus efforts to bring about the most change in the shortest time. 


We’d like to thank Dan and James for their time in helping us to put this Guest Blog together, on such an important topic. . They’ve also been delighted to work with us in helping to shine a spotlight on their work and the neurodiverse community as a whole.

 

NeurodiversAtSea is the seafarers’ neurodiversity charity. Founded by seafarers and informed by leaders in industry, academia and the charitable sector, it champions neurodivergent seafarers and the ‘neurodivergent advantage’. It aims to end discrimination and prejudice, and to enable neurodivergent individuals to succeed in maritime professions.


You can find out more about NeurodiversAtSea here: https://www.neurodiversatsea.org

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James Griffiths - Guest Blog

by Rachel Smith • 6 November 2024
Welcome to our latest guest blog where we’ve been chatting to James Griffiths, General Manager of Ocean Operations for Scenic Group and finding out more about what happens behind the scenes in order to keep a fleet of luxury expedition ships running. Here’s what James told us… As General Manager of Ocean Operations, I’m responsible for the operations of our fleet which includes four ships in service with around 850 colleagues. I currently live in Mumbles, near Swansea in the UK, but due to the nature of my work I spend a significant amount of time living in Croatia. Prior to this role, I spent many years working at sea and worked up through the ranks to Captain and over the last 15 years, my main focus has been on polar expedition travel. I hold a master mariner certificate of competency in addition to a degree in engineering and a post graduate diploma in law. Part of my job is to work with our medical service provider (Red Square Medical) to ensure that our ships are offering medical services that are appropriate for their deployment, and this can often be to some of the most extreme and remote locations around the world. It’s extremely varied, though during the COVID-19 pandemic, I came ashore when our operations paused for a significant period of time. I was fortunate enough to be given the opportunity to lead the restart of our Ocean Operations, which included setting up everything from a company to manage the ships, to selecting our crewing, medical, helicopter and submarine partners and providers, amongst many other things. Our areas of operation, and the nature of our cruises (expedition), plus having aircraft and submersibles onboard some, do mean additional elements involved in the management of these ships. You could say that this current position is more of a happy coincidence than one that I actually planned for! In some ways this is a great positive - I do think it’s possible to plan a little too much and then be disappointed if things don’t go quite the way you had imagined. But there’s no danger of that here!

Paramedic on tour - Simon Lawton heads to Mexico

by Rachel Smith • 3 October 2024
Back in February 2022, we brought you one of our very first guest blogs from Simon Lawton, a Paramedic who has swapped out his ambulance for a Superyacht! You can read the original blog here: https://www.redsquaremedical.com/superyacht-paramedic-a-guest-blog-from-simon-lawton Over the last 2+ years, we’ve followed Simon’s career, and some of you may even recognise him as he does put a Red Square Medical instructor hat on from time to time. But, as for all healthcare professionals, Simon has to keep his skills up to date. So, we asked him to tell us a bit more about how he juggles this along with a rota onboard. Here’s what he told us… I’m originally from Stoke-on-Trent in the UK and trained as a HCPC registered Paramedic. I’ve spent almost 5 years working at sea now, with almost continuous employment on three different vessels, after leaving the ambulance service in 2019. My first role was as a Paramedic/Deck hand on Superyachts, and I now work as a Medical Officer on a maritime vessel. Even before I applied to become a Paramedic, I intended to complete my studies to help find employment in a remote or offshore environment. I had always been attracted to the idea of being able to travel the world while earning a salary. Working at sea has meant that I have travelled extensively, earnt a higher salary, and have a better work/rest balance than would be possible in a role on land. Note: At the time of writing, a qualified Paramedic’s starting pay in the UK was £28,407 and Simon’s old rota was 2 days, 2 nights (all 12 hours) and 4 days off with very inflexible annual leave. This year I decided to carry out some continual professional development (CPD) at a hospital in Mexico, to keep my skills up to date. I was interested in travelling to find out more about how healthcare services are provided outside the UK and Europe. The CPD activity in Mexico allowed me to do exactly that, while caring for and treating a wide variety of patients who had either self-presented in the emergency department, or been conveyed to hospital by ambulance.

Inequalities in CPR on Women

by Rachel Smith • 25 September 2024
Welcome to our September blog, and as we all start (in the UK at least!) to think about adding a few layers for warmth, we’d like to talk about getting naked! Well, to be more specific, getting bra’s off. Fact: Women are dying because bystanders are less likely to carry out CPR on women than men. Research shows that women are 27% less likely to receive CPR than men and if a defibrillator is used, their chance of survival is affected by bra’s being left on. Most of us have never had the chance to train using a female manikin. The #BraOffDefibOn campaign aims to address the inequality in CPR for women and we’re supporting it.

Dr. Will Duffin - Joint Medical Director WEM

by Rachel Smith • 4 September 2024
In August, we brought you a Guest Blog from Mark Hannaford, the founder of World Extreme Medicine. This month, it’s the turn of another of the key WEM faculty members… introducing Dr Will Duffin. Hello everyone, I’m Dr Will Duffin and I’m a GP in Devon in the UK. I’m the Joint Medical Director of World Extreme Medicine (WEM) and the Lead Medic for the US CBS TV show ‘Survivor’ - for Seasons 43, 44, 46 and 48, which is also through WEM. Extreme Medicine is healthcare that is delivered across the full spectrum of remote, austere and challenging environments. This includes high mountains, deep oceans, jungles, deserts, polar, low earth orbit and refugee camps… the list is endless. Being a part of the wider Extreme Medicine community through WEM has been a portal into new worlds of possibility and opportunity in my medical career as an NHS GP. It’s a huge privilege to treat patients in a remote setting. You get to do proper ‘hands on’ medicine that truly tests your clinical skills, risk management and decision making. Even basic techniques and principles done well can transform patient outcomes. That’s the big reward. I graduated from Bristol Medical School in 2008 and completed my GP Training in Cornwall, UK in 2016. In between, I spent 18 months in Australia to gain as much emergency department experience as I could, whilst doing Wilderness Medicine Courses. I landed my first expedition gig 12 years ago when I was post-FY2 (Foundation Years follow on after qualifying as a doctor). I covered a Kilimanjaro Trek after another doctor dropped out at the last minute. Once I had this under my belt, I was able to leverage this experience to get the next trip. So, I soon found myself providing regular medical cover for various commercial and charity sector expeditions. These expeditions have taken me all over the world: Kilimanjaro, the Peruvian Andes, the Himalayas, Northern China, Eastern Europe, Myanmar and Madagascar. One highlight was working as the private doctor for a Luxury Trans-Siberian Train! Though I became frustrated having to constantly wrangle annual leave to go away, so I made the switch to being a freelance (locum) GP, which has given me the flexibility I need. I joined WEM in 2018 after responding to a Facebook Ad for the ‘Survivor’ job. I was invited to a selection weekend in the Peak District, which is when I first met Mark Hannaford WEM founder and CEO and Dr Joe Rowles, WEM’s other Medical Director, and it all went on from there. Early on, I was given the opportunity to lead on the content for the annual World Extreme Medicine Conference and our various podcasts and webinars. Through doing this, I have met a colourful cast of characters; other extreme medics who are as audacious as they are inspirational! We have a lot of fun at the conference every year, learning from one another. https://worldextrememedicine.com/registration/wem-conference-2024 (Note from the RSM team – the conference is highly recommended and well worth a visit!)

Mark Hannaford - Founder and CEO of World Extreme Medicine

by Rachel Smith • 5 August 2024
Last year, the Red Square Medical team descended on the World Extreme Medicine (WEM) conference for the very first time. We’d been aware of this unique organisation for many years, but just not had the chance to get involved. Liz was involved in a panel discussion and spoke at the conference, and we came away literally buzzing with enthusiasm - our first impressions were that WEM is a place with no ego’s, where everyone wants to learn, and is willing to share. We met some of the most fascinating people ever and can’t wait to go back this year. But what about the person who started it all… We spoke to Mark Hannaford, founder of World Extreme Medicine and its far reaching impact. Here’s what he had to say. I’ve been involved in expeditions, working in low resource environments and extreme medicine for the past three decades! My family was made up of generations of seafarers from Cornwall although I was brought up variously in Devon, Antigua in the Caribbean and the Middle East; reflecting my father’s job as a Master Mariner. My father was at one time the youngest captain aboard the UK’s largest registered vessel, and my grandfather was Harbour Master for Malta and the first in that role in Plymouth at the start of Queen Elizabeth’s reign. I wear a number of hats but primarily I am the founder and CEO of World Extreme Medicine, and the annual WEM Conference. I also founded the MSc in Extreme Medicine at the University of Exeter and Graduate Certificate program at Bouvré College of Health Sciences, Northeastern University, Boston.

Women's Health

by Rachel Smith • 3 July 2024
Women’s health is a huge topic, while it’s true that in the maritime sector women make up just 2% of seafarers at sea, up to 34% of the shore based staff are female. Looking at the bigger picture, women’s health directly affects just under half of our population globally, and indirectly (whether you like it or not!) the other half, we thought it was worth a blog about some of the issues, and the taboo’s, that could be affecting our maritime workforce and the women in our lives. It's common knowledge that women experience huge hormonal changes at puberty and menopause, both of which can have significant physical and mental health impacts. In the UK, there is a growing discussion and openness about peri-menopause (the years before periods stop altogether) and how for some women, this has devastating effects across all aspects of their lives, including work. Of course men experience changes at puberty, but their later life changes are less significant and generally don’t affect their ability to work. In December 2023 the World Health Organisation (WHO) issued a statement to advise that every year, at least 40 million women are likely to experience a long term health problem caused by childbirth. So there’s a good chance that we all know one or more women affected, or if you are female… this could be you. As part of a special series on maternal health, the study showed a high burden of postnatal conditions that persist in the months and years after giving birth. These issues include more than a third of women experiencing pain during intercourse, urinary incontinence (8-31%), anal incontinence (19%), anxiety (9-24%), depression (11-17%), perineal pain (11%), a fear of childbirth (6-15%) and secondary infertility (11%). All in all it doesn’t paint a great picture of life after childbirth for some women. If any of your workers experience these issues, either on or off shore, it could have a significant impact on areas of their working life and it’s something they may be reluctant to open up about. Even before childbirth, we may take it for granted that contraception is available, certainly in the developed world. But in developing countries where sexual violence is not uncommon, contraception is considered lifesaving due to the high level of unsafe abortions carried out. Around 13 million women (and girls) under 20 give birth annually and complications in the pregnancy and birth is a leading cause of death. Consequently abortion is an option, but this carries its own huge risks.

Guest Blog - Wendy Sullivan

by Rachel Smith • 25 June 2024
We just love speaking to and finding out more about the people who inspire us and we guarantee that this month’s blog will not disappoint! We first got in touch with Wendy Sullivan via LinkedIn and thought she seemed like a pretty awesome human. Wendy and her company, Maritime Medical Solutions in Australia, certainly share the same outlook as Red Square Medical. Fast forward a couple of years and we’re now collaborating on a project in Australia and the Pacific Islands. What we’ve learnt along the way is simply fascinating and Wendy has kindly agreed to share her story with us… Here is Wendy’s Guest Blog: I was born in Canada, grew up in Africa and now call Australia my home. I feel lucky to live in paradise where the weather allows us to be on the water year-round. I had to work hard to gain my Australian citizenship and I credit my work in the marine industry with giving me a pathway to stay in Australia permanently. It took years of hard work and uncertainty to gain my residency and is still one of the achievements I am most proud of. I started sailing in Canada and since emigrating to Australia gained my professional and commercial qualifications as a vessel master, marine engine driver, trainer and assessor. I also have a Diploma of Paramedical Science, ship masters medical qualifications, business administration and development and there is still so much more to come.

Safety of Lives at Sea

by Rachel Smith • 17 June 2024
Working at sea can be one of the most rewarding and fulfilling careers. But you can’t gloss over the fact that it can be dangerous. Whether you’re working on a tanker, ploughing up and down the oceans, a Superyacht enjoying a busy season of charters, or any vessel in between; our love/hate relationship buddy Neptune takes no prisoners! The Safety of Lives at Sea (SOLAS) Convention in its successive forms is generally regarded as the most important of all international treaties concerning the safety of merchant and other vessels. The first version was adopted in 1914, in response to the Titanic disaster, and went through several iterations up to 1974. The Convention in force today is generally referred to as SOLAS 1974, as amended. SOLAS regulations cover all areas of safety at sea, including construction, fire prevention and detection, life saving equipment, cargo carriage, navigation, communications and a host of other areas. Regulation 33 of the SOLAS Convention applies to all ships, and places an obligation on Masters to respond to distress calls at sea and proceed ‘with all speed’ to their assistance. Anyone working in the maritime sector, hopes that they are never on the receiving end of this regulation, but we’ve experienced two quite different instances, where the ships we work with have responded and our Medical teams have played an important part in rendering aid.

Telemedicine - access to a healthcare professional

by Rachel Smith • 29 May 2024
This week’s blog is an introduction to telemedicine as although it’s probably been around for longer than you think, you might not be familiar with what’s available to help you. So whether you’re a leisure sailor taking on the ARC; work in commercial shipping, spend your time on a Superyacht, or anything in between, read on for more information… According to the UKs National Institute for Clinical Excellence, (NICE: https://www.nice.org.uk/), ships being on the water for months at a time mean that health can be a life-threatening challenge for sailors and seafarers. Access to healthcare providers has always been one of the most critical issues for offshore crews and it’s worth remembering that the International Labour Organization (ILO), dictates that access to medical treatments and health services should be guaranteed to seafarers in the same way as for people working ashore. Nowadays, telemedicine technology has emerged to improve healthcare delivery in many remote areas where there is no direct access to healthcare services using telecommunication services. Among them, maritime Telemedical Assistance Services (TMAS) have become more readily available and are now considered an integral part of a shipowner's emergency response operations. The advent and uptake of Starlink in both the commercial and leisure sectors can only be a positive from a medical perspective. So, what is Telemedicine? What does it do and how does it work? Telemedicine is a term that’s becoming more and more common in the maritime world. Quite simply, it is the provision of remote clinical services, via real-time two-way communication between the onboard medic (trained crew or healthcare professionals) and/or the patient themselves, and a shore-based healthcare professional, using electronic audio and visual means. The modern history of Telemedicine can be traced back as far as 1905, when a Dutch physician used long distance transfer of ECGs (electrocardiograms) to be read remotely. But as early as the 1920s onwards, radio communications were being used to pass medical information to patients at sea on ships and on remote islands. More recently, the COVID-19 pandemic has brought Telemedicine to the forefront of healthcare. Though we may not easily recognise what it actually is, the majority of GPs (certainly in the UK) and other allied healthcare professionals in the non-acute world, such as Physiotherapists and Mental Health support, have relied heavily on telephone and video consultations since March 2020. A survey conducted by Nautilus International and Martek Marine (2017) showed that a staggering 98% of seafarers believed that greater access to Telemedicine support would save lives at sea. Of those questioned, 68% had been on a vessel that was forced to divert due to a medical emergency and 70% had been on a vessel where there had been a medical evacuation. Emergencies experienced at sea ranged from severed limbs and broken bones, to gunshot wounds, tropical diseases, allergic reactions and sudden cardiac arrest. Whether you’re a commercial seafarer or leisure sailor, it would improve confidence in making a decision on whether an injury, or illness was severe enough to warrant a diversion, or evacuation, if there was a trained medic on the end of the phone or radio. Ever improving communications also means that we can now go far beyond voice calls. Photos of injuries, files of test results and even live streaming is all possible and helps to provide a much more indepth service. Our own team member, Rachel, received Telemedicine support via SatPhone and email, on a 7 metre Ocean Rowing Boat (yes, you did read that right!) in the middle of the Atlantic, when her rowing partner developed a painful injury. Remote intervention from a Doctor onshore helped to maximise use of the medical kit contents for the short and long term, rule out immediate worries of infection, and develop a pain management plan for the rest of the rowing race. One in five commercial ships a year are forced to divert for a medical emergency, with unknown numbers of other, non-commercial vessels on top. So there is also consideration for the cost and time involved, plus the stress to both the patient, and their medic who is managing a situation onboard, possibly alone!

Guest blog: Jordan Lin

by Rachel Smith • 8 May 2024
At Red Square Medical, we’re keen to support those who have a passion for maritime medicine. While we can’t provide placements for everyone, occasionally a request pops up at just the right time and we can provide some experience and insight into our unique and specialised world. Last year we were contacted by Jordan Lin, a medical student with a love of the ocean. This is his story… When I was a boy, my dad and I used to go fishing with a local fisherman off the Norfolk coast. I absolutely loved being on the sea and so for quite a long time, I wanted to be a fisherman. When I got a bit older I kind of forgot about this and think I may have been slightly put off by watching the TV series ‘World’s Deadliest Catch’! But I have always loved being on the water and spent a lot of time sailing dinghies; I was also a swimming teacher for children back in high school and college. Later, I decided to study medicine and I’m now a final year medical student at the University of Bristol where I completed an intercalated degree; a Masters in Health Sciences Research. I’m now looking forward to starting work as a qualified Doctor in August. Though having spent 6 years training, my next 2 years will be spent working for the required two foundation training years that must be completed before being able to work independently as a Doctor in the UK. At university, I joined the VITA network which is a group dedicated to developing a health and public health approach at the heart of any response to human trafficking and exploitation. I became the blog coordinator for the organisation and you can read the blogs, including those that I have written, here: https://vita-network.com/blog/ In my spare time, I have been involved with the Bristol University Hot Air Ballooning Society and trained through the society to get my Balloon pilots licence. So, I often spend weekends during the summer flying in a leisurely fashion over Bristol and the surrounding area!
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