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ICSW - S.H.I.P. Seafarers’ Health Information Programme. Topic 7 : STIs, including HIV / AIDS. Maritime Sector. >90% of World Trade is transported by Ship ± 1.2 million people work at sea: 450,000 officers = 2-5% shortage 750,000 ratings = 10-15% surplus 60 % from Asia

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maritime sector
Maritime Sector

>90% of World Trade is transported by Ship

± 1.2 million people work at sea:

  • 450,000 officers = 2-5% shortage
  • 750,000 ratings = 10-15% surplus
  • 60 % from Asia
  • >20% from The Philippines
maritime sector1
Maritime Sector

Global sector:

  • fierce competition >> low wages
  • harsh working conditions
  • manning countries = cheap labor countries
  • manning agencies for recruitment and contract
maritime regulators
Maritime Regulators
  • IMO:
      • Standards on Training, Certification & Watchkeeping STCW ’95 treaty 1995
      • International Shipping & Port facilities Security ISPS Code 2001
      • SOLAS: Safety of Life at Sea
      • MARPOL
  • ILO:
      • Maritime Labor Convention 2006
seafarers health
Seafarers’ Health

Plenty occupational, physical, chemical and other health hazards:

  • Construction, cargo, isolation, climate changes
  • Noise, vibration, radiation
  • Loading, discharging, cleaning, painting
  • Travelling, accidents, infections, unsafe sex
why s h i p
Why S.H.I.P.?
  • To stimulate seafarers to take responsibility for their health in the living and working environment onboard
  • Healthier, fitter, safer…
ten topics
Ten Topics
  • Food Safety
  • Fit on Board
  • Safe travel
  • Healthy food
  • Malaria
  • Overweight
  • STI, HIV / AIDS
  • Mental Care
  • Dental Care
  • Skin Care
slide13
How?

Contact points

  • Pre-employment examination: clinics
  • Health Policies: Shipping Companies
  • Transit points: seafarers’ centers
  • Ship visitors in ports
  • Courses
  • Website
  • Sportsevents: ISS
seafarers and stis hiv aids
Seafarers and STIs, HIV / AIDS

An intervention has to involve:

  • Shipping Companies
  • Unions
  • Welfare Organizations
  • IMHA
  • ILO / IMO / WHO
seafarers and stis hiv aids1
Seafarers and STIs, HIV / AIDS
  • Shipping Companies:

C.S.R. = Corporate Social Responsibility

  • Unions
  • Welfare Organizations
  • IMHA
  • ILO / IMO / WHO
c s r
C.S.R.
  • “The essence of corporate social responsibility (CSR) is that companies should not seek profits alone; they must conduct their business activities with consideration of society, the environment, and human rights, and strive for sustainable growth as part of the global and local community”
  • “Corporations are one of the building blocks of modern society. And we have seen time and time again that when a company loses the trust of society, it is quite difficult to recover”
c s r health
C.S.R. & Health
  • Health of employees is an integrated part of the organisation
  • People are the most important asset in the organisation
  • Every employee, on any level, has a unique contribution to create and maintain a healthy work environment and promote a healthy lifestyle
  • Care for health of employees is an essential part of the success of an organisation
  • Healthy employees improve the performance of the organisation
seafarers and stis hiv aids2
Seafarers and STIs, HIV / AIDS
  • Shipping Companies
  • Unions
    • ITF = International Transport Workers Federation
      • “Highway of Hope”
      • AIDS coordinator
    • ITF Seafarers’ Trust: startup funding for S.H.I.P.
  • Welfare Organizations
  • IMHA
  • ILO / IMO / WHO
seafarers and stis hiv aids3
Seafarers and STIs, HIV / AIDS
  • Shipping Companies
  • Unions
  • Welfare Organisations
    • International Committee on Seafarers’ Welfare
    • Faith-based Organisations:
      • AOS, MTS, BISS, DSM …
    • Seafarers’ Centres
  • IMHA
  • ILO / IMO / WHO
what are we
What Are We ?
  • A Charity registered in the UK
  • An international umbrella organisation dedicated to the implementation of the ILO Instruments on Seafarers’ Welfare.
    • Convention 163
    • Recommendation 173
seafarers and stis hiv aids4
Seafarers and STIs, HIV / AIDS
  • Shipping Companies
  • Unions
  • Welfare Organisations
  • IMHA
    • Maritime Medical Professionals
    • Expertise & Research
    • 2007 IMHA & ITF join to condemn HIV discrimination at sea
  • ILO / IMO / WHO
seafarers and stis hiv aids5
Seafarers and STIs, HIV / AIDS

ILO / IMO / WHO

  • 1988 IMO resolution A.639 (16): undesirability of HIV screening of crews and passengers on ships
  • 1989 IMO/IMO/ WHO joint consultation: seafarers are not at particular risk of HIV infection in their occupational environment
seafarers and stis hiv aids6
Seafarers and STIs, HIV / AIDS

HIV / AIDS is a maritime issue. Not only because it affects the workforce, but also because ships have a role to play in the wider struggle to limit the spread and effects of the epidemic

seafarers and stis hiv aids7
Seafarers and STIs,HIV / AIDS

Risks and vulnerabilities:

  • Working and living away from spouses and partners
  • Working in isolation with limited social interaction and limited health facilities
  • Single-sex working and living arrangements dominated by men, where women are in a small minority
  • Limited control by the individual on protection against infection
slide26

Seafarers and STIs,HIV / AIDS

The number of HIV positive seafarers is thought to be quite low, because of:

  • Shorter turnaround time in ports
  • Stringent duty and watch systems
  • High workload ~ crew reduction
  • Port facilities far away from town centers
  • ISPS code: more stringent security systems
  • Increased dangers and hostilities faced by seafarers in some regions

…/…

seafarers and stis hiv aids8
Seafarers and STIs,HIV / AIDS
  • Mandatory pre-employment testing in major manning countries
  • Higher education and training level:
    • …Making choices…
  • Drug and Alcohol policies:
    • “dry” ships

“Healthy worker effect”

True for all Seafarers?

slide28

Seafarers and STIs,HIV / AIDS

Prevalence:

  • Not enough facts and figures
  • HIV prevalence among seafarers is not higher in most studies
  • Prevalence of other STI is higher in most studies

“Absence of evidence ≠ evidence of absence”

slide29

Seafarers and STIs,HIV / AIDS

Prevalence:

The Philippines:

2002 2006

HIV + n=1611 n=2484

OFW 28% 50-60%

Seafarers 38% (n=171)

UNAIDS estimate: n=12,000

slide30

Seafarers and STIs,HIV / AIDS

Prevalence:

  • Higher in certain sailing areas?
  • Patchy pattern of high prevalence?
  • Like “Corridors” in road transport
  • Higher in certain types of trade: e.g. cabotage?
slide31

Seafarers and STIs,HIV / AIDS

Knowledge, Attitude, Behavior and Practice:

  • Small group: sexually very active
  • Large group: occasionally unsafe sex
  • Small group: no risk at all
slide32

Seafarers and STIs,HIV / AIDS

Knowledge, Attitude, Behavior and Practice:

  • Knowledge: misconceptions
  • Peers are more important than knowledge for behavioral change
  • Use of condoms varies from 20% to 60% depending on the study
slide33

Seafarers and STI, HIV / AIDS

Challenges of a Maritime STI, HIV / AIDS Awareness Campaign:

  • Neutrality of the message:
    • Tone, level, technicality
    • Culturally indifferent
    • No stigmatization
  • Faith-based welfare organizations
  • Participation of sector and community
slide34

Seafarers and STIs,HIV / AIDS

  • Guidelines on the Prevention of Sexually Transmitted Infections including HIV and AIDS Onboard Merchant Ships
  • STI, you are part of it!...
  • Trailer
  • Three posters
  • Questionnaires
  • Health Promotion in a Shipping Company + PP
slide36

Seafarers and STIs,HIV / AIDS

A Campaign in Seven Steps

  • Why a Campaign on STI HIV AIDS for seafarers?
  • How to handle this?
  • What is important?
  • What needs to be done?
  • Start the campaign!
  • Have the goals been achieved?
  • Keep the momentum going!
slide37

Seafarers and STIs,HIV / AIDS

A Campaign in Seven Steps

  • Create support for a STI HIV AIDS campaign
  • How to handle this?
  • What is important?
  • What needs to be done?
  • Start the campaign!
  • Have the goals been achieved?
  • Keep the momentum going!
slide38

Seafarers and STIs,HIV / AIDS

A Campaign in Seven Steps

  • Create support for a STI HIV AIDS campaign
  • Set up a structure for a STI HIV AIDS campaign
  • What is important?
  • What needs to be done?
  • Start the campaign!
  • Have the goals been achieved?
  • Keep the momentum going!
slide39

Seafarers and STIs,HIV / AIDS

A Campaign in Seven Steps

  • Create support for a STI HIV AIDS campaign
  • Set up a structure for a STI HIV AIDS campaign
  • Investigate what the target group needs and wants
  • What needs to be done?
  • Start the campaign!
  • Have the goals been achieved?
  • Keep the momentum going!
slide40

Seafarers and STIs,HIV / AIDS

A Campaign in Seven Steps

  • Create support for a STI HIV AIDS campaign
  • Set up a structure for a STI HIV AIDS campaign
  • Investigate what the target group needs and wants
  • Make a plan for a STI HIV AIDS campaign
  • Start the campaign!
  • Have the goals been achieved?
  • Keep the momentum going!
slide41

Seafarers and STIs,HIV / AIDS

A Campaign in Seven Steps

  • Create support for a STI HIV AIDS campaign
  • Set up a structure for a STI HIV AIDS campaign
  • Investigate what the target group needs and wants
  • Make a plan for a STI HIV AIDS campaign
  • Implement the campaign
  • Have the goals been achieved?
  • Keep the momentum going!
slide42

Seafarers and STIs,HIV / AIDS

A Campaign in Seven Steps

  • Create support for a STI HIV AIDS campaign
  • Set up a structure for a STI HIV AIDS campaign
  • Investigate what the target group needs and wants
  • Make a plan for a STI HIV AIDS campaign
  • Implement the campaign
  • Evaluate
  • Keep the momentum going!
slide43

Seafarers and STIs,HIV / AIDS

A Campaign in Seven Steps

  • Create support for a STI HIV AIDS campaign
  • Set up a structure for a STI HIV AIDS campaign
  • Investigate what the target group needs and wants
  • Make a plan for a STI HIV AIDS campaign
  • Implement the campaign
  • Evaluate
  • Adapt and continue
key elements
Key elements
  • Website
    • www.seafarershealth.org
    • www.seafarerswelfare.org (ICSW)
  • E-mail
    • ship@icsw.org.uk
  • Campaign material