Medical care

MLC 2006 Regulation 4.1 and Standard A4.1 require the shipowner to provide medical care at no cost to you for the duration of your SEA — onboard and ashore in any port the vessel calls. SOLAS Regulation V/4 independently mandates Telemedical Maritime Assistance Service (TMAS) availability for any ship in distress, free of charge; the flag state designates a TMAS provider (CIRM in Italy, Radio Medical Germany, Medlink in the US are common commercial providers). The ship's medical kit must meet the STCW-aligned Category A, B, or C standard set out in the IMO Medical First Aid Guide (MFAG, 3rd ed., 2022). If your condition requires disembarkation, the master must request medevac via the Maritime Rescue Coordination Centre (MRCC). Serious illness or injury that requires sign-off triggers owner-paid repatriation under MLC Std A2.5.1. The P&I club insurer — named on the DMLC Part II — covers medical costs, lost wages during incapacity, and compensation under MLC Std A4.2.1. For the full legal framework, see /reference/mlc.

What this usually means

Your first call in a medical emergency is your Master. Onboard medical decisions are supported by telemedicine providers — the ship's flag or owner usually contracts one (CIRM, Radio Medical, Medlink are common). TMAS (Telemedical Maritime Assistance Service) is free under SOLAS for any ship in distress.

Step-by-step

1. Alert the Master immediately; Master contacts TMAS via the flag state's channel (often MF/HF or INMARSAT-C).
2. Provide the patient's age, sex, vital signs, and the ship's full medical kit contents (Cat A/B/C per STCW).
3. Follow TMAS instructions to the letter — the medical log becomes a legal document.
4. If disembarkation is needed, Master requests medevac via the nearest MRCC (Maritime Rescue Coordination Centre).

Evidence to save

• The complete medical log entry for your illness or injury made by the master — request a copy immediately.
• TMAS consultation record including the advising doctor's name, instructions, and recommended medication.
• Photographs of injuries, defective equipment involved, and the accident scene taken as soon as safe to do so.
• All medical records, consultation notes, scan reports, and prescriptions — collect from every treating facility before disembarking.
• The ship's Official Log Book entry recording the incident, witnesses, and immediate actions taken.
• Fitness-for-duty or 'fit / unfit for work' assessments — do not let an 'unfit' determination be changed to 'fit' without proper examination.
• Written record of any refusal by the master or owner to arrange medevac or shore-side treatment.

What NOT to sign

• A 'fit for duty' declaration if you have not been examined by a qualified doctor and you do not feel fit — signing while unfit creates personal liability and removes the owner's obligation to treat you.
• A release of P&I medical-cost claims before all treatment is concluded and all bills have been settled directly by the insurer.
• A statement that the injury was caused by your own negligence if you believe the vessel's equipment or procedures contributed.
• Any document waiving the right to further compensation for an injury whose long-term effects are not yet known.

Escalation path

1. Any medical emergency: alert the master immediately. Master contacts TMAS via the flag state's designated channel (MF/HF radio or INMARSAT-C).
2. If medevac is needed: master requests assistance from the nearest MRCC. This is mandatory under SOLAS V/4.1.
3. On disembarkation: go directly to a hospital; insist the owner's P&I club is billed directly. Do not pay out of pocket if avoidable.
4. If the owner refuses to arrange or pay for treatment: contact ISWAN SeafarerHelp (24/7) and the ITF inspector at the port.
5. File a formal complaint with the flag state if the owner fails to provide medical care required under MLC Reg 4.1.
6. For compensation in case of injury: submit a claim through the shipowner's P&I club (contact via master or DPA). For disputed claims, engage a maritime injury solicitor or your union.

Legal basis

SOLAS V/4.1 (SAR), ILO C164 (medical care onboard), MLC 2006 Regulation 4.1.

Organisations that can help

• ISWAN SeafarerHelp
  Global · 24/7
  📞 +44 800 012 1004
• CIRM — Centro Internazionale Radio Medico (Rome)
  Global · 24/7
  📞 +39 06 5923331
• Centre de Consultation Médicale Maritime (Toulouse)
  Global · 24/7
  📞 +33 5 34 39 33 33
• Radio Medico Norway (Haukeland Universitetssjukehus)
  Global · 24/7
  📞 +47 55 97 50 00
• Sailors' Society
  Global · 24/7 crisis line
  📞 +44 23 8051 5950
• Headway — Brain Injury Support (relevant to seafarers post-incident)
  Europe · Mon-Fri 9-17 GMT
  📞 +44 808 800 2244

Primary sources

• SOLAS Regulation V/4 — Meteorological services and TMAS
• ILO NORMLEX — MLC 2006 Regulation 4.1 + Standard A4.1 (medical care)
• ILO Convention C164 — Health Protection and Medical Care (Seafarers)
• IMO Medical First Aid Guide for Use in Accidents Involving Dangerous Goods (MFAG), 3rd ed., 2022
• WHO International Medical Guide for Ships, 3rd edition

See also

• Right: Injury, death, and compensation
• Right: Repatriation
• Right: Seafarer Employment Agreement (SEA)
• Right: MLC 2006 — your bill of rights
• Help: Medical at sea — action guide
• Help: Injury at sea
• Help: Sign-off and repatriation
• Reference: MLC 2006 — Maritime Labour Convention
• Reference: STCW

Disclaimer. General information only — not medical or legal advice. In a real medical emergency at sea, contact TMAS via the flag-state channel and follow the medical professional's instructions. Onboard medical decisions are the master's responsibility under SOLAS V/4.1.

Original help topic at /help/medical.