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ICSW - S.H.I.P. Seafarers’ Health Information Programme

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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ICSW - S.H.I.P. Seafarers’ Health Information Programme

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  1. ICSW - S.H.I.P.Seafarers’ Health Information Programme Topic 7 : STIs, including HIV / AIDS

  2. 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

  3. Maritime Industry

  4. Maritime Sector Global sector: • fierce competition >> low wages • harsh working conditions • manning countries = cheap labor countries • manning agencies for recruitment and contract

  5. Threats and Challenges

  6. 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

  7. 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

  8. Why S.H.I.P.? • To stimulate seafarers to take responsibility for their health in the living and working environment onboard • Healthier, fitter, safer…

  9. Ten Topics • Food Safety • Fit on Board • Safe travel • Healthy food • Malaria • Overweight • STI, HIV / AIDS • Mental Care • Dental Care • Skin Care

  10. How? Contact points • Pre-employment examination: clinics • Health Policies: Shipping Companies • Transit points: seafarers’ centers • Ship visitors in ports • Courses • Website • Sportsevents: ISS • …

  11. Seafarers and STIs, HIV / AIDS An intervention has to involve: • Shipping Companies • Unions • Welfare Organizations • IMHA • ILO / IMO / WHO

  12. Seafarers and STIs, HIV / AIDS • Shipping Companies: C.S.R. = Corporate Social Responsibility • Unions • Welfare Organizations • IMHA • ILO / IMO / WHO

  13. 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”

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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

  21. 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

  22. 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 …/…

  23. 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?

  24. 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”

  25. 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

  26. 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?

  27. 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

  28. 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

  29. 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

  30. 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

  31. Seafarers and STIs,HIV / AIDS

  32. 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!

  33. 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!

  34. 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!

  35. 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!

  36. 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!

  37. 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!

  38. 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!

  39. 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

  40. Key elements • Website • www.seafarershealth.org • www.seafarerswelfare.org (ICSW) • E-mail • ship@icsw.org.uk • Campaign material

  41. VII. THOU SHALT TAKE AND WEAR THY PROPHYLACTICS

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