Professor of Psychiatry at the Department of Behavioral Medicine, Lagos State University College of Medicine, Ikeja, Professor Olurotimi Coker, believes that shipowners and the regulatory agencies especially the Nigerian Maritime Administration and Safety Agency (NIMASA) need to be mindful of the mental health of seafarers. This aspect of the well being of seafarers, according to the scholar, has been neglected for too long.
He speaks on the need for psychological fitness and mental evaluation of seafarers and what shipowners and NIMASA can do to facilitate their well being of crew members.
How can shipowners provide emotional support for ship crew?
Shipowners can provide emotional support for the seafarers by training the health personnel on board on how to recognize crew members that show symptoms of emotional disorders. If the medical personnel are not trained to recognize these mental health disorders, they won’t know how to attend to them and treat them. This is because initially, mental health disorders start to manifest physically with signs and symptoms of malaria, weakness, body aches and tiredness. These are like the initial signs of malaria or typhoid fever. So, if the attending medical personnel do not know that underlying such physical ailment might be some mental disorders such as anxiety disorders, depression, panic, then, there can be a problem.
Also, while researching, I discovered that most ships do not have medical personnel on board. I don’t know how true that is – that a certain ship that usually has more than 30 crew members does not have medical personnel. This is one thing we need to create awareness about. Even if the crew members are 10 and are going away for two weeks, there should be medical personnel that must take care of their physical and mental health on board.
Loneliness is associated with being on the sea for many months. If not addressed early, what can it lead to?
Loneliness is also part of the causes of mental health disorders. During the outbreak of COVID 19 pandemic that necessitated many people to stay at home for five to six months especially the elderly ones, the incidents and prevalence of mental disorders rose significantly. People had nowhere to go and were listening to negative news about the pandemic. This triggered a lot of anxiety, panic and depression in people. So, let’s now put an analogy to somebody who is on the ship for four weeks. If that person does not have a stable emotional health, social wellbeing, does not make friends easily while on board and he’s not engaged in creative activities, what will happen to him?
Loneliness can trigger certain mental disorders in seafarers such as anxiety, panic, phobia, depression and those who have had physical or mental health problems before embarking may have a resurgence of such conditions while on board. Somebody who does not have social wellbeing, that is, ability to initiate and sustain relationships, make friends easily, would be lonely for eight weeks if a journey on the sea lasts that long. And that is why we are advocating that they should create recreational activities like karaoke; let them learn how to sing and dance while on board, to play table tennis if possible, and indoor games to keep these seafarers actively occupied while they are not on duty.
Recently, you said kissing and hugging of a spouse is one of the ways to maintain mental order. How can that be achieved considering the long stay of the seafarers on the sea?
Well, the idea behind this is that charity begins at home. Love, unconditional agape love begins at home. If you are at home, get closer to your spouse. Hug her, kiss her, so that when you are away, you are still thinking about that bond of love and you are hoping and aspiring that you want to quickly go back to that love. So, it is very essential that you get closer not only to your spouse, children, siblings, parents, and that is also part of social wellbeing. Family is the single unit of socialization and if you don’t have love in your family, then you are in trouble. Can you imagine somebody who is going away for four to six weeks, and had an argument with his spouse before leaving the house. He would definitely have some emotional discomfort while being away and then of course, such a person would not be eager to go back home. Therefore, this does not only apply to seafarers, it also applies to everybody. Either you are a seafarer or not, you must be very close to your spouse and family members for you to have adequate emotional wellbeing.
How about the health evaluation of seafarers?
Well, you know if you want to start work anywhere, you’ll be asked to go for a physical checkup to check if you are physically fit to work. So, it is for someone to go away to a very hectic work for four to six weeks, you must be strong physically. Now, most people don’t know that you don’t have to be strong physically alone but also mentally and emotionally to withstand the hazard that they encounter at sea. That is why we are proposing for the physical, mental and emotional wellbeing of seafarers. When they do not evaluate them and determine those who are fit mentally, they would break down while at sea. And that is minus one of your personnel who would not be effective, productive, and participating in all occupational duties. So, it is very important that mental health conditions be assessed and evaluated before embarking on that long journey.
It is also essential that we assess their mental health on arrival. It is like a soldier who has gone to war. When they come back, they have the briefing called psychological first aid so that when they go back to the society, they would fit in socially into their family and the society. They would not have what we call post-traumatic stress disorders. Now, if they were attacked by pirates on the sea or somebody died, or they had turbulent waves, you know that can be very scary; it could affect their family life and productivity when they come back because they could have suffered from post-traumatic stress disorders. Post means weeks, months and years after they’ve encountered overwhelming trauma, so they can still be disturbed. And when they are disturbed, unfortunately no one recognizes that their emotional conditions were affected while they were on the sea. So, that is why seafarers must be evaluated before and after embarking on a journey and that is what the Nigerian Maritime Administration and Safety Agency (NIMASA) must do. If NIMASA cannot do it, Mission to Seafarers should do and other NGOs in the maritime industry. That is where the media comes in to inform the people and educate them about mental health of seafarers. However, nobody is actually looking in that area and that is the beauty of the symposium by Mission to Seafarers that took place recently to make us aware that the mental health of seafarers has been neglected for decades.
What are the medical measures to be applied in carrying out therapy while at sea?
The medical personnel should be trained on how to recognize the signs and symptoms of common mental disorders, which include anxiety disorders, panic, phobia and then depression. So, such medical personnel would have been trained or should be trained on how to carry out counseling services known as talk therapy while on board. And in milder, moderate stages of mental disorders, you can treat them through talk therapy, which is just counseling. After you have recognized the signs and symptoms, you then counsel the person on how to use psychological strategies to overcome the signs of fear of the unknown, rising heartbeat, fear of water etc. So, the individual recognizes the manifestation of the mental health condition and counsel on how to overcome them. In severe cases, the personnel then prescribe medication to assist them to overcome those manifestations.
It is advised that a person should rest for at least eight hours. How can that be achieved in a busy megacity like Lagos?
It should also apply to those who are not living in Lagos. However, in Lagos it doesn’t even apply to everybody unless those who are working in Ikorodu and CMS who have to travel two or three hours to their place of work. So, if you don’t get your eight hours of sleep and make the brain and all other organs of the body to rest and recuperate, it makes one vulnerable to physical and mental health disorders. That is why sleep is very important for human beings and eight hours have been said to be the best. However, in situations where you cannot get your eight hours, try and get a minimum of six. One should try and get a minimum of six hours and if six hours is not possible, get five hours. But to say you want to do two hours, three hours or four hours in a day shortens one’s lifespan. It makes people develop hypertension and diabetes. They won’t know that it is as a result of sleep deprivation that has been going on for years and they are silent. So it is advisable to have eight hours of sleep but there are situations when you wake up by 4am in the morning to go to work and get home by 10pm or 11pm in the night. You should still try hard to sleep for at least five or six hours in a day.