IMHA first looked at the issue of a standardized ship’s medicine chest in 2008 and more recently addressed the issue with a medicine chest booklet included in the ICS Medical Guide for Seafarers and Fishers. Very few countries frequently revise their medicine chest contents which gives IMHA space to do this work and provide guidance and recommendation especially as several current published guidelines do not take into account the latest toxic substances carried on board ships and antidotes needed.
Current medicine chest contents are not based on epidemiology specific to the sea environment but rely more on land based medical experience. Also, current medicine chest lists often state quantities to be included per medicine but these are not based on dosage requirements or statistics relating quantities to crew number. This presents a danger where even if a needed medicine is available on board, it may be too little for the patient to complete the treatment. So there are obviously areas for expert focus and a studied approach to the topic is needed.
Potential areas of improvements where IMHA’s aims to provide guidance include 1) analysis of TMAS data on usage of medicines and medical equipment on board especially as related to the gender of seafarers on board, 2) quantification of these parameters in relation crew size, length of voyage, distance from shore, cargo carried, etc, 3) setting a time frame for the revision of the recommended medicine chest lists of flag states and other bodies, 4) the creation of labelling standards in English as purchased medications overseas do not include multilingual leaflets, and 5) the establishment of a best practice standard for the management and inspection of the medicine chest on board.
Further areas of study can include quality of medicines on board. This is key to ensuring unregulated and unregistered medicines are provided. Packaging formats such as blister packaging and storage techniques to avoid moisture ingression. This could also minimize the unacceptable practice of “repackaging” expired medicines. Finally, TMAS centers might begin to record and share medicines prescribed including their dosages.
Members interested in joining research and future studies related to the Ship’s Medicine Chest should contact the office at : office@imha.net
