Home ILO MLC 2006 › You are here


MLC 2006 Regulation 4.1 - Seafarer Medical Care On Board Ship and Ashore to Protect the Health of Seafarers and Ensure Their Prompt Access to Medical Care On Board Ship and Ashore

{reg 4 1 medical care

MLC 2006 Regulation 4.1 deals with medical care on board ship and ashore for seafarers. The MLC 2006 requirements under Regulation 4.1 are primarily directed to flag States and address access to medical care for seafarers working on board ships. It also has provisions directed to port States and coastal States regarding access to medical care for seafarers on foreign ships in their ports or territories.

The majority of the requirements are directed to flag States to ensure that adequate measures are adopted to protect the health of seafarers on their ships and to ensure access to medical care while working on board ships. The standard for care on board a ship must be as comparable as possible to that which is generally provided to workers ashore.

The MLC 2006 requires that laws and regulation be adopted for some requirements, while in other cases, the country is required to ensure that measures are adopted. A number of the requirements reflect terminology and standards that are also found in the IMO’s STCW Convention. These provisions in this Section are also linked to MLC 2006 Regulation 3.1 in these model provisions in connection with hospital accommodation on ships.

MUST READ

mlc2006 medical care

MLC 2006 Regulation 4.1 Seafarer Medical Care On Board Ship and Ashore (Summary)


Purpose: To protect the health of seafarers and ensure their prompt access to medical care on board ship and ashore



  • Whilst you are on board you must be able to protect your health and have prompt access to medical care, including dental care, should you need it.
  • The flag State is responsible for standards of health protection on the vessel and for promoting health education programs on board.
  • You should not be worse off than people working ashore. This means you should have prompt access to necessary medicines, medical equipment and facilities for diagnosis and treatment as well as medical information and expertise.
  • All States that have signed the Convention must give you access to medical care if you are in urgent need of it whilst in their territory. When in port you should be able to visit a doctor or dentist without delay.
  • You should be able to get medical care and health protection free of charge, though the level of provision may vary according to national law.
  • You should have access to:
    • Outpatient treatment for sickness and injury
    • Hospitalization if necessary
    • Facilities for dental treatment, especially in cases of emergency
    • Hospitals and clinics for the treatment of disease
  • You should be admitted promptly regardless of nationality or religious belief and, where possible and necessary, you should receive continuing treatment.
  • Ship's Captains and medical personnel on board and ashore must use a standard medical report form which must be kept confidential.

On-board Medical Facilities

  • All ships have to have a medical chest, medical equipment and a medical guide on board. The contents of medical chests and the equipment on board should be determined by national medical guides taking into account the latest edition of the International Medical Guide for Ships. Inspections should be carried out at least every 12 months and should look at labelling, expiry dates, condition of storing medicine and the correct functioning of equipment. 
  • Whenever dangerous goods are carried on board, you should be informed of all necessary information on the nature of the substances, including risks, necessary measures for personal protection, relevant medical procedures and antidotes. Any such antidotes should be carried on board along with
    protective devices.
  • For ships carrying 100 or more people, on international voyages of more than three days, there must be a qualified medical doctor on board. National laws may require other ships to carry a doctor depending on the nature and conditions of the voyage.
  • Where there is no doctor on board, at least one seafarer must be in charge of medical care as part of their regular duties, or able to provide medical first
    aid. Appropriate training must be completed as specified in the STCW Convention. Training should be based on the contents of the following
    publications as well as any national guidance:
    • International Medical Guide for Ships
    • Medical First Aid Guide for Use in Accidents Involving Dangerous Goods
    • Document for Guidance - An International Maritime Training Guide
    • International Code of Signals (medical sections) 
  • Normally seafarers with medical responsibilities should go on refresher courses every 5 years to maintain their knowledge and keep up to date with new developments.
  • There must be arrangements for sending medical queries and receiving medical advice by radio or satellite communication 24 hours/day, free of charge. Ships should carry a complete, up-to-date list of radio stations and coast earth stations that can be contacted for the purpose.
  • If you are the person responsible for medical care on board, you should have had:
    • instruction in the use of the ship’s medical guide and the medical section of the most recent edition of the International Code of Signals 
    • training in medical care and first aid in line with STCW and requirements and national laws, including practical training and training in life-saving techniques
  • You should be able to demonstrate that you can:
    • provide satisfactory medical care to people who become sick or are injured during the period they are likely to remain on board
    • understand the type of information needed by an advising doctor as well as the advice received

Title 4. Health Protection, Medical Care, Welfare and Social Security Protection

Regulation 4.1; Code Standard A4.1 and Guideline B4.1


MLC 2006 Regulation 4.1 - Medical Care On Board Ship and Ashore

Purpose: To protect the health of seafarers and ensure their prompt access to medical care on board ship and ashore
  1. Each Member shall ensure that all seafarers on ships that fly its flag are covered by adequate measures for the protection of their health and that they have access to prompt and adequate medical care whilst working on board.
  2. The protection and care under paragraph 1 of this Regulation shall, in principle, be provided at no cost to the seafarers.
  3. Each Member shall ensure that seafarers on board ships in its territory who are in need of immediate medical care are given access to the Member’s medical facilities on shore.
  4. The requirements for on-board health protection and medical care set out in the Code include standards for measures aimed at providing seafarers with health protection and medical care as comparable as possible to that which is generally available to workers ashore

Standard A4.1 - Medical Care On Board Ship and Ashore

  1. Each Member shall ensure that measures providing for health protection and medical care, including essential dental care, for seafarers working on board a ship that flies its flag are adopted which:
    1. ensure the application to seafarers of any general provisions on occupational health protection and medical care relevant to their duties, as well as of special provisions specific to work on board ship;
    2. ensure that seafarers are given health protection and medical care as comparable as possible to that which is generally available to workers ashore, including prompt access to the necessary medicines, medical equipment and facilities for diagnosis and treatment and to medical information and expertise;
    3. give seafarers the right to visit a qualified medical doctor or dentist without delay in ports of call, where practicable;
    4. ensure that, to the extent consistent with the Member’s national law and practice, medical care and health protection services while a seafarer is on board ship or landed in a foreign port are provided free of charge to seafarers; and
    5. are not limited to treatment of sick or injured seafarers but include measures of a preventive character such as health promotion and health education programs.
  2.  The competent authority shall adopt a standard medical report form for use by the ships’ masters and relevant onshore and on-board medical personnel. The form, when completed, and its contents shall be kept confidential and shall only be used to facilitate the treatment of seafarers.
  3. Each Member shall adopt laws and regulations establishing requirements for on-board hospital and medical care facilities and equipment and training on ships that fly its flag.
  4. National laws and regulations shall as a minimum provide for the following requirements:
    1. all ships shall carry a medicine chest, medical equipment and a medical guide, the specifics of which shall be prescribed and subject to regular inspection by the competent authority; the national requirements shall take into account the type of ship, the number of persons on board and the nature, destination and duration of voyages and relevant national and international recommended medical standards;
    2. ships carrying 100 or more persons and ordinarily engaged on international voyages of more than three days’ duration shall carry a qualified medical doctor who is responsible for providing medical care; national laws or regulations shall also specify which other ships shall be required to carry a medical doctor, taking into account, inter alia, such factors as the duration, nature and conditions of the voyage and the number of seafarers on board;
    3. ships which do not carry a medical doctor shall be required to have either at least one seafarer on board who is in charge of medical care and administering medicine as part of their regular duties or at least one seafarer on board competent to provide medical first aid; persons in charge of medical care on board who are not medical doctors shall have satisfactorily completed training in medical care that meets the requirements of the International Convention on Standards of Training, Certification and Watchkeeping for Seafarers, 1978, as amended (“STCW”); seafarers designated to provide medical first aid shall have satisfactorily completed training in medical first aid that meets the requirements of STCW; national laws or regulations shall specify the level of approved training required taking into account, inter alia, such factors as the duration, nature and conditions of the voyage and the number of seafarers on board; and
    4. the competent authority shall ensure by a prearranged system that medical advice by radio or satellite communication to ships at sea, including specialist advice, is available 24 hours a day; medical advice, including the onward transmission of medical messages by radio or satellite communication between a ship and those ashore giving the advice, shall be available free of charge to all ships irrespective of the flag that they fly.

Guideline B4.1 - Medical Care On Board Ship and Ashore

Regulation 4.1 Guideline B4.1 PDF

Disclaimer: For general information purpose only - please check with ILO MLC 2006 for the latest requirements and accurate info

LAST UPDATED ON Dec 13, 2019

1 1 1 1 1