ON THE QUAYSIDE

With Dr Sage Gerdharee

Breaking into a new market with new technology can be daunting.  Factor in trying to convince vessel owners to allocate budget to an area that has traditionally lacked attention, and it is easy to understand why the success of the Ocean Doctor concept is worth celebrating. Maritime Review Africa sat down with its founder, Dr Sage Gerdharee, to get a better understanding of the motivation behind this new venture that puts healthcare into practice at sea.

▶︎  Most new service offerings in the maritime sector stem from people who are connected to or working within the industry. What is your connection and what made you decide that this was worth pursuing?

My extended family has a history in the fishing sector, and my father, who was in operations, would relay questions to me about how to deal with acute health issues facing seafarers. Despite this, even after my training and having spent a lot of time in rural communities, I swore I would never go into the maritime industry because it seemed too intense – but nevertheless, here I am.

When you realise that a lot of these crew are out at sea for months at a time and do not have the luxury of popping into a local General Practitioner (GP) or clinic, then you can see the real need for something like Ocean Doctor. It speaks to healthcare rights, workers’ rights and the basic human right to access healthcare, which is limited when you are at sea.

I realised that the reality facing seafarers was not very different to the underserved communities I had been working in and that simple primary healthcare could make a major difference to life on board vessels - and the vessels’ operations, directly in turn.

▶︎  You seem to have decided to focus on the fishing industry as a way to introduce Ocean Doctor to the market, but I am assuming that the goal is not to limit your market?

With some connection to the fishing industry, it seemed like a natural starting place for us. We were also hearing anecdotal accounts of hair-raising incidents at sea from the operations teams, shore skippers, and captains who expressed that they needed help. We felt we could perfectly address these gaps.

It, therefore, seemed like a practical place to start, but the Ocean Doctor platform is built for and applicable to any type of offshore or remote environment. Our vision is that a person does not stop being human when they are no longer on shore. Diseases don’t stop being diseases, and pain does not stop being pain when you leave the quayside.

The platform is designed to address this. Regardless of what type of ship a crewmember is working on, the aim remains to afford them that access to healthcare that we maybe take for granted on shore. And for the vessel owners, as we say, “healthy crew, healthy catch”. Looking after your workforce is looking after your business.

▶︎  It’s one thing to notice a need, but how are you managing to translate this into a service that both addresses that need and makes sense for the vessel owner?

Yes, that is key. After identifying the gap, which is keenly felt by seafarers, we also realised that offering a preventative care model would make just as much sense for the vessel owner. In the fishing industry, for example, the crew is literally the main driver of fishing effort on board a vessel. If they are not able to work effectively and safely, then the vessel is not able to function or fish optimally.

A single unscheduled return to dock for a vessel can cost the business many, many thousands of rands in fuel spent and catch lost in the process and time it spends not fishing. Our job is essentially to mitigate those incidents, and in a very direct way, improve operations and profits for fishing companies.

The idea was to service this niche portion of the maritime community and find a way to provide access to healthcare that made sense for the workers and made sense for the companies as well. In this way, Ocean Doctor sits at the intersection of maritime operations, risk mitigation, and workforce sustainability - making it an operational asset that is already proving itself in our waters.

▶︎  So, what can a company expect when signing up for a service like this? Walk us through the process?

Once a company signs up, we provide thorough training on how to use the Ocean Doctor tools and platform. It’s very much a plug-and-play kit. Everything stays in the case, and the instruments do not need to be removed for charging. It is purposefully very easy to use and comes with a small manual and a quick-start guide, designed for easy access and to answer questions.

During the onboarding process, which can be done on board the vessel or in an office in an hour, we walk them through everything inside the case. We have seen that, once the skipper has used it once or twice on board, they become empowered and the behaviour change is almost immediate.

We also have technical support available remotely to assist users navigating any difficulties or to help troubleshoot issues before they become a problem in an emergency.

The case itself, or the Doc on Deck kit (DOD Kit), contains everything needed to remotely assess the crew. This includes instruments to test vitals; several diagnostic tools like a digital stethoscope, HD cameras, as well as point-of-care testing items such as urine test strips and a glucometer. It also includes a tablet on which the encrypted telemedicine software enables live and cached video consultations.

Ultimately, once a company has signed up, they are given peace of mind knowing that sending their crew out with the Ocean Doctor kit on board will ensure that every seafarer has access to quality medical input. Captains are also reassured that they have a medical “button to press” - no query or question is too small. They feel supported in making medical decisions that they aren’t necessarily trained to handle or manage.

▶︎  Apart from the physical use of the Ocean Doctor kit, what other type of administrative set-up is required to ensure that your system manages the patient base? You mention the telemedicine software provided – does this come with any administrative input at all?

Ocean Doctor has its own, in-house developed Electronic Medical Record (EMR) system that has been specifically customised for our use in the maritime environment. During the onboarding process, crew members are provided with a secure link that allows them to add their personal medical information and provide their patient consent. This remains aligned with POPIA and HPCSA regulations, and is exactly the type of information you would normally give to your GP during a consultation.

This allows us to respond to individual medical situations as they present when out at sea. With access to that information, the attending doctor is easily able to streamline the consultation and not waste time trying to gather information during a consultation.

This step is, therefore, very important when we onboard new clients, but each crew member is responsible for inputting their own information to ensure confidentiality and remove some of the administrative burden from the vessel owner.

▶︎  That’s great, and the aim is therefore, obviously, to see as many seafarers gain access to this type of healthcare as possible. How will you ensure that Ocean Doctor’s response grows alongside an expanding client base?

TThat’s a good question and one that we take seriously. If you consider the ratio of doctors to patients that you commonly see on shore, it ranges from one doctor to 10,000 patients in State-run facilities to about one doctor to 3,000 patients in the private sector. This is an important ratio to manage for us, and our first priority is to ensure that we have a strong relationship with the crews and captains on board the vessels we serve.

It’s important that they feel empowered to discuss issues and maintain a low threshold to reach out if there is anything they need to know. The quality of that contact is very important to us, and as the business scales to bring new crews onto the system, we will be working to maintain an optimised ratio of patients to doctor that never compromises the quality of care we provide. We manage a panel of well-vetted doctors and there will always be somebody on call to respond 24/7.

We are also able to meet a patient at the quay, if necessary, to provide a follow-up to a consultation that may have occurred during the voyage or to perform minor surgical procedures on-site. This is all to keep crew out of long waits at clinics and back to fishing as soon as possible.

▶︎  What exactly does that on board consultation look like?

Initiating a consultation requires nothing more than a WiFi connection. Captains and crew can reach out via WhatsApp or phone, and our doctor assesses the situation. A consultation is either booked or begins immediately depending on the situation. Once a diagnosis is reached, a thorough treatment plan is put in place with appropriate follow-up and monitoring if necessary. Sometimes it is just regular medical advice that is needed on an issue - which is dealt with swiftly and effortlessly.

In general, it is important to determine the right course of action and help the captain make choices in the best interest of the health of the crew. In some cases that may mean calling in an evacuation or returning to port, but in many instances professional medical input can help avoid these more drastic responses safely. The captain’s word remains gold, and we never overstep in their decisions - our role is to advise and support - allowing crew leadership to breathe easier.

As part of the service we offer, we consult with operations teams and audit their medication requisition lists for medications onboard. This allows them to reduce medication waste, reduce redundancy, save costs, and strengthens the ability to effectively respond to situations as they arise.

For example, we have even managed to catch surgical and medical emergencies pre-hospital, and treat them early enough whilst at sea using medications and antibiotics onboard - preventing the need for emergency evacuations and serious complications for those crew members.

▶︎  This type of incident management obviously highlights the impact that effective medical input can have on vessel operations and potential disruptions. Is this the selling point presented to vessel owners?

Yes, absolutely. By proactively managing healthcare - our preventative approach - we are able to prevent delays and downtime for operations. In these cases, the vessels were able to maintain their original schedules and were not diverted to shore to disembark the crew.

Similarly, in many cases, we are able to bench patients while at sea and monitor them until they are able to return to active duty without either organising an evacuation or diverting the vessel. The doctor is at their cabin bedside, so to speak.

For an industry where medical issues can force costly diversions and where crew often spend weeks at a time far from a doctor, the service is aimed squarely at the operational and welfare pressures vessel owners face daily. Early intervention at sea can prevent an unplanned and costly return to port, while ongoing access to a doctor supports crew wellbeing, workers’ rights and alignment with international Environmental, Social and Governance (ESG) standards.

As an employee cost, the service is fully tax deductible. Ocean Doctor also saves company costs by streamlining and optimising medication requisition lists and auditing medication use on board.

Interestingly, it is also possible to flag instances of potential malingering using the medical instruments included in the kit, and trained clinical astuteness. Certain vital signs cannot be faked and are easily confirmed using simple tests.

Ultimately, Ocean Doctor sits at the intersection of maritime operations, risk mitigation and workplace sustainability, transforming the healthcare of fishing crews from a cost centre into a strategic operational asset.

ON THE QUAYSIDE