Medical treatment of seafarers in the Southern Indian Ocean - interaction between the French Telemedical Maritime Assistance Service (TMAS) and the medical bases of the French Southern and Antarctic Lands (TAAF).

Background: The waters surrounding the French Southern Lands are a fishing zone, accessible only by sailing for several days in a region where weather conditions are often difficult. The scientific bases of the region have medical staff whose services can be called upon if seafarers require assessment and rapid medical treatment. We conducted an epidemiological study of the maritime teleconsultations carried out by the French Telemedical Maritime Assistance Service (TMAS), where patients navigating in the Southern Indian Ocean zone were advised to disembark on the medical bases in the French Southern Lands, between 2015 and 2020, to receive medical treatment.

Materials And Methods: We extracted data from all of the maritime records from 1 January 2015 to 31 December 2020 relating to patients who attended a maritime teleconsultation with a French TMAS doctor in the Southern Indian Ocean zone and who had been redirected to the medical bases in the French Southern Lands. Data were collected on the patients' age, gender, nationality, rank, type of vessel, teleconsultation diagnosis, patient management on board and in the French Southern Lands medical bases, as well as the medical outcome. We carried out a descriptive data analysis.

Results: French TMAS doctors managed 11,908 cases including 76 in the Southern Indian Ocean zone (0.6%). Nineteen (25%) patients were redirected to the French Southern Lands over the study period. Eighteen patients were men with an average age of 45 ± 10 years. Eighteen patients were on board a trawler and 11 of them were sailors. Nine patients were treated for a trauma-related condition, 8 for a medical condition and 2 for a surgical disease. Eleven (58%) patients were evacuated to Reunion Island and 8 (42%) patients received medical treatment and were able to re-embark aboard their vessel.

Conclusions: Relatively few patients are redirected to the French Southern Lands for medical assistance, but referrals occur on a regular basis. The presence of these medical bases is unusual in a maritime setting, but they can be a valuable asset when maritime medical assistance is required in this region. The type of condition encountered, and the patient profile, were typical of the fishing community. The presence of these bases and communication between the various stakeholders delivering maritime medical assistance provided these patients with optimal care despite their isolated location.