In order to control the quality of the Pre-Employment Medical Examination (PEME) in the Philippines, Skuld started a PEME programme in 2008 in order  to help members select healthy crew. The Skuld PEME is an enhanced medical examination established by Skuld in co-operation with Nigel Griffith from Marine Medical in Singapore. This enhanced medical examination goes beyond a normal PEME carried out in ordinary clinics. As the programme has proven a useful tool, it was decided to find and approve PEME clinics in India as well. As of 20 February 2012, members are now able to sign up for the PEME programme at five different clinics in four cities in India in addition to the four clinics we have in Manila.

What does the PEME include?
The examination and test criteria are selected based on the risks we see in our claims statistics. Risks differ from one nationality to another due to local diet, local customs or way of life in general. The tests will be tailored accordingly. For the Philippines, we have found that the following list covers the main risks.

• Identity of seafarer
• A medical declaration
• Physical examination
• Genital examination
• Dental examination
• Psychological evaluation
• Visual testing and colour blindness
• Audiometry
• Chest x-ray and lung function
• Electrocardiogram
• Faecal examination
• Complete blood test (CBC/FBC)
• Hepatitis test
• Liver function test
• Yellow fever vaccination
• Virology TPPA – Syphilis test
• Biochemical examination of the blood
• Cardiac risk factor calculation
• Diabetes mellitus
• HIV testing
• Malaria smear
• Drug testing
• Urinalysis
• Ultrasound examination of the kidneys and bladder
• Body morphology (BMI)
• Pregnancy test (when appropriate)
• Billary tract (gallbladder)

You will find many of these tests in a normal PEME. The main differences are in the test methods and criteria, and how the test results are collated to form a better picture of the seafarer’s health. One example is the cardiac risk factor calculation that uses different information and test results to calculate the risk of any cardiac disease. This method of using test results gives us a better understanding and certainty of the seafarer’s health.

What do we provide for our members?
Members are provided with a tested clinic capable of performing high quality examinations. Skuld audits the clinics and controls that examinations are not falsified and that there is little or no opportunity to influence the results. The seafarer undergoes a thorough examination to reveal any health risk and, if necessary, is given advice on how to take care of his/her health. The cost is approximately USD105 per person.

Skuld covers 50% of the cost
The member covers the initial outlay and upon renewal will be able to send in a claim for a 50% refund.

Who is eligible?
All members employing seafarers from the Philippines and India are welcome to participate in the programme. If/when clinics in other countries are added, participation will be extended accordingly.

Whom to contact
For members who would like to join the progamme, please contact your syndicate.

Members’ requirements and policy
Members who decide to join the programme have to establish a medical policy in accordance with Skuld’s PEME policy/requirements and have all crew members examined in one of the approved clinics.
NB: If a member decides to take on a seafarer who does not fulfil the requirements, but is declared fit under the POEA or Indian DGIS requirements, the deductible will be doubled, with a minimum of USD 25,000 in case of medical repatriation.

Fit for duty/Philippines
The Department of Health in the Philippines and the POEA contract decides if a seafarer is fit for duty. If a seafarer has an A, B or C result from a normal PEME, he/she is normally fit for duty. It is important that a seafarer who does not pass a Skuld PEME is not called 'not fit for duty'. The seafarer is, however, not fit in accordance with the company’s medical policy, i.e. a policy reflecting the test criteria set by the Skuld PEME. This is important in order to avoid problems with Philippine authorities.