O-184 MEDICAL AND SOCIAL COVER FOR FISHERMEN IN MOROCCO: CURRENT SITUATION, CONSTRAINTS AND PROSPECTS

Introduction: Objective critical analysis of medico-social cover for fishermen: limitations and recommendations. Medical and social cover for fishermen raises a number of issues of a legislative, ethical, deontological and practical nature. Methods A cross-sectional epidemiological survey was carried out among physicians working in the seafarers’ health facilities (ASGM). Results and discussion ASGM physicians, providing both care and prevention activities, infringe the provisions of the law relating to the practice of medicine. We have 20 occupational health physicians for 120,509 fishermen. We need around 70. The Ministry of Health provides the medical staff, which is an aberration because it pays the occupational health physicians who provide preventive care in the private sector. The Labor Code stipulates that medical services and the remuneration of occupational physicians are the responsibility of the company. Wouldn’t it be useful to introduce a compulsory prevention contribution, which would enable occupational health cover to be extended to the entire working population? Should the compulsory maritime insurance required of all shipowners include a contribution to occupational risk prevention? The high turnover of fishermen who change port of registration disrupts the proper monitoring of ASGMs. Wouldn’t it be useful to digitize the medical records and individual maritime booklet of fishermen as part of an intranet? The national reference rate has not been increased since 2006, resulting in quantitative and qualitative shortfalls in care. Shouldn’t a third-party payment system be considered? Conclusion Several actions are needed to improve the health and safety of fishermen