N.L. marine medical calls routed to Italy

When Shang Rideout called for medical assistance for his ailing father Ronald, skipper of the fishing vessel Sherry Ann Chris, he did not expect to speak with a doctor in Rome — and did not expect the doctor to have difficulty understanding him.

CBC News has learned that radio calls for medical help from ships needing to speak with a doctor while in Newfoundland and Labrador waters have been routed to CIRM, a free service in Rome.

The move comes in the wake of Ottawa's recent shuttering of the Maritime Rescue Sub-Centre in St. John’s.

But the federal government said the move was an interim measure, and that "a Canadian solution has now been found" with a contract being signed late Wednesday with the company that used to provide the service.

Rideout has first-hand experience with the new medical calls protocol.

The Sherry Ann Chris was in waters more than 130 kilometres northeast of Twillingate on Tuesday when Ronald Rideout took ill, suffering dizzy spells, hot flashes, and briefly losing his vision.

Shang Rideout, one of three brothers aboard the ship, called the coast guard’s marine communications and traffic centre in St. Anthony, on Newfoundland’s Northern Peninsula. They patched him through to a doctor more than 5,000 kilometres away, in Italy.

The doctor did not know where Twillingate was — or Newfoundland, for that matter.

"When he asked me what country, I was like, ‘Oh my God, what am I into?’" Rideout told CBC News. "I wasn’t getting no sense from him at all from that point on."

Dealing with the doctor in Rome was a "complete waste of time," Rideout noted.

The doctor didn’t ask for his father’s symptoms, and seemed more concerned with where the ship was located, and what type of fishing they were doing.

Then there was the language barrier.

"He didn’t understand me — he didn’t understand me, hardly at all," Rideout said.

"I repeated, and he said, ‘Slow down.’ We had to spell the name of the boat out in phonetic alphabet. It wasn’t a good phone call."

Rideout said that after he hung up, frustrated, he didn't speak with another physician about his father’s condition until the Sherry Ann Chris made it back to port in Twillingate — more than 10 hours later.

His father was OK, and went to hospital in Gander Wednesday for testing.

New procedure

Until last week, such radio calls from Newfoundland and Labrador waters for medical assistance were funnelled to a Halifax-based company, Praxes Medical Group.

The Canadian Coast Guard did not respond to inquiries before deadline Wednesday.

But in emails obtained by CBC News, coast guard officials indicate that the new procedure is to call the free service in Italy.

'It’s a pretty scary situation when you’re that far away from any medical help and you’ve got no voice, no doctor to talk to.'  —Shang Rideout

"When the MCTS centre receives a request for a radio medical, the centre is to contact CIRM Roma and request the radio medical," a May 7 e-mail from Denise Veber, superintendent of marine communications and traffic services, noted.

MCTS is the acronym for the five coast guard centres in the province that handle marine traffic and communications. They are often the first point of contact for emergency or medical calls.

"Effective May 7, 2012, MCTS centres in the Newfoundland and Labrador region shall use CIRM Roma for all radio medicals," wrote Ann-Margret White, regional director of maritime services with the coast guard in St. John’s.

According to its website, CIRM provides free round-the-clock radio medical assistance to patients on ships flying any flag, all over the world.

"CIRM is headquartered in Rome, where specially trained physicians and radio operators are on continuous duty," the website notes. "In addition highly qualified specialists in all medical branches can be consulted. The duty-doctor, by means of consecutive calls, maintains regular contact with the ship requiring radio-medical assistance until their arrival in a port with adequate medical facilities or until the complete recovery or evacuation of the patient."

President Francesco Amenta told CBC News that CIRM is a not-for-profit organization offering only basic services for free to international ships.

The group is also undergoing its own series of budget cuts because of the Italian debt crisis, Amenta noted.

The Canadian government does not provide any funding.

"Absolutely none," Amenta said. "Definitely none."

Should they? "Of course any kind of support is appreciated," he said. "To keep alive our mission, it costs a lot of money."

If a medevac is recommended by the doctor, the rescue centre in Halifax will co-ordinate the response, coast guard memos note.

Centre closure

The change in policy from a paid medical consultation service based in Atlantic Canada to a free one in Rome comes shortly after Ottawa officially shuttered the Maritime Rescue Sub-Centre in St. John’s.

Officials with Praxes Medical Group, the Atlantic Canada company that had held the contract until the closure of the Marine Rescue Sub-Centre, told CBC News they had been unaware of the status of their contract. But on Wednesday evening, the Department of Fisheries and Oceans said that a new contract with Praxes had been signed to cover the entire Atlantic region.

Prior to its closure, the local sub-centre played a role in co-ordinating search and rescue and medical response efforts in Newfoundland waters.

Proponents of the St. John’s facility touted its local knowledge in recommending it stay open.

The facility was axed as part of a wave of budget cuts by the Harper government, saving an estimated $1 million.

The Rome situation for medical calls only applies to Newfoundland and Labrador.

Similar calls in Nova Scotia are handled by the Queen Elizabeth II hospital in Halifax, said Merv Wiseman, a former employee of the St. John’s sub-centre who fought bitterly against its closure.

"Oh my god, this is awful — I couldn't possibly conceive of this," Wiseman said.

"We thought we would see things fall through the cracks. We just didn't think it would happen this quickly."

According to Wiseman, many nations would not use the Italian company for medical calls.

"In most cases, affluent countries like Canada, like the U.S.A., Norway, England ... they would never avail of this situation. I'm not saying it's substandard, but there's all kinds of problems ... logistical problems, language problems that would creep in.

"It's something that I feel, and many people feel, that Canada would be going to as a last resort."

The Department of Fisheries and Oceans statement said Canadian authorities use CIRM "when required."

It added: "The safety and security of mariners is the top priority of the Canadian Coast Guard."

‘Pretty scary situation’

Meanwhile, back in central Newfoundland, Shang Rideout is not happy with the change in procedure.

"It’s a pretty scary situation when you’re that far away from any medical help and you’ve got no voice, no doctor to talk to," he said.

He made a similar medical call while at sea about six years ago. Again, his father Ronald needed help.

Rideout talked to a doctor. He’s not sure where the doctor was, but knows it wasn’t Rome.

On that doctor's advice, a chopper was sent to airlift his father off the ship and transport him to hospital in St. John’s. The problem turned out to be painful kidney stones.

Rideout says that experience contrasts sharply with this one.

"You’d like to have a little more reassurance, to be able to speak to somebody sensible, you know what I mean?"