The current state and problematic issues of medical care in the waters of the Northern Sea Route
Authors: Voronkova Svetlana V. , Abakumov Alexey A. , Bumai Oleg K. , Grabsky Yuri V. , Torshin Georgy S. , Malinina Snezhana V. 
Published: May 2022

Introduction. The solution of state issues for the development of the Arctic zone of the Russian Federation involves the active use of the Northern Sea Route as the main strategic highway. In order to preserve the life and health of ship crews in conditions of climatic and geographical and industrial risks, a smoothly functioning national system of medical care, harmonized with international requirements, is of great importance. The study aims to assess the state of the medical care system for ship crews on the Northern Sea Route, identify regulatory and organizational problems, and substantiate proposals for their elimination. Materials and methods. The researchers conducted an expert and analytical study, as well as analyzed and compared data during search and rescue operations in the waters of the Northern Sea Route (2010-2020), statistical data on medical examinations of ship crews conducted in 2020 in the organizations of the FMBA of Russia. The authors also have studied the main stages and forms of medical care in the waters of the Northern Sea Route. Scientists have conducted the analysis of scientific publications for the period from 2000 to 2021, contained in scientific electronic libraries, current international and Russian regulatory legal acts, information from official websites of executive authorities and organizations. Results. The system of medical care involves the implementation of measures for several interrelated elements: the provision of medical care on a ship, consultation by a medical professional using communication means, search and rescue operations, medical evacuation, medical care in the conditions of a coastal medical organization. International and Russian regulatory legal acts regulate the implementation of measures to provide medical care on board the vessel, the work of a wide range of participants from among federal executive authorities, executive authorities of subjects, institutions and organizations, officials and employees. In the course of the study, we found that there are concretized schemes of medical care, name lists and coordinates of participants. Specialists update all this in the Basin Plans for each territory of the Northern Sea Route. Despite the established rules of interaction of participants and conditions of medical care, the gaps identified by the researchers in administrative and legal regulation significantly affect the quality of medical care to members of the crews of ships, violate the constitutional rights of citizens to health protection. Conclusions. Experts have substantiated the proposals for improving the system of medical care in the waters of the Northern Sea Route when applying an integrated approach to the development of the coastal infrastructure of medical organizations, staffing ships with medical workers and providing medicines. Ethics. Scientists conducted the study in compliance with Ethical standards. This study did not require the conclusion of the Ethics committee.