The Little Ships article by Doctor Kenneth Prudhoe Club de Mar Medical Centre Palma de Mallorca

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"DOCTOR AT SEA" a monthly Column in The Islander Magazine

The Little Ships

Early in June I had to spell "Dunkirk" to a Spanish friend and explain a little about the week from 26 May to 4 June 1940 when about 190,000 British soldiers and another 140,000 French soldiers were evacuated under fire from the beaches at Dunkirk in France. I realised afresh that we all have our different national stories and can make wild cross-cultural assumptions about each other's history and understanding. It is only since living in Spain that I have learned much more about the Spanish Civil War and how to spell "Guernica". Every yachtie national will have a similar symbolic military event built into their national psyche ' Gettysburg, Gallipoli, Pearl Harbour, Trafalgar and many more which are not military.

Appealing to the Dunkirk spirit in British culture can only be understood in the context of that massive evacuation achieved against all the odds and which transformed a huge military defeat into a miraculous second chance to win the war. The 70th anniversary celebrations were an inspiration last month but also a reminder that war is chaos and chaotic circumstances breed innovation. The Little Ships were the innovation that made the difference.

The warships in deeper water were much less able to approach the shallow beaches but an armada of volunteer or requisitioned small craft, such as fishing boats, pleasure craft or small steamers, could get much nearer and about 700 of them made repeated and dangerous crossings from the south coast of England to rescue many thousands. From the air it was said the Channel looked like traffic on a busy road on a Bank Holiday and that you could almost walk across the Channel without getting your feet wet!

It was a time for national leadership in a dire situation that prompted the King to call for a National Day of Prayer and to which the population responded in droves and then subsequently a Day of National Thanksgiving the following Sunday after a week in which the enemy advance suddenly stopped for no good reason, a violent storm grounded the enemy aircraft and a remarkable calm facilitated the sea journey over the Channel.

You may be wondering, like me, if there will be a medical dimension to this piece!

It's about being fit for purpose in an emergency.

The Little Ships were on naval duty in a split second, the guys knew their sea-worthy craft and they themselves were fit for the job in hand. Health and safety precautions are an essential even if sometimes a boringly overdone aspect of modern life.

The ENG1 medical does not make anyone fit but it is a tool to try to make sure someone is fit for purpose especially caught in emergency conditions. I heard a report of an insulin-dependent diabetic who managed to get onto a voyage as crew but who was a liability to the Captain in a storm - seasick, unable to eat, heavy workload - diabetes all out of control and not fit for purpose but an ENG1 check would have prevented the crisis.

Officers and crew who are responsible for medical care onboard need to have the proper level of training and certification for their work. This means having the Medical First Aid certificate up to engineer and first mate level and Medical Care Onboard Ship for captains although anyone can be charged with medical responsibility and then also needs these relevant qualification.

MCA Marine Information Note MIN 385 (M), published in May, has made some important changes to the certification guidance which should make life a bit easier. The certificates in medical care are no longer time-limited (previously it was five years) for the purposes of undertaking Certificates of Competency. The Medical Care Onboard Ship certificate (Ship Captain's) is limited to five years for any individual actually responsible for administering medical supplies "On EU Member State flagged vessels the captain and any other worker or workers to whom he (or she) delegates the use of the medical supplies must receive special training updated periodically, at least every five years". There is therefore an Update course for medical persons in charge whose Medical Care certificate becomes time-expired after five years.

Some boats take their crew through health and safety routines on a regular basis and this helps to spread the message and also the skills for use when needed. We have good examples of students on our own courses who go back to boats where there is well established in-house updating and practice and it gives them a chance to consolidate their new knowledge and skills. Admittedly this is often more evident on larger crew vessels but even the little ships need to be ready!

Dr Ken Prudhoe, MCA Approved Doctor, can be contacted at Club de Mar Medical Centre, Palma de Mallorca. Tel: (+ 34) 639 949 125.