Nine Steps for Effective Action Against Sexual Assault at Sea

I read with dismay and familiarity the story of Midshipman X. As an emergency medicine physician, the failure of our society to address women’s health and safety is evident on a daily basis. Support for sexual assault survivors, even in major urban areas with plentiful resources, is sadly lacking. Midshipman X’s story was therefore not surprising, and the response of discomfort and uncertainty from the industry, not surprising either. Violence towards women is a public health disaster our society is not managing well.

The maritime industry has a culture and safety problem. Harassment and bullying, assault and intimidation, are difficult to quantify and difficult to prevent but anecdotally widespread. People are naturally uncomfortable discussing sexual assault, and the lack of normalization of discussing the topic is preventing the opportunity for meaningful intervention. Midshipman X’s story can be a catalyst for leadership in the industry to implement change now.

Let Midshipman X’s story be the industry’s Titanic moment. This is an event we all saw coming and all failed to prevent. The Titanic disaster led to SOLAS, a well-considered, well-reasoned set of procedural modifications, resource modifications, and cultural modifications that revolutionized the industry. There is no reason a similar approach cannot be taken to preventing sexual assault.

There is a component of sexual assault that is a medical problem. The specifics of evaluation of physical trauma, post-exposure prophylaxis, and forensic evidence collection are straight forward to document and implement. Victim advocacy and support systems exist for ongoing mental health. Maritime medical advisors can give recommendations on prevention, evaluation, and treatment. Viewing sexual assault at sea from a public health perspective, the importance around education and prevention is apparent, and this must come from leadership. This cultural change cannot be forced from the bottom up. Unacceptable behavior must be established and corrected by leadership. 

The reality of the maritime industry, today and in the future, is that the workforce is and will be comprised of both men and women.  Unlike industries ashore, there are a finite number of crewmembers, and all must be able to function and rely upon each other for the physical and economic safety of the ship and the operator.  An environment where sexual intimidation and assault is tolerated is no more acceptable than an environment where substance abuse is tolerated or condoned.  The maritime industry of today has advanced beyond the “Boys’ Club” of 100 years ago, or that many entered 30, 40, or 50 years ago. We can no more afford to ignore sexual intimidation than we can afford to ignore substance abuse.  Doing so places individuals, vessels, and companies at risk.

The responsibility to prevent sexual assault at sea falls squarely on vessel owners and unions. The maritime industry knows how to assess and mitigate safety hazards. Sexual assault is a safety hazard no different than any other. Every mariner knows the adage “safety rules are written in blood.” By viewing sexual assault as an on-board safety hazard, the steps to eliminate it become clear.

As maritime medical advisors, these are immediate interventions we recommend to vessel owners, executive leadership, safety and health teams, and union leadership:

1. Download and review the Best Practices Guide on Prevention of Sexual Assault and Sexual Harassment in the US Merchant Marine. This contains resources to start to create a meaningful anti-harassment policy. 
2. Develop a zero-tolerance culture for assault, harassment and intimidation. This must come from the executive leadership and must be revisited on a regular, recurring basis. Culture comes from the top down and requires continual reinforcement to be effective.
3. Educate employees on the “bystander effect” and give them tools to intervene if witnessing harassment or intimidation.
4. Expand “Stop Work Authority” to include witnessing of harassment and bullying and enable anyone to call out unsafe processes and work with appropriate team members to create a safe condition.
5. Educate managers, supervisors and DPAs on the proper procedures to report incidents and support victims.
6. Educate responders on trauma-informed sexual assault investigation methods. Seek out professional training from the Rape Abuse and Incest National Network (RAINN) or other resources to understand how to deliver trauma informed care.
7. Ensure resources are available on board for assault victims. RAINN has a 24/7 hotline to offer confidential support services.
8. Ensure your medical officers are trained on how to respond to sexual assault and that the on-board medical kit is appropriately stocked with post-exposure prophylaxis medications. Some of the recommended medications and laboratory evaluations may not be available at sea.
9. Survey employees regularly on their impressions of the shipboard culture and prevalence of harassment and intimidation. Quantifying a problem is the first step to eliminating it. Regular employee surveys provide tangible metrics to evaluate if interventions are successful.

Let this be a call to action to safety and health professionals in the maritime industry. Now is the time to update or develop your sexual harassment prevention policy, develop and communicate a zero-tolerance culture for harassment and assault, enact mandatory anti-harassment and sexual assault prevention and response training, and put into place emergency response checklists and resources to respond to events at sea.

Taking a strong, proactive approach to building an anti-harassment and anti-assault culture will go a long way to removing the stigma around discussion of assault and improving safety culture. Once interventions are woven into the culture of an organization, they become second nature. For companies that would like assistance in creating anti-harassment and assault policies, RAINN offers consulting services.

A work environment that allows sexual intimidation or sexual assault affects everyone on board and poses a risk to the safe operation of a vessel. It is in everyone’s best interest to implement policies and procedures that will ensure continuous improvement in the industry’s prevention and management of sexual assault.

Dr. Ann Jarris is a maritime and remote medicine specialist based out of Seattle, WA. She has practiced as a physician for over 15 years in urban and remote settings. Her experience is in occupational, emergency, wilderness and virtual medicine. Dr. Jarris leads innovation and research efforts at Discovery Health MD as co-founder and CEO.