Navigating Health at Sea: A Comparative Review of Seafarers’ Wellbeing and Healthcare Access in the Cruise and Cargo Sectors (2023–2024)

The wellbeing of seafarers is the chief concern for those working in maritime ministry and shore-based seafarers’ welfare. An ambitious research initiative led by Professor Helen Sampson and her team at the Seafarers International Research Centre (SIRC), Cardiff University, shed important light on the current state of seafarers’ health across both the cruise and cargo sectors. Four interconnected reports published in May 2025 and funded by Stiftelsen Sveriges Sjömanshus and the Sjöbefälsföreningen, combined the results of over 2,200 questionnaires and 200 interviews with seafarers to investigate their experiences of accessing medical care, mental health challenges, sleep deprivation, and their ability to take shore leave. Published online and widely circulated among maritime welfare networks, this research offers a rare and detailed comparison of the cargo and cruise industries from the seafarers’ perspective. For those in seafarers’ welfare—especially those who advocate on behalf of crew members in port—the findings offer both encouragement and cause for renewed advocacy.

The research confirms that many seafarers are taking positive steps to improve their personal health. As the authors note, “Seafarers in 2024 smoked less, consumed alcohol less frequently, and in smaller quantities, and ate fried food less often than they did in 2011 or 2016.” In the cargo sector, 60% of those surveyed said they never drank alcohol at sea, a significant increase from earlier years. This growing health consciousness was matched by a greater awareness among seafarers of the importance of staying fit for duty. Yet, despite these improvements, the reports also point to stark differences in the support structures available to cruise and cargo seafarers, especially when it comes to food provision, rest, medical care, and access to the shore. Cargo workers in particular expressed frustration with the lack of fresh produce, describing how “insufficient provisions in terms of fruit and vegetables and of poor food preparation on board” meant that their diets were consistently worse at sea than at home. Cruise ship workers, by contrast, were more likely to agree that they could “eat as much fruit and vegetables as I want.”

Sleep deprivation and chronic fatigue were another recurring theme, particularly among cargo seafarers working with small crews. As one Georgian second officer put it, “Over fatigue is not exception, it’s like normal… I never get enough sleep, during cargo operations or whatever, and yes, it’s normal.” Such exhaustion was not limited to emergencies or isolated incidents; it was woven into the fabric of daily working life. Officers in both sectors—especially on cargo ships—described round-the-clock operations during port calls, ship-to-ship transfers, or cargo loading, with no opportunity to recover. These conditions were found to correlate with short-term anxiety and depression, with more than 40% of senior officers in the cargo sector reporting symptoms of mental distress in 2024. The study also found that incidents of sexual harassment and assault remain underreported, often due to fear of retaliation, disbelief, or losing one’s job.

Of particular importance to shore-based welfare organizations was the extensive attention paid to the issue of shore leave. The study found that shore leave is “very much needed” by seafarers and functions as a key protective factor for mental and emotional health. “When I do shore leave, I feel like I regain my strength,” said one cruise catering worker. “Even if you don’t buy anything, you just go out, use the internet outside. It feels different when you are outside.” Another seafarer linked his recent health issues to the inability to leave the ship, explaining, “I tell you, if you can’t do shore leave, it feels different, it does something to your brain.” A cruise manager likewise emphasized the health benefits of getting off the ship: “Even a 30 minute walk outside would make a big difference… it makes a difference going out.”

Unfortunately, the ability to take shore leave remains severely limited in the cargo sector. The research showed that while 84% of cruise workers had taken shore leave in the previous two weeks, only 42% of cargo workers had done the same. Fifteen percent of cargo seafarers reported having had no shore leave for 43 days or more. Several explained that the vessels they worked on—particularly VLCCs and tankers—almost never came alongside, making disembarkation impossible: “VLCC no shore leave.” Others pointed to port-specific immigration rules or political tensions between countries that barred them from disembarking. A Pakistani captain explained, “If you are Pakistani and you are going to discharge cargo in India you won’t be allowed to go out because of the political tension out there.” Even when ships were anchored close to shore, shore leave was often blocked by company unwillingness to pay for launch services. As one third officer recounted, “The vessel will stay, for example in anchor two days… The company won’t pay for… the boat who will take you from vessel to the port.”

The publication of these findings comes just after the 2025 amendments to the Maritime Labour Convention (MLC), which now affirm that seafarers “shall be allowed shore leave to benefit their health and well-being, consistent with the operational requirements of their positions.” The amendments further state that “shipowners shall allow shore leave to seafarers when off duty, upon the ship’s arrival in port, except when leaving the ship is prohibited or restricted by relevant authorities.” While these changes are a welcome recognition of the problem, the study’s authors argue they still fall short. “The 2025 MLC amendments stop short of requiring companies to organise or pay for transportation to facilitate seafarers’ shore leave,” they note. For welfare advocates, this gap between principle and practice highlights the need for continued pressure on both flag states and companies. The study concludes that “to make sure that cargo seafarers do not spend their entire contracts confined on board their vessel, a means needs to be found to address the issue of companies saving money by not paying for launch services from anchorages.”

Finally, the study reflects on the wider economic realities that prevent meaningful reform. The authors observe that “finance, profit and competition between companies is invariably cited as a reason for inaction, or worse still for cutting the existing resources… that support seafarers’ health and wellbeing.” And yet, they suggest, in an era where fuel taxes or consumer tariffs are accepted for environmental or political goals, the marginal cost of improving seafarers’ health support should not be seen as prohibitive. Improvements that fulfill the promise of the MLC to ensure “healthcare for seafarers as comparable as possible to that which is generally available to workers ashore” are long overdue. For those who work alongside seafarers in ports, this research provides the data, testimonies, and international standards to continue making the case for dignity, access, and care for all who serve at sea.

Links to these reports and similar research are found on the NAMMA research bibliography.