Posted by By Darrell Nicholson at 01:21PM - Comments: (14)
The story of the rescue of a sick 1-year-old girl, her parents, and toddler sister from aboard the boat Rebel Heart last week provoked a storm of controversy over whether ocean voyaging with young children is sensible. The Kaufman family of four was pulled from their boat about 900 miles off the coast of Mexico, when the youngest child, Lyra, 1, was covered in a rash and had a fever.
Although my wife, Theresa, and I made a conscious decision after 10 years of living aboard to move ashore to have children, I have known many cruisers who have raised their children aboard. In every case, their own lives and the lives of their children have been richer because of this experience.
What interested me most about the Rebel Heart story were the practical matters. Would it have been possible to treat this infant at sea? Should we be prepared for these types of emergencies—particularly those of us sailing with vulnerable crew, be they the young or the old. (See my recent column about the experiences of the crew aboard Corsair.) Like many cruisers I know, my most frightening experiences while cruising had nothing to do with storms or pirates, or all the imagined threats that landlubbers conjure up. They were health related—severe skin infections, venomous fish, dengue fever, debilitating gastrointestinal illnesses, you name it. Tropical paradises, people often forget, is rife with tropical diseases.
The March and April 2014 issues of Practical Sailor addressed a growing trend in health at sea, the use of telemedicine services to treat onboard illnesses remotely, and the growing number of private air-ambulance services to rescue people in remote places. Although it is unlikely that the family’s rescue would have gone differently had they subscribed to an air-ambulance service (none of the services we polled are equipped to manage such a complicated at-sea rescue), a subscription with one of the telemedicine services we profiled might have allowed the Kaufman’s to treat their daughter on board and keep their boat. (Ultimately, the U.S. Navy scuttled Rebel Heart, so it would not be a navigational hazard.)
One of the reasons that Theresa and I chose not to have and raise children aboard our boat were our own dicey experiences with illness in the tropics. (Our threadbare, vagabond lifestyle at the time raised other salient concerns, as Theresa put it—“I’m not giving birth in the forepeak!”) But if we had decided to cruise with young children, we would have likely avoided long passages and kept pediatric care within close reach. If we had decided to embark on longer passages such as the Kaufman’s into the Pacific, I would have likely invested in satcom equipment (as the Kaufman’s did) and subscribed to one of the telemedicine services offered today. But there are other, more affordable options.
One of the biggest benefits of telemedical services is the pre-departure consultation, which ensures that you have pharmaceuticals and first-aid tools on board to treat the most likely ailments. You don’t have to be a subscriber to benefit from this pre-departure advice. It can be a one-time consultation.
This is the path we took before we set out. Before our own departure, we paid a private physician who specialized in tropical diseases to consult us on equipping our first-aid kit, which included several courses of antibiotics of different types. He and my father, who is a physician, also helped us build a library of books on board for treating illnesses, and provided specific guidance on the use of the medications we had. For non-prescription supplies, we looked at various commercial kits and built our own based on their contents. Our December 2008 issue profiled Practical Sailor's favorite pre-packaged medical kits for voyagers.
Fortunately, when the most serious illness struck Theresa (dengue fever), we were near an island clinic, but even then, the only thing that the doctors could do was diagnose the problem and prescribe an anti-nausea pill that we did not stock (but soon did). Ultimately, I was the one who treated her using our own medicines to control fever and ensure that she remained hydrated.
The bottom line is that when you do decide to embark on a more prolonged cruise, you will almost surely find yourself in a situation where you have to be your own doctor, if only temporarily. Like storms and squalls and reefs, illness is something we should try to prepare for as much as possible. Though it is reassuring that such rescues at sea are possible in worst-case situations like the Kaufman’s, it would be wrong (and potentially fatal) to embark on any cruise without making our own health and the health of our crew a top priority.
As an update to this story, the Kaufman's did have a satellite phone on board, and, apparently, the medication required to treat their sick child. However, it appears the satellite phone did not work. The Kaufman's filed a lawsuit against the service provider earlier this year.
Editor's note: For those inclined to donate, a fundraising site has been set up to help the Kaufman family.