A copy of an article which we wrote for an HS&E Magazine recently...

Duty of Care Overseas - New case revives an old issue

15 armed services personnel are taking legal action against the Ministry of
Defence (MoD) after they contracted malaria*. They allege they were not given
anti-malaria medication in sufficient time before their posting to west Africa.
One of the claimants is reported to have settled already.

The case is a reminder that employees can sue the UK parent company for
illnesses contracted overseas. Connelly set the precedent in 1994 when he sued
Rio Tinto for the throat cancer he believed had resulted from his work for (a
subsidiary of) the company in Namibia. The House of Lords found (1997) that
Connelley had the right to take the parent company to court in the UK. In his
dissenting judgement Lord Hoffman warned that "any multinational with its parent
company in England will [now] be liable to be sued here in respect of its
activities anywhere in the world".

The Law Lords made a similar decision affecting the rights of foreign workers in
1999 when they allowed a group claim brought by a number of South African
nationals against Cape (Asbestos) to be heard in the UK. Cape had hoped that
their lack of any continuing activity in South Africa would protect them from a
claim. Paradoxically, this may have been one of the issues which ensured the
success of the action.

Most companies would like to apply UK standards of health and safety overseas
but believe it would be logistically impossible or financially crippling.
Attaining western standards may be beyond the capability of many operations in
the developing world but basic standards are not difficult - or costly - to
achieve. Interventions with the greatest impact are invariably the simplest and
usually the least expensive. Overseas this usually means refocusing expenditure
away from the unnecessary treatment of coughs and colds and into basics such as
clean water, dependable medicines, and effective emergency response. At home it
the simplest - and most productive - steps are to rationalise medical
examinations for travellers and provide simple one day seminars on health
overseas. Medical kits - with prescription medications - can also be a cost
effective way of helping to ensure the health of employees abroad - as well as
preventing the sort of litigation faced by the MoD.


A structure for change:
1. Audit : There is no reason why health cannot be assessed in the same way as
any other area of industry - and with the same requirements for
cost-effectiveness.   Audits do not necessarily need to be carried out by a
doctor - experience in tropical medicine, industrial health and experience
overseas is more important than qualifications. The basics which need to be
looked at are:
  Emergency provision on site and locally
  Quality of medical care on site
  Safety of medical care - reuse of needles etc.
  Occupational health - putting in place basic health surveillance for
  Purity of water supplies
  Sanitation
  Control of disease vectors - especially mosquitoes
  On-going training support for health workers

2. Train and equip expatriate staff:
   The ideal is to hold health seminars for international staff covering all the
likely health issues they may come across overseas. A low cost alternative is to
leave it to the GP to cover the basics and give employees some written
information to back it up
  Issue all expatriate staff with medical kits. In many parts of the world
quality medicines may be difficult to find. Making sure that staff have supplies
of quality western drugs with them before their trip can save a business trip
from failure and - as the case against the MoD showed may save the company from
litigation


Medical Services Overseas Ltd.
42 Bloomsbury Street
London WC1B 3QJ
Tel. 00 44 207 299 4343

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www.mso-uk.com

 *The Times reported (5th February)