Screwed If By Sea

Cruise lines throw workers overboard when it comes to providing urgent medical care.

After the cruise line refused to pay for much of his medical treatment, McDonald sued Royal Caribbean and won an undisclosed amount. "I'm not rich," he says, smiling. "But I'm okay."

The papers he signed prevented him from staying in the U.S. legally -- and from having a seaman's visa, which would enable him to go back to work for another cruise line. Meanwhile, though, McDonald has become engaged to be married to a Haitian woman who resides in the U.S. and has applied for citizenship. McDonald is in the States illegally, working with an immigration lawyer to regain his legal status. "It doesn't look good because of the paper I signed," he says.


Cruise ships, with crew from around the world, are often registered outside the U.S., allowing South Florida-based companies such as Carnival Cruise Lines and Royal Caribbean International to skirt some U.S. labor laws (Legend of the Seas, for example, is registered in Liberia). The jurisdictional jumble -- foreign nationals working on ships registered abroad and often operating in international waters -- creates a legal gray area that can work to the detriment of employees.

There are few industry watchdogs; this is no surprise given the disparate ethnic groups that work on cruise liners, the transient nature of employment (contracts for a single cruise are not uncommon), and the constant movement of the ships themselves. But those who do keep an eye on corporations such as Carnival and Royal Caribbean say that employees, especially foreign-born employees, are being funneled to cheap doctors in the Caribbean who provide sometimes inadequate care for cut-rate prices.

"We hear about it all the time," says Scott Brady, an inspector with the International Transport Workers' Federation in Cape Canaveral. "A lot of people don't want to complain, because they want to keep their jobs. This line of work is the only hope for some of the poorer people from the Caribbean and from Eastern Europe, so they want to stay on with whatever company they're with. But you hear the horror stories." ITF doesn't keep any statistical data on health care for cruise line employees -- in fact, an exhaustive search conducted by New Times couldn't turn up a single advocacy group or agency that keeps comprehensive information on the subject.

"I can't prove anything, industry-wide, except that the cases keep coming in, and I see, one by one, instances where these companies are overlooking an obligation to provide quality medical care in order to save money," says Brett Rivkind, an attorney with the Miami firm Rivkind, Pedraza and Margulies. "We think it's cost-saving in terms of treatment, and also to avoid workers pursuing claims here in the U.S. They try to cover that up by saying öWe're sending them to their hometown,' as if there's sentimental value that counts for something."

Carnival settled such a case with Rivkind client Francisco Romero in August. "We had a case where a Carnival worker needed cataract surgery. He was using a Miami ophthalmologist, and the cruise line said, öNo, no, we want to send him home to Honduras,'" Rivkind recounts. "The ophthalmologist in Honduras had just had a baby, and her husband was studying to be an ophthalmologist, so she just let him do the surgery." Fifty-year-old Romero, a long-time Carnival employee, lost his eye in 2000, and filed suit in June 2001. Carnival fought the suit for more than two years. "It's not enough they let this happen, when they could easily have gotten him a good surgeon in the U.S., but then they fought us tooth and nail when he tried to get compensation," Rivkind says. The settlement included a nondisclosure clause, so he can't reveal the amount Carnival paid Romero.

"These companies are making decisions regarding crew members' medical conditions on a legal basis and a financial basis, rather than a medical basis," Rivkind avers.

U.S. immigration policy makes it easier to send foreign-born crew members to second-rate doctors in Third World countries, according to Rivkind and others. Foreign-born crew members need medical visas to receive treatment on U.S. soil. Medical visas are usually good for 30 days, and if a crew member needs an extension, the employer must produce documented proof of the need for further treatment. In some cases, Homeland Security requires that the crew member be produced in person. This arrangement can work out to the employers' advantage if the crew member is fighting to receive medical treatment in the U.S. "Look, it's impossible to prove collusion," says Rivkind. "But I've had calls from these companies saying, öYeah, sure, we'll get him the treatment he needs, but we have to produce him for an immigration hearing first, so he can stay in the country. It won't be a problem.' Next thing I know, the guy's being shipped home where he's likely to get god-only-knows what kind of care."


Royal Caribbean officials deny taking advantage of crew members. Blackwell, the crew medical manager, says that Royal Caribbean employs about 36,000 people, and takes good care of the 400 or so on medical leave around the world at any given time. But, he says, the company has to follow immigration rules. In the U.S., medical parole for foreign-born crew members is difficult to arrange since September 11, 2001 (Department of Homeland Security officials did not return phone calls asking about interaction with cruise lines).

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