PEME, Ready ka na ba?

Sample of a Medical Certificate

It does sounds like pabebe but there is nothing pabebe with PEME (Pre-Employment Medical Examination). You might have the skills and the voluminous training certificates tuck under your belt but if you are not going to pass PEME, then forget going abroad. Both aspiring and seasoned seafarers undergo PEME. For the first timers, it is the last hurdle to pass that can make or break your dreams: that of earning dollars and traveling to different parts of the world. And of course, you still have to pass through a bullet free Ninoy Aquino International Airport (NAIA) but that’s another story.

So what preparations should you do to pass PEME?

Fresh maritime graduates are mostly young and healthy people, thus, they do not have much of medical issues yet. I just hope you were checked for Ishihara Test for color-blindness before you started your maritime academic schooling because it will save you money, heartaches and depression. A very good friend of mine when we started as cadets carried lots of coins “barya” on his pockets before stepping on the weighing scale. It adds more kilos to his weight. He was underweight then. If you are underweight and you will have your medical exam soon… that is an option, hehehe.


Suggestion: If you are wearing eyeglasses, you need to bring at least 2 pairs onboard, masira o mahulog man sa dagat yung isa, may reserba ka pa.

Para sa mga datihan nang sumasakay, kung plano mong magbakasyon ng tatlong buwan, may 2 o 3 tatlong linggo ka na kumain at uminom ng gusto mo. Pagkatapos nun, maghigpit ka na ng sinturon. Dahil baka kapusin ka na sa budget, mag dieta ka na rin. Isama mo na rin buong pamilya mo. Tama na ang painom at fiestang kainan.  It is time to get medically fit once again.

Actually according to what I’ve read, which I can no longer remember where and when, you need at least 2 months to prepare to be PEME-ready. (Three-month vacation then 2 months preparation for PEME?! ) Kill joy (KJ) ko naman, alam kong hihirit ka kaya, sige 2 weeks prep(aration) na lang. Hopefully by that time, no more birthdays, fiestas and tambay sa kanto that will call you for a shot or two that will end up inumang magdamagan.

Give your liver a break! Isama mo na rin mga baga mo at buong katawan sa masasamang bisyo.

Sure it is your money (kung ikaw ang taya sa inuman, yung iba kasi malakas sa inuman at pulutan pero sagot lang ay pagiging bangka sa kwentuhan) that you are spending for those vices but that money and time spent with your katomas should be better well spent with your family. Ilang buwan ka na nga lang nagbakasyon barkada pa uunahin mo. Tubig at tsaa inumin mo bro.

Bawas-bawasin din ang yosi kung hindi mo kayang mag totally quit. Let your lungs heal faster by lessening your sunog baga habit. Mahirap sumabit sa X-ray, ikaw rin.

Eat natural and healthy food

Avoid junk and processed food. Instead of eating potato chips eat sweet potato instead. Huwag naman yung camote que na sobrang daming asukal. Nilagang kamote ang ipalit mo sa puting kanin na kinakain mo.  If you can’t live without rice, switch to brown rice instead of camote or white rice. Samahan mo na rin ng prutas at gulay para panlinis sa bituka. If you are too bloody lazy to chew your food, put it in a blender and gulp it! Wala ka ng rason para hindi kumain, este lumunok ng gulay at prutas. Parang Reboot ba ni Joe Cross (Fat, Sick and Nearly Dead).

Dahil thuma-thunderbolts na ang lolo (getting older) ka na, hinay hinay sa fatty and salty foods. Go for lean meat. Isaw, kwek-kwek, one day old chick, PAL, Adidas at iba pang street food na hindi kasama sa lean meat category kahit na sabihin mo pang pagkanipis nipis ng hiwa ng karne ng baboy na tinuhog for barbeque.  Iwas parekoy sa Hepatitis B, ikaw na lang gumawa ng sarili mong sawsawan kung hindi mo maiwasan bumili at kumain ng mga yun.

Sabi rin ng nabasa ko, taba ang nagbibigay ng lasa sa karne kaya pag lean meat ang kakainin mo lagyan mo ng herbs and spices para magkaroon ng lasa. Hindi naman kailangang magpagutom ka para lang makapasa sa PEME. There are many cookbooks that you can use as references for different healthy recipes or you can ask a nutritionist or if you can afford… hire a chef!

If you have weight issue, don’t worry you are not alone. You need cardio and strength training. Get your ass off that chair and start moving. Pag sinabing weight issues, bakit ang unang papasok sa utak ay overweight? Weight issue rin naman ang pagiging patpatin, hindi po ba? Nakakapagod at nakakagutom ang mag exercise ba kamo. Natural!!!

If you reach a certain age, you will need to pass stress-test which mean you need to spend at least 10 minutes on the treadmill. If you can do brisk walking, jumping jack and a little bit of jogging 20 minutes daily for two weeks before your PEME, that will suffice but if you need to lose weight, sad to say, you need to give more effort. Add strength training to burn more calories. Start with the basic, use your body weight. You can do plank, push up, chin up, tricep dip and squat then you can start adding bench press and other exercises with free weights. Don’t procrastinate on exercise kasi if you cannot find 20 minutes today, how sure are you that makakabawi ka at mag e-exercise ka ng 40 minutes kinabukasan?

Push Up Level of Fitness

  Age     Excellent     Average     Poor
20-29      54              35-44         20
30-39      44              25-34         15
40-49      39              20-29         12
50-59      34              15-24           8

I’m not an exercise expert. Just find physical activities that you enjoy like swimming, biking, hiking, mountain climbing or even working in your vegetable garden. Pwede ka ring maglampaso ng sahig gamit ang bunot at maglaba ng mga damit, mag plantsa, magbuhat ng timba na may lamang tubig para magdilig ng mga halaman at iba pang gawaing bahay. Otherwise if you have the budget enroll in a gym or invest in some gym equipments, pwede rin.

Have your prophylaxis done

Ano raw? Ibig kong sabihin, pumunta ka sa dentista at magpalinis ka ng ngipin. Pa pasta mo na rin yung mga dapat pastahan o pabunot ang dapat pabunot. Ask for a dental certificate before you leave your family dental office, you will need it to show to the medical clinic dentist. I suggest do your dental treatment a day before your PEME (at least a week or two kung may bunot para healed na at least).

Go and Donate Blood

Kumain ka na kamo ng kilo-kilong bawang.  One of the best ways to lower your blood cholesterol level and to renew the blood in your circulatory system is to donate blood. Nabawasan na ang cholesterol mo sa dugo, nakatulong ka pa sa nangngangailangan ng dugo. That is if you forego eating cholesterol rich foods from the previous weeks. Wa effect kung ang huling hapunan mo bago ka mag PEME ay bulalo at pinakbet na maraming sahog na bagnet (chicaron ng Ilocos)! Sigurado akong sasabit ka sa PEME. Nangyari na sa akin yun eh. So go pa-member na at maging donor sa Red Cross.


Fasting

May kadete akong kasama, tinanong siya ng nurse kung nag fasting ba siya bago pumunta sa medical clinic. Sumagot siya ng alanganing “Oo”.  Tinanong siya ng nurse, “Alam mo ba ang ibig sabihin ng fasting?” Sagot si cadet, “Hindi”. Nagalit daw ang nurse sa kanya, hahaha.

Ano nga ba ang fasting?

Yung iba nag a-after 6 diet. Hindi na sila kumakain pag nag 6 pm na. The logic is that physical activities after 6 pm don’t need further food sustenance. (Sampol: Pagkatapos mong makipagbalyahan para makasakay, na traffic ka, so nakaupo ka lang o kaya pag minalas-malas ka nakatayo ka sa MRT o bus).  Ewan ko kung effective ba ang after 6 diet kasi pag sa nagreport ka lalo na kung ang office ng crewing agency mo ay sa bandang Makati, mga after 8 pm ka na makakarating pauwi ng bahay. Sa PEME naman pagsinabihan ka na No Oral after 7 pm, hindi ka dapat kumain o uminom pag 7 pm hanggang kinabukasan ng umaga na makunan ka ng blood sample. Fasting ang tawag dun. Hindi po yun pag mamadali na maka-pumunta sa medical clinic, hindi fast-ing yun, hurrying yun (corny ko.)

Stool sample (Pasintabi po – NSWE – not safe when eating)

Merong nabibili sa mga drugstores na stool sample bottle (or container). Ang stool sample na ipapasa mo sa medical clinic ay pea size lang dapat. Ibig sabihin kasing laki lang ng monggo. Hindi dapat punuin yung lagayan. Yucky yung iba, sobrang dami ang dalang sample.  Meron akong kakilala, para makatipid sa lagayan pinaghalo nya ang ang stool at urine sample nya. (Don’t do that or else your sample will be rejected).

Sleep

Get enough sleep. One medical clinic prescribed to take 3 tablets of laxative the night before PEME. The purpose is to clean the digestive system. Dahil masunurin ako at first time ko sa medical clinic na ito, sinunod ko naman. First and last ko na yung gagawin. Why? I lose precious nap time because I keep going back and forth to the toilet. Hindi tuloy ako nakatulog ng maayos. (Note: Lack of sleep can raise your Blood Pressure). Sino kayang henyo ang nakapag-isip nun? Na-try nya kaya yung prescribe nya?

Be Ready for Psych Test

First thing they going to ask you when you will go for a Psych Test is if you ate already. Magtataka ka tuloy kung ano ang relasyon ng isasagot mo sa Psych Test sa pagkalam ng sikmura mo? Aba pag gutom ka, magmamadali kang sagutin ang mga tanong, pero kapag busog ka eh makapag iisip ka ng maayos. Ayus- ayusin mo rin ang pagsagot sa test at pag-drawing mo, bawal ang stickman at yung kulang kulang ang mga daliri sa mga kamay, walang tenga, etc.  Dapat kumpleto ang external body parts. Kwento ni Third Mate Richard Enriquez, noong nag pa PEME siya, Psych Test lang ang naipasa nya. Sagot naman ng isang kasama namin dito sa barko, “Mas mabuti na yun kaysa naipasa mo lahat tapos sa Psych Test ka bumagsak!” May tama ka!

There are some (unscrupulous) medical clinics that will say you have high blood pressure (BP). But everything will be okay after buying a month supply of medicines from them. So, you just need to show the receipt that you already bought those medications from their own pharmacy, okey na blood pressure mo (sana lang hindi ka na high blood sa inis sa kanilang panloloko).

Yung iba namang clinics, hahanapan ka talaga ng sakit. So tendency mo magpapa-second opinion ka sa ibang doctor. Pero no bearing at di nila accepted yun kung ang result ay taliwas sa kanilang diagnosis, ang rason nila hindi naman daw approved ng association at medical clinic nila yung doctor na pinuntahan mo. Mapapakamot ulo ka na lang at tatanunggin ang sarili mo, “Hindi ba lahat ng certified doctors ay members ng Philippine Medical Association (PMA)?“

Marami pang ibang diskarte para kumita sila sa mga mandaragat pero ayokong tumaas ang BP mo sa pagbasa ng sinulat ko, kaya, relax and enjoy your PEME. Go through the experience. Pero sana lang tignan ito ng ating mga mambabatas at mga nakaupo sa DOH. Kung yung mga nagpapamedical na mga OFWs papunta ng Saudi at Middle East napatigil ng pamahalaan ang monopolyo at decking system ng mga clinic ng Gulf Cooperation Council (GCC) Approved Medical Centers Association  (GAMCA), sana lang tignan din ang hindi magandang kalakaran at pang-aabuso na ginagawa ng nga medical clinics sa aming mga seafarers.


Sample of  PEME Package offered by clinics and required by some manning agencies:

1. Complete Physical Examination
2. Psychological Examination/Test
3. Optical test and Visual acuity
4. Dental Examination
5. Urinalysis
6. Chest x-ray
7. Fecalysis
8. Complete blood count (CBC)
9. Blood typing
10.Color vision (Ishihara Test for color-blindness)
11. Audiometry
12. Electrocardiogram (ECG)
13. Fasting blood sugar
14. Hepatitis B Antigen
15. VDRL
16. Pulmonary Function Test (PFT)
17. Erythrocyte Sedimentation Rate (ESR)
18. Blood Chemistry (SGOT(AST) / SGPT(ALT) / Alkaine phosphatase / Bilirubin / Total Protein BUN / Creatinine Cholesterol / Tryglycerides / Uric acid)

Other Additional Tests:
1. HIV
2. Malaria Test
3. Drug & Alcohol Test
4. Stool Culture


List of Accredited Medical Facilities for Overseas Workers and Seafarers

Department of Health (as of May 20, 2015, check POEA website for new/updated list)
http://poea.gov.ph/ofw/ofw_clinic_may202015.pdf


Dagdag kaalaman.

Check your Medical Certificate for Service At Sea. It should contain information as per Standard of Training, Certification and Watchkeeping for Seafarers (STCW) Code, Section A-I/9 Medical Standards

7.3 Declaration of the recognized medical practitioner
7.3.1 Confirmation that the identification documents where checked at the point of examination: Y/N
7.3.2 Hearing meets the standards in section A-I/9? Y/N
7.3.3 Unaided hearing satisfactory? Y/N
7.3.4 Visual acuity meets standards in section A-I/9? Y/N
7.3.5 Colour vision meets standards in section A-I/9? Y/N
          7.3.5.1 Date of last colour vision test
7.3.6 Fitness for lookout duties? Y/N
7.3.7 No limitations or restrictions on fitness? Y/N (If ‘N” specify limitations or restrictions.)
7.3.8 Is the seafarer free from any medical condition likely to be aggravated by service at sea or to render the seafarer unfit for such service or to endanger the health of other persons on board? Y/N
7.3.9 Date of examination: (day/month/year)
7.3.10 Expiry date of certificate : (day/month/year)

4. Details of the issuing authority
4.1 Official stamp (including name) of the issuing authority
4.2 Signature of the authorized person

5. Seafarer’s signature- confirming that the seafarer has been informed of the content of the certificate and of the right to a review in accordance with paragraph 6 of section A-I/9.

Bago ka pumirma nakasulat doon

I have read and understood and was informed of the contents of the certificate and of the right to review in accordance with paragraph 6 of section A-I/9 of the STCW Code.

Ano ba yung paragraph 6 of section A-I/9 of the STCW Code? Standard of Training, Certification and Watchkeeping for Seafarers (STCW) Code, Section A- I/9 Medical Standards

Paragraph 6. Each Party shall establish processes and procedures to enable seafarers who, after examination, do not meet the medical fitness standards or have had a limitation imposed on their ability to work, in particular with respect to time, field of work or trading area, to have their case reviewed in line with the Party’s provisions for appeal.

source -http://www.evergreenmdc.com/images/peme.png

Ayon naman pala, pwede kang umapela kung may sabit ka sa medical. Pagkailangan ng gamutan pero kailangan mo ng sumampa, papaprimahan ka ng waiver.

Balitaan mo ako kung pumasa ka na sa medical exam mo, ha.


Disclaimer: The author of the article is an active seafarer and has no formal qualification in the medical profession. Views expressed are based on his own experience and that of others. The author shall not warrant or assume any legal liability or responsibility for the accuracy, completeness, or usefulness of any information provided herein. He may be reached through his email at pinoyseafarerako@gmail.com. You can also join the discussion by leaving your comments below.

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