Remote area health care challenges E&P companies

Exploration and production projects in remote areas without medical infrastructure now demand a greater level of concern about health services from the international oil industry. Remote drill sites are often in regions with communicable and tropical diseases, poor sanitation, and poor water. But it is no longer a matter of protecting just expatriate and national employees from these hazards. Locals have begun to look to E&P operators for health-care services not otherwise available.

June 29, 1998

4 min read

Exploration and production projects in remote areas without medical infrastructure now demand a greater level of concern about health services from the international oil industry.

Remote drill sites are often in regions with communicable and tropical diseases, poor sanitation, and poor water. But it is no longer a matter of protecting just expatriate and national employees from these hazards. Locals have begun to look to E&P operators for health-care services not otherwise available.

The new problem, and other health management topics, were covered earlier this month at the Society of Petroleum Engineers international conference on health, safety, and the environment in Caracas (OGJ, June 22, 1998, Newsletter).

In some cases, mothers from nearby impoverished villages bring their sick or hurt children to a drilling rig or construction site for the western-level medical care that can be found there, administered by a skilled paramedic with access to bandages, medicines, antibiotics, and so-called telemedicine if necessary.

The questions E&P companies must ask are: How much health service can a project be expected to provide the indigenous community, and how can it be sustained?

Health services

Jerry G. Simpson, medical director of the Baylor College of Medicine occupational health program in Houston, pointed out that health conditions in most of the areas in which E&P companies operate do not meet acceptable global standards. He noted some sobering examples.

Malaria, he said, is the major cause of sickness and death in developing countries. It results in 1.5-2.7 million deaths/year (some estimates are as high as 5 million/year). About 30 million new cases of tuberculosis occur each year, causing 3 million deaths annually. And nearly 16,000 people are infected with human immunodeficiency virus (HIV) each day, with 40% of the new cases being women and 50% in the 15-24-year age group.

Health care is a worry for E&P workers and their families as the globalization of the industry accelerates. Simpson said remote health care issues have caused difficulty in recruiting qualified people for E&P projects, early returns from assignments, medical evacuations, disabilities, and even deaths.

There are E&P project managers, Simpson said, that want the health challenges to be dealt with quickly and easily. But E&P companies-particularly small to medium-sized ones-are especially affected by the cost of complex health needs because of the increased health risks that they face.

This puts tremendous demands on health services providers to manage comprehensively and effectively and provide high-quality health services.

Industry cooperatives

Confronted with bad water, poor sanitation, insect-borne diseases such a malaria, and communicable diseases such as tuberculosis and acquired immune deficiency syndrome (AIDS), operators have typically taken on the role of health care provider in remote locations, said Stuart R. McGill, president of Exxon Co. International. They have set up costly medical facilities to deliver care to their employees and families.

But, said McGill, "There is a significant shortcoming associated with this approach. It does nothing to build the local health care infrastructure and therefore is typically not sustainable."

McGill described Exxon's participation in health care programs in Sakhalin, Chad, and Cameroon, where it has operations.

He emphasized that the approaches taken by industry will facilitate health care development but will not take the place of government in developing adequate health care infrastructure.

The approach used at Sakhalin involves working with other companies in an industry cooperative. This cooperative, he said, has agreed on a strategic health plan and uses a single external health service provider to meet its near-term needs.

Industry's continuing role will be to facilitate the efforts of the health provider in working with the local health authorities to build their capabilities.

In Chad, he said, Exxon's approach will enable it to focus primarily on the health needs of the work force while strengthening existing systems in the surrounding communities through the assistance of local health organizations.

He said that the E&P companies will be launching an unprecedented HIV/ AIDS education and control program in Chad and Cameroon in partnership with local health organizations and governments.

"This approach recognizes that sustainable solutions do not rely solely on industry for implementation. It also reinforces the notion that government must shoulder ultimate responsibility for the welfare of the community," he said.

McGill proposed that industry work together to develop sustainable local health care capabilities.