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THE SINKING OF THE DOA PAZ A CRITIQUE

ON MARITIME DISASTER PREPAREDNESS IN
THE
PHILIPPINES: II. Policy implications
Article in Acta medica Philippina March 2011

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ORIGINAL
ARTICLE
The Sinking of the MV Doa Paz II. Policy implications
CASE REPORT

The Sinking of the MV Doa Paz A Critique on Maritime Disaster

Preparedness in the Philippines: Policy Implications
Anthony R. Perez,1 Carl Abelardo T. Antonio2 and Rafael J. Consunji3,4
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery,
College of Medicine and Philippine General Hospital, University of the Philippines
Manila
2
Pasay City Health Office
3
Division of Surgical Critical Care and Trauma, Department of Surgery,
College of Medicine and Philippine General Hospital, University of the Philippines
Manila 4Study Group on Injury Prevention and Control, National Institutes of Health,
University of the Philippines Manila
1

ABSTRA
CT
Objective. To discuss the various factors contributory
to maritime disaster preparedness in the Philippines,
in the context of the sinking of the MV Doa Paz and
formulate recommendations to address these
factors.
Method. Review of the state of maritime
preparedness in the pre-disaster setting and the
post-disaster response following the sinking of the
MV Doa Paz by the government and responsible
agencies. A scrutiny of the state of preparedness of
concerned agencies and subsequent response to the
disaster
was conducted with the objective of
formulating recommendations which may lead to
prevention and mitigate loss of lives.

Corresponding author: Anthony R.

Perez, MD Department of Surgery
Philippine General Hospital
University of the Philippines
Manila
Taft Avenue, Ermita, Manila 1000
Philippines Telephone: +639209703622
Email: [email protected]

Results. Multiple factors accounted for the

occurrence of this tragedy. These factors include an
inherent risk due to the geography of shipping lanes
in the Philippines, the economic problems besetting
the shipping industry and its labor force. Economic
conditions prevent both the industry and government
agencies
from
upgrading
vessels
and
communications equipment. Lack of enforcement of
existing regulations allows vessels to sail overloaded
and at times manned by less-than- qualified crew.
Delayed response and deficient post-disaster medical
response may have led to a disproportionately high
mortality.

VOL. 45 NO. 3 2011

ACTA MEDICA PHILIPPINA

Conclusions. The systems inadequacies

of
the
Philippine maritime disaster response mechanism are
highlighted by the Doa Paz tragedy. Many of the factors
contributing to the disproportionately high incidence of
maritime disasters in the Philippines and the resulting
loss of limb may be preventable. Recommendations on
regulation and enforcement, disaster preparedness,
search and rescue, and medical response are discussed.
Key Words: drowning, Philippines, maritime industry,
disaster response, disaster preparedness
Introduction
Maritime travel is a major mode of transport between the
Philippines more than 7,000 islands, owing primarily to its low
cost. Regulation of this industry, however, appears to be
inconsistent at best, as can be gleaned from the numerous
maritime disasters and sinkings in the history of the Philippine
domestic shipping industry, the worst of which was the sinking
of the MV Doa Paz in 1987, claiming the lives of more than 4,000
people.

The first paper in this series dissected the events before,

during and after the sinking of the Doa Paz, discussing
existing maritime industry regulations and the response
evoked by the disaster, both in the immediate and long-term
periods (Table 1). The policy implications of these with
respect to prevention, rescue, and emergency medical
response are the focus of the second paper in this series.
Methods
References1,2,3 dealing with disaster management and
disaster preparedness were used as bases for the analysis of
the pre-disaster, disaster and post disaster events. The 1st
cited reference recommends an analysis of physical factors
(vessel, equipment and crew) which may have been relevant
to the occurrence of the event. Emphasis will be placed on
factors contributing to the occurrence of the event in the
hope of primary prevention. The 2 nd cited reference

was

used to identify existing systems in the local setting

established for disaster preparedness and response. Factors

ACTA MEDICA PHILIPPINA

VOL. 45 NO. 3 2011

The Sinking of the MV Doa Paz II. Policy implications

Table 1. The Haddon Phase-Factor Matrix

Human Individual
Carrier
Pre-Event
(Will an injurious event
occur?)

Event (Collision)
(Will an injury occur?)

Post-Event
(Post-event, what will
the outcome be?)

Agent and

Qualification of vessel
crew (i.e. license, training)
Passenger density
(overloading and
overcrowding)
Capability of passengers
to swim

Seaworthiness of
maritime vessels:
Navigational (radar,
rudder) and
communications (radio)
equipment.

Number and location of

passengers
Crew state of inebriation
during the event, training
Ability to swim
Crews ability of provide
at least basic life support

Flammability of vessel
cargo

Environment
Physical
Social
Gangway obstruction
Lax enforcement of
Passenger density
maritime regulations (i.e.
Frequent typhoons along
passenger load, nonshipping lanes
sailing of vessels found
Inconsistent weather
unseawoarthy)
reports
Lack of government
Inadequate or nonsupport to the shipping
functional navigational
industry (i.e. low budget
aides (i.e. buoys,
allocation for Coast
lighthouses)
Guard rescue
equipment).
High coast of
refleeting/purchase
of new vessels
No safety culture (preboarding safety and
security instructions
ignored, passengers
purchasing tickets from
scalpers)

Life preservers in locked

in cabinets
Sprinkler system in ships
present and working
Burning seas
Inadequate, and late,
disaster response (i.e.
organized search and
rescue team, on-site
emergency care,
on0shore triage,
transport from shore to

Minimal or no penalties
for ship owners for
violation of maritime
regulations

proper hospital)
Source: Haddon W. Jr. The changing approach to epidemiology, prevention and amelioration of trauma: the transition to approaches etiologically rather than descriptively based.
Am J Public Health Nations Health. 1968 Aug;58(8):1431-8.

contributing to the immense loss of lives will likewise be

there were 80 collisions, 177 sinkings and 53 shipboard fires

analyzed to minimize loss of lives in similar events in the

resulting in the deaths of more than 4,000 people.

future (secondary prevention). Equal emphasis will be

A lot of factors will account for this dismal record, and

placed in the medical care of casualties, both in addressing

many of these can be corrected. The geography and location of

actual medical problems and in prevention of further injury

the Philippines within the typhoon belt and frequent but

and possible sequelae (tertiary prevention).

difficult to predict tropical storms puts its domestic maritime

Results and Discussion

The sinking of the Titanic pales in comparison to the
tragedy that is the MV Doa Paz, and yet the history of the
maritime industry in the Philippines is notable for numerous
mishaps, and this tragedy is but a footnote in a long litany of
misfortunes. In fact, from 1972 to the time of the Doa Paz,

The Sinking of the MV Doa Paz II. Policy implications

Both vessels, the Doa Paz and the MT Vector, were

vessels at significantly increased risk of storm damage,

vessel grounding, overturning or outright sinking.

definitely not state of the art ships. Steel-hulled ships in the

The majority of navigational aids, including buoys and

Philippines average 22 years of age. The Doa Paz was 24

non-

years old at the time of the accident. 4 Though it is easy to

functioning or defective. Correcting these will require an

recommend that only new, seaworthy ships should be

increase in budgetary allocation of the Coast Guard, which

allowed to carry cargo and passengers, the Conference of

sorely lacks ships and equipment not only for patrolling

Interisland

the seas but for mounting search and rescue operations as

immediately contend that the poor economic conditions in

well.1

the country, in addition to the high tariffs imposed on them,

lighthouses

in

the

Philippines

are

obsolete,

Shipowners

and

Operators

(CISO)

will

will render refleeting with new ships impractical from an

economic and return-on-investment (ROI) standpoint.

Poor communication systems have often figured in

previous sea disasters. Not only does this hamper
communications between ships, this also delays the
emergency response to disasters when they occur.

Unfortunately,

the

consequences

passengers are uniformly fatal.

for

the

unknowing

Although the role of human error in the occurrence of

this particular catastrophe is debatable, prevention of future

The National Telecommunications Commission (NTC)

mishaps will definitely involve the people riding these vessels,

has difficulty going after ships without functional radio

both crew and passengers. Coast Guard Chief Commodore

equipments. A 1988 NTC report cited inadequately trained

Carlos Agustin and the CISO agreed that at least 80 percent of

personnel, underequipped radio monitoring stations and

all sea accidents between 1984 and 1990 involved human error

lack of police power to implement radio laws. The lack of

and the limited competence of crewmen. A study of the

communication compounded the problems from the time

Maritime Industry Authority

the two ships sailed to the time the last survivor was
rescued.5
Another practice that frequently compounds loss of
lives during sea mishaps is overloading. Overloading occurs
due to laxity on the part of those tasked to enforce
regulations and the ship-owners desire for profit. Coast
Guard officials are required by law to inspect all ships before
they sail. Unfortunately, even some Coast Guard personnel
acknowledge that corruption at times causes officials to turn
a blind eye to overloading. Some bend rules to allow as
many passengers as possible. Ship personnel allow children
to board without listing them in the manifest. Passengers
boarding without tickets are allowed to pay personnel
selling unregistered tickets on the ship. It is no surprise that
the Doa Paz may have been carrying 4,000 people when it
sank that fateful night.1
The Coast Guard is tasked to inspect the ships and attest
to their seaworthiness and to make sure they are not
overloaded. It was remiss in all its duties in the case of the
Doa Paz. It was allowed to sail grossly overloaded, with an
expired

certificate

of

inspection

and

with

defective

communications equipment. Unfortunately, the impact of

law enforcement is only as strong as the law itself. The
biggest fine that can be imposed on a ship-owner for sailing
an unregistered vessel is 1,000 pesos. The maximum fine for
sailing without a valid inspection certificate is 200 pesos. The
fine for overloading is 100 pesos for every passenger in
excess of the authorized capacity. A Navy Coast Guard
commander admitted that they allow as many passengers as
possible for as long as the water does not reach the loadline
mark, a line along a vessels hull which drops below water
level when a ship is overloaded. It becomes clear that even if
the laws are strictly imposed, ship-owners can clearly get
away with violations with minimal consequences to them.

(MARINA) by the Barlindhaug Og Fuglum A/S of Norway

and overcrowding can be avoided. Attention must be given

supports this observation. Of the 27 maritime schools in the

to pre-boarding safety and security instructions, commonly

country, most are ill-equipped and use substandard

ignored in the mayhem of trying to find comfortable spaces

teaching methods to instruct the thousands of ill-prepared

in the crowded ships. A culture that puts a premium on safe

seamen they graduate yearly.

rather than swift and/or cheap travel must be created

Juan Nolasco, Vice President of the Philippine

amongst the domestic maritime market. They must be

Merchant Marine School, the biggest marine school in the

educated that it is their basic right to demand safe travel that

country,

meets international standards from all domestic maritime

however,

dismissed

the

claim.

Most

local

graduates of maritime schools land jobs abroad and most

industry stakeholders.

major international shipping companies at one time or

Much can be said about the response to maritime

another employ Filipinos as crewmen. CISO president

disasters when they occur. In the case of Doa Paz, a

acknowledges that PRC records show passing rates as high

coordinated response to the accident on board the ship was

as 90 percent plus for seamen. It is acknowledged that

virtually nonexistent. No one directed evacuation efforts on

Filipino seafarers are known worldwide and are major

board and this was compounded by the unavailability of life

revenue earners for the country.7

veststhey were under lock and key in deck lockers. No one

Unfortunately, a lot of these qualified seamen leave for

greener pastures, leaving the local shipping industry to

among the crew had the time to react to the collision, and no
distress signal was sent out.

newcomers and less skilled crewmen. In the case of the

These maritime disasters have a high mortality, with

Vector, the vessels crew at the time of the accident was led

very few long-term sequelae in terms of having to deal with

by a seaman with a 2nd mates license instead of a chief

health problems resulting from the initial incident. The

mates license. The exodus of qualified seamen can only be

majority of the fatalities died on the spot. In incidents such

stemmed by improving economic conditions. In this

as these, injuries come in the form of burns, drowning,

particular case however, simple enforcement on the part of

smoke inhalation, blunt trauma and occasionally penetrating

authorities and compliance on the part of the Vectors

trauma. Secondary injuries may theoretically come from

owners could have affected the outcome.

shark attack. In this particular incident, although the ships

The public utilizing water transportation must do its

share. Self-discipline must be exercised so that overloading

sank in shark-infested waters, there was no way to verify the

cause of death of the fatalities since those who were rescued

who were ambulatory had to secure their own transport and

only had minimal injuries.

proceed to their destinations on their own. Those who were

2,3

This brings to the fore the response to the disaster.

found to have injuries had to be transported to tertiary

There was no coordinated response at the time of the

hospitals on private ambulances contracted by relatives, or by

incident, as with many other maritime disasters in the

public transportation. In fact, even the injured passengers

country. The ships that were in the vicinity of the disaster

received very minimal medical attention prior to being

conducted the only search and rescue effort that bore fruit

brought to the hospitals where they were brought for

and this is directly attributable to a breakdown in

definitive medical care. Establishing a system whereby those

communication. Improving the communication systems will

involved with the actual search and rescue can immediately

not only contribute immensely to prevention of these

accidents, but also to the rapidity of response when they
occur. One thing to focus on is the capability of the
responding units to extract as many survivors as possible
from the water and to attend to any immediate lifethreatening conditions among them. This will entail a wellequipped Coast Guard with ships and aircraft capable of
extracting survivors from hostile environments and with
sufficient facilities and trained personnel to provide them
with the necessary emergency care. Search and rescue teams
must be capable of conducting resuscitation since many of
those who will be extracted from the site may have
survivable injuries. Personnel on board must at least be
certified with Basic Life Support (BLS) Training if not higher
levels of expertise.
It is worth noting that many of the maritime disasters
actually happened a few kilometers from the shores of cities
that have hospitals and that it is usually local fisherfolk, in
indigenous bancas, who are the "first responders" to these
maritime

incidents.

Another

strategy

that

is

worth

considering is the establishment of medical units or camps

very near the shore which will be capable of receiving the
survivors extracted by first responders and providing
immediate emergency care for victims. They can also serve
as triage centers from which victims will be directed to local
hospitals, to tertiary centers in Manila or to other specialty
centers. Those with minimal injuries can be directed to
centers where they can undergo counseling and be provided
assistance for contacting relatives and/or acquaintances.
This strategy will necessitate rapid transport from the site,
ideally through high-speed Coast Guard vessels or via air
transport. Such transports are actually available at present.
Unfortunately, majority of the victims of maritime accidents,
as in the Doa Paz tragedy, have to be ferried all the way to
Manila. The victims who were brought to Manila were not
received by an organized emergency medical team. Those

perform triage will save precious time and prevent

alone. Immediate medical attention must be made available

secondary injuries. Patients who have to be brought to

to attend to the needs of the injured and to resuscitate those

Manila can be attended to properly by informing those in

who may yet be saved. This will entail providing Basic Life

Manila of the precise nature of the injuries. The capabilities

Support training for people on the ground, and Advanced

of the hospitals in the provinces in proximity to the

Trauma Life support for those in the hospitals receiving the

shipping lanes must be well defined. There are several

injured if feasible. Post-incident counseling must be made

hospitals capable of attending to victims, which will negate

available to the victims.

the need for transport to Manila. There are primary and

Much has been said about the socioeconomic, political

secondary hospitals capable of rendering immediate care to

and legal factors surrounding this case. Focus on improving

drowning, burns and trauma. Upgrading the capabilities of

the medical standpoint must now be given attention,

these hospitals may not necessarily mean spending for

knowing the complexity of trying to address the other

additional equipment but simply holding workshops for

issues. A coordinated medical response will necessitate that

preparedness in attending to victims of these disasters.

all involved have a thorough understanding of their

Local governments can be tasked with creating teams

particular roles and the interdependence of these roles.

capable of establishing the camps or units for initial

Initial knowledge of the incident must trigger a

evaluation and treatment. There must likewise be a point

mechanism that relays information to the PDCC. The Coast

person or agency (such as the Philippine Disaster

Guard will be dispatched immediately for search and rescue

Coordinating Council or PDCC) that will transmit to the

operations. The responding ships will be the site of first

receiving hospitals the condition of the victims.

contact

between

the

victims/patients

and

the

In this particular incident, we can only surmise that

responders/caregivers. The initial triage unit will necessarily

more could have been saved if an organized search and

be aboard the responding ships. Responding teams must

rescue mission was dispatched immediately. It is being

immediately notify the receiving medical teams of the nature

claimed by the government that ships are available to the

of injuries they should be expecting. If feasible, it would be

Coast Guard along with air support provided by the US Air

ideal to have a doctor or other medical personnel on board

Force in the form of helicopters and reconnaissance planes.

the responding vessels. However, knowing the usual

Improving communications will allow optimal use of these

problems of manpower shortage, workshops may be

resources. Saving lives does not end with finding survivors

conducted to provide some amount of training to

non-

medical personnel responding to these emergencies. In the

absence of a medically trained person, training in basic life

Conclusions and Recommendations

It has been several years since the Doa Paz sank, taking

support becomes a necessity. If logistical support permits,

more than 4,000 lives. Several more maritime accidents have

facilities for resuscitation like ambubags, oxygen tanks,

occurred since that time, highlighting the need for everyone

intravenous fluids and a code cart must be on hand. Splints,

to once and for all take a harder look at this manmade

cervical collars and warmers should be available to prevent

phenomenon. Prevention will need to involve not only the

secondary injury. Those directly involved in the initial

government agencies but the riding public as well. Laws

search and rescue will likewise play a crucial role in the

must be strictly implemented, people well educated and

dissemination of information. These teams will need the

resources spent to improve equipment and systems already

skills to assess the situation, determine the logistical

in place. Response to these incidents must be well organized,

requirements, process and relay the necessary information to

and this will again involve not only the government agencies

the relevant receiving parties.

but the public as well. They must be wary that such

Medical teams will play a crucial part after the initial

incidents may and do occur, and when these happen they

search and rescue operations. The National Disaster

must be well oriented as to how they should react. The

Coordinating Council must come up with a list of hospitals

medical response to this disaster must likewise be well

that are capable of handling casualties in the event of a

organized. Response must be initiated at the scene of rescue

maritime disaster. The Department of Health may assist in

if possible, or at nearby centers established to accommodate

mapping out these hospitals and rating their capabilities in

survivors. Personnel, both medical and paramedical, must

handling specific injuries expected in maritime accidents.

be trained to respond to these disasters when they occur,

These hospitals will be tasked to organize teams that will

and transfer of victims to more competent centers facilitated

receive the casualties. These teams may be situated very near

when necessary. Care of these victims must be continuous,

shores in makeshift staging areas or may receive patients

extending beyond the primary medical attention to involve

directly in their hospitals. Workshops must be conducted to

all aspects including post-traumatic counseling.

maintain a certain level of preparedness in the hospitals

We have by no means heard the last of these Philippine

identified as receiving areas for maritime casualties. Medical

maritime disasters. We can only hope that the next time such

transport must be arranged to ensure that no secondary

an incident occurs, more lives will be saved and we are

injuries are sustained during transport. These hospitals will

better prepared to take care of our Filipino brothers who

likewise be expected to serve as triage in multiple/mass

have no choice but to ride these vessels that may be sailing

casualty accidents. Medical teams, whether situated in the

their last voyages.

staging areas or in the hospital itself, will be expected to

perform triage, initial resuscitation and treatment (if not
done on the rescue vehicles), onsite care, and injury
evaluation. A team will provide definitive care if the

Staff must be updated on Basic Life Support and Advanced

capabilities of the hospital permit. Previous experience with

Cardiac Life Support when possible.

maritime disasters have shown that victims of maritime

disasters sustain injuries secondary to burns, asphyxiation,
drowning, blunt thoracoabdominal trauma, and potentially
infected traumatic wounds. Assessment of the capabilities of
the hospitals and the staff in handling mass casualties and
providing definitive care to victims will have to put these
injuries in focus. Doctors and support staff must undergo
training through short courses or workshops to be prepared
to handle the initial management of patients sustaining these
injuries, providing definitive care when possible, and
recognizing the need for referral and transport as needed.

References
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Bateman S. Ferry Safety: A neglected aspect of maritime security?

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Heide EAD. Disaster Response Principles of preparation and
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Lumley JSP, Ryan JM, Baxter PJ, Kirby N. Handbook of the Medical
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Ronquillo M. Ships 20 years or older ply island routes. Philippine Daily

Inquirer. 1988 Nov 1.
Esplanada J. DOTC grounds 17 more vessels. Philippine Daily Inquirer.
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