In 1889, Dr. W.S. Birge of Provincetown wrote a letter to the Boston Medical and Surgical Journal in which he reported that at least 20 fishermen had recently returned to town with a disturbing set of symptoms: shortness of breath, severe cramps and pain, and an inability to lift their legs.
Birge noted that the fishermen, who had been on long voyages working the waters near Newfoundland, had been able-bodied at launch, and he blamed their decline on the food they’d lived on at sea, which, he noted, consisted of poor-quality salt beef and a highly inadequate supply of fresh vegetables. The disease had actually killed several of the fishermen, some at sea and some after they returned home.
Birge identified the disease as beriberi, an affliction that was rampant around the world at the time, especially in the Far East. One in every three members of the Japanese Navy suffered from the disease, for example, and it was killing great numbers of the Dutch soldiers who were then occupying Indonesia. At the time Birge wrote his letter, nobody understood the cause of the disease, which would only be identified several decades later, in the 1930s, when scientists linked it to a deficiency of vitamin B1, or thiamine — and, by extension, to diets that consisted largely of white rice, which lacks the nutrient.
After beriberi’s cause was identified, armies and navies and fishing fleets began stocking up on thiamine-rich provisions such as barley, meat, milk, bread, and vegetables — and, eventually, B1-infused white rice. These measures led to a precipitous decline in the incidence of the disease worldwide, and as the end of the 20th century approached, it seemed to have been all but eradicated.
But today, tragically, it’s back, especially at sea, where it is killing an untold number of fishermen and sailors each year.
How can this be, given how easy the disease is today to prevent and cure?
The answer is complex and troubling. It involves our growing global demand for seafood, the resulting collapse of near-shore fish stocks, and, notably, the rapid rise of China in recent decades as the dominant fishing presence on the high seas.
Seafood is now the largest globally traded food commodity, and China’s industry, which is worth more than $35 billion, accounts for a fifth of this trade. The Chinese state owns some 20 percent of its distant-water fleet. The industry creates jobs and helps China feed its population; the country consumes more than a third of the fish caught or harvested in the world.
With as many as 6,500 ships, the Chinese distant-water fleet is by far the largest in the world and more than double the size of its nearest competitor. This fleet also routinely engages in abusive and illegal labor practices that are often hard to flag, because they take place out in the open ocean, beyond any government’s jurisdiction, in waters where oversight and policing are just about impossible. But the rising incidence of beriberi, which is easy to detect when sailors return to land, is a strong indicator of what’s happening. Fishermen, in particular, are falling sick with and dying from beriberi because they’re being compelled to spend longer and longer periods of time — often years — at sea in illegal and intolerable conditions.
“There is absolutely no reason people should be getting, much less dying from, this disease,” says Nicola Pocock, who teaches at the London School of Hygiene & Tropical Medicine. “Beriberi fatality at sea is a red flag for severe neglect or captivity.”
Much of this story concerns China and the labor practices of its distant-water fishing fleet, which are deeply problematic. But just about any American who eats seafood may also be implicated. More than 80 percent of the seafood eaten by Americans, including most likely the fish sticks, calamari, and tuna served at your favorite New England restaurant, is imported. Much of that has been either caught by Chinese ships — ships that are regularly engaging in the appalling practices that can cause beriberi to occur — or processed in China before it is sold in this country.
During the past four years, in my role as the head of The Outlaw Ocean Project, a nonprofit journalism organization based in Washington, D.C., I was part of a team of reporters conducting a broad investigation of working conditions, human-rights abuses, and environmental crimes in the world’s seafood supply chain. Because the Chinese distant-water fishing fleet is so large, so widely dispersed, and so notoriously brutal, we made that fleet our focus. We interviewed captains and boarded ships in the South Pacific Ocean, near the Galapagos Islands; in the South Atlantic Ocean, near the Falkland Islands; in the Atlantic Ocean, near Gambia; and in the Sea of Japan, near Korea.
Our visits to these ships revealed in stark detail a broad pattern of human rights and labor abuses, including debt bondage, wage withholding, excessive working hours, beatings of deckhands, passport confiscation, prohibiting timely access to medical care, and deaths from violence. Workdays on many Chinese open-water fishing vessels routinely last 15 hours, six days a week. Crew quarters are cramped. Injuries, malnutrition, illness, and beatings are common — as is beriberi, which was one of the first signs of problems that we observed during many of our encounters.
The Chinese government declined to comment on this matter. But in December 2022, China dismissed US sanctions of its fishing fleet over forced labor concerns as “interference in other countries’ internal affairs under the pretext of human rights,” and an act of hypocrisy. “Pointing fingers at others while turning a blind eye to its own violations is blatant double standards,” Chinese Foreign Ministry spokesperson Mao Ning said, adding that US seiners operate on the high seas for long durations in violation of limits set by fisheries management organizations. In March 2023, the Foreign Ministry again dismissed criticism, calling on the United States to address issues in its own fleet, “rather than act as a judge or police to criticize other countries’ normal fishing activities.”
In 2020, the US Department of Labor reported that many deckhands on Chinese squid-fishing vessels work involuntarily under conditions of coercion, fraud, intimidation, or debt bondage. Similarly, when the Environmental Justice Foundation, a human-rights advocacy group, interviewed 116 Indonesian members of the crews of Chinese fishing vessels in 2021, they found that 97 percent of them had experienced some form of debt bondage or confiscation of documents.
Many of the men who serve as crew on Chinese ships are, in effect, captives engaged in forced labor. Typically, they’re Indonesians or migrants from inland China, almost all of whom are poor and many of whom are trafficked. We interviewed more than four dozen of them and found that many had contracts obligating them to stay at sea for extended periods, sometimes more than three years.
That’s three years at sea, without returning to land, not three years just as a crew member. Why so long? The main reason is the industrial and global way that seafood is now harvested, transported, and processed. As near-shore fish stocks have collapsed, fleets — especially the huge Chinese fleet — have begun traveling farther and staying at sea longer in hopes of maximizing their haul. This trend is facilitated by a popular system called at-sea transshipment, where ship captains avoid coming to shore and instead offload their catch to refrigeration ships in the middle of the ocean. Two to three years is now a common amount of time for crew aboard Chinese distant-water fishing vessels to spend at sea.
Not surprisingly, these vessels are rarely stocked with enough fresh vegetables to keep crew members healthy. Typically, for long trips they stock rice and instant noodles, which are cheap, calorie-rich, and slow to spoil. The vegetables, fruit, and meat eaten on these ships tends to be canned or dried, which makes them low in B1 and other nutrients and high in salt, sugar, and preservatives. Ship cooks also frequently mix rice or noodles with raw or fermented fish, and they supplement meals with coffee and tea, all of which are high in an enzyme called thiaminase, which destroys B1. An additional problem is that the body requires more B1 when carbohydrates are consumed in large amounts and during periods of intense exertion, both of which are conditions that prevail on distant-water fishing vessels.
On one Chinese squid ship that we boarded while it was fishing in the Pacific Ocean roughly 350 miles west of the Galapagos, the cook told us that his ship had no fresh fruits or vegetables at all. As he spoke, he stood in the galley watching over a large rice cooker, flecked with small pieces of boiled squid, and a bubbling vat of instant noodles. On another Chinese squidder, located in the South Atlantic Ocean about 370 miles north of the Falkland Islands, a deckhand in the mess hall, where the workers eat, gestured toward a bag of rotten and blackened cabbages and onions, the only vegetables on the ship. He asked for donations of any fresh fruit or vegetables.
Since beriberi tends to be painful and slow-acting, victims typically see it coming before it kills them. “Please rescue us,” a Filipino deckhand aboard a Chinese squid ship called the Han Rong 368 pleaded in a July 2020 video, recorded on his cellphone from the Indian Ocean, near Sri Lanka. “We need to go to the hospital,” he said. “Please, we are already sick here. The captain won’t send us to the hospital.”
On a trip to Jakarta, Indonesia, in 2020, we met a half dozen young men who told us about an outbreak of beriberi on a Chinese squid ship called the Wei Yu 18, in 2019. One member of their crew, a 25-year-old named Fadhil, died because the captain refused to bring him to shore. “He was begging to return home,” we were told by Ramadhan Sugandhi, one of Fadhil’s friends from the ship, “but he was not allowed.” We heard many similar stories during our investigation. They are reprehensible, given that beriberi can be treated effectively today with nothing more than vitamin pills. When B1 is administered intravenously, patients typically recover within 24 hours.
This type of captivity and neglect is not a far-away problem. Seafood is one of the top commodities shipped through the Port of Boston, with more than 99,000 tons arriving annually. Much of this seafood is caught by Chinese ships or processed in China. Beyond the scourge of beriberi, our investigation found many of these imports through Boston’s port were tied to abuses not just on the ships but also on land in processing plants.
Since 2018, over 1,400 tons of seafood products tied to Chinese factories using Uyghurs have moved through the Port of Boston. Of these imports, over 500 tons were destined for companies in Massachusetts. One of these importers has supplied over $50 million of seafood to US government programs, including federal prisons and food assistance programs like the National School Lunch Program. Products tied to Uyghur labor are banned from entering the US because the Chinese government is engaging in widespread repression of and forced labor with this Muslim minority.
More than 2,900 tons of squid tied to other kinds of labor and environmental crimes has entered the United States through the Port of Boston in the past five years. All of these squid shipments are going to PanaPesca USA, based in Massachusetts and one of the largest importers of squid into the United States.
Chinese ships are not the only ones with crew dying from beriberi and other forms of neglect. When the Thai government researched a 2016 outbreak on two trawlers in its fleet, each of which had stayed at sea for at least nine months, it found that the ships carried 32 crew with beriberi, some of whom were Cambodian and victims of forced labor. Six other crew members had died earlier from the disease, their bodies thrown overboard at sea. In its report, the Thai government recommended that all fishing companies be required to provide B1 supplements to crew on ships that stay away from shore longer than 30 days.
The Thai report identified the seafood industry’s use of transshipment as another cause of beriberi. The Thai trawlers received new shipments of fresh meat and vegetables every two to three months, the report explained, but these supplies ran out within 20 days, and after that the crew relied on fermented food for up to two months, leading to cases of beriberi. “Ship operators are not providing adequate food and nutrition,” says Phil Robertson, the deputy director of Human Rights Watch’s Asia division. “That’s criminal.”
John Hocevar, the oceans campaign manager at Greenpeace USA, says that beriberi is an indicator of a larger set of indefensible practices that long-haul fishing captains are engaging in, out of sight, as they roam the high seas and harvest fish at an industrial scale in order to satisfy our ever-growing demand for seafood. “You don’t have to shoot or stab someone for it to be murder,” Hocevar says.
Beriberi becomes especially dangerous when captains fail to identify the disease or refuse to transfer crew back to shore for treatment. Captains often refuse to carry sick or injured crew back to shore because of the time and expense required to do so. It can also be difficult to transfer sick crew members to other boats, because swells make it dangerous for large ships to get close to each other and most fishing ships don’t have small skiffs to traverse the water between vessels.
An obvious solution would be for ships to provide their crew with vitamin supplements and to allow workers to return to shore for medical care if they fall ill. In addition to these preventive steps, fleet operators and seafood companies should serve B1-bolstered rice and pasta and ensure that captains and crew know how to identify the early symptoms of the disease.
Ken Kennedy, the former director of the forced-labor program at Immigration and Customs Enforcement, says that the US government needs to block seafood imports from China until American companies can demonstrate that their supply chains are free of forced labor and abuse. “The US is awash with criminally tainted seafood, most of it from China,” he says.
Robert Stumberg, a supply-chain expert and law professor at Georgetown University, says that the Uyghur Forced Labor Protection Act is distinctly powerful because it shifts the burden of proof when there is evidence that suppliers operate in Xinjiang or rely on workers transferred from there. When there is, importers and their suppliers have to prove there is no connection to the Uyghur region, rather than demanding that advocates or journalists prove that there is. In light of the overwhelming evidence in China’s seafood supply chain, the US government could already apply this law to some seafood processors that use Uyghur or North Korean labor. Congress could also expand this approach — of shifting the burden of proof to importers and their suppliers — when seafood comes from a region like the South China Sea or from a company using Chinese vessels.
“The big question now,” Hocevar says, “is whether consumers and governments will be as upset about beriberi and seafood companies murdering their own workers as they were about these companies drowning dolphins.”
Ian Urbina is the director of The Outlaw Ocean Project, a nonprofit journalism organization in Washington, D.C. Reporting for this piece was contributed by Dan Rosenzweig-Ziff, who formerly worked with the organization.