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So I presume there's a requirement that you have a visa for each country you visit on a cruise ship, although I've never done one.

However, if you're passing a country that you're not actually stopping at, and a passenger gets ill (eg the recent norovirus outbreaks that one of my friends was part of on a Europe cruise) and needs to be airlifted to a hospital, how do they choose where to send them, and what if it's a country you don't have a visa for?

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I would expect most countries to allow exceptions to their usual immigration procedures in cases of emergency (there may even be some pieces of international legislation about this). Japan does, in Article 17 of its Immigration Control and Refugee Recognition Act:

In the case of disease or any other accident which urgently requires the landing of a foreign national aboard a vessel or aircraft for the purpose of medical treatment, an immigration inspector may grant permission for emergency landing to the foreign national concerned based on an application by the captain of the vessel or aircraft or the carrier who operates the vessel or aircraft until the cause thereof ceases to exist, subject to a medical examination by a physician designated by the Minister of Health, Labour and Welfare or the Minister of Justice.

(Note that in Japanese immigration parlance, landing means entering Japan by passing through immigration, etc.)

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