European reality, humanitarian crisis – doctors without borders in the Mediterranean

On Sunday evening, we are leaving the YES Summer camp: tired, yet packed up with impressions and full of excitement about our upcoming vacation in Sicily. When traveling to our first stop in Trapani, we receive messages of comrades from all over Europe sending in pictures of their symbolic “refugees welcome” paper boats being photographed at the Airport of Palermo. We are happy about having spread our political message in so many countries, but especially in Sicily since it is one of the few places in Europe for which simply relying on the Dublin Agreement has never been an option. As a result, the island has been left alone for years trying to cope with the high numbers of newly arriving refugees.

In Trapani we find a Bed and Breakfast located close to the harbour. When passing by, one specific boat immediately captures our attention: The Aquarius. Despite its bright orange color and its former name “Meerkatze” (engl. Sea cat) showing through the fresh coat of paint, it is not its look, but its mission that makes it unique. It is one of three boats the NGO “Médecins sans Frontières” (Doctors without borders) together with SOS Mediterranée is currently operating within the Mediterranean.

We all sigh. Even though we had spent the last weeks discussing all the theoretical aspects of the challenges refugees face at European borders on a daily basis, seeing the impact of Europe’s policies so closely makes us shiver.

While we stand in front of the boat, two women of the crew approach us. One of them quickly turns out to be the doctor on the boat. Her colleague is working for SOS. As her main tasks she describes interviewing refugees about their journey and their treatment by Libyan and European authorities.

We ask them, how much time they get to spend in Trapani until the boat goes offshore again. They both look at each other and explain that they usually get three days off. This time, however, their stay has been elongated by a day because the crew still needs to recover from their last mission. This time, they have had to salvage 22 bodies, 22 human beings that had not made it through the Mediterranean Sea.

Not knowing what to say, we remain silent. The two women, both acting in a very professional manner, fill our silence by continuing their stories. Usually they spend about three weeks offshore, most of it close to Libyan territorial waters awaiting rescue calls.

They explain Libya to be the preferred leaving country due to its lack of governmental infrastructure. Around 20 boats are leaving from Libya daily, none of them carrying enough fuel to make it to Italy, not to mention their poor conditions and overfilled capacities.

They explain that most refugees do not make it out of Libyan territories on their first attempt, many being captured before and often being made to pay high sums to human traffickers.

SOS explains to be patrolling all areas close to the Libyan coast, including the areas covered by the FRONTEX mission Triton.

As a reason, they diplomatically state the different mandates of FRONTEX and doctors without borders. Expecting to know what they are referring to, we ask about their experiences with Push Backs[1].

Their faces darken and they confirm our concerns: even though there are no direct incidents with FRONTEX, they suspect the EU of having made a deal with Libyan authorities. Similar to the case with the Turkish Deal, the European Union has handed over the dirty work to Libyan coast guards.

We do not want to keep them from anything, but they seem to be happy about our curiosity.

They continue by telling us about their last mission from which they had just returned the day before yesterday. They were taking care of more than 200 people on board, a comparably small number as we should find out later.

According to the doctor, one out of 23 refugees dies trying to cross the Mediterranean Sea. “If fleeing was a disease, the world would be shattered by its deadliness”, she explains. Despite all the tragedies they are facing on a daily basis, they still have joyful experiences to talk about. They tell us about a baby being born on the boat just two days ago, an event which she describes as an amazing experience to the crew and all of their guests. The fact that they refer to the refugees as their guests as well as their political awareness leaves us deeply impressed.

After the unexpected conversation with these fascinating women, we politely ask for a more detailed interview. They ask us to come back tomorrow – an offer which we happily accept. When returning to the boat the next morning, a security guard is protecting the ship. Luckily, the SOS employee we have been talking to yesterday is standing on deck and recognises us. She tells the security to invite us on the ship – an invitation we have not been expecting. When entering the boat, we are not sure how to deal with this overwhelming situation. A volunteer approaches us. Judging by his outfit, he is about to go for a run. He seems accustomed to tourists being interested in his work and explains that he drives one of the smaller rescue boats. He offers us a medical tour with the two nurses. Besides the doctor and a midwife, they are the only medical staff working on the boat, taking care of up to 600 guests.

They talk about their daily routine on the boat and how – in the case of emergency – journalists, nautical and medical staff are working together side by side taking care of people.

All members of the current team have already been working for Doctors without borders in the past, they are all highly skilled and familiar with the challenging work. As the language of communication, they state English, but all of them speak at least French in addition, some even more than three languages.

Several team members including the two nurses belong to the permanent staff of doctors without borders, others just temporarily work for them. A new doctor who usually works in a hospital in London had just arrived the day before.

Technically speaking, the crew consists of two legal entities, MSF and SOS, but in reality, they work as one – especially in situations of emergency. For those cases the crew is regularly provided with training; white boards explaining how to react in case of emergency can be found in every single room.

If there are no patients in serious conditions they continue looking for other boats, if immediate medical treatment is required, they ask for permission to enter a port on the Italian coast. The guests then get to apply for asylum in Italy and the Aquarius leaves right away to continue its mission offshore.

Our tour leads us to the sick room. We cannot keep from wondering how so many people could even fit inside that small room, not to mention being medically treated.

A German couple that has joined the tour asks about security measures such as masks and protective suits being used by governmental authorities. The nurse describes them as unnecessary in their case. The risk is minimal and wearing it would only make their work more difficult and frighten their guests.

As most difficult, they describe the situation on board when it is exceptionally crowded. The nurse explains how hard it is to ensure a dignified, yet safe and calm stay for such a large number of people. Something they want to provide to all of their guests.

We are impressed, shocked, sad and angry and yet burning to know more. However, we do not want to keep them from spending their well-deserved free time off the boat before going offshore again.

We are leaving the Aquarius behind with mixed feelings, waving the crew goodbye. One sentence of the nurse echoes in our heads.

“Change European politics and our work here would not be needed at all.”

By: Naomi Dutzi, Ella Hofreiter, Matthias Krainz, Miro Verdel

[1]  A push back is the deportation of a refugee before having the possibility to apply for asylum. Push backs violate the principle of non-refoulement as well as the 1951 Refugee Convention. 

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