Anatomy of a rescue

MSF nurse Courtney Bercan documents a long day rescuing desperate people from the Mediterranean Sea

03 Mar 17
Courtney Bercan Canadian Nurse Mediterranean Area

It’s still pitch black out when I wake up to a siren-like alarm. I’m disoriented and it takes me a moment to remember where I am and why on earth there is a siren going off. I look at my phone. It’s 4:34 am and I remember that I am aboard Médecins Sans Frontières/Doctors Without Borders (MSF)’s rescue vessel the Dignity I.

The alarm means that we have received a distress call from one or more boats who left in the night to attempt to cross the Mediterranean from Libya to Italy. It is telling us we have about 20 minutes to get to our stations in order to respond to the distress call.

I scramble to get dressed, put on my safety gear and splash water on my face. This is my first rescue ever and I am so nervous thinking about everything that could go wrong that I think I may vomit.

I receive a reassuring smile from the logistician, who grins and says: “This is it. This is why we are here”. And I know he is right. We are well stocked, organised, and prepared for a safe rescue.

A terrifying thought

I am told that the flimsy white boat I can barely make out in the distance has more than 100 people in it, and that there are several more in the vicinity.

I feel unexpectedly overwhelmed with emotion when I see the refugees perched, without life jackets, on the sides of the dinghy.

I have seen so many pictures of these boats that I didn’t think it would hit me this hard.

It is so dark; all it would take is one stray wave and the entire boatload of people would be swept into the sea, the only proof that they were ever there, being some white plastic and floating water bottles.

It’s truly a terrifying thought and I feel much more at ease when I see our sailors distributing life jackets to everyone and bringing the first group on board.

"We thought you were going to shoot us"

The men are lining up to be registered and receive provisions, a few weak or near fainting when they first board, but no one seriously ill. The sun is coming up by the time they are all aboard.

During a lull I strike up a conversation with one of our new passengers. When we first saw their boat, it appeared to be heading away from us. I ask him if they were trying to avoid our boat.

"If the men arriving on the boat are collapsing, what condition will we find this baby in?"

“Some of us, we were so scared," he says. "We thought you were going to shoot us. We didn’t know what to do. We were so scared."

Hearing this, it becomes very clear to me why people collapse upon boarding our boat - they have just gone from abject terror to relief and that is a lot for a malnourished, dehydrated, sea sick, heat exhausted person to process.

The man goes on to tell me, that he had left his country a year ago to escape a difficult life there. When he arrived in the new country he had his papers confiscated and was put to work in slave-like conditions.

He shows me the scars he has from abuse at his previous 'job'. Is it still considered a job, I ask myself, when you are being kept against your will and only paid sporadically?

His fear that we would shoot them makes a lot of sense to me now.

A newborn's first journey

We arrive at another boat with 100-plus passengers, including more than 20 women and children. The women start to board. My job is to register them and identify any unaccompanied minors or passengers needing medical attention.

I try to smile and make eye contact with each woman and child as I register them. I can see that many are still scared or unsure and I want them to know they don’t have to be.

A woman collapses as she enters the women’s waiting area and my colleague helps her to sit up and eat and drink a little. We place a white bracelet on her wrist signalling that we need to do a more thorough assessment as soon as everyone has boarded.

The next woman enters and is cradling something tiny. My heart beats faster; if the men arriving on the boat are collapsing, what condition will we find this baby in?

I uncover the baby’s face to see she is breathing and responding normally and I feel a wave of relief. The little babe is 10 days old and already on quite the journey.

The process of loading four more boat loads of people onto the Dignity I continues all morning. By noon, our final passenger count is 466 people. I and the other nurse, Antonia, complete a general health check - taking the temperature, speaking with and performing triage - for each passenger on board. We send urgent cases to the ship's hospital to be seen immediately by our doctor, Pierre.

Today, we see a lot of people with emotional distress, dehydration, skin conditions and seasickness but, luckily, no one is in too critical a condition.

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Waves as high as three metres

The seas have been rough through the night and morning, but are getting worse now and the boat rocks incessantly. Waves are as high as three metres. Our passengers are sea sick. We are sea sick.

The hospital is over 40 degrees with no airflow (joys of working on an old shipping boat!). The need to stay hydrated easily pales in comparison with the need to have nothing in my stomach.

Antonia, looks green, vomits over the side of the ship and admirably, somehow, returns to work. I have to keep leaving the room to get air to keep from getting sick myself.

We are not working at maximum efficacy to say the least, but we have dealt with all the urgent cases, pre-natals, and children and decide to do a round on all decks with anti-nausea medications before taking a break ourselves.

Early the next morning we arrive at the port in Sicily. The Red Cross tents are waiting for us, along with other non-governmental organisations (NGO’s), Italian government officials and a medical team. The disembarkation of our passengers takes several hours and the atmosphere is a little impatient, a little nervous, but joyous.

The women sing and play with their children. The passengers exchange contact information and joke and talk like they have known each other for years.

Finally our last passenger disembarks and we set to the task of cleaning the ship. We are tired, but happy. Every one of our 466 passengers has made it to shore alive.

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