copyright msf caption © Kenny Karpov/SOS MEDITERRANEE
18 Jun 18 03 Jul 18

Mediterranean search-and-rescue: Aquarius disembarks 630 rescuees in Valencia, Spain

Following this week’s political stand-off over the fate of people rescued in the Mediterranean, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) denounces Italy’s closure of its ports to prevent 630 rescued people from disembarking and European governments’ choice of political point-scoring over saving lives at sea.

“The men, women, and children on board the Aquarius have fled conflict and poverty, and have survived horrific abuse in Libya. They have been shipped from one boat to another like cargo and endured the elements on an unnecessarily long journey at sea,” says Karline Kleijer, MSF Head of Emergencies. “We are grateful to Spain for stepping in, even as Italian and other European governments have shamefully failed in their humanitarian responsibilities and placed politics over the lives of vulnerable people.”

Ahead of the European Council meeting next week, MSF calls on European governments to put human lives first. They must facilitate swift disembarkation in the closest safe ports in Europe where rescued people can receive adequate care, and ensure those in need of international protection are able to apply for asylum or other forms of protection. They must not obstruct independent non-governmental search and rescue initiatives and must set up a proactive, dedicated search and rescue mechanism in the Central Mediterranean.

Italy closes its ports and plays with the lives of 630 rescued persons

Over the weekend of June 9 and 10, the Aquarius search and rescue vessel, operated by SOS Méditerranée in partnership with MSF, rescued more than 200 people and received an additional 400 people from Italian naval and coastguard ships. Although the rescue and transfers of the 630 people were initiated and coordinated by the Italian Maritime Rescue Coordination Centre (MRCC), the Italian authorities denied Aquarius authorization to bring them ashore in the closest port of safety in Italy. In doing so, they broke with past practice and international law. Malta, which had the nearest safe port, also refused to allow the Aquarius to disembark, citing Italy’s coordination role and responsibility.

Eventually, on June 11, the Spanish government intervened and offered to let the Aquarius disembark in Valencia, 1,300 kilometres away.

MSF continued to press the Italian authorities to authorize disembarkation in the closest safe port as stipulated under international maritime law. MSF also raised serious safety and humanitarian concerns connected to sailing with 630 passengers in an overcrowded boat for four more days without adequate shelter or sufficient food.

“Often, the Italian authorities appeared callous. At first, they suggested that MSF transfer any vulnerable people. However, when MSF provided a list of almost 200 people, including unaccompanied minors, the sick and injured, pregnant women and women with children traveling alone, they refused. The Italian authorities then requested that we transfer only the seven pregnant women, but failed to respond to MSF’s concern about separating families and the need for husbands to accompany their pregnant partners,” said Kleijer.

Despite MSF’s concerns about the humanitarian and medical impact of the sea journey to Valencia, the Italian authorities instructed Aquarius on June 12 to transfer 524 people back to Italian ships and embark with the remaining 106 rescued on a four-day journey to Spain.

“Italian authorities shamefully closed their ports to 630 rescued people and moved them around the sea for political point-scoring,” says Kleijer. “Even if Italy has legitimate grievances about other European governments failing to accept their share of refugees, that’s no justification for this degrading treatment.”

Rescued people are caught between European political agendas

This week’s events in the Central Mediterranean underscore the wider political dynamics on migration in Europe. Many European governments have not prioritized saving lives of vulnerable migrants and refugees at sea. Instead, they have tightened their borders and closed their doors. They have actively supported the Libyan coastguard to return people rescued in international waters to Libya, where they will be forced to endure further inhumane and abusive treatment.

Throughout Europe, governments have not given enough support to frontline countries, such as Italy and Greece, who process the vast majority of arriving asylum-seekers and migrants. They have not taken their responsibility in sharing the relocation of asylum-seekers across Europe.

“European governments must appreciate the importance of search and rescue. More than 500 people have drowned in 2018 while attempting the perilous journey on unseaworthy dinghies across the Central Mediterranean. According to news reports, 12 people died this week in one incident in which a US naval ship rescued 40 survivors after their dinghy capsized,” says Kleijer.

The Aquarius is one of only a few remaining independent non-governmental search and rescue vessels still operating in the Central Mediterranean. Yet this does not mean the need is gone. By 8 June, the Aquarius had already rescued and/or transferred 2,350 people in 2018, all of whom would otherwise have drowned. Independent search and rescue capacity has dwindled over the past year due to bureaucratic barriers and legal proceedings against staff working for non-governmental search and rescue initiatives.

“The smear campaign against NGO ships has to stop. Our only intention is to save lives at sea. It is hard to explain why Aquarius could not disembark the 629 rescued people and had to set out on a four-day journey to Spain, while one day later the Italian coastguard vessel Diciotti was allowed to disembark 900 people in Italy,” says Kleijer.

“Valencia is the end of a terrible ordeal for 630 people. But there needs to be a serious European commitment to save lives and disembark rescued people properly. As long as governments fail to fulfill their responsibilities, the teams on board the Aquarius will continue to conduct search and rescue operations in the Central Mediterranean.”

'Pawns in a political game': A doctor speaks out against the denial of refuge for 630 people rescued in the Mediterranean

By Dr. David Beversluis, an MSF physician on-board the Aquarius

As I walked the deck of the Aquarius checking on patients several nights ago, I stopped to chat with some young Nigerians we had on board. They pointed to a glow on the horizon, curious if we’d reached Europe and why we had stopped for so long. With my smartphone I showed them our GPS position on the map, stuck between Sicily and Malta. Facing north from the bow, we could see the faint lights of Italy. As they looked up and down between the phone and the nearby shore, they realized their destination was finally in sight and they beamed. Sadly, this was short-lived as they remembered their situation, adrift in political limbo, caught between European countries. Their hopes would remain only a faint glow on the horizon.

This week, I met 630 people that had been rescued at sea. They risked their lives to reach that horizon. Now, the actions of the Italian government have turned them into pawns in a political game. Italy’s decision to deny them access to a port of safety flies in the face of international law. And, more importantly, the political stand-off seeks to diminish the value of these vulnerable people as human beings. It is a disgrace and a stain on modern Europe.

As the doctor on the Aquarius I gladly accept responsibility for the health and wellbeing of these rescued people. I have a duty to my patients to treat their medical problems and here on Aquarius we’ve had plenty to do. Fortunately, I work with a dedicated team to provide the best possible care under very difficult circumstances.

On Saturday night, during the initial rescue, we provided lifesaving care to hundreds of people pulled from collapsing rubber rafts in the search and rescue zone north of Libya. We resuscitated several people who had nearly drowned after falling into the water. We warmed up patients suffering from acute hypothermia. And we quickly organized hundreds of warm showers to wash off fuel and cold salt water before giving out dry clothes, blankets, food and somewhere to shelter. Most people said they’d been at sea for over 20 hours without water and the symptoms of dehydration were obvious; each person received as much fresh water as they could drink during those first hours.

Over the next few days, as we waited for a port of safety to be offered, our team continued to provide important basic care to each rescued person. Immediately after the rescue we opened our ship clinic where we’ve continued to see patients with all types of complaints. We’ve treated many with chemical burns caused by a mix of fuel and saltwater at the bottom of the rubber boats. We’ve treated dehydration, compounded by stress and exhaustion, chronic medical issues like diabetes, and patients with old injuries who haven’t seen a doctor in months or years while trapped in inhuman conditions in Libya.

And now, as we travel toward Valencia, our medical team must adapt to having people on board for almost a week, much longer than the typical one or two days transit back to Italy. We are passing through rougher seas on the way to Spain and have treated most of the people on board for seasickness since starting this completely unnecessary four-day journey. And, although grateful for a destination, we’re disappointed by the need to travel so far and risk worsening medical conditions for so many people on board.

'I have a duty to advocate for my patients'

As their doctor, my responsibility goes further than just treating patients while on the ship. I also have a clear duty to speak out and advocate for the rights and health of my patients. The Aquarius and its passengers were launched into international headlines this week as part of a larger debate on migration and the right to asylum  in Europe and throughout the world. As this debate rages between governments, these 629 people are being denied their basic rights as human beings and are unable to advocate for themselves.

I, along with the entire Doctors Without Borders/Médecins Sans Frontières (MSF) and SOS MEDITERRANNÉE team aboard the Aquarius, stand in solidarity with them and will speak out for each of these 630 vulnerable people. They risked their lives to leave horrendous, slave-like conditions in Libya only to become stranded at sea. Instead of extending welcoming arms towards suffering men, women and children, the Italian government has turned its back on them and recklessly put further lives at risk. Through their cynical actions, Minister of Interior Salvini and the Italian government diminish the humanity of these people. Each person that we pull from the sea on to the Aquarius is a human being, deserving of dignity and respect. It is deplorable that instead they are treated as less than human and used to score political points.

Furthermore, in forcing us to undertake the long journey to Spain the Italian government has deliberately sidelined the search and rescue capabilities of this vessel. Had we disembarked immediately in Sicily we would already be back in the southern Mediterranean search and rescue zone, ready and able to save more lives. Instead, while we sail across the Mediterranean, people continue to drown in the waters north of Libya.

And, despite the generous outpouring of support from individuals across Europe and the world, the rest of Europe’s governments have made pitiful progress towards creating a system to prevent more deaths in the Mediterranean. It is unacceptable that Europe has not implemented an effective search and rescue mechanism to save lives at sea or addressed its broken immigration and asylum system. When people are denied a safe and legal alternative, we leave them with no choice but to take to the sea and risk their lives. How many people will have to die before a sane humanitarian response is put in place, before the underlying incentives pushing desperate people into rubber rafts are addressed?

'Are we willing to sit idly by as people drown?'

Ultimately, we must ask on behalf of these marginalized people, what type of society do we want to be? Are we willing to sit idly by as people drown, cold and alone in the sea, or will we respond with an effective system that grants people the dignity and respect they deserve?

As the doctor on board the Aquarius I consider it a privilege to care for these 630 cold, hungry, and tired people. I take my responsibility seriously and will speak to their humanity in the face of cynical and hypocritical governments. I have seen the suffering of these people as they boarded our ship. I have heard the horrific stories of their journeys. The young Nigerians I talked with earlier this week, and every other person attempting the dangerous Mediterranean crossing, whether on the Aquarius or not, wish desperately to trade the nightmares they’ve been living for grander dreams. It is time that Europe finally takes responsibility for protecting them, and reached out from the horizon with welcoming arms.

Dr. David Beversluis is an MSF physician on-board the Aquarius, and an assistant professor of International Emergency Medicine at the University of Southern California.

UPDATE - June 12

Doctors Without Borders/Médecins Sans Frontières (MSF) is urging European Union member states to facilitate the immediate disembarkation of 629 people rescued over the weekend in the Mediterranean. Those rescued are now onboard the Aquarius, a dedicated search and rescue vessel run by SOS MEDITERRANEE in partnership with MSF. Aquarius remains in international waters off Malta and Italy, the countries with the closest ports of safety, but which continue to refuse permission to dock.

MSF welcomes the important gesture of humanity from Spain to disembark in Valencia. However, this would mean already exhausted people rescued at sea would have to endure four more days exposed to the elements on the deck, in an overcrowded boat already well over maximum capacity and in deteriorating weather conditions. The better option would be to disembark the rescued people in the nearest port after which they can be transferred to Spain or other safe countries for further care and legal processing. 

“Disembarkation cannot be delayed further.” said Dr. David Beversluis, MSF’s doctor on board Aquarius. “The priority must be to immediately disembark all 629 people – including 123 unaccompanied minors, 11 children and six pregnant women – to the nearest port of safety. The medical situation on board remains stable for now, but people are exhausted and stressed.”

MSF is particularly concerned about several critical drowning and hypothermia patients who were resuscitated. These patients are being closely monitored on-board, as they could quickly develop significant pulmonary issues after aspirating sea water. Many rescued people have reported aspiration of sea water and so are at risk for developing pulmonary disease or pneumonia over the coming days. There are 21 patients who have suffered severe chemical burns after being exposed to a toxic mixture of sea water and fuel for an extended period of time. These patients are stable but will need ongoing wound care and dressing changes over the coming days and weeks. Finally, there are several serious orthopedics cases with associated infections that need immediate surgical evaluation and operations which MSF is unable to provide on the ship.

Once people rescued at sea have been disembarked in a port of safety, the next priority is for EU governments and institutions to step up and find shared solutions to support countries on the frontline such as Italy who are dealing with the burden of arrivals of refugees, asylum-seekers and migrants by sea.

“Denying disembarkation to desperate people rescued at sea cannot be considered as a victory: it is the wrong response to the lack of responsibility and burden sharing between member states,” said Aloys Vimard, MSF’s project coordinator on-board the Aquarius. “All EU governments and institutions must step up and support countries on the frontline dealing with sea arrivals such as Italy, to guarantee shared solutions and stop unacceptable silence and inaction from EU states.”

UPDATE - June 10: Further information on rescues and transfers

The 629 people currently aboard the Aquarius were rescued during night of Saturday to Sunday, when Aquarius carried out six rescue and transfer operations in the span of nine hours – all under instruction from the Italian Maritime Rescue Coordination (IMRCC). The rescue of two rubber boats turned critical when one of them broke apart in the darkness, leaving over 40 people in the water.

After rescuing 229 people from these boats, the Aquarius was requested by the IMRCC to accept a transfer of people who were rescued by Italian navy and coast guard ships on 9 June. The Aquarius received a transfer of 129 people from an Italian Coastguard ship (CP 312), followed by 64 others from a second Italian Coastguard ship (CP 319) and finally 88 survivors from a third (CP 267). The ship San Giusto then assisted teams of the Aquarius for a final transfer: 119 shipwrecked were transferred from Italian merchant ship MV Jolly Vanadio to the Aquarius.

The Italian MRCC coordinated all these actions from the start and took responsibility for the rescue of all these people. However, despite transferring rescued people from Italian Navy and Coast guard ships to the Aquarius, the Italian MRCC refused now to take any responsibility to bring the rescued people to a port of safety.


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