After seven rescues from the central Mediterranean, 470 people need a place of safety

After seven rescues from the central Mediterranean, 470 people need a place of safety

Beginning on the morning of 9 May and over the following 72 hours, Médecins Sans Frontières (MSF) teams have rescued 470 people from seven boats in distress in the Libyan and Maltese search and rescue zones and brought them on board our search and rescue ship, the Geo Barents, operating in the central Mediterranean sea.

Over the course of three intense days, the boats in distress were spotted from the bridge of the Geo Barents after alerts received from Alarm Phone, the Mediterranean monitoring organisation, and with the support of Pilotes Volontaires, a French-based non-profit organisation providing aerial observation in the central Mediterranean. None of the boats were identified by the relevant maritime rescue coordination centres.

Early on the morning of 9 May, our team spotted two rubber boats in distress carrying a total of 204 people. Among them was a nine-month-old boy named Mohammed who was carefully pulled from the crowd along with his mother by MSF teams and handed to safety on deck. All survivors on the rubber boats were soon transferred to Geo Barents.

More than 24 hours later, MSF received an alert about another overcrowded rubber boat, this time with 59 people on board. Geo Barents headed to its location with the guidance of a Pilotes Volontaires’ airplane and carried out the rescue.

Late in the day on 10 May, two new email alerts from Alarm Phone landed in MSF’s inbox, indicating that two more boats were in distress nearby. The rescue speedboats on Geo Barents were launched at around 9 pm and, after an intense five-hour search conducted in darkness, the team finally found the two boats drifting near an oil platform. The 111 survivors on board these vessels were rescued and transferred onto Geo Barents at around 2 am, ending the longest rescue since the beginning of the ship’s operation.

On 11 May, further alerts from Alarm Phone indicated that more boats were in distress, this time in international waters under the search and rescue responsibility of Malta. With the help of Pilotes Volontaires, Geo Barents navigated to the exact location of the first boat, where our team found 67 people drifting in a wooden vessel, all looking terrified, exhausted and disoriented. A few hours later, all the survivors were brought on board the MSF rescue ship.

“When the rescuers came I was almost unconscious,” said a 26-year-old woman from Syria. “I couldn’t understand what was happening. By that time, we were at least 48 hours at sea. I was sure I would die.”

The long day of rescues continued with another boat carrying 29 people, which was drifting in the Maltese search and rescue zone. Once again, no action was taken by the Maltese authorities.

“It’s incomprehensible that, after all these years of deadly migration journeys in the Mediterranean, private organisations like us are taking on the major burden of saving lives at sea,” says Juan Matias Gil, MSF head of mission for Search and Rescue operations in the central Mediterranean. “At least 24,000 people have officially drowned or gone missing since 2014, yet Europe is still turning a blind eye to what is happening on its southern borders.”

“We were again appalled by the inaction of the Maltese and Italian authorities while almost 100 lives were hanging in the balance. The Maltese armed forces, who are primary responsible for rescues in the Maltese search and rescue zone, were informed at the same time as us, but they remained silent and inactive, neglecting their legal obligation to provide or coordinate assistance. They also ignored our request for a port of safety,” says Gil.

Most of the survivors on board Geo Barents have experienced physical abuse of various forms, including sexual violence and forced labour. Four embarked on their journey across the Mediterranean with fractured bones, the result of injuries inflicted during their time in Libya.

One survivor currently on board Geo Barents has diabetes and is dependent on insulin but has been without his vital medication for what is likely to have been weeks. Two other survivors have suffered psychotic episodes on board. All 470 survivors on board Geo Barents are either physically or mentally vulnerable and need to disembark to a safe place as soon as possible.

Despite our six requests, the Italian authorities, also responsible for search and rescue activities in the Mediterranean, haven’t granted us permission to disembark the survivors to a safe place.

Intersecting crises: Climate change and access to medicines

عائلات تتجه إلى أرض جافة في بنتيو. تضرر 835000 شخص بشكل مباشر من الفيضانات.

Intersecting crises: Climate change and access to medicines

عائلات تتجه إلى أرض جافة في بنتيو. تضرر 835000 شخص بشكل مباشر من الفيضانات.
Climate change has been described as the biggest threat to global health in the 21st century. Médecins Sans Frontières (MSF) has responded to some of the world’s most dire medical and humanitarian crises for more than 50 years. Many of the places where we work are in the most climate-vulnerable settings in the world. Our teams provide care for people experiencing the health impacts of the climate emergency first-hand. It is very clear this crisis hits people in the most vulnerable situations the hardest.

The climate emergency, together with lack of access to medicine, aggravates existing vulnerabilities and humanitarian situations. For example, in Niger, changing rain patterns are impacting food production and infectious diseases such as malaria. This comes on top of recurring epidemics and food insecurity linked to demographic pressure and land use, as well as violence and displacement. The deadly combination of malaria and malnutrition takes a heavy toll on children under five.

As MSF continues to work with communities facing humanitarian crises, we reflect on the intersection between climate change and access to medicines through two lenses: vaccine equity and intellectual property.

The climate crisis and the COVID-19 pandemic have both shown the world what it means to face a direct existential threat. We have seen the measures we need to take – for COVID-19, equitable access to vaccines for all – and the resources we need to mobilise to face such a crisis.

What this means is that countries with higher vaccination rates, like the UK, have been able emerge from the pandemic earlier, and open up their economies once more, while many countries around the world are still in the midst of the crisis. Their vulnerable populations and healthcare workers remain at risk, while rich countries have chosen to hoard vaccines and prioritise their own populations while others have been forced to depend on promises of donations.

The second lens through which we look at the intersection between climate change and lack of access to medicines is intellectual property. Specifically, its impact on access to medical technology. The same laws that feed the access to medicines crisis – enforcing drug and other medical technology patents through the World Trade Organization – apply to innovative green technologies.

These technologies are concentrated in rich countries yet are urgently needed by all countries to adapt their economies and reduce carbon emissions. Green technologies include renewable energy sources; transition technologies to limit the environmental impact of existing sources of emissions; hydrogen cell devices; medicines for new illnesses that arise due to climate; and new crops needed for changing weather patterns.

It is clear that, as with access to medicines, our critical need to share innovative green technologies to address the climate crisis requires us to explore fully the impact of intellectual property law on our research and development system and how it impacts on access to these vital technologies.

Much remains to be explored in the interaction of the climate crisis and access to medicines, what we can learn from the responses to both crises, and how the many injustices stem from common causes rooted in the way global systems and power structures are built.

Humanitarian organisations respond to crises regardless of the cause. But their efforts in responding will not make up for the failures to act on the causes of some of these crises by our political leaders. Concrete political action to implement solutions to limit global warming and remove barriers of accessing medicine is needed to prevent disastrous humanitarian consequences and hopefully end injustice in access to medicine and green technologies so that people can live in health and well-being.

MALARIA: “HOPE IS VITAL, IT’S WHAT KEEPS YOU GOING”

MALARIA: “HOPE IS VITAL, IT’S WHAT KEEPS YOU GOING”

Her father laid her carefully on the bed in the emergency room. She was unconscious, barely breathing. The medical team began the assessment immediately. A little girl, around eight years old. They said she’d been having seizures Before we’d even done any tests, we all thought the same thing. Malaria.

Malaria is endemic in this region, and in my time as a paediatrician in the MSF hospital in Agok – in the Abyei Administrative Area between Sudan and South Sudan – it was rare for us to have a patient who didn’t have it.

Seizures can easily be fatal if not stopped in time

The rainy season creates pools of stagnant water, perfect breeding grounds for the mosquitoes which carry the malaria parasite, infecting people in such high numbers that we’d had to erect tents to act as overflow wards.

A brain in overdrive

The little girl’s family had walked for two days to get to us. They lived in a rural area and we were the only health facility for miles.

This long journey (they’d had to spend a night on someone’s floor until it was light enough to start walking again) meant that she’d been in a critical condition, rapidly deteriorating, for at least 48 hours.

Somehow, one of our nurses managed to place a cannula and we started her on fluids, strong antibiotics, strong antimalarials and antiseizure medicines. She was moved to the high dependency ward, where the sickest children are cared for. Although the rapid work of the ER team had stabilised her condition, she was still in a coma, and she was still having seizures.

Seizures can easily be fatal if not stopped in time.

During a seizure, the brain is in ‘overdrive’ and doesn’t get enough oxygen or sugar, which can cause brain damage. Another danger is that children can easily stop breathing during a seizure, which can have the same consequences.

All this meant we had to get the seizures under control.

Too severe to survive?

The high dependency team were incredible. In the UK, where I’m from, this little girl would have been cared for on an intensive care unit, probably intubated, with electronic monitoring. She would have had a CT scan and multiple blood tests to understand what was going on. None of this was available to the team in South Sudan. All they could do was simple, structured care.

The girl needed many medications at specific times, and each dose was carefully documented so we could get the balance right. She needed round the clock care to ensure she was hydrated and fed through a tube into her stomach. Even simple things like her position in the bed were important for lowering the pressure in her head.

Still, she didn’t wake up.

Hope is vital, it’s what keeps you going in situations like this. Everyone redoubled their efforts.

A lumbar puncture confirmed that the child had meningitis as well as cerebral malaria.

We told ourselves that if she got to 14 days in the coma, we would have to accept the possibility that we might lose her.

Sometimes we have to switch the focus from trying to save a patient’s life to trying to make them as comfortable as possible, realising that the condition is just too severe for the patient to survive independently.

Filled with hope

On day 13, she opened her eyes.

Suddenly, we were all filled with hope again. Hope is vital, it’s what keeps you going in situations like this. Everyone redoubled their efforts.

All this time her family had been with her. And we had had a lot of conversations with her father, in particular, explaining that even if they wake up from a coma, not all children survive.

Those who do may have very high levels of impairment, while others, with care and a supportive family, would be able to get back to a decent level of functioning.

This little girl’s family were inspiring. The hospital has a physiotherapist, which is amazing for somewhere so remote. He worked with them with real compassion and skill, explaining how to interact with their daughter to help stimulate her brain to start working again.

At first, she was still super sick, unable to move by herself. Her father would sit with her on his lap, talking to her, lifting her hands as if she was waving at the people on the ward. Her mum and grandmother would get involved.

Together they did more than we ever could.

Gradually she started moving her arms a little, and then her legs. And then one day I came on to the ward and found her father supporting her as she walked with her straight, stiff legs. All the other families beamed as they went by.

It had been less than two weeks since she’d woken from the coma.

A team of teams

As I watched her, I thought about the team who had worked to get her to this point.

There was her family, who had been dedicated throughout. There was the team in the ER who gave her that vital initial care. The diligent staff in the high dependency unit who had literally kept her alive day-to-day.

There were the doctors who treated her convulsions, the lab staff who identified she had meningitis and malaria, the nutritional assistants who provided her special feeds, the physio who worked on her mobility, the counsellor who supported the family.

And none of that direct work would have been possible without the logisticians, the administrators, the myriad support staff, and of course the donors, who make all of those steps possible.

Twenty-eight days after she’d first arrived, the little girl was able to go home with her family. She was walking, eating sweets, smiling.

“Nothing will stand in my way”: Pharmacist, student and pregnant in a pandemic

“Nothing will stand in my way”: Pharmacist, student and pregnant in a pandemic

MSF pharmacist Ola Barakat shares her determination to follow her own path and to go where her skills are needed most.

My motto has been: If I don’t follow a path of development, I will end up a miserable woman and a grieving mother.
Ola Barakat, Pharmacy Supervisor

First of all, I am a woman.

I am also a mother of two children, Ayham (four years old) and Adam (eight months old).

From a professional standpoint, I am currently a pharmacy supervisor with MSF in Jordan.

My journey

I’ve worked as a humanitarian with Médecins Sans Frontières / Doctors Without Borders (MSF) for nine years now.

Being part of a humanitarian organisation means you are witness to human suffering, and this experience has made me strong and caring at the same time.

This combination has helped me advance in my career with love and passion and to fulfil my ambitions although this has meant breaking with some of the customs and traditions of my community in Jordan, that can limit the realisation of a woman’s dream.

My journey with humanitarian work helped me fight all my battles, succeeding without hesitation or fear.

Rising to the challenge

Before starting my job as a pharmacy supervisor, I worked in Zaatari and Azraq refugee camps, which are about 85 km away northeast of Amman, the capital of Jordan.

This daily trip was my first challenge as a working woman in a traditional society. I know I was talked about by both the women and men around me, and I was bombarded by questions daily.

I was sure that I was doing what I wanted in both my mind and heart.

“How do you travel alone for such a long distance?” or “how do you keep away from your children in order to work?”. “How do you walk around as a woman among the refugees?” and “are you not being bullied or even harassed?”

All of these questions did not bother me at all. I was sure that I was doing what I wanted in both my mind and heart.

Pregnant in the pandemic

With the spread of COVID-19, pharmacists were fighting on the frontlines of the pandemic. We stood by people who desperately needed us, especially the most marginalised.

Under the general lockdown, when most people were at home, we were on the ground facing the pandemic.

When COVID-19 swept the world, I was seven months pregnant. And, I had three difficult months going back and forth between work and home.

I do not deny that I was afraid, because pregnant women are more at risk of severe forms of the disease, but I took all the necessary preventive measures out of fear for myself and my children.

Disinfection has become a routine daily task.

Balancing life

My days are not easy, between work, family and studying, but I have been able to establish a balance as I am currently pursuing my graduate studies.

My daily working hours in the pharmacy are from eight in the morning until five in the afternoon. I allocate my children three hours of my time, and my studies, too. Given the current situation, most of my studying is online.

I am a master’s student, pursuing a degree in Humanitarian Practices at the University of Manchester in the UK.

I was able to pursue this thanks to a scholarship granted by MSF, which I was able to land through my work with the organisation. I applied to the scholarship, and soon after my application was accepted after I passed an exam.

After my return from Lebanon, many of my female Jordanian colleagues told me they were inspired and encouraged to take on travel assignments.

This is how I became a worker, mother, and student in the most difficult period in history.

This came as a shock to people who surrounded me in our Jordanian society. Everyone considered me weak for being a woman:

“As a woman, you cannot work, raise children and learn. We are men and we cannot do everything you do,” they would say.

I used to get a lot of comments such as “you exhaust yourself”, or “what do you want from this world”, “take care of your home and your children”, and “do not take your role and the role of others”.

But I grew stronger and stronger the more I heard this negative feedback.

Detachment and inspiration

My work at MSF presents many challenges, one of which is the subject of travel or what is known as “detachment”, meaning the experience of working for a certain period outside your country.

The organisation paved the way for me to go on an assignment to Lebanon. I applied with many others to the vacancy and was finally selected.

I was over the moon when my visa was accepted. My assignment was in a pharmacy in one of the organisation’s hospitals, in eastern Lebanon, specifically in Zahle, in the Bekaa governorate.

This assignment was the talk of my community back in Jordan, and it was a shock to them that I would be travelling for six months, leaving my family for work. They considered my behaviour as a mother unacceptable, they never looked at my successes and my ambitions.

After my return from Lebanon, many of my female Jordanian colleagues told me they were inspired and encouraged to take on travel assignments – that was a huge achievement for me.

Ambition without limits

Partnership is one of the main things that help a marriage succeed. My husband is my greatest supporter, and he encourages me to be adventurous, unlike most of the men in our society, stressing that he would be by my side in the good times and bad.

My husband works in the field of journalism and has a PhD in Arabic literature. He is an open and confident man who appreciates my work, cares for my happiness and nurtures my ambitions. It is important to note that few of the men around him support their wives to advance, learn and study the way he has supported me.

I can’t deny that the pressures and responsibilities are great and many, between work, studying and fulfilling family duties. But, all of these tasks make me a successful woman, full of life, and my ambition knows no limits.

My motto has been: If I don’t follow a path of development, I will end up a miserable woman and a grieving mother.

So, instead, I put my career on one hand and my family on the other, and will always find a balance.

“I will carry the memories I made in the Congo for life”

“I will carry the memories I made in the Congo for life”

My name is Samy Gerges. I’m 26 years old and hold a degree in advertising, but until recently I worked as a supply chain officer in a petrochemicals trading company.

I’ve always wanted to go into the humanitarian field where my work would really help others, not help them make money only.

So, I started looking for opportunities in local and international organisations, including MSF. I did some reading on each one of them to know more about where they work and the services they offer.

I identified with MSF more than other NGOs, particularly as a medical humanitarian organisation that is far from politics and agendas.

I applied on its regional recruitment website in the hopes of joining its teams in the field, and after a couple of months, I got the acceptance letter.

At first, I was shocked. I went on to tell my mother, who was aware of my interest in shifting my career from the private sector in Lebanon, then I told my friends with great excitement.

Next destination: the Democratic Republic of Congo.

Lebanon to Congo

I travelled from Beirut to Kinshasa, the capital of the DRC, and I went from the airport straight to MSF’s base.

The trip took us though rough terrain and and a huge variety of different scenes. I’ve always wanted to work in DRC, and I was aware of the economic situation and social disparities through the media and social media platforms. But being there made it all much more real.

People in DRC are dealing with an unstable political setup, and some are also facing homelessness, malnutrition or epidemic outbreaks.

I remember very well when a five-year-old girl, who had been hit by a sharp weapon on the head, was brought to us. Our medical team gave her the necessary care, but, sadly, she didn’t make it. I was the one who prepared the paperwork for her burial and I was there during her funeral. It wasn’t easy for me and I don’t like to think of that incident.
Samy Gerges - Supply Chain Manager

Touching moments

Some of the MSF hospitals I worked in are the only available hospitals in their regions.

We treat patients who have been victims of conflict or sexual violence, including children who have received fatal injuries, such as machete wounds.

I remember very well when a five-year-old girl, who had been hit by a sharp weapon on the head, was brought to us. Our medical team gave her the necessary care, but, sadly, she didn’t make it. I was the one who prepared the paperwork for her burial and I was there during her funeral. It wasn’t easy for me and I don’t like to think of that incident.

A couple of months cannot sum up a whole experience, nor can a couple of paragraphs.

One time I was doing a round at the hospital and I saw a child in one of the beds. He was very small and weighed just 16 kilograms (around 35lbs). He was so thin that his skin seemed to be covering just bones. I asked the nurse about his age, and was shocked to learn he was 10 years old.

I had seen people suffering with malnutrition in documentaries, but that was the first time I saw someone with my own eyes. It was very painful. The child was an orphan who was found on the street and brought to our facility.

Thankfully, he got better as weeks passed by. He was eating well, and he started to interact with me more.

A new perspective on poverty

Malnutrition is common in DRC due to the tough economic situation. However, the country also suffers from epidemics such as cholera, malaria and an ongoing Ebola outbreak in the northwest.

But, despite all that, I feel that my work has a meaning. What I do is needed because it contributes to helping people who are in most need.

For me, my idea of poverty has changed. Some families in Lebanon are impoverished, yet it’s very different compared to what I’ve seen in DRC. Material possessions didn’t matter to me before, but they mean even less and less now. I’ve become more aware of the notions of suffering and need.

A couple of months cannot sum up a whole experience, nor can a couple of paragraphs. I’m sure that the future has a lot in store for me. 

My new family

I worked as a supply chain manager, supervising all supply activities at MSF’s base, warehouse and hospital in Kananga.

Some of my main tasks were keeping the supply chain department functioning properly, managing the logistics of medical supplies and incoming and outgoing shipments, as well as coordinating with other projects while upholding MSF’s rules and regulations.

I was also responsible for the development of the team’s capacities and ensuring all team members were doing their jobs.

From the moment I met the team working in the project, I felt that we were one big family.

The way the team welcomes newcomers makes it easier for us to adapt and alleviates the longing for our families back home. Over the months we’d spend time together during weekdays and weekends.

One thing I took time to adapt to is the use of “mum” and “dad” in DRC, used not only towards one’s parents, but as a respectful way to refer to any elderly people.

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