If despair could be a single image...

"The universal language of smiles is often mixed with tears. These are emotions that are hard to describe."

If despair could be a single image...

… it would be an overcrowded rubber boat filled with fellow humans on the horizon of the Mediterranean in the early morning.

Two rubber dinghies sit on the horizon of the sea

© Anna Surinyach/MSF

If fear could have a face, it would be the one of 22-year-old Mussa from Senegal, who was tortured brutally in Libya  and will be taken care of by our medical team on the ship Dignity 1 because he has multiple rib fractures and he is suffering from severe pneumonia.

I will never forget his anguished look when I had to wake him up, because he was asleep – or more precisely, semi-conscious - lying on the floor blocking the way to our small ship hospital.
His facial impression will stay with me for a long time. He didn’t know immediately where he was, and that he is now in safety. And it’s not only Mussa’s face where I’ve seen this fear. Each human individual we receive on the boat carries their own history with them that drives them to the perilous flight across the Mediterranean. If we have 450 rescued people with us on board, that not only increases the load the ship carries in kilos, but we also take on an indefinable and incredibly heavy emotional load.
People sleep on the deck of the ship

© Marta Soszynska / MSF

For a month now I  been on an MSF assignment  in the Mediterranean Sea on our rescue ship Dignity 1. Thousands of people, women, children, men and families are still taking the perilous route across the Mediterranean to reach Europe, because there is still no safe alternative. There are still so many people whose living conditions are so bad that they would rather risk their lives than to stay where they are. "I'll drown rather than go back to Libya", is something we often hear.
Antonia sits with children on the boat
© Anna Surinyach/MSF
This is already my eighth assignment with MSF, and to be working on a ship is extremely unusual. Never before has the organisation worked on a ship. Daily life here has its own rules.
Overall, we are a team of 20 people. With a length of 50 meters, there are one or two spots where you can escape the busy work schedule for a few minutes and to take some personal time off. But if then there are an additional 450 people on board, you sometimes don't know where you to step without tripping over someone. 
The ship's MSF crew is mostly Spanish, and although I speak fluent Spanish, I had to start again learning the vocabulary that’s specific to life on board a ship. 
On a day like today, if there is not a rubber boat in distress on the radar because the waves are now too high for people to even begin the journey, the ship is entertained by the sailors. 
The medical team is preparing the hospital for the next rescue mission. Since we never know exactly when that will happen, we have to be ready. 
And we all take this moment to take a deep breath and to process our experiences. So for now, I sit on deck in the fresh air to prevent sea sickness (working on the computer at sea is quite a challenge!) and write this blog, which still gives me shivers even after re-reading it.
Photo of Antonia with her back to us.
© Anna Surinyach/MSF
This 'quiet-ish' time may change at any moment. If a loud shrill alarm sounds throughout the ship, we know that we need to be ready as quickly as possible for a rescue. So let’s put on a life jacket, boots and a helmet, grab your walkie-talkie, close some doors and open others, turn on the ventilation and be prepared for the people who come aboard. 
Sometimes we find rubber boats 'by chance', but also we get emergency calls from the Italian MRCC (Maritime Rescue Coordination Centre), when  there is a rubber boat that needs our help. 
First, we approach the boat, which we do with our own smaller rescue rubber boats. This is not always easy, since they often move away from us, because people do not know who we are and are afraid of us. Or else, they simply don’t know how to manoeuvre the boat or how to switch off the motor. 
Once we can get the first contact, we explain who we are and that we will take everyone with us on the Dignity 1 to bring them safely to Italy. Life jackets are distributed and the transfer begins.
A rescue taking place - the rubber boat draws alongside the ship
© Anna Surinyach/MSF
Once they are on board with us, we give everyone a warm welcome, register them and give out food and water. A very short triage helps us to know what state of health they are in. The first thing many people do is pray - the relief is written on their faces.
A man prayers on board the ship
© Anna Surinyach/MSF
When they come on board many people are extremely hungry and thirsty, but after a few sips of water and a few bites of food, they just lie down and immediately fall asleep because of they are so exhausted.
Sleepers on board the ship
© Anna Surinyach/MSF
Many women cry when they arrive, when the enormous tension and anxiety suddenly is relieved. Often they fall right into my arms and the only thing I say is "You're safe".
The universal language of smiles is then often mixed with tears. These are emotions that are hard to describe. I am very happy to have these feelings; because of these emotions I know that I'm not jaded or indifferent even after my experiences with MSF and the confrontation with extreme amounts of suffering.
A single tear trickles down the cheek of a woman who has been rescued
© Anna Surinyach/MSF
As soon as all the people are on board and the hecticness has calmed down a bit, and as long as we’ve dealt with any medical emergencies, we then perform a general medical 'check up'. We take everyone’s temperature and check everyone for scabies. People with medical problems are then cared for in our hospital.
Antonia performs a health check on a man on board the ship
© Anna Surinyach/MSF
People remain on board with us for different amounts of time. If we go to Italy, they often stay on board for two nights and we get to spend some time with them. That's very nice and I really appreciate this time a lot. But it is also very important then to find your own personal balance, to be able to hear the often very stressful life stories and at the same time to protect yourself so that the emotional load does not paralyse you.
Many people tell us about their stay in Libya before their departure. There, torture, forced labour, sexual violence and human trafficking are commonplace. The stories are like hammer blows, Libya seems to be hell for many people who pass through it. (Our photo story Trapped in Transit has more about the situation in Libya.)
Sometimes a transfer is made to another rescue ship, which is already on the way to Italy and we are able to remain in the rescue zone for any further rescues. In those situations, we often have to work late into the night to get everything ready to accommodate new guests on board the next day.
The days go by very quickly, because there is always something going on and because I love my work. I consider it a great privilege to be on the Diginity 1 and to welcome our fellow human beings with dignity. I am grateful that I can do this.
If hope could be a melody...
... then it would be the clapping rhythms and vocals of our guests on board, echoing across the sea, once they are strong again and realise that they are safe.
Women raise their arms and sing with joy on board the ship
© Anna Surinyach/MSF
And if there was a safe and legal way to Europe, so many people would not have to be risking their lives every day.  #SafePassage