Fieldset
Saving lives at sea: Part One

It's September 2018 and nurse Catherine is on board the search and rescue ship Aquarius, jointly operated by MSF and SOS Méditerranée. In this diary extract, she describes a rescue that almost ended in disaster for dozens of people fleeing violence in Libya.

MSF nurse Catherine Flanigan watches on as survivors are transferred from Aquarius to Maltese authorities

The journalists are awake. It’s 2 am on deck, windy and cold, and I can see the journalists are being woken up by the communications staff.

When all of them are up in the middle of the night you know something’s happening. Have we spotted a boat? Are we heading to a rescue?

I lie on a bag of lifejackets outside on the main deck, on my rostered deck watch shift. We take it in turns to stay on deck with the rescued people all through the day and night, and tonight I’m on with one of the SOS Méditerranée guys.

Usually, we’re giving out food, taking the rubbish, cleaning up. But at 2 am and with only 11 rescued people on board, there’s not much to do.

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Search and rescue ship, Aquarius
Search and rescue ship, Aquarius

We watch through the doorway to the corridor as the communications staff and journos talk. We just keep chatting, a little bit of forced calm from my side, probably less so for him – he’s done this 100 times before.

It’s only my second rotation of three weeks at sea.

The waiting game

The Aquarius has 11 people on board but is still in the search and rescue zone off the coast of Libya. We could spot another boat at any minute.

The Italian Maritime Rescue Coordination Centre in Rome has stopped alerting any vessels to boats in distress, so if we find anyone, it’s on our own, often with very little warning. It’s a weird feeling of trying to relax and save energy and being hyper-alert at the same time, 24 hours a day.

We’ll find out eventually what’s happening when we need to. It might be a relaxed update in the morning meeting, or a sudden call on the radio – “Easy 1, Easy 2, prepare for rescue” – and it’s all go.

This time the deputy search and rescue coordinator gets to us with the information first. There’s a wooden boat in distress. It’s a few hours away so he tells us to try and get some sleep; he’ll call us when we’re needed.

Wooden boats can be especially dangerous – there’s a risk of the whole boat tipping over and trapping people, injuring people

I don’t think he, the deputy search and rescue coordinator, or the project coordinator ever sleep. They're up on the bridge, in the dark with the green glowing monitors, watching everything.

Then we hear that the Libyan Coastguard is going after the same boat but they're further away from it than we are. We go to the aft deck and see a tiny red dot in the distance.

“Is that the Libyan Coastguard?”

“Could be.”

A race against time

We don’t know the situation of the wooden boat – it could be taking on water, anything could be happening. Time counts.

All three engines of Aquarius roar as we speed to the location. The rescued men are all fast asleep on the deck, oblivious, exhausted from their own ordeal over the days and weeks and months before.

I go back to my cabin, aware that as soon as we start a rescue, it could be a very long time before there’s a chance to eat or sleep again. I’m about to go to sleep but reconsider, get changed into the clothes I’ll wear for a rescue and make sure my lifejacket, helmet, everything is laid out and ready to go.

I’m the medic on the rigid-hulled inflatable boat this time, so I need to be ready within minutes if we get called. I sit on the floor of my cabin nervously eating chips, going over the steps of a rescue in my head, trying to remember if I’ve forgotten any equipment.

Around 4 am I’m on deck when the deputy search and rescue coordinator comes to find us again. He tells us to get ready, “but just slowly, take your time, have some coffee”.

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Rescue crew members on board the Aquarius
Rescue crew members on board the Aquarius

Within a few minutes, the deck is alive with people; everyone is up and wearing all their rescue gear, preparing to lower the rescue boats into the water. The deck leader is coordinating a team and a lot of different ropes, cranes and movement.

The rescue teams are up on the small boats doing checks and getting ready. The MSF team is all up now too, getting all the resuscitation equipment ready on deck, preparing the bags of food and clothes we give to survivors on arrival.

The logistician is explaining to the sleepy survivors what is happening; they are now on an upper deck silently watching us. They saw a rescue from the waterside yesterday, now they are watching from a much safer vantage point. I wonder what’s going through their minds.

No time to talk to them. Aquarius has stopped and the air is motionless. I sit near the landing gate, checking my medical bag – Ambu bags for rescue breaths, check. I’m nervous to leave my team and go out into the black.

It’s my first night rescue and it feels different.

Target: medium wooden boat

The MSF cultural mediator comes to sit next to me. He’s waiting to get onto his boat too. He makes the first contact with the people, gives a speech in English, Arabic, French.

It’s an extremely responsible job. If you do it well, you can keep people calm, keep the rescue smooth, keep everyone safe. If you don’t manage to do that… it’s a very responsible job.

The boats are ready in a matter of minutes. The search and rescue coordinator comes down to the main deck and quickly briefs us.

“So the target is a medium wooden boat, maybe 50 people on board...”

Wooden boats can be especially dangerous – there’s a risk of the whole boat tipping over and trapping people, injuring people. Night rescues are also notoriously difficult. You can’t see the waves, you can’t see people in the water.

One little boy with a huge mop of hair is positively beaming, his eyes glowing at the sight of orange inflatable boats

We’re going to need to be really careful. But we know all of this, we’ve done drills on it many times. Most of the team have done this before, many times.

I normally love the sea. But it’s so different at night; you can’t see the movement, you can’t see the waves, just black. I certainly can’t see a wooden boat with my eyes blinded by all the deck lighting.

We’re not sure how far away the Libyan Coastguard boat is. We’ve had some tense confrontations with them before and the political situation has made this even more complicated.

But it’s not the time for us to think about that right now – time is precious for this wooden boat.

"We are all here standing with you"

Easy 2 is in the water. Easy 1, my boat, is lowered down into the water by a crane, I grab my backpack and climb on board. As soon as I’m here, the driver calls: “hold on!”

I grab a rope. “Holding!” we reply, and we pull away from Aquarius and speed off into the dark.

The rest of the Easy 1 team is already on board. The deputy is standing at the front of the boat, coordinating all of us. He is speaking into his radio, being guided by the search and rescue coordinator on the bridge.

I remember my radio and do a test call to my project coordinator, Aloys. “Aloys to Catherine, radio check,” and wait in the dark for the standard reply of “good copy”.

Aloys is up on the bridge in an extremely tense situation but somehow the reply that comes is still uniquely his: “Yes Catherine, I can hear you clearly, and we are all here standing with you.”

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Aquarius rescue crews set their sights on the wooden boat in distress
Aquarius rescue crews set their sights on the wooden boat in distress

It didn’t hit me until much later how nervous I was and, simultaneously, how much better his message made me feel. No time to think about it, suddenly I see it.

We are approaching the blue wooden boat, rocking in the waves, lit up by Aquarius’s searchlights. Thankfully it looks stable. As much as a tiny, overcrowded matchbox boat in the middle of the Mediterranean is ever stable.

Easy 2 makes the first approach and the cultural mediator gives his message. It’s difficult to hear with the engines and the wind.

I can hear men shouting but they sound urgent rather than panicking: “There’s water, there’s water coming on the boat, from the back.”

The deputy search and rescue coordinator reassures them: “Everything’s going to be okay, you’re safe now. I just need you to stay sitting down and do exactly what I say.”

The boat leader asks them if anyone is sick. A few people are vomiting. I climb up to the front and we do a lap around the boat so we can assess the situation and I can do a quick triage.

One by one

There’s something like 50 people on board – men, women and children. They speak Arabic and English. Everyone looks alert.

There’s no one I’m immediately worried about medically. A few people are vomiting off the side of the boat as it lurches.

I radio this info back to the Aquarius. I don’t hear if there’s any reply, we’re barely close enough for radio connection.

We start distributing lifejackets, passing them up by the armful to the deputy search and rescue coordinator, who passes them to the wooden boat, one by one. He keeps reassuring the people and explaining things.

It’s difficult to see clearly and the boats are rocking, but everything feels under control.

We start to take the women and children on board Easy 1, with Easy 2 standing by to stablilise the boat if needed. The guys help them step up off their blue wooden boat and onto the rescue boat, and I help them sit down on the rubber sponsons.

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People are transferred from the wooden boat to the Aquarius' rigid-hulled inflatable boats
People are transferred from the wooden boat to the Aquarius' rigid-hulled inflatable boats

Our one job is to keep track of how many people on each side, which is surprisingly difficult to do – they seem to arrive faster than we can count.

The women are all well enough to climb on themselves. Some of them look bewildered, some of them are happy to see us, some are vomiting.

This first interaction of a few seconds: take them by the hand, “welcome”, sit them down. Try and convey in that few seconds that they’re safe now, that they’re going to be fine.

One by one, one adult then one child.

The children

The children are a total mix. Some of them are tiny, have no idea what is going on and are clearly loving the novelty.

One little boy with a huge mop of hair is positively beaming, his eyes glowing at the sight of orange inflatable boats.

A few are terrified. One little boy starts screaming when separated from his mum as she climbs in. One of the rescuers crouches down and flashes his headtorch to distract the boy and he stops, mesmerised. 

I’m mildly surprised until I remember he has two little girls of his own at home. A very different context but distracting toddlers is not new for him. 

People keep arriving; we try to keep the kids with their mums or at least an adult, put child lifejackets on or tighten the adult ones they already have, and quickly assess the vomiting ones who I now see are a bit drowsy. 

“How many do we have?”

“Eight women, 10 children.”

The deputy asks: “Are there any more children?”

I hear something about a dog but of course, I misheard. How can there be a dog? But another child gets passed to me and then: “Here comes the dog!”

A small white dog is suddenly on the rescue boat. Her family quickly settle her on a bed of lifejackets. Whether she’s calm or terrified I don’t know, but she curls up and doesn’t move.

A small part of my brain files away how ridiculous this is that we have a dog on board, a fact to consider later.

A sinking feeling

Eventually, Easy 1 is full of people, with rows of women and children sitting on either side. We keep busy checking their lifejackets, making sure they’re okay, making faces at the kids.

The deputy search and rescue coordinator is on his headset radio to the bridge.

“Yeah Aquarius, this is Easy 1. Can we get green light to boat landing? We have 10 women and 12 children on board.”

I can’t hear his reply and am concentrating on the vomiting women, but it gradually sinks into me that something’s not quite right. We’re not moving.

We should be heading back to Aquarius to disembark the women and children. But we’re just floating there.

The deputy search and rescue coordinator keeps speaking to the bridge. We circle around the wooden boat.

Eventually, he looks up at all of us and announces something: the Libyan Coastguard is coming very near.

SAVING LIVES AT SEA: PART TWO >