Fieldset
Macaroni

It’s hard to believe that I’ve developed such a negative visceral reaction to the name of a food that I actually like to eat: the word “macaroni” now fills me with a sense of hopelessness and dread.

It’s hard to believe that I’ve developed such a negative visceral reaction to the name of a food that I actually like to eat: the word “macaroni” now fills me with a sense of hopelessness and dread.

For the past two months I have been working as the MSF doctor on the MV Aquarius, a search and rescue boat operated by MSF in partnership with SOS Mediterranee. Virtually every person we have plucked from dangerously overcrowded rubber and wooden boats off the coast of Libya has told me that they were held in “detention” in Libya. 

There are many different types of “detention” – some are government-sanctioned holding facilities where people who are caught in the country without proper documents are held, but other “detention centres” are windowless hovels devoid of toilets, full of despair, holding people who have been kidnapped for ransom while trying to get to coastal Libya. People often wait indefinitely until their families can gather enough money to pay for their freedom from the detention centres. 

Our passengers tell us that they are often beaten, raped, and starved while in detention. As they are tortured, their families are called so they can hear their screams of their loved ones as motivation to pay up quickly.  We are told that the price of freedom is as high as $6000 USD.  In these detention centres, we are often told that when, and if the people do get fed, they are given meager servings of plain macaroni.

This week I met a woman who told me that she had been in detention for 9 months.  Her weight prior to detention was 58kg but when I weighted her on Aquarius, she was only 36kg. She had gone from being a woman roughly my size to a skeletal frame who was so short of breath and weak that walking a few steps made her sweat and pant for air.  When I asked her what she had eaten in the past 9 months she answered with the usual words: “only plain macaroni”. 

Those in detention are not given tomato sauce (which might have some vitamins in it) or meat sauce (which would have some protein) but just plain noodles. Along with generalized malnutrition, I have seen people with classic signs of scurvy (vitamin C deficiency): mouth ulcers, lip sores, fissured tongues, loose teeth, and sores over their bodies. 

Prior to this mission, I had seen cases of severe malnutrition in children and adults with chronic diseases or in contexts where there were severe food shortages due to conflict, but I had never severe malnutrition through willful neglect in a place where food is available.  I am horrified by people’s ability to torture their fellow human beings.

Most of our passengers tell us that for the rest of their lives, they will never eat pasta again. It is, therefore, somewhat ironic that we disembark them in Italy – the land of pasta. Their stories alone are enough to leave me with mixed feelings about pasta in general and what will likely be a longstanding irrational aversion to macaroni.