All's (sort of) well



Since I arrived in Malta on April 18th over sixteen hundred people have drowned in the Mediterranean, and it's sadly starting to look like the deadliest year ever for trans-Mediterranean crossings. European politicians have scrambled to respond and the "Triton" program, consisting of naval and coast guard ships patrolling Europe's maritime frontiers, has just seen its funding tripled. Still it seems their objective won't be specifically "search and rescue" (SAR) benefiting those near death and close to the Libyan coast, but rather "wait and see" much, much farther north. There's chatter in the media about a possible "pull-factor" of Mediterranean SAR operations perhaps luring migrants to their deaths. But people at sea needing rescue and medical care can't really wait for the long-term solution of peace and social justice in Syria, Libya, Eritrea, Iraq, and sub-Saharan Africa to begin, let alone fully kick in. They deserve at least a chance, and certainly nobody deserves to drown at sea.

My six team-mates on this pilot project are all veteran Doctors Without Borders/Médecins Sans Frontières (MSF) staff, with far more than a few dozen missions amongst them, but it's the first such on a ship for all of us. They are all very competent, very efficient, very likeable, and very keen like myself to sail on May 2nd. There's a lot involved in setting up for a six-month season, rescuing and providing medical care for an estimated 10,000 persons! A typical day begins at 8 a.m. making our way in the crazy Malta traffic to the shipyard and/or bonded warehouse near the airport, then some combination of picking through boxes to find just what you're looking for, carrying supplies onboard or stacking and sorting in our warehouse at the shipyard, and setting up our clinic onboard the Phoenix. Medications and supplies are getting organized into sea-worthy storage, and equipment unpacked and tested and batteries checked and charged. A "cold chain" cooler with backup batteries is going in, for perishable medications and some vaccines. The obligatory meetings and other interruptions must happen, such as a safety-tour of the ship and briefing from the captain, etcetera. One day rolls quickly into the next.

Me and Dr. Erna Rijnierse setting up the clinic onboard the Phoenix. This is where the majority of rescued people in need of medical attention will be treated. (Photo Gabriele François Casini/MSF)

Toilet facilities for three hundred are nearing completion on the freshly-painted deck, MSF logos are being painted on the hull, and a couple of decals have gone on the windows showing assault rifles with red lines around and across them: no weapons on board, in keeping with MSF impartiality and neutrality. And yes we had our somewhat sobering security meeting considering various threats and hazards, crowd control, small boats and a small ship at sea, contagious diseases , etcetera, and our contingency plans for each.

The MSF logo being painting on the Phoenix’s hull. (Photo Gabriele François Casini/MSF)

According to planning estimates there may be three births this season on the Phoenix, considering an average of 55 new persons coming on board daily for six months. Therefore we're equipping the clinic with some serious medical equipment including a Dash 4000 monitor with capnometry, oximetry, EKG, and temp probe, a portable iStat chemistry analyzer, two oxygen concentrators, an ultrasonic nebulizer, a Monnal T50 ventilator and associated supplies, EZ-IO drill and supplies, prn isolation tent, diagnostics for malaria, Hepatitis E, and other conditions, obstetrical and gynecological equipment and supplies such as fetal doppler ultrasound, vacuum extractor, and so on. We wouldn't and won't have to use any of it, in a perfect world, but it would be more than a shame to come up short at a critical time, in this imperfect one.

This past week was notably punctuated by a candle-light walk here in Malta for the many, many migrants who perished in one single recent incident, even as rescue was at hand; no lifejackets, probably not able to swim, cramped from sitting or standing crushed together for many hours, and trapped below deck or behind closed doors as their vessel capsized and sank. "There must be about 800 people in view now", one of my companions noted, looking at the long quiet procession, candles flickering, stretching around the St. Julian's Bay promenade. "Imagine us all suddenly drowned." Nobody spoke for a while. I thought about that once again today, a needed Sunday of rest for our team, as I rode the ferry back from a brief stroll around historic Valletta. A beautiful and substantial wooden two-masted sailing vessel entering the harbour caught my eye, rails lined shoulder-to-shoulder with people. Enjoying the sunny, cool, clear Mediterranean late spring afternoon, before returning to their hotels.

I am ready and I really want to see us and the Phoenix fully prepared, and heading south.