The official death toll from the shipwreck off the coast of Steccato di Cutro in Calabria, southern Italy, recently had to be corrected from 70 to 72 – a woman and a 3-year-old girl. They belonged to a group of almost 200 Migrants who left Turkey, but whose wooden ship was smashed against rocks in rough weather and broke.In a similar situation, in the night from 6. to the 7. March a group of 105 migrants found drifting in international waters off the coast of Libya. The engine of their 12 Meter long inflatable boots was fancy. It was full of water and weather conditions deteriorated rapidly. On board were 59 Men, 17 Women (one of whom is in the 7. 25-unaccompanied minors. They had Zwara, Libya, on 6. March at 14:00 Originally from Nigeria, Côte d’Ivoire, Guinea Conakry, Gambia, Sudan, Cameroon, Mali, Mauritania, Sierra Leone, Chad, Eritrea and Burkina Faso.
The Italian non-governmental organization (NGO) Emergency fortunately sent these endangered passengers their rescue ship, the Life Support, to help.Around 4:00 In the morning, the RHIBs (rigid inflatable boats) were launched. 3 Hours later, the transfer of the castaways was completed.
Paola Tagliabue, M.D., a specialist in anesthesia and intensive care medicine at the Policlinico Hospital in Milan, has worked on 3 Rescue missions at sea. In the years she was for the Spanish NGO ship Open Arms and in December last year she took part in the first mission of the Life Support. «When we arrive near the boat, the first RHIB leaves with an experienced nurse and a cultural mediator on board to make an initial assessment of the situation,» explains Dr. Tagliabue to Univadis Medscape Italia. «This is a very critical phase.»
The first task of the cultural mediator is to explain that the crew is not from the Libyan Coast Guard.The latter has reached an agreement with the Italian Government to send immigrants back to Libyan detention camps from which there is evidence of torture and ill-treatment. The aim is to prevent passengers from getting upset, as this could endanger the stability of the makeshift boats. The nurse performs an initial triage. It determines whether there are persons on board in a critical condition who need priority treatment. Then the passengers are divided into groups of about 20 People are taken to the rescue ship, where they are immediately given a thermal blanket and a numbered bracelet. A second rapid triage is performed to identify victims of burns due to prolonged contact with fuel and seawater. Afterwards, passengers take a shower and receive fresh clothes. «Fortunately, most rescued people do not require emergency treatment, and besides burns, the most common major complaints are hypothermia and symptoms of drowning,» explains Dr. Tagliabue.
State intervention sometimes hinders the performance of rescue organisations.The «NGO decree» is a controversial law passed in January by the Italian government with its right-wing Prime Minister Giorgia Meloni. The law prohibits NGO rescue organizations from calling at the nearest port. Instead, it requires them to ask permission to dock at an approved port, often hundreds of miles away. Even before this new decree was passed, migrants often had to spend long periods of time, sometimes days and weeks, on ships before reaching an approved port. On a mission of the ship Open Arms, some migrants risked for 8 days of waiting to drown by jumping overboard. They had been waiting within sight of the coast for permission to enter a port.
Protocols and bureaucracy
For each rescue situation, Emergency has developed a protocol that takes into account space availability and personnel composition.At Life Support there is a station for first emergency treatment, a ward for primary care and two-year mobile stretchers for observation. The staff includes a doctor specializing in resuscitation or emergency medicine, two-_ nurses and two-_ Cultural mediators who also act as translators. In extreme cases, evacuations are necessary. Such a situation occurred on the recent mission of Life Support. A woman in the advanced stages of pregnancy began to vomit and suffered from incipient dehydration. She was quickly brought ashore by patrol boat.
The Geo Barents, a vessel operated by Médecins Sans Frontières, recently rescued a group of 48  in the waters off the Libyan coast; Migrants and refugees. On the basis of the aforementioned «NGO decree», which imposes restrictions on civilian rescue operations, the ship was ordered to take the migrants to the port of Ancona, Italy—– it has been stuck there ever since.Médecins Sans Frontières (MSF) is accused of failing to provide data from the voyage data recorder (VDR, i.e. the black box). The Port Authority of Ancona has a 20-day administrative penalty and a fine of 10,000 Euro. However, according to the NGO, this data may only be requested in the event of an accident at sea. For this reason, the decision was appealed. In the meantime, however, the ship is stuck and cannot be used for new rescue operations.
«We plan to set sail again in the next few days,» said first-aid physician Riccardo De Bernardi, a member of the medical staff on board the ship, told Univadis Medscape Italia. Staff also includes a medical team leader, nurse, psychologist and obstetrician. According to De Bernardi, after several months of lack of assistance, these migrants are often in dire straits.Many suffer from diseases such as scabies («scabies»), which they contracted in Libyan prisons. They can also have conditions such as otitis, mycoses, various infections or acute abdominal complaints, often caused by constipation. In addition to managing medical cases, Geo Barents staff deal with psychological stress and the consequences of torture and violence, including sexual violence, which is very common in Libyan prisons.
The medical staff working with Emergency and Médecins Sans Frontières are determined to participate in future rescue operations at sea. Before working on rescue ships, Paola Tagliabue spent three  in 2015; months in Sierra Leone to help set up Emergency’s Ebola treatment centre. Now she plans to participate in a new mission before the summer. «Taking care of these people also means respecting their silence,» explains the Milan-based intensive care doctor.»During the mission last December, I had the privilege of listening to many of their stories—but it’s hard for me to describe the feeling I felt when I saw the eyes of the people we were bringing to safety on board. Saving lives is the only right thing to do.»
This article originally appeared in French at Univadis France.
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Source — https://www.univadis.de/viewarticle/die-rolle-von-%25C3%2584rzten-bei-der-rettung-von-migranten-auf-2023a10005u1