Since SOS MEDITERRANEE started its operations in 2016, 5,137 women have been rescued by the Ocean Viking and the Aquarius. They represent about 15% of the 34,074 people rescued in the central Mediterranean by our teams. Pauline, SOS MEDITERRANEE midwife in charge of taking care of the women and children rescued by the Ocean Viking on April 2021, looks back at the medical care and psychological first aid provided onboard, as SOS MEDITERRANEE is getting prepared for a new mission at sea. This mission will be the first joint mission with the International Federation of Red Cross and Red Crescent Societies (IFRC), our new partner. The IFRC will provide post-rescue support, such as medical care, psychological support, protection activities as well as basic necessities to the people who have been safely brought onboard the Ocean Viking. Pauline tells us more about the medical needs of the women and children rescued by our team and the crucial activities to be soon undertaken by the IFRC.
1/ What was the state of health of the women you met on board the Ocean Viking in April 2021?
The women rescued by SOS MEDITERRANEE since 2016 have, for the most part, made long journeys in different countries. They have been highly exposed to many types of violence: physical, sexual, psychological, and/or forced labour. Girls and women who travel without a parent or male partner are particularly vulnerable to human trafficking and sexual exploitation in Libya. This sexual violence leads to immense suffering, loss of dignity and immediate and long-term medical and psychological consequences. Women may contract sexually transmitted infections or face unwanted pregnancies. Most have not had access to medical care for several months or even years. Untreated infections and unwanted pregnancies in Libya can lead to medical complications. It also has consequences for mental health causing anxiety, depression, addictive behaviour, and tendencies towards social isolation which can sometimes lead to suicidal behaviour. Pregnant women are also particularly vulnerable as they are excluded from all preventive and monitoring care related to pregnancy.
Most of the women I met on board the Ocean Viking last April told me that they had experienced several of these forms of violence on their migration route and in Libya. They arrived in a very tired and stressed state with, in addition to the rest, symptoms directly linked to the sea crossing. They were seasick, dehydrated, and reported generalized body pains, especially due to their position in the overcrowded boat we rescued them from. Most of them reported being beaten to force them to board the makeshift boat. Some also had fuel burns. The mixture of salted water and fuel in the bottom of these dinghies is extremely corrosive to the skin. These burns may require treatment for several days or even weeks.
Some women were accompanied by young children who are also exposed to the violence of this migratory route. I could see the impact on their mental health as they gradually relaxed and opened up to our teams and between each other after a few days on board the Ocean Viking.
2/ What are the main medical and psychological treatments that you and your medical team have been able to provide?
Once the evacuation phase from the boat in distress is over and the survivors are on board the Ocean Viking, one of the first needs identified for these women and children is for them to rest and feel safe in a place where they do not have to fear for their lives. We have a shelter dedicated for women and children on the aft deck, where their privacy is ensured.
We also have the capacity to provide medical first aid in a clinic installed on the aft deck. This medical module is similar to a mini hospital. There, we receive pregnant women for consultation in order to monitor their pregnancy, identify any pathologies and prevent complications. We have all the necessary equipment to manage childbirth and provide first aid to the new-born. We are also able to stabilise the health of patients who require specific care on land. We can report them to the health authorities upon disembarkation or request a medical evacuation from the maritime authorities depending on the urgency of the situation.
As with every mission at sea, last April we also explained to the women survivors (as well as the men) the support that can be offered to survivors of sexual violence. We can provide medical care and, if the assault took place within five days of their arrival on our ship, provide women with emergency contraception to prevent unwanted pregnancies. We also have treatments to prevent sexually transmitted infections (HIV, Hepatitis B and other STIs).
Finally, the Ocean Viking is a place where women can benefit from a place where they can talk and be listened to. For us, respecting the confidentiality of such exchanges is crucial, even in a reduced space like a ship.
3/ You have just returned from your first mission at sea. What has marked you the most?
Beyond medical care, we want to offer a benevolent ear and a safe space where words are free of judgement and where everyone can drop off what they wish to leave behind. I sometimes had the feeling that the deck of the Ocean Viking was a repository of emotions and memories, sometimes almost unspeakable. For example, some women confided in me a part of their story that they had never spoken about before. I think it’s important that they felt free to share what they often cannot tell their families or loved ones, and which will perhaps allow them to leave the ship a little lighter, to continue their life’s journey.
I had an image in mind before I got on the boat. The idea that in a small space, a little out of time, I was going to share snippets of lives, emotions, stories, looks, gestures, smiles… Coexisting with these terrible stories, and in spite of the hardships and the events experienced, these women keep hope. The courage and strength that this mobilises grips me. For some, the hope is to live in a peaceful country one day, for others, it is to study or to allow their children to have a chance to get out of the cycle of violence in which they grew up.
Seeing these women and children open up as the days go by on board, smile and exchange, is a very strong memory for me.
A woman’s story: “This man forced her to work for him in his home and reduced her to a state of sexual slavery”>
“On board the Ocean Viking, I met a 22-year-old woman from Cameroon, whom I will call Leïla to respect her anonymity. She told me part of what she went through in Libya. While she thought she was going to Algeria, Leïla was brought to Libya against her will. As soon as she arrived, she was forced into prostitution. She was threatened with death when she tried to defend herself and escape.
After a while, Leïla eventually managed to escape. She tried to flee Libya via the sea once, but the Libyan coastguard intercepted her boat. All the people onboard, including Leïla, were forcibly returned to Libya. She says she was then taken to a detention centre in a coastal town.
There, a man picked her up and took her home – after tying her up and laying her down in the back of the car so that she would not know where she was being taken. This man then forced her to work as a handywoman in his home, and sexually abused her. Then one day, without her knowing exactly why, he finally set her free. She fled by sea three weeks later.”
Cover picture: Flavio Gasperini / SOS MEDITERRANEE