Krankenschwester Christine während eines Trainings auf dem Rettungsschiff Ocean Viking

[Interview] Christine – nurse and medical team leader on board- about emergency care during a pandemic

The nurse Christine spent seven weeks on board the Ocean Viking as head of the medical team for the rescue mission. During this time, the crew rescued hundreds of people from boats in distress. Christine and her team – a doctor, a midwife and another nurse – provided medical care to many of them. Her team was also busy complying with the strict COVID-19 protocols on board. In this interview she recalls her experiences and the challenges related to search-and-rescue operations during a pandemic.

1. It had been your wish for a long time to work on a civilian rescue ship. Why?

I wanted to support people in need again after a long break working in different fields. Until 2007, I had gained experience in numerous MSF projects around the world. Afterwards, I worked in palliative care, which is very fulfilling for me, but I also wanted to get involved politically and socially. Working in sea rescue seems to arouse so much anger and hatred among the population, even though we just give a hand to people fleeing across the Mediterranean so that they do not drown. Saving lives of people in distress at sea is a legal duty, but for me it is also a moral duty.

2. What are the tasks of the medical team during and after a rescue? What care can you provide with your onboard clinic?

Many survivors are deeply exhausted immediately after their rescue, some have inhaled fuel fumes, which can lead to confusion. The longer they have spent in their unseaworthy boat, the greater the risk of dehydration from not drinking enough water, of hypothermia from being wet and cold, or overexposure to the sun. Not to mention the fact that medical care in Libya is inadequate and many people have suffered terrible injuries, both physical and psychological. Many women were raped. Some come on board our rescue ship being pregnant.

Once the survivors are on deck after a rescue, our task is to immediately decide who needs medical help the most urgently. Is it the woman, heavily burdened by rape and who got pregnant from it, or the little boy with insatiable vomiting, or the 18-year-old whose leg has grown together crookedly after an untreated fracture and whose second leg shows scars from torture?

Our clinic is very well equipped and so we can treat acute health problems such as pneumonia, dehydration or infected wounds. We have enough antibiotics and painkillers on board, the most important medicines. The clinic has some beds, so people can also stay overnight for monitoring. And if there is a situation that needs intensive monitoring, we request a medical evacuation. During the two missions I participated in, there were two such situations. Both times it was a woman with a high-risk pregnancy.

3. As soon as survivors are on board, a strict hygiene protocol is prevailing on the ship to prevent possible coronavirus infections from spreading. How does this work with several hundred rescued people on deck?

With more than four hundred people on board, sufficient distance can hardly be maintained. But the survivors wear medical masks and are urged to practice hand hygiene; there is plenty of water and soap. The shelters are open, so they are permanently ventilated, and during the day people are mostly on deck, outside. Crew members wear protective clothing, often with goggles and always with a tight-fitting FFP2 mask. We have enough rapid tests on board and we test people with COVID-19 symptoms.

In the last rescue mission, we happened to detect coronavirus infections on board among the survivors. There is the possibility of isolation, but of course not for a very high number of people affected. After each rescue we immediately request a place of safety – when there are COVID-19 cases on board, this is of course even more urgent.

4. Wearing a protective suit, mask and visor or goggles, how is it possible to build trust with people, many of whom have experienced violence, torture and exploitation?

People quickly understand that we are acting in their interest. They realize that we ensure their survival and don’t take them back to Libya, but instead to a safe place. Our team immediately informs them and reassures them about this. After the rescue and the registration is completed, there is a welcome speech explaining who we are, what we do and what the procedures on the ship will be. Of course, we don’t know how much trust will develop in the following days. But it is often enough for them to tell us their escape stories or to seek medical care from us.

5. You have decades of experience in global humanitarian aid, working in conflict regions and refugee camps. How did you experience the rescues and the time with the survivors on board? What was new or surprising for you?

My joy about having rescued so many people was and still is overshadowed by the fact that in the same time period, even more people were intercepted by the Libyan coast guard and forced back into a situation marked by violence, exploitation, hunger and hopelessness. The time with the rescued people on board was too short to build a relationship. But some of them I will keep in mind: For example, the Sudanese man with a severe wound to his head who had been beaten up in Libya. Despite his difficult situation, he appeared composed, but also grateful to have been in our care for a few days. I fear he will still have a long way to go.

To me, emergency aid means helping another human being to survive; sea rescue does this in such a direct way that it takes my breath away.

6. Given the reality of refugees, the humanitarian catastrophe in the Mediterranean, how do you think the EU is dealing with the situation?

We should not speak of a humanitarian disaster; it is much more a political disaster and, as a result, a human tragedy. Both show that the values of the European Union do not apply in the Mediterranean Sea. The fear of the “foreigner” obviously leads to human rights being denied and human lives meaning little. The fact that we all contribute financially to the Libyan coast guard which forces people back into the inhumane camps they have just escaped from shames me deeply. And it motivates me, and hopefully many others, to act against this injustice.

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Interview: Petra Krischok
Photo credits: Header – Fabian Mondl / SOS MEDITERRANEE, Gallery – Flavio Gasperini / SOS MEDITERRANEE and Hippolyte / SOS MEDITERRANEE