An Emergency Evacuation

We were at the rescue zone off the Libyan coast, where we understand that some 8,000 refugees were plucked from their little boats in the last 2 days. How appalling is that. It is said that this huge increase corresponds with the end of Ramadan – refugees now being able to eat at sea during the day.

At 6 am we received a call from NGO vessel Sea Eye requesting assistance with a critically ill refugee. A 36 year old Ghanaian man was comatose, with a very high fever, seizures and a stiff neck. My splendid nurse Roberto and I went across to Sea Eye by RIB boat

Having excluded cerebral malaria with a test kit we transferred him across to G Azzurro. With an initial diagnosis of meningitis we started intravenous antibiotics and gave meningococcal prophylaxis for our crew. He was deeply unconscious and required intubation.

After the huge refugee pickup over the last 3 days, mercifully we had no reports of further boats at sea. Our request for air evacuation was refused by the authorities because of their concern about infection.

After hours of unproductive negotiation with the Italian Coast Guard, Rome and the EU border protection group Frontex we decided to take our bloke back to Lampedusa ourselves.

I felt easier about this 8 hour trip because there were no reports of other refugee boats at sea and those thorny moral equivalence debates did not arise.

We used this trip to continue aggressive cooling and rehydration of our patient, given our alternative diagnosis of severe heat stroke. He began breathing spontaneously but he tolerated his endotracheal tube without demur, which was presumptive evidence of severe brain damage. We were met by ICU doctors on the wharf at Lampedusa at midnight. He was transferred from there to Sicily but sadly he did not recover consciousness and died en route.

All in all this was a huge effort by Golfo Azzurro. There had been no question by Open Arms about the decision to undertake the detour and I was impressed by the energy and absolute commitment with which her crew undertook the task.

Now, 24 hours later, we are back on station at the rescue zone, some 20 miles off the Libyan coast. With no reports of refugee boats at sea we heave to, swim and laze. Not quite what I had been led to expect.

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