Leone was an entirely unpretentious person. We joked a fair amount about the name of the boat, the Pilacchiera, which struck him as a curious name.* I did not tell him that she was named after the pilacchi, or winged cockroaches, with which she was crawling.
When we took tourists and divers aboard the Pilacchiera for a small fee, we would usually provide a picnic. The difficulty was making sure the pilacchi did not get to the food first. Many years later, when I at last canceled the boat’s registration, I discovered she was 102 years old. My great-grandfather had christened her the Gaetanino; I had not known she had lived through so many generations of Bartolos.
Sometimes the local fishermen also took the island’s visitors for trips in the trabiccoli, also called saccalleva, which were sailing boats without motors. But in time the coast guard decided to dispose of the trabiccoli, because they were old and obsolete. They were stacked one on top of another at Cala Palme, the beach behind the pier. They were fine boats, and they soon became our playground. At the sterns we would construct nache, rope swings from which we swung five or six yards above the sand.
The authorities eventually decided that the trabiccoli had to go, because they were taking up too much space. Even as children, we were upset because we realized that a piece of our history was being destroyed. The livelihood of Lampedusans had once depended on these boats, and now they had been consigned to the scrap heap. But since there not many trees on Lampedusa, the wood the boats were made from was also immensely valuable.
Ironically, the task of destroying the boats fell to us boys. We dismantled the boards one by one. Like a line of ants, we carried them to a bakery that wanted them for the ovens, and there they were turned into firewood.
It saddened me to see them slowly burn and turn to ashes. My only consolation was that we were earning some money. In fact, after the ashes had been shoveled out of the oven and into a heap outside the bakery, we boys had the shrewd idea of rummaging through them in hope of finding something even more valuable: the nails that had held the board to the shell-plating of the ship. We sometimes got into fights over these, since there was an old man in town who collected scrap metal and who was always willing to buy them. He paid us far better than the bakery did for the wood.
When I grew up, I sometimes thought of the mistake our parents’ generation had made. We should have saved at least some of those boats, and housed them in a museum to preserve our heritage. Today, we are committing the same mistake all over again. Near the football field of Lampedusa, there are even higher piles of boats: those on which migrants made their crossings, and that tell dramatic stories of rescues and tragedies. We call that place the “boat cemetery.” It is a colorful cemetery, full of blue, turquoise, and white vessels. They bear Arabic names on their sides, recalling the days when they helped people to fish for a living, and ferried no one to their deaths. Those boats will almost certainly be dismantled too. There is not enough room for them, just as there was not for our trabiccoli. Only the objects left on them will survive: life jackets, scarves, and clothes salvaged by young Lampedusans. This time, they will be exhibited in a museum.
* Deriving from the Greek for “to spread mud,” pilacchera is a mildly vulgar, antiquated term for a sordid and miserly person.
You brought this upon yourself
I received an urgent call to the pier. Five hundred people had come ashore in a single boat. Almost all of them had scabies. In Libya they had been forced to live in filthy huts for months, sleeping on straw mattresses and under blankets crawling with mites and lice. In conditions like that, you are lucky if scabies is the worst of your ailments. The mites burrow under your skin and give you a maddening itch, especially at night. The more you scratch, the angrier the rash becomes, until finally you are in searing pain, covered with infected crusty sores.
I have often come across scabies, but this was an unusually large-scale outbreak. One young Eritrean couple had the worst case I had ever seen. Their hands were raw and flaking, and they scratched themselves to bits, mutilating their skin as if it were not their own. They were both taken to the reception center along with all the others, where they would be given a two-day course of benzyl benzoate, a powerful regimen that works well but requires careful dosage. I had determined the dose myself and it was exceptionally heavy, but there was no alternative. The infection was severe and had to be eradicated at once.
As doctors, we are continually responsible for making difficult decisions. If you cannot cope with the risks involved, you should not enter the profession. There are no short cuts: you simply must have a clear head when deciding how and when to treat a patient, and once a decision has been made, there is no turning back.
When the two days were up, I returned to the reception center to check on the couple. While I was waiting to get through the security checks and all the usual red tape, I saw a young man and woman I did not know coming toward me. The man was weeping. He dropped to his knees in front of me and kissed my hands. I was bewildered. “Get up, what are you doing?”
“At last, after seven years of torture, my wife and I have finally been able to get a good night’s sleep.” Only then did I recognize them as the Eritrean couple I had come to see.
I embraced them, and went on my way. I needed no further confirmation that the treatment had worked.
“Pietro, come to the bathroom right now.”
Rita woke me one day as I was dozing on the couch. She sounded worried. I had been on the pier for hours, examining yet another group of refugees, and was stopping by home to take a break. I was still half asleep, but what she said next jolted me upright: “I found blood in her stool.”
Our daughter Rosanna was born with a heart condition, and was operated on when she was only a few months old. Five years on, she was still our most protected child – we would get nervous if she had so much as a cold.
We took the next flight to Palermo and rushed Rosanna to hospital. She was admitted and the doctors did all kinds of tests, but they could not find the cause of the bleeding. So we got on another plane, this time to Rome. Meanwhile, we were getting frantic. Rosanna was admitted to a well-known pediatric hospital, but they could not give her a diagnosis either.
It had been two weeks, and the specialists were still in the dark. Then something occurred to us. I talked to the doctor and asked him to perform an analysis of her stools. He declined, saying that it was not necessary, that I should remain calm, and that sooner or later they would find a way to cure her. There is nothing worse than being a doctor among doctors, and feeling powerless as your own child wastes away.
We cajoled a nurse into collecting a stool sample in secret, which I then took to a laboratory for tropical diseases. One of the doctors there obligingly agreed to help. “Leave it with me, and I’ll phone you when I have the results,” she said. But I never had to wait for that call: by the time I had reached the ground floor, she already had the answer. As I was walking out of the building, she called to me from the balcony. “Please come back, Dottore.” I bounded up the three flights of stairs with my heart in my mouth.
She took me to the room where the slides were examined and motioned to a microscope. “Look at this little cotton ball. It’s giardiasis.” I had learned about giardia infections at university. The giardia is a microscopic parasite that attaches itself to the intestine. Though it sometimes causes blood to be present in the host’s stools, it is easily treatable. Our hunch had been well founded: I must have picked up the parasite while working at the pier. Though I had no symptoms, I had passed it on to Rosanna. Infections are fairly common in some of the countries that people flee, because giardia thrives in contaminated water.
I thanked the doctor profusely and dashed back to the hospital, elated that we had diagnosed the problem and that it was nothing serious. I gave Rita the news and hugged her tightly. Rosanna was in bed, and I covered her with kisses as if I hadn’t seen her in a century. We were as happy and carefree as anything. The following day, we returned h
ome with the antidote in our pockets.
Rosanna soon recovered, and those twenty days became nothing more than a bad memory. But when I told certain friends and acquaintances about the incident, there was something sour in the way they responded. You brought this upon yourself, they seemed to be thinking. No one is making you spend all your time with people who could be carrying serious infections and diseases.
I have watched this attitude spread wider as the number of asylum seekers increases. It does not help that news coverage of the issue has been sporadic at best, and inattentive at worst. Mothers are worried about sending their children to schools near reception centers. Some of them even protest against classes for migrants being held in their children’s classrooms after school.
Not only are these fears morally unacceptable, but they are idiotic. It is true that scabies occurs frequently, but we make sure it is treated before the migrants leave the reception centers. And if you look at the numbers, you will see that the cases of tuberculosis or other infectious diseases are extremely rare. We simply have to do our jobs as doctors, and identify the serious cases quickly so that the contagion does not spread – which is exactly how we treat our Italian patients too. We cannot and will not be governed by our fears. We must open our doors and homes to the migrants. Rita and I have done it before, and we would do it again.
Favor with the media
May 25, 2016. It was 2:00 a.m. A freighter full of migrants who had been rescued in the Sicilian Strait raised the alarm. Twenty of them were severely unwell. Since they were unable to continue their journey under such conditions, a rescue boat went to pick them up. We alerted the ambulances, as well as both our own helicopter and the one belonging to the nearby island of Pantelleria. By the time they came into port, it was already 8:00 a.m. Most of the passengers were women, and victims of what might be called “rubber raft sickness.”
In twenty-five years of medical emergencies, I had never dealt with burns of this kind until Operation Mare Nostrum* and the Frontex missions began. The further afield the rescuers went, the more they found people relying on makeshift or run-down boats, often rubber rafts that ran on gasoline instead of diesel.
The smugglers top up the tank during the voyage, and inevitably spill some of the fuel. The petrol combines with salt water to form a dangerous mixture, which then snakes its way along the air deck toward the passengers.
In the rafts, men usually sit along the edges while the women stand in the center with the children in their arms. The lethal mixture of petrol and water soaks through the clothes of these women. At first it gives them a pleasant and apparently harmless sensation of warmth, but gradually it begins to cause chemical burns on the skin of their feet, legs, and buttocks. The liquid slowly eats through every inch of their clothing and then goes on seeping into the flesh, softly mangling its victims.
The pier had become a disaster scene. The first woman I saw was lying on a stretcher, covered with a space blanket. She did not have the strength to stand. The second woman could barely walk. Even leaning on me and a volunteer, she only just made it to the ambulance.
A third woman lay on the floor of the rescue boat, wrapped in a white sheet. She looked like an angel, but one who was suffering greatly. We helped her onto the pier. “Take it slowly,” I told the rescuers. “Be careful of how you touch her.” She was in such poor shape that she could scarcely move. I carefully lifted her arm onto my colleague’s shoulder and we started walking, taking little steps. I gently removed the sheet. Her buttocks had been reduced to raw flesh. She was determined to stay strong, and refused to let out a single whimper even though her face was convulsing. One at a time, the women got off the boat, all suffering horribly from the burns from that deadly solution.
Then a volunteer handed me a beautiful little baby girl, with big black eyes and a sweet, round face. The child looked perfectly dazed. I asked where her mother was, but nobody could tell me. I gave her to Elena, who was there to assist me again that day. “Don’t leave her alone for so much as a minute,” I said. “And don’t give her to anyone unless it is her father. Please just take care of her until I get back.” I kissed the child on the head, and went back to the women.
At the clinic, we dressed the wounds. Everwhere we turned, we saw horrific white sores on black skin. We were in a frenzy as we tried to disinfect and bandage them all. Beneath the gauze, the wounds were still burning. It was excruciating to witness the agony of these unfortunate women. A strong smell of gasoline permeated the room.
All around me, nurses, doctors, assistants, and ambulance workers were charging to and fro. As always, every second counted.
As we finished treating each group, the stretcher- bearers came in and carried them off to the ambulances, which then took them to the landing pads, where the helicopters were already waiting.
Words cannot describe the generosity and selflessness of my colleagues at the clinic. We are a small team, and each person plays a unique and crucial role. Emergencies are all too ordinary here – we see them almost every day. Over the past twenty-five years, we have examined and treated almost three hundred thousand people.
That day, I was so tired I could hardly breathe. I was feeling sick, and my chest felt tight. I wanted to scream. You can wear all the protective gear you like, but you cannot protect your soul. This is war. A war we did not ask for, and in which we are up against superior forces. This war sends dozens of its wounded to us every day. And all we can do is wait, literally, in the trenches.
When the last of the women had been taken to the ambulances, I returned to Elena and to the only miracle that that hellish morning had left us.
“Her name is Favor,” Elena said. “She is nine months old, from Nigeria. Her mother was pregnant, but she died during the crossing. Another woman has been keeping her safe ever since. She told me there were a hundred and twenty passengers crammed onto that raft.”
I tried to imagine Favor’s mother, desperate in the knowledge that she was about to die. She’d had no choice but to leave Favor in another woman’s arms: a stranger whom she had only met on the last leg of her journey. She had given away her precious child in the hope that she, at least, would survive.
Favor looked at me with her wide eyes. She was wonderful. She had been given a bath, and was wearing a new dress that made her all the more adorable. She drank all her milk up straight away – she must have been hungry. Now she was playing with a doll. I held her in my arms for hours. It felt as though she had always been with me. Our photograph together went viral. She looked straight into the camera as if she were used to being photographed, almost as if she were posing.
I took her to the reception center where, according to law, I would have to leave her. But I did not want to hand her over. I had a lump in my throat.
I ran home to talk to Rita, and called my children. I wanted to apply for custody of Favor. Rita was patient with me. She knew how impulsive I can be. This time she did not say no as she had done with Anuar. But she did say: “Pietro, I don’t want you to be disappointed. The court will have to decide who should take care of Favor, and they aren’t going to just award us a baby.”
I was determined. I called the district office and the officials I knew at the ministry – everyone I had met during my years of working with refugees. I knew it might not be proper procedure, but the child had stolen my heart. I was sure she would thrive with us. We could give her the care and attention she deserved.
The following morning, shortly after dawn, a social worker named Cristina helped me to put together a formal application to be sent to the family court. I hoped to be the first to submit an application. All morning I kept checking my mobile telephone, hoping I would get a call from the authorities.
But as usual, Rita was right. No one called. We would not be given custody of Favor.
Meanwhile, the reception center prepared for Favor’s departure for Palermo. I could not muster the courage to go to the airport. I knew it would hurt to see her in the arms of t
he smiling police officer whose job it was to take her away – even if I knew it was wrong to think such things.
The photograph of us together and my public appeal to win custody of her meant, at least, that the situation was quickly resolved. Hundreds of families from all over Italy called the authorities to say they would be willing to host her. The adorable baby with big black eyes did not have to wait long. In Palermo, she has been entrusted to a couple who may end up being her new parents. They have waited years for a child, and are willing to adopt irrespective of race, age, or sex. They have received a wonderful gift in Favor, but they also know they may still lose her. The adoption is not yet final, since the authorities will have to make sure that Favor has no living relatives, and there are complicated bureaucratic procedures to complete. Favor’s mother may have been trying to reach family members elsewhere in Europe.
If it turns out that Favor really is eligible to be adopted, then the adoption will be a national one. As President Sergio Mattarella declared on his visit to Lampedusa, Favor is “unquestionably Italian.”
The woman who had been taking care of her on the boat, Sofii, also asked after Favor from her hospital bed, where she was still recovering from her burns. She wanted to know whether she had managed to complete the mission the mother had given her. The doctors were able to reassure her that Favor was in excellent hands.
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