TEARS OF SALT
A Doctor’s Story
Pietro Bartolo & Lidia Tilotta
With the collaboration of
Giacomo Bartolo
Translated from the Italian by
Chenxin Jiang
W. W. NORTON & COMPANY
Independent Publishers Since 1923
New York • London
For our fathers,
Giacomo and Gaspare.
For our mothers,
Grazia and Nuccia.
For the mothers, fathers, sons
and daughters, who are only asking
for a place where they may
live and grow.
CONTENTS
Mare nostrum
One red shoe
There is no getting used to it
Women on the way
The wounds you cannot see
Drawing lots
An irrevocable choice
The girl in the front row
Risky investments
A Fèrra
Back to the island
Little pieces of home
Omar is unstoppable
The will of the waves
The greatest gift
Faduma and Jerusalem
Young Anuar’s wisdom
A blessing from heaven
Giacomo’s path
Arms of giants
God is not to blame
The lengths they will go to
When a mayor understands what world leaders cannot
L’erba tinta un mori mai
The off-season tourist
Never shall I forget
The boat cemetery
You brought this upon yourself
Favor with the media
Lampedusa
October 3, 2013
Children of the same sea
Acknowledgments
Letters to Pietro Bartolo
TEARS OF SALT
Mare nostrum
The water is icy. It’s freezing me to the bone. I can’t bail it out fast enough. I run from one end of the dinghy to the other, using every ounce of strength and agility I have, but it is no good. The boat is still full of water.
Then, before I know it, I’m overboard. It is the dead of night. I am only sixteen, and I thought I was invincible: how could this be happening? It hits me that I am about to die.
On board the boat, almost everyone is asleep. Whoever it is at the rudder, he does not even seem to have discerned that the dinghy is now unmanned. I’m frightened. We are forty miles from Lampedusa. If the others do not hear me right now, they’ll leave me behind, and that will be the end of me – they won’t even know I’m gone until they are back in port. This is not how I want to die, not at sixteen. I’m terrified.
Panic sets in and I start to shout at the top of my voice, kicking hard to stop the sea from dragging me under. The Mediterranean enables us fishermen to make a living, but at any time it can choose to abandon us, turning into a cruel and pitiless monster. “Patri!” I shriek, hysterical. “Patri!” The man at the rudder is my father. But he cannot hear me. This is it, I think to myself, but I keep screeching at the top of my lungs. Then something astonishing happens. My father turns, and notices me. He sees my flailing arms, hears my desperate, croaking voice, and turns the boat around to rescue me.
My father calls out to wake the others, and soon there is a flurry of activity on board the Kennedy. The waters are choppy and the seamen struggle to haul me out, but soon enough they manage to lift me to safety. I am cold and sick. As I vomit salt water, shivering and bawling like a small child, my father holds me tight and does his best to warm me up. The trawl is over. But although we return home empty-handed, we have saved one life. Mine.
At home in our modest fisherman’s cottage, I refused to speak for days, even though I had never been a quiet boy. Usually I could not keep still, but now I could barely move. Not a single word escaped my lips. For the first time in my life, I had stared death in the face.
I did not know it then, but that would not be the only night to remain etched in my memory. My whole life would be scarred by a capricious sea that spits out living or dead bodies at will. One day it would be my job to try to save the living, and to be the last person to touch the dead. Now, every time I go to the pier and see a man, woman, or child, frozen and sodden, eyes wide with fear, I think back to that night when I was sixteen. Sometimes the memory returns to haunt me, but in the three decades that have passed since then, I have accumulated other, more devastating nightmares. I am afraid that there are still more to come.
In an attempt to cook one last hot meal before the long crossing, Amina and the other women were trying to fit a gas canister to a makeshift stove with a length of pipe. The flames blew back, and they could not get away. Burns carpeted ninety percent of their bodies. It was a horrifying sight. But the smugglers in Libya took no pity on them. The women were forced onto a raft, and there they drifted, in agony, until the military police of the guardia di finanza picked them up.
The rescue workers did not even know how to touch the women, how to get them on board the patrol boats without causing them more pain. And yet, even as they were carried to shore, the women did not utter a single moan.
I could hardly believe my eyes. Looking at the scale of the injuries, I barely even knew where to begin. Every time a boat lands, it brings a new challenge: we never know what to expect. Each group of migrants needs different treatment, another kind of specialist care that we are not prepared to give.
This time, there were twenty-three. One nineteen-year-old had died of her injuries. The youngest child was two years old and burned from head to toe. I tried my utmost not to hurt them, but scraps of skin were peeling off their bodies, exposing the raw flesh beneath. They all needed to be transferred immediately to a hospital in Palermo or Catania, where they could receive the care they needed. There was not much we could do for them, here on Lampedusa. The helicopters raced against time, shuttling the patients to hospital. Finally, when the last woman had been taken on board, we took a deep breath. We had done it again – almost.
A few days later, I was walking along the Via Roma, Lampedusa’s main street, still thinking about those patients. A social worker stopped me and told me about the only man on the boat, who was now in the refugee reception center nearby. I remembered seeing him too, unhurt, with a toddler in his arms. I had assumed that the little boy was his son, but the social worker explained that, in fact, the child belonged to one of the women who had suffered burns. Days had passed, and they were still navigating the bureaucracy, trying to figure out who the mother was.
We got into a car and sped toward the reception center. I was fuming. If the mother had already been discharged from hospital and sent somewhere else, we might not be able to reunite her with her boy.
Since we did not know his name, we called him Giulio. We spoke to the man who had been holding him the day the boat came in, and had him describe to us Giulio’s mother. We ascertained that she was one of the women who had been sent to Palermo, and immediately set to work to make sure the two would be reunited. Only a few hours later, Evan was in his mother’s arms – that was what his name was.
One red shoe
One red shoe on Favaloro Pier. That one shoe and so many others like it lie there, scattered like pebbles in a trail that leads to nowhere, breaking off abruptly like the migrants’ hope of coming ashore in a different world. Those shoes appear in my nightmares. So do all the little pendants, necklaces, and bracelets on all the tiny bodies I examine. It is my job to unzip them, one by one, from those horrible green bags.
As children, my friends and I never wore shoes. The hardened soles of our feet were all we needed. We went to school barefoot, went fishi
ng barefoot, and played barefoot in the streets of Lampedusa. The island was our single stepping stone in the middle of an immense sea. Breathtakingly beautiful and breathtakingly remote, Lampedusa is a rock that leaves all who set foot on it with a yearning for Africa. It can draw you into its magnetic field, bewitch you, seduce you like Circe.
No shoes, therefore, except on formal occasions.
Not that there were many of those on Lampedusa. In fact, there were hardly any at all. One of them, however, would change the island’s future: the opening of the only civilian airport. It was such an important day that we were all told to put on our detested shoes for a ceremony officiated by the minister for the Mezzogiorno, Paolo Emilio Taviani, who had undertaken to build the airport after Lampedusans protested the lack of one by abstaining en masse from voting.
We filed out of our classrooms in starched smocks, accompanied by our teachers. Everything had to be perfect. Unfortunately, halfway there, I found I had somehow lost a shoe. I left my place in line and ran back to retrieve it, pursued by my teacher. She has never let me live down that act of disobedience. But I simply could not have gone home with one shoe missing: it was the only pair I had, and we could not afford to buy another. A moment later, I was back in my place in the line, wearing both shoes, and we were at the airport.
It was a ceremony so solemn one would have thought that the Lampedusans had been engaged in an historic fight for our lives. In time I came to understand that, in fact, this was precisely true. On Lampedusa, people were dying of perfectly ordinary flu-related complications. Travel by sea took hours and often, in winter, the ferries had to remain in the port for weeks on end. Every now and again we would see a Grumman, the emergency service hydrofoil. But this happened only rarely. After the Grumman was shut down people relied on military aircraft instead, but they took hours to get to Lampedusa and often arrived too late.
When I returned to the island in the 1980s, after studying medicine and specializing in obstetrics and gynecology, I felt strongly that this should change. The mayor, who had known me as a boy and seen in me a potential for political advocacy, encouraged me to run for a post in local government and fight for the improvements I had in mind. Sure enough, in 1988 I was appointed deputy mayor and councilor of health, and the five years that followed were some of the most intense of my life. During this period I pushed hard for Lampedusa to get a permanent air ambulance. I made repeated trips to Palermo until the regional government agreed to put up the six hundred million lire (350,000 dollars) it would cost to establish the service.
This was a big step forward. Finally, Lampedusans would be able to reach a hospital quickly, and we would all feel a little less isolated. But at the very beginning there was no doctor on board, and until we had the means to hire one, I often ended up accompanying the patients on a voluntary basis. We then found the plane to be an unsatisfactory solution because it could not be landed on our neighboring island, Linosa, and so those residents were still being unfairly deprived of care. After a few years, it was replaced with a helicopter. Though my term as deputy mayor ended in 1993, my struggle for better health systems on Lampedusa and Linosa continues.
There is no getting used to it
Sometimes I think I cannot hold out any longer. I cannot take this pace of work, and more importantly, I cannot handle this much suffering, this much pain. Many of my fellow doctors think I must have got used to it by now, that the postmortems must have become routine. That is not how it is. You never get used to seeing dead children or women who died giving birth on a wrecked boat, their tiny babies still attached to them by their umbilical cord. You never get used to the indignity of having to cut off a finger or ear from a corpse to be tested for DNA so that the victim might be given a name, an identity, and not merely a number. Every time I open a green body bag, it feels as if I am doing it for the first time. Every body carries the marks of its long and tragic journey.
People often assume the chief obstacle for refugees is having to cross the sea. That is just the last hurdle. In a mixture of Italian and French, and with the help of the interpreters who work at Lampedusa’s reception center, I have spent hours listening to their stories. The choice to leave behind home and country. Then the desert: they say that is a hell you cannot understand unless you have been there yourself. The heat is stifling. You are crammed onto a pickup truck, and if you so much as sit in the wrong place, you will be thrown out and left to die. When the water runs out, you are reduced to drinking your own urine. Finally you arrive in Libya and think the nightmare is over, but it has only just begun: ill treatment, prison, torture. Only if you manage to survive all of this do you finally make it onto a boat. Only then, if you do not die on the open sea, will you arrive at your destination and begin to hope that your life can start all over again.
On Lampedusa, I have seen it all.
One morning on the pier, I was taken aback on seeing a woman disembarking from a motorboat. She had come from Gambia, and she was radiant. She had on a brightly colored dress, and was carrying a suitcase as if she had just got off a train. She looked elegant and proud, as though all her troubles were behind her. As I watched her get on the bus to the refugee reception center, I was seized by the impulse to follow and ask her to tell me all about her painful past and newfound hope. But the reality was that I had to stay put and do my job. The bus turned a corner and disappeared.
I have seen Palestinian families who thought that in Syria they would find asylum from the war in their homeland. Instead, they had been caught up in another war and made to start all over again: another journey, another ordeal.
The Syrian families were perhaps the most sorely uprooted of all the refugees. They were forced without warning to give up their way of life, and they might never be able to get it back.
When the first migrants arrived more than twenty years ago, the Lampedusans called them “Turks.” They were mostly North Africans who landed on the beach in dinghies or on life rafts, having made their way without the help of smugglers. At the time, this was a new phenomenon and they were few in number. But all at once, everything changed: many more refugees arrived, with many more reasons for fleeing home. And that is why I now need the support of Lampedusans to do my job. When despondency threatens to get the better of me, they give me the strength to keep going.
Women on the way
Jasmine arrived on a vessel packed with more than eight hundred people. Many of them had been huddled together on top of one another in the hold, and all of them were doing badly. By the time they were on land, Jasmine’s waters had broken. There was no time to take her to Palermo – her child would not have made it. So I tried to keep her calm while I did an ultrasound, and showed her the tiny heart and head of her daughter, who was in fetal distress. I decided to perform an episiotomy, a surgical cut at the opening of the vagina – a risky but necessary procedure. The delivery went smoothly and Jasmine gave birth to a perfect little baby girl. She decided to name her Gift.
It is invariably a joy to see a mother smile when her child is born. But what happened next was a surprise. I came out of the operating room late at night, covered in blood and exhausted, to find a crowd of women waiting outside. They were Lampedusan mamme who had brought Gift everything she could possibly need: nappies, baby clothes, toys.
It was at that time that I realized we needed better facilities for children at the clinic. The women who were pregnant often had young children, who would watch the doctor fearfully as he took their mother off to a room full of strange machines. We had the simple idea of setting up a cheerfully decorated playroom next to the examination room, with plenty of toys and games to keep the little ones busy while they waited. It worked so well that children did not want to leave when it was time to go – though they could usually be coaxed out again with a small present.
In the spring of 2016, one boat brought in three pregnant women, including one from Nigeria named Joi. She was in her fourth month and alone, because the traffickers had forcibly
separated her from her husband. She had been ordered to one side and he to another, and both were powerless to object. The traffickers had raped her, then bundled her onto a boat. She had no news of her husband.
“Please help me find him,” she implored me. “I don’t want my son to grow up without a father. We have risked everything so that he could be born in a better country. You can find him. Please, I’m begging you.”
Sometimes, when I am the only friendly face in front of them, patients feel as if I am no longer their doctor, but a savior who can give them back their loved ones and reunite their families. Regrettably, as in Joi’s case, this is not always within my power. At other times, I am simply the only person in whom they dare confide the unabridged horror of their plight. Too often, when I have performed an ultrasound, the patient makes the same heartbreaking request: to abort a fetus conceived not of love, but of rape.
One day, a Nigerian seventeen-year-old named Sara arrived at the clinic. She told us over and over that she wanted to die. The other young girls who had been traveling with her told us that Sara had made several attempts on her own life. In the ward, she threw herself off a stretcher in a desperate effort to end it all.
We did an ultrasound that revealed she was eighteen weeks pregnant. I tried to show her the screen, but she could not stop crying. “There, there,” I said. “Everything will work out. You’ll see.” But who was I to console her?
Sara looked me straight in the eyes. “I do not even know who the father of this child is,” she said. “I was raped by five men. They took turns and only stopped when they had run out of energy to torture me. What do you think, Doctor? What is this thing inside me going to mean to me, now and for ever?” Her story enraged me. Those evil thugs.
I could not possibly condemn her decision. I called the doctors and social workers at the health authority in Palermo. She was transferred there by helicopter the following day. She had an abortion and is now being cared for in a shelter.
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