Dr. Conor Kenny:

In response to the rest of the questions, I will return to what Mr. Taylor said about NGOs being a pull factor. It is very frustrating to work in that environment and for the narrative to be there focusing on the pull factor instead of the fact that people are dying at sea and that has been the case for many years. We should bear in mind that NGOs only got involved in the water in 2014 and 2015. There were naval vessels well before that. The majority of rescues still continue to be done by Government vessels. NGOs serve to take the burden off merchant navy oil tankers and other people who are ill-equipped to deal with the situation. It is frustrating to hear that when the narrative should be on the number of deaths at sea. Regarding organ donation and migration, I have never heard of anything like that and I have not come across it in the medical clinic at all.

In terms of the medical care provided when people reach Italy, the night before disembarkation I draw up my list of people whom I need to refer to the Italian Ministry of health. The number of people on the list is directly proportional to the poor quality of detention centres from which they have come. Often, many people suffer from the same infection as a result of horrific sanitation. I then refer those people to the Italian Ministry of health. I also refer people whom we could deem to be vulnerable cases. They may be unaccompanied minors or people who have suffered serious psychological distress after being tortured for many months or witnessing people being killed. The problem I face is that I could refer everyone on the boat, all 600 or 900, but I cannot. I have to think of an arbitrary threshold to make the referrals on psycho-social issues people have. It is very difficult to do that. There is a strain on what the Italian health care system can do. One has to be selective in whom one can refer on. MSF does work in Italy. It is doing new projects in Sicily to manage the psycho-social issues on land and to help support the Italian health care system that way.

As Mr. Taylor said, the co-ordination of rescues is done through the MRC in Rome. Very often we work with naval vessels and other NGOs to support them doing a rescue. We may provide the life jackets and they may take the people on board their boats or vice versa. If a naval vessel needs to go back to port we disembark people onto the naval vessel or vice versa.

My experience is that the co-operation has been positive. The problem is that often there are not enough assets in the water. More often than not, our boat has been overloaded by almost double its capacity. Going into port in Catania or Sicily, we have been found to be listing to one side because we were well over double our capacity. That is an insanely and incredibly dangerous situation but we have no other support. We do not even have a merchant navy vessel to assist us in rescues. This is a major issue.