A tiny Italian outcrop just 113 kilometres from Africa, Lampedusa rose to worldwide prominence in the years after the Arab Spring, when it became widely known as the front line of the migrant crisis.
Thousands of citizens from Tunisia, Libya, Eritrea, Nigeria, Somalia, Syria and elsewhere fled from conflict and catastrophe and attempted the short but treacherous crossing from Tunisia to Europe, many having bankrupted themselves and their families to pay smugglers for their passage.
Almost half a million people have attempted to sail to Lampedusa from Africa since the millennium, and at least 15,000 have died on the journey. In truth, the scale of the tragedy may be far worse than those dreadful figures imply.
Like many other satellites separated from their mother ships, Lampedusa has endured a challenging history.
Overseen, administratively at least, by Sicily, the island is an outlier in every sense of the word. In the early 18th century, the Earl of Sandwich visited Lampedusa and found it deserted, save for one inhabitant.
Two centuries later, by now more populated, it was bombed into submission by Allied planes during the Second World War and surrendered in 1943. Back under Italian control in the post-war years, basic infrastructure, such as telephony and a power station, was put in place to serve the island’s 6,000 inhabitants. Nevertheless, its beautiful beaches, rocky landscape and characteristically sleepy way of life make it ill-prepared to serve as the door to Europe that thousands of migrants seek to walk through every month.
Dr Pietro Bartolo, who runs the medical clinic on the island, and the journalist Lidia Tilotta bring the island's present to life in a book titled Lampedusa: Gateway to Europe.
The volume serves as part-memoir and part-reportage from Europe’s graveyard route. A slim work, it should be required reading for those EU politicians tasked with migration policymaking.
Dr Bartolo will be familiar to those who have watched Fire at Sea, Gianfranco Rosi's Oscar-nominated 2016 documentary about Lampedusa and migration. Rosi's subtle film weaves a delicate story far removed from the blunt prodding that is preferred by more polemical filmmakers. He points the camera at the tough and challenging work of the Italian Navy as it rescues and processes a near endless stream of migrants.
Never judgemental nor prejudiced, always sympathetic, these duties and the snapshots of migrant life are recorded without commentary. But his film’s loose narrative finds its centre in a trifecta of unlikely sources on the island: one of the town’s radio presenters, as well as Samuel Pucillo, a 12-year old boy, and, finally, Dr Bartolo, who is both a man of extraordinary compassion and a world-weary soul. Lampedusa may appear on a map as an inviting gateway to Europe, but the reality is something else altogether, a theme that the film explores in great detail.
This is a message he carries into the book, where the same mix of heavy heart and compassion is at work. “On Lampedusa,” he tells us, he “has seen it all”. It is his job to make the trip to the pier each time new arrivals are spotted or picked up. Those who survive the trip from Africa are universally dehydrated, malnourished and exhausted.
Many suffer from stinging chemical burns from boat fuel that their skin has come into contact with. This is what he calls “rubber-raft syndrome”, a seemingly benign term for the most malignant condition.
“The lethal mixture of petrol and water soaks through the clothes. At first it gives a pleasant and apparently harmless sensation of warmth, but
gradually it begins to cause chemical burns … softly mangling its victims.”
Others perish mid-crossing. “Every time I open a green body bag, it feels as if I am doing it for the first time,” he writes.
Death and doom punctuate the book, none more so than the tragic events of October 3, 2013, when rescue boats were scrambled, but brought back hundreds of corpses. The death toll reached 368. “Dead bodies floated everywhere,” the doctor recalls.
Deceit is in the air too. Many of us may foster an opinion that migrants cram on boats as a final option to escape desperate circumstances. In truth, traffickers spin fanciful lines to those willing to pay for passage: “I was happy to leave Ghana,” a 19-year-old migrant relates. “Everyone told us how amazing Europe was. They said we would find jobs and make money … but we have been through hell. The journey was horrible and I have no idea what to do now or where to go.”
Others are told Lampedusa and the European Union will provide safe harbour. Omar, a Tunisian who fled the uprisings, thought “they would be in Italy within hours, and that from there they could make their way to other countries in Europe.” He was, instead, pencilled in for repatriation and future likely imprisonment.
Dr Bartolo treats a teenage girl who was given a contraceptive injection by traffickers before she travelled. The drug forced the temporary onset of a premature menopause. His medical opinion is that these injections are administered to allow the traffickers to sexually abuse their prey with impunity. He wonders how those he treats and cares for have such inner strength and fortitude.
Trafficking, always the darkest of arts, appears to be descending further into the depths, with organs and body parts being the new currency.
Dr Bartolo sees this as an inevitable consequence of the dehumanisation of migrants, who can be “exterminated without trace”.
Only joined-up, multinational international policy-making can combat this new threat and find solutions to the broader issues at play here.