Another dispatch from Alison Criado-Perez of MSF, from a search and rescue boat in the Mediterranean run jointly by @MOAS (Migrant Offshore Aid Station and @MSF. She joined a few days ago.

The call has come in from the MRCC, the organisation in Rome that coordinates the rescues: we’re being directed to help two wooden boats with about 700 people on board. So it’s happening. Our adrenalin starts pumping. What are we going to find? What kind of a state will the refugees be in?

The MOAS crew – Igor, Antoine, Mimmo – lower the rescue boat (RHIB) into the water and set off with Simon, our Canadian doctor, to assess the situation. The rest of us, the small MSF team, stay on board the Phoenix to help prepare for the embarkation. I check the clinic to make sure everything is in order: the drugs, the oxygen concentrator, the monitors – we have no idea what we’ll need.

“Ali, Ali!” I hear someone call. I rush to the embarkation gate at the side of the boat – and Mimmo hands a tiny child up to me from the RHIB, his big brown eyes wide open in stunned amazement. (I later learn that at about the time I am holding this little boy in my arms, the world is being shocked by the photo of little Aylan Kurdi, drowned on a beach in Turkey.) The small boy is quickly followed by a seemingly endless stream of exhausted, bedraggled women and children. We welcome them on board: life-jackets off, hands filled with a rescue package containing water, nutritional biscuits, a protective onesie, towel and a pair of thick socks.

The rescue boat goes back and forth, the lower deck fills up, they start placing people on the upper deck.

Soon we have 332 people on board, nearly all Eritrean, 28 of them young children. They trickle into the clinic for medical attention: dehydration, general exhaustion, headaches, insulin for a diabetic who hasn’t had any for too long. They are escaping from a country with political repression and arbitrary arrests, of enforced national service that lasts a lifetime. To get onto that leaky boat on the shores of Libya, they have already travelled thousands of miles, and many of them will have suffered in detention centres in Libya as they wait for their last chance saloon, an unseaworthy boat in which they will risk their lives in the hopes of a better future.

The next day the clinic is busy from 6 a.m. on.

One young girl stays in my mind. She is sixteen, and she is travelling alone. I will call her Miriam. She has a high fever due to pneumonia, but we can treat that with antibiotics. It’s not too severe. What is worse, what worries me more, is that she can hardly walk. She is limping, dragging her right leg. She speaks little English, but manages to convey to me where it hurts, and why: “I was beaten, here and here and here,” pointing to the back of her calf, her thigh, the bottom of her foot, “In Libya.” I am told that this happens in the detention centres, where the smugglers are attempting to extort more money from these already poverty-stricken and oppressed people.

Yes, maybe if you hit them enough, they will start bleeding money.

The next day they approach Italy.

Will, our emergency coordinator, is giving a talk to the crowded group: information on what happens on arrival, and some indications of what the process for them will be. The decks begin to buzz with excitement.

And then something happens that takes my breath away. A young woman, her head swathed in a bright pink scarf, stands up in the centre of a group and starts a rhythmic chanting as she sways and moves in time to the tune. She is joined by another woman, and another; soon the whole deck seems to be clapping and singing this repetitive tune. Their faces are wreathed with smiles; they are singing of hope, of relief, of joyful expectation. I can control the lump in my throat no longer, and tears pour down my cheeks.

Later, when everyone has safely disembarked, I go to the upper deck and stand in the stern, looking out to sea. And suddenly spot a small padlock, locked onto the protective netting. This is the deck where the refugees have been. One of them has put it there. Like the padlocks lovers lock onto bridges in Paris, in Stockholm, it glistens there in the evening light as a symbol of hope, of hope that a new and better life is beginning.

Good luck to them.