Agnes vividly remembers the sound of voices desperately calling out for air as she and her daughter huddled together on the deck of a small boat surrounded by scores of women and children. She was grateful not to be stuck below, in the dark, sweltering bowels of the vessel, where people scrambled for gulps of air.
Four years earlier Agnes, her husband and their daughter were forced to leave their home in Eritrea. They spent three years in Sudan, trying to earn enough money to travel to Europe.
In the end Agnes had to leave without her husband, using what little money they had in search of a better life for their daughter. Their journey north took them through the Sahara Desert to Libya, where they were transported to Tripoli in containers “like animals or objects”.
Libya was a dangerous place for women, and for two months Agnes was threatened and beaten. She was desperate to leave and paid $1,700 (€1,600) for passage to Europe.
“I knew that the journey would be very dangerous and difficult, especially for my daughter. But what was the alternative? We could not survive in Eritrea or Sudan. With our documents in Eritrea there was no other way to get to Europe.”
A lack of alternatives is what has driven more than 800,000 refugees and migrants to embark on the perilous journey across the Mediterranean so far this year. Half of these people are fleeing fighting and death in Syria; large numbers from Afghanistan, Iraq, Eritrea, Nigeria and Pakistan are also choosing to get on unseaworthy boats in search of safety and security on European shores.
About 3,460 people have died or gone missing while crossing the Mediterranean since January. As harsh winter sets in, people continue to pay large sums of money to travel to Greece and Italy in search of asylum.
Those who pay for the sea crossing initially feel a sense of relief when they step aboard the boat leaving Libya, says Will Turner, an emergency coordinator for Médecins Sans Frontières.
“They have spent months, sometimes years, searching for an escape and are eager to reach Europe as quickly as possible. However, they soon realise the danger and vulnerability of travelling across the Mediterranean.
"They don't have a life jacket, they're crammed in an unseaworthy boat, they can't swim and they're sent out in the dark of night in the hopes they'll be rescued," says Turner, who has spent six months co-ordinating rescue missions aboard the Médecins Sans Frontières search-and-rescue boat MY Phoenix.
Turner is one of a small team of Médecins Sans Frontières rescue co-ordinators and medics who have seen first hand the refugee crisis making headlines across Europe.
He describes the first time he spotted a boat floating on the horizon crammed with men, women and children. “These people are really fleeing for their lives,” he says. “Death has looked them in the face. They have been though hell, having fled their home countries, places like Syria and Eritrea. They travel to get to Libya in the most horrendous conditions. Many are left to die in the desert along the way.”
After it receives the boat's co-ordinates from the Maritime Rescue Co-ordination Centre in Rome, the Turner's vessel must approach with extreme caution, to avoid panic that could capsize the boat.
Once they’ve identified the boat through binoculars, a rescue team goes in a small high-speed boat to meet the refugees and migrants on board.
“You want to ensure people stay as calm as possible, because, of course, the conditions on the boat are very bad in terms of it being overloaded; it’s very unstable,” says Turner. “At the same time you want to get people off as quickly as possible. People trapped underneath are at a high risk of suffocation or risk of drowning if the boat is leaking.”
Once the rescue crew has distributed life jackets it can begin to transfer people to the larger ship, where they get medical help, food and water.
According to UNHCR, the UN Refugee Agency, 65 per cent of the people sailing to Europe so far this year have been men, with 14 per cent women and 20 per cent children. Turner and his team have seen a mix of ages and genders during his six months in the Mediterranean.
“We had one rescue where we had half men and half women and children. The deck of the boat was more like a creche than a rescue ship, with loads of toddlers and kids running around and playing.”
Sometimes the crew discovers children who have made the journey alone, and last month a woman gave birth to a baby boy aboard the Médecins Sans Frontières rescue boat.
“It really highlights the desperation. How tragic is it that someone is forced into taking a boat when they’re at that stage and giving birth in the middle of the Mediterranean?”
Turner says that the numbers of boats crossing the central Mediterranean has dropped in recent weeks but warns that thousands of people continue to cross the sea into Europe through Turkey and Greece every day.
UNHCR reported earlier this month that smugglers transporting people across the Mediterranean were halving their prices, in an attempt to boost traffic during winter.
Turner believes that smugglers will not put people’s lives directly at risk by sailing into a storm but says that, ultimately, the groups behind trafficking are in it to make a profit.
In August the crew of the MY Phoenix came face to face with the tragedy of these refugee voyages when they went to help the Irish naval patrol ship LÉ Niamh in rescuing more than 600 people who were washed overboard when the boat they were travelling in capsized.
“It was a very sad situation to arrive late and just see a flotilla of boats scouring the sea for any hope of survival, but by that stage it was too late,” says Turner, adding that about 200 people died that day. “It’s those times you realise how important it is that there is a maintained presence of search-and-rescue boats in the sea.”
Having taken part in search-and-rescue operations over the past six months, Turner often feels frustrated by the needless loss of life in “Europe’s backyard”.
“There is no safe alternative to reach and apply for asylum. Effectively this is the only way in and they gamble it all to get here.”
But Turner says he also feels inspired by the resilience and determination of the people he has met to reach Europe and create better lives for themselves and their children.
“Hearing them say ‘I’d rather drown in the Mediterranean than go back to my home country’ is very powerful. Listening to their stories of what they’ve gone through and the resolve and strength they have to keep going . . . it’s a very positive experience meeting these people.”
Will Turner is giving a talk, Life and Death on the Mediterranean, at 7pm on Thursday, November 19th, in the Pillar Room of the Rotunda Hospital in Dublin, next to the Gate Theatre; bookings via events@dublin.msf.org