This is the story of a small medical center on a small island that has never had so many patients. The incessant arrival of canoes full of migrants to El Hierro has changed many of the dynamics of the island’s only hospital and leaves its mark on its health personnel. The assembly hall is now a large room to care for men, women and children who come ashore dehydrated and injured after a crossing across the Atlantic that sometimes lasts more than a week. The hallway has also been transformed, where oxygen intakes have been installed. A “bad cayuco,” as doctors call it, can cause 16 seriously injured people in a single night, a colossal emergency in a hospital with only six. boxes for emergencies.
In 2023 alone, when all landing records were broken on the smallest of the Canary Islands, 378 castaways ended up in the El Hierro Island Hospital, which only has 32 beds. Some died, others have continued their migratory journey as best they could and, from time to time, they show signs of life, but there is one that everyone remembers: patient J15. They call it that because the migrants, when they disembark, alive or dead, do not have a name. “The dehumanization is so great that we only know what they are called in the aftermath”, laments Luis González, medical director of the hospital.
Pope died of an ailment known as ‘patera foot’, an infection of wounds caused by contact with water contaminated by feces on the bottom of boats.
J15 was the fifteenth passenger of the cayuco J. The boats, as they dock in the port, are registered with a letter and each of their occupants, which can be more than 300, with a number. An alphabetical order is followed and, upon reaching the letter zeta, the rosco begins again. J15 was actually called Papa Moussa Diouf, although few of those who met him know his name. He died last November when everyone thought he would be saved. “Every time we reach the letter J, I relive everything,” laments Francis Mendoza, the coordinator of Civil Protection, the group of volunteers that assists the new arrivals.
Pope died of an ailment known as boat foot It is the lethal infection of small wounds on the legs and feet due to being in contact for so long with water contaminated by feces that accumulates at the bottom of the boats. His foot oozed pus when he reached the port. He was admitted to the auditorium for two days and in the last video call he made with his uncle Hassan, who was traveling with him, he told her that he was fine. But his diagnosis became complicated. The infection spreads like gangrene.
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In those autumn months, when the cayucos didn’t stop arriving, Dr. González went from one place to another at full speed with his old Mercedes, but he ended up stopping halfway to start crying. “He would come home, take a shower and go to bed. It doesn’t bother me to cry because he let me off my chest, but later I saw how I naturalized it. I have not completely dehumanized him, but you get used to seeing that pain,” he explains. “Now it breaks my soul, but I don’t cry anymore.” The doctor continues flying with his Mercedes from the port to the hospital and from the hospital to the police camp, but now he is more tired than sad.
They all are. Doctors and nurses live waiting for the beeping of their cell phone. “In October and November I didn’t sleep. The phone was ringing in my dreams, I lived with a lot of anxiety,” recalls Amparo Morales, primary care nursing coordinator. Now, when a new cayuco arrives, Morales thinks carefully about the WhatsApp she is going to send to ask her staff to extend the shift or cancel her payroll. “They react well and, when push comes to shove, I have five nurses who mobilize, but we are burned out, very tired. We do not have the resources to provide the assistance we would like and, even so, we do more than our responsibility,” she explains.
The last few months in this hospital have been hard for everyone. Thousands of migrants disembarked faintly and health care for the rest of the residents suffered. It was in October, with more than 7,300 arrivals, that the spark was about to light. “Before, when a boat arrived every two months we sent the team from a health center, they were there for two hours and it was very punctual, but when the arrivals began to increase we had to send them every day,” explains the head of nursing. The locals then began to complain because their usual appointments were delayed. “It’s normal,” Morales concedes. That same month, “the cayuco team” was created, made up of a doctor and a nurse on each shift. And a certain calm was recovered, not easy to maintain on an island that has become the main port of arrival for the entire EU.
El Hierro has been the Canarian hospital where the average admission stay has increased the most, by more than 19%. If in 2022 there were 3,662 days, in 2023 it reached 4,535. It has also been the third hospital in the archipelago with the most growth in emergency activity. Both the doctor and the nurse praise the efforts of the Canary Islands Executive, competent in health care, but they miss more resources from Madrid. “In the hospital they do not have powers, but they could have their own team for medical assistance in the port or in the police camp,” the doctor slips. “Not everyone has assumed their responsibility,” he says.
On the first floor of the hospital, far from the comings and goings of the waiting rooms on the ground floor, there is a quiet room that almost no one visits. For a month now, Ibrahima and Moussa, two Malians who arrived together in a canoe from Mauritania, have been counting the days they have to wait before leaving. And they are not few. The two, who prefer to appear with a name that is not theirs, have deformed and bandaged feet and a lot of pain. They suffer from patera foot, the same ailment that killed Papa, patient J15. Ibrahima, 31, fled the war in his country and never thought that the nail he injured himself with as soon as he got on the boat would have so many consequences. The wound became infected and several of his fingers will probably have to be amputated. The same thing happens to Moussa, who shows a photo of his foot when he disembarks as a kind of proof of survival: you can see right down to the bone. There is a third boy from Mali admitted who only thinks about dying and doesn’t want to talk to anyone.
Boredom takes over everything, although a little over a week ago, the Ombudsman, Ángel Gabilondo, passed by that room. “The three were very affected by what they had experienced in their country of origin, by the harshness of the journey and by the severity of the injuries they suffered,” transmitted a spokesperson for the institution. Gabilondo has asked the Ministry of Migration and the General Immigration Commission that, when they are discharged, they receive treatment appropriate to their circumstances and that, once they are discharged, they are referred to a resource appropriate to their needs and can request asylum. .
There are many other recurring ailments after this type of journey. They are treated without an instruction manual or translators. “We come from a migration crisis many years ago, but especially in emergencies we have to learn every day,” says Dr. González. Not all of them end in death, but they leave serious consequences and injuries. Most come with burns all over their bodies caused by the salt water mixed with the fuel or with abrasions after a week in the same position. When you take off their clothes, their skin is torn off. Rhabdomyolysis is also common, resulting from the effort of tense muscles for days, which releases toxic substances that can cause acute kidney injury. Also constipation, something common that in these cases can lead a patient to go up to 10 days without going to the bathroom. Before getting on the canoe, many eat a paste made of flour and water to fill their stomach. With it they deceive hunger and avoid relieving themselves, but it ends up being a problem that gets worse with each passing day.
Papa Moussa Diouf died on November 6, 2023 at only 22 years old. He left two children, aged one and three, in Senegal. Several neighbors attended his burial in the El Mocanal cemetery, in Valverde, the island’s capital. Some read some verses from the Koran and left two wreaths of flowers, one from the City Council and the other from Quorum Social, the company that takes care of minors on the islands. On his tombstone you can barely read the date he died and the no-name by which everyone knows him: “DEP J15″. Since Papa’s death, the donut of letters with which the cayucos are named has already gone around three times.
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