As I walked the deck of the Aquarius checking on patients several nights ago, I stopped to chat with some young Nigerians we have on board. They pointed to a glow on the horizon, curious if we’d reached Europe and why we had stopped for so long. With my smartphone I showed them our GPS position on the map, stuck between Sicily and Malta. Facing north from the bow, we could see the faint lights of Italy. As they looked up and down between the phone and the nearby shore, they realised their destination was finally in sight and they beamed. Sadly, this was short-lived as they remembered their situation, adrift in political limbo, caught between European countries. Their hopes would remain only a faint glow on the horizon.

This week, I met 630 people that were rescued at sea. They risked their lives to reach that horizon. Now, the actions of the Italian government have turned them into pawns in a political game. Italy’s decision to deny them access to a port of safety flies in the face of international law. And, more importantly, the political stand-off seeks to diminish the value of these vulnerable people as human beings. It is a disgrace and a stain on modern Europe.

As the doctor on the Aquarius I gladly accept responsibility for the health and wellbeing of these rescued people. I have a duty to my patients to treat their medical problems and here on Aquarius we’ve had plenty to do. Fortunately, I work with a dedicated team to provide the best possible care under very difficult circumstances.

On Saturday night, during the initial rescue, we provided lifesaving care to hundreds of people pulled from collapsing rubber rafts in the search and rescue zone north of Libya. We resuscitated several people who had nearly drowned after falling into the water. We warmed up patients suffering from acute hypothermia. And we quickly organised hundreds of warm showers to wash off fuel and cold salt water before giving out dry clothes, blankets, food and somewhere to shelter. Most people said they’d been at sea for over 20 hours without water and the symptoms of dehydration were obvious; each person received as much fresh water as they could drink during those first hours.

Over the next few days, as we waited for a port of safety to be offered, our team continued to provide important basic care to each rescued person. Immediately after the rescue we opened our ship clinic where we’ve continued to see patients with all types of complaints. We’ve treated many with chemical burns caused by a mix of fuel and saltwater at the bottom of the rubber boats. We’ve treated dehydration, compounded by stress and exhaustion, chronic medical issues like diabetes, and patients with old injuries who haven’t seen a doctor in months or years while trapped in inhuman conditions in Libya.

And now, as we travel toward Valencia, our medical team must adapt to having people on board for almost a week, much longer than the typical one or two days transit back to Italy. We are passing through rougher seas on the way to Spain and have treated most of the people on board for seasickness since starting this completely unnecessary four-day journey. And, although grateful for a destination, we’re disappointed by the need to travel so far and risk worsening medical conditions for so many people on board.

As their doctor, my responsibility goes further than just treating patients while on the ship. I also have a clear duty to speak out and advocate for the rights and health of my patients. The Aquarius and its passengers were launched into international headlines this week as part of a larger debate on migration and the right to asylum in Europe and throughout the world. As this debate rages between governments, these 629 people are being denied their basic rights as human beings and are unable to advocate for themselves.

I, along with the entire Médecins Sans Frontières (MSF) and SOS MEDITERRANNEE team aboard the Aquarius, stand in solidarity with them and will speak out for each of these 630 vulnerable people. They risked their lives to leave horrendous, slave-like conditions in Libya only to become stranded at sea. Instead of extending welcoming arms towards suffering men, women and children, the Italian government has turned its back on them and recklessly put further lives at risk. Through their cynical actions, Minister of Interior Salvini and the Italian government diminish the humanity of these people. Each person that we pull from the sea on to the Aquarius is a human-being deserving of dignity and respect. It is deplorable that instead they are treated as less than human and used to score political points.

Furthermore, in forcing us to undertake the long journey to Spain, the Italian government has deliberately sidelined the search and rescue capabilities of this vessel. Had we disembarked immediately in Sicily we would already be back in the southern Mediterranean search and rescue zone, ready and able to save more lives. Instead, while we sail across the Mediterranean, people continue to drown in the waters north of Libya.

And, despite the generous outpouring of support from individuals across Europe and the world, the rest of Europe’s governments have made pitiful progress towards creating a system to prevent more deaths in the Mediterranean. It is unacceptable that Europe has not implemented an effective search and rescue mechanism to save lives at sea or addressed its broken immigration and asylum system. When people are denied a safe and legal alternative, we leave them with no choice but to take to the sea and risk their lives. How many people will have to die before a sane humanitarian response is put in place, before the underlying incentives pushing desperate people into rubber rafts are addressed?

Ultimately, we must ask on behalf of these marginalised people, what type of society do we want to be? Are we willing to sit idly by as people drown, cold and alone in the sea, or will we respond with an effective system that grants people the dignity and respect they deserve?

As the doctor on board the Aquarius I consider it a privilege to care for these 630 cold, hungry, and tired people. I take my responsibility seriously and will speak to their humanity in the face of cynical and hypocritical governments. I have seen the suffering of these people as they boarded our ship. I have heard the horrific stories of their journeys. The young Nigerians I talked with earlier this week, and every other person attempting the dangerous Mediterranean crossing, whether on the Aquarius or not, wish desperately to trade the nightmares they’ve been living for grander dreams. It is time that Europe finally takes responsibility for protecting them, and reached out from the horizon with welcoming arms.