Intended for healthcare professionals


From a refugee health centre to Brussels: Pietro Bartolo now has two constituencies

BMJ 2019; 366 doi: (Published 04 September 2019) Cite this as: BMJ 2019;366:l5306
  1. Marta Paterlini, freelance journalist, Stockholm, Sweden
  1. martapaterlini{at}

For 30 years the Italian doctor Pietro Bartolo has been caring for migrants arriving on Lampedusa, where he grew up in a fishing family. The 22 km2 island, an exclusive Italian tourist destination, is closer to the Libyan and Tunisian coasts than to Sicily and has been at the centre of the migrant tragedy in the Mediterranean. In May this year, Bartolo was elected to the European parliament. Marta Paterlini asks him about his life

Why did you decide to move from frontline care to the offices of the European parliament?

Simply, because I want to change the sensibility of Europe towards the migration phenomenon. I nurtured the idea after having spent years talking about the drama experienced by those people through films, books, and lectures and opposing the anti-migrant rhetoric. It was not enough.

I want to be sure that people stop seeing migration as a problem. Migration is a phenomenon that occurs among animals too. We all migrate to where we are better off.

I now spend four days a week in Brussels, but every weekend I travel back to Lampedusa. There, I go back to my usual routine of providing care to people on the island. I miss my island very much, but from September I will stay in Brussels on a more permanent basis.

What does it mean being a doctor to migrants in Lampedusa?

You will never hear me talk about migrants but about human beings. From 1988, I was the doctor responsible for everybody on Lampedusa’s soil. In 1991, the first three people emerged from the sea on a small vessel. Since then, we have witnessed a continuous and growing flow of human beings. I’m now on leave, but in nearly 30 years I have treated something like 300 000 people. My eyes have seen so much suffering, so much horror. I have had to do inspections on too many corpses.

On 3 October 2013, 368 people died just a few hundred metres from the shores. You often recall it as one of the worst moments of your life. How did you make it past this?

I thought many times about abandoning my job. The pain I witnessed affected me so much. After that day, I spent two weeks inspecting corpses. It was devastating. Why should I see this? But then, somehow, I managed to cope and even feel good about some of the things I was doing. My specialisation in obstetrics and gynaecology also offered me the wonderful opportunity to supervise the births of many babies of the sea.

What are your priorities in Brussels?

Immigration, of course. One of my priorities is to put a stop to the populist wave that runs throughout Europe. The answer is not to reject refugees. These people can’t keep coming by dinghies; they need humanitarian corridors. Europe must consider migration as a structural phenomenon and not as an emergency. I believe that many things can be changed. I want to fight for a world in which there is no need to have non-governmental organisations rescuing people in the middle of the sea. I want a world where migrants won’t have to risk their lives to reach our continent.

I am glad that the European Commission has chosen me as vice president of the LIBE Freedom Commission (responsible for protecting civil liberties). I will try to carry out work that is partly done—that is, the modification of the Dublin regulation so that immigrants can choose where they live without having to stay where they arrive. I will work for full participation of all member states—and those countries that refuse must pay sanctions.

I would also like to tackle the phenomenon of emigration from Italy. Our young people are extraordinary, but if we don't give them a chance to stay here creating a generational change then our society is dead.

Moreover, we need to rethink the 2002 European directive that allows member states to condemn people who help migrants at sea. It is not acceptable that countries sanction those who save other lives in danger.

What do you think of the Italian decree made in July that prohibits humanitarian boats from landing?

The new security decree is unconstitutional and violates all international norms. It must be retracted. Government officials say the ports are closed, but hundreds of people keep arriving with the so called “phantom landings.” These people are not ghosts. Many are rescued by the coastguards.

I also believe Europe must take responsibility for the way agreements have been concluded with Libya. In Libya there are camps of torture and violence. The women are raped, and lately we have seen young men who have been tortured by having their skin pulled off. They escape from countries that we Europeans have plundered. The only thing we can do now is to give something back by accepting and integrating them into our societies. This is what I will do in Brussels to ensure that human rights are respected.

How do you explain your unexpected victory in the EU election?

There are still many humane people who believe in certain values, I suppose. There is within Italy a better, fearless country that knows respect and trust and that does not look at others with hatred. What is bad is the communication from some politicians. They manage to speak to the ugliest part of Italians, but we are not like that.

How can you fight the bad communication?

We have to seed values not fears and lies. It is extremely challenging to fight bad information that is pure political strategy—it’s a weapon of mass distraction. But I am totally committed to the challenge.

When I hear all those lies around me I get angry, frustrated—especially when the politicians say the refugees are all terrorists and they come to steal our jobs. They are not terrorists; they would never make a journey where they risk their lives just because they have to complete a task. They are people like us who need help. No child has to die like this anymore. I see them as wonderful resources, opportunities for the European continent.

Many claim that migrants bring diseases. Is it true?

I am the living proof that it is untrue. It is my duty to ensure that they don’t bring infectious diseases to the European borders. All these years, I have never met anyone infected with a serious infectious disease. What they have often is scabies and lice because they are forced into precarious hygiene conditions, and these problems are usually gone with a couple of treatments.

The worst burden for them is psychological distress. In particular, young people have experienced mental trauma. This is our weak side, and I feel totally powerless. These people do not come from refugee camps but from concentration camps. We have to be clear and loud on this.

You spent many nights on Favaloro pier waiting for people rescued from the sea. How was it on a daily basis?

It was hard. I had to meet every single migrant and refugee who reached Favaloro. Most of the time they had been horribly tortured, often close to death with injuries from blows, electric currents, gunshot wounds, or razor blade cuts. They were dehydrated and had hypothermia. Many had what I dubbed the rubber dinghy disease—chemical burns from petrol that spills inside the boats and sticks to clothes and skin.

We doctors usually do a quick triage to promptly screen all new arrivals, to separate the sick and injured from the healthy. This ensures that those most in need can get faster access to the hospital and, if needed, are taken to Palermo by the air ambulance service I organised for severely sick people when I was deputy mayor of Lampedusa. Those in a better condition are transferred to Lampedusa’s reception centre for shelter, warmth, and a meal.

You know, in providing medical care, I saw these people who had emerged from the sea without their clothing. I saw that they are like us. And they should have the chance to dream.


  • Competing interests: I have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.

  • Provenance and peer review: Commissioned; not externally peer reviewed.

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