Everyone is exhausted and anxious and the rescue crews work tirelessly to keep them all calm so they don't capsize the boat. After several hours everyone is brought safely on board the rescue ship. Later they're all transferred to the Italian coast guard who will take them to Italy. The Aquarius stays in the rescue zone to search for more dinghies. And so we wait.
The shame of the St Louis, now memorialized in holocaust museums around the world, is a timely reminder. Since the beginning of this year some 340,000 people have piled into boats or trekked overland to reach Europe. They have been called a "swarm", "marauders" and "cockroaches". By August, more than 2,000 had drowned crossing the Mediterranean.
Europe has been quick and unified to launch a war on smugglers but has shown no political willingness to offer immediate alternatives to these dangerous journeys... Clearly, no political willingness exists in Europe to carry the legal responsibility to provide protection and assistance for people in distress calling for help in the waters just off European shores.
In the last 15 years, the Mediterranean Sea has transformed into a graveyard for more than 20,000 migrants and refugees searching for protection and a better life in Europe. At least 3,500 people drowned close to European shores in 2014, many of them from Syria, Eritrea or sub-Saharan Africa. Already this year, 500 people have lost their lives at sea, and that's before the summer period when the majority of people attempt the dangerous crossing.
In 2014, the fourth year of the conflict in Syria, a bleak humanitarian situation deteriorated even further. To date, there have been over 200,000 fatalities and one million casualties. Three million people have sought refuge across borders and more than seven million people have been displaced. More than half of the country's population - including five million children - require some form of humanitarian aid. Not only has violence increased, but access to aid has also been restricted. Needs are greater than ever but the aid system is not meeting them. Today, Syria remains the most serious humanitarian crisis in the world.
The affected West African States won't recover quickly after this epidemic ends, even if that end is currently incalculable. This region will need assistance from the international community more than ever. Liberia's economy is in ruins, the already fragile health system has collapsed, and social networks have been divided by both death and stigma. Ebola has also caused psychological trauma among the living. This will take time - and there will be a lot to do.
Besides all the drama currently taking place in West Africa, miracles sporadically happen right before our eyes. Just like this Ebola epidemic will write history, since last week our Ebola case management centre in Foya will probably also appear in history books. We are glad to announce that so far in Foya we discharged both the youngest, and the oldest recovered Ebola patient.
As I was leaving Sierra Leone, the president declared a public health emergency. He'd finally acknowledged that his country was in crisis. Now we're six months into the outbreak and the CDC are predicting as many as 500,000 Ebola cases by the end of January. What was very much an avoidable epidemic may now become endemic in a part of the world already crippled by poverty.
"Liberia?" The taxi driver asks disbelievingly. His reaction is similar to those of most people in the past few days. Open mouths, rolling eyes, horrified amazement, warping of the cheek muscles, accompanied by a hissing sound. "Why don't you just go on holidays somewhere? To the sea, and relax a bit?"
Occasionally everyone stops what they are doing; the doctors, nurses, and cleaners. Everyone. All attention is directed to the decontamination exit from high risk zone. A patient is being discharged. Like a celebrity the survivor is surrounded by an excitable crowd of whooping and clapping. The beaming faces of the crowd reflected in the broad smile and shining eyes of the survivor. It is an intensely emotional moment, though often bittersweet.
The number of children on the route to the US keeps on growing. Nine per cent of the patients treated by MSF in south and central Mexico are minors. "Kids typically come with their families - normally they are not alone," says MSF psychologist Miguel Gil. "They live it in another way, they have a clearer perspective of time than adults, and they learn the route and the places by heart."
Despite the work of both government and Médecins Sans Frontières, there is still an atmosphere of anxiety surrounding the crisis. Lahai says that patients admitted to the hospital for other conditions have been escaping because they are afraid and don't feel protected: every day someone dies from Ebola and they think that they are at risk of dying if they continue to stay at the hospital.
For those who do manage to reach health facilities, actual care often remains elusive because of cost. In Khost, in the east of the country, and in the capital, Kabul, roughly half the people surveyed by MSF borrowed money or sold what they could to pay for medicines or doctors' fees during a recent illness. Several sought care in neighbouring Pakistan.
Ordinary South Sudan citizens have been extraordinarily affected by the violent events of the past weeks. The destruction of hospitals and markets, as well as the increased pressure on host communities due to mass displacement, brings me to this conclusion: South Sudan will face a humanitarian emergency for the months to come, and its people will need all the help they can get.
The team in charge of installing the inflatable hospital is arriving. It's with real joy that I meet up with old friends. Eric, my firm friend from Quebec with whom I already shared adventures in Burundi and Haiti. I had bumped into Daniel the mechanic in Nigeria, Damien the Aussie in Niger, Aurélie the electrician last summer when we were carrying on a vaccination campaign in a refugee camp in South Sudan.