Voices From Lampedusa: The Spectacle of births

The past 4th May, the local municipality of Lampedusa opened a new playground in Via Roma, dedicating it to an Ivorian baby, born in the island on 31st July 2021. This episode was celebrated as the first birth in the island in the last 50 years. 

On that occasion, the mayor said: "From the mid-70s here you cannot give birth, for logistic reasons and insularity. Nobody is born here, if not due to force-majeure." Moreover, the baby born in Lampedusa was given honorary citizenship.

However, this episode was not the first since the 70' nor will be the last of a person forced to give birth in an emergency situation in Lampedusa (1).

The spectacularization of the border regime in Lampedusa interconnects with multiple aspects both for the local community and people on the move (2). The result of these attempts, such as the one of the ivorian baby, is to divert the attention from the real struggle of people and from the segregation that the frontiers unfairly limit the freedom of movement.

The interconnection between the border regime's infrastructures and the rhetoric of welcoming land and openness, often underlined by the media, leads to several undesirable results; one among them is to cast a shadow on subtle and complex local issues and struggles. If on one hand the island is at the spotlight of national news, due to the phenomenon of migration, on the other structural shortages are never taken in consideration both from media and from local administration.

The biggest island of the Pelagie is connected by sea through the mainland (Sicily) by 10 hours trip by ferry, which replenishes its resources daily, if the weather allows it or no accidents occur, while with 1hr plane Lampedusans can get to the main cities of Sicily. The distance of the island is enhanced when considering emergency situations like the need of medical assistance.

Lampedusa does not have a proper hospital, rather there's a Territorial Emergency Point (PTE) active since the end of the 80s: in which only basic emergencies are issued. For more severe cases, people move to Palermo's or Agrigento hospitals by plane, or in worse cases with the helicopter.

To better understand how the phenomenon has developed through the years, I met Giovanni, an almost 80 year old former mayor of Lampedusa, who was in charge when the PTE was built. He claims that Lampedusa is left to handle the migration crisis and the related struggles of people on its own. In his view, this topic, though overly discussed, was always poorly managed

Our constitution is a juridical masterpiece, but also an awful hypocrisy. How can you guarantee the rights to access healthcare in such an extended and diverse manner? They should have written that these rights are guaranteed where possible, if not possible, then the state should intervene.

As Giovanni suggests, the right to healthcare should guarantee proper access to cure for all the people in the national territory, however, this is not as easy to ensure. This aspect is even more evident regarding giving birth on the island, as Giovanni is pessimistic on its administration.

Here in Lampedusa, we have so few births that there is no funding for that, and even if there were, they would not be used.

A proposal for expanding the current medical infrastructure and creating a new hospital was made in the past years, although funds still haven't been used and the improved medical assistance was never put in practice.

Maria, a 76 former chef of a fish restaurant in the island, also recalls her experience about giving birth in the island:

Once in Lampedusa it was impossible to know anything about the children that were born. There was no ultrasound, you didn't know if he had any illnesses, if he was male or female.

Once a woman had to take a helicopter to give birth. Unfortunately, she died on the helicopter, but the baby was born. Then the helicopter returned. I looked out from my house and saw the helicopter returning, and I saw that the body was loaded on the back of a "lapa" (Piaggio Ape) wrapped in a green bag with the feet sticking out.

Until the 70's, people were born only on the island, using home-based practices with the help of midwives. Then, between 1966 and 1978, Lampedusans started to go somewhere else to give birth. Indeed, during that period, over 80% of births were registered out of Lampedusa, especially in the Island of Pantelleria, which had a maternity department for pregnancies. After the law 883 of 1978 (3), with the introduction of the National Healthcare System, free assistance to pregnancy was included in hospitals, followed by the extinction of the home-based model of births.

Though this system gave a significant improvement to the quality of healthcare services in the mainland, it also contributed to develop further dependance for which locals lampedusans have to bear the costs personally. Moreover, the phenomenon of de-territorialized births was occurring contemporarily to the period of mass emigration from southern regions towards center and north of Italy. Nowadays, people travel well on time to Sicily to give birth, however, cases of medical malpractice still occur.

As such, Maria, and other women of Lampedusa, know well the struggle and the costs of having a baby:

All the money that we earn is spent on healthcare. If you want to have a baby and you don't have relatives in other places, you have to pay for the travel and accommodation in Sicily or Italy, as well as leaving as late as one month before the predicted date of birth.

Living on a small island is challenging, especially due to the lack of a systematic and supportive approach to the resident's needs. As a result locals often have no choice but to use their own finances to cope, frequently opting for private healthcare over public services. This leads to further reliance on the private sector and access to cure limited to those who can afford it.

On the other hand, people on the move arriving on the island have also the right to healthcare, which means they are sent to Sicily for medical help, including childbirth.

Over the past year, many arrivals in Lampedusa have needed urgent medical attention for conditions like hypothermia, skin burns, petrol intoxication or even more severe conditions.However, the PTE lacks sufficient capacity to accommodate everyone in need, and there are limited slots for medical evacuations to Sicily. As a result, many people are sent to the hotspot, which is not equipped to handle their medical conditions. Moreover, during difficult situations like shipwrecks, the management is often further marked by lack of basic services, leading to tragic events such as the one of April 10th.

This situation keeps the island in a constant state of emergency and turns it into a political tool, manipulated as needed. In her book (1), Quagliariello further remarks that in the exceptional context in which Lampedusa is part of, basic needs for locals and people on the move are much more entangled than what is usually portrayed. As such the strengthening of the local medical infrastructures could lead to an improved assistance and quality of life for all the people inhabiting Lampedusa, both for locals and for the people arriving by sea. 

1. Quagliariello, C. "L'Isola Dove Non Si Nasce.Lampedusa Tra Esperienze Procreative, Genere e Migrazioni." Unicopli (2021).

2. Cutitta, P. Lo spettacolo del confine. Lampedusa tra produzione e messa in scena della frontiera Mimesis (2012).

3. The Republic protects health as a fundamental right of the individual and interest of the community through the national health service. The protection of physical and mental health must take place with respect for the dignity and freedom of the human person[…].