Jacques Autran has combined his lifelong passion for the sea with his concern for the underprivileged. Autran, his doctor companion, Martine Le Fur, and their team of specialists have treated, fed and helped hundreds of people in various coastal communities around the globe with their floating medical centre.
Autran won a Rolex Award for Enterprise in 1987 for his project to sail a restored fishing boat out to the extensive archipelagos of the Indian Ocean, in particular the Maldives, and help these isolated island communities. Since then, Autran’s original project has moved on to include operations in Mozambique, the Comoros, Madagascar and as far away as Haiti. Impressively, he has clocked over 40,000 nautical miles — the equivalent of sailing twice around the globe — on his missions.
Seamen Without Borders
Although he had studied economics and theology in Paris, Autran began his career as an agricultural engineer. He soon returned, however, to his true vocation — the sea. During several years of navigating the Indian Ocean, he and Martine Le Fur saw first-hand the problems and conditions of people isolated by water. These experiences convinced them of the need to combine their knowledge, skills and energy to improve the lives of others. In 1981, they founded a non-profit association, Marins sans Frontières (Seamen without Borders), whose objective was to bring medical and technical assistance to isolated communities by ship.
The first and most difficult task of the new association was to locate a suitable ship, and that same year, Autran and Le Fur found the MFV Listaos, a badly rusted but seaworthy trawler. With a large hold and accommodation for 20 people, it was just right, and the couple used their life savings to buy it. The purchase marked the start of four difficult years during which Autran rebuilt the Listaos from scratch. With salvaged tools, equipment and materials and the help of numerous friends, supporters, and private companies, he managed to keep the cost of refurbishing the vessel down to a minimum.
In 1985, the Listaos passed inspection for the stringent safety requirements for official permits. "Full of memories, symbols and hopes", as Autran described it, the Listaos began the maiden voyage of its new life. It sailed 3,200 kilometres from Cherbourg to Marseilles via Gibraltar, proving it could undertake missions far out to sea.
Hidden Health Needs
While the Listaos was being refurbished, Autran continued travelling to the Indian Ocean. Visits to the Maldives in 1983 and 1984 had impressed upon him the lack of basic health care for most of the population. All the country’s doctors were located in the capital Male — a five-day boat ride for some islanders. "Beyond the coconut-lined beaches and tropical landscapes one sees in tourist ads, 1,200 islands are home to people who need better living conditions," Autran said.
As a result of his contacts, Autran was asked by health officials in the Maldives to plan an immunisation and health education campaign for the islands. The Listaos had its first humanitarian mission, and Autran started working out the details and raising funds, including applying for a Rolex Award for Enterprise.
In 1987, Autran’s years of effort began to reap rewards. The association’s membership reached 500, a grant of 30,000 French francs was received from a French organisation, and Autran learned that he was to receive a 50,000-Swiss franc Rolex Award. The Rolex Award helped him cover fuel costs, port and canal fees and supplies for the crew of the Listaos’ first voyage. Receiving the Award also helped him attract widespread media coverage and brought international recognition to the project.
Ironically, while the Maldives provided the initial inspiration for the project, Autran in fact never carried out his plan for a health and immunisation campaign there. Permission for operations was slow in coming, and Autran and his team soon realised there were other seaside communities with far greater needs.
Finally, in April 1987, Autran stood at the wheel of the Listaos and steered out of Marseilles harbour en route to the Indian Ocean. His crew, made up of a dozen people, including Le Fur and their two children, doctors, nurses and sailors, were all volunteers. Their initial destination was Réunion, a French overseas island department, which was to become the group’s operational hub.
The outward journey gave the team their first opportunity for active humanitarian service. The minute Mauritian island dependency of Agalega, some 600 nautical miles from the nearest land, was running short of everyday requirements, and the supply ship was not due to arrive for another three weeks. "In June 1987", explains Autran, "with special permission from the Mauritius government, the Listaos emptied its hold of rice, sugar, pasta and various medical products on the harbour side." Soon after, other operations followed in Madagascar and the Comoros.
The Listaos’ early missions provided important experience of how the trawler behaved under various weather conditions, including in two major cyclones. It was also an opportunity to test the equipment of the vessel. It contained a small operating theatre, a complete pharmacy, a laboratory, sterilisers, and the refrigeration equipment needed to ensure cold storage for vaccines. A 130-cubic-metre hold could transport up to 50 tonnes of supplies. The Listaos also had a large fuel capacity and long cruising range, plus wind-powered generators, a solar battery system and its own water purification equipment.
In 1988, Autran and his team decided to turn their energies to Mozambique. With a coastline of 2,500 kilometres extending from Tanzania to South Africa, Mozambique had been paralysed by civil war since 1975. Lines of communication were cut and the population, fleeing combat zones, was suffering from lack of adequate nutrition, hygiene and medical care. Marins sans Frontières’ work in Mozambique turned out to be its largest and longest-running operation.
A team of five sailors and a doctor first set up base in the port of Pemba in the northern province of Cabo Delgado and began a four-month programme to transport emergency food and drug supplies to coastal dwellers. They carried local medical personnel from area to area, provided technical assistance and training to health units and evacuated emergency cases. Tonnes of cereals and medicines were also shipped in to those cut off from the rest of the country by the conflict.
The Mozambican operation brought in funding from new sources, including financing from the European Community. From April to November 1989, the Listaos ploughed back and forth on 800-kilometre voyages along the coast of Cabo Delgado province and further north to the province of Nampula delivering supplies and providing technical and medical support. By now the crew had increased to five sailor-technicians, three medical and nursing staff and two additional Mozambican seamen.
New European Community financing made it possible to extend the emergency programme all the way from the Tanzanian border in the north down to Ilha in the south. Between April 1990 and October 1991, three successive teams operated the Listaos, transporting food, medical workers, drugs and vaccines. The ship’s medical team assisted in vaccination and treatment programmes, and the crew lent a hand in repairing hospital buildings and equipment. In the 1990-1991 campaign alone, over 200 tonnes of supplies were transported. The Listaos crew sometimes treated and vaccinated as many as 500 children in one stopover.
In 1989, Autran and his team began refurbishing a small health centre on the Mozambican island of Ibo, in order to receive patients from the mainland where hospitals were constantly disrupted by the hostilities. A crew member eventually joined the site on a permanent basis, and a team nurse was delegated to start up a health care programme and expand it to two other hospitals in Quirimba and Matemo. In September 1991, Marins sans Frontières officially handed over to the District Health Director the keys of the hospital on Ibo Island and of a new maternity clinic on Quirimba Island, which are now staffed by Mozambican personnel.
Expanding Across the Planet
Although in recent years, the centre of activities has remained Mozambique, the Listaos has also been transporting drugs and medical equipment from Réunion to St. Marie Island off Madagascar. In addition, political changes that occurred in Haiti made it possible for the association to launch an aid programme for the Caribbean nation. Since 1994, as part of the European Union’s Haiti emergency plan, Marins sans Frontières has been operating at three points on the island, on the other side of the world from the association’s original starting point.
Autran declines to put a figure on how many thousands of people have been helped in the past decade by Marins sans Frontières. “Making an overall evaluation of these emergency programmes is not something which can be done using conventional criteria,” he said. It is enough to say that Autran and his colleagues — with ingenuity and commitment — have brought hope to many of the world’s underprivileged.
Published in 2006