Fleeing the war in Syria, Dr Ayman Mostafa lost his young wife and daughter attempting to reach Europe. Rescued from one of worst tragedies off Lampedusa last October, he tells Ariadne Massa that while nothing can quell his anguish, the generosity of the Maltese is anaesthetising the pain.

Clinging to a plank in the freezing Mediterranean sea, Ayman Mostafa waded through the debris and dead bodies trying to identify his wife and daughter.

“My wife was a good swimmer so I believed that if I was alive, she was safe too; she was like a fish,” says Dr Mostafa, 38, struggling to block the pain that engulfs him every time he recounts how he lost everything last October.

He spent two hours in the sea before rescuers arrived on the scene of one of Lampedusa’s worst tragedies after a rickety fishing boat carrying some 450 Syrians and Palestinians sank off the island on October 11.

“In those hours, instinct kicks in and you just grasp on to anything to survive,” he recalls, clutching a damp tissue for wiping away his silent tears for his missing 28-year-old wife Fatama and three-year-old daughter Joud.

Sitting in an office at Mater Dei Hospital more than seven months later, the Syrian surgeon is eternally grateful to the Maltese and the government for giving him the chance to rebuild his life from scratch.

“My English wasn’t so good when I arrived and I wasn’t the right doctor or person to get the job, but I saw nothing but kindness in the eyes of Chris Fearne [Health Parliamentary Secretary who was then a paediatric surgeon] when he offered to help me,” Dr Mostafa adds.

Now, working as a medical officer at the hospital helps to momentarily anaesthetise the pain, but nothing can heal the anguish that pervades his every waking hour.

Looking at his watch, Dr Mostafa smiles as wonders how he can squeeze his tragic journey – starting in Aleppo in 2012, continuing in Turkey, through Libya and ending in Malta – in just a couple of hours. An established surgeon with his own private clinic, Dr Mostafa was living a comfortable life with his wife, an environmental engineer, and his daughter before the war broke out in Syria.

When the fighting reached Aleppo, the country’s biggest and richest city was split in half: Syrian President Bashar al-Assad’s forces ruling the part where his house was located, and the opposition fighters seizing the area where his clinic was.

“The regime was attacking the ill-equipped freedom fighters with missiles, tanks and aeroplanes – neighbourhoods were under attack, and I was in the line of fire every day when I crossed through the roadblocks to get to work,” he says, smiling at how his only ‘weapon’ was the pen in his pocket.

Every day the situation would get worse – the bodies of Syrians killed by snipers were strewn across the street, while homes were destroyed.

“On some days there would be 30 patients needing urgent intervention but we had just three operating theatres: we had to take the hard decision of choosing three patients and letting the others die.”

Every day when he returned home he would find his wife worried sick that he would not make it back alive. The day after he was arrested for 12 hours for crossing into the ‘enemy’ side to help the wounded was the day the family decided to seek refuge in Turkey in August 2012.

“Leaving Syria was the hardest decision to take. I was with my wife and daughter but I had to leave everything else behind – my parents, friends, memories. You leave a very important part of you in your motherland,” he says.

We had to take the hard decision of choosing three patients and letting the others die

Renting a flat in Turkey, Dr Mostafa calculated he had enough money to bide him through a few years until the situation in Syria improved, but as a surgeon he needed to work.

Working in the medical field in Turkey was impossible and he also found every door closed when he called his friends in the Arab world seeking a job: “Syrians were suddenly a problem”.

The only job he could find was in Misurata, Libya, so after three months in Turkey the family packed their bags again hoping to find a better future.

“Misurata was worse than being in Syria. there were no police, nor any authority. Every day the fear was palpable, we heard stories about rape and the killing of foreigners. Misurata was the safest place for Libyans, but foreign people were not welcome; we were targets,” he recalls.

After 10 months of sleepless nights, Dr Mostafa applied for a job at Saint James Hospital in Tripoli but on the day of the interview they heard the news that three Syrian women had been raped and killed in the city, and suddenly there was no safe haven left, except for Europe.

“We tried, but found no legal means of reaching Europe – the only way to get out was by paying traffickers $1,200 each. They promised to get us to Europe in a big safe boat that would not be crowded,” he says.

Dr Mostafa had heard all about the tragic crossings across the Mediterranean, but “we thought we were cleverer by investing in a big boat”.

In the beginning the traffickers were “kind”, but when they crossed to Zuwara everything changed: the traffickers were brandishing AK-47s and bellowing orders nobody dared defy.

Dr Mostafa and his family were locked for 24 hours in a small apartment with 150 other Syrians and Palestinians. There was just one toilet and everybody was crammed into the tiny space.

“We were like prisoners, but we tried to keep morale high – we had no choice and there was no turning back. We were in a strange city, with strange people with guns.”

On the night of October 10, 2013, the refugees were transferred from the flat into a van with blacked-out windows and driven for 15 minutes to the coast. There, all 150 were grouped with some 300 others.

There was no boat in sight, but under the cloak of night the traffickers used rubber dinghies to transfer the refugees to the “big boat” in groups of 10.

“When I saw the rickety boat I knew this would be the last day of my life. I looked at my wife and there was no need for any words – we knew we were going to die.

“The traffickers waved goodbye and told us, ‘when you’re going to die say there is one god and Mohammed is our prophet’,” he says, managing to smile at the irony of it all.

Dr Mostafa and his wife settled on the top of the three-decked boat: “We had 10 centimetres of space each and Joud was sleeping on my lap; there was nowhere else for her to stay.”

Three mobile phones equipped with GPS that were in his pocket gave him some solace on that cold October night.

The old boat was captained by a Tunisian and everything ran smoothly for the first two hours, until a speedboat started chasing them.

Three men brandishing Kalashnikovs ordered the captain to return to Libya. The old boat, which was travelling at about 14 km/h, could not outpace the speedboat.

“The captain disobeyed the orders. Nobody wanted to return to Libya – it was better to die in the sea than go back.”

The speedboat left, but returned after 10 minutes and started shooting in the air demanding the boat turned back. This situation repeated itself several times and each time the speedboat returned the men on board became more aggressive.

No amount of pleading by the women and children softened the men’s hearts and after a long chase shots were fired at the bottom of the boat.

By about 6am, when the boat left Libyan territorial waters, the speedboat stopped the chase, but by then the old vessel had started taking in water.

At about 11am, Dr Mostafa’s friend made the first call for help with the Italian coastguard.

He gave the coordinates, told them there were wounded people and children on board and that the fishing boat was sinking.

He was assured help is on the way, but an hour elapsed and nothing.

They called again and this time they were told to call the Maltese army. Another call was made to Malta at about 1.30pm and by this time the situation was desperate.

The lower deck was flooded and everybody on board was terrified.

Passengers started to climb to the top decks, as little Joud hugged her mother, fast asleep and oblivious to the ensuing chaos.

At about 4.30pm the engine spluttered and went dead.

By now the boat was see-sawing dangerously and the passengers were running from one side of the deck to another in the hope of balancing it out.

I looked at my wife and there was no need for any words – we knew we were going to die

A Maltese army helicopter was flying overhead and during those last “terrible” moments, all Dr Mostafa could do was lock eyes with his wife and daughter.

“In one second the boat capsized. I jumped into the sea as it turned 180 degrees into the sea dragging everybody down with it.

“It happened so quickly. I’m not a good swimmer, but my wife is.

“The woman who was next to her survived so I was sure she would come out alive. We were weak after more than 24 hours without food and water and all I could do was cling to a plank of wood,” he says.

International media reported that at least 268 drowned on that day, with just 26 bodies fished out of the water and 212 survivors.

Many questions were raised about the time lost in protocol and red tape between the moment the first call was made and the time the rescuers arrived.

Dr Mostafa hopes this tragedy will lead to a quicker rescue in future, but refuses to pass judgement because “our brothers in Libya shot at us, when our brothers in Malta saved us”.

Instead he reserves his criticism for the EU: “The solution is in Syria, not in the sea. They shouldn’t wait for Syrians to make the dangerous crossing to rescue them; Europe has to stop the war.”

When Dr Mostafa and the survivors were brought to Malta they were taken to the Safi detention centre and kept there for three days.

“At that moment I couldn’t feel anything – no pain, no hunger, no thirst – I was just like a stone, in shock.”

Apart from losing his precious wife and daughter, Dr Mostafa also lost €15,000 in cash, all his credit cards, passport and his professional certificates.

“I arrived in Malta with nothing,” he says, recalling how touched he had been by the kindness of then social solidarity minister Marie-Louise Coleiro Preca who visited the refugees in Safi.

The tragedy was making headlines abroad and in Malta and when Chris Fearne, who was chairman of Mater Dei’s Surgical Department at the time, heard there was a Syrian surgeon among the survivors who had lost his young wife and daughter, he could not get the story out of his mind.

Within a week, Mr Fearne interviewed Dr Mostafa and seeing his skill and talent, offered him a trainee post with the Department of Surgery.

“I have to admit there was a mountain of paperwork to get through. But there was also a lot of goodwill from everyone involved,” Mr Fearne says.

“Eventually, things came through and today I am very proud to say that Dr Mostafa is proving to be an asset and is providing a service to Maltese patients as a valuable member of our staff.”

Dr Mostafa has nothing but gratitude for Mr Fearne, the government, and all the Maltese who “have cried with us, prayed with us, felt our pain and smiled with us”.

He is aware of the racist sentiments among some Maltese towards immigrants, but he has witnessed nothing but kindness and generosity on the island.

“When you have lived in Libya and have been persecuted for being a foreigner everything pales in comparison. It’s normal to feel anger towards those who come uninvited – I cannot judge their minds, just their actions.

“I had lost everything except my name. I am now Dr Ayman Mostafa again and if I achieve success here, it is a success story for the Maltese and the government.”