I'm on a little old boat somewhere off the Libyan shore, and it's one o'clock in the morning.

The wind has picked up, and the waves are getting bigger and bigger. The captain tells us it's no longer safe to stand on the deck, and so we retreat to our cramped cabins below.

There, I sit on my bunk bed, and feel the rising and plunging sensation as the boat lurches back and forth.

Through the tiny round porthole I can see the waves crashing against the bow. This is what it must be like to be inside a washing machine, looking out.

Soon I'm overcome by nausea. I struggle down the corridor, holding onto the rail to keep my footing, breathing in the warm and sickly engine fumes. Quick, where is that bucket?

View from the cabin of the refugees rescue boat, Dignity [Barnaby Phillips / Al Jazeera]

For an entire week, that 50 metre boat was my world, as we sailed back and forth, across the Mediterranean.

The sea - sometimes benign, often choppy - stretched to the horizon on all sides. The boat is called the Dignity, and it's owned and run by the aid organisation Medecins Sans Frontieres (MSF) Spain.

There were some 20 of us aboard - an odd but congenial mix of sailors, nurses, logisticians, translators and doctors.

MSF had invited me and a colleague from Al Jazeera aboard. They wanted to show us the work they're doing in the Mediterranean, rescuing desperate people who are attempting the perilous crossing from Libya to Italy.

It's a radical departure for MSF, which has plenty of experience of some of the world's most dangerous places, but has no prior experience of search and rescue missions at sea.

'Even the mechanics of a rescue are very complicated,' one of the team explained to me.

'If we see a sinking boat full of refugees we have to be very careful. If we approach it too quickly, we can provoke a stampede that causes the boat to capsize. But if we're too slow, people may also panic.'

In other words, one tiny misjudgment in a moment of high stress on the high seas can result in many lives lost.

The Dignity works in conjunction with the Italian navy and coastguard, and the other European ships - including from the UK, Germany and Norway - which now patrol off the Libyan coast.

They're searching for the overcrowded, unseaworthy boats that the smuggling gangs in Libya are using to send desperate people across the Mediterranean towards the comparative safety and prosperity of Europe.

Some 100,000 people have made the crossing this year, but not everybody makes it across; more than 2,000 have lost their lives.

Tens of thousands of people have made the perilous journey across the Mediterranean this year [Agus Morales/MSF ]

Travelling with us is the president of MSF Spain, Dr Jose Antonio Bastos. I put it to him that MSF is doing brave and selfless work, but that its actions are actually facilitating the smugglers' business, by making a safe crossing of the Mediterranean more feasible.

He refutes the charge, insisting that the 'push' factors making people leave countries like Syria or Eritrea are more important than anything else.

He argues that the trends of recent years show there is no correlation between the numbers crossing the Mediterranean and the degree of risk associated with the journey.

But it's also true, I point out, that many of the people crossing from Libya are from sub-Saharan African countries like Senegal and Gambia, which are not at war.

There are also many Nigerians who come from areas not affected by Boko Haram. Shouldn't we consider these people to be 'economic migrants?'

Bastos replies that many Africans are subject to violence and abuse in Libya, and that MSF is compelled to help all individuals whose lives are at risk.

They hope their work in the Mediterranean will shame European governments into a more proactive response, not only in terms of providing more patrol shops, but also safer and legal ways for people to reach Europe.

This crisis can present MSF with cruel dilemmas. The Dignity is equipped to take some 400 people on board, and transport them in safety and relative comfort to a larger rescue ship or the nearest port.

But, what I ask, if it comes across a sinking refugees boat that has 700 people on board?

In that case, the MSF team told me, they'd have to try and rescue everyone, and simply make room for them on the Dignity, no matter how difficult that proved.

But it's also true that in rough seas such a complex rescue may not be possible.

My week at sea coincided with bad weather, and north winds that made it impossible for boats to leave the Libyan coast. I disembarked at Malta, and flew home to London.

By the time I got back the weather in the Mediterranean had improved.

The next day, the Italian coastguard reported that more than 4,000 people had been rescued off the Libyan coast. It said it had received distress calls from more than 20 boats.

The Dignity was in the midst of the drama, taking on board 303 people, including a two-week-old baby. It transported them to the Sicilian port of Augusta.

But as the Dignity arrived in Sicily, there was a tragedy on board. A 15-year-old Somali boy, already weak and hungry when he'd been pulled out of the sea, passed away, despite the best efforts of the MSF doctors.

He was travelling alone.

Source: Al Jazeera