LA CROSSE, Wis. — Liza Ramlow has been delivering babies for about five decades as a professional midwife, but the birth of baby Mercy was like no other.

Delivered on the MV Aquarius in the Mediterranean Sea, the healthy baby girl was something of a miracle, her mother, Taiwo, having come aboard just 36 hours before giving birth, fleeing brutal violence in Libya. Ramlow, administering care on the Aquarius on assignment with Doctors Without Borders, was at Taiwo's side for the duration of the labor, witnessing the joyous arrival of the sole baby to be delivered during Ramlow's three months at sea.

Doctors Without Borders, also known as Médecins Sans Frontières, or MSF, provides medical and psychological care to refugees in more than 70 countries, assisting with deliveries, providing vaccines and delivering food and clean water. Ramlow, a La Crosse native now living in Gill, Massachusetts, joined the organization on its search and rescue mission in the Mediterranean in February 2017, marking her ninth assignment with MSF, the La Crosse Tribune reported.

The waters of the Mediterranean are rife with families escaping the hostile conditions of Libya, where many arrive after fleeing any of the 15 African countries in the midst or still suffering the effects of war. Libya serves as a stepping stone for refugees on their way to Italy, but many struggle to reach the water as gangs capture those fleeing, holding them for ransom and interning them in labor camps. Escapees often face torture or imprisonment, and those stopped by the Libyan coast guard may be sent to detention centers where food is scarce and medical attention is not guaranteed.

MSF and SOS Méditerranée, a European maritime and humanitarian organization, not only administered medical care aboard the Aquarius but scoured the waters to make sure those attempting to cross the sea didn't drown in the process.

"They are trying to flee a situation none of us could or would want to survive," Ramlow said. "... Doctors Without Borders has found a way to get into challenging situations to offer help to the people who really, really need it."

Ramlow, who lived in La Crosse until she was 18, was inspired to experience the world by a high school teacher, who had his students read the La Crosse Tribune and national papers each day, instilling in her an interest in what was happening beyond her hometown.

It took decades before Ramlow made the leap. Earning her degree in maternal and child health and nurse midwifery from Columbia University, Ramlow completed her internship at Gundersen Health System in La Crosse and became a staff midwife. She went on to found The Birthplace, a midwifery OB/GYN practice at the Franklin Medical Center in Greenfield, Massachusetts, leaving the facility after 28 years in 2010 to join MSF.

In her eight years with the organization, Ramlow has taken assignments in South Sudan, Central African Republic, Burundi, Democratic Republic of Congo, Zambia, Nigeria and Bangladesh in addition to her work on the Aquarius, where she encountered women who astounded her with their resilience and bravery.

Taiwo was one such woman. Her husband and son on another boat to Italy, she knew no one on the Aquarius and needed to gain the trust of Ramlow and her colleague, Martina, before her body would allow her to progress into labor. When Mercy emerged, Ramlow held a radio to the baby, her cries filling the airwaves.

"Such a shout came out on the boat and port," Ramlow recalled. "It was amazing. When she cried and went directly to breast, it was a really wonderful time for me and for Martina. It was quite something."

Mercy's birth proved so touching that it inspired a song by Madame Monsieur that was featured in the 2018 Eurovision Song Contest. As of April 2018, Taiwo and Mercy were living in a refugee camp in Sicily.

A 20-year-old woman named Precious left a lasting impression on Ramlow as well. Separated from her husband in Libya, she was ordered to work as a prostitute for her freedom and refused. Locked in a room for a week, she again refused her captors' demands and was brutally raped and yet again locked up. A man finally took pity on her, helping her out a window, and she reached the Aquarius.

"That kind of principle and strength ... I've met so many strong women who just impress me so with their faith, their hope, their resilience in what would be considered hellish conditions," Ramlow said.

In January 2018, Ramlow arrived in Bangladesh on behalf of MSF, spending four months assisting mothers and children in Cox's Bazar, home to the world's largest refugee camp. More than 905,000 individuals currently live in the city's camps, most of them Rohingya refugees, having crossed the border from Myanmar to escape the violence of the country's military in Rakhine State. The Rohingya, ineligible for citizenship in Myanmar, have been targeted by government troops, which have been accused of human rights violations from rape to extrajudicial killings in an attempt at ethnic cleansing. Medical care in Myanmar is often denied to the Rohingya, or is used as a source of torture, with poisonous substances administered through IVs or abuse occurring during "examinations."

"It is a situation that has existed for many, many years but has intensified in the last year," Ramlow said. "MSF knew we needed to be there."

Over the past year, some 693,000 Rohingya, the largest Muslim group in Myanmar, have crossed the border into Bangladesh, and MSF has established a team of 2,000 to assist in the refugee crisis, running three primary health care centers, five inpatient health care facilities and 10 health posts. MSF is one of the few organizations allowed to administer care to detainees, many of whom suffer from conditional ailments such as respiratory infections, diarrhea and scabies infestations as well as mental health concerns from depression to PTSD.

MSF teams also offer reproductive health care to teens and women in Dhaka's Kamrangirchar slum, offering prenatal consultations, delivery assistance, family planning sessions, STD treatment, and mental health care for sexual violence survivors. Many who seek help are pregnant as the result of rape. Unwed pregnancies are considered unacceptable in the country, resulting in dangerous attempts at abortion, home births in unsanitary conditions or ostracism from their families and communities.

"Rape has become such a frequently used weapon as far as wars," Ramlow said. "The rate of sexual violence is incredibly high."

Each week during her four months in Bangladesh, Ramlow assisted with up to 30 deliveries, as well as making referrals for cesarean sections or tending to the ill. Malnutrition and dehydration among pregnant women and infants is common, and pregnancies among teens and those who have given birth up to a dozen times are especially high risk. Currently, the country requires midwives to be Bangladeshi, and Ramlow hopes in the future to help integrate Rohingya midwives.

Ramlow's next assignment with MFS will keep her stateside, serving as a tour guide for the Forced From Home exhibition, a traveling 10,000-square-foot installation that will debut at The Commons in Minneapolis Sept. 9 and move on Chicago, Atlanta, Charlotte, North Carolina and San Antonio, Texas.

The exhibit, enhanced with virtual reality and 360-degree videos, is designed to immerse visitors in the plight of the some 68.5 million people who are fleeing persecution and conflict in countries throughout the world. Designed for adults and youths 12 and older, videos feature accounts from refugees, from the challenges and dangers they face crossing borders to the primitive living conditions in the camps.

While the images and stories from sea rescue missions, medical emergencies and refugee camps can be distressing, the realism is necessary to promote awareness of the dire plight of refugees worldwide. Statistics and written words simply don't have the same power.

"We put them as imaginatively and as physically as we can in the places the refugees find themselves," Ramlow said. "What is it like for a child to be born into those camps knowing in some way there really is no future? The world seems not to understand these people don't leave home, they don't cross into Bangladesh because they want to. It's because they have to. These people are calling out for our help in saving their lives."

Ramlow hopes to take another assignment overseas this fall, calling her work with MSF an enormous privilege and valuable experience.

"Whenever you station yourself among a people who have, many times, been abandoned by their country ... You have a chance to stand with them and say, 'We recognize you, we see you, and we're going to create awareness of your situation and find a safe location for yourself and your family,'" Ramlow said. "I hope I can help and, more than that, support the national teams and the work they do after Doctors Without Borders is gone."

An AP Member Exchange shared by the La Crosse Tribune.