Mexico: health-care workers on the front line

Over the past three years risks to health-care workers treating the wounded and sick in the Mexican city of Ciudad Juarez have increased. Attacks on facilities and patients have become more common in this city of 1.5 million on the US border, hindering patients' access to health care.

"Four masked men walked into a public state medical centre in the city. They pointed their guns at us and at the patients in the waiting room. We dropped to the floor and one of the men found the intended victim and shot him dead," says Francisco from the Ciudad Juarez branch of the Mexican Red Cross.

The killers, he recalls, then left the centre as if nothing had happened while he and other Red Cross workers calmed down the patients and medical personnel.

According to Mexican government figures, some 3,100 people were killed in drug-related murders in Ciudad Juarez in 2010. The violence has put health care in danger, risking the lives of medical staff and often preventing patients from getting the treatment they need.

Increasing violence, increased risk

Over the past three years there has been a surge in organized crime in the city. The Mexican Red Cross has scaled up its services, opening a third chapter and recruiting more qualified staff to deal with medical emergencies.

"We have been witnessing a unique situation in Ciudad Juarez," says Raul, a Red Cross worker in the city, "in which the violence has increased so much that we had to increase our services for the community."

The Red Cross has improved its service, increasing the number of ambulances from 15 to 35. More than two hundred paid staff and volunteers help to run three medical centres in the city, tending to the sick and wounded in increasingly difficult circumstances.

Most of the call-outs used to relate to road accidents or taking the sick to hospital. But according to paramedic Javier, "it was rare that they had to deal with victims of shoot-outs but these have become more frequent". They are also finding fewer victims alive and most of those they evacuate are in a critical condition.

Safer access saves lives

The ICRC has been working with the Mexican Red Cross on improving safety for their volunteers and staff with its safer access programme.

"There has been a 180-degree turnaround in the way we work," says Jorge, relief coordinator. "A few years ago we could approach the scene of an incident relatively freely but now we have developed a specific protocol to respond to emergencies."

From the moment the Red Cross receives a call at its radio operations centre, they have to confirm that the police are at the scene, the victim is alive and needs pre-hospital care. The ambulance team can only approach after the police have checked the area and must follow strict rules on how to evacuate the patient.

Accessing a patient in need is a constant challenge as Red Cross radio frequencies are regularly disrupted with warnings to the ambulance teams to steer clear of a particular incident or to retreat from an area.

"They broadcast one of their famous songs for 20 to 30 seconds on our airwaves and then tell us not to go to a particular area," explains Francisco, adding that the teams always follow their security protocol and return to base.

Without a doubt, Red Cross paramedics, doctors and nurses are working in a dangerous city but despite facing considerable personal risks they are committed to ensuring that patients get the health care they need and deserve.

For many like paramedic Javier, working for the Red Cross is not a job but a vocation.

"I like what I do. It is something that I shall never stop doing. I know that there is always something that you can do to help people and ease their pain."