Mexico: medical provision in jeopardy in Ciudad Juarez
The Mexican city of Ciudad Juarez is one of many places in the world where it is becoming more difficult for doctors and nurses to treat their patients in safety. Over the past three years attacks by organized criminals on health-care workers and facilities have increased in this city of 1.5 million on the US border. They are entering clinics and hospitals, carrying out targeted killings and abducting medical personnel. Dr Leticia Chavarria Villa works at a clinic in the city which has been attacked and says the constant insecurity is jeopardizing provision of health care in the city.
What sort of violence have you experienced?
The clinic where I work is in an ordinary neighborhood but it has been attacked three times. Two of the attacks were armed robberies that left people wounded. The criminals even got into the area where the patients are treated. They also came and kidnapped a gynecologist who was working at the clinic.
What security precautions do you now take?
We now have two guards patrolling outside the clinic. We have bars on the pharmacy windows and we have installed a panic button. All clinics take these precautions. Those that can afford it have installed security cameras. Generally clinics don’t publish doctors' names nor consultancy hours nor telephone numbers. The majority of consultancies are done only with fixed appointments. Every doctor has had to change the way they work for their own safety and that of their patients.
When did the violence escalate?
From 2008 there was a worrying new development. The criminals started carrying out targeted killings inside private clinics. The killers would finish off victims who had been brought in by the medical services suffering from bullet wounds as a result of shoot outs in the city. Of course this put everyone at risk including all the patients and doctors. In November 2009 they entered a public hospital for the first time and in broad daylight an armed commando killed a patient who had just been brought in. This then started to happen repeatedly.
Can you tell us more about the kidnappings?
These organized crime networks started kidnapping doctors in 2008. In 2010 some of the doctors who were kidnapped were even killed. In October 2010 a pediatrician who was kidnapped was killed. For one and a half months the family had no word. They twice paid a ransom and eventually they found his body. Another doctor was also kidnapped and murdered. We are all extremely vulnerable.
What has been the impact on health care provision?
We are all working under incredibly difficult conditions. Everyone is permanently stressed which is not at all good for the emotional and physical well-being of the patients. Sixty per cent of clinics have closed down. Doctors have either left the city or they have moved their clinic to safer areas such as within a big hospital where there are guards. This means that in some areas there are no clinics. The situation was already bad before so now it is much worse. Patients have a real struggle to access health care especially during the night and on weekends.