Pubdate: Fri, 5 Dec 2008
Source: New York Times (NY)
Page: A1, Front Page
Copyright: 2008 The New York Times Company
Contact:  http://www.nytimes.com/
Details: http://www.mapinc.org/media/298
Author: Marc Lacey
Bookmark: http://www.mapinc.org/area/Mexico (Mexico)
Bookmark: http://www.mapinc.org/people/Felipe+Calderon
Bookmark: http://www.mapinc.org/topic/Tijuana
Bookmark: http://www.mapinc.org/topic/Juarez

HOSPITALS NOW A THEATER IN MEXICO'S DRUG WAR

TIJUANA, Mexico -- The sedated patient, his bullet wounds still fresh 
from a shootout the night before, was lying on a gurney in the 
intensive care unit of a prestigious private hospital here late last 
month with intravenous fluids dripping into his arm. Suddenly, 
steel-faced gunmen barged in and filled him with even more bullets. 
This time, he was dead for sure.

Hit men pursuing rivals into intensive care units and emergency 
rooms. Shootouts in lobbies and corridors. Doctors kidnapped and held 
for ransom, or threatened with death if a wounded gunman dies under 
their care. With alarming speed, Mexico's violent drug war is finding 
its way into the seeming sanctuary of the nation's hospitals, shaking 
the health care system and leaving workers fearing for their lives 
while trying to save the lives of others.

"Remember that hospital scene from 'The Godfather?' " asked Dr. 
Hector Rico, an otolaryngologist here, speaking about the part in 
which Michael Corleone saves his hospitalized father from a hit 
squad. "That's how we live."

An explosion of violence connected with Mexico's powerful drug 
cartels has left more than 5,000 people dead so far this year, nearly 
twice the figure from the year before, according to unofficial 
tallies by Mexican newspapers. The border region of the United States 
and Mexico, critical to the cartels' trafficking operation, has been 
the most violent turf of all, with 60 percent of all killings in the 
country last month occurring in the states of Chihuahua and Baja 
California, the government says. And it has raised fears that 
violence could spill across the border, because dozens of victims of 
drug violence have been treated at an El Paso hospital in the last year.

The federal government argues that the rising death toll reflects 
President Felipe Calderon's aggressive stance toward the cartels, 
which has forced traffickers into a bitter war over the dwindling 
turf that remains.

In fact, most of the deaths do appear to be the result of infighting 
among traffickers. But plenty of innocent people are dying too, and 
the spate of horrifying killings -- bodies are routinely decapitated 
or otherwise mutilated and left in public places with handwritten 
notes propped up nearby -- has left people from all walks of life 
worried that they might be next.

"If a patient is in the E.R. bleeding, we should be focused on the 
wounds," said Dr. Rico, who has led doctors in street demonstrations 
to protest the rising violence in and around Tijuana, where 170 
bodies were discovered in November alone, the bloodiest month on 
record. "Now we have to watch our backs and worry about someone 
barging in with a gun."

Doctors feel particularly vulnerable. When they leave their offices, 
they say they face the risk of being kidnapped and held for ransom, 
as about two dozen local physicians have been in the last few years. 
Doctors also complain about receiving blunt threats from patients or 
patients' relatives. "Salvame o te mato," save me or I will kill you, 
is what one orthopedic surgeon said he was told by a patient, who 
evidently did not grasp the contradiction.

Adding to the anxiety, hospitals and health care workers have to 
notify the authorities when a patient comes in with a gunshot or 
knife wound, a legal requirement that the traffickers know well. That 
leads to further threats.

Then, there is the risk of shootouts.

Authorities suspect that the killers and the victim in the intensive 
care unit at the private hospital, Hospital del Prado, had links to 
the drug cartels that are wreaking so much havoc across Mexico. 
Nowhere to be found were the police, who received a call from the 
hospital authorities when the shooting victim, who was in his 20s, 
first arrived, as is required by law. The police did not show up 
until after the gunmen had come and gone and bullet casings littered 
the hospital floor.

Hospital General de Tijuana, the city's main public hospital, has 
twice been ringed by police officers and soldiers in the past 20 
months. The first time, in April 2007, gunmen stormed the building 
either to rescue a fellow cartel member who was being treated in the 
emergency room or to kill a rival, said the police, who were not 
certain which scenario it was. Two police officers were killed, and 
all but one of the gunmen got away.

A video taken by a hospital worker revealed a terrifying scene, with 
two state police officers firing inside the emergency room to protect 
patients while doctors, nurses and others cowered in closets, under 
gurneys and wherever else they could find cover.

An elderly woman in a wheelchair is seen hiding under a blanket, 
while a patient in a hospital gown is sprawled on the floor near his 
hospital bed.

Meanwhile, panicked patients were escorted out of the building, some 
with IVs in their arms, to a nearby sports field.

The second time was this past April, when soldiers in camouflage 
ringed Hospital General de Tijuana, shutting it down while doctors 
treated eight traffickers who were wounded in various shootouts in 
the city. The Mexican Army was apparently trying to prevent a repeat 
of the 2007 shootout. In a recent third episode, soldiers were sent 
to the hospital for a bomb scare.

"Fear has become part of our lives," said one of the doctors at 
Hospital General de Tijuana, speaking on the condition of anonymity 
for fear of reprisals from organized-crime figures. "There's panic. 
We don't know when the shooting is going to break out again."

The violence is already affecting service, as hospitals armor 
themselves with more police officers and guards. To protest the spate 
of killings, some doctors closed their offices for a day in November. 
And Tijuana clinics are closing earlier on a regular basis, with more 
and more doctors shunning late-night medical care as too risky.

In Ciudad Juarez, which abuts El Paso, the local Red Cross hospital 
called a halt to 24-hour emergency service earlier in the year after 
gunmen killed four people who were being treated for gunshot wounds. 
Emergency service now ends at 10 p.m.

Paramedics in Ciudad Juarez temporarily stopped treating gunshot 
victims one day in August after receiving death threats over their 
emergency radios. They resumed ambulance service later the same day, 
but only after they were provided armed police escorts.

An episode that took place in the early morning hours of Oct. 5 in 
Tijuana shows the complicated new environment in which health care 
workers find themselves. After a major shootout, two wounded men were 
carried to Clinica Londres, a private health clinic that was closed 
for the night. There was a lone nurse inside the locked facility, 
tending to the patients there, and she initially did not open up to 
the small group of anxious people outside.

The nurse was not qualified to treat gunshot victims, and the clinic 
did not offer emergency care. But the crowd outside included two men 
dressed in law enforcement uniforms, who banged menacingly on the door.

Frightened of the men in uniform -- criminals routinely wear police 
uniforms in Mexico -- she eventually relented, she told authorities. 
What happened next is shrouded in confusion.

Tipped off, the army and the police arrived at the clinic and asked 
the nurse and two other employees who had since arrived if they were 
treating gunshot victims, and they were told no. Then, hearing a 
groan from another room, the authorities discovered the two wounded 
men -- the men in uniform had already fled -- and accused the health 
care workers and the group of people who arrived with the patients of 
having links to the drug traffickers.

The clinic workers, who have been detained for two months while 
authorities decide whether to charge them, deny that they did 
anything wrong. "It is not true that this is a narco-clinic," said 
their lawyer, Rafael Flores Esquerro.

Another Tijuana doctor, Fernando Guzman Cordero, has also found 
himself denying connections to traffickers. Dr. Guzman, a prominent 
general surgeon, was kidnapped in April and suffered a bullet wound 
to his leg. But the kidnappers released him 36 hours later, even 
giving him cab fare home.

Then two weeks later, after another Tijuana shootout, a group of 
gunshot victims were taken to his clinic for treatment. In radio 
call-in shows and on Internet chat sites, local residents wondered 
whether the traffickers were now in cahoots with Dr. Guzman, 
something he vehemently denied.

"People can say whatever they want," he said. "They say I kidnapped 
myself or made a pact with them. They say a million things. I know 
who I am. Why would I get involved with criminals?"

The problem everyone in Tijuana faces, no matter their line of work, 
is that they might be associating with traffickers without even 
knowing it. Doctors say they now screen their patients carefully. 
Traffickers pay well and in cash, but they are not worth the trouble 
they bring, doctors say.

But hospitals do not have that luxury. "We're not judges," said 
Carolina Aubanel Riedel, whose family owns Hospital del Prado. "We 
treat those who arrive." 
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MAP posted-by: Richard Lake