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The way of the cross for ambulances in Tijuana amid the health crisis

Tijuana.— “Five-bravo, five-bravo!” heard on the frequency: a man was shot in the leg. Paramedics arrive, treat him and stabilize the wound. There are no nearby medical centers, none that receive it, they are saturated or are converted to only Covid 19. They end up sending him to a clinic – at the other end of the city – to get an X-ray, then the instruction is to send him to another hospital with a surgeon available: in Rosarito Beaches, another municipality.

The first responders wait to receive an instruction from the Regulatory Center for Medical Emergencies (CRUM), a project that was born during the pandemic to channel emergency patients with greater agility and efficiency, the problem, says the Tijuana Red Cross coordinator, Juan Carlos Méndez is that despite the effort there is simply not enough staff or infrastructure.

While the young man wounded with the bullet in the foot waits with the paramedics, the clock has already ticked at least half an hour, one of the officers who writes his report of the facts asks one of the young women in the ambulance if she knows where he is. They will take, nobody knows, all without being able to do much wait for an instruction from the other side of the receiver.

The police officer interrupted the silence and threw a single sentence “To Rosarito, (General Hospital of Playas de Rosarito) … they are all being sent to pa’lla”.

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December has been the worst month during the pandemic, it is not over yet and has already broken the record in emergency calls related to respiratory problems, in addition to those that have to do with high-impact incidents. Only between December 1 and 22 there were 654 calls to the Red Cross headquarters in Tijuana for respiratory diseases.

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With just 12 ambulances active, sometimes only 10, paramedics roam the city to pick up patients and transfer them to hospitals, but between the Covid 19 health crisis, hospitals also attend a number of emergencies in one of the most violet cities in the country: Tijuana, which until November registered 1 thousand 839 murders.

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On one occasion Evenlyn waited three hours to be assigned a hospital and received the patient he was transferring, he was a gunshot wounded. She was unconscious, not first they sent her to one, there they told her no, that she had to first confirm that she did not have Covid, in the middle of the urgency they asked her to go for an X-ray. It was a second and a third, they did not let them in until one more try.

“That’s how they have died, if it happened,” recalls the young lifeguard, “it’s one of the saddest feelings because you can’t do anything and they close the doors, even with a padlock or insurance, but they just won’t let you pass.”

Back on the radio, a lifeguard is heard from the other side of the receiver, his voice breaks between the anger and despair, parked in one of the converted hospitals and concentrating the reception of patients with the virus, one of the doctors on duty refuses to receive the man who is still on the stretcher inside the Red Cross ambulance.

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“What do I do?”, He asks his supervisor, “they don’t receive him, they tell me to take him to another, not here anymore.” A call to managers solves the problem, but while that patient with a lack of oxygen, he had to wait almost an hour for urgent care.

Juan Carlos Méndez, coordinator of the Red Cross in the city, explains that the average time for a hospital to be assigned to them is 44 minutes, but there were other times when they reached practically two hours and with patients on board without them receive up to three and a half hours. But the problem grows, during the second wave of the virus, hospitals are left without beds and are left with ambulance stretchers.

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“Staying with them is like shooting yourself in the foot,” says Juan Carlos, “who is most affected is the community because if an ambulance runs out of bed it is a unit that I cannot use, we have been left with up to 10 to a guard… The maximum time to retrieve a stretcher was on December 11 with a 26 hour and 10 minute wait at the Tijuana General Hospital ”.

He Secretary of Health in Baja California, Alonso Pérez Rico, recognized that the hospitals chose to keep the ambulance stretchers when they lack the equipment and for the safety of the patients who must remain lying down, as in the case, he said, of those who have dyspnea.

“This is precisely the challenge of emergencies … when services begin to saturate, there are not enough stretchers to move patients from a transfer stretcher to an emergency stretcher,” lamented the state official.

According to the latest report from the Ministry of Health in Baja California until December 24, an 81.54% hospital occupancy was registered, a figure that forces the health system to expand its capacity to guarantee care. That number equals 134 beds and 104 fans available statewide.

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