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At 1 p.m. on Wednesday, August 24, the doctor assigned and in charge of the Health Center of Tuzantla, Michoacan, called the rest of the staff: a female dentist, three nurses, and three medical and nursing interns, to tell them that things were going to get ugly. Armed people came to the area. The person in charge gave the order for those assigned to go to their homes, in the same community, and the interns, all foreigners, would remain locked up in the health center. Thus began 24 hours of panic and abandonment for them.
“The person in charge of the health center told us: stay here, because the road is very dangerous. We don’t know where these people come from. Don’t expose yourself. Close the unit, do not open it to anyone, do not lean out, keep everything dark, do not see that there are people inside, because if they know they are here, they are going to knock down the door so that they can attend to them”, says David, the medical intern who stayed at the health center, along with the two nursing interns.
After receiving that order and no other instructions from any other authority, neither from the health jurisdiction nor from his university, the Michoacán University of San Nicolás de Hidalgo (Umich), David and the nursing interns went out to the store to buy some groceries, padlocked the entire health center, and went to lock up the manager’s office.
“I tried to keep a cool head, but we were very afraid and that we did not think that what we are experiencing would happen, we believed that these people were only going to pass by the place and now, but at 2 in the followingnoon, a An hour following the person in charge sounded the alarm, we began to hear the shots at the entrance to Tuzantla, regarding three blocks from the health center, and also in the community center, another three blocks from where we were.”
The three interns were left in the middle of the fire caused by and armed conflictpresumably between rival internal groups of the La Familia Michoacana Cartel, in which eight people died.
During the daylight hours, the young people stayed in the manager’s office, with the little food they had managed to buy in the store, before all the businesses closed and the community became a kind of ghost town. From their hiding place they listened to the shots and tried to keep calm.
But at night, what little calm they managed to gather was broken by the noise of a truck that parked in front of the health center, on board of which were armed people. “They started pointing their flashlights inward. At that moment I did see my life pass by. I said what I have done all my life, because if they had wanted, they would have entered. The health center has a fence of regarding two meters, which they might easily jump over, and the entrance door is made of glass, they might break it and that’s it,” says David.
They did not enter, deduces the intern, because they did not see them. “We stayed in a ball in a corner of the manager’s office, without moving, while they kept pointing their flashlights inside, looking to see if there was anyone, any movement, like that, regarding 20 minutes passed, until they left.”
A call was what saved them from all that terror. That of the former medical intern who a year earlier had done his social service at the health center and who came to Tuzantla to do some paperwork just for the release of his service, and there he was caught by the shooting.
“He brought his van and told us that the National Guard was already guarding the roads and that we might escape, that we would leave at 7 in the morning. It wasn’t until 11 o’clock the next day, Thursday the 25th, that he told us: ‘Let’s go’. We got out and got into his truck. We went to the dentist’s house, because she also wanted to leave, with her daughter, and that’s when some cars passed by honking and with people yelling that these people were coming once more and that we should lock ourselves up. We locked ourselves in the dentist’s house”, says David.
They had to wait two more hours to get out. At approximately 1 p.m. on August 25, 24 hours following it all started, they managed to board the truck of the former Tuzantla intern and start fleeing the community.
“We were afraid of running into armed people or that there would be Army checkpoints and they would return us to Tuzantla, we didn’t bring much gasoline, and everything was closed, there was nowhere to load. We were desperate. We mightn’t go back because we had no food and nowhere to buy it. So we started the road. We did find a checkpoint, but they let us through.”
David says that it was impressive to see Tuzantla as a ghost town. “Between 11 in the morning and 1 in the followingnoon there is always a whole gang of people, the ladies, the children, the cars, all the businesses open. That Thursday there was no one on the street, it was deserted, with all the curtains of the premises closed”.
The medical intern says he was relieved until he saw the Zitácuaro sign. “I never thought I would be so happy to see the dam in that place.” Now David is in a place far from Tuzantla, where he would return only if there is security and a contingency protocol that operates to safeguard health personnel in events like the one he experienced.
“I am very grateful to the former intern. He saved me, the dentist, his daughter and the two nursing interns, if it hadn’t been for him, we wouldn’t have gotten out of there. No authority called us to tell us such personnel will go for you or a patrol to protect you. The manager of the clinic told us that he was going to send us someone with food and no one ever came”.
Andrés Castañeda, coordinator of the Collective of Doctors in Training, says that this is a constant problem now that the interns are facing situations like the one David experienced, because no authority is responsible for safeguarding them and there are no protocols for this.
Bruno Rául Vargas, clinical supervisor of the Compañeros en Salud organization, which operates in the Frailesca zone of Chiapas, providing support to medical interns, says that in effect there are no protocols on the part of the authorities to protect those who are doing their internship other than the instruction to contact your Teaching Coordinator.
“We have installed communication systems with radios and in case of any call for help because the staff does not feel safe, we go for them in the organization’s vans and ask for the support of the police or community authorities to remove them from the place and put them safe,” explains Vargas.
Castañeda says that the problem they see in general with medical interns is that they fall into everyone’s land and no one’s, on the one hand there is the responsibility of the federal government, in terms of which is the one who organizes the issue of assigning places for services; On the other hand, there are the health secretaries of the states and institutions, IMSS, ISSSTE, and then the clinics, the headquarters, where there is a head of education or in the jurisdictions.
There are also the universities that are responsible for the students, or at least that is what the regulations say, regarding internships and internships, Castañeda points out.
“Because there are so many involved, in reality no one is responsible, in addition, the protocols of action for these cases are lacking and there should be them, as well as committees, well structured, well integrated, with the participation of all the actors and the students, to deliberate in case there is a controversy or problem”, says Castañeda.
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