It’s just gotten dark in Tijuana, and paramedic Sergio Garcia is careening through traffic on a main thoroughfare appropriately called Via Rapida, his sirens blaring.

More than 13 hours after his shift started at 6 a.m., Garcia is headed to his next emergency call and explaining what it is like to save lives in a city where it often means risking his own.

“When it’s just a gunfight between narco-trafficker and narco-trafficker, it’s not as bad,” said Garcia, the static from the police scanner punctuating his words.

“But when it’s police against the gangs or the people who sell drugs and have guns, it’s very tense, because the police are also scared and we’re scared. We attend to people very quickly; load up and go because we don’t want to be there very long.”


In Tijuana, a city of about 1.8 million people in the grip of a spike in violence, the average ambulance response time is 24 minutes — sometimes too late to save a person’s life.

The wave of cartel-fueled carnage means emergency calls are at an all-time high, straining the city’s fleet of 13 ambulances and its team of medics and EMTs, run by Cruz Roja, or the Red Cross.

Mexican Red Cross paramedics Victor Ramirez, left, and Sergio Garcia chat outside the Tijuana General Hospital after delivering a patient on Friday. (David Maung)

This recent foggy Friday is a little quieter and more traffic-clogged than usual because of a Xolos soccer game — and everyone on duty hopes it stays that way. Because two nights earlier “was crazy,” they all say.


On Jan. 22, six state police officers were shot, one fatally, at a hot dog stand where they had stopped to eat.

Days later, police discovered a narco-message hanging from a bridge, promising more violence against state police and anyone around them.

“Don’t get involved,” the message warned.

Mexican Red Cross paramedic Sergio Garcia, center, prepares to attend to a man who had a seizure on Friday in Tijuana. (David Maung)


It’s unclear if the warning was directed at first-responders like Garcia or journalists or food service providers. The food vendor had also died in the attack in Tijuana’s Benton neighborhood.

“It was not safe for us,” said Cruz Roja Rescue Coordinator Juan Carlos Méndez.

Méndez said emergency responders did not have access to the shooting scene until it was secured by police.

“We had to leave the area until we got confirmation from police that authorities had arrived and secured it,” said Méndez.


A forensics team member investigates the hot dog stand where a group of state police officers were ambushed in Tijuana’s Benton neighborhood shortly before midnight Wednesday. One officer was killed. (Margarito Martinez)

The Red Cross operates in an environment where police guards are often called to protect recovering crime victims from further violence at the hospital. The wounded officers last month all had such protection.

Garcia said he tries to stay focused on his next call to endure the high levels of stress and his 24-hour shifts, which can cause the days to blur together.

That next call is for Raymundo, a 61-year-old bicyclist with a large hole in his skull above his left eye. He is drifting in and out of consciousness when Garcia arrives in a compact Cruz Roja car. The vehicles are often sent to emergencies ahead of ambulances to preserve the city’s limited resources.


“I fell,” Raymundo vaguely tells Garcia from the back seat of a Tijuana municipal police truck.

A Tijuana cop echoes the patient loudly.

“He fell,” the officer asserts.

On any given night, 70 percent of the calls Garcia receives are for minor issues, not real emergencies. But this one is; Raymundo needs a doctor and fast.


There are no ambulances available to take him to Hospital General, the facility that accepts the city’s lower-income patients.

“It’s that we don’t have any plastic, and he’s bleeding all over our truck,” the officer explains.

“Well, I don’t think I have any plastic either,” responds Garcia, searching his Kia Soul.

“We’re going to help him one way or another,” Garcia says quietly. “The only sure thing here is that we’re going to try to help him.”


Someone locates part of a cardboard box on the street and spreads it out in the backseat of Garcia’s new Kia. Garcia buckles in Raymundo and takes off for the ER.

The patient groans whenever the car hits a bump and starts drifting out of consciousness from the back seat.

“Listen, Raymundo, were police chasing you when you fell?” Garcia asks him, loudly, trying to keep him awake.

“They ran over me!” he declares. “I just went to get some chicken. I want some chicken.”


“We’re almost there. We’re arriving soon,” Garcia tries to reassure his patient, glancing into the backseat through his rearview mirror.

For the next 12 hours, Garcia responds to call after call: overdoses in the city’s Zona Norte area; a 26-year-old woman asphyxiating after drinking more than three-quarters of a bottle of tequila; a man convulsing outside a closed Red Cross clinic near the Cinco y Diez neighborhood.

On Calle Coahuila, the paramedic blandly notes a homicide scene as he rolls past, unruffled; there’s nothing he can do for the dead.

“This city never sleeps,” he remarks.


Garcia often works 24-hour shifts as a paramedic, and then the next 24 hours as a firefighter, sometimes catnapping between calls. For his work with Cruz Roja, he gets paid between $100 and $200 a week.

On Saturdays, he sometimes spends part of his only day off training volunteers in CPR so the agencies can have more help from civilians.

Mexican Red Cross paramedic Daniel Larios waits for a call outside the Red Cross hospital on Friday in Tijuana. (David Maung)

“It just gets to the point where you know you love it and you know you wouldn’t be happy doing anything else,” said Daniel Larios, who has been a paramedic with Cruz Roja in Tijuana for 22 years.


Larios described getting addicted to the adrenaline of responding to the calls, the pride of helping people, and the camaraderie that builds among people who work in high-stress jobs.

“It’s also lots of coffee and taking little naps every four minutes,” he joked.

Larios remembered a time in 2008 when the Cruz Roja would receive phone threats from cartel members, warning paramedics not to try to save anyone they intended to kill that night.

“But worse than that is seeing the kids get hurt or killed,” Larios said. “Because the kids are not supposed to get hurt, and we’re going to try to help them if they do.”


Both Garcia and Méndez agreed that the job takes a certain dedication and belief in something greater than themselves.

“Why do we want to be paramedics? Because we love it,” Méndez said. “I believe we are convinced in what we are doing. In my case, I am convinced of the principles of this institution.”