Interview about the project with


Publicado el noviembre 2, 2015 por 

Marco A. Flores
Nogales, Sonora.- Como ejemplar calificó la colaboración y trabajo realizado entre bomberos de la franja fronteriza de Sonora y Arizona, la profesora lituana Ieva Jusionyte, quien visitó Nogales como parte de un estudio para la elaboración de un libro, en la Universidad de Florida.

La maestra del Departamento de Antropología del Centro y Latinoamérica de la Universidad de Florida estuvo por periodo de dos semanas en esta frontera, con el propósito de estudiar la forma de trabajar de los bomberos en la región.

Dicha visita fue gracias una beca de una fundación nacional de ciencias, para escribir un libro sobre cooperación binacional de bomberos y de protección civil entre Sonora y Arizona.

Jusionyte dijo que empezó con su investigación desde mayo pasado, con visitas de varias semanas a los departamentos de bomberos en Nogales, Arizona, Arivaca, Río Rico, Suburban y terminó trabajando en Nogales, Sonora, con el apoyo del teniente Víctor Garay, del cuerpo “Gustavo L. Manríquez”.

Read more: 

Using Marijuana Bale as a Splint

Before the checkpoint was placed on Hwy 286 near Three Points there were multiple MVAs that would occur along that stretch of highway between Sasabe and Three Points. I can recall an MVA involving drug smugglers where they were being followed by USBP and when USBP lighted up and attempted to pull over the driver and occupant became nervous and attempted to flee. They were driving a white pickup truck that was fully loaded with marijuana. They lost control of their vehicle at approximately MP 9 on Hwy 286 and rolled several times coming to a stop in the upright position.

Arivaca Fire then a volunteer department was dispatched. Three personnel were enroute to the scene in an ambulance and an engine. U/A met by USBP who claimed they had two pts. First patient had been ejected during the crash and the second was trapped in the vehicle. LN4 from Tubac was launched.

I remember the first thing I saw as I was walking towards the scene were pot bales strewn about the landscape. They were everywhere. USBP was armed on scene and needed everyone’s names for documentation. My job was to attend to the trapped occupant. My partner and I used our extrication tools to remove the driver side door and the roof of the vehicle. The driver’s seat was broken and because we had to stabilize the patient we used what we had near us to stabilize the seat during extrication. That “something” happened to be a bale of marijuana as it was the right size and weight. I have learned in this business you use what you have available to use.

Due to the severity of the accident and the fact that both patients needed access to ALS and Arivaca Fire at that time was only BLS it was imperative that we stabilize the patients for transport while awaiting the arrival of the helo. The driver had a severe head injury and was unconscious.

Due to limited personnel, we were unable to extricate the patient and provide needed pt care so we held off on extrication and attended to the patients until the arrival of additional units. Once LN4 arrived on scene their Flight Nurse took over patient care while we then extricated the patient. The patient, still unconscious, was placed on LSB and lifted out of the top of the vehicle where the roof had been. The Flight Medic assumed pt care for the other patient who was ultimately transported by ground.

Both patients were transported to UMC due to it being the closest trauma center. Both patients survived.

The biggest challenge for this call was the fact that there was limited personnel and this was a very complex scene. We easily could’ve used medical and fire personnel who each had their jobs to perform but in this case while all three of us were both fire and medical trained we didn’t have the luxury of delegating specific responsibilities. We had to do it all! That was and is almost always the case in rural areas such as this.

This call made the KVOA news. It was circa 2005 or 2006.

Nogales International: Fire Crews Prepare For Rescues

News piece in Nogales International (September 22, 2015; page 10A) about the Del Campo warehouse drill, which took place in Rio Rico, Arizona in mid September. Pictures show firefighters from the Nogales Fire Department, who participated in training together with Tubac Fire District, Rio Rico Fire District, Green Valley Fire District, as well as bomberos from Nogales, Imuris and Santa Ana in Sonora, Mexico. For more pictures see the gallery

Op-Ed: 911 on the U.S.-Mexico border

Here's the link to an op-ed I wrote for the Guardian 

In it, I argue that the federal government must create a mechanism to fund firefighters and paramedics without requiring fire departments to go through the border patrol to get reimbursed for the care they provide to injured migrants, thereby putting an end to a practice that makes emergency responders accomplices in immigration policing . 

Interview with CBP: Patient Transfer at the Port of Entry

On September 3, 2015 I met with Teresa Small, Tucson Sector spokeswoman for the U.S. Customs and Border Protection’s Office of Field Operations, to ask about the procedures of transferring patient care between Mexican and U.S. healthcare providers at the port of entry in Nogales. Her colleague, Edith Serrano, joined us. Here are the excerpts of our interview.

IJ: What are the procedures for transferring patients from a Mexican ambulance operated by the Cruz Roja or other entities to a U.S. ambulance, often sent by the Nogales Fire Department?

Ms. Small: “Throughout the ports in Arizona it is typically going to be like this. The hospital in Mexico makes the arrangements with the U.S. hospital to transfer the patient. Once this is completed, the U.S. hospital faxes the port the detailed information regarding the severity of the medical situation and any other pertinent information to review. This gives us, Customs and Border Protection, time to review the situation and information of the person arriving into the U.S. to determine if the patient will be authorized to be transported. Once this is established, CBP allows the paramedics to transfer the patient from the Mexican ambulance to the U.S. ambulance and obtains biometric information if possible."

IJ: What type of documentation is required? What type of documentation is required of Mexican doctors and other healthcare providers who want to cross into the U.S., accompanying patients? What about patient's family members?

Ms. Small: “If they are a U.S. citizen, they are required to present their valid Western Hemisphere Travel Initiative document, such as U.S. Passport, U.S. Passport Card, Enhanced Driver’s License, or Trusted Traveler card (examples would be the Global Entry or SENTRI documents). If they are a U.S. citizen, we cannot deny their entry into the U.S. Now, if the patient is an alien, seeking to lawfully enter the United States, they must establish their admissibility to the satisfaction of the Customs and Border Protection officer. This is done as part of the inspection process. CBP typically encounters Mexican nationals, at least in these border areas, to either have a DSP-150 document, which is also known as our Border Crossing Card, or lawful permanent resident document, which many refer to as the Green Card."

“The process for Mexican healthcare providers and family members who want to accompany the patient is the same.” 

IJ: What are the procedures for transferring patients from a U.S. ambulance to Mexican Cruz Roja or other ambulance at the port of entry?

Ms. Small: “They take them into vehicle secondary. Just because somebody has come onto our port, doesn’t mean that they’ve been admitted into the United States. If the person is in an ambulance, they’ll be transported to the vehicle secondary where there is more space and they are able to place the patient from one ambulance into the other."

Ms. Serrano: “I think it depends on the port. At DeConcini they will use one of our outbound lanes. […] They will call over the radio to stop all incoming traffic, the ambulance comes in against traffic and backs up to Lane 1, they open the gates and they transfer the patient right there. […] That’s when we go and look at the documents and make sure that everything is intact. Then they make the transfer and off they go." 

IJ: Are there any situations when Cruz Roja or other Mexican ambulances are allowed to cross the border and take patients directly to the Holy Cross hospital? If so, what are those situations? Who escorts the ambulance?

Ms. Small: “This isn’t typically what occurs. Because they would be considered working in the U.S., if they were to come over in that form of capacity. So unless they had some special visa to be able to do that, it’s not going to occur."  

IJ: I know that previously, perhaps decades ago, Cruz Roja used to be able to take patients to the U.S. hospitals...

Ms. Small: “And that was decades ago, like you said. From what I was reading, I came across something that was in the early 90s. It probably ended in the early 90s. Since our merger this is not the process that is done any longer."  

IJ: Are there any exceptions for critical emergency situations, when the patient is unresponsive or has a life-threatening illness or injury?  Can U.S. ambulances take them? Earlier in July a 9-year-old Mexican girl was struck by lightning in northern Sonora and taken across the border to Tucson for treatment.

Ms. Small: “The process is still going to be the same. We will ask for documentation. If they don’t have some form of documentation, if it is that form of severity that you’re talking about, we may consider a parole. But it’s not automatic. […] It’s going to be a case by case situation. Typically, if they have no documents, depending on the severity of the medical situation, we may provide a parole for that person to enter the U.S. to receive the medical attention. The parole would be provided at the port. […] The decision of the port director is not based on meeting the person, though. They are provided with the paperwork pertaining to the situation and they make the determination if the person is going to be paroled or not."

Ms. Serrano: “It’s case by case. Sometimes they come from as far as Hermosillo, so by that point they’ve already connected to us. […] This gives us time to do some research to see if [the patient] had any issues in the past. Again, case by case. Obviously, the more time we have in advance, we are able to make those inquiries. So it depends. It really depends. Ultimately it is the decision of the port director to allow that." 

IJ: What are the procedures for letting Mexican firefighters come into the U.S. to provide mutual aid when the binational plan is activated in emergency situations? What type of documentation is required from the firefighters? 

Ms Small: “In general, when those situations occur, we are given a list of those potential firefighters that are going to come over. So we are able to make sure that there’s nothing derogatory in their background."   

“In essence, when we deal with these situations, we know that it can be a life-threatening situation, so we do everything possible to expedite where we can. But of course the coordination between the hospitals is huge. If they are able to get that in place, it makes our job just that much easier. We are not there to try to impede the patient care. We want to get them help as well. But it really depends on the situation.”

Migrants Injured Falling from the Border Fence

The Mexican Consulate in Tucson and the Juan Bosco migrant shelter in Nogales, Sonora, have seen an increase in serious injuries along the fence, reported Fernanda Echavarri (Arizona Public Media) and Perla Trevizo (Arizona Daily Star). Their stories cite Ricardo Pineda, the Mexican Consul in Tucson, that there had been 37 cases of injured Mexican migrants in 2015 (in 2014 his office reported 56 cases). This number includes all injuries, not just falling from the fence, but the consul said that in 2015 they had more migrants in need of medical attention from falling off the border fence than from crossing the desert. By the beginning of July, 200 injured people were dropped off at the shelter across the line in Nogales; in June alone there were more than 30. Most of them are women with fractures to their feet, ankles or legs. AZPM article quotes the shelter's director, Gilda Felix: “They think it’s easier than walking for days in the desert but it’s not. [...] It’s the same crossing through the wall or through the desert, both difficult and dangerous.” 

Emergency responders in the Nogales Fire Department (NFD) say that they often receive calls to the fence. Even after in 2011 the new fence replaced its earlier version (with promises to make it more difficult to climb over and thus acting as a deterrent), people keep trying to get across and continue to be injured; only the mechanism of injury changed: though the earlier barrier, made of landing mats left over from the Vietnam War, had sharp edges and often caused finger amputations, falling from the present bollard-style fence, which stands over 20 feet above the ground, people fracture their ankles, tib-fibs or femurs, as well as injure their spine. Though I do not yet have statistics to estimate how frequently the fire department is dispatched to the border, on the first two days I observed the work of NFD by accompanying them on calls in May we went twice to help injured crossers. The first one was a 30-year-old woman who fell off the fence west of Mariposa Port of Entry; she had bilateral ankle fractures. The second, merely three days later, was another 30-year-old female whom we found down in the ravine by the corrals, where she had crawled after she fell off the wall; she had a laceration on her forehead and complained of back pain. Both women were flown by helicopter to the Level 1 Trauma Center in Tucson. 

Paramedics from the Nogales Fire Department provide emergency care to an injured woman who fell off the border fence. May 2015. Photo by Ieva.  

Patient being transferred onto LifeLine helicopter at the landing pad near Nogales Holy Cross Hospital. May 2015. Photo by Ieva.