Over the past three years risks to health-care workers treating the wounded and sick in the Mexican city of Ciudad Juarez have increased. Attacks on facilities and patients have become more common in this city of 1.5 million on the US border, hindering patients' access to health care.
"Four masked men walked into a public state medical centre in the city. They pointed their guns at us and at the patients in the waiting room. We dropped to the floor and one of the men found the intended victim and shot him dead," says Francisco from the Ciudad Juarez branch of the Mexican Red Cross.
The killers, he recalls, then left the centre as if nothing had happened while he and other Red Cross workers calmed down the patients and medical personnel.
According to Mexican government figures, some 3,100 people were killed in drug-related murders in Ciudad Juarez in 2010. The violence has put health care in danger, risking the lives of medical staff and often preventing patients from getting the treatment they need.
Increasing violence, increased risk
Over the past three years there has been a surge in organized crime in the city. The Mexican Red Cross has scaled up its services, opening a third chapter and recruiting more qualified staff to deal with medical emergencies.
"We have been witnessing a unique situation in Ciudad Juarez," says Raul, a Red Cross worker in the city, "in which the violence has increased so much that we had to increase our services for the community."
The Red Cross has improved its service, increasing the number of ambulances from 15 to 35. More than two hundred paid staff and volunteers help to run three medical centres in the city, tending to the sick and wounded in increasingly difficult circumstances.
Most of the call-outs used to relate to road accidents or taking the sick to hospital. But according to paramedic Javier, "it was rare that they had to deal with victims of shoot-outs but these have become more frequent". They are also finding fewer victims alive and most of those they evacuate are in a critical condition.