Doctors are lacking in 45 of the 50 municipalities with the most homicides

In 45 of the 50 municipalities that concentrate almost 40% of the murders that are committed daily in Mexico, there is a shortage of medical specialists, mainly internists, emergency surgeons, anesthesiologists, gynecologists, and pediatricians. It is a deficit that the government hopes to cover with the recruitment call launched last week, although medical associations consider it urgent that, at the same time, safety conditions be guaranteed for those who come to work there.

In total, according to official information, there are 13,750 vacancies for medical specialists in Mexico. To try to cover these spaces, on May 24 the so-called National Day of Recruitment and Hiring of Medical Specialists was announced, where the available places are detailed by state, but not by municipality.

However, a review of Political Animal The platform that the government enabled for applicants does allow identifying in which towns and hospitals there are vacancies for specialists. Although the total number of spaces per municipality cannot be identified, it is broken down into where there are available spaces.

The review of said platform shows that, in total, there are 948 municipalities with some shortage of doctors from 98 specialties and subspecialties. And precisely among those localities are the 45 municipalities cataloged by the administration of Andrés Manuel López Obrador as priorities in its security strategy, due to their high concentration of homicides.

The municipality that is in first place in number of murders, according to the government’s April 2022 security report, is Tijuana, Lower California. There is a lack of specialists in internal medicine —the specialty with the most vacancies in the call—, in the Regional General Hospital 20 of the IMSS and in the General Hospital of Tijuana.

In fact, the latter has a shortage of doctors in several specialties that are among those with the highest number of vacancies in the call, such as medical-surgical emergencies, gynecology and obstetrics, general surgery and anesthesiology.

In August 2021, María Fernanda Hernández Viera, a dental surgeon with two postgraduate degrees and three young children, was murdered in Tijuana. She was shot in her office. The alarms went off.

The president of the College of General Medicine of Tijuana, Yessenia Espinoza García, pointed out that the authorities must take seriously the problem of insecurity and violence, which also affects the rest of the population.

Espinoza García lamented the murder of the dentist and told local media that this was an indicator that crime was turning to look at the union again.

Juarez City, Chihuahua, is the second municipality in the entire country with the most murders. There is a lack of internists in the General Hospital of Zone 6 and in 35, of the IMSS. There is also a lack of specialists in medical-surgical emergencies. And at Hospital 66, there are vacancies in pediatrics.

On September 21, 2021, in Ciudad Juárez, orthopedic doctor Sergio Espejo Guasco was murdered while traveling in his vehicle. Once again, the union raised its voice to express alarm and sorrow for the murder of his colleague.

Alonso Ríos, president of the advisory council of the College of Physicians, said that as a union they felt indignation and demanded that the authorities clarify the facts and guarantee the safety of health personnel.

In León, Guanajuato, the municipality that has the third position in the highest number of homicides, the federal government hopes to fill vacancies in pediatrics, in the Hospital de Gyneco Obstetricia 48 of the IMSS, where there is also a lack of specialists in that field. For medical-surgical emergencies, there are vacancies for the entire state delegation of the IMSS.

It is not attended by fear

In ZamoraMichoacán, the municipality that is in position 10 in the list of those with the most homicides, the hospitals of the IMSS-Well-being of Villamar and the General del Insabi have a lack of specialists in internal medicine, medical-surgical emergencies, pediatrics, gynecology and obstetrics and anesthesiology, among others.

For years, Michoacán has been a state where being a health personnel is a security challenge. ‘Alicia’ —who asked to be quoted under a pseudonym— is doing her internship in a state municipality. She treats patients at a clinic in a community during the week and on weekends she has to go to another one three minutes from the municipal seat.

Last February, on a Saturday, when I was at the clinic on weekends, they saw smoke coming out right at the municipal seat. They also heard gunshots. “We saw groups of three or four patrol cars go by in both directions of the street. The detonations lasted more than 10 minutes. Then they stopped. And then they started again. There were like three attacks at the same time in the area,” he says.

The intern assures that, although the media only reported that houses had been burned, the truth is that in those February attacks, organized crime murdered and raised entire families.

“I was accompanied in the health center only by the nursing intern and a person from the pharmacy. We called the director of the clinic and he did not answer us. We decided to lock ourselves up. After a while they began to touch wounded people so that we could attend to them. We hid, so they would think there was no one there, and we decided not to open. We don’t even have supplies to care for the wounded, so they were going to get angrier or who knows what group they would be from and after a while the rivals come to finish them off or for us, ”she says.

‘Alicia’ says that they reported the incident to the director of the health center, to the health jurisdiction and to state education. “They told us that everywhere people were shot and that if we didn’t have a direct death threat they weren’t going to change us, because in addition, there is insecurity everywhere or that they could send us further away and it would be worse. That was the response we got.”

The intern had to insist and submit many trades to different instances so that they would at least allow her to leave the weekend shifts. The same thing happened to one of her companions in another municipality in Michoacán.

‘Martha’, another doctor in social service —whose real name is also omitted—, has experienced a very similar situation in Michoacán. She recounts that one night when one of the nursing interns was on duty at the health center, she was intercepted by armed persons. They questioned her about where she was going and held her for several minutes without explanation.

Another of the trainee doctors and a social service nurse trainee who were on duty at the weekend had to attend to two people who assured them that they had suffered a kidnapping. Fearing what might happen, they decided to close the health center while they were treated.

All this has been communicated to the authorities, says ‘Martha’, but the director of the health center decided to suspend only the weekend night shifts, although there are not only shootings and criminal acts on Saturday and Sunday.

On the vacancy platform there is no information on whether doctors are offered permanent positions or how long the contracts are, nor the salary they will be paid.

Political Animal He asked three doctors if they would be willing to change their residence entity to have a job. The three pointed out that they depend on being assured of a stable job, a good salary and adequate security conditions and supply of supplies to be able to carry out their work.

“I want to work, yes, but I have the right, like any worker, to say ‘this proposal doesn’t suit me’. I am not going to go to places where I know you can be assassinated or where you are forced to serve members of organized crime. If work entails my life, I wouldn’t leave,” says David Ibarra.

The 5 municipalities with the most homicides and their vacancies in the specialties with the most supply:

  1. Tijuana Baja California: Internal medicine, anesthesiology, general surgery, medical-surgical emergencies.
  2. Ciudad Juárez, Chihuahua: Medical-surgical emergencies, gynecology and obstetrics, pediatrics, internal medicine.
  3. León, Guanajuato: Gynecology and obstetrics, surgical medical emergencies, pediatrics, anesthesiology.
  4. Cajeme, Sonora: Anesthesiology, pediatrics, general surgery, internal medicine, medical-surgical emergencies.
  5. Guadalajara, Jalisco: Medical-surgical emergencies, gynecology and obstetrics, anesthesiology, pediatrics.
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