Responders on the Borders Face Unique Challenges

Responders on the Borders Face Unique Challenges

News Jan 24, 2013

Ricardo “Bojo” Bojorquez loves his job, as unpredictable as it is.

“I don’t know what I’m going to do that day; it’s always a toss-up,” he said. “It can be a fire, it can be hazmat, it can be a brush truck, it can be a heart attack. So I can’t prepare for anything. It’s just come as you are and you have to be ready to go.”

Bojorquez is a firefighter in Ambos Nogales, where the border-town setting creates a unique set of challenges for the crews charged with fighting fires and responding to medical emergencies. He consistently works on both sides of the border after starting his career in Nogales, Sonora. Because of his bi-national background, Bojorquez said, he feels connected to both countries.

When he began fighting fires in Nogales, Sonora, the fire department lacked much of the basic equipment required in the United States.

“We didn’t have air packs, all we had were handkerchiefs. We’d wet ’em and put ’em over our mouths. It’s a pain in the ass to work that way because you actually can’t see anything. Smoke – it’s in your eyes, it hurts, you work for 10, 20 minutes and you’re out trying to breathe. And then you go back in,” he said.

Even so, he said, these difficult conditions make a person better at fighting fires. “We risk a lot to save a lot, and the best thing we can save is a life. Everything else really doesn’t matter,” he said.

Bojorquez said he likes working on both sides of the border, for different reasons. He described feeling “more taken care of” when he’s in the United States because there are more rules and regulations. When he’s in Mexico, he feels a greater urgency to put the fire out as quickly as possible, because “the less things that burn, the more things they can salvage. There’s no insurance so we hurry up just to save stuff.”

Nogales, Ariz. has a population of about 20,833, according to the 2010 Census, and many of the firefighters at the Nogales Fire Department stress the city’s size when they describe their work. Pete Ashcraft, a captain and the senior officer for A-Shift at Station One, explained how the population shifts dramatically during the day. Because of its location on the border, thousands of people travel through Nogales, Ariz. each day.

“We can have upwards of 150,000 here during the day in Nogales and we have to deal with all those emergencies,” he said. “We get a little bit of everything and it’s a lot of fun. We see unique stuff.”

“If Nogales was just the ‘sleeping population’ of 20,000 and it was a good day for everybody, we’d just relax. The probability of an incident would be less,” said Ken Larriva, another firefighter working at Station One. However, because of the “non-sleeping” population of tourists and non-residents who travel through, the department gets a greater variety and number of calls than one would usually expect in a city the size of Nogales, the firefighters agreed.

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Across the border, Nogales, Sonora is much bigger than its sister city in the United States. While the U.S. Consulate in Nogales, Sonora lists an unofficial population of 250,000, the firemen cited a population of up to to 400,000 residents. Many of those residents visit the United States, and sometimes they get sick after crossing the border.

There might be “people with a visa that can cross just for the day that end up getting sick on our side of the border, or they have a visa to cross and they decide, ‘I’m coming over to have my baby today,’” said Steven Bergier, a paramedic working at Station One. Babies have even been born at the port of entry, “in the border crossing right there, on the tile floor,” Ashcraft said. And since they are in the United States, the NFD paramedics treat them, Bergier said.

Tricky transfers

Cross-border patient transfers are another unique aspect to the medical treatment in Ambos Nogales. Sometimes U.S. citizens are injured in Mexico and must be transported back to the United States.

This creates challenges because each country has different medical laws and transport methods, explained Genaro “Tony” Meras, an Emergency Medical Technician (EMT) and firefighter in Nogales, Ariz.

The American EMTs must “redo everything as if they’re a brand new patient found on the street” when a patient is transferred from Mexican emergency services to the U.S. services, Meras explained. That’s because in the United States, whenever a patient is transferred to a new emergency medical provider, the new provider must be of a higher care level than the original provider. This is a way to ensure nothing was skipped in the process of treating the patient and a way to ensure the patient receives the correct care, Meras said.

The American EMTs cannot cross the border to treat the patient, but Meras said his department receives the call and then rushes to the port of entry to meet them.

Sometimes patients are transferred across the border when they usually would not be cleared for traveling, said Bergier. “We see people on medication drips or certain things that normally we would never transport somebody on some of these medications,” Bergier said. Nonetheless, they transport the patient to the nearest hospital or medical facility and continue to care for them there.

Fence falls

Border security and immigration laws have also played a role in medical response work in Ambos Nogales.

A fence has run through the two communities since the mid 1900s, growing taller and taller through the years. Its most recent makeover began in June 2011 and, while also adding height, the new barrier included a rocky and sharply angled base, which makes it more difficult for people to jump over without getting hurt.

“The fence went from like 18 to 20 feet to about 25,” said Bergier. “When they first finished that section of fence we rolled in a lot of people that were badly hurt. Badly hurt like multiple fractures, femur fractures, a lot of injuries.

“It’s hard to land from 20 feet, you know, even if you have the right shoes,” Bergier said.

He and Ashcraft agreed that the number of injuries related to people jumping over the fence has not changed, but the injuries themselves have become more severe.

“I don’t think people realize a lot of times how far of a fall that is,” as he discussed injuries related to people trying to jump over the fence.

“We get a lot of broken legs, broken femurs, broken hips. Sometimes they’ll get their foot caught up at the top and they fall on their head.”

Desert dangers

In summer, heat exhaustion and dehydration are concerns for the paramedics in Nogales. Dehydrated people are found trying to cross into the United States through the desert and the EMTS help them recover.

One change that the firefighters have observed within the last years is a difference in the demographics of the people attempting to cross the border. “They’re called OTMs: Other Than Mexicans,” Bergier said, laughing at the Border Patrol-created acronym. “Yeah, we didn’t make that up.”

This classification can be “anybody from Central America, or anywhere else,” Bergier said. “We’ve picked up people from India and China.”

Meras recalled a Portuguese-speaking Brazilian he had treated as an example of how difficult communication can be in some cases. Although most of the men working at Station One are bilingual in English and Spanish, they need more resources when working in other languages. “That’s why it’s good people have the smart phones now,” Meras said.

Google translation apps provide a new way for the emergency workers to communicate. They work well, “as long as they [the patient] can read,” Ashcraft said. “I’ll type in what I want to say and then I’ll just show it to them.”

Between using basic sign language, movements and the translation apps, the EMTs can determine what is wrong and get the person to a hospital, Meras said.

Such diversity in patients is unusual for a small town, but Bergier said he sees it as another distinctive aspect of working in a border community.

(Reporter Christa Reynolds wrote this story as part of the University of Arizona’s “Reporting in the U.S.-Mexico Borderlands” class that spent last semester working in the Ambos Nogales area.)

Copyright 2012 Nogales InternationalDistributed by Newsbank, Inc. All Rights Reserved

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Nogales International (Arizona)
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