Interns, easy targets of crime

Karen Valverde remembers lying on the floor of the room, tapping the screen of her cellphone with shaky hands, desperate to get a signal. Her coworkers – other medical interns – are trying to do the same thing: ask for help. Yet the signal is poor at the Santiago Tepetitlán medical clinic, in the State of Mexico.

Ten minutes before they all threw themselves on the floor, they heard footsteps outside the door and, believed for a moment it could be a patient. Outside it was dark. It was a Saturday night in November 2013 when three men shouted: “You're done for […]! It's over for you […]! We know you have women in there, so bring them out here!” And a shower of stones fell upon the building.

Similar cases of assault and aggression against medical interns – and even murders – were reported at least in 21 states of Mexico from January 2007 to December 2015.

The Ministry of Health documented 34 official complaints of threats and aggressions against the students of 12 public and private institutions, among them the National Autonomous University of Mexico (UNAM), the University of Guadalajara, the Autonomous University of Nayarit, the Autonomous University of San Luis Potosí, the University of the Valley of Mexico(UVM), and the National Polytechnic Institute (IPN) – of which there is only one case recorded, back in 2009 in Tlaxcala – according to documents obtained by EL UNIVERAL via the transparent access to information.

However, pursuant to another information request made to the IPN, the figure surpasses federal data: from January 2007 to September 2015, the students of this institution filed 50 complaints and lawsuits. The numbers of both documents give us a total of 84 cases and the states with the highest level of incidents:

The years with the highest number of cases are:

In many occasions, threats or assaults are not reported because of the fear of retaliation or the omission of authorities.

M.D. Ricardo León Bórques, president of the Mexican Association of Faculties and Schools of Medicine (AMFEM) says that according to their records of the last five years, there's been close to 10 cases per month, that is, a total of 600 cases, and that the states with the highest number of cases are Guerrero, Michoacán, and Chihuahua – states crippled by organized crime .

The most frequent incidents reported by the Ministry of Health and the IPN against interns are threats and aggression from both, locals and patients; muggings; attacks and lack of security at medical centers and clinics; rapes and attempted rapes; sexual harassment; life threats; beatings; and admittance of people carrying firearms, requesting medical assistance.

Sometimes, criminals “pick interns up”, blindfold them and take them to an unknown location so they can provide medical attention to another gang member, wounded as a result of an armed conflict.

According to the president of the AMFEM – which gathers 93 public and private Mexican institutions – interns are put in a “save him or die” situation.

When Diana Rodríguez – not her real name – knew she would be doing her social service in a Náhuatl-speaking community in Hidalgo, she was eager to put into practice what she had learned at the UNAM. In February 2015, a few days after she had begun her internship there, she had to endure the rude and offensive comments made by a group of men who gathered outside the clinic to get drunk; one month in, a local cop tried to hit her because he refused to wait for his turn and demanded to receive immediate medical attention for his eye infection.

Unlike the rest of professions, medical students are required by law to provide a social service for 12 months “at primary medical care units, mainly at the most underdeveloped areas,” that is, a vast majority of the 14,000 Medicine students in Mexico are sent to marginalized areas, to serve in clinics of the Ministry of Health or the Mexican Institute of Social Security (IMSS).

The study “Expectations and motivations during the role transition during social service at the Faculty of Medicine of the National Autonomous University of Mexico,” was based on a sample of 360 surveys applied to 814 interns who did their social service during the academic year 2009-2010. Their results: 57% felt insecure at their clinic; 60% mistrusted the medical equipment they were asked to use; 37% didn't have the motivation to carry out their social service; 27% of the interns at rural areas didn't enjoy it; and 23% considered quitting.

Currently, the AMFEM is working on a reduction of the compulsory length of the social service so it can be similar to that of other professions, says Bórquez, in addition to working on a new model involving the Ministry of Health, local governments, and the state governor so interns can have a safe and secure place to provide their social service.

While treating a difficult patient, Diana talked to her supervisors about the situation and she was told to “put up with it.” After a trip she had to make to Mexico City to pick up some studies, Diana returned to the clinic where eight women were waiting for her and threatened to kill her.

Pursuant to the data of the Ministry of Health and of the IPN, a total of five interns were killed during this period yet newspapers have covered two additional cases not included in the official data, despite one of the interns was found dead with torture marks on his neck in Campeche and the other was found hanging from a tree in Guanajuato.

The rain of stones lasted half an hour, breaking the glass of the entrance door of the clinic Santiago Tepetitlán. Karen Valverde feared there would be a repeat of the incidents of October 2012 in Nayarit, when four men raped a female intern – similar to the events of October 2015 in Oaxaca.

Before the attack stopped, one of the interns managed to contact the coordinator and asked for help but authorities arrived at 1:30, an hour after the attackers had already left. The only thing authorities found were the stones hurled at the clinic in which hours earlier the interns had gathered to celebrate Doctor's Day.

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