Nurse

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0:00:02 > 0:00:05This programme contains scenes which some viewers may find upsetting

0:00:05 > 0:00:08Three British workers, a ferryman a miner and a nurse.

0:00:08 > 0:00:11They've all accepted the challenge to do their job

0:00:11 > 0:00:15under the most stressful and dangerous conditions on the planet.

0:00:16 > 0:00:18They must be a really hard, hard people here

0:00:18 > 0:00:20to be able to cope with this.

0:00:21 > 0:00:24At home, we'd shut the department, you know.

0:00:24 > 0:00:26People wouldn't come back to work.

0:00:26 > 0:00:27This is gun-down mining, this is.

0:00:27 > 0:00:30It's really dangerous. REALLY dangerous.

0:00:35 > 0:00:37Emergency nurse Maria Connolly is leaving

0:00:37 > 0:00:39her job at the Royal Hospital, Preston,

0:00:39 > 0:00:41to work in Ciudad Juarez, Mexico.

0:00:44 > 0:00:47She'll find a city engulfed in a brutal gang war...

0:00:49 > 0:00:51Do we know if it's a gun or a knife?

0:00:51 > 0:00:53Where doctors and nurses are targets

0:00:53 > 0:00:56and have to be protected by armed guards.

0:00:57 > 0:00:59I have never seen so many guns. Never ever.

0:01:01 > 0:01:04And she'll witness first-hand what it's like to live and work

0:01:04 > 0:01:07in a city with one of the highest murder rates in the world.

0:01:07 > 0:01:11He's dead. There's nothing they can do.

0:01:30 > 0:01:3241-year-old Maria Connolly

0:01:32 > 0:01:36is a sister at the Royal Hospital in Preston.

0:01:37 > 0:01:39Did you remember what happened this morning, Lawson?

0:01:42 > 0:01:44You haven't got a clue? No?

0:01:45 > 0:01:48'I love nursing. I love looking after people. You're sharing quite a...'

0:01:48 > 0:01:52a sort of private and often difficult time with people,

0:01:52 > 0:01:56and it's just quite a privilege to share that.

0:01:56 > 0:01:59Right. Just straighten your arm again for me.

0:01:59 > 0:02:02Just do what you got to do, dear.

0:02:02 > 0:02:05- You're a perfect patient. - Yeah?

0:02:06 > 0:02:10The nurses here treat an average of 200 people a day,

0:02:10 > 0:02:12most of them for minor complaints.

0:02:13 > 0:02:15One, two, three.

0:02:16 > 0:02:17There we go.

0:02:17 > 0:02:19But for life-threatening conditions,

0:02:19 > 0:02:23Maria and her experienced team swing into action.

0:02:23 > 0:02:25Say, for example, if it was a cardiac arrest,

0:02:25 > 0:02:28I would say, "Right. Somebody in charge of airway,

0:02:28 > 0:02:30"let's have somebody in charge of the defib,

0:02:30 > 0:02:33"let's have somebody who's going to be in charge

0:02:33 > 0:02:34"of doing compressions."

0:02:34 > 0:02:38You start on one job and we work as a team.

0:02:39 > 0:02:42Preston A&E department is a Level 1 Trauma Centre

0:02:42 > 0:02:45with four high-tech resus bays.

0:02:45 > 0:02:49'Nursing without all the equipment that we have, I think I'd be lost.'

0:02:49 > 0:02:53You can just see, at a glance, that all their observations are OK.

0:02:53 > 0:02:55You can see the heart rate,

0:02:55 > 0:02:57you can check, you know, they're getting plenty of oxygen

0:02:57 > 0:02:58and that they're well.

0:02:59 > 0:03:02'Obviously, we get people that die.

0:03:02 > 0:03:05'If you can't deal with death and dying,'

0:03:05 > 0:03:09you shouldn't really be in a health profession, really.

0:03:09 > 0:03:13It does happen. It's a fact of life.

0:03:13 > 0:03:16In a few days, Maria's heading for Ciudad Juarez in Mexico,

0:03:16 > 0:03:20a city where death is very much a fact of life.

0:03:20 > 0:03:23The murder rate there is up to 100 times higher

0:03:23 > 0:03:25than in Maria's home town of Manchester.

0:03:25 > 0:03:28'Living on my own in the city, I never feel'

0:03:28 > 0:03:30scared or frightened for my sort of safety.

0:03:34 > 0:03:37'I run. I do a lot of running round Manchester.

0:03:39 > 0:03:42'The areas that I run round, they're not picturesque.

0:03:42 > 0:03:45'They're quite sort of cityscape runs, but I feel'

0:03:45 > 0:03:48really safe and I can, you know, jog at night.

0:03:50 > 0:03:54'I feel confident to do anything, anything I want to do.'

0:03:56 > 0:03:59I enjoy city living.

0:03:59 > 0:04:01I think it suits my kind of lifestyle

0:04:01 > 0:04:05because I'm single, got friends who live in Manchester

0:04:05 > 0:04:08and everything's on my doorstep, really.

0:04:11 > 0:04:13'I'm quite laid-back,

0:04:13 > 0:04:17'quite a relaxed person, quite happy person.'

0:04:17 > 0:04:18- ALL:- Cheers!

0:04:20 > 0:04:22'I like being around people

0:04:22 > 0:04:25'and like spending time with friends, my family,

0:04:25 > 0:04:28'and just generally quite sociable, I think.'

0:04:31 > 0:04:32LAUGHTER

0:04:32 > 0:04:34Does that sound OK?

0:04:35 > 0:04:36Out of all of us at work,

0:04:36 > 0:04:39if we have to say who was going to go, it would be Maria.

0:04:39 > 0:04:41She's got an adventurous spirit.

0:04:43 > 0:04:45Any stories that I've heard

0:04:45 > 0:04:48since I found out where I'm going, it's all been about people

0:04:48 > 0:04:50being killed, basically.

0:04:50 > 0:04:52When I read about it,

0:04:52 > 0:04:56I was quite shocked about the murder statistics

0:04:56 > 0:04:58and the drugs and the crime levels.

0:04:58 > 0:05:01I thought, "Oh my God! You can't go there!"

0:05:01 > 0:05:04And I thought of texting you to say, "You have to pull out!"

0:05:04 > 0:05:08'Don't know what to expect, really,'

0:05:08 > 0:05:12so I think that makes me more fearful, really.

0:05:12 > 0:05:14I know when I get there,

0:05:14 > 0:05:18I'll either be more relaxed or I'll turn around and go home.

0:05:18 > 0:05:20LAUGHS

0:05:25 > 0:05:27Ciudad Juarez,

0:05:27 > 0:05:31a city of one million people on the Mexican-US Border.

0:05:33 > 0:05:35It's a battleground for powerful Mexican drug cartels

0:05:35 > 0:05:39that traffic cocaine and cannabis to America.

0:05:42 > 0:05:43These ultra violent gangs

0:05:43 > 0:05:47are fighting to control a trade worth billions of dollars.

0:05:53 > 0:05:55Hundreds of police officers have been murdered.

0:05:58 > 0:06:00It's a world where multiple executions,

0:06:00 > 0:06:05torture and kidnapping have become a fact of everyday life.

0:06:07 > 0:06:10Since 2008, Juarez has been a far more

0:06:10 > 0:06:13dangerous city than even Baghdad,

0:06:13 > 0:06:16with 10,000 people murdered on the streets.

0:06:16 > 0:06:18SHE SCREAMS

0:06:23 > 0:06:24Just thought

0:06:24 > 0:06:26the streets'd be empty and you'd have this sense of...'

0:06:27 > 0:06:29..of kind of danger or fear.

0:06:29 > 0:06:34In that sense, it just feels like a sort of normal city.

0:06:38 > 0:06:41Juarez General is the only public hospital in the city.

0:06:41 > 0:06:45It treats thousands of people caught up in the violence.

0:06:47 > 0:06:49For the next two weeks,

0:06:49 > 0:06:51Maria will be working in the A&E department,

0:06:51 > 0:06:54joining the nurses on the front line of the drugs war.

0:07:04 > 0:07:06- Pablo?- Hola!

0:07:06 > 0:07:09- Hola!- Que tal?- Buenas noches.

0:07:09 > 0:07:11- Buenas noches.- Mucho gusto. - Como estas?

0:07:11 > 0:07:13Buen, buen...

0:07:13 > 0:07:15Maria's host is auxiliary nurse Pablo Vasquez.

0:07:15 > 0:07:19He's been working the night shift in A&E for six years.

0:07:23 > 0:07:28On the surface, Juarez General is a hospital like any other.

0:07:38 > 0:07:40Do you do this? Do you put the casts on?

0:07:45 > 0:07:49But there are stark differences from Britain's NHS.

0:07:49 > 0:07:51For a start, the emergency care budget in Preston

0:07:51 > 0:07:54is 12 times bigger than at Juarez General.

0:08:00 > 0:08:02What's this lady's name?

0:08:02 > 0:08:04- Evitte.- Evitte?

0:08:04 > 0:08:06Here, even taking a patient's blood pressure

0:08:06 > 0:08:08means getting back to basics.

0:08:09 > 0:08:12We do use manual BPs at home, but...

0:08:13 > 0:08:15..I haven't.. Gosh, yeah!

0:08:15 > 0:08:19Hardly ever used them, so I'll give it a go.

0:08:22 > 0:08:25Nurses here can't rely on state-of-the-art technology.

0:08:25 > 0:08:27Compared to Britain,

0:08:27 > 0:08:29the treatment is basic.

0:08:29 > 0:08:33Juarez General has no CT scanner,

0:08:33 > 0:08:37no MRI and just one resus bed for life-threatening conditions.

0:08:38 > 0:08:40'My first impressions, walking in,

0:08:40 > 0:08:44'it just doesn't feel very clinical. It feels just so...

0:08:44 > 0:08:46'kind of just basic, really.'

0:08:50 > 0:08:53'Just, like, you know, metal beds with sort of really

0:08:53 > 0:08:55'thin mattresses and...

0:08:55 > 0:08:58'and no equipment.'

0:08:58 > 0:09:00Yeah, it's just very different.

0:09:04 > 0:09:07It's not long before the first emergency arrives.

0:09:10 > 0:09:14It isn't clear what's happened to him, but the man isn't breathing.

0:09:25 > 0:09:27- Do you want me to take over in a second?- OK.

0:09:29 > 0:09:32It's a race against time to try and resuscitate him.

0:09:50 > 0:09:53Despite their efforts, the patient is not responding.

0:09:53 > 0:09:56When would you decide that you'd call it?

0:09:57 > 0:09:59- 15 to 20 minutes. - You'd always do 15 to 20 minutes?

0:09:59 > 0:10:02Yeah. Yeah, mostly. 15, 20.

0:10:05 > 0:10:07The man has died.

0:10:07 > 0:10:10But in Juarez General, there is little time to stand on ceremony.

0:10:13 > 0:10:15With another emergency arriving,

0:10:15 > 0:10:17the dead man will have to be moved out of resus.

0:10:17 > 0:10:20As usual, the hospital morgue is full.

0:10:20 > 0:10:22'When they needed to make room,'

0:10:22 > 0:10:26they just sort of moved him into a bay

0:10:26 > 0:10:29with other patients just sitting in there.

0:10:29 > 0:10:32So, that's just really... yeah, really weird.

0:10:32 > 0:10:35'He's been wheeled around quite a few places.

0:10:40 > 0:10:44They do care, you know. They're doing everything they can.

0:10:44 > 0:10:48All the equipment, all the drugs that they have, you know, they're using.

0:10:48 > 0:10:53But yeah, I think that must just come...

0:10:53 > 0:10:56That attitude must just come with

0:10:56 > 0:11:00a kind of daily occurrence of lots of death.

0:11:03 > 0:11:06It's almost kind of, "Right, OK. Package up and OK!"

0:11:06 > 0:11:11Not even a mention of what's happened.

0:11:14 > 0:11:16The man was found on the street and has no ID.

0:11:29 > 0:11:31What happens now with this gentleman?

0:11:34 > 0:11:35Sad.

0:11:42 > 0:11:45So far, it's been a quiet night

0:11:45 > 0:11:50and now Pablo has some time to show Maria the department's records.

0:12:01 > 0:12:04- So, every patient?- Todo. Everybody. Todo.- Everybody?- Mm-hmm.- OK.

0:12:21 > 0:12:26There's lots of gunshot wounds and stabbings on every page.

0:12:31 > 0:12:34And is this just this month?

0:12:50 > 0:12:53- They came in here? Through there?- Si.

0:12:55 > 0:12:57- And they come in with guns?- Mm-hmm.

0:13:02 > 0:13:05Did anyone stop them? What happened?

0:13:11 > 0:13:13HE LAUGHS

0:13:13 > 0:13:15You just laugh about it!

0:13:18 > 0:13:21With the threat of gangsters roaming the hospital,

0:13:21 > 0:13:25it is now patrolled 24 hours a day by heavily armed guards.

0:13:25 > 0:13:29'Think we'd be offered counselling if somebody kind of shouted'

0:13:29 > 0:13:32really loudly in our face, you know. You'd kind of...

0:13:32 > 0:13:35You'd be allowed a few days off, and possibly more.

0:13:35 > 0:13:37But that?!

0:13:38 > 0:13:41We'd shut the department, you know. People wouldn't come back to work.

0:13:47 > 0:13:48It's just before midnight

0:13:48 > 0:13:52and Maria is about to get her first experience of violence in Juarez.

0:13:52 > 0:13:54GIRL WAILS

0:13:55 > 0:13:58A teenage girl has been shot through the neck.

0:14:03 > 0:14:06The doctors are worried she's paralysed.

0:14:06 > 0:14:07Can she move her feet?

0:14:21 > 0:14:25The bullet passed straight through her neck, just missing an artery.

0:14:41 > 0:14:42Does she know why?

0:15:03 > 0:15:07The girl faces a long road to recovery.

0:15:07 > 0:15:10Her friend was not so lucky, shot dead in the street

0:15:10 > 0:15:11for not joining a gang.

0:15:14 > 0:15:18Not everyone who comes to the hospital is an innocent victim.

0:15:18 > 0:15:21A man arrives at A&E in an agitated state.

0:15:21 > 0:15:24He's been stabbed three times in the back.

0:15:41 > 0:15:43Shall I check his sats? Maybe he's OK?

0:15:43 > 0:15:45- Oxygen.- Oxygen?- Si, si.

0:15:49 > 0:15:51Shall we put something on the...?

0:15:51 > 0:15:53Do you have, like, a dressing for...?

0:15:56 > 0:15:57These?

0:16:07 > 0:16:09Just having a look at the wounds.

0:16:09 > 0:16:11They look quite superficial.

0:16:11 > 0:16:13Doesn't look like he's had lots of blood loss,

0:16:13 > 0:16:16but they're just checking his blood pressure and his pulse.

0:16:18 > 0:16:21They've taken all his clothes off so they can just see if there's any more

0:16:21 > 0:16:22stab wounds that, you know, we've missed.

0:16:22 > 0:16:24But I think they're just quite superficial.

0:16:24 > 0:16:27But I think he's obviously really anxious and worked up

0:16:27 > 0:16:29cos he's just come from something horrible.

0:16:33 > 0:16:36The man gives his name as Alfredo.

0:16:36 > 0:16:39His tattoos show membership of a notorious street gang

0:16:39 > 0:16:42called the Aztecas, the foot soldiers

0:16:42 > 0:16:44of the Juarez drug cartel.

0:16:46 > 0:16:48What's happened to you tonight? What happened?

0:17:01 > 0:17:02Has this happened before?

0:17:11 > 0:17:12These are gunshots?

0:17:14 > 0:17:16And how old were you when this happened?

0:17:22 > 0:17:24Have you got any family?

0:17:43 > 0:17:46Juarez wasn't always like this.

0:17:46 > 0:17:50Ten years ago, it was just another border town, with factories making

0:17:50 > 0:17:51cheap goods for America,

0:17:51 > 0:17:54and bars and clubs catering for the tourist trade.

0:17:54 > 0:17:57The drug traffickers controlled their own territories

0:17:57 > 0:18:00and paid off the local police.

0:18:03 > 0:18:04But in 2006,

0:18:04 > 0:18:07the Mexican Government launched a war on drugs,

0:18:07 > 0:18:10trying to crush the cartels with thousands of troops

0:18:10 > 0:18:11and federal police.

0:18:17 > 0:18:19It didn't work.

0:18:21 > 0:18:23Violence erupted along the border.

0:18:25 > 0:18:28In Juarez, the chaos led to a vicious three-way war

0:18:28 > 0:18:32between rival cartels and the authorities.

0:18:33 > 0:18:36The bloodshed has left no-one untouched.

0:18:49 > 0:18:52For her first few nights in Juarez,

0:18:52 > 0:18:55Maria will be staying with Pablo and his family at his house

0:18:55 > 0:18:58in one of the huge ramshackle suburbs of the city.

0:19:02 > 0:19:04Wow!

0:19:06 > 0:19:07Ah, it's beautiful!

0:19:08 > 0:19:10SHE LAUGHS

0:19:10 > 0:19:12- You're all inside! Hola!- Hola!- Hola!

0:19:16 > 0:19:17Hola.

0:19:20 > 0:19:21Hola.

0:19:25 > 0:19:27- Como esta?- Buen. Buen.

0:19:30 > 0:19:32Hi. Nice to meet you.

0:19:33 > 0:19:37- Hi.- Hi. Pablo.- Mucho gusto. - Mucho gusto.- Mucho gusto.

0:19:39 > 0:19:41LAUGHTER

0:19:45 > 0:19:48Pablo and Elvira met as teenagers,

0:19:48 > 0:19:50and they've been married for 21 years.

0:19:52 > 0:19:54HE RECITES GRACE

0:20:12 > 0:20:15- It's salsa. - Ah! I've got some. Ah, OK!

0:20:17 > 0:20:20- I can see the chillies.- It's hot! - I can see chillies in here, yeah!

0:20:22 > 0:20:24Maria has been up for over 24 hours,

0:20:24 > 0:20:26and it's time for bed.

0:20:26 > 0:20:30Pablo, who I've been working with, has been amazing.

0:20:31 > 0:20:35He's just really funny and laughs at everything.

0:20:35 > 0:20:37I think he felt that...

0:20:37 > 0:20:40He worried I thought he wasn't sensitive,

0:20:40 > 0:20:44but he's sensitive. He is. He's lovely.

0:20:44 > 0:20:48He is really caring, but as he said, it's just his way of coping.

0:20:48 > 0:20:52And some of the stories he's told me about already, you know,

0:20:52 > 0:20:55people coming into the department and shooting people.

0:20:57 > 0:21:01You'd have to have a coping strategy to keep working there.

0:21:01 > 0:21:05I'm glad I've kind of done the shift already and I'm a bit prepared.

0:21:05 > 0:21:07I think I'll be...

0:21:07 > 0:21:10I won't find it as difficult cos I'll know what to expect.

0:21:12 > 0:21:14Yeah. Try and get stuck in.

0:21:14 > 0:21:16So, I'm going to go to bed. Good night.

0:21:26 > 0:21:29It's 8pm, time for the next nightshift.

0:21:31 > 0:21:34Working nights means leaving the house in darkness,

0:21:34 > 0:21:36the most dangerous time in the city.

0:21:41 > 0:21:43Precautions are essential.

0:21:59 > 0:22:03Does that happen? Have nurses been kidnapped on the way to work?

0:22:13 > 0:22:14Gosh.

0:22:14 > 0:22:17And is it dangerous when you actually get to work?

0:22:26 > 0:22:29I can't imagine having to think about all of that.

0:22:29 > 0:22:33I'm just straight down the motorway, don't have to think of anything,

0:22:33 > 0:22:36just, "Have I got enough petrol?" That's about it.

0:22:36 > 0:22:39And, "Can I get a space to park at work?" And then I'm in.

0:22:40 > 0:22:43It's the easiest part of my day.

0:22:48 > 0:22:50It's Maria's second shift

0:22:50 > 0:22:53and two severely-injured teenagers have arrived in A&E.

0:23:01 > 0:23:04OK, so it's his pelvis. Si?

0:23:04 > 0:23:06Can you straighten your arm?

0:23:06 > 0:23:09MAN SPEAKS IN SPANISH

0:23:09 > 0:23:11There's been a really bad train crash.

0:23:11 > 0:23:13These two guys have just been brought in to us.

0:23:13 > 0:23:15They were on the top of the train

0:23:15 > 0:23:18and trying to smuggle themselves into America.

0:23:18 > 0:23:22Back home, these blokes would have come into resus

0:23:22 > 0:23:25and there just isn't the room here.

0:23:25 > 0:23:28They'd have had all the equipment that we've got to use.

0:23:28 > 0:23:32You know, we'd have got X-rays done in resus.

0:23:32 > 0:23:34They'd have probably had ultrasound scans

0:23:34 > 0:23:37to make sure there's no internal bleeding as well,

0:23:37 > 0:23:39so we've just got access to so much more.

0:23:42 > 0:23:45It's not long before the violence of the streets

0:23:45 > 0:23:48begins to fetch up in the hospital ward.

0:23:48 > 0:23:51OK, a bit of a stab.

0:23:51 > 0:23:52Sorry.

0:23:52 > 0:23:55Brilliant. OK?

0:23:55 > 0:23:57Sorry, was that sore?

0:23:57 > 0:23:59Was that worse then the...?

0:23:59 > 0:24:02These men have all been brutally beaten.

0:24:08 > 0:24:11Police officers armed with assault rifles

0:24:11 > 0:24:14keep watch over the more dangerous patients.

0:24:26 > 0:24:30I've never seen so many guns, never ever

0:24:30 > 0:24:33and they're big guns, they're not just pistolas,

0:24:33 > 0:24:35they're massive great big...guns.

0:24:35 > 0:24:38OK, bit of a scratch.

0:24:38 > 0:24:40All patients receive equal treatment,

0:24:40 > 0:24:42no matter which side of the law they're on.

0:24:42 > 0:24:45- Done.- Yeah?- Perfecto.

0:24:45 > 0:24:47SIREN WAILS

0:24:56 > 0:24:59The ambulance crews provide a steady flow of victims.

0:25:07 > 0:25:09Do we know if it's a gun or a knife?

0:25:17 > 0:25:20I've been shocked by what I've seen.

0:25:20 > 0:25:23I think it's the numbers of people coming in

0:25:23 > 0:25:25who have been involved in violent attacks.

0:25:25 > 0:25:29There are so many that don't obviously get to A&E as well.

0:25:29 > 0:25:31That's kind of in the background.

0:25:31 > 0:25:36You hear about the people that are killed every night.

0:25:36 > 0:25:40The violence has dropped from its absolute peak in 2010,

0:25:40 > 0:25:43but the daily slaughter goes on.

0:25:48 > 0:25:51OK. So this is the local paper today.

0:25:54 > 0:25:58This is in Juarez, in the centre?

0:26:20 > 0:26:23Did this happen...did this happen on the street?

0:26:41 > 0:26:44And this all happened today?

0:26:47 > 0:26:51You're telling me this is like, every day, this would be the same?

0:26:55 > 0:26:57I'm really shocked.

0:27:03 > 0:27:05But there's another hidden tragedy in Juarez

0:27:05 > 0:27:07that rarely makes the papers.

0:27:07 > 0:27:09After their shift,

0:27:09 > 0:27:13Pablo takes Maria to one of the most notorious roads in the city.

0:27:27 > 0:27:30Hundreds of women have gone missing in Juarez in recent years.

0:27:30 > 0:27:32Many have never been found.

0:27:32 > 0:27:35The bodies of others have been discovered dumped by the roadside,

0:27:35 > 0:27:39with signs of horrific violence.

0:27:39 > 0:27:42Who are these women that are going missing? Where they from?

0:27:55 > 0:27:57Do they know what happens to them?

0:28:06 > 0:28:09How does this make you feel with your daughters?

0:28:40 > 0:28:44Luz Elena Luis is one of Pablo's neighbours.

0:29:25 > 0:29:28I'm so sad, I'm so sorry for you.

0:29:28 > 0:29:33In England, if this happened just to one person,

0:29:33 > 0:29:37there would be a lot done by the authorities.

0:29:37 > 0:29:41It's just so wrong that this happens even to one person,

0:29:41 > 0:29:45but its happened to so many women.

0:30:05 > 0:30:07As a woman it does make me feel angry,

0:30:07 > 0:30:10because you should be free to walk round,

0:30:10 > 0:30:12you shouldn't go into town for a job interview

0:30:12 > 0:30:15and then disappear off the face of the earth

0:30:15 > 0:30:18and have nobody care apart from your family.

0:30:18 > 0:30:23It's estimated that 96 % of all murders in Juarez go unsolved.

0:30:23 > 0:30:25The police seem powerless,

0:30:25 > 0:30:28and have been accused of widespread corruption.

0:30:35 > 0:30:39In the face of the chaos and violence, the people of Juarez

0:30:39 > 0:30:43have to get on with their everyday lives as best they can.

0:30:55 > 0:30:58After the other night, Pablo, when the girl came in,

0:30:58 > 0:31:01the young girl that was shot in the neck,

0:31:01 > 0:31:04you were talking about how worried you are for your children.

0:31:04 > 0:31:07It just made me... I can't stop thinking about it, how you cope.

0:31:20 > 0:31:24You must live in this constant worry. I mean, is it safe here?

0:31:24 > 0:31:25Does anything ever happen here?

0:31:35 > 0:31:39Pablo keeps a close eye on his kids. They're not allowed out at night.

0:31:41 > 0:31:44Does it make you very angry that this has all been happening

0:31:44 > 0:31:46while you've been trying to grow up?

0:32:13 > 0:32:17I think it's amazing how you've ended up with such a wonderful family.

0:32:17 > 0:32:19You should be really proud of them,

0:32:19 > 0:32:23and proud of what you've achieved and what you've done.

0:32:27 > 0:32:31It'd be a tough act to follow.

0:32:45 > 0:32:50It's been a really nice day to get to know the family more.

0:32:50 > 0:32:55They've got huge worries about their children dying and being killed

0:32:55 > 0:33:03and it's very real, so it's very moving listening to him,

0:33:03 > 0:33:09and his children talking about how they cope.

0:33:09 > 0:33:15(SIGHS) It just makes me think how lucky I am.

0:33:25 > 0:33:28Maria's back at Juarez General.

0:33:31 > 0:33:36She's come to work the day shift with Head Sister Trine De La Cruz.

0:33:36 > 0:33:41Trine looks after the most critically ill patients in the hospital.

0:33:41 > 0:33:45But Trine also has to deal with another group of patients,

0:33:45 > 0:33:49because up here on the first floor is the prison ward,

0:33:49 > 0:33:54constantly locked and guarded by armed police.

0:33:54 > 0:33:58What kind of criminals are in there? What have they done?

0:34:12 > 0:34:17With patients like these, the nurses have to take precautions.

0:34:37 > 0:34:40So what's wrong with this patient?

0:34:51 > 0:34:55With this... This one, we're going to wash this, yeah.

0:34:56 > 0:34:58This one, put here.

0:35:00 > 0:35:02- Just the saline in here?- Mm-hmm.

0:35:04 > 0:35:07And do you aspirate as I do that?

0:35:07 > 0:35:09Is the bullet still in his head?

0:35:09 > 0:35:11Did he have surgery to try and remove it?

0:35:15 > 0:35:19- So it's an exit wound at the... - Mm-hmm, yeah. In this side.

0:35:22 > 0:35:24Do you get many patients like this

0:35:24 > 0:35:28who you don't know who they are and they've been shot?

0:35:47 > 0:35:50It's just mad that they've got a jail on the ward.

0:35:50 > 0:35:56Really bizarre, having to cover your name and your face at work.

0:35:56 > 0:36:01I would... I'd just say, "That's not in my job description, not at all."

0:36:04 > 0:36:07Doctors and nurses are seen as wealthy

0:36:07 > 0:36:10and are a prime target for kidnappers.

0:36:10 > 0:36:14Many have been held for ransom and even murdered.

0:36:14 > 0:36:16Hundreds of medical staff have fled the city,

0:36:16 > 0:36:20leaving more than a third of the clinics and hospitals abandoned.

0:36:22 > 0:36:26It's part of an exodus that has seen a quarter of a million people

0:36:26 > 0:36:29flee Juarez since the violence began.

0:36:39 > 0:36:42I can't imagine being threatened. You're not involved,

0:36:42 > 0:36:44you're just looking after people.

0:37:30 > 0:37:33Four years ago, Trine used her life savings to buy her dream home

0:37:33 > 0:37:36in an upmarket family estate.

0:37:39 > 0:37:41But within months, the drug gangs took over the area.

0:37:41 > 0:37:44This is what it looks like now.

0:37:47 > 0:37:49When the family were caught in a gunfight,

0:37:49 > 0:37:52they fled the house with nothing.

0:37:52 > 0:37:56This is the first time Trine's been back.

0:37:56 > 0:37:57Ah...it's my home.

0:37:59 > 0:38:02This was my room.

0:38:02 > 0:38:04- This is your bedroom?- Yeah.

0:38:06 > 0:38:12Here is the closet and everything.

0:38:15 > 0:38:18It's only little, but it was mine.

0:38:38 > 0:38:40Why did you have to leave, what was happening?

0:39:01 > 0:39:06It's lot of sadness inside that you must carry round all the time.

0:39:06 > 0:39:08Yeah.

0:39:24 > 0:39:25It's just derelict, isn't it?

0:39:25 > 0:39:30Whole rows of houses that people have just up and left.

0:39:30 > 0:39:32To me, that happens in a war,

0:39:32 > 0:39:36when bombs are being dropped on houses.

0:39:40 > 0:39:42My life is so, so different

0:39:42 > 0:39:46and they are doing the same job as me, they're working,

0:39:46 > 0:39:48they've got families,

0:39:48 > 0:39:54and they seem to be so strong and positive and happy

0:39:54 > 0:39:59and then you find out what really goes on in their lives.

0:39:59 > 0:40:02Yeah, it's just really depressing

0:40:02 > 0:40:06because it's just so unfair, isn't it?

0:40:12 > 0:40:15But Trine is luckier than some.

0:40:15 > 0:40:18Her family have dual nationality

0:40:18 > 0:40:21and now live just across the American border in Texas.

0:40:22 > 0:40:25She goes to visit them whenever she can.

0:40:39 > 0:40:42How come it takes so long to get through?

0:40:47 > 0:40:53Is where a lot of the drugs leave Juarez and get into America?

0:40:57 > 0:41:01This is what the drug war in Juarez is all about.

0:41:01 > 0:41:04Two major cartels are fighting for control

0:41:04 > 0:41:06of the smuggling route to America.

0:41:08 > 0:41:11Mexico is the world's largest exporter of marijuana.

0:41:11 > 0:41:14And almost all of it is smuggled across the border

0:41:14 > 0:41:19to supply the 17.5 million Americans who use it.

0:41:20 > 0:41:23The bridge is also a conduit for millions of dollars

0:41:23 > 0:41:25of Colombian cocaine.

0:41:42 > 0:41:43OK. Thank you.

0:41:47 > 0:41:50Just a stone's throw from Ciudad Juarez,

0:41:50 > 0:41:54the Texan city of El Paso might as well be on a different planet.

0:41:54 > 0:41:56It's one of the safest places to live in America.

0:41:59 > 0:42:02It just feels really weird having been in Juarez

0:42:02 > 0:42:06and not being able to go out on the street at all,

0:42:06 > 0:42:09it just feels amazing to be back to normal.

0:42:09 > 0:42:13Yes, I feel free here.

0:42:13 > 0:42:14Yeah.

0:42:14 > 0:42:21We go to the store or we go to a restaurant or to the park

0:42:21 > 0:42:28we can go to everywhere you want and you feel free.

0:42:28 > 0:42:30It's safe here.

0:42:30 > 0:42:32Yeah, it just feels so different.

0:42:37 > 0:42:40Trine's husband and children live with relatives

0:42:40 > 0:42:42on the outskirts of El Paso.

0:42:42 > 0:42:46Her son, Ricardo, is 17.

0:42:46 > 0:42:48I get very worried when she goes to work

0:42:48 > 0:42:52because Juarez is very dangerous

0:42:52 > 0:42:54and sometimes I get worried

0:42:54 > 0:42:59because I don't know if she's coming back, to see her again.

0:42:59 > 0:43:03You'd rather she stayed here and didn't go back to Juarez?

0:43:03 > 0:43:08Yes, yes, I would prefer for her to stay here,

0:43:08 > 0:43:12but it's her passion and it's her life.

0:43:12 > 0:43:14Do you feel guilty? How do you feel about it?

0:43:14 > 0:43:15Of course!

0:43:18 > 0:43:24She is guilty of me having a good life and I just have to say thanks.

0:43:24 > 0:43:30But I know she loves what she does so what can I do?

0:43:30 > 0:43:32I'm proud of my son.

0:43:32 > 0:43:33Yeah, you should be.

0:43:33 > 0:43:35- And I'm proud of my mum too.- Aw.

0:43:35 > 0:43:37THEY LAUGH

0:43:45 > 0:43:51In 2010, there were five murders in El Paso.

0:43:51 > 0:43:56In the same year in Juarez, there were 3,075.

0:43:58 > 0:44:03Unlike in Mexico, guns are openly and legally on sale in Texas.

0:44:09 > 0:44:10I've never seen so many guns.

0:44:10 > 0:44:12Yes.

0:44:12 > 0:44:15This is for hunting or fishing or whatever.

0:44:15 > 0:44:18- Hello.- Hi.- Hi.

0:44:18 > 0:44:19- This is Maria.- Hello.

0:44:19 > 0:44:22How are you? I'm Shane. I'm the manager, welcome.

0:44:22 > 0:44:23Hi, Shane, hi.

0:44:23 > 0:44:26I'm just having a look at all your guns.

0:44:26 > 0:44:27What are some of these?

0:44:27 > 0:44:29These are your semi-automatic pistols.

0:44:29 > 0:44:31Flipping heck!

0:44:31 > 0:44:34These are...they range anywhere from 380 calibre

0:44:34 > 0:44:36all the way up to 45 calibre.

0:44:36 > 0:44:38And what are some of these?

0:44:38 > 0:44:40These are shotguns as well.

0:44:40 > 0:44:42These are more personal defence shotguns.

0:44:42 > 0:44:4612 gauge. The barrel is too short to do any damage to a bird

0:44:46 > 0:44:47that's flying far away.

0:44:47 > 0:44:50But for self-defence in your home.

0:44:50 > 0:44:52Do people come in and buy these?

0:44:52 > 0:44:54Absolutely.

0:44:54 > 0:44:56- How often? How many people would buy? - Every day.

0:44:56 > 0:44:59How many hand guns would you sell every day?

0:44:59 > 0:45:02I would say on an average day, five to six.

0:45:02 > 0:45:05It's estimated that 90% of the guns used in the drug violence

0:45:05 > 0:45:07over the border, originate in the US.

0:45:07 > 0:45:13Many are bought here perfectly legally and smuggled into Mexico.

0:45:13 > 0:45:15If somebody comes in and they look at bit dodgy,

0:45:15 > 0:45:18you're worried, what do you do?

0:45:18 > 0:45:21We do reserve the right to refuse service,

0:45:21 > 0:45:23to anyone we feel is suspicious

0:45:23 > 0:45:26or we have any reason not to want to sell them the weapon, we can.

0:45:26 > 0:45:31So it hasn't happened often, but if it does, we will refuse service.

0:45:31 > 0:45:34God, I've never seen so many guns.

0:45:35 > 0:45:39I got quite sort of giddy, almost, when I walked in.

0:45:39 > 0:45:42I was laughing because it's just so different, it's so...

0:45:42 > 0:45:45I've never been in a gun shop.

0:45:45 > 0:45:48I didn't really realise how easy it was to buy guns.

0:45:48 > 0:45:50And the way...the guy was lovely,

0:45:50 > 0:45:54but he was talking about buying guns

0:45:54 > 0:45:56as if I was in buying a pair of shoes.

0:45:56 > 0:46:00Made me a bit sad because you see all these guns and he's saying,

0:46:00 > 0:46:01these are just for self-defence

0:46:01 > 0:46:03or they're for taking to the firing range,

0:46:03 > 0:46:05but...they're not.

0:46:05 > 0:46:08These guns end up in Juarez.

0:46:11 > 0:46:15One in eight gun shops in America are situated on the border.

0:46:19 > 0:46:21It's thought that the Mexican cartels

0:46:21 > 0:46:26employ people with no criminal record to buy guns in the US.

0:46:29 > 0:46:32It's a shocking irony that a brutal war to smuggle drugs to America

0:46:32 > 0:46:37is being fought with military grade weapons smuggled the other way.

0:46:54 > 0:46:58The Mexican government complains bitterly about the flow of weapons,

0:46:58 > 0:47:03but it seems to do little to check what's actually crossing the border.

0:47:03 > 0:47:04You don't have to show your ID?

0:47:04 > 0:47:08No. I don't need nothing to come here.

0:47:13 > 0:47:15It's Maria's last night in Juarez.

0:47:17 > 0:47:19Tonight she's going to experience

0:47:19 > 0:47:22one of the city's most dangerous jobs for medics,

0:47:22 > 0:47:25working in the ambulance service.

0:47:25 > 0:47:27Red Cross ambulances attend everything

0:47:27 > 0:47:30from car accidents to multiple shootings.

0:47:30 > 0:47:34Not surprisingly, they work under police protection.

0:47:34 > 0:47:38I'm excited but I'm kind of anxious now a little bit

0:47:38 > 0:47:42because I've seen what comes in to A&E so I have this sense

0:47:42 > 0:47:46of what's happening out there but I've not witnessed any of it.

0:47:46 > 0:47:50I know they're used to being out there and they've got their safety

0:47:50 > 0:47:54precautions and procedures in place, but I don't think you can ever

0:47:54 > 0:48:00eliminate all risks, so I'll be a bit scared that first time we get out.

0:48:00 > 0:48:04She's going to be working with volunteer Dr Jesus Weckmann.

0:48:04 > 0:48:08Tonight we're mostly going to be seeing motor vehicle accidents

0:48:08 > 0:48:11involving people that have been drinking,

0:48:11 > 0:48:15some victims from aggressions

0:48:15 > 0:48:17and possibly gunshot victims.

0:48:17 > 0:48:20They've just sprayed out the ambulance that came back

0:48:20 > 0:48:22covered in blood, where had it been?

0:48:22 > 0:48:30Actually, they went to a crime scene that involved a shooting.

0:48:30 > 0:48:33They transported a victim with six gunshot wounds.

0:48:33 > 0:48:35They were having a bit of trouble

0:48:35 > 0:48:38controlling the haemorrhages from the patient.

0:48:38 > 0:48:40It was a bystander.

0:48:40 > 0:48:43Just passing by when they started shooting at each other

0:48:43 > 0:48:46and he got six shots.

0:48:46 > 0:48:47SIREN WAILS

0:48:51 > 0:48:54The first call is to one of the city's major roads.

0:49:00 > 0:49:02So they arrested this guy?

0:49:02 > 0:49:04Yeah, he's the driver.

0:49:04 > 0:49:06Three cars have been involved in a collision.

0:49:08 > 0:49:10- So, has he been drinking? - Yeah.

0:49:10 > 0:49:12I can smell alcohol on him, yeah.

0:49:12 > 0:49:14You going to take him back to one of the hospitals?

0:49:14 > 0:49:16We'll take him to one of the hospitals,

0:49:16 > 0:49:18but he's going to go under police custody.

0:49:18 > 0:49:21- So he'll go with the police, in their van?- No.

0:49:21 > 0:49:22He'll come with us?

0:49:22 > 0:49:25Yeah, one of them will come with us to the hospital.

0:49:36 > 0:49:39The team are racing to another call.

0:49:39 > 0:49:43They're heading into one of the most dangerous parts of the city.

0:49:45 > 0:49:48They can't go in without police protection.

0:49:50 > 0:49:52Is it OK to get out straightaway?

0:49:54 > 0:49:57Armed police squads have locked down the area.

0:50:00 > 0:50:02So what's he called?

0:50:02 > 0:50:03Where's this guy stabbed?

0:50:03 > 0:50:05Is he dead?

0:50:05 > 0:50:08Seems dead. He has a stab wound to the chest.

0:50:08 > 0:50:12OK. It just looks like such a small wound, doesn't it? But it's...

0:50:12 > 0:50:14- Really long.- ..Yeah.

0:50:14 > 0:50:16Probably hit his heart or a main artery.

0:50:17 > 0:50:20It's a young guy, looks like in his 20s,

0:50:20 > 0:50:22and he's been stabbed in the chest.

0:50:22 > 0:50:25Um, he's dead, there's nothing they can do.

0:50:27 > 0:50:33I think he been here 20 minutes, some guys up there reported it.

0:50:35 > 0:50:39He just looks really young. Yeah, it's really sad.

0:50:47 > 0:50:50They're cordoning off a few blocks around

0:50:50 > 0:50:52so that they can collect any evidence.

0:50:55 > 0:50:59- The yellow, plastic side down? - Yeah.

0:50:59 > 0:51:05But, no, I've never seen anyone murdered before. So...

0:51:07 > 0:51:09Yeah, it's just a waste.

0:51:09 > 0:51:11Kind of think, that's probably

0:51:11 > 0:51:14what's been heading his way all his life, you know?

0:51:14 > 0:51:17Living here there's probably nothing else,

0:51:17 > 0:51:19nothing he could have done about it.

0:51:19 > 0:51:22It's just this inevitable tragedy that so many people

0:51:22 > 0:51:27are going to have happen to them just because they live here

0:51:27 > 0:51:30and because of what's going on in Juarez.

0:51:30 > 0:51:31Yeah, it's, um...

0:51:32 > 0:51:34..really sad.

0:51:38 > 0:51:40SIREN AND HORN

0:51:53 > 0:51:55It's Saturday night.

0:51:55 > 0:51:58The busiest night of the week for the emergency services.

0:52:03 > 0:52:06Maria is spending the rest of the night in the hospital

0:52:06 > 0:52:08for her final shift with Pablo.

0:52:12 > 0:52:15Her first job is to help treat a 21-year-old man.

0:52:15 > 0:52:19He's got a head wound that was bleeding when he came in.

0:52:19 > 0:52:24It's an arterial bleed, so it's quite a pulsing bleed.

0:52:24 > 0:52:27So that's why the doctor has kind of come in to tie that artery off,

0:52:27 > 0:52:30or they can lose quite a lot of blood.

0:52:30 > 0:52:34He and his friends were subjected to a mock execution and badly beaten.

0:52:36 > 0:52:38They're lucky to be alive.

0:52:43 > 0:52:48The hospital begins to fill with case after case of violent crime.

0:52:54 > 0:52:58How did that happen? Can we say how that happened?

0:53:00 > 0:53:01A hammer?

0:53:03 > 0:53:05I'll just get some clean gloves on.

0:53:09 > 0:53:13They've stamped on his shoulder or his scapula.

0:53:13 > 0:53:15So it's certainly... The shoulder's deformed.

0:53:15 > 0:53:16They need to get an X-ray,

0:53:16 > 0:53:19because he has dislocated it and it's incredibly painful.

0:53:19 > 0:53:23He's got grazes and cuts all over him.

0:53:23 > 0:53:26He's been sort of stamped on and hit

0:53:26 > 0:53:30all over his back and his legs and his arms.

0:53:32 > 0:53:34I can see a big graze across his shoulder.

0:53:37 > 0:53:42There's one man, tucked away in the corner of the ward,

0:53:42 > 0:53:45whose story epitomises the cruelty of Mexico's drug war.

0:53:48 > 0:53:51What's happened? Yeah? PATIENTS CHATTER IN BACKGROUND

0:53:57 > 0:53:58Yeah.

0:54:11 > 0:54:13- And set you on fire?- Yeah.

0:54:13 > 0:54:16Luis and his son were kidnapped and tortured.

0:54:16 > 0:54:20An armed gang poured petrol on him, then set him alight.

0:54:20 > 0:54:24- Cos you've got open burns, haven't you?- Yeah.- They must be sore.

0:54:25 > 0:54:27This is... This is...

0:54:29 > 0:54:30- OK.- Yeah.

0:54:32 > 0:54:36- OK. But that's worse.- Yeah.

0:54:36 > 0:54:39It's terrible. It must have been absolutely terrifying.

0:54:39 > 0:54:42How long were you held for?

0:54:42 > 0:54:44Two days.

0:54:45 > 0:54:48You're lucky to be alive, I guess.

0:54:48 > 0:54:50- Yeah.- Terrible.

0:54:50 > 0:54:53It was a case of mistaken identity.

0:54:53 > 0:54:56When the gang realised, they released him.

0:54:56 > 0:54:59If that had happened in our department,

0:54:59 > 0:55:01it would've been news. You know, somebody would've...

0:55:01 > 0:55:03It would've been the first thing somebody would've said,

0:55:03 > 0:55:06that this had happened to one of the patients. And it's...

0:55:06 > 0:55:08You just kind of walk around

0:55:08 > 0:55:11and have a little look at what patients have come in with,

0:55:11 > 0:55:15and you just... This is sort of, yeah, normal I guess.

0:55:15 > 0:55:18It's...just...crazy.

0:55:21 > 0:55:26For the night shift at Juarez General, life goes on.

0:55:35 > 0:55:39Pablo and the team have bought Maria a treat to say goodbye.

0:55:39 > 0:55:41Wow! Both for me?

0:55:41 > 0:55:44- This is! - THEY LAUGH

0:55:44 > 0:55:46Aww, thank you very much!

0:55:46 > 0:55:49Thank you for having me and letting me work here with you.

0:55:49 > 0:55:53I've had a brilliant time. You've all been great. Thank you.

0:56:09 > 0:56:14I'd describe the Juarez people as warm, friendly,

0:56:14 > 0:56:18incredibly welcoming, happy, brave,

0:56:18 > 0:56:23positive people who have this amazing kind of spirit.

0:56:28 > 0:56:31SHE LAUGHS I want to hug everyone!

0:56:34 > 0:56:36'When you actually come to a place and you talk to people,

0:56:36 > 0:56:39'it just drives it home really that it's individuals

0:56:39 > 0:56:43'it's happening to and it's families'

0:56:43 > 0:56:47and they're living under such terrible circumstances.

0:56:48 > 0:56:51Pablo, thank you so much. Yeah...

0:56:56 > 0:57:00Yeah, I'll see you soon. Thank you for everything.

0:57:00 > 0:57:01OK.

0:57:01 > 0:57:05'I've come now to Juarez, I've spent a couple of weeks here,

0:57:05 > 0:57:07'and I could stay another couple of months

0:57:07 > 0:57:11'and still not really understand what's happening.'

0:57:11 > 0:57:13It just made me think a lot about, I guess,

0:57:13 > 0:57:17the world and everybody living in it and how lucky I am.

0:57:27 > 0:57:30Maria has been back at the Royal Preston for a month.

0:57:34 > 0:57:37Right, Alan, are you all right if I take some blood?

0:57:37 > 0:57:39- Yeah.- I'm Maria...

0:57:39 > 0:57:41'I felt really different when I came back.

0:57:41 > 0:57:45'I'd done something and it was a real challenge.

0:57:45 > 0:57:47'It's made me more grateful for what I have,'

0:57:47 > 0:57:53and it's made me vow to stop moaning about the petty things in my life.

0:57:58 > 0:58:00When I was in Juarez, if somebody had said,

0:58:00 > 0:58:03"Would you stay or would you want to move out?"

0:58:03 > 0:58:07I remember just thinking, "There's no way. No way I'd stay."

0:58:07 > 0:58:10And then I think since I've come home,

0:58:10 > 0:58:13just reflecting on how dedicated they are.

0:58:13 > 0:58:18It renewed my belief in nursing and how important it is.

0:58:19 > 0:58:24It made me just think maybe I've forgotten a bit of that, really.

0:58:47 > 0:58:50Subtitles by Red Bee Media Ltd