Ricardo “Bojo” Bojorquez loves his job.

It’s not an easy job; “I don’t know what I’m going to do that day; it’s always a toss-up. 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,” he explained.

Bojorquez works as a firefighter in ambos Nogales: Nogales, Arizona and Nogales, Sonora, Mexico. He consistently works on both sides of the border and actually started his career in Nogales, Sonora. Because of his bi-national background, Bojorquez feels connected to both countries.

When he began fighting fighters in Nogales, Sonora, the fire department lacked much of the basic equipment required in the U.S. “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.

Showing optimism, 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 isa life. Everything else really doesn’t matter,” he said.

Bojorquez likes working on both sides of the border, for different reasons. He described feeling “more taken care of” when he’s in the U.S. 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, Arizona has a population of about 20,833, according to the 2010 Census. Many of the firefighters working in the Nogales, Ariz., Fire Department stress the city’s size when they describe their work. Pete Aschcraft, 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. daily.

“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,” said Ashcraft.

“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 L’Arriva, 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.

Across the border, Nogales, Sonora is much bigger than its sister city in the U.S. The U.S. consulate provides an unofficial population of 250,000 people living there, but the firemen cited a population of between 200,000 to 400,000 residents. A great deal of the population growth has occurred since the 1970s, as the maquiladoras were built and people moved to the city, explained Bojorquez. Many of the residents visit the U.S. and sometimes they get sick when they are 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 been born at the port of entry, “in the border crossing right there, on the tile floor,” said Ashcraft. They are in the United States, so the paramedics treat them, said Bergier.

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, he explained. In the U.S., 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, he said. The American EMTs cannot cross the border to treat the patient, but Meras said his department receives the call and thenrushes to the border 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,” said Bergier. Nonetheless, they transport the patient to the nearest hospital or medical facility and continue to care for them there.

Border security and immigration laws have also played a role in medical response work in Nogales. A fence has run through ambos Nogales since the mid 1900s and photos of the fence in its many manifestations are on display at the Pimera Alta Historical Society, in Nogales, Ariz. In the earliest photos, the fence was simple and non-threatening, yet as time passed, the fence grew taller and taller. Since June 2011, the fence has undergone a makeover.

“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,” he explained. The current fence has a rocky and sharply angled base which makes it more difficult for people to jump over without getting hurt.

“It’s hard to land from 20 feet, you know…even if you have the right shoes. People cross, they don’t realize they’re gonna jump 20 feet…they don’t get a chance to land right,” Bergier explained. Ashcraft added, “I don’t think people realize a lot of times how much…how far of a fall that is,” as they 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,” said Ashcraft.

The men agreed that the number of injuries related to people jumping over the fence had not changed after the security measures were increased, but the actual injuries were more severe, due to the increased height and rockier base of the wall.

Their calls are also environmentally-based injury or trauma. In summer, heat exhaustion and dehydration are concerns for the paramedics in Nogales. Dehydrated people are found trying to go through the desert and the EMTS help them recover.

One change that the men have observed within the last years is a difference in the demographics of the people attempting to cross the fence. “They’re called OTMs: Other Than Mexicans,” Bergier laughed, “That’s a US Border Patrol…yeah, we didn’t make that up.” This classification can be “anybody from Central America, or anywhere else…we’ve picked up people from India and China,” said Bergier.

After mentioning a Portuguese-speaking Brazilian he had treated, Meras explained how difficult communication could 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…I’ll type in what I want to say and then I’ll just show it to them,” explained Ashcraft. Between using basic sign language, movements and the translation apps, the EMTs can determine what is wrong and get the person to a hospital, said Meras. This diversity in patients is unusual for a small town and Bergier sees it as another distinctive aspect of working in a border town.

While some aspects of work in Nogales could be said to be the same as they would be in departments almost anywhere: basic emergency calls, trainings, teaching classes for school children, it’s clear from speaking with the men who work in these towns that this is a unique place. And, as they described, this leads to some very interesting calls.

By: Christa Reynolds

November 2012