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Mexico's pirate ambulances profiteering in the pandemic

People repair a "pirate" ambulance light outside the General Hospital in Mexico City, Saturday, Sept. 12, 2020. The poorly equipped, often broken-down rattletraps ply Mexico City streets listening to emergency radio dispatch frequencies and race to beat legitimate ambulance services to medical emergencies. (AP Photo/Marco Ugarte)
People repair a "pirate" ambulance light outside the General Hospital in Mexico City, Saturday, Sept. 12, 2020. The poorly equipped, often broken-down rattletraps ply Mexico City streets listening to emergency radio dispatch frequencies and race to beat legitimate ambulance services to medical emergencies. (AP Photo/Marco Ugarte) (Copyright 2020 The Associated Press. All rights reserved.)

MEXICO CITY – Many people have been profiteering from the coronavirus pandemic in Mexico; prices for oxygen cylinders, medicinal alcohol and face masks all have skyrocketed. But perhaps the cruelest are the so-called pirate ambulances that take advantage of patients' desperation.

The poorly equipped, often broken-down rattletraps ply Mexico City streets listening to emergency radio dispatch frequencies and race to beat legitimate ambulance services to medical emergencies. They charge patients’ desperate relatives outrageous sums to take them to a hospital, and sometimes even divert them to poorly equipped private clinics from which they receive kickbacks for bringing in business.

Activists and medical authorities have long complained that they're not only abusive, but dangerous: Recent inspections have found many of the vehicles operate without sufficient equipment, with untrained personnel and expired medications.

Rachel Sieder, a Mexico City university professor, fell victim to a pirate ambulance on August 11, when a friend suffered what appeared to be an epileptic-type attack at her apartment. Relatives called Mexico's 911 emergency number, which dispatches free city ambulances, but somehow a pirate ambulance showed up first.

They charged Sieder's account 7,300 pesos, almost $350, for a 5-mile (8-kilometer) trip to a local hospital — the sort of charge more common for a fully licensed service in the United States rather than in a country where it amounts to almost 60 days’ wages for many workers, and where public ambulance service is supposed to be free.

Sieder paid. “Nobody is going to argue about money when somebody may be dying," she reflected.

The ambulance crew pressured relatives at the scene, saying the patient's blood pressure had spiked, though when asked to take it again, her blood pressure was normal.

When asked for a receipt, needed for insurance reimbursement and tax purposes, the crew gave her a handwritten note listing the ambulance company's address as a provincial city 250 miles (400 kilometers) away.

When reached by telephone there, an employee of the company, listed as Asistencia Bios, replied “We do not have ambulances in Mexico City.”

The scam started years before the arrival of the coronavirus. But the pandemic has only made the pirate ambulances more greedy, and some charge extra for transporting COVID-19 patients.

Two weeks ago, Alejandra Isibasi told her father to call 911 to get an ambulance for his handyman, who fell sick at work. When the ambulance arrived, its crew stabilized the man and took him to a private clinic — but charged him about $175, almost half a month of his wages, for the short trip.

“I told him to call 911 because to my knowledge it sends the fastest ambulance and because it is a government service, or in the case of the Red Cross, a free service, that is going to come with professional personnel," said Isibasi. But the pirate ambulance, as usual, got there first.

In April, when Gustavo Briseño's 78-year-old father Manuel was suffering from COVID-19, ambulance drivers charged the family several times their usual rate to transfer his father to the hospital.

“They take advantage of your pain to make money,” Briseño said. “While they normally charge 6,000 pesos ($250), now they want 35,000 pesos ($1,400). It doesn’t make sense.”

Mexico's health and medicine regulation commission has called on city residents to avoid the unregistered ambulances, saying that 2,257 inspections of the vehicles starting in late 2018 had found that many were unregistered private vans that had simply been painted to look like ambulances.

They often lacked basic maintenance and medical equipment, carried uncertified crews, and dispensed medicine past its expiration date.

Red Cross Mexico spokesman Rafael González said the city's Red Cross ambulances operate under an agreement with the city to provide free service on the city's west side. But when they get a call, they often arrive only to find a pirate ambulance has gotten there first.

“In the case of pirate ambulances, when one of our ambulances arrives at the emergency scene and finds a pirate there, we ask the patient, ‘We are Red Cross paramedics, do you want our help?’” González said. “If they say yes, then we help them. If they want the other ambulance, we withdraw, and make a record of it.”

Fernando Aviléz Tostado, president of the nonprofit group No More Medical Negligence, said “it is a known fact that people in this private business intercept emergency calls and dispatches and arrive at the scene of an emergency before public-service units like those of the Red Cross."

“That situation constitutes a crime,” Aviléz Tostado said.

He said they often work in cahoots with private clinics that pay the pirates for bringing patients in.

Aviléz Tostado said there has been “a considerable increase in reports about collusion between this type of transport and some private hospitals that charge excessive amounts for people requiring emergency medical attention."

The city's real ambulance crews are "unsung heroes," Avilés Tostado said, “but if instead of them, an impostor shows up, there is a risk of vital signs getting worse, or losing a life.”