JUAREZ UNREST TAKES TOLL ON PHYSICIANS

Violence Shrinks Ranks by Half, but Some Doctors Are Fighting Back

MEXICO CITY - Trauma specialist Jose Alberto Betancourt was kidnapped
from the parking lot of a Ciudad Juarez hospital after finishing work Dec. 2.

He was found murdered two days later after negotiations with the
kidnappers - who had demanded 2 million pesos (about $160,000) - broke down.

The violence that has claimed more than 3,000 lives in Ciudad Juarez
last year has hit physicians especially hard. Their
upper-middle-class status has made them targets for kidnappers and
extortion demands.

Their poorly protected hospitals and clinics, meanwhile, have been
declared, "high-risk zones," by Chihuahua state Gov. Cesar Duarte -
places criminal groups raid in search of wounded rivals and where
kidnappers target physicians.

"We're fearful to head into the streets, to do our jobs," said
Leticia Chavarria, a physician and president of the Juarez Doctors'
and Citizens' Committee, a civic group, which led protests after
Betancourt's death.

The Chihuahua state attorney general's office said four doctors in
Ciudad Juarez were murdered last year, and at least 15 others were kidnapped.

Chavarria estimated that half of the approximately 2,000 physicians
practicing medicine four years ago have fled the city.

Medical-assistance missions have been scaled back because of threats
and violence in the city of 1.3 million on the Texas border. At least
20% of medical clinics have closed, Chavarria said.

Some doctors now live across the border in El Paso, but commute back
to Mexico to practice medicine, since they don't have a U.S. medical license.

"Doctors are targets because they have money," said Howard Campbell,
sociology professor at the University of Texas-El Paso who has
studied Ciudad Juarez. "Anyone with money is shaken down in Juarez."

Physicians protested the deteriorating security situation and
Betancourt's death by withdrawing all but emergency services on two
occasions in December.

Attacks on physicians have occurred in other parts of Mexico, but not
to the same degree as Ciudad Juarez.

Ciudad Juarez physicians profited for decades from American patients
crossing the border to seek medical care at cheaper rates.

"If a consultation costs $400 in El Paso, it would cost 400 pesos
(about $40) in Ciudad Juarez and be done by a specialist," said
Ciudad Juarez surgeon Arturo Valenzuela.

The violence, which erupted in 2007 with a turf war between rival
drug cartels, has dissuaded many El Paso residents from crossing the border.

Valenzuela - who participated in the early stages of Betancourt's
kidnapping negotiations - said salaries for physicians working in
private hospitals and clinics have tumbled by more than 50%, while
cross-border medical visits dropped by 90%.

Many residents remaining in Ciudad Juarez are unable to pay - the
product of widespread job losses and businesses closing due to
extortion and violence, Valenzuela said.

Valenzuela previously earned a good living by performing gastric
bypass surgeries on obese foreigners. Now, he operates on up to four
gunshot victims daily. Some victims refuse to pay - and there is
little he can do to force payment, he said.

Valenzuela is now one of fewer than 10 surgeons making emergency
night calls. Many of his colleagues have left town, and those
remaining prefer not to head out after dark.

"You risk your life going to the hospital and then they don't pay
you," Valenzuela said.

He said hit men who burst into hospitals to finish off rivals, and
gangs sometimes blame doctors if patients don't recover.

Physicians no longer make house calls, which have become traps for
kidnappings, he said.

Surgery resident Antonio Torre said physicians in some hospitals no
longer wear nametags, and friends and relatives of some patients
carry guns into medical facilities.

"Security (personnel in the hospital) don't do much other than ask
for credentials," he said.

Some Ciudad Juarez physicians have fought back against the violence.
They formed the Juarez Doctors' and Citizens' Committee in 2008 and
organized protests that year.

The group has evolved into a prominent civic group by promoting
activities such as voting and teaching courses on how to survive kidnappings.

The latest protests following Betancourt's murder prompted meetings
with government officials, which led to the reversal of proposed
funding cuts for security and anti-crime programs, said Valenzuela,
who helped found the group.

Gustavo de la Rosa Hickerson, an official with the Chihuahua state
human rights commission, said physicians have set an example for
fighting back and they have prompted other groups to organize.
"Physicians are the ones that can really save Ciudad Juarez," he said.