Formal and Informal Work in Medical Attention to Victims of Violence: Evidence from Cali and Medellin

• In Event: Addressing Violence: Prevention, Intervention, and Treatment

Abstract

Research has documented the critical importance of pre-hospital intervention work on victims of violent trauma across case outcomes such as lethality, disability, and cost of care. However, most of this literature is based in countries of the Global North with robust EMT systems and low levels of violence. We contribute to this area of work by documenting patterns in the transportation and initial medical care to victims of gunshot/stab wounds in Cali and Medellin—two of the most violent, unequal cities in the Americas. In each city, we fielded teams of trained observers for about a month and charged them with tracking all violence-related admissions to the main ER center (N=115 in Cali, N=60). We draw on these data to show that unlike other settings, EMT ambulances do not transport victims from crime scenes to hospitals, and that there is inconsistent communication among medical personnel and other formal first-responders such as the police at the scene or in hospital settings. Instead, nearly all victims of violent trauma are transported to health centers by relatives/friends or via public transit—a pattern that delays service delivery and impact case outcomes.

Authors

• Karyna Reyes, Hospital Universitario del Valle Evaristo Garcia

• Gina Cabarcas, Laboratorio de Justicia y Política Criminal

• Juanita Duran, Laboratorio de Justicia y Política Criminal

• Alvaro Pretel, Rutgers University-Newark

• Andres F. Rengifo, Rutgers University

• Santiago Tobon, EAFIT University

• Michael Weintraub, Universidad de los Andes