This article originally appeared on VICE.
Earlier this year, I met Dr. Jorge Chiu at a murder scene while I was documenting the Bomberos Voluntarios, the volunteer paramedics of Guatemala City. A man had been shot dead on the street, and a plastic tarp had been placed over the body as blood slowly pooled in the cracks of the pavement.
While we all waited for the cops to arrive and secure the scene, Chiu came over to me and introduced himself. He told me that he was the only fully qualified doctor going to scenes like this with the volunteers, which, given the extreme violence in this city, is a job that most people would expect to get paid for. Chiu, who is obviously not most people, is out here risking his life nightly for nothing.
Guatemala City's metro area is the largest in Central America (population estimates vary widely, but there are somewhere between 2.5 and 4 million people here), and the nation is one of the most violent on Earth. According to the US State Department, in 2012 there were about 100 murders a week in the country of 15 million, and as many as 60 percent of Guatemalans own a gun.
Put a heavily armed populace together with a region where gang warfare and drug trafficking are rampant, add a corrupt, incompetent police force and the problems that come along with widespread poverty, and you get a lot of corpses in the streets. Chiu is a very busy man.
The doctor offered me a lift back to the fire station where he was based. As we drove, another call came in, and we rushed to another scene. Thus began my journey into Chiu's gruesome, adrenaline-fueled world, and for the next ten days I followed him and recorded his harrowing work.
Chiu, a native Guatemalan, went to medical school at Francisco Marroquín University, in Guatemala City, and eventually became a thoracic and cardiovascular surgeon. He did a couple stints at the famed Cleveland Clinic and lived in the US from 2003 to 2007 and from 2011 to 2012, along the way picking up training as a firefighter.
Three years ago he returned to his homeland, where he spends his days as the head of the cardiovascular department at the Guatemala military medical center and his nights as the subdirector of the country's volunteer EMT service, an unpaid position that has him responding to calls and training volunteer medics, many of whom come in with little to no medical experience.
On the evenings I spent with him, we drove around in his battered Land Cruiser, which was rammed to the gills with medical gear, most of it from donors overseas. Chiu's radios were tuned to frequencies used by paramedics, firefighters, and the police. There was a cacophony of chatter crackling over the lines at all times — there are way too many assaults, accidents, and murders for the government-funded emergency services to take care of, so it falls to volunteers, to pick up the slack.
"Much of our work happens before the police arrive at the scenes," Chiu told me. The medics get there as early as possible, and much of the time there's a chance that the violence isn't over yet. "We just have to pack and run, as the killers are still in the area," Chiu said.
There are 13 Bomberos Voluntarios teams in the Guatemala City area. Chiu tries to teach them new skills on quiet nights, though there aren't many of those — he estimates there are 10 to 15 gunshot wounds in the city every weekday, and that's on top of the fires, car wrecks, and cases of fatal drunkenness they have to deal with. On weekends, there can be as many as 30 shootings a day. He personally responds to 20 to 30 calls in a typical week.
When I asked about the dangers of the job, Chiu told me about the time two years ago he pulled up to a crime scene on the outskirts of the city.
"It was a mess. There were bodies everywhere," he recalled. "Dispatch had told me that it had been a multiple shooting, and units from all over town were responding. As I got out of my truck, I heard a loud crack, and the next thing I knew, I had blood pouring down into my boots. I'd been shot. This is the shit we deal with here in Guatemala City!"
For more on Chiu and his teams of medics, check out the next episode of the series VICE Profiles, premiering on VICE.com this summer.
See more of Giles Clarke's work on his website.