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'Midnight Family' Shows How Family-Run Ambulances Give Emergency Care In Mexico City

AILSA CHANG, HOST:

In Mexico City, there is a tiny fleet of government-operated ambulances that can't possibly respond to every call. By one count, just 45 rigs in a city with millions and millions of people. That's where private ambulances come in, like the one run by the Ochoa family. It's a tenuous business where they risk their own lives racing other private ambulances to the scene, then they work to save lives with no guarantee of getting paid. Luke Lorentzen is a filmmaker who rode along with the Ochoa family for three years. He chronicles their ups and downs and the gray space they navigate in.

LUKE LORENTZEN: I think what I kind of wanted to show with the film is how government dysfunction and government corruption, we kind of think about in these really abstract ways. But as it trickles down to people like the Ochoas, it's life and death on a daily basis.

CHANG: I spoke to Luke Lorentzen about his documentary "Midnight Family." And first, I wanted to know, how did he even find the Ochoa family?

LORENTZEN: I was living in Mexico City at the time, working on a few other films that weren't quite panning out and woke up one morning and just in front of my apartment building was this family-run ambulance. And...

CHANG: How could you tell it was a family-run ambulance? Like, what were the signifiers?

LORENTZEN: There was a 9-year-old boy who was playing soccer, you know, like almost against the van.

CHANG: (Laughter).

LORENTZEN: The driver of the ambulance is 17 years old. And they were on a break. They were eating tacos. It was this really lively family that was kind of, you know, inside this medical vehicle, and that just sparked my interest almost immediately. And I built up the courage to walk up to them and introduce myself. And within a few moments, I was invited to ride along for a night with them to see them work.

CHANG: Really? Why do you think they granted you such free access right away?

LORENTZEN: I think they're really warm, open people (laughter). You know, in this first night, I found myself whizzing around Mexico City in this ambulance, chasing other private ambulances to the scenes of accidents, and I saw this whole underworld of for-profit health care that raised enormous ethical questions. And, you know, behind it was this really warm family that was just trying to stay afloat.

CHANG: Yeah.

LORENTZEN: And from that very first moment, I kind of knew there could be a film here that explored that tension of a family trying to make a living, patients trying to survive, and the two of those kind of things bumping into each other and not always lining up perfectly.

CHANG: Now, how did the Ochoa family first get into this line of work? Did it happen kind of by accident? Or was this kind of work something that generations in the family did?

LORENTZEN: They're the first generation - or their father, Fer, who's in the film, is the first generation to do this work. He was a bouncer at a nightclub...

CHANG: (Laughter) Really? Wow.

LORENTZEN: ...And just through that kind of nighttime work got to know a lot of ambulance workers with the Mexican Red Cross. And he eventually volunteered with them and kind of got trained through their system and learned that there are these for-profit businesses that are also kind of out there. So they were able to get their hands on an ambulance that was actually shipped from Oklahoma. There's a whole...

CHANG: Yeah, I read that. That's astonishing.

LORENTZEN: There's a whole network of, you know, medical equipment that's no longer usable in the U.S. that gets sent down and bought by people like the Ochoa family, and they started their own business. A huge percentage of people in Mexico work in some sort of informal economy. It's almost like 60% or 70%. And the Ochoas have chosen emergency medical services as their kind of informal economy to make a living in.

CHANG: There's this one scene where a guy just got shot in the leg, and the Ochoas are talking to his mom outside. And she's telling them, you know, I wish I could pay you. I wish I could even afford to buy you a cup of coffee, but I can't. How do they keep this business afloat?

LORENTZEN: You kind of see, in the film, this financial pressure pushes them into kind of more corrupt ways of making a living. And without kind of giving the film away, there are other networks of health care providers that benefit from patients being brought in.

CHANG: Right.

LORENTZEN: So, you know, for example, private hospitals that need patients will work with private ambulances to, you know, boost their numbers. And you quickly see that the choices the Ochoas need to make are impossible, and, you know, they are family trying to make a living within this kind of ladder of victims. You know, the patients are being victimized by a broken health care system. The Ochoas are being victimized by kind of a broken law enforcement system, and so on and so on. And nobody on that ladder is getting what they need to survive.

CHANG: I mean, that's so true when you watch this film. We see the Ochoas paying cops bribes for tips about accidents. The Ochoas have a deal with at least one hospital to bring patients their way.

LORENTZEN: Yeah. When I was in this ambulance, I had this whole spectrum of feelings. There were some nights where the Ochoas were responding to patients that would otherwise have been left without any care at all, and they were kind of these heroic people, you know, filling in for a government that wasn't doing its job. And then we would whiz around the corner and go to another accident, and I would, you know, sometimes really fear for the patients that were in the care of the Ochoas just because of how financial pressures really limited the choices of what kind of care could be provided.

CHANG: Yeah.

LORENTZEN: And the biggest kind of ethical slip that you kind of feel throughout the film is hospitals that maybe aren't the best, aren't the closest, that are really encouraging the Ochoas to bring their patients there. And, you know, the Ochoas will be making dinner out of a gas station where they've just been able to buy a few cans of tuna and then are kind of...

CHANG: Yeah, they're literally counting out their pesos to see if they have enough for canned tuna.

LORENTZEN: And then, you know, arrive to an accident and need to, you know, keep their business afloat. It's absolutely heartbreaking, but they are stuck within a very dysfunctional system, trying to do their best.

CHANG: What keeps the Ochoa family going, do you think? I mean, what drives them to keep doing this work, despite how hard it is and how financially precarious it is?

LORENTZEN: I think in a certain way, they're incredibly proud of the work they do, despite the big challenges. And I was saying earlier that there were nights when I really felt like they were this heroic family showing up to accidents that no other ambulances were showing up to. And I think that makes them feel needed by a city and I think keeps them ticking and keeps them going.

And then on the on the other side, when things would get really tough and difficult, it's kind of all they have. They've invested all of their resources into this one ambulance. All the equipment, you know, getting the paint job right, getting the uniforms is incredibly expensive. And Juan, you know, this 17-year-old dropped out of middle school to start working in this ambulance, and it's kind of all he knows.

CHANG: Yeah.

LORENTZEN: So, you know, they're kind of stuck, in a way.

CHANG: Luke Lorentzen - his new film is called "Midnight Family."

Thank you very much for speaking with us today. I tremendously enjoyed your film.

LORENTZEN: Thank you, yeah, so much for having me.

CHANG: Luke Lorentzen directed, shot and edited the new documentary "Midnight Family."

(SOUNDBITE OF VECTOR LOVERS' "PATIENCE") Transcript provided by NPR, Copyright NPR.

Corrected: December 13, 2019 at 12:00 AM EST
A previous headline on this story incorrectly referred to the documentary Midnight Family as Midnight City.