August 1, 2012
By Dave Hirschman
Photography by Chris Rose
The dangers in northwest Mexico are well known to the volunteer doctors, nurses, and technicians who come to provide desperately needed medical care, as well as the U.S. pilots who use their own general aviation aircraft to bring them.
AOPA Pilot accompanied about 65 volunteers traveling in 16 general aviation airplanes on a three-day trip to LIGA International’s main clinic in the historic city of El Fuerte, Sinaloa, in early June, one of nine monthly working trips the group makes here annually. But their visit turned tragic when a fatal aircraft accident took the life of a LIGA volunteer, injured three passengers, and dealt the organization a severe blow.
LIGA (also known as Flying Doctors of Mercy) volunteers perform much of their work in this city of 40,000 where local, state, and federal police cover their faces with balaclavas as they patrol the area with automatic weapons. Airplanes are protected from drug cartels by heavily armed soldiers.
Nonetheless, LIGA volunteers have been returning here since 1934 because the healing they provide outweighs the risks. Audiologists fit deaf people with hearing aids that allow them to hear again; ophthalmologists perform cataract surgeries that give sight to the blind; orthopedic surgeons repair crippling birth defects; and other medical specialists obtain results that the local population—and sometimes the medical teams themselves—regards as miraculous.
GA aircraft provide the best means for getting to and from the impoverished agricultural region about 600 miles south of the Arizona border. Most volunteers travel Friday, work up to 18 hours Saturday, and return home Sunday.
“Volunteer pilots are essential to our mission, and none of the work we do here could happen without them,” said LIGA President Janet Lapp, a San Diego psychologist, registered nurse, Bonanza pilot, and CFI who leads the 2,000-member organization. “There’s tremendous camaraderie between all LIGA volunteers, and especially among our pilots. They take great pride in getting our medical volunteers to Mexico safely, and they go to extraordinary lengths once they get here to make sure the medical mission helps as many people as possible.”
Flights to and from this area must cross the inhospitable deserts of northern Mexico, and sometimes the jagged mountains of the Sierra Madre. But the tragic flight that shook LIGA to its core was a local flight that took place in good weather with a veteran pilot at the controls.
“We make contingency plans because we know that the work we do, and the places we go, can be hazardous,” said Erik Knudson, a LIGA pilot and 10-year volunteer from Arizona who made the June trip to El Fuerte with wife, Jodi, a registered nurse, in their 1969 Bonanza. “This accident is like a nightmare you don’t wake up from. You try everything you can think of to help, but nothing changes the reality of what happened—or the consequences.”
On June 2, a Cessna 182 owned and flown by LIGA volunteer John Frederic Slater, a 50-year-old Arizona business owner, was transporting three teenaged family members and friends of other volunteers to an outlying clinic when the airplane struck power lines and crashed into the El Fuerte River a few miles from the airport. Slater, a divorced father of two, died at the scene.
Passengers Liam Guzman, 15, of Redondo Beach, California; Julia Tower, 17, and Hayley Brown, 18, both of San Diego, survived with broken bones, lacerations, and internal injuries. Guzman is the son of LIGA volunteer pediatrician Ernie Guzman, and Brown is the granddaughter of LIGA President Lapp. Brown was the most seriously hurt, with a head injury that required her being put into a medically induced coma to reduce brain swelling. (All three were transported back to the United States several days after the accident.)
Witnesses said the airplane clipped power lines suspended above the broad, shallow river before hitting the water in a flat attitude with such force that both doors sprang open and all four occupants were ejected. Two Mexican fishermen in a rowboat helped rescue the survivors, and others transported them to a local hospital in their own vehicles. Slater was unconscious when the fishermen brought him to the muddy riverbank—and he died there about 30 minutes later.
Patients seeking medical care had been lining up at the El Fuerte clinic since 6 a.m. that Saturday morning, well before the doors were scheduled to open, just as they do every time LIGA volunteers come to town. Ailments varied from recent injuries to chronic conditions, and patients ranged from newborn babies to the elderly. Children watched a Spanish-language Shrek video in an open-air courtyard while they waited.
Pedro Apodaca, 21, received a set of custom-fitted hearing aids that allowed him to hear clearly for the first time since childhood.
“People here suffer from the same kinds of diseases that we see at home, but the cases are far more advanced here because they often go untreated,” said Ben Schick, a LIGA volunteer from Santa Monica, California. “[Apodaca] had ear infections as a child. But instead of being treated with antibiotics, he lost his hearing.”
Apodaca was fitted for custom hearing aids in May. The first time he put them on the following month, they worked. “Give me a smile if you hear me,” said California technician Pilar Horowitz. “Una sonrisa?” A beaming, ear-to-ear grin gave the answer.
Other medical conditions are dire and far beyond the clinic’s ability to treat. One man with a massive facial tumor the size of a grapefruit sought immediate surgery but was told it was impossible.
“It’s hard to accept the fact that we can’t cure everyone,” Knudson said. “In such situations, all we can offer is compassion.”
“It’s hard to accept the fact that we can’t cure everyone. In such situations, all we can offer is compassion.”
Three single-engine airplanes were scheduled to fly medical personnel and supplies that morning from the paved runway at El Fuerte to a dirt strip near a remote clinic in El Carrizo—and Slater’s beautifully restored 1970 Cessna 182 was the last to leave. El Carrizo is a short flight of less than 20 minutes by GA aircraft. When Slater’s airplane didn’t arrive, Lapp, the LIGA president, called Knudson and asked him to drive by the El Fuerte airport to see if Slater and his passengers were still there.
AOPA Photographer Chris Rose and I were traveling with Knudson and shared a taxi. Just as we were closing the doors, however, an El Fuerte resident breathlessly told us an airplane had crashed into the river, and he jumped in with us to direct our driver to the accident site. The white Chevrolet Suburban’s horn blasted during the frantic 10-minute ride. When we got there, about 50 silent spectators lined the riverbank near the overturned Cessna. In hushed tones, some expressed their shock, sadness, and prayers for the victims.
“They all know the LIGA volunteers,” Knudson said. “They know why we come and what we do here. LIGA has become part of this community.”
Local and state police were on the scene, too, and they directed us about 100 feet downstream to Slater’s body. He seemed at rest with his back on the damp riverbank, legs partially submerged. He was dressed in the short-sleeve shirt and cargo shorts that he had worn at breakfast in the hotel restaurant 90 minutes before, where he had discussed a recent camera purchase with Rose.
A soldier removed a wallet from Slater’s back pocket, and the Arizona driver’s license and FAA pilot certificate confirmed his identity. Mexican officials made it clear no one was to touch Slater’s body or remove anything from the scene until the medical examiner arrived. Meanwhile, the crowd swelled; the news media came; and local and state officials arrived by car, truck, and helicopter. LIGA volunteers spent hours giving statements to a long list of agencies.
By afternoon, Slater’s body had been taken to the morgue, and then a wrecking truck hauled the aircraft out of the water with a winch. Workers loaded the pieces onto a flatbed truck and dumped them at the airport where investigators could examine the wreckage, but little was left intact.
Slater was an instrument-rated private pilot who had performed 22 LIGA missions in the past seven years. He had brought his Spanish-speaking mother and daughter on other LIGA trips to El Fuerte and enthusiastically supported the group’s mission. Now LIGA (the Spanish word for “league”) members faced the wrenching tasks of caring for their own injured volunteers, informing Slater’s family of his death, and confronting the fact that their group’s mission was suddenly in jeopardy.
After the accident, there was a stark change in the way Mexican officials treated the LIGA group. Instead of deference and gratitude, there was strict adherence to cumbersome regulations. When LIGA volunteers showed up at the El Fuerte Airport for departure, they were only allowed to enter the airfield one car at a time. Soldiers searched every piece of luggage as well as identification papers and passports, a big change from previous trips. At Ciudad Obregon, the group’s refueling and eAPIS filing stop on the way home, customs officials required departure tax payments of about $25 for each volunteer—also a new policy.
Medical volunteers typically pay LIGA about $250 to $350 to help cover transportation costs, and they pay their own food and hotel bills in Mexico. Pilots get some reimbursement for their direct operating expenses, but they don’t profit from LIGA trips.
Knudson, the Arizona volunteer coordinator, said he is sure LIGA will continue because its members are resilient and committed, and its services are so needed. “People here depend on us—and they have absolutely nowhere else to turn,” he said. “We have to take a hard look at what we do, and how we do it, and we have to be willing to make changes that can improve safety. But all those people who lined up at our clinics on Saturday morning still need our help. And we still have the desire and ability to serve them.”
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