“Who saves a life, saves the entire world”The Talmud.
May 26, 1793, The Viceroy Count of Revillagigedo He sent a blunt order to the Court of the Royal Protomedicate: all doctors, apothecaries, surgeons and midwives had to go immediately when they were called to attend patients or injured, without frivolous excuses or delays. The instruction responded to a recurring practice: some doctors refused to go out at night or eluded care in dangerous circumstances, which put not only the lives of patients, but also the administration of justice. The viceroy warned that, before the slightest complaint, “serious orders” would be imposed against whom he missed his duty.
This mandate was not new. Already in 1777, Viceroy Bucareli had published a side forcing surgeons to attend to any immediately injured, even without a court order, imposing economic and exile sanctions to whom they breached. In both cases, the background was clear: life, public health and justice depended on the inescapable commitment of health professionals, even when their own safety could be questioned.
More than two centuries have passed since that mandate. However, the essence of the dilemma is still in force in Mexico: how to ensure that doctors serve the population when doing so implies serious personal risks?
During the Covid-19 Pandemia, Mexico became one of the countries with the highest number of deaths from health professionals. Physicians, nurses and camilleros faced the virus without sufficient supplies, with strenuous days and many times with poor protection equipment. The balance was painful: hundreds of health workers lost their lives fulfilling that duty that, since colonial times, is required as ethical and social commitment. His sacrifice inevitably evoked the hardness of that side of 1793: the obligation to serve even at his own risk.
But the tragedy did not end with the pandemic. Today, health professionals in Mexico face another threat: the violence of organized crime and insecurity in rural areas. Young doctors, in social service, are sent to isolated communities without minimal security guarantees. Some have been attacked, kidnapped or killed simply for being in the wrong place, fulfilling the mission of attending to those who need it most. Again, the echo of the side resonates: they are required to fulfill their duty, even when doing so can cost them life.
Here the big difference arises with the past. In 1793, the colonial authority dictated unilateral mandates, without major obligations towards the safety of doctors. In today’s Mexico, the State has a constitutional duty to protect its health workers, to provide them with supplies, working conditions and security. And yet, again and again we see that the logic of yesteryear is repeated: to demand individual heroism to replace the structural deficiencies of a system that fails to respond.
Imagine, to illustrate it, two scenes. In Mexico City of 1793, a surgeon receives a night call to serve a white weapon wounded. The neighborhood is dangerous and knows that it risks its life when leaving. But the viceroy’s order is clear: it must go, or face economic sanctions, banishment or prison. He takes his instruments and goes out dark, knowing that his duty exposes it.
In 2025, in the Sierra de Guerrero, a medical in social service is assigned to a rural clinic. There are no sufficient medications or security protection. One night, an armed group breaks into the community; The doctor becomes a victim, not for negligence, but for the simple circumstance of fulfilling her duty. Both stories reflect the same principle: the State demands, but does not always protect.
Today, the debate must go beyond recognizing the sacrifice of doctors. It is about rethinking the social pact with whom they maintain the right to health in Mexico. It is not acceptable that they remain cannon meat against pandemics without equipment or against violence in crime controlled territories.
The echo of the 1793 side reminds us that the authorities have been appealing to the unwavering responsibility of doctors. But two centuries later, the awkward question is another: Has the state learned to fulfill its part of the pact? Or do we continue to repeat the same story, demanding delivery without conditions, without guaranteeing security or dignity?
Mexico has a historical debt with its health personnel. It is not enough to commemorate them as heroes in official speeches; It is necessary to translate that recognition in clear policies: effective protection in risk areas, sufficient inputs in hospitals, respect for your life and your work. The constitutional reform for the wage approval of doctors approved unanimously in both chambers and federative entities since October 15, 2024 continues with a pocket veto in the presidency of the Senate, shameful attitude of the federal government.
If the viceroy Revillagigedo looked up today, maybe he would recognize in our streets the echo of his sides. But I would also see that, two centuries later, injustice persists: we continue to ask for individual sacrifices to cover the cracks of a system that, with all advances, still fails to guarantee the essential: the life of those who save lives.
*Éctor Jaime Ramírez Barba (www.lectorjaime.mx) is a specialist in general surgery, public health certificate, doctorate in health sciences and public administration. He is a legislator and defender of the public health of Mexico, reelected deputy of the Parliamentary Group of the PAN in the LXVI Legislature.
