We barely slow for red lights as cars pull out of our way.
We virtually take off as we scream over a hilly stretch of road.
We’re on board a Red Cross ambulance answering an emergency call in the northern Mexican city of Tijuana. It’s one of the most dangerous cities in the world.
A two-person team, talking into the walkie-talkie, asks for details of the emergency.
“It’s a shooting,” paramedic Zulma Cruz tells me. “We get as many as a dozen a day sometimes,” she says as we see blue lights flashing in the distance and pass a National Guard vehicle with a soldier holding a machine gun, silhouetted against the night sky.
As we approach, what is now a crime scene as well as a medical emergency, I can see that the streets of one of the most cartel-infested neighbourhoods in this city are awash with police and military.
A second ambulance is surrounded by locals, watching on, and I can see ambulance teams inside treating a man who appears to be conscious.
“He is stable but critical,” Zulma tells me as she grabs an oxygen canister and her trauma pack and heads off to assist her colleagues.
Zulma is an experienced paramedic, who is used to the menacing presence of security forces and the stares of the local community, many of whom identify with or are part of the cartel.
This is another gangland assassination attempt – the patient has been shot in the head.
Three cartels are fighting for control over Tijuana – the Sinaloa Cartel, Jalisco New Generation, and the Tijuana Cartel.
There are over 2,000 murders a year here – that’s over six murders a day. To put that into perspective, in London last year just over 100 people were murdered.
It’s that crazy, and the Red Cross teams are the only ones capable of saving lives out here on the streets.
Zulma tells me that sometimes while she has been trying to save the lives of other victims of a hit, the cartel gunmen have approached her and told her to stop treatment.
Her Red Cross colleague, who didn’t want to be named, said the gunmen couldn’t be persuaded.
“That man dies here,” the gang member said, “then he shot him again,” her partner told me.
“We just had to walk away.”
I ask Zulma if she thinks a lot of this violence and chaos on the streets is linked to the growing fentanyl business.
“It definitely is, it definitely is,” she replies without hesitation.
“I think that it is linked to all that, the drugs, the cartels and fights for selling on the street, and sometimes they cross into each other’s turf…”
Another call for the Red Cross, this time for a fentanyl overdose.
Their medics carry the antidote to fentanyl poisoning – one of the most toxic drugs in the world.
Read more: Inside a secret fentanyl lab
It’s called Narcan, and it can save the lives of those who are almost dead.
They arrive on scene as the fire brigade administer first aid. Paramedic Alan Leon jumps out and gets ready to give the victim Narcan.
He briefly talks to the family gathered around the victim, unconscious on a pavement in a quiet residential area.
The man is completely unresponsive. His name is Juan, and he is dying.
Alan instructs a policeman holding a drip to raise it higher.
He then administers the Narcan directly into a cannula, and into the victim’s vein, while explaining to his emergency service colleagues what he’s doing.
They all wait. Time is critical and they’re hoping they’ve caught this victim in time.
Alan gently presses into Juan’s chest with his fist and tells everyone to wait.
He feels Juan’s chest again and then there is a sudden movement – the Narcan is working.
Moments later Juan sits up, utterly surprised, and grabs at the medical paraphernalia all around him.
“I’m okay, I’m okay,” he says. It really is quite remarkable.
Alan tells him to wait a minute, and then gives him another shot of Narcan.
“It’s reversing the fentanyl,” he tells Juan.
After a few minutes, Juan stands up and leans against a vehicle parked nearby – he is talking, he’s shocked he’s alive.
His wife and young son, who had watched the whole scene unfold, hug him as he fist bumps our producer.
Fentanyl use, fentanyl trafficking, gang wars, death and murder – the ambulance crews see it all every day, and it’s all linked.
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Tijuana’s red-light district is the most public location for the cartel wars and the use and sale of fentanyl on the streets.
It’s also a popular tourist hang out.
The gangs make a fortune from the drugs and sex industry here 24 hours a day, which is why they fight so hard to hold or take territory.
The area is constantly patrolled by police, the National Guard, and the Mexican army, who were deployed here last year to try to reduce homicides, and to fight organised crime.
We joined the Baja California State Police on one of their patrols through the district.
They told us the cartels don’t care what fentanyl does to people, they are interested in one thing only – money.
“They know what they’re doing, they know what they’re producing, they know the problems they cause selling the drugs, they know that people are becoming more addicted in this country, they know it’s a problem, but they don’t care, they only worry about their own interests,” an officer, who didn’t want to be named, told me.
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The cartels know Mexico’s security services have a huge presence in the city, but they taunt them anyway, by posting videos on social media platforms like TikTok, showing off their guns, drugs, and money.
“Many times it’s to send a message to the other organisations, sometimes it’s to send a message to the police officers that we can’t touch them, but we are fighting back against all these organisations… we try to stop them in all the conflict zones and arrest them,” the officer explained.
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This district in Tijuana is ground zero for the fentanyl trade in Mexico, and the city is the gateway for drug and people smuggling over the border.
This trade is fuelling an illegal drug epidemic in the United States, and a street war inside Mexico.