Inside it's a typically hot Friday night at Bonsucesso General Hospital (HGB) in Rio's sprawling north side, and the gunshot victims are rolling in. They are part of an annual tide of firearms casualties that tops 40,000. That is four times the number in the United States, despite the fact that Brazil's population is 100 million fewer. Brazil's response to this appalling cull comes tomorrow when its people will be the first in the world to vote in a national referendum on an outright ban on all guns.
The HGB is on the frontline of this undeclared war and is fast earning the tag as world leader in the treatment of gunshot wounds. "We're an international reference point when it comes to gunshot treatment," says Dr Flavio Sa, in charge of registering the blood-spattered human traffic, with a mixture of horror and pride. A sign of the times is that, 10 years ago, no one kept records of gunshot victims, nor had much experience treating them.
By 8:40pm, there are four bullet wound victims in emergency. Four minutes later, more arrive. Among them is a police officer, Marco Antonio dos Santos, 34. Mr dos Santos and his partner were on a police call when they were attacked. He was hit in the eye by a bullet and by shrapnel from a grenade. "This is getting worse than Afghanistan," says a female police officer.
Brazil already has tough gun laws, but the referendum would ban the sale of any firearm. Supporters say that most legal weapons end up in the hands of criminals who kill innocent people. Opponents say a ban on firearms sales will only increase illegal trafficking.
The homicide rate in Rio rivals that of any declared war zone in the world. A Unesco study published this year shows gun deaths over the past decade surpass 325,000 - that's more than the 26 armed conflicts surveyed, including the Gulf War and the Israeli-Palestinian conflict during the first and second intifadas.
The hospital gets most of its gunshot victims from the gang wars in Rio's slums. The HGB is surrounded by two dozen slums, known here as the "Gaza Strip".
The area is notorious for shoot-outs between rival drug gangs and the police. Innocent bystanders are regularly caught in the crossfire and on any given weekend, ambulances, police cars, buses and cars pull up to deliver the wounded.
In May 2001, the hospital hit the headlines when associates of the drug trafficker Marcio Greick launched a rescue bid for him. Greick had been arrested as he tried to steal a car, which happened to belong to a police officer. Injured in the event, he was kept at the hospital for a week, handcuffed to his bed. That was until 10 masked men armed with assault rifles and police-issue bulletproof vests, entered the hospital, shot his handcuffs off and pulled him from the fourth floor to a getaway car waiting outside. Seven people were injured, two guards beaten and one police officer killed.
Last year, the HGB registered 352 cases of firearm victims and 82 "dead on arrival" cases. The DOAs are those who make it to emergency even though they are dead. To avoid responsibility, the police have a habit of delivering them that way. Some doctors refuse to accept the DOAs brought by police, since they are usually the ones responsible for their condition.
The neighbourhood is so dangerous that doctors now work in 24-hour shifts to avoid coming and going at night. Stray bullets pockmark the hallways of the hospital, and have been responsible for the death of a hospital worker.
Most of the work here is on bullet wounds, especially from high-calibre assault weapons. The only protection from these weapons would be body armour but most of the people arriving at the emergency room turn up in flip-flops and shorts.
Dr Sa explains the difference between the most common wounds from revolvers and assault weapons. "High-speed projectiles cause more damage," he says. "The hole is bigger, so patients can lose entire body parts. You can't let people go around with one of those kinds of weapons."
The Brazilian Statistics Institute registered a 37 per cent increase in the homicide rate from 1992 to 1999. "Unfortunately Brazil is world champion in firearm homicides," said the Senate president, Renan Calheiros, the man behind the firearms referendum.
Among young people, guns are the number one cause of death. The human tragedy behind these statistics spills off the stretchers in HGB. The emergency room floor with its red pools littered with gauze, cotton, plastic tubes and syringes, tells the story of lives cut savagely short.
On this night, there was a shoot-out on a nearby avenue which separates two slums. Bruno Custódio, 19, was hit by a stray bullet during the fight between drug traffickers and police. Medical personnel whisk him into the operating room.
The other victims were residents of the slum, or passing by, like bus driver Joao Carlos Ramos, 52, who was scraped by a bullet on his left thigh but still had time to help Monica Morais, 36, and Marcelo Mendonça de Souza, 36. Morais was hit in the stomach and Souza in his left arm. They will be OK, but Bruno Custodio was not so fortunate. He died.Reuse content