In 2013, a large number of smooth calluses were discovered around San Pedro Mártir Island, off Kino Bay, Sonora, in northwestern Mexico. Héctor Hernández, who was 53 years old at the time, undertook the trip and dived for periods of 15 minutes to a depth of 40 meters. When she left, she felt tingling running down her legs and a loss of strength.
The lack of specialized medical personnel to deal with these types of incidents and the availability of the hyperbaric chamber when he needed it, incapacitated him for the rest of his life.
That day he experienced decompression, a condition that occurs when divers ascend too quickly to the surface, causing nitrogen dissolved in blood and tissues to form bubbles, according to the decalogue of good practices in diving made by the organization Community and Biodiversity (COBI).
From 2011 to August 2025, 308 divers with decompression sickness attended the hyperbaric chamber of the Basic Rehabilitation Unit of Kino Bay, which has provided 546 sessions for divers. However, not everyone comes to receive care, so the number of accidents can be much higher.
In a study conducted by COBI in which 113 people engaged in scuba fishing were interviewed in 2023, 50% had suffered from decompression sickness and 19% said they had suffered it more than once.
In Kino Bay, everyone has a family member or an acquaintance who has died from decompression sickness. An article from the University of Sonora indicated that between 2011 and 2012, 15 deaths were recorded in diving fishing out of a universe of 150 divers in the northern region of Sonora.
A battle against time
On the day of the accident, Hernández arrived at the port at half past 1 in the afternoon, his legs were so weak that he couldn't get off on his own and they carried him home. He waited for the cramps and cold in his legs to go away as on other occasions, however, the discomfort did not subside.
He went to the Basic Rehabilitation Unit, but it was Sunday and it wasn't open. There was a number on the door to call in case of emergency. They never answered him.
At the time, Hernández worked for a fish market, but he was not insured with the Mexican Social Security Institute, so he went to the community Health Center, run by the Ministry of Health of the state of Sonora.
According to COBI, 75% of people who fish by dive lack access to social security or life insurance, increasing the vulnerability of people who depend on this type of fishing.
The doctor who treated him did not specialize in diving fishing accidents, and according to Hernández, he did not properly assess his case.
“I told the doctor that it was time to enter the decompression chamber, but the doctor clung to the fact that I had a problem with my head and wouldn't let me out,” Hernández said.
The doctor ordered his transfer to Hermosillo, when he arrived there it had been five hours since the accident and he could still move his legs. In Hermosillo they put serum on him and five hours later, they sent him back to Kino Bay.
“When we enter the water, with pressure, the nitrogen in the body is placed in the tissues, mainly in the muscles, because there is more blood. If it becomes saturated, these bubbles will form like clots, and if they go to places where the blood vessels are small, they become obstructed causing coagulation, inflammation, and so on,” explained doctor Jorge Grijalba, a specialist in hyperbaric and underwater medicine.
The time that elapses between decompression and entry into the hyperbaric chamber is very important because, according to Grijalba, the damage that the obstruction will cause depends on this. Some of the sequelae can occur at the spinal cord or brain levels, or cause necrosis and heart attacks.
Through the pressure exerted by the hyperbaric chamber, bubbles are reduced and oxygenated to prevent further damage.
“When we put pressure on the bubbles formed by nitrogen gas, they become small, we reduce them. These are the laws of gas physics: the higher the pressure, the lower the volume. That obstruction that the diver had in an area and that was causing lack of oxygen and necrotizing, by reducing bubbles by 80%, will stop clogging, oxygen will arrive and everything will recover,” Grijalba said.
However, in Hernández's case, it had been more than 15 hours when he was back in Kino Bay where he took some sessions in the hyperbaric chamber, but he no longer had strength in his legs.
Over time and with a lot of effort, he began to walk on a walker, then with crutches and finally with a cane. At every step he stepped on his feet due to weakness and that caused him several falls, and even a hip fracture that forced him to use a wheelchair.
“From the hip down, my legs are tingling and my legs are numb all the time. I move my feet and everything you want, but I don't have the strength,” Hernández said.
When he got into an accident, he lost his main economic income, which was fishing, so he invested in metal structures to rent shadows on the seashore, with that and a pension he has managed to maintain himself economically. He lives alone and is highly dependent on the care and attention of his family and friends.
“It changes your world and your life, because after being what I was and doing what I liked, I can't do anything anymore. It's not easy, but I'm calm, because here we are and we can talk the story so that the one who is listening stops his ear: just as the sea gives, it also takes away,” said Hernández.
Francisco García, 51, a diver and fisherman in Kino Bay with sequelae caused by decompression sickness. Source: Daniela Reyes.
This story is repeated among divers in the Bahía de Kino community, such as that of Francisco García, who had an accident in 2009. He went to a private hyperbaric chamber in Hermosillo where they didn't apply the right treatment, so he had to go to Ciudad Obregón to go to another chamber, but two weeks had passed in the course.
“In the Obregón chamber they told me that everything possible had been done. The damage had already been done,” Garcia said.
He currently faces weakness in his legs, but because he took some rehabilitation therapies, he retains some mobility in them and walks with the support of crutches.
Not able to handle critical cases
On the day of the interview, Grijalba was expecting a 16-year-old patient with two months of diving experience who had a type two decompression, characterized by neurological or cardiorespiratory symptoms that can be fatal.
It affects the central nervous system, spinal cord, heart and lungs. This young man had a neurological and vestibular problem, that is, in his ear, which caused him a lot of instability when he got up.
These cases are sent to the General Hospital of Hermosillo, which is 100 kilometers away, where there are personnel and equipment to carry out the medical tests they need, and once stable, they are discharged to be transferred to Kino Bay and enter the hyperbaric chamber.
The protocol works this way because at the Community Health Center, now IMSS-Wellness, there is no staff and infrastructure to care for patients who need critical care.
“It's a small center. We have a long way to go here. I once had a talk with the Secretary of Health and I told him, 'we need a stabilizing center, not one that has an operating room or anything, but one that stabilizes and an emergency doctor',” Grijalba said.
This was confirmed by Francisco Sosa, a doctor attached to the IMSS-Community Welfare, who recognized the need for a specialist to deal with this type of emergency, since currently all doctors have general training.
He also pointed out that they do not have their own ambulance to transport patients, but that they lend them one from the Regulatory Center for Medical Emergencies (CRUM) of the State of Sonora, an agency belonging to the State Secretariat of Health, and sometimes they also struggle to get an ambulance operator and ask for support from the Red Cross.
Every time they receive a person for an accident of any kind, a record sheet is filled out, however, they do not have the disaggregated data of how many divers have come to receive decompression care.
Once stable, the diver is sent to the hyperbaric chamber of Kino Bay. This chamber in the Basic Rehabilitation Unit, created in 2011 at the request of the community, is in charge of the System for the Integral Development of the Family (Sedif) of Sonora.
Hyperbaric Chamber of the Basic Rehabilitation Unit of Kino Bay. Source. Daniela Reyes.
When a diver is decompressed, a socioeconomic study is carried out and charged according to his possibilities. However, the unit has no capacity to care for patients who need critical care either, according to Grijalba.
“We don't have equipment for intubating or a respirator that can withstand the pressures inside the chamber. It is not for critical or intensive care. This is why the patient must be stable. But we do need equipment for critical care,” Grijalba said.
In addition, the Unit does not have enough trained personnel to handle more cases, since they are only a doctor and an operator who attend from Monday to Friday from eight in the morning to three in the afternoon and, depending on their possibilities, attend to emergencies.
“It's hard to have someone who specializes in diving diseases because nobody here knows. I think it also lacks personnel because there should always be someone specialized, so that at any time an accident happens it reaches the camera directly and there they can give it all the attention,” said Ramón Ballardo, a diver in Bahía de Kino.
Towards better care
The incidence of these accidents, according to COBI, violates the right to physical and mental integrity of divers and divers, in addition to generating loss of income for families, thus aggravating the state of vulnerability and poverty in communities.
That is why it recommends establishing specialized health care services for divers and divers in fishing communities and generating clear emergency protocols to deal with this type of accident, since if not done so, the sustainability of fishing activity is threatened and inequality is perpetuated.
The divers interviewed for this report agree that it is necessary to strengthen care for accidents during diving, such as decompression, since Kino Bay is a community well recognized nationally for the large number of divers that make up it.
According to Ballardo, who is part of a new generation of divers, this community is expanding, increasing the likelihood of accidents. Meanwhile, those who experienced an accident, such as Hernández and García, advocate that the errors that left them with sequelae be corrected and thus prevent the repetition of their history.
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