After the evening roll call, Zaldaña (44) a 15-year veteran of the Comandos De Salvamento volunteer paramedic organization, goes to man the radio. His colleague and fellow veteran volunteer, Manuel Perez, keeps him company for a while during the lull in activity.

The CDS was founded in the early 1960s with the aim to expand access to emergency care. They operated through El Salvador’s brutal civil war (1980-92) and today volunteers face a different kind of conflict: an epidemic of gang violence that has claimed thousands of lives and led to an exodus of the country’s youth.

It’s not long before the crew are called out to a road traffic accident. A woman is trapped in her car after a collision at an intersection. Two CDS ambulances and a specialist crew with cutting equipment arrive on the scene. There are already paramedics from the Cruz Roja Salvadoreña (Red Cross) tending to the victim. The CDS stays to provide support.

Sandra Vanegas (16) treats an injured man in the back of a CDS Ambulance.

Rambo: First Blood plays muted on an old wall-mounted TV outside the dispatch office. The static humming of the radio equipment can be heard through the eerie silence of the El Bosque neighbourhood. As soon as it’s dark here people avoid venturing outside. Medics stay behind the gate of the HQ. With no street lights around, the neighbourhood quickly drops off into an inky black darkness

Luis Pineda, 35, a paramedic with the CDS, supports the neck of a road accident victim while colleagues move the patient onto a stretcher.

A local musician plays music for volunteers before the evening shift roll call.

Saul Jimenez (20) and Michael Jason (18) relax with friends in their dormitory during a quiet moment on shift.