What if more than 600 people were murdered in Arizona or Tennessee in one month — 22 dead every day?
That's the problem facing the tiny Central American nation of El Salvador, which has the same population as each of those states. Last month, the death toll in El Salvador hit 677, nearly twice as many murders as at the same time last year. Politicians, police and experts differ on what do to.
Sigfrido Vitan Marin, a forensic doctor, rushes to the scene of a homicide on the edge of San Salvador. Sitting between him and the driver, who is struggling through the capital's notorious traffic, I ask why don't they put on the ambulance's siren.
"We go silently," says Vitan, "so there's no confusion. We could get shot at if someone mistakes us for the police."
Vitan knows what he's talking about. He's been collecting bodies and evidence at crime scenes for nearly two decades. But he says he's never seen it this deadly.
"There used to be areas that were more or less calm," he says. "But now there isn't one place in all of El Salvador that's safe."
Murders have shot up dramatically this year. There are more murders now than there were during the last month of the country's bloody civil war that ended in 1992.
Vitan steps out and walks down a steep hill into a green gully where El Salvador's latest homicide victim lies.
Blanca Madrid Perez cries at the top of the hill, unable to cross the yellow police tape. She says her husband is dead. Someone called their house last night and threatened him.
She leans closer and, just above a whisper, says, "He used to be a gang member but had recently left. That's why they killed him."
El Salvador has long been embroiled in a bitter gang rivalry between the 18th Street and the MS13 gangs, since the two groups began being deported from the U.S. in the 1990s.
As Mexican drug traffickers have recently arrived here, the gangs have grown, becoming foot soldiers for these and other organized crime groups.
Father Walter Guerra, now 72, says the violence now is similar to what it was during the war — or worse. He blames the FMLN, the former leftist guerrillas who now rule the country. President Salvador Sánchez Cerén was a guerrilla leader.
"They were once themselves cells of guerrilla fighters, just like these gangs now," Guerra says. "If anyone could relate to them, the FMLN should be able to."
But he says the government has done nothing to help the youth getting caught up in the gangs. He says they need prevention programs.
Instead, the government has opted for a hardline stance, with well-publicized raids, roundups and a crackdown on gang leaders, locking them away in maximum security prisons.
Raul Mijango, a former FMLN fighter and legislator, says this military solution won't work. He helped negotiate a truce between the rival groups in 2012 that many believe led to a significant drop in the homicide rate. But the deal fell apart about a year later, after the government pulled out of the process, Mijango says.
"The government made a political calculation that they couldn't be seen negotiating with criminals anymore," he says, dropping out right before last year's presidential elections.
Indeed, the truce was controversial from its outset, criticized by police and prosecutors. Analysts say the gangs capitalized on it to expand operations. Proof of that, critics say, is the dramatic homicide rate now engulfing the country.
Back at the hillside crime scene, the body of the murdered man, enclosed in a white plastic bag, is carried to the road and into the back of a funeral home's pickup. His widow gets in the front seat.
A police officer closes the door, then turns to me.
"This isn't a safe place," he says. "You better leave quickly."
"OK," I say.
But I'm surprised. After all, it's only 11 in the morning.