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Helping to Shut Illegal Clinics

July 21, 2002

It's been more than three years since a pair of Orange County toddlers died after being treated in backroom clinics. County officials have taken some action to combat the illegal shops--but clearly not enough, because clinics are still threatening the health of vulnerable residents.

The district attorney's office is going after shops where people with little or no training treat patients and illegally sell prescription drugs. The drugs might be tucked away in gift shops, health food stores and swap meets that often are located in the county's immigrant communities. Prosecutors, for example, are preparing to file charges against four shops in Little Saigon.

Law enforcement alone, though, won't stamp out the shops. As long as the demand exists, some people will risk supplying bogus drugs and possibly life-threatening treatment.

These fraudulent medical shops have strong appeal to Latino and Vietnamese immigrants in part because they offer a cheap and readily available source of treatment for low-paid workers who often lack insurance. But the clinics raise a broader health issue than simple access to safe care.

Many Latino immigrants distrust U.S. doctors, according to a recent study. Mexican immigrants, for example, are used to quick, convenient and aggressive care, often featuring shots of penicillin. Doctors in Mexico also are more likely to respect their patients' belief in folk remedies and in the role that spirituality and community play in health and illness.

Illegal clinics are a danger to all Southern Californians. The medications sold usually have been smuggled into the U.S. Many are counterfeit, mislabeled, outdated or don't meet stricter U.S. standards. And the overuse of antibiotics for every cold or flu encourages resistant strains of bacteria.

It's important to move quickly and decisively to shut down these shops. County officials created the Safe Healthcare Program four years ago to steer immigrants away from fraudulent clinics. The program puts up posters, trains health-care providers who work with immigrants and provides doctors with information about cultural sensitivity. These attempts, though well-intentioned, fall short of the creative street-level campaign needed to reach the people who most need it.

Schools could play a crucial and low-cost role in spreading the word. The Latino and Vietnamese populations tend to have great reverence for teachers and schools, creating an easy avenue to reach parents.

Immigrants often rely on their U.S.-educated children as the main connection to their adopted country. Public schools already teach children about the dangers of tobacco and drugs; it would be easy to add illegal and inexpert medical care into the message. Fliers warning about the dangers of illegal clinics should be going home in students' backpacks.

Spanish-language television and radio talk shows are immensely popular among Latinos. These shows should be approached about their willingness to tackle the subject because it would provide a needed service to the community.

Finally, it's important to take a closer look at how U.S. medical care, with all of its superior science and technology, is failing immigrants. Many of their health-care issues mirror those that U.S.-born patients complain about--but grudgingly have come to accept.

Immigrants aren't alone in turning to alternative medicine and self-treatment in the face of a cold, impersonal medical system. And immigrant dissatisfaction with the status quo could help fuel improvements for every patient.

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