ORANGE COUNTY PERSPECTIVE : Hole in the Safety Net

The recent death of a pregnant woman at an unlicensed family planning clinic in Santa Ana is yet another indication of the serious problems in health care access for Orange County’s poor. Underground clinics--some operating out of garages--are filling the gap, sometimes with tragic results. Even in an era of budget cutbacks, Orange County must do more to provide medical care for those too poor to afford it.

The exact cause of the Jan. 19 death of Angela Nieto Sanchez, 27, a mother and housecleaner from Orange, is not yet known. Authorities believe that she was given some kind of injection.

On Tuesday, the district attorney charged Alicia Ruiz Hanna, the director of the unlicensed Clinica Feminina de la Comunidad, with three counts of improper practice of medicine.

Hanna, who pleaded not guilty, is believed to have been operating a clinica clandestina , a medical office that dispenses treatment and medication to the poor--often Latino immigrants.

It should not be surprising that underground clinics are on the rise in Orange County; there is no organized public health clinic system for people to turn to. In the works now is an Orange County version of a state health system designed to reduce costs and deliver better care to the county’s 225,000 poor people who receive Medi-Cal.

But 400,000 other people have virtually no access to care, nor are there plans to change that. The risks to those who fall through the safety net became obvious with the death of Sanchez.