When Mariano Lemus Gas heard that two local "natural medicine" stores were ordered to cease operations last month because of allegations of unlicensed surgeries, the consul for Mexico in Las Vegas wasn't terribly surprised.
These types of "botanicas" have exploded in Hispanic neighborhoods in recent years, some of them harboring unlicensed "doctors" who might be putting lives at risk, he said.
"They are building like waves," Lemus Gas said on Thursday. "We aren't sure why. But we are very worried and angry that they may be performing unsafe surgeries."
State health officials in June delivered cease-and-desist letters to two Las Vegas retail stores suspected of operating as illegal and unlicensed surgical centers. The stores, "Botanica Maya" and "Botanica San Francisco," advertised "hierbas y medicinas naturales," herbs and natural medicines.
Authorities said they took action after gathering information from a female victim of a botched gynecological surgery at Botanica Maya, 5347 E. Lake Mead Blvd., Suite B. They also found medical waste in the store and in a trash bin behind the business near Nellis Boulevard.
"We know there are a number of these kinds of places in business that, behind the scenes, are illegal and are not about natural medicine," Lemus Gas said. "The problem is there; we need to solve it."
Xavier Rivas, a commissioner with Nevada's Commission on Minority Affairs, agreed.
"It's about time somebody did something about this," he said. "A lack of attention by the authorities has created a space where so-called doctors with no licenses are practicing medicine. They are taking advantage of our people."
Marla McDade Williams, chief of the Bureau of Licensure and Certification for the Nevada State Health Division, said reallocation of resources within the division has made it possible to respond to complaints more aggressively. She said she has 40 surveyors responding to 1,200 complaints a year on many types of facilities, including hospitals and ambulatory surgical centers.
She said the public shouldn't think the health department is targeting facilities that serve the Hispanic community because a few places recently given cease operations letters were in that community. The bureau is hearing rumors about unlicensed surgical centers cropping up, she said, but investigators can't go knocking on doors based on rumors.
"We only respond to specific information that comes our way."
Ben Kieckhefer, a spokesman for the state Health Division, said it's unknown what kind of procedures are being undertaken in the back of stores such as the sister botanica outlets.
"They don't do the best record keeping," he said.
But he said there is no doubt that the health division is more aggressive now.
"We were slapped in the face with a disease," he said, referring to the recent hepatitis C crisis. "We needed to be."
He said if it wasn't for the 911 call from a woman who was hemorrhaging, it's possible that the botanicas would still be operating. People who go to a place for low prices aren't likely to call in otherwise, he said.
Immigrants sometimes fall prey to such operations because they might lack health insurance or believe that proper treatment will be too expensive, said Dr. William Jacks, who runs a bilingual family practice office in North Las Vegas.
Jacks, who is originally from Paraguay, said illegal immigrants might figure they can't get care at a medical clinic or hospital, and they might not speak English well.
It's also common in other countries for people to go to their local pharmacies to get medical advice and pick up certain drugs that wouldn't be available in the United States without a prescription.
If someone accustomed to that system then moves to the United States, they might seek out the familiar routine.
"You can find antibiotics and blood pressure pills there (at U.S. botanicas)," Jacks said. "But sometimes they are expired, out of date, and they were brought into the country illegally. Once you go to these places, you are engaged in that trade."
Jacks said seeking medical care at such places often winds up being more expensive, anyway.
"It's very important for people to be educated about these issues, to call around to doctors and find out their prices," he said. "There are plenty of doctors who speak Spanish."
But it just feels comfortable to some immigrants to seek nonemergency medical help at their corner "botanica," said Malena Burnett, the owner of a local business that helps immigrants with citizenship applications and other legal issues.
Stepped up immigration raids and heightened anti-illegal-immigrant sentiment in the United States in recent years also might scare those who are living illegally in the country away from licensed clinics and hospitals, Burnett said.
Instead they visit doctors who "come in through the botanicas on a regular basis."
"It's prevalent and well-known," she said.
Such doctors come from Central America to Southern Nevada on the weekends and set up shop in the back rooms of botanicas, Burnett said. They charge a fee, perhaps $25, for a consultation, she said.
"It's awfully dangerous," Burnett said. "There's no way to verify their (the doctors') credentials."
Lemus Gas has scheduled a Wednesday meeting with local leaders in the Hispanic community and health officials to discuss the growing problem, he said.
"We want to reach out to the community, to open their eyes to the danger."