Border Clinic in Jeopardy After Fatal Bus Crash

Standing beside a turnstile at the U.S. border checkpoint here, Josephine Van DeGraaff scanned a line of people on the Mexican side for blind or crippled adults and children.

“Vengan aqui,” she said, motioning for the handicapped to form a separate line where they receive special temporary passes to enter the United States.

Van DeGraaff then led the group--some on crutches, some in wheelchairs--on a wobbly march toward a small brown building a few hundred yards away.

That building, the Valley Orthopaedic Clinic, was filled with the cries and laughter of 200 handicapped Mexicans waiting to be examined by a doctor or to be scheduled for treatment at Los Angeles-area hospitals.

It was a typical day at the clinic, which has sponsored treatment for 50,000 people from Mexico since it was founded in 1961 by Dr. Robert B. Nichols of Burbank--the 6-foot, 3-inch, 268-pound physician known around the clinic as the “big gringo doctor.”

Fatal Accident

Now, after operating for years on a shoestring budget with the help of volunteers and charitable hospitals, the clinic is struggling to stay open in the aftermath of a fatal accident involving one of the buses it uses to transport patients to the Los Angeles area.

Two weeks ago, as a result of the accident, liability insurance was canceled on all three of the clinic’s buses, putting a halt to the transport of as many as 80 patients a week.

The clinic, which operates on donations from local business owners and charities amounting to $13,000 a month, cannot afford high-risk insurance for its buses, or to have patients flown to Los Angeles.

“If we can’t get these people to Los Angeles, there is really no reason to keep the clinic open,” said Richard Ellis, president of the clinic’s board of directors and owner of one of the largest department stores in Calexico.

“These people are very poor and have no other place to go,” added Wayne Van DeGraaff, a retired U.S. Immigration and Naturalization Service border inspector who manages the clinic, where volunteers and workers screen, schedule and transport patients to Los Angeles-area hospitals and perform follow-up treatment and therapy.

On Dec. 2, 1986, a clinic bus returning from Los Angeles flipped onto its side about 40 miles northwest of Calexico, killing two adults and injuring 28 other passengers, 12 of them seriously.

California Highway Patrol investigators later determined that the bus was mechanically sound and that the accident may have been the result of “driver error,” said Chester Watts, a court liaison officer at the CHP office in El Centro.

The driver, Raphael Ramirez Chavez, 37, of Mexicali, was charged with two counts of vehicular manslaughter and one count of failing to maintain a logbook, Watts said. Each of the misdemeanor counts carries a maximum penalty of one year in jail. Trial is scheduled for Jan. 29 in El Centro Municipal Court.

Three of the passengers have retained an attorney to help them with claims against the clinic for injuries and property damage resulting from the accident.

With the insurance cancellation keeping the clinic’s buses off the road, hundreds of patients scheduled for surgery or treatment at the Shriner’s Hospital for Crippled Children, Hollywood Presbyterian Hospital, Burbank Community Hospital, St. Vincent Medical Center, St. Joseph Medical Center, Los Angeles Orthopedic Hospital and the City of Hope face an uncertain future.

Dr. Tom Grogan, a Shriner’s orthopedist, was at the clinic examining a baby girl born without arms or legs. “For children such as this, it is not a question of having less medical care,” Grogan said, “it’s a question of having no medical care at all.”

Nichols said he had considered sending patients to Los Angeles on commercial buses, but the idea was tossed aside because it is prohibited by the INS, which permits the Mexicans to enter the United States only for temporary medical treatment.

Went to Spiritual Healer

Despite the setbacks, the clinic has struggled to continue serving the hundreds of people who stream across the border each weekend in search of medical attention.

Before coming to the clinic in 1980, Jesus Renterria, 12, of San Luis, Mexico, near Yuma, Ariz., was seeing a brujo (spiritual healer) who tried to cure his polio by chanting and smearing raw egg and herbs over his disease-ravaged legs.

“I could not afford to take him to a doctor,” said the boy’s father, Roberto Renterria, 56, who supports a wife and 15 children on the $30 a week he earns as a bus driver in San Luis.

In the last five years, the boy has undergone two operations at Shriner’s Hospital at no cost to his parents. On Saturday, he was fitted for leg braces to replace the crutches he has used for 10 years.

But the braces will not be ready until April.

“I pray the clinic is still open then,” Renterria said. “There is no other place to go.”