How did a fugitive doctor set up his own licensed medical practice in Costa Rica?

First in a two-part series

PLAYA CARMEN – The 12-kilometer strip that joins Playa Carmen with Malpaís and Santa Teresa is a surfer’s dream-come-true. A series of beach towns on Costa Rica’s southern Nicoya Peninsula, the area is well known for spectacular sunsets and fast-breaking waves. Expats come here to drop out, start a small business or raise a family in paradise.

Tourism development provides jobs to local Costa Rican families and mostly poor Nicaraguan immigrants, who find work in shops, hotels and the kitchens of restaurants that cater mostly to foreigners.

Like many other tourist villages in rural Costa Rica, the region remains underdeveloped despite the influx of tourist dollars. Services are lacking. Roads remain in poor condition. Until a few years ago, a single private medical clinic tended to the frequent scrapes, sprained ankles and ear infections that are common in a surf town. A skilled multilingual doctor could carve out a nice living here.

In a small strip mall on a dusty, gravel road that dead-ends on the beach, a sign posted above a recently shuttered storefront window advertises “Doctor’s Office.”

Dr. German E. de Jesús Moreno Rojas, who U.S. and Costa Rican authorities know as German Enrique Moreno Rojas, opened his clinic here almost three years ago as the community’s second private medical practice. He caters mostly to foreigners.

While many local Costa Rican and Nicaraguan residents visit a public clinic in a nearby town when they’re sick, expats and tourists liked Dr. Moreno’s clinic because he speaks five languages and accepts health insurance policies issued by the National Insurance Institute, or INS.

Patients describe the clean-shaven doctor with pudgy cheeks, dark complexion and deep-set eyes as “charming,” and in most cases, a knowledgeable physician.

Visitors could get a checkup or receive prescriptions that would be filled around the corner at the local pharmacy.

The doctor would sometimes distribute medication that was stocked on the shelves of his office. Other times he’d rely on a young male assistant to administer antibiotic shots to patients or run to the pharmacy to pick up prescriptions.

But the local doctor was hiding a secret. One of Moreno’s patients felt uneasy during a recent visit. Something about the doctor’s behavior was unsettling.

“[Moreno] made me feel uncomfortable, and I wanted to go and run a background check on him through Google. When I did, the first thing that came up was an Interpol international arrest warrant,” said the patient, who asked The Tico Times to withhold his name. “I immediately went into self-defense mode and got scared. But I knew I couldn’t keep this information to myself.”

After waiting three “torturous” days, Moreno’s patient began telling others: The doctor, who treated many of the community’s children and offered free CPR classes at a local school, was a convicted pedophile and fugitive from justice.

Disappearing Acts

The first of Moreno’s victims emerged in 1989, when an INS lawyer filed a complaint with the Judicial Investigation Police (OIJ) in the Caribbean slope town of Turrialba, the daily Al Día reported in 2005. The complainant accused Moreno of sexual abuse.

Four more victims, whose ages ranged from 14 to 17, came forward and accused the doctor, who was working for INS at the time, of molesting them. Six years later, a court sentenced Moreno to three years in jail for each victim. Sentencing guidelines established by Costa Rica’s criminal code reduced his time to nine years.

But Moreno didn’t serve a single day. Instead, he fled to the United States. For more than eight years he blended into a Houston, Texas neighborhood until he was arrested again on May 11, 2005.

 In Houston, Moreno, then in his late 30s, quickly became a popular parishioner at the St. Francis de Sales Catholic Church in southwest Houston, where he served as choir director. Fellow choir members called him Pavarotti, according to the Houston Press. He was well mannered around parents and charming to their sons. Although he had no children, he owned a big-screen TV and always had the newest video games in his apartment. The boys with the church, who mostly came from poor, immigrant families, were always welcome.

Moreno, who studied medicine at the University of Costa Rica, opened the Dynamic Health Care Clinic in Houston, where he received tens of thousands of dollars in exchange for offering health screenings to refugees under the U.S. Refugee Medical Assistance Program, the Houston Press reported in 2006.

In April 2005, police began investigating Moreno after five boys who often hung out at Moreno’s apartment and clinic, aged 11 to 15 at the time, told police Moreno had drugged and sexually abused them from 1997 to 2001.

Police arrested Moreno the next month and charged him with six counts of indecency with a child, two counts of sexual assault of a child and one count of aggravated sexual assault of a child, a spokeswoman from the Houston District Attorney’s office said.   

According to media reports at the time, the alleged victims accused Moreno of giving them white pills disguised as vitamins. Houston police believe the pills were the tranquilizer Xanax. He’d sedate the boys before sexually assaulting them.

A judge set bail at $60,000, which seemed a low amount for a suspect that had fled a conviction on similar charges in Costa Rica. Moreno paid the bail and disappeared again.

Eventually, he slipped back into Costa Rica. Although convicted of sex crimes against minors, police cannot arrest him here because the statute of limitations on his crimes has expired and the constitution protects him from extradition to the U.S.

Eric Turner, a spokesman for the U.S. Embassy in Costa Rica, would not comment on the case. He said the embassy would issue a statement next week.

The Past Catches Up, a Community Responds

Almost three years ago, Moreno set up shop in Playa Carmen. He lived a cozy life as a local doctor in a hot and isolated beach on the Pacific coast. This time he brought a family with him. He told local residents that the woman and three kids (two boys and a girl) who lived with him were his wife and children. School officials say they often saw Moreno dropping off two boys at school. They assumed they were his sons.

Moreno also had a large staff for such a small clinic. At one point, five young male assistants dressed in medical garb would tend to patients. Today, Moreno has only one assistant at his Playa Carmen clinic.

Moreno liked to spend his mornings jogging around the soccer field next to the public school in Santa Teresa, where 180 students aged four to 13 study just a few kilometers from the clinic, school principal Minor Jiménez said.

“I was never comfortable around Dr. Moreno and I never saw him as a trustworthy person,” Jiménez told The Tico Times. While many area residents have discussed the local doctor with The Tico Times, Jiménez is the first to allow his name to be published.

“Now that I have all of this information, it is my responsibility to talk to the children and their parents and make them aware of this man’s criminal past,” he said.

Residents also say the woman they believed to be his wife left a few months ago, taking the children with her. Moreno has since installed a large-screen TV and Xbox in his split clinic and residence, the front of which is lined with tinted plate glass and advertisements. Patients are buzzed in through a front door. 

Last Friday, three days before Moreno’s 50th birthday, the doctor’s past became public. Concerned parents distributed old news clippings about Moreno at a meeting spot. They scoured the Internet on their laptops for more information on the doctor. They wanted Moreno out of their community. People who knew him began recalling incidences when the seemingly jovial doctor would become angry, even intimidating.

“As members of the community and as a parent, when we found out this information, we knew we had to do something about it,” said a local resident who asked to remain anonymous.

Parents scheduled a meeting with Moreno last Sunday at a local restaurant. He never appeared. He told the host of the meeting that he had to accompany a patient to San José. Moreno told another that his mother was ill. The previous afternoon, Tico Times reporters saw the doctor and his assistant loading bags into a white SUV. The clinic remains closed.

A Convicted Pedophile with a Medical License

One question repeatedly has been raised by local residents: Given his past, how was Dr. Moreno allowed to continue practicing medicine?

Medical licenses are issued by the Costa Rican Doctors and Surgeons Association. Moreno’s license, issued by the association, is currently valid. In June 1989, after INS filed abuse charges that led to Moreno’s arrest and conviction, the association filed for disciplinary action against him. The complaint was redirected to the association’s Medical Ethics Tribunal (MET).

The MET failed to take action pending results from an information request submitted to the Turrialba Prosecutor’s Office, according to a press release issued Wednesday by the association in response to questions from The Tico Times.

On May 9, 1990, the association once again asked the Turrialba Prosecutor’s Office about Moreno’s case. Prosecutors denied the request. They responded that only individuals directly involved in the case could access the information. Three years later, in March 1993, a court found Moreno guilty. Local media published information about the Moreno case, which was then filed at MET.

The same year, Moreno’s attorney filed an appeal against the conviction. Association attorneys informed the MET that the appeal prevented them from moving forward on any action against Moreno’s license. The appeal was denied in July 1993, but according to the doctor’s association, they never knew about it.

In February 1996, the association suspended Moreno’s license because he was past due on association fees. In July 2005, someone paid the fees and Moreno’s license was reinstated. That paved the way for Moreno, a fugitive from U.S. justice, to begin practicing medicine legally in Costa Rica.

Officials at the Costa Rican Doctors and Surgeons Association say they first learned of the Interpol arrest warrant against Moreno from The Tico Times this week. They also said they didn’t know that Moreno had been convicted of charges stemming from the 1989 abuse case in Costa Rica.

“The Medical Ethics Tribunal never knew about a conviction (against Moreno), and that impeded it from dictating a final ruling,” the statement from the association said.

The association said it would open a new investigation that would look into Moreno’s activities in the U.S.

But there’s a catch. Article 40 of Costa Rica’s Constitution prevents nationals from receiving life sentences for any crime. The doctors association interprets that to mean that they also cannot issue a perpetual reprimand, meaning that although they may suspend licenses in certain cases, those licenses could eventually be reinstated. No matter the crime, doctors legally can go back to practicing their trade if they serve their time, the association said.

Meanwhile, neighbors and patients of the clinic say they are frustrated by the government’s inability to pursue justice in this case. Officials say that unless new criminal complaints are filed, Moreno is a free man. The only two countries in Central America where he could be extradited to the U.S. are Panama and El Salvador.

“An Interpol international arrest warrant has to be ratified by national authorities,” said OIJ Director Jorge Rojas. “The country that submitted the warrant needs to ask the Costa Rican authorities to execute the order, and a national judge has to give that order. In this particular case, since (Moreno) is a Costa Rican, he can’t be extradited. This is a constitutional principle stated in Article 3 of the Extradition Law.”

Moreno declined to comment for this story, referring The Tico Times to his attorney. A man saying he was Moreno’s attorney answered Moreno’s cellphone, but refused to give his name.

“You have no right to invade my privacy,” Moreno said this week. “You’re calling a private number and telling me (about charges) that have already expired and been pre-judged,” he said before hanging up.

See next week’s edition of The Tico Times for the second half of the series. Follow the story online at wordpress-257819-2837440.cloudwaysapps.com.