Clinic of Hope

Alawode Oladele

“We sometimes forget that refugees have quite a task before them,” says Alawode Oladele, medical director of county-wide services for the DeKalb County Board of Health.

Alawode Oladele helps refugees begin life anew

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The patients who visit the clinic run by Alawode Oladele 93MPH have been through a lot. Most have just arrived in DeKalb County to escape war, torture, and persecution in other nations.

Oladele, medical director of county-wide services for the DeKalb County Board of Health, helps ensure that the 1,000 to 2,000 refugees screened yearly at the clinic begin their new lives as healthy as possible. "We sometimes forget that refugees have quite a task before them," says Oladele, also known as "Dr. O."

Today, nearly 10% of Georgia residents speak a language other than English in their households. Of the more than 2,000 refugees who arrive in Georgia each year, more than 85% settle in DeKalb County, which offers the state's only Refugee Health Program. In response to their needs, Oladele co-founded the Refugee Stress Clinic in 2002 and the Center for Torture and Trauma Survivors in 2005.

"We've developed a very structured health screening program by default and put some grants together to expand our capacity," he says.

Early each week, 20 to 30 refugees come daily to the DeKalb clinic for initial screening. They return later in the week for thorough evaluation that includes physical, mental, and nutritional assessments. Clinic staff also brief refugees on the U.S. health care system.

While clinic staff anticipate many of the refugees' needs, unexpected challenges arise. When the first wave of Karen and Chin refugees from Burma arrived, none of the available interpreters could speak their languages. Four years ago, the majority of refugees came from Sudan, Somalia, and Vietnam. Now clinic staff primarily see refugees from Bhutan and Iraq as well as Burma.

The Refugee Health Program screens all refugees for communicable diseases including hiv, syphilis, hepatitis, and TB; chronic diseases such as hypertension and diabetes; mental health problems such as anxiety or depression; and nutrition problems such as anemia. Additional screenings for parasitic and other diseases vary, depending on the country of origin. New arrivals from north Africa and Egypt may be tested for schistosomiasis, while refugees from Vietnam may be examined for leprosy.

Clinic staff invariably see unusual presentations of disease. In one instance, a young Somali woman was diagnosed with genital tuberculosis, which can scar the uterus and prevent pregnancy. Last year, Oladele co-wrote a Southern Medical Journal article about the condition seen in some women from sub-Saharan Africa and India.

Alawode Oladele

"Dr. O" takes a special interest in helping refugee children succeed in school.

"It's unusual in women of child-bearing ages," says Oladele. "If you catch it early, women can still become pregnant."

In a more recent Southern Medical Journal article, Oladele and colleagues from the DeKalb County Board of Health and Emory School of Medicine recommended further study to evaluate the role of vitamin D in TB treatment. Patients deficient in vitamin D appear to be more resistant to treatment.

Such knowledge helps inform the practice and research of experts at Emory, Morehouse School of Medicine, Georgia State University, the Georgia Division of Public Health, Atlanta-area hospitals, and the CDC. A member of the CDC's TB Trials Consortium, the refugee clinic was a testing site for Quantiferon-TB gold, approved in 2005 by the FDA to detect latent TB.

"We can learn a lot from the populations we see in the refugee clinic because they represent true pathology from different parts of the world," says Oladele.

A GIANT impact

Born in Nigeria and schooled in Lagos, Oladele arrived in Atlanta at age 15 to attend Morehouse College and Morehouse School of Medicine. He completed his residency and his fellowship at Emory. He has been former Ambassador Andrew Young's physician and holds a patent for a bladder cancer treatment. In Africa, he co-founded the Global Initiative for the Advancement of Nutritional Therapy (GIANT). The small project evolved to help eliminate hunger and malnutrition through improved nutrition, better food access, and clean water across the continent.

Oladele is a moving force behind GIANT's promotion of the moringa, a nutrient-rich plant that helps people who are HIV-positive maintain their weight. The Moringa Tree of Hope initiative teaches villagers how to plant and grow trees throughout Africa to use as a food supplement.

"We have seen whole villages full of malnourished children regain a healthy weight due to moringa," he says.

Back in DeKalb County, Oladele sees patients in the refugee clinic four days a week. Once they are screened, he is never sure if they will continue to seek treatment should they need it. They are more concerned about finding a job and a place to live, learning English, and enrolling their children in school.

There are success stories, especially among children who overcome the anxiety and emotional trauma of resettlement to become stellar students and citizens.
"We're now seeing the fruits of our labor," says Oladele. "Kids are graduating from high school and going on to college."

David Thon 09MPH is among them. One of the former Lost Boys from Sudan, Thon graduated from Rollins and now consults for The Carter Center in Sudan to help eradicate Guinea worm disease.

For Oladele, former patients like Thon are the ultimate success story. "They are reinvesting in communities," he says.

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