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September 6 , 2005
Physicians establish Tropical Medicine Clinic at Grady

BY alicia sands Lurry

A new clinic, designed to provide specialized care to immigrants and refugees who have either acquired various illnesses from their birth countries or from travels outside the United States, is now open at Grady Hospital.

The Tropical Medicine Clinic is led by Phyllis Kozarsky, professor of medicine in the School of Medicine’s Division of Infectious Disease, and Carlos Franco, assistant professor of medicine. Both Kozarsky and Franco are experts in travelers’ health and tropical medicine.

Deborah Nicolls, an infectious disease fellow at Emory, and Alicia Hidron, chief resident in internal medicine, also work in the clinic. Carlos del Rio, professor of medicine and chief of medicine at Grady Hospital, is credited for helping establish the clinic.

The clinic sees patients on the first Monday of each month and is specifically targeted at immigrants and refugees seeking care for various tropical infectious diseases but do not have adequate insurance to cover blood work, CAT scans and other necessary diagnostic tests. Doctors also see people who have traveled outside the United States and come back ill; other patients have never been screened for chronic diseases. The doctors hope to expand the clinic’s hours as the demand increases.

Kozarsky said the need is great given the increasing number of immigrants in the metropolitan Atlanta area.

“We’ve been thinking about a clinic like this for a number of years and have wanted to take care of immigrants and refugees in a setting like Grady,” said Kozarsky, who serves as co-director of the clinic and medical director of TravelWell, Emory’s travelers’ health clinic, which offers pre-travel advice and education for those traveling abroad, as well as post-travel care. TravelWell, based both at the Emory Clinic and Crawford Long Hospital, serves the public, business travelers, large corporations, volunteers, missionaries, immigrants and refugees.

“While the education and training of our physicians is excellent, it does not focus on many of the chronic or acute illnesses that many immigrants may bring with them or develop when traveling to visit their friends and family,” Kozarsky said. “That’s why we were so elated when hospital administration at Grady supported our efforts to open this clinic.”

Franco, who serves as the clinic’s director, said it provides specialized care to immigrants and refugees from countries that include Africa, Southeast Asia and Latin America.

“Because we’re experts in tropical and infectious diseases, we believe we can make a difference with treatment and hopefully provide relief,” he said. “While we won’t be able to cure all of the diseases, we can usually control them or at least stop the progression once we’ve confirmed the diagnosis with the proper testing and with the medications for these types of illnesses.”

So far, physicians have treated a patient for lymphatic filariasis, a disease transmitted by mosquitoes in specific geographical areas, and another for schistosomiasis or bilharzia, a parasitic disease that people acquire through contact with contaminated water. Most people become exposed to the disease in Africa and Southeast Asia; screening is very important because it can lead to liver or bladder disease.

Kozarsky said that, while schistosomiasis is not prevalent in the United States, more than 200 million people throughout the world have acquired it, making it a major public health problem worldwide.

“It’s one of those diseases we’d really like to focus on because it’s a burden to populations around the world,” she said. “Being able to treat people for it is extremely important.”

Psychiatric support also is available for refugees and immigrants experiencing difficulty transitioning to a new country.

“This is an effort to support those people who are coming here who need that extra support while getting used to living in a totally different environment,” Kozarsky said.

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