Charlene McGee has taken on some hard assignments.
She’s convinced parents and pastors to welcome HIV-positive gay men for discussions about safe sex. She has recruited first-generation college students from big cities across the nation to rural-based Oregon State University. And she’s persuaded international foundations to invest in rebuilding post-war Liberia, where 85 percent of its citizens lived on less than $1.25 per day.
But when she accepted a position at Multnomah County this winter she agreed to tackle her toughest task so far: coordinate an overhaul of the state’s refugee health system.
From her office at the health department, McGee will help state and local health officials navigate changes to refugees’ insurance resulting from the Affordable Care Act. She’ll organize and connect the network of social service and health providers to improve access to refugees. And, she’ll help assure newly arriving refugees receive the primary care services they’re entitled to -- and advocate for them when something goes wrong.
It’s a daunting to-do list, and she has gone home a few nights, tired and a little teary-eyed.
“It’s hard, trying to welcome families into a system that’s not ready for them,” McGee said. “I’m really driven when people don't have equal access, when people aren’t given a chance to succeed. I see this role as a way we can assure they get that access.”
McGee has devoted her professional life to helping refugees because her family got the chance to do what most do not -- escape a deadly war in Liberia and build a new life in the United States.
“We were blessed to survive. The war was brutal. Whole families were wiped out,” she said. “We were blessed to leave, so we have a responsibility. You see the privileges you have and with those privileges comes responsibility.”
If refugees need an advocate who will make change rather than wait for it, they will find one in McGee. She was, after all, born in the back seat of a taxi as it pulled up to the Old Maternity Center in Monrovia, Liberia.
McGee grew up the middle child of five, in a working-class suburb, Steven Tolbert Estate. Her father worked as chief of staff to the Liberian director of police, making him a target for dissent that began to bubble up.
McGee still remembers the patterned white fabric of her nightgown on that morning in December, 1989, when rebels loyal to former government minister Charles Taylor knocked on her family’s door. She was 8. She remembers their red t-shirts and black boots. And she remembers walking.
Her family joined others streaming out of homes along their street and beginning a long march that didn’t end until they approached a roadblock when sun had already begun to set. There they spotted a young man they recognized.
“My maternal grandmother, she took in anyone and everyone,” McGee recalls “One kid she took in ended up joining the rebels.”
At the roadblock that young man pulled her family aside. “If you pass this roadblock, they’ll kill you,” he warned. Instead to he took them to his family’s house, a southern-style Colonial surrounded by fields of peanuts and corn. For months, the McGee family lived in the attic, growing accustomed to the blasts from AK 47s and the lines of refugees streaming past, and surviving on so many legumes her mother never wanted to eat them again.
In 1993, the family was finally able to flee. McGee’s father, Charles, resettled in Portland, where he had a brother. Charles McGee began taking classes through Concordia University and earned money corralling shopping carts at a Safeway grocery store while he waited for U.S. authorities to approve his family’s visas.
Liberia is an English speaking country. Nevertheless, when they arrived in Oregon, McGee and her siblings were sent to English as a second language courses through Portland Public Schools.
“My parents tried to tell the school that we speak English,” she said and laughed. “It didn’t matter because we had an accent. We started reading a book in class and everyone was like, ‘They can read!’”
Even though they spoke English, McGee says it was hard not to feel different than the other kids in class.
“It wasn’t easy, but you adjust,” she said. “It’s what you have to do. You recreate your life here. The thing we learned was to be proud of who we were.”
McGee went on to earn a degree in public health at Oregon State University, where she served in student government, and the served as an admissions officer recruiting first-generation college students.
Meanwhile McGee worked as a sexual health educator at the Multnomah County Health Department. She earned the trust of black congregations and parent groups and spoke about safe sex. She brought in HIV-positive African American men to share their stories, and placed (and refilled) baskets of condoms at African-American barbershops and beauty salons.
And she joined the board of the African Women’s Coalition, which held leadership workshops for refugee women, recruited volunteers to teach English to women in their homes, and helped Muslim girls organize a basketball team.
And in 2012 she returned to Liberia and worked for the Philanthropic Secretariat, encouraging international foundations to invest in new schools, clinics and wells throughout the country.
Today McGee works for the Health Department’s Communicable Disease Services’ Refugee Health Promotion program. Part of her job is to work with Tasha Wheatt-Delancy, director at Multnomah County’s Mid County clinic and the official state Refugee Health Coordinator.
All newly-arriving refugees complete a medical screening at Mid County as part of their immigration requirements. After that initial visit, too many disappear, landing in the emergency room with preventative illnesses because they haven't connected to primary care.
Wheatt-Delancy and her team want to change that by making sure each new arrival is scheduled for a primary care appointment at Mid County before their screening is complete. They’re calling the new transition the Rose City Refugee Clinic.
“Charlene will help support infrastructure we’re building around the refugee program,” Wheatt-Delancy said. “She will have to advocate, be the voice for communities who might not have a voice,” Wheatt-Delancy said.
Refugee resettlement agencies want McGee to look beyond Mid County. Rent in the Portland area is high and housing availability for larger families is limited. Agencies are trying to settle new arrivals in cities such as Salem and McMinnville. McGee will need to help neighboring counties prepare to meet a new set of needs.
“That means partnering with new organizations and making sure they can serve the clients,” said Toc Soneoulay-Gillespie who oversees the resettlement program at Catholic Charities. “We have a huge tendency to be siloed. So she needs to look at networking. We need to be interconnected.”
Soneoulay-Gillespie says she’ll look to McGee to work with the official state refugee team to identify national best practices, “inform the rest of us about strengths, areas for growth, trends, to bring the rest of us up to speed, and to move the rest of us forward together.”
On a recent sunny Monday morning McGee sits in her windowless cubby at the health department, two computer screens demanding attention and a to-do list growing on a pad of paper in front of her.
When asked if the job she’s signed up for is possible, McGee smiles.
“You have leaders who are willing to mobilize resources. People who are willing,” she said. “People always say that government is slow. But if the people are willing to move, the system will move.”