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Ricci Silberman

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When Ricci Silberman first heard about the organization Grounds for Health and its mission to curb cervical cancer in coffee-growing communities in Mexico, Nicaragua and Tanzania, she decided she wanted to volunteer. However, she put those plans on hold while raising children and helping run the Cushing Street Family Practice. With the kids finally raised and the business more established, Silberman recently spent three weeks in Tanzania, where she taught people how to save women's lives. For more information on Grounds for Health, visit www.groundsforhealth.org.

How long have you worked in health care?

I've been a physician assistant for 26 years. I actually used to live in Vermont before I moved to Arizona, and I worked there in a women's health clinic doing gynecology. I learned so much and decided to go into family practice, which is what I've been doing for 24 years in Arizona.

Where do you work in Tucson?

I started the Cushing Street Family Practice. I co-own it with Molly Wheelwright. We felt downtown needed some good medical care. ... It has been quite successful in that it is so accessible, and so many people are moving downtown and living downtown. It's a welcoming practice. Our staff is wonderful, and our mission was to do something a little different. We refuse to put our phones on hold or turn them off during lunch, because that's usually when people call to make appointments.

How did you find out about Grounds for Health?

I used to live in Vermont, and used to train as a midwife with a woman doing homebirths. I was her assistant in Vermont, and she became the director of Grounds for Health. I learned about their mission to create sustainable and effective cervical cancer prevention and treatment in coffee-growing communities.

How does it work?

The organization works with coffee-plantation owners and volunteers to go where these plantations are and train local medical providers to screen women for cervical cancer. The medical community found that (one of the most) common causes of death in Third World countries is cervical cancer, because they don't have access to pap smears and lab testing. (Grounds for Health) uses a specific method, a single-vision approach: We train local women to apply vinegar to the cervix for two minutes, and then look for lesions. If there are lesions, it could be HPV, so they use cryotherapy to freeze them off. The women come back to retest in a year. They are seeing in initial studies that this method is decreasing the death rate. We go into a community, and in two weeks, we screen 400 women and train at least 10 providers to continue the work after we leave. That's sustainable health care.

Are they always in need of volunteers?

Well, they are always looking for money, but, yes, they want volunteers. Most are medically trained, but I don't think you have to be. You pay your own way. When they go to the Spanish-speaking countries, they want people who are bilingual.

How do the owners of the coffee plantations figure into this?

They were concerned when they saw these women dying. They were the ones who brought this up and asked for help. They are partners, too. In Tanzania, the Jane Goodall Institute is involved, and there's a place called Sustainable Harvest that works with coffee-growers all over the world. An AIDS organization has also become involved, because women who have AIDS also have a higher rate of cervical cancer.

Did you learn anything new from this experience?

In family practice, we see everything ... but this was very focused on just gynecology. I do pap smears on a regular basis, but this was so focused on pre-cervical cancer, so, yes, it was a true learning experience. I (was) wondering, "Why can't we bring this back? Why is this just used in Third World countries? As access to medical care diminishes more, why can't we do this style of treatment?"

Had you been to Africa before?

No, and I have a travel bug. It was great. ... One woman walked eight hours to get to our clinic and stayed the night and walked back home the next day. They want to take care of themselves. We did a lot more (socially) with the people we trained, because they are bilingual. I feel like I made lifelong friends after spending 10 days together.

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