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Common 'Grounds': Screening for Cancer in Coffee Regions

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In June 2012, nurse practitioner Ellen Starr arrived at the foothills of the Mount Kilimanjaro region in Tanzania, exhausted after a bumpy, two-hour car ride. She and a colleague from Williston-based Grounds for Health were supposed to supervise a local health care provider they had trained to perform cervical precancer screenings. But no "patients" showed up, and the visitors were perplexed. Another individual — a local health promoter — later told them why. Starr recounted: "Word got out in the community that a woman would go in, lie down on the table, spread her legs, the nurse would ... insert her hand in her vagina, take hold of her uterus, pull it out, treat it or test it, and shove it back again." The health promoter and a priest quickly spread the word that none of those rumors was true. Soon enough, women began arriving for tests. Starr said the incident illustrates the crucial role that community leaders play in aiding the mission of Grounds for Health, which aims to reduce cervical cancer among women in the developing world. It works closely with public health authorities and coffee cooperatives to train local doctors, nurses and community health promoters. The nonprofit coordinates screening and treatment services in areas where the disease is prevalent. One of the original employees at Green Mountain Coffee Roasters — now Keurig Green Mountain — founded the organization, as a result of a shrewd observation in the field. Daniel Cox was visiting a Mexican coffee cooperative in 1995 and had brought along a friend. Retired obstetrician-gynecologist Dr. Francis Fote noted that the women there were dying of cervical cancer at an alarming rate. Caused by the sexually transmitted HPV virus, cervical is the second most common cancer in women living in less developed regions, according to the World Health Organization. Since the women lack access to screening, cervical cancer often escapes detection until it has advanced and women are exhibiting symptoms. By then, their chances of getting proper treatment for the late-stage disease are poor — hence the high fatality rate: Nearly a quarter-million women in low-income countries die of cervical cancer every year, compared to 35,514 everywhere else, according to the WHO's ICO Information Centre on HPV and Cancer. Fote urged his younger friend to start a screening clinic. "Doc, I'm a coffee guy," Cox said he replied. Fote told him: "Well, you have contacts." GMCR…

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