Penn neurologist honored for sharing expertise with developing nations

Donald Silberberg has won Ecuador's highest scientific medal for easing brain and nervous system diseases.
Donald Silberberg has won Ecuador's highest scientific medal for easing brain and nervous system diseases.
Posted: August 23, 2012

In June, the National Assembly of Ecuador gave Donald Silberberg, an emeritus professor of neurology at the University Pennsylvania medical school, its highest scientific award, the first such honor for an American.

The Vicente Rocafuerte medal was given in recognition of Silberberg's efforts over two decades to enhance medical education and improve patient care for neurological and psychiatric conditions in Ecuador as well as around the world.

"I was honored and really pleased," Silberberg said in his office recently.

The medal was a tribute to a physician and educator who has worked to ameliorate diseases of the brain and nervous system, especially in developing countries.

"He is one of the few leaders in neurology who has had a profound effect on neurological care and healing around the world," says Mohamad Rostami, chairman of the department of neurology at Thomas Jefferson University Hospital.

Neurological disorders - headaches, brain tumors, strokes, head trauma, psychiatric problems such as schizophrenia and depression - cause a quarter to a third of global death and disability, Silberberg says. Cerebral palsy, mental retardation, and epilepsy are much more common in developing countries. In some nations, epilepsy alone is 10 times more frequent, likely because of early-childhood infections, head trauma, and cerebral malaria.

Neurology deals with disorders of the brain, spinal cord, nerves, and muscles. At Penn, Silberberg, 78, still conducts research, lectures around the world, and comes to the office three or four days a week.

He prompted the National Institutes of Health to launch a grants program that enables international investigators to cooperate in studying and exploring solutions to neurological issues. So far, the NIH has funded more than 125 grants under the program.

In 2003, Silberberg was recruited by the National Security Council to formulate a plan for a pediatric hospital in Basra, in southern Iraq.

The $150 million hospital, the first to be built in Iraq since the 1980s, was completed last year and is now fully staffed. Says Silberberg: "It's one of the best things the U.S. has done there."

In Ecuador, he was invited by Marcelo Cruz, a neurologist and former minister of health, to help increase awareness of neurological and psychiatric disorders, especially at the community-health level. During multiple visits, Silberberg taught, lectured, inaugurated and obtained funding for research projects, helped develop a clinic and outreach program in the impoverished town of San Juan de Cumbayo, helped draft a medical school curriculum and a master's degree program for community health workers, and met with the National Assembly's health committee to discuss neurological well-being.

"As a physician, he's very sympathetic to the suffering of his patients," Cruz says, "and he believes that education is the main way to understand the diseases of these patients."

Silberberg's current project, begun six years ago, is researching neurodevelopmental disorders, such as autism and cerebral palsy, among children in India. The study involves 25,000 households in every region of that vast and populous country.

His international perspective was shaped by growing up in Washington during World War II. "I got used to the idea that people are similar no matter where they're from," he says.

After earning his medical degree from the University of Michigan and joining Penn's medical faculty, Silberberg, accompanied by his wife, Marilyn, and their two sons, spent the summer of 1974 in Shiraz, Iran, teaching and seeing patients.

What especially captured his interest was a community-health program that served about 20 rural, impoverished villages. In each village, a person was selected by the villagers to receive six months of training and become the local health worker. Once a week, a resident or doctor would visit to consult and deal with especially difficult cases.

"I saw amazing things," Silberberg recalls. "These health workers, who by design were not high school graduates, were dealing with the pressing problems of the village effectively - from eye and respiratory infections to delivering babies."

He remembers one young woman, 26, a village health worker wearing a chador, who sought his advice about a patient, an elderly man who was slumped over, with weakness and pain in his arm. Silberberg immediately suspected a herniated cervical disk that was pressing on the nerves of the man's spinal cord. He asked the young woman what she thought. Her diagnosis: arthritis in his neck that was pressing on his nerves.

"There are bright, brilliant people no matter what the setting," Silberberg says. "It's a matter of finding people who can do things and giving them opportunity. There are superb people everywhere."

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