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Grounds for Health

Caring for Coffee Communities

Erika Mohr vividly recalls one of her first experiences as a volunteer in Pluma Hidalgo, Mexico, for Grounds for Health, an ambitious non-profit organization working to reduce the incidence of cervical cancer in Latin American coffee-growing communities. Mohr, a registered nurse, remembers a woman who was diagnosed with advanced cervical cancer and given money for a bus ride to a treatment center. Because he couldn't setect any outward signs of illness, the woman's husband took the travel money and drank it away. When his wife began feeling ill six months later, she returned to the clinic for help. "I was appalled because time is of the essence with these lesions," Mohr says. "We were thinking we had saved somebody." Fortunately, this time, the woman got the transporation and treatment she needed.

This case is extreme compared to most of the situations Mohr typically sees in her volunteer work, but it is part of what inspired the creation of Grounds for Health. Because of early diagnosis and the ease of obtaining treatment, cervical cancer tends to be less of a life-threatening illness in the U.S. But, in fact, it is the leading cause of early death among women in coffee-producing countries. According to Grounds for Health executive director Kiko Malin, the disease is easy to cure if it's caught in the early stage, but most families in coffee communities are so poor that they will only seek medical treatment in an emergency. Malin says that even if the families could afford medical treatment, most don't understand the benefits and necessities of preventative health care. Unfortunately, cervical cancer remains hidden for so long that by the time a woman notices symptoms, it's often too late.

Malin says that another complicating factor is the status of women in Mexican society. "We are talking about a culture where women have very little bargaining power in their communities," she says. "A woman is in charge [of the family], she's in control [of the household], but she may have to ask her husband if she can see a doctor. If a man doesn't have very nuch money and says, 'You can't see a doctor,' she's not going to go."

Today, visitors who witness a Grounds for Health screening clinic in the small Mexico town of Pochutla wouldn't know there was ever resistance to the group's efforts. "There's always a line of women stretching out the door," Malin says. "I've heard some women come the night before to get a place at 5 a.m. It's chaos. It's noisy, and everybody wants to be seen."

In fact, the effort has been so successful that over the past six years, Grounds for Health has screened more than 5500 women and diagnosed 112 pap smears with high-grade lesions or cancer. "These women probably wouldn't be alive today if we hadn't screened them," Malin says.

Aside from conducting screenings, Grounds for Health has begun to increase its emphasis on educating women about cervical cancer and other health issues. Education is critical because not only does a lack of information leave women unaware of vital health issues, it also leads to fear of the screenings. In response, the organization has begun teaching local health promoters about the importance of cancer screenings. Promoters then return to their communities to inform women about upcoming screenings and to explain why they are necessary. One educational effort was so successful that Grounds for Health saw 234 women over two days. "It was just a question of promoting it extensively," Malin says. "Women from rural areas wouldn't make the trip normally because they are suspicious. They need someone to tell them it's OK."

But women aren't the only focus of the educational effort. Grounds for Health also teaches men about cervical cancer and other women's health issues because as Malin stresses, the more men know, the more willing they are to allow their wives get screenings and treatment. "Often women can't take care of themselves if men don't understand that this is important," she says. "They want to care for their wives. They just need to have it explained in a way that makes sense."

According to Malin, the organization's ultimate goal is to provide equipment, training and ideas that will enable community members to make this project their own. If Hautusco, Veracruz, is any indication, the effort is working. The head of the area's community health center recently told Malin that it had conducted its own screening campaign in October 2001, testing 600 women. "That's exactly what we want," Malin says. "They see that it works, they know how to make it happen and they are going with it."

With this kind of tangible success, Grounds for Health has begun to enjoy increased support from the coffee industry, including such companies as Swiss Water Decaffeination Coffee Co., Coffee Kids, Coffee Holding Co., and Indigo Coffee Roasters. "I think it's a great organization and a great cause," says Karen Gordon, director of specialty green sales for Coffee Holding Co. "We've been providing support almost from the start. We support it because this is our business and women are the heart of coffee growing."

Indigo Coffee in Northampton, Mass., raised funds for Grounds for Health by putting out a collection box at a trade show and sending the money with a matching donation of its own. The company also spreads the word about the organization's work whenever possible. Co-owner Lourdes Tallet says the response has been favorable. "I think people are excited that Grounds for Health does very concrete work for women's health care," she says.

Such support has made a significant difference in the organization's ability to operate effectively, but Malin acknowledges that Grounds for Health must still work harder tp tap resources in the coffee industry. The organization raises about $50,000 a year through direct mailings and personal solicitations from Cox and Wettstein, but it needs $75,000 to cover basic expenses and to hire a much-needed additional employee for office support. Malin says another employee would allow her to take care of more program planning and field support. Eventually, she would also like to hire someone in Mexico to be a community trainer. Malin believes there are plenty of opportunities to beef up the organization's efforts, including more systematic mailing campaigns, possible events like bike-a-thons, and smaller fundraising parties with a targeted list of donors. She's also considering widening the donor pool to include women's health organizations, medical groups and an even wider audience: "Anyone who drinks coffee."

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