by Kiko Malin

Most of us in the coffee industry are aware of the dire financial situation in which many coffee farmers find themselves today, but we may not realize how this desperate poverty translates into lack of access to the kinds of services that we take for granted. Let's take the case of cervical cancer. It's not something we think about very much, probably because we know very few people who have had it and even fewer who have died from it. But this is not the case in Mexico, especially for the millions of women who depend on coffee farming for their livelihood.

In 1992, Mexico recorded the highest mortality rate for cervical cancer in the world, five times higher than the rate among white women in the US during the same year [1] . Even in this new millennium, the mortality rate remains steady: during the time that you are at work today, four women will die of cervical-uterine cancer in Mexico alone [2] .

Why is this easily preventable cancer killing so many women in Mexico? The main reasons are lack of awareness about cervical cancer and lack of access to quality screening. Grounds for Health (GFH) is a non-profit organization created to bridge the gap between available medical services and the needy coffee-farming population that they serve. It was founded by Dan Cox, the president of Coffee Enterprises in Burlington, VT, when he and family friend Dr. Francis Fote found out about the high mortality rate from cervical cancer while on a coffee buying trip to Pochutla, Oaxaca in 1996.

The project started by sending small teams of American volunteers to Pochutla to do Pap smears. The Pap smear slides were sent for interpretation to the state laboratories in Oaxaca City, an eight to ten hour truck ride from Pochutla, but the state system was fraught with problems. Too often, results were never returned and, when they were, the diagnoses were questionable. In 1998, Jon Wettstein of Green Mountain Coffee Roasters became involved in the project and connected GFH with the Cytopathology Department at Fletcher Allen Hospital in Burlington.

Adding cytopathologists to the team of volunteers allowed the project to interpret the Pap smear slides on site and deliver the results to the patients within the week. With the assistance of Gyné-Tech Instrument Corporation and Ben and Jerry's Homemade, the project was able to donate more than $25,000 worth of diagnostic and treatment equipment, allowing the Pochutla hospital to set up a clinic where women with pre-cancerous conditions could receive treatment, the first of its kind in the region.

In September 2000, the project became an official non-profit organization, Grounds for Health, Inc. Shortly thereafter, Kiko Malin was hired as the executive director and the project continued to grow. In October of 2000, GFH began offering services in Huatusco, Veracruz, an important coffee-producing city in that state. Over 350 women attended the initial two-day clinic and when the team returned in March, almost 1100 women were screened in a week—an all time high for the project.

Thanks to Grounds for Health, women in two coffee-growing communities now have access to high-quality cervical cancer screening. To date, the project has served more than 4000 women, and has referred hundreds of them for potentially life-saving treatment. Most importantly, GFH makes these hard-working women feel that they are a priority, and that is a great gift.

Grounds for Health will continue to expand its services by improving health education programs and working with the local agencies and coffee co-ops to develop a community-based mechanism for tracking and follow-up of patients. It is only with the commitment of its many volunteers, both American and Mexican, that GFH will succeed in accomplishing this goal. By working closely with the community and mobilizing highly trained American medical professionals GFH is helping the local people to help themselves.

Grounds for Health is now raising money for its November trip. The founders and sponsors of GFH are proud of the contribution that they are making to the women whose hard labor makes our businesses possible, and whose needs are so often overlooked. They hope that others in the industry share their vision and will join them in supporting this important cause. To learn more about becoming a GFH sponsor or volunteer, or to make a tax-deductible donation, please contact Kiko Malin at 1-800-375-3398 or write to

Grounds for Health is a 501(c)(3) organization

[1] Mexican data from Lazcano-Ponce EC, Najera-Aguilar P, Buiatti E, et al. The Cervical Cancer Screening Program in Mexico: Problems with Access and Coverage. Cancer Cases and Control. 1997;8:698-704. US data from SEER Cancer Statistics Review, 1973-1996.

[2] Lazcano-Ponce EC, Castro R, Allen B et al.  Barriers to Early Detection of Cervical Cancer in Mexico. Journal of Women's Health. 1999;8:399-408.

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