In recent years, sustainability has been THE buzzword in both the coffee industry and the public health sector. At Grounds for Health, through 15 years of hands-on experience developing health care programs in some of the world’s poorest and most remote areas, we have seen first-hand that too often, well-meaning development programs are funded, set up, and run by outsiders, and then abandoned without the necessary support or training to keep the project sustainable. The third world is literally littered with ineffectual programs, broken equipment and broken promises.
Grounds for Health focuses on preventing cervical cancer, the number one cause of early death for women in most developing countries. The fact that thousands of women die from a preventable disease is truly stunning. It is also an eye-opening fact that cervical cancer is perhaps the easiest of all cancers to detect and to treat. Right now, the technology and the resources are there to save lives and avoid the huge financial and personal burden that cancer care and early death bring to families and societies. So how does an organization begin to tackle this major health problem skillfully and effectively to reach a sustainable solution?
Grounds for Health has discovered a few key ingredients:
• Locally Driven: Communities must recognize the need, buy in to the program, and assume local ownership.
Grounds for Health programs always start with an invitation from the community. The community has decided cervical cancer is a priority problem and is willing to put energy and resources into the solution.
• Affordable: Local communities must be able to pay for their own resources and materials to continue indefinitely.
In countries such as Nicaragua or Tanzania where the annual family income can be as little as $300/year, any health care solution needs to cost pennies and not dollars. The simple screening test Grounds for Health uses costs 25¢ per test and is considered a “best buy in public health” by the World Health Organization.
• Focus: Programs should begin by reaching out to the populations at greatest risk.
In rural areas, poor women between the ages of 30 and 50 are at greatest risk of developing cervical cancer. By screening and treating this segment first, society will receive the greatest benefit despite limited resources. Grounds for Health’s close community links provide the community education and mobilization that helps identify and encourage these women to go for services. The coffee co-op helps with transport and makes sure she gets follow-up care if she needs it. Without that link, she may never arrive for prevention in the first place.
• Locally Sourced: When supplies run out, communities should be able to find new materials locally.
Grounds for Health scrutinizes every ingredient, supply, and piece of equipment to make sure it is necessary, can be locally sourced whenever possible, and/or doesn’t require fancy technology to keep it going.
• Locally Sustained: Programs should empower with the knowledge to continue.
Grounds for Health invests heavily in training local providers, thereby improving health systems, and increasing access to basic care. Local providers continue the work and our co-op partners make sure that if there is a break in access either through loss of a local provider or a lack of necessary supplies, that efforts are made to correct the problem early. We are now focusing on educating master trainers in rural communities who can help develop new providers and continue to support new programs without our assistance.
And, the final key ingredient to sustainability is the investment at all levels of the funding base. In the case of Grounds for Health, what runs our engine is the sustained support from the Specialty Coffee Industry. Having a funding base that truly cares about and is willing to invest in the population we serve means that the support does not change when the next big crisis blows through the media. And because our funding comes from many sources in the form of direct donations, it means that there is no single funder dictating our work. We have had the uncommon luxury of flexibility and freedom to try out new ideas and to test what really works, change what does not, and make constant improvements to our model.
The result has been wide recognition for outstanding, sustainable programs that address cervical cancer prevention – from community education and mobilizations, to high quality local health services, to assurance of care and follow up for women who need more. As part of that recognition, Grounds for Health received the 2011 SCAA Sustainability Award, was named a National Demonstration Project by the Tanzanian and Nicaraguan Governments, and has been appointed to the World Health Organization’s Technical Advisory Group on Cervical Cancer.
What started 15 years ago with a few good people from the coffee industry joining together to address the high rate of cervical cancer in a small coffee-farming community in southern Mexico, has grown into a model of community-empowered sustainable development. We are fully caffeinated.
Thank you Specialty Coffee. To learn more about Grounds for Health or to donate, visit: www.groundsforhealth.org.
Ms Burns, Executive Director of Ground for Health, is an expert in women’s health and has worked in more than a dozen countries. She is co-author of “Where Women Have No Doctor,” a health guide for women in low-resource settings, now translated into over 30 languages and used around the world.