A Crucial Connection

As the Grounds for Health Director of Programmes, you occupied an interesting space at the intersection of coffee and public health. What did your journey into coffee look like?

I grew up in Addis Ababa, the capital of Ethiopia. After spending 12 years in the US for my education and work experience, I returned home. My initial background was in health, but I transitioned into the coffee industry around 2011.

I had previously operated a retail business that combined a convenience store with a health food concept, but it wasn’t successful, and my wife and I wanted to venture into roasting coffee. In 2016, I completed the Illy Masters programme through the University of Trieste, the same year I joined Grounds for Health. Since then, I’ve focused on coffee research related to African coffee cultures and their role in domestic market development, as well as in the global specialty coffee industry. My aim has been to explore how these cultures can enhance product development globally while promoting coffee consumption across Africa.

Although coffee has a problematic legacy, I strive to appreciate its potential. There’s an expansive community of practice surrounding coffee that allows me to approach it meaningfully from various angles, like business, science, health, and economics. Coffee is remarkably flexible.

Can you explain how Grounds for Health connects coffee and cervical cancer?

Coffee farming typically occurs in rural communities where women often lack empowerment and may not seek preventative healthcare. Additionally, low- and middle-income countries have limited treatment options for cervical cancer, which is caused by the human papillomavirus (HPV), a sexually transmitted infection (STI) that begins with a lesion. Our work involves identifying and treating these lesions before they develop into cancer.

To clarify, there is no direct link between coffee and cervical cancer. Grounds for Health conducts cervical cancer screenings in rural areas where coffee is grown, which also experience high rates of this preventable cancer.

Exactly. For instance, in Ethiopia, we operate in the Sidamo and Gedeo regions. Annual health examinations are virtually non-existent, and women often don't seek health services unless they are feeling unwell. Our goal is to improve the health of women in coffee-growing communities. As part of our screenings, women receive comprehensive examinations of their sexual and reproductive health, allowing us to identify other issues like STIs or uterine prolapse, which can occur in women who have endured hard labour and multiple births.

Tell us about your role as Director of Programmes.

At Grounds for Health, we don’t establish independent clinics; instead, we support government institutions by providing financial and technical resources. This enables them to mobilize community health workers and deliver essential public health services at no cost. Our teams in Ethiopia and Kenya work to implement our programme intervention model effectively by fostering relationships with local health authorities, coffee cooperatives, and other stakeholders. Each day, I focused on creating an integrated partnership between our country teams and colleagues at the US headquarters. I visited each programme quarterly, unless I needed to oversee the introduction of a new technology or process. I also conducted quality assurance and oversight to ensure that the health system can deliver care both in our presence and in our absence.

So you worked for a nonprofit, own and operate several businesses, and conduct coffee research. It sounds like you must be very busy!

I don't feel particularly busy because coffee is my platform. There’s nothing mundane about it. My work with Grounds for Health kept me connected to the community at the grassroots level while providing services beyond coffee. It also allowed me to explore sustainability modelling, as not everything needed to be transactional. On the surface, cervical cancer prevention may seem unrelated to coffee, but it can be implemented in coffee-growing communities in a way that directly and indirectly impacts the coffee industry by improving the health of women, who make up over 70 per cent of the workforce involved in picking, sorting, and processing coffee.

How has this experience shaped your perspective on sustainability work?

There isn't a single entry point for sustainability work, and I am committed to addressing its root causes. In the context of Grounds for Health, the principles of healthcare intervention remain constant, regardless of whether one approaches it from the perspective of the healthcare or coffee industry perspective. I also work to manage and align these two viewpoints.

For coffee companies, the connection between women’s health and coffee is complex. They recognize a direct correlation between investment and impact when it comes to paying a premium through certification mechanisms or cleaning polluted water at wet mills. When companies fund projects like schools, bridges, or roads, the results are immediate and visible, allowing companies to showcase their contributions. In contrast, our efforts in healthcare screening are long-term, making it challenging to observe the immediate benefits of investing in healthcare quality.

On the other hand, the healthcare sector views coffee-growing communities merely as populations in need of services. The World Health Organization has set targets for eliminating cervical cancer, but we are far from meeting those goals; in Ethiopia and Kenya, we have only screened about 10 to 15 per cent of the 2030 target.

Grounds for Health leverages resources from both coffee companies and foundations to provide essential care. However, global health institutions often impose strict funding guidelines. Partnership with coffee companies is vital, granting Grounds for Health the independence needed to sustain its operations and innovate in its approaches.

I believe the coffee community is beginning to understand that women’s health directly affects workplace performance and child labour. When women are healthy, their children are more likely to attend school. That makes cervical cancer screening a vital programme for community development, as well as for the coffee and health sectors.

What other kinds of support do you think are necessary for women to become equal participants in coffee?

If opportunities and resources were equally accessible, discussions about gender in coffee would be unnecessary. For me, coffee should empower people to pursue what they care about.

In Ethiopia, women know more about coffee quality, processing, and roasting than men. However, legal frameworks and social circumstances have historically limited women’s involvement, particularly in obtaining business licences or accessing bank loans, which often required assets. Women typically own land through their husbands rather than directly, though reforms are now underway. Today, women lead in coffee production, processing, value addition through roasting, and retailing. So, advocating for equal participation for women in coffee might seem ironic, because they are already the dominant players. Nevertheless, the full benefits of their engagement and participation are still lacking.

A few years ago, I hosted a tour of the roastery I co-founded with my wife for some American roasters. They were surprised to find that I was the only man working there; all other roles—cleaners, graders, roasters, packagers, our accountant, and my wife, who manages and owns the business—were filled by women. This experience highlighted for me the importance of supporting women in advancing within the coffee value chain.

We’ve touched on the concept of ‘empowerment’ a few times so far. I’m curious, how have your experiences of living both in the U.S. and Ethiopia influenced the way you think about empowerment?

The two cultures have very different perspectives on empowerment. In the US, there is often an assumption that women are disadvantaged. However, in the communities where I’ve lived and worked, not all assigned roles are disempowering. Men and women are recognized differently in social spheres—such as family responsibilities, community well-being, conflict resolution, and intergenerational relationships—and this is often seen as a mutually beneficial arrangement, even if it does not always serve women’s best interests. I also recognize that this mindset may not translate directly between cultures.

The language of empowerment can sometimes resemble ‘black or white’ thinking. You might want to empower someone who is being victimized, manipulated, or taken advantage of, but I don’t believe that’s how East Africans perceive the situation. The question is whether I am a victim or not. In Ethiopia, being a mother can be the greatest leverage for influencing discourse. Empowerment comes into play when women assert that they want to make their own decisions and access the same opportunities as others. Ethiopian women are increasingly recognizing that access should be based on their own merits, not on their husbands.

What did you enjoy most about your work?

Grounds for Health tackles a practical problem with an already available solution. All it takes is vinegar and a skilled healthcare provider to screen women for lesions. Yet globally, hundreds of thousands of women die from cervical cancer each year. That it often happens in coffee-growing countries is heartbreaking. However, I find it meaningful and personal to make a difference for around 30,000 women annually in collaboration with our team and partners. I dislike failing to address a problem when I know how to solve it.

I also view coffee as an experience that brings people together. That’s what I hope we continue to celebrate and enjoy. While I don’t mind having my morning coffee alone, whether in Scandinavia or East Africa, there’s a moment when coffee becomes a purely social experience. Not every commodity can create that connection. For me, coffee ties it all together.