Rwanda, "the land of a thousand hills," is also the land of 10 million people, making it the most densely populated country in Africa. In issue 22 of ESCP's FOCUS series, author Irene Kitzantides describes the SPREAD Project's integration of agribusiness development with community health care and education, including family planning. She outlines the project's successes and challenges in its efforts to simultaneously improve both the lives and livelihoods of coffee farmers and their families.