Tackling a cinderella issue – lethal indoor pollution
In this guest post, Oxfam’s Ian Bray (left) looks at the latest developments in getting clean cookstoves to the world’s poor (and saving two million lives a year)
The recent massive electricity blackout across India received a great deal of media interest and comment. The coverage, with the exception of the ever excellent Onion, masked a deeper problem that for too long has been a Cinderella in the list of issues the aid world tries to address.
In India 500,000 people die each year because they don’t have access to modern energy sources. Globally nearly 2 million people, primarily women and children, die each year due to high levels of smoke in their homes from burning wood, animal dung or crop waste. It is a death toll greater than that of malaria. Yet while a great deal of effort has gone into tackling malaria, relatively little has been done on combating this ‘killer in the kitchen’.
One reason why this problem has not been so high on the development community’s agenda is a lack of knowledge about the crisis. So a quick romp through the issues:
Some 2.7 billion people, 39 percent of humanity, are reliant on biomass (wood, dung, crop waste etc) for cooking. Levels of smoke in the home from these fires are many times higher than safe recommendations. The smoke is a noxious mix of “carbon monoxide, particles, hydrocarbons, and nitrogen oxides.” It also “contains many organic compounds considered to be toxic or carcinogenic, such as formaldehyde, benzene, and polyaromatic hydrocarbons.”
The resultant health problems include acute lower respiratory infections, chronic obstructive pulmonary disease, lung cancer, pulmonary tuberculosis, low birth weight, cataracts, and asthma. In the countries with high mortality rates it constitutes the fourth greatest risk of death, disease and injury.
The burden falls heavily on women. They are not only exposed to massive levels of pollution in the home, but also have to walk miles carrying firewood. In many places this exposes them to the risk of violence.
Indoor air pollution is a problem caused by poverty. As people become wealthier they tend to cook on cleaner fuels such as kerosene, gas and electricity. The challenge is to find “ways to make people healthy before they become wealthy.”
Another reason why so little had been done is that there has not been sufficient scientific evidence to convince policy makers of the extent of the link between indoor air pollution and ill health. After a great deal of work that link is now generally accepted. Finally there is also little scientific evidence that relatively affordable technologies can reduce levels of smoke in the home that in turn leads to lower health risks. Last year the results of a study in Guatemala showed that simple chimney stoves could significantly reduce severe pneumonia in children.
And while the Guatemala study was in progress enter someone to take Cinderella to the ball: Hillary Clinton. In September 2010 she announced $50m seed money to the Global Alliance for Clean Cookstoves. The Alliance, which is a public-private partnership, has an ambitious target of introducing 100 million clean cookstoves by 2020. Indoor air pollution is now on the agenda, not all that high up, but there, nonetheless.
The technological solutions to the problem appear fairly straightforward and include using cleaner stoves, having chimneys or hoods to get the smoke out of the home and affordable cleaner fuels.
If only problems driven by poverty could be sorted by simple technology. Alas, it is never that simple.
The results of a recent seven year study in India showed that clean cookstoves that performed well in the laboratory performed badly in ‘real world’ settings. After an initial positive take-up, usage dropped off significantly and there was no effect on family health. The results were a blow to the Alliance but to its credit it took the findings on board, publicly at least.
Besides getting the technology right the main challenge is to have solutions that are affordable, last long enough without breaking down, are easily maintained, and most important of all, desirable to the user. A tall order.
The next big hurdle is ‘going to scale’. With nearly 40 per cent of humanity requiring clean healthy ways of cooking that means a lot of stoves, and stoves that a suitable for each different setting. Can it be done?
China has been successful in introducing 175 million improved stoves and follow-up studies showed some 70 per cent were frequently in use. There have been some notable successful attempts in Sri Lanka and Kenya, but in general improved stoves programmes have not been all that successful. Learning the lessons from these relatively successful programmes will be key.
But ‘going to scale’ will not be easy. There are precious few examples of ‘going to scale’ in the development community. Micro-finance is one example, offering cash instead of in-kind aid may become another. But I can think of few others (do please suggest some).
Clearly there does need to be better evidence of what works, but the relatively poor performance of some improved cook stove programmes should not be used as an excuse for inaction. In the developed world it has taken many decades of massive public information campaigns to reduce cigarette smoking. The initial results of those campaigns were not encouraging. However governments stuck with it and found successful ways to reduce cigarette smoking. It will need similar level of commitments from governments to tackle indoor air pollution.
But who is going to push them in this direction? The Alliance may act as a catalyst for greater action and they have the ear of arguably the most powerful woman in the world.
But what of the members of the wider development community? I have always found it puzzling that many development agencies that are so genuinely committed to improving the position of women living in poverty have been so silent on this issue.
And here’s a TED talk on cookstoves