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Indoor air pollution: key questions answered

Smoke - frequently asked questions

Why is Practical Action highlighting this problem?

Smoke in the home from cooking on solid fuel - wood, dung, crop waste and coal - kills 2 million people every year. That is a life lost every 20 seconds. Smoke in the home is responsible for more deaths than malaria. It is one of the world's greatest child killers, killing nearly one million children annually.

Its victims are predominately women and children who die primarily of pneumonia and chronic bronchitis. Women spend three to seven hours a day by the fire. They are exposed to levels of smoke more than 100 times above accepted safety levels.

Smoke in the home is the fourth greatest risk to death and disease in the world's poorest countries according to the World Health Organisation. The other major risks are: being underweight, unsafe sex and unsafe water and sanitation.

How does smoke affect people's health?

Because women spend so much time near the fire when cooking they are at acute risk. Women who cook on fires using wood, dung or crop waste are up to four times more likely to suffer from chronic obstructive pulmonary disease, such as chronic bronchitis.

There is also some evidence that smoke in the home is responsible for diseases such as asthma, tuberculosis, low birth weight and infant mortality and temporary blindness.

High levels of smoke cause children to suffer from acute lower respiratory illnesses, such as pneumonia. A child is two to three times more likely to catch this infection if exposed to smoke in the home.

Young children are particularly at risk because under the age of five they spend most of their time with their mothers. Children's airways are small, therefore more susceptible to inflammation. Their lungs are not fully developed until they are teenagers, so they breathe faster. Also, their immune systems are not fully developed. These facts mean that children absorb pollutants more readily than adults and also retain them in their system for longer.

How bad is the smoke inside a home?

Smoke levels can reach 100 times the internationally agreed levels. Women, sometimes with small children next to them, spend many hours a day next to the fire breathing in these high levels of smoke. The UN estimates that the impact of smoke from these fires is the equivalent of smoking two packs of cigarettes a day.

What is in the smoke that causes these problems?

One of the dangers comes from the small particles that make up smoke. These small particles float in the air and get into people's airways and lungs and trigger infections or diseases. In the case of bronchitis they cause the progressive and irreversible obstruction of the airflow.

Smoke from burning wood, dung and crop waste contains significant quantities of several pollutants such as carbon monoxide, particles, hydrocarbons, and nitrogen oxides. In addition it contains many organic compounds considered to be toxic or carcinogenic, such as formaldehyde, benzene, and polyaromatic hydrocarbons.

Where is the problem worst?

It is in the world's poorest regions that smoke is a major threat. Over half of all the people cooking on wood, dung or crop waste live in China and India. However the highest proportion of people cooking on these fuels live in sub-Saharan Africa, rising to over 90 per cent in many countries.

On current trends, the number of people relying on wood, dung and crop waste for cooking and heating is set to rise by 200 million, to 2.6 billion, by 2030. The majority of the rise will be in South Asia and sub-Saharan Africa. The actual percentage of the world's population relying on wood, dung and crop waste is projected to decline, but the rate of decline will not keep up with population growth.

In parts of Central Asia where gas and electricity used to be available people are reverting to using wood as their main fuel source. In Tajikistan since 1991 the incidence of acute respiratory infection, the world's greatest child killer, has risen by 35 per cent largely as a result of burning wood indoors according to the UN.

Why do people cook on these fuels?

Poverty condemns more than a third of humanity - 2.4 billion people - to cook on wood, dung and crop waste. They cannot afford to buy cleaner fuels. In rural areas women can spend many hours a day collecting fuel, which doesn't cost any money. Poor people usually cannot afford to cook on cleaner fuels.

In the towns where firewood or charcoal is normally only available if people buy it, cleaner fuels such as paraffin or liquid petroleum gas (calor gas) can be cheaper. But in the case of gas people have to buy a gas stove and large gas bottles which puts it beyond the reach of most poor people.

Why use fires inside the home in the first place, why not simply cook outside?

For very practical reasons people usually do not cook outside. In the dry season it's too hot, in the rainy season it is too wet. When it is windy dust and dirt blows into the food. Animals can steal the food if it is being cooked outdoors.

On an open fire even a slight breeze blows the heat away from the cooking pot. This means that it takes ages to cook a meal and uses a lot more fuel, fuel that may have taken hours to collect. A breeze at mid-day in the sun's burning heat means that the food doesn't cook but the cook does.

There are also deep-seated social reasons why people don't cook outdoors. What people eat reflects their social status and people can be very sensitive about their neighbours' views of their status. Sometimes people may not want their neighbours to know what they are cooking as it may be seen as being inferior. In many cultures people do not like other people seeing what they are eating so seek the privacy of their home.

In some cultures fire can be considered sacred and must be at the heart of the home.

What can be done to reduce the levels of smoke?

The technical solution to smoke in the home seems relatively simple: either stop smoke getting into the home or remove it from the home.

The healthiest option is to cook with a cleaner fuel such as liquid petroleum gas. For the urban poor this could be an option as the cost of cleaner fuels maybe just as cheap as buying firewood. The main problem is the up front costs needed to cook on cleaner fuels. Gas comes in large bottles that poor people cannot afford to buy. There is also the cost of the gas stove. However these cost issues should not be an insurmountable problem if governments were to put in place the right support programmes.

However for the vast majority of people at risk, especially those who live in rural areas, the cleaner fuel option is not available. For them the best option is to find simple efficient ways of getting the smoke out of the home.

In Kenya Practical Action has successfully introduced a simple smoke hood that sits over the fire and directs the smoke out of the home. With good ventilation and the use of increased eaves space Practical Action has reduced smoke levels by up to 80 per cent. This has transformed conditions in the home.

There are a few well-designed fuel-efficient stoves that incorporate a chimney. These not only reduce fuel use but also remove the smoke safely from the home.

Even reducing smoke levels by 80 per cent, levels are still high?

More statistical research needs to be done to understand the health benefits on an 80 per cent reduction in smoke. We do not know precisely what the health impacts are. However the families who have the smoke hood tell us that their health is much improved.

Can the poor afford a smoke hood and how much do they cost?

In the area of Kenya where Practical Action has been working, the hoods cost about two goats, which is not cheap but is affordable. In money terms, the prototypes cost around $50 to produce but the cost has since fallen dramatically.

Poor people are quite willing to pay for a smoke hood but only if they see a tangible benefit and it is affordable.

Don't fuel efficient stoves help reduce levels of smoke?

Fuel-efficient stoves were designed to reduce the amount of fuel used, not to reduce the amount of smoke. Some fuel-efficient stoves, for example the Kenyan designed Upesi stove, do also reduce the amount of smoke. Some stoves actually increase smoke.

Where it suits the life style of the family a fuel-efficient stove and a smoke hood provides the best of both worlds - a reduction in both fuel use and levels of smoke.

Why not use solar cookers?

Solar cookers, which concentrate sunlight directly to cook food, have been hailed as the clean alternative for cooking in the developing world. They do not cost anything to run as the energy from the sun in free and plentiful, especially in the tropics.

However in many cases these cookers do not fit in with the life style of many societies in the developing world, and as a result, there has been a low take up rate.

One of the biggest problems with the cookers is that it means cooking around midday, which does not coincide with the main family mealtime. It also requires working out of doors that reduces privacy, another cultural imperative, and as many women tend to work on land away from their home at this time, leaves the food open to theft.

Solar cookers also will only cook a limited variety of foods and cannot be used for making flat bread.

In some cases solar cookers are appropriate and do provide families with clean and affordable cooking.

Will the poor be able to afford cleaner fuels?

If clean fuels were made available in smaller quantities and credit, in the form of saving clubs, micro-credit loans or subsidies, was available to poor people for the up-front costs of buying the gas stove and bottle, this would greatly increase access to a clean fuel.

In Sudan Practical Action is working with poor communities to facilitate the take up of clean fuels by using a revolving fund. This is a small loan that is constantly replenished by the members of the fund as loans are repaid.

Wouldn't the large take up of fossil fuel put a lot of people out of work who depend on selling firewood and charcoal?

Many poor people make a living collecting and selling firewood. A switch to fossil fuels will remove this vital source of income. Whatever policies governments instigate to increase the use of cleaner fuels there will need to build into them transitional support for the people who make a living out of providing firewood and charcoal.

The United Nations Development Programme's LPG challenge aims at overcoming these sort of problems and aims to improve access to the fuel where it is available in urban areas.

Why is Practical Action supporting the use of fossil fuels?

Practical Action recognises that there may be environmental concerns about swapping to cleaner fuels such as liquid petroleum gas, as it is a fossil fuel and therefore emits greenhouse gases. However liquid petroleum gas will generally produce less greenhouse gases than wood being burnt very inefficiently on a three stone fire.

However the environmental impact must be balanced with the health impact. These fuels could offer an immediate answer to indoor air pollution and save the lives of millions of people.

The issue of global warming is more to do with the over consumption of the West. Even if fossil fuel was available to an extra two billion people in the developing world the increase in greenhouse gas emissions could be easily be offset by increasing the efficiency of the world car fleet by not much more than one mile per gallon.

Is the use of fossil fuels a short-term fix which should be replaced by renewable energy in the future?

While Practical Action supports the use of renewable energies where appropriate, there are few renewable energy options that are clean and affordable. One such fuel is biogas from animal dung and other organic waste.

Biogas is being introduced in parts of Asia very successfully - there are over 120,000 bio-gasifiers in Nepal alone - but its introduction in Africa has been very limited. Further research and development of renewable, clean cooking fuels will be essential for longer term cooking options. These would additionally reduce national dependence on imported fuels.

There is also some exciting work being done around the world developing clean and environmentally friendly fuels such as gelfuel, ethanol and methanol from organic sources.

However the problem of global warming is mainly an issue of over consumption in industrialised world. Dealing with the massive over consumption in the west would have a far bigger impact on the threat of global warming than depriving the developing world of access to potentially life saving fuels.

What is being done about smoke in the home?

The international community has been slow to recognise this problem. However it is beginning to gear up to tackle it with recent launches of new initiatives such as the World Health Organisation's Healthy Environments for Children Alliance (HECA), the United States Environmental Protection Agency-led Partnership on Clean Indoor Air and the United Nations Development Programme's LPG Challenge. The World Bank Energy Sector Management Programme (ESMAP) has a significant research and development programme on indoor air pollution, particularly in India and China.

Organisations such as the Shell Foundation and a number of non-governmental organisations, including Practical Action, are working directly with poor communities to find solutions and scale up their efforts.

However, compared with action on the other main risks, there has been extremely limited funding and insufficient high-level international political backing for such initiatives.

If it is such a problem how come nothing has been done about it?

Up until now there has been very little evidence of the health impact of smoke in the home so world leaders and global organisations deemed no action necessary. However there is now ample evidence to justify widespread action. And as more and more evidence comes to light, the excuse for inaction will become more and more untenable.

What exactly is Practical Action calling for?

Practical Action is calling for the international community to back the newly formed Partnership for Clean Indoor Air with the necessary resources and political will. This partnership, which is backed by the World Health Organisation, the US Environmental Protection Agency and others, is beginning to turn round the shameful inaction on smoke in the home but needs high level political and financial support if it is to have a significant impact on this killer in the kitchen.

How could this come about?

The first step would be for the UN Secretary General to convene urgently a high level international conference to set in motion action plans with the necessary resources. This conference should agree a four-part strategy:

  • Millennium Development Goals - a specific reference on preventing and reducing child deaths from indoor air pollution in the Millennium Development Goals.
  • An international coalition - which puts the global political weight and resources into the existing Partnership for Clean Indoor Air.
  • A fundraising strategy - that establishes the funds needed to promote practical solutions.
  • National Task Forces - that bring together the key national and local actors to enable them to address the problem with international support.

How much will all this cost?

Cleaning up the air in people's homes will cost as little as $500m each year, less than one per cent of what the West spends on aid to poor countries.

The total cost of providing three billion people with access to healthy indoor air would be in the region of US$2.5 billion annually over the next 12 years. To kick-start an effective market in low cost smoke solutions, it is estimated that government spending and international development aid would be in the region of 20 per cent this total - $500m.

Who will fund the changes?

The funding could quite easily come from a very small increase in the world's aid budget.

Rich world governments have committed themselves to raising their aid budgets to 0.7 per cent of national wealth. Only the Scandinavian and Nordic countries are any where near this figure. An increase of less than one per cent increase is miniscule.

The international community has also committed itself to significantly reduce poverty and child deaths by the year 2015, the so-called Millennium Development Goals. If smoke in the home is not tackled then there will be little chance of reaching these goals.

There is a great deal the international oil companies should and can do to help get clean fuels to poor people.

Spending money to prevent pneumonia in children and bronchitis in adults makes economic sense and is very cost effective. Currently children are sent to health centres when they catch pneumonia. Dealing with the causes of these infections and diseases will save money and health workers time on dispensing the medicines such as antibiotics.

A study in three northern province of India estimated that smoke in the home in the rural areas of India costs poor people US$1.84bn per year from lost earnings and medical costs.

What should the British Government be doing about the situation?

The British Government has a vital role to play in acting as a torch-bearer: helping raise the necessary funds and mobilising its fellow Europeans and other members of the Western world to action. It has played a similar and effective role in action on malaria, debt and funding of international aid. It is already very generously supporting Practical Action in our work on reducing smoke.

Smoke - indoor air pollution

More than four million people die each year as a result of inhaling lethal smoke from kitchen stoves and fires. Most victims are women and children under five.

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