Wood smoke kills 1-1/2 to 2 million people annually according to the World Health Organization. Cooking is the fifth biggest killer in developing countries. (1)
Clean air, according to the EPA, contains less than fifteen micrograms of fine particles per cubic meter. Five times that amount will set off a smoke alarm. Three hundred times as much—roughly what an open fire produces—will slowly kill you. Wood smoke, as sweet as it smells, is a caustic swirl of chemical agents, including benzene, butadiene, styrene, formaldehyde, dioxin, methylene chloride, and hydrogen cyanide. (2)
Some three billion people prepare meals at rudimentary stoves that burn wood, dried dung or coal that produce choking smoke or lack proper ventilation. Because cooking chores most often fall to women, and children are typically at hand, they are the primary victims of smoke-related respiratory illnesses such as pneumonia, lung cancer and chronic obstructive pulmonary disease. Having an open fire in your kitchen is like burning 400 cigarettes and hour in your kitchen says Kirk Smith, a professor of global environmental health at UC Berkeley. (1)
Betting that new stoves offer a promise of better health and lower carbon emissions, the US government has committed millions of dollars to the Global Alliance of Clean Cookstoves, which aims to induce 100 million homes to adopt better stoves by 2020. (3)
A program in Guatemala supports this effort. This trial gave poor households special chimney stoves. Field workers inspected the stoves weekly for proper use and ordered repairs as needed. Under these circumstances, carbon monoxide exposure was about 50 percent lower in the randomly selected sampled that received the stove. As Edward Glaeser notes, “This study is good, important research, but how widely applicable is it? The stove's cost, over $100 is high for communities where annual incomes are below $200. And the weekly visits to ensure proper use and maintenance seem infeasible on a big scale. Yet the idea of promoting new stoves has gathered a momentum of its own.” (3)
A paper by Rema Hanna and colleagues provides some answer to the question of applicability. The researchers looked at an initiative that distributed cheaper ($12.50) stoves and skipped the weekly visits. A nongovernmental organization in Orissa, India, distributed the stoves to a randomly selected treatment group and provided training. During the first year, the stoves reduced carbon monoxide exposure, at least for the household's primary cooks.
By the third year, though, there was no relationship between receiving the stove and better air quality. Nor was there any discernible effect on recipients' health. (4)
There are a couple of reasons why the stoves had such a small impact. For one thing, people were still using their old fires to cook most of their meals. Plus, the stoves started accumulating maintenance problems that didn't get fixed, and households reported spending hours repairing the new stoves. The old technology was dirty, but it was easy to operate and didn't break, and so people stuck with that. (3)
The authors note, “This study underscores the need to test environmental and health technologies in real-world settings where behavior may temper impacts, and to test them over a long enough horizon to understand how this behavioral effect enables over time.” (4)
Another example is an earlier study from 1983. The Indian government launched a national program that distributed some thirty-five million stoves across the subcontinent. The units came in various designs from local manufacturers; most were neither sturdy nor especially efficient. Several years later, when a doctoral student from Berkeley surveyed the results, she found a single stove in use—as a bin for grain. (2)
This doesn't imply that the program of improving indoor air quality should be abandoned, but it does mean that researchers need to think about behavior as well as technology. As Glaeser notes, “Dumping stoves into the developing world isn't going to alter the long-standing advantages of traditional methods. If we want to help people in poor countries, our engineering skills alone won't be enough.” (3)
In some places people liked their stoves and maintained them well enough. But they considered the smoke from cooking more of an annoyance than a threat. In Africa, some even welcomed the smoke as a defense against flies and mosquitoes. These kinds of correlations just aren't easy to make. “Stories like these were a source of endless frustration to stove makers. The trouble with tradition, is that it can be remarkably thickheaded. Ignore it, and your shiny new stove may get turned into a flowerpot. Cater to it, and you may end up with a new version of the same old problem,” reports Burkhard Bilger. (2)
Not to be deterred, the two year old Global Alliance mentioned earlier is the most concerted effort to date attempting to coordinate the world's many clean-strove projects, from arranging financing sources to establishing quality-control standards. The Alliance enjoys growing support partly because of the potential benefits of cleaner cooking.
Toilets
Robert Desowitz provides another example, this one with toilets. Health advisers from a western nation decided to use their government's aid funds for a pilot project that would provide simple water-seal toilets to a selected village in Somalia. In due course, several hundred of the cast concrete devices were placed over soak-away pits that had been laboriously dug to the prescribed dimensions. (5)
The advisers then returned to their office in the capital, satisfied that they had propelled these people onto the road to modern sanitation and did not return until a year later. To their surprise they found the toilets to be horrible messes. Each one was stuffed with a pile of stones and made useless.
When they asked why anyone would dump stones into a toilet, their respondent was surprised. They were told that Somalis distract themselves when defecating by clicking two stones together and when finished they drop the stones into the most convenient receptacle, in the case of the new toilets, the water toilet seat. (5)
These examples reveal some of the problems that can arise when countries in the first world try to help countries in transition areas. The western desire to 'fix' certain things often falls on deaf ears or comes up against unforeseen obstacles. Without a true understanding of the culture of the people being 'helped' and trying to provide help from afar, things can go awry.
References
- Ingfei Chen, Open-fire stoves kill millions: how do we fix it?”, Smithsonian, December 2012
- Burkhard Bilger, “Hearth Surgery,” in The Best Technology Writing 2010, Julian Dibbell, Editor, (Yale University Press, 2010) 137
- Edward L. Glaeser, “Dreams up in smoke,” New York Times, April 21-22, 2012
- Rema Hanna et al., “Up in smoke: the influence of household behavior on the long-run impact of improved cooking stoves,” NBER Bulletin on Aging, Working Paper No. 18033, May 2012
- Robert S. Desowitz, New Guinea Tapeworms and Jewish Grandmothers: Tales of Parasites and People, (New York, W. W. Norton & Co., 1987) 187
