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Household energy for life
For this target to become a reality, 1.7 billion people will need to gain access to liquefied petroleum gas, biogas, and other modern fuels – as indicated by the arrows in Figure 1 (Source: WHO, 2006). The challenge is enormous: Every day between now and 2015, access to cleaner fuels will need to be extended to 485000 people. And, reaching the target would still leave 1.5 billion people cooking with solid fuels and exposed to harmful pollutants in ten years’ time. These numbers illustrate the urgent need for action to address this neglected public health and development issue. Data for 2015 are based on:
As described by Nathan Johnson and Mark Bryden, burns and scalds resulting from use of open fires or unsafe stoves represent another important threat to health, resulting in deaths and life-long disfigurement and handicap. Hospital records, however, do not habitually report the underlying causes of such injuries, and there is an urgent need to document the links between household energy use and burns and scalds. Finally, there is an increasing recognition of the special risks associated with fuel collection in circumstances of social instability. Cheryl O’Brien’s interviews with women living in the Kebrebeyah refugee camp in Ethiopia provide sad testimony of girls and women being assaulted when they leave the relative safety of their homes, but her article also highlights that solutions are being put into practice with success. In his update on the health and climate impacts of household solid fuels, Kirk Smith implies that although somewhat fewer childhood pneumonia deaths than previously thought may be due to indoor air pollution, our growing knowledge about links between indoor air pollution and other health outcomes that affect very large numbers of the world’s poor, such as tuberculosis, cataract and low birth weight, means that the overall estimates of the burden of ill health can be expected to remain very substantial. Overall, this issue of Boiling Point is a source of optimism for all those concerned about household energy and health, as it illustrates the variety of approaches available to reduce indoor air pollution. In the short term, outdoor cooking and improved ventilation may represent no-cost or low-cost alternatives to traditional practices, at least until technical interventions become available and affordable. Brendon Barnes and colleagues demonstrate that outdoor cooking is associated with substantially lower carbon monoxide exposures among South African children than indoor cooking. Burning charcoal in a test kitchen, Dean Still and Nordica MacCarty are able to show that better ventilation, in particular opening the door or a small hole in the roof, lead to reduced concentrations of both carbon monoxide and fine particles. In the longer term, improvements to stoves and switching to cleaner fuels will lead to the most substantial reductions in pollution levels. Besides a switch from biomass fuels to kerosene or liquefied petroleum gas (Figure 2), other modern renewable energy products may represent options that are both healthy and environmentally friendly. Darwin O’Ryan Curtis answers the most frequently asked questions about solar cooking and concludes from project evaluations that many of the barriers to the cultural acceptance of solar cooking can be overcome. Joe Obueh describes how a pilot study will introduce the CleanCook methanol stove among households in the Delta State of Nigeria, where absolute energy poverty is widespread despite the oil and gas wealth of the country and this State in particular.
Past and ongoing household energy and health initiatives provide a wealth of important insights. Yet, at least two major constraints need to be overcome for their more widespread implementation.First, most interventions have been implemented locally and, while several market-based approaches to take such interventions to scale are underway, as exemplified by Laura Spautz and colleagues in China, we currently lack the experience of welldocumented successful programmes. Making sure that the poorer and more vulnerable households and communities are not left behind will be critical. Second, the lack of a thorough evaluation of intervention impacts on indoor air pollution levels, health outcomes, the socioeconomic situation of the household and the environment remains a barrier to their acceptance among policy-makers as a means to improve health and stimulate development. The article by Klas Heising and colleagues about the Ayamachay community in Northern Peru is very encouraging. Following the introduction of the rocket type Inkawasi stove, an evaluation by trained health professionals reported substantial reductions in respiratory symptoms and illness among young adults living in homes using the improved stove. These results, as well as those of other past and ongoing work, will feed into a systematic review of the impacts of household energy and health intervention projects and programmes being conducted by WHO and the University of Liverpool. In view of the dramatic gap between the additional MDG target and 2015 projections of patterns of energy use by the poor (see front cover), what is required to accelerate the pace of change in sustainable adoption of modern household energy practices? Critical ingredients will be a substantial increase in awareness of the problem at international, national and local levels, inter-sectoral policies that bring together health and development efforts, and – last but not least – funding support from governments, donors and the private sector. With the new World Bank investment framework for clean energy and development and the European Union Energy facility’s call for proposals, funding sources that place emphasis on access to modern cooking energy are finally becoming available. Health is a winning argument and we should use it to make the case for scaling up household energy interventions. In particular, health system staff should be made more aware of the health consequences of IAP and energy use, and translate this actively into practice through – for example – advice given in clinical settings and in community health activities. Also at the local level, social marketing can utilise, among other arguments, the concerns about children’s and women’s health as a motivation for adoption. At the national level, better energy for better health may be an important entry point for introducing access to modern cooking fuels and improved stoves into Poverty Reduction Strategy Papers or National Sustainable Development Plans. Moreover, it should be highlighted that modern household energy practices do not only contribute to reducing child mortality and improving women’s health but are also essential for tackling poverty and achieving the Millennium Development Goals overall. Finally, as exemplified by the joint WHO/GTZ/Practical Action/PCIA/ USEPA side-event at the 14th session of the UN Commission on Sustainable Development (see full article in this edition, and also: http://www.who.int/ indoorair/policy/hhhcsd14/en/index. html), evidence on the health impacts of household energy and the potential benefits of interventions is making an increasingly effective contribution to raising the international profile of this issue. [top] [end]ReferenceWorld Health Organization. Fuel for life: household energy and health. Geneva: World Health Organization, 2006.[top] [end]Download the original article Theme editorial: Household energy for life by Eva Rehfuess and Nigel Bruce (254 KB)[top] [end]Contents: Boiling Point 52 - Health, safety and household energy
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Page created:
22 June 2007; Last edited:
26 June 2007; Version: 3 | ||||||||||||
Pagename: HouseholdEnergyForLife @HEDON: NBFA | ||||||||||||
