Reducing exposure to indoor smoke is key: Household air pollution fuels pneumonia
Posted by African Press International on June 28, 2012
VIENTIANE, – More than 95 percent of the Lao population use solid fuels for cooking, but the smoke produced by burning them contributes to the high number of child deaths from pneumonia, particularly among the poorest families, say health experts.
World Health Organization (WHO) statistics show that in 2010, the latest year for which there are figures, 1,777 children under the age of five died from pneumonia in Laos, but health experts believe the number could be significantly higher.
A report by WHO and the UN Development Programme (UNDP) in November 2009 noted that 1,200 of the 1,777 deaths could be directly attributed to solid fuel use.
Burning wood, crop waste, charcoal and animal dung indoors for cooking and heating results in high levels of air pollution inside the living space, where small soot particles and other pollutants are inhaled and enter the lungs of young children. WHO warns that such exposure more than doubles the risk of pneumonia for children.
Reducing this risk could be easy. “We know that when Lao people get richer the smoke issue goes down. If you look in Vientiane [the capital] – how do they cook? Out[side]… the back door. So they found a Lao solution, and it works absolutely fine, just by going outside,” said Edward Allen, a technical advisor to the Lao Institute for Renewable Energy (LIRE), a non-profit organization based in Vientiane, who also advises the government.
Allen thinks an awareness campaign to inform people about the safest places to cook, particularly targeting women because they do most of the household cooking, would reduce household pollution levels significantly.
Another prevention measure gaining attention is the development of improved cook stoves (ICS), which are designed to be more efficient by burning hotter and using less fuel, said Bastiaan Teune of SNV, a Netherlands-based development NGO.
SNV and the World Bank are working with the Lao government to set up large-scale ICS programmes in the landlocked Southeast Asia nation. A prototype stove has been developed, with initial results showing that it uses about 20 percent less fuel, Teune said. SNV plans to produce about 420,000 ICS in the next eight years.
While the ICS could potentially reduce the incidence of pneumonia cases, in the mountainous and cooler north of Laos, the poorest parts of the country, solid fuels are not only burned for cooking but also for heating.
Ensuring adequate treatment for pneumonia is available to northern communities is essential to bringing down the number of pneumonia cases. A United Nations Children’s Fund (UNICEF) report released on 8 June 2012 showed that among the poorest 20 percent of the Lao population, only 28 percent seek medical care for suspected pneumonia.
Photo: Toby Fricker/IRIN
|Just cooking outside can make a difference|
Viorica Berdaga, the chief of the health and nutrition section at UNICEF in Laos, noted that a number of obstacles prevent effective pneumonia treatment in the poorest communities, which are found mainly in the north.
A lack of knowledge about the symptoms and danger signs of the disease is common, and the use of traditional remedies is widespread.
“The second important barrier is geographical access, financial access, social access, meaning the ability to speak the same language, share the same culture,” she said. There are 49 officially recognized ethnic groups in Laos, many of whom speak their own language and live in the most remote areas of northern Laos.
The final difficulty is the availability of qualified care and the quality of services in health centres, Berdaga said.
An August 2011 health workers reach index, published by the international NGO, Save the Children, ranked Laos at 159 out of 161 countries – just above Chad and Somalia – as the worst countries for a child to fall sick in. The index took into account indicators such as health worker density and vaccination coverage.
UNICEF said in its report that the child survival gap within and between countries could be closed if proven and cost-effective interventions for pneumonia were scaled up to reach the most disadvantaged children.
According to WHO, pneumonia kills an estimated 1.4 million children under the age of five worldwide every year – more than AIDS, malaria and tuberculosis combined.