Teaming up to Study Health Impacts of Clean Cookstoves in Honduras

Bonnie Young

by Bonnie Young, Ph.D., MPH
Postdoctoral Research Fellow
Department of Environmental and Radiological Health Sciences
Colorado State University, Fort Collins, CO

Remember that parable about the boy and the starfish? It went something like this — a boy walked along the beach, picking up starfish and throwing them back into the ocean. A recent storm had passed, and the shore was covered with thousands of them. A man stopped and asked the boy what he was doing, pointing out that he couldn’t possibly help all the starfish. The boy bent down, picked up another one, threw it into the ocean, turned to the man and replied with a smile, “It made a difference to that one.”

Our research in environmental health can feel daunting. Around 2.8 billion people, almost a third of the world’s population, use solid fuel to meet their household energy needs, like cooking and heating (Bonjour et al., 2013). Using inefficient stoves to burn solid fuel — like wood, animal dung, and coal — creates toxic pollution. Imagine hovering over the thick plume of smoke from a campfire for hours a day. Now imagine doing that indoors for the majority of your life. The health impacts from breathing solid fuel smoke are many, such as lung cancer, pneumonia, poor pregnancy outcomes, and cardiovascular effects (Quansah et al., 2017). It is estimated that in 2015, 2.9 million people died prematurely due to their exposure to solid fuel smoke, mostly from cooking (Forouzanfar et al. 2016). In addition to the negative impacts on human health, these inefficient stoves create hazardous pollution for the environment and use resources, such as trees, for fuel.

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Clean cookstoves, like this one, reduce deadly indoor air pollution, which accounts for an estimated 2.9 million premature deaths per year. Photo by Joanna B Pinneo

With a problem this vast, it can be hard to imagine that one project among 230 women in rural Honduras would make a difference.

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The Colorado State University research team use health indicators, like lower blood pressure, to determine health impacts before and after a family receives a clean cookstove. Photo by Joanna B Pinneo

But we are making good on a promise that was made in 2014 to these women and their community leaders — to select a group of families to receive an improved Justa (pronounced ‘who-sta’) stove and visit them every six months for a few years to see how their pollution levels and health change after receiving a Justa clean cookstove. The Justa is a well-accepted, culturally appropriate stove, which was originally designed by Trees, Water & People, and is now made locally in Honduras. If you ask the women in our study, who had cooked their entire lives on traditional stoves and then received their Justa stove in 2016 or 2017, you’ll hear heartfelt stories of less smoke, less coughing, and cleaner air for the entire family.

Of course, it will be ideal at the end of the study if we see improvements in women’s health, like lower blood pressure, plus reductions in household air pollution and use of less wood-fuel.

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Blood tests, like the sample being collected here, are another indicator of health before and after a clean cookstove is installed. Photo by Joanna B Pinneo

Changes like these can have larger public health impacts and potentially lead to stove interventions among entire communities. However, regardless of the bigger picture from this study, I know that the 230 houses that were involved with this intervention are now cooking on cleaner and more efficient stoves, with less smoke inhaled by the entire family, and I feel confident that we have made a difference for those “ones.”

Trees, Water & People and our partner organization,  Utz Che’, are working to build 500 clean cookstoves this year in Guatemala. If you would like to help fund a stove for a family or would like to learn more about the importance of this project, click the button below.

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References:
Bonjour S., Adair-Rohani H., et al., 2013. Solid fuel use for household cooking: country and regional estimates for 1980-2010. Environm. Health Perspec. 121, 784-790.
Forouzanfar M., Afshin A., et al., 2016. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the global burden of disease study 2015. Lancet 388, 1659-1724.
Quansah R., Semple S., et al., 2017. Effectiveness of interventions to reduce household air pollution and/or improve health in homes using solid fuel in low-and-middle income countries: A systematic review and meta-analysis. Environment International 103, 73-90.

The Principal Investigator of this project is Maggie L. Clark, Ph.D., along with Co-Investigator Jennifer L. Peel, Ph.D., MPH. This research is funded by an NIH K99/R00 grant (PI M.Clark).

Bonnie joined the CSU Honduras cookstove team in September 2014 after finishing a 2-year epidemiology fellowship in Hawaii. She earned her Ph.D. in evolutionary anthropology and M.P.H. from the University of New Mexico. As an Anthropologist interested in global health, Bonnie has worked with urban and rural communities around the world, including Mexico, Costa Rica, Paraguay, the Marshall Islands, and the Federated States of Micronesia. Her research interests span environmental health, tuberculosis, and perinatal health. Now as a Postdoc with the cookstove team, Bonnie enjoys the fieldwork in Honduras, working with community leaders, eating corn tortillas, tutoring neighbor kids in English, and doing yoga in her free time.

Community Voices: Marta Alicia Orellana

Sra Marta Orellana en la construcción de la obra gris ó caja receptora de su Letrina Abonera
Ms. Orellana stands next to her unfinished composting latrine in the town of El Porvenir.

Several years ago, Marta Alicia Orellana of El Porvenir, El Salvador had invested in building a formal latrine at her home, but due to a lack of finances it was never finished.  As the base and the walls deteriorated, she found herself using shower curtains around the latrine for privacy, but risked “exposing her physical and moral integrity” daily due to the poor state of her family’s bathroom.

When Trees, Water & People and the Mayor’s office of El Porvenir announced another round of latrine donations, she quickly put her name on the list. She now says she feels more secure having reduced risk of contamination for her family and for those who visit her home, and shows off her new latrine proudly.

Sra. Marta Orellana beneficiaria de Letrina Abonera
Marta stands proud next to her finished dry composting latrine.

How does a dry composting latrine work?

doublevaultcompostinglatrineThe dry compost latrines consist of two chambers made of concrete cinder blocks with a toilet seat, including urine diverter, placed over each of the chambers.  After each use, stove ash, compost, and/or sawdust is added inside the chamber to reduce odors and keep the chamber dry. It also includes a vent to allow fresh air to circulate and further dry the solid matter.  After one chamber is filled it is left to dry during six to eight month periods while the second chamber is in use. The contents of the first chamber are then transformed into a rich fertilizer that can be used on surrounding crops or trees after a drying period under the sun and mixed with a 1:1 ratio of earth.  One dry composting latrine can serve families of more than six people for over 10 years with proper maintenance.

This region is tropical and volcanic, with regular seismic activity, episodes of torrential rains, and a high water table. During big rain events, the ground gets completely saturated, flooding traditional pit latrines, which then leach excrement and pathogens onto open land, into agricultural fields, and into drinking water supplies. Replacing these common pit latrines with composting latrines means cleaner groundwater and a more hygienic conditions in the home, leading to a lower disease burden in these communities.

New Report: The Health Consequences of El Niño in Central America

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Rural, poor farmers in Central America are often hit hardest by El Niño events.

by Lucas Wolf, Assistant International Director

A new report released by the World Health Organization (WHO) calls attention to the devastating effects of El Niño in Guatemala, Nicaragua, Honduras, and El Salvador. El Niño refers to the “large-scale ocean-atmosphere climate interaction linked to a periodic warming in sea surface temperatures across the central and east-central Equatorial Pacific (NOAA, 2016).”

El Niño Wreaks Havoc on Central America

The presence of El Niño has caused prolonged drought in Central America that is expected to last through at least March of 2016. Crop failure, especially in the “dry corridors” of Guatemala, Nicaragua, Honduras and El Salvador, has already affected 4.2 million people in the sub-region.

As with many climate-related events, the poorest households are most affected. Food insecurity and malnutrition are the biggest challenges facing these countries and are expected to last through the next harvest in August 2016. Guatemala and Honduras have gone as far as to declare a state of emergency. The governments of Nicaragua, Honduras and El Salvador are providing support to farmers by distributing seeds and water pumps.

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Source: World Health Organization (WHO), 2016

Most farmers in the region, particularly subsistence or small-scale campesino (rural farmer) operations, rely predominantly on natural rainfall for their crops, and these recent weather patterns, caused by El Niño and increasing climate volatility, have exacerbated food insecurity and overall instability in the rural areas of Central America. We are not even halfway through the summer season here, with full bore temperatures (and corresponding dryness) reaching its peak in the months of March and April.

Eco-Friendly Agriculture in a Changing Climate

One of the key takeaways from the campesinos that I work with and visited on my last regional tour in October is that increased variability creates significant uncertainty around the arrival of the first rains in May. Many farmers are unsure about when, what, and how much they should plant for the season. These conversations played over and over again as I traveled from El Salvador to Guatemala, and then from Honduras back to Nicaragua.

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A farmer in Honduras takes us on a tour of his small tree nursery, where he grows a variety of species.

According to Gerardo Santos, a field coordinator for Centro Educativo de Agricultura Sostenible (CEASO), “These fluctuations and changing climate dynamics are wreaking havoc in the most vulnerable areas and increasingly encroaching upon the majority of the country. Without the stability and predictability of the rains, campesinos are really in a difficult spot; they are in a struggle for survival.” 

To assist these farmers, Trees, Water & People supports programs in sustainable agriculture, like those of our newest partner, CEASO in Honduras. A shifting paradigm in agriculture emphasizes climate mitigation and adaptation strategies like better soil management, conservation, rainwater harvesting, enhanced water storage capacity, agroforestry, crop diversification, and better and more resistant local seeds.

We believe that a more diverse, holistic approach to farming will protect campesino families in the long run, ensuring rural communities have access to food and other natural resources in a rapidly changing climate.

To read the full WHO report please click here.

Eco-stove Study in Nicaragua

Here’s a report with lots of great pictures (for those who don’t speak Spanish) of several Nicaraguan communities where we will be doing the multi-year health study on how the Eco-stoves benefit local women. Partnering with us on this project are Colorado State University, PROLENA, and Casa de Mujer, a Nicaraguan NGO based in Granada.

Stuart