Notes from the Field: Measuring the Health Impacts of Clean Cookstoves in Honduras

Honduras clean cookstove study

by Sebastian Africano, International Director

I first met Maggie Clark, an environmental epidemiologist at Colorado State University (CSU) , back in 2005 in Tegucigalpa, Honduras, when she came to test the health of women exposed to wood smoke from cooking over open fires. Since then, we have both worked continually on improving conditions in Central American kitchens via clean cookstoves designed and built by Trees, Water & People (TWP) and partners.

clean cookstove study
Meeting with community members is an important first step in initializing a new clean cookstove study.

Last week I had the great pleasure of joining forces with Dr. Maggie again in Honduras, as we launch an ambitious, comprehensive study to show the benefits of improved cookstoves on the health of rural women and their families in the mountainous western region of the country. While most studies of this kind are short term snapshots of the benefits that come from improving cookstove technology, this study proposes following over 400 women over three years as they transition from traditional open fire cooking to improved cookstoves.

Trees, Water & People began working with cookstoves in 1998 as an effort to reduce deforestation and carbon emissions, and together with Aprovecho Research Center designed a culturally appropriate cookstove that reduced firewood consumption in any given household by an average of 50%. What we later learned, is that the smoke that families (mostly women and children) are exposed to daily during cooking is responsible for up to 4 million deaths a year globally, and leads to chronic lifelong health complications for millions more.

We are certain that improved cookstoves improve conditions in households where firewood is used to cook daily. What CSU and TWP seek to show, however, is that many factors play into a family’s decision to adopt, fully utilize and benefit from a cookstove over time, and that the presence or absence of certain factors influence the degree to which health improves. By using data generated by this study to optimize what technologies we introduce and how we implement them, we seek to improve the impacts of our work and inform the work of the countless other organizations working to improve life in firewood-dependent communities.

It’s an honor to be working with my friend Dr. Maggie Clark and CSU on such a groundbreaking study, and its great to see the dedication and resilience of the cookstove community as we work to improve living conditions in some of the most challenging environments in the world.

Indoor Air Pollution: The Silent Killer in the Kitchen

Indoor Air Pollution

Indoor air pollution is often referred to as “the killer in the kitchen.” The World Health Organization (WHO) estimates that 4.3 million people, mostly women and children, die each year from the effects of this pollution, and millions more are chronically sickened. This toxic pollution is caused by billions of people cooking their meals indoors, over open fires.

Worldwide, more than 3 billion people still rely on biomass fuels (wood, dung, and agricultural wastes) for their daily cooking and energy needs. Cooking with wood over an open fire fills kitchens with smoke; smoke that contains dangerous levels of particulates and carbon monoxide. This heavy exposure has been likened to smoking five packs of cigarettes a day. Breathing the toxic smoke from open cooking fires can lead to acute respiratory illness, pneumonia, cancer and chronic obstructive pulmonary disease. Women and children are most seriously affected, as they are the family members who spend the most time in the kitchen.

To address this problem, we build clean cookstoves that are designed to use far less wood and emit up to 80% less IAP than a traditional open fire. Our cookstoves are designed to be built locally, using local materials and labor. This approach reduces deadly smoke in the home while also stimulating local economies.

clean cookstove Guatemala
International Director Sebastian Africano (right) visits with a family who has a clean cookstove built into their kitchen.

Conservation can, and should, create a bright future for all. Join us in our effort to reduce toxins and pollution in the kitchen. Visit our website to learn more about our clean cookstoves and how you can become a supporter of this important program!

Community Voices: Juana Mancia Alvarado

clean cookstove El Salvador

Juana Mancia Alvarado lives in the town of Rio Abajo, El Salvador and makes her living by selling homemade tortillas. Over the years, her health has been negatively impacted from breathing the toxic smoke and fumes emitted from her traditional cookstove. And, Juana is not alone. More than 2 million people in El Salvador, and 3 billion people worldwide, are impacted by indoor air pollution, the majority of which are women and children.

When families do not have access to electricity, they are forced to cook their meals with wood. This causes many human health problems, as well as deforestation throughout the country.

Trees, Water & People (TWP) and our partners address this problem by building clean cookstoves for families and small business owners like Juana. Each of our cookstoves decrease a families’ need for firewood by 50-70%, as compared to standard open fire cooking. When vented to the outside of the home, these improved cookstoves also decrease indoor air pollution, which is responsible for the death of 4.3 million people globally every year (World Health Organization, 2014).

Our partners at Arboles y Agua para el Pueblo built a Justa clean cookstove inside Juana’s kitchen, which now removes nearly all that toxic smoke from the home. She says “now, I never get sick!” In addition, she has greatly reduced her fuelwood expenses, allowing her to save more of her hard earned money.

To learn more about our Clean Cookstove Program and to make a contribution please visit our website.

Photo of the Week: Creating Jobs with Clean Cookstoves

Nicaragua cookstove factory

About this photo

TWP’s Clean Cookstove Program is unique because we build all of our stoves in-country, using locally sourced materials and creating much needed jobs. Our local staff are proud to be building products that will create healthier homes and a better environment for their country.

(Pictured: Staff from our clean cookstove factory in Nicaragua.)

Photo of the Week: Partnership Brings Clean Cookstoves to Families in Central America

clean cookstove El Salvador

About this photo

Our partnership with the Energy and Climate Partnership of the Americas (ECPA) is helping thousands of families in El Salvador, Nicaragua and Honduras gain access to clean cookstoves, which replace dangerous and polluting open fire stoves. Since becoming an implementing partner with ECPA on the “Improving Access to Clean Energy in Latin America” project, 1,350 cookstoves have been built.  Often times, families will decorate the stoves with tile, turning them into a beautiful centerpiece within the kitchen.

Learn more about our work with ECPA at our website!

Photo of the Week: Clean Cookstoves Save Children’s Lives

clean cookstove Guatemala

About this photo

Sebastian Africano, TWP’s International Director, took this picture during a recent visit to Nuevo Todos Santos near Escuintla, Guatemala. This young boy is standing in front of his families Emelda clean cookstove, installed by TWP and our partner organization, La AsociaciĂłn de ForesterĂ­a Comunitaria de Guatemala Ut’z Che’.

In Guatemala, more than 71% of the nation’s 14.7 million people are dependent on wood to cook every meal. Cooking over an open fire causes a wide array of human health issues, affecting women and children the most. In fact, it is estimated that 4 million people die every year from exposure to smoke in the home. TWP’s clean cookstoves reduce deadly indoor air pollution by up to 80% and reduce fuelwood consumption by up to 70%.

Learn more at

Photo of the Week: TWP and Ut’z Che’ Build Cookstoves in Guatemala

clean cookstove Guatemala
TWP and AsociaciĂłn de ForesterĂ­a Comunitaria de Guatemala Ut’z Che’ build clean cookstoves in rural, indigenous communities of Guatemala. Each cookstove greatly reduces deadly indoor air pollution and uses up to 70% less fuelwood than a traditional open fire. Because cooking shouldn’t kill!

New Study: Household air pollution from cooking kills 4 million people annually

indoor air pollution

According to new global burden of disease estimates published in The Lancet, household air pollution (HAP) from cooking with solid fuels, such as wood, dung, coal, and charcoal, kills 4 million people annually. These findings double the previous known mortality rates of HAP from 2 million (WHO 2009) to 4 million deaths worldwide.

Everyday, approximately 3 billion people around the world depend on solid fuels for cooking meals and heating homes. Cooking over an open fire fills kitchens with smoke that contains dangerous levels of particulates and carbon monoxide. This heavy exposure has been likened to smoking five packs of cigarettes a day. Breathing the toxic smoke from open cooking fires can lead to acute respiratory illness, pneumonia, and chronic obstructive pulmonary disease.

The Global Burden of Disease 2010 study represents the work of 486 co-authors from 50 countries, an effort led by the University of Washington’s Institute for Health Metrics and Evaluation and funded by the Bill and Melinda Gates Foundation.

The Gloabl Alliance for Clean Cookstoves (GACC) is a public-private partnership led by the United Nations Foundation to save lives, improve livelihoods, empower women, and protect the environment by creating a thriving global market for clean and efficient household cooking solutions.

“This shocking doubling of previous estimates of HAP-related mortality necessitates a redoubling of Alliance efforts to ensure that cooking a meal is a life-enriching, and not life-taking, activity for all people,” said Alliance Executive Director Radha Muthiah.

Trees, Water & People (TWP) has worked with GACC as an implementing organization since 2010, when the Alliance was created. In the past 15 years, TWP has built more than 50,000 clean cookstoves throughout Central America and Haiti in an effort to address the environmental, economic, and human health issues caused by open-fire cooking and HAP.

More information about the new global burden of disease study please visit the GACC website.

Photo of the Week: Clean Cookstoves Save Lives

Three billion people around the world still cook every meal over an open, smoky fire. This leads to two million deaths every year, mostly among women and children. Clean cookstoves replace open fires, greatly reducing indoor air pollution and deforestation in developing countries. Cooking shouldn’t kill! (Photo: A mother and her child with their new Justa clean cookstove in Honduras.)



From El Salvador, with Love

We recently received this beautiful letter from Sara Gale, a Peace Corps Volunteer (PCV) in the rural village of Rio Abajo, El Salvador, who we trained to build clean cookstoves as part of our partnership with the Peace Corps and the Energy and Climate Partnership of the Americas. This letter is a reminder of how important our work is to families who live each day in a state of energy poverty, with no access to basic energy. We are honored to work with Sara and all the other PCVs who are dedicating years of their life in service to others. Thank you, Sara!

Dear Trees, Water & People,

On behalf of my community in rural El Salvador I want to thank you all for your amazing and generous work. We enjoyed having Sebastian, Elliot, and Ken visit in August. I believe that they saw how in love the families are with their Estufas Justas! The work that you guys do to design, monitor and re-design is so valuable to so many people of the world. Although I see the stove as perfect now, I’m certain with your help it will be even closer to perfection in the years to come. Thank you for making this work your life passion; it was obvious by the enthusiasm, expertise and experience of Sebastian in improved cookstoves that my community of Río Abajo is in great hands with Trees, Water & People. Although my end of service is in March of the coming year I hope to extend in my site a year longer to be able to monitor the 41 stoves in my project and hopefully build 60 more in a second phase in the coming months. We are currently working on getting replacement planchas up in the community, as that thickness of sheet metal isn’t sold anywhere near here. I’m looking forward to continuing my work here for an extra year and to seeing how each household continues to care for and appreciate their Estufa Justa.

¡Gracias de Corazon!

Sara Gale y Los Miembros de RĂ­o Abajo