Where there’s fire, there’s smoke: How Nepal is combating house smoke inhalation
By Meghan Gollant
Cooking with gas and electricity is something developed countries take for granted, but for many people living in rural Nepal, traditional wood fires are still the only option.
According to the World Health Organisation, over 4 million people a year die globally due to illnesses caused by household air pollution from cooking with solid fuels such as wood, crops and animal dung.
The smoke that is released from burning wood contains harmful chemicals such as carbon monoxide, as well as small soot particles that penetrate deep into the lungs.
After many hours of exposure every day, year after year, these substances can cause a number of potentially fatal illnesses, including pneumonia, chronic obstructive pulmonary disease (COPD), heart disease and lung cancer.
Dr Saroj Pokhrel is a physician at the CIWEC Clinic in Pokhara, Nepal, and has experience treating patients who have respiratory illnesses caused by smoke inhalation.
“Most people are involved in cooking two times per day, lunch and dinner, so with that kind of exposure in 5 or 10 years they can easily have COPD,” Dr Pokhrel said.
“After more years, they may get lung cancer.”
The risk is more severe for women and children. Women spend the most time preparing meals, and often have to take care of the children at the same time.
“The men are working on the rice field, so there is no one to look after the children, so mothers have to carry the children with them even when they are cooking,” Dr Pokhrel said.
In the village
At midday in Tangting village, nestled in a valley at the lap of the Annapurna ranges, pillars of smoke rise from the kitchens as the women prepare dal bhat, a Nepalese staple that consists of steamed rice and cooked lentils.
Debi Gurung, 58, squats in the corner of her small kitchen, tending the flames. The tin roof ceiling is covered in black soot, and is not high enough to allow standing. Not that you would want to – smoke rises and forms a heavy cloud in the space above Debi’s head. Sitting on the floor nearby, Debi’s grandson Laleet coughs intermittently as he scoffs down his rice.
“I would like a chimney but it costs too much money to make it,” Debi Gurung said.
Karnu Gurung is Tangting village’s health clinic worker. On a wall in her clinic there is a list of the top 5 illnesses she treats. This includes upper and lower respiratory tract infections, which she says are caused by the smoke. She says people are disbelieving of new technology.
“A lot of people still think the modern stove will have less heat, and it won’t cook fast enough,” Karnu Gurung said.
“We had a chimney trial but it wasn’t successful.”
In 2011 the Unica Foundation, in partnership with Red Cross Society Nepal, installed 206 metal ovens with an attached chimney in Tangting village.
Asha Maya Gurung had one of these stoves installed, and uses it only about five times a month.
“I prefer to cook with the old woodfire, everyone can sit around the fire and it makes more heat,” she said.
“I don’t have many problem, sometimes coughing and sore throat.”
For the majority of people living in rural Nepal, burning wood is the only way to keep warm during the colder months.
“The temperature is minus 10, minus 15, in some areas, and the only way they can protect themselves from the cold is by wood fire,” Dr Pokhrel said.
“They don’t have AC or electricity.”
In some rural areas high in the Himalayas, this can mean 24/7 exposure to the harmful smoke.
Some villagers have taken matters into their own hands. Bishnu Gurung is 68 years old, and has lived in Tangting her whole life. Her husband, Parshad, has built a small chimney for their kitchen out of rocks.
“Before the chimney, I had lots of problems. After chimney, it is better, about half the smoke gets out,” Ms Bishnu Gurung said.
Her husband was concerned about her health.
“I have had lots of problems with my eyes, my lungs, but my wife has more problems, because she cooks more,” Mr Parshad Gurung said.
The barriers to change
Jase Berry is a mechanical engineering graduate from the University of Adelaide, and has written a thesis on design strategies for cook stoves in developing countries.
He says the two main challenges preventing communities adopting better cooking technologies are education and cost.
“Improved cook stove adoption requires that the stove design goes hand in hand with an appropriate education program within the community,” Mr Berry said.
“Without this, as has happened with many programs in the past, you’ll return to the village several months later to find the stoves sitting in the bushes overgrown with plants, in an attic somewhere, or pulled apart and used for scrap metal to fix a hole in the roof.”
The cost of installing an improved cooking stove is another challenge. The average income per day for Nepal is US$1.89, and these stoves can cost upwards of 1000 rupees (US$10). While it is a high initial investment, such stoves are often far more fuel efficient in the long run, however users are sceptical.
Health workers both in villages and in the cities are trying to raise awareness about the harmful effects of smoke inhalation. Health clinic worker Karnu Gurung says small changes are easier to make.
“I tell them to separate the kitchen and the bedroom, and separate where the baby sleeps,” she said.
In Pokhara, Dr Pokhrel gives similar advice.
“I can’t say destroy your house, make new house, but I can advise them to make enough ventilation, and to stay outside when cooking is going on,” Dr Pokhrel said.
“People are getting educated, the condition is decreasing, but still there is poor health.”
A local solution
Nepalese engineer Ram Chandra Thapa works in Kathmandu for Field Ready, an NGO that aims to improve technology that is used in humanitarian projects.
In July last year he met with Madhukar KC, a local innovator from a small village in Pyuthan District, Western Hilly Nepal. Madhukar wanted to cook food using less wood while emitting less smoke. Ten years ago, while observing a goldsmith melting gold, he discovered that a fire burning with a high enough intensity produced far less smoke. He thought he could apply the same technology to a wood fire stove, and drastically reduce the smoke emissions.
He has spent the last ten years developing a stove top burner design, by a very slow method.
“He would carve a wooden pattern, then use a lathe person to finish it, then go to a factory near the Indian border to mould a pattern, come back to Kathmandu to get a clean casted product and then back to the border to cast in quantity,” Mr Thapa said.
The metal burner is then placed inside a mud-and-brick or metal stove, and delivers more oxygen to the wood to make it burn hotter, reducing smoke and increasing fuel efficiency.
Over ten years Madhukar went through 33 different designs. But then he heard there was a new 3D printer at Field Ready.
“Here at Field Ready, we designed his complex idea into a 3D model and 3D printed a sample pattern which was ready to go to a foundry for metal casting,” Mr Thapa said.
Using the 3D printer drastically reduced the prototyping stage, and allowed Madhukar to develop a new burner design that burnt the wood significantly hotter, reducing smoke.
Dubbed the Matribhumi Improved Cook Stove (Matrbihumi translates to “motherland” in Nepali), it saves nearly 65% of fire wood, vastly reducing the cost and time spent for firewood collection. There is also virtually no smoke produced.
“In the quest for a sustainable form of improved cook stove, this new invention brought revolution in its kind,” Mr Thapa said.
“The new contracts and proposals for the installation of his improved cook stove is inundating.”
Mr Thapa believes when local innovators come up with solutions to problems, rather than foreign organisations, the result is more sustainable development.
“Local inventors have a good sense of local market and resources…they can apply it better in a local context.”
“They adopt design thinking processes and come up with more innovative local solutions, and they can turn this into a sustainable business model.”
Madhukar’s new and improved cook stove burner has been installed in more than 5000 houses in Nepal, and he has engaged with governmental and NGO organisations to reach rural villages, schools, canteens and hotels.
In the village
Back in Tanting village, no households are yet to adopt Madhukar’s innovative 3D printed solution to their smoke problem.
For Debi Gurung and the women of Tanting, inhaling smoke twice a day to cook the family meals is simply considered a fact of life.
When asked if she thinks about getting sick and having to go to hospital, or the years of life she may be losing because of the smoke, Debi Gurung simply replies “huncha”.
[Interviews with Karnu Gurung, Debi Gurung, Bishnu and Parshad Gurung and Asha Maya Gurung conducted via Nepali/English translator. Feature photo of Debi Gurung by Elliana Saltalamacchia.]