Microfinancing the reduction of indoor air pollution: an access initiative for improved cookstoves in Guatemala

1
Microfinancing the reduction of indoor air
pollution an access initiative for improved
cookstoves in Guatemala
Nancy K. Etzel1 and Justin Schram2 University of
Pennsylvania School of Nursing1, University of
Pennsylvania School of Medicine2 Funding
GAPSA-Provosts Award for Interdisciplinary
Innovation
Problem
Local Setting
Project Goals and Methods
Local Partnerships
Future Direction

• Guatemala has the third lowest life expectancy
  and the third highest infant mortality rate in
  Latin America7.
• The prevalence of acute respiratory illnesses
  among children ltage 6 is estimated to be 51 in
  rural areas7.
• A 2005 community health assessment8 in Santiago
  Atitlán, a Maya community in the Guatemala
  highlands, adapted the WHO World Health Survey to
  reflect local priorities, community input, and
  culturally salient issues. Findings include
• Pulmonary disease ranks second overall in a
  combined measure of self-reported burden of
  disease.
• 49 of households cook over a comal, or a metal
  cooking plate placed on rocks over an open fire.
• 46 used a plancha, a masonry wood-burning stove
  with a chimney.
• In focus groups, women report a strong preference
  for the plancha.
• Perceived benefits include respiratory and eye
  health, household cleanliness, comfort,
  durability, cooking efficiency, and fuel savings.
  

• Use Participatory Action Research (PAR) via
  interviews and focus groups to integrate the
  ideas of local community members and NGO leaders.
  
• Increase access to the Onil Stove, a plancha
  which produces less smoke and uses up to 70 less
  wood than the traditional comal or commonly-used
  plancha9. Such a stove will promote better health
  and reduced energy costs.
• Partner with established institutions in Santiago
  Atitlán to build upon and synergize with
  pre-existing local development expertise.
• Create a business plan in coordination with local
  partners to increase access to an improved
  cookstove among the poorer of the poor.

• Indoor combustion of biomass fuels such as wood
  and crop residues is the second most important
  environmental risk factor for disease worldwide.
• More than two billion people worldwide use
  biomass fuel for cooking and heating purposes1.
• Chronic exposure to smoke constitutes a major
  risk factor for respiratory diseases such as
  asthma2 and acute respiratory infections1,3 in
  developing countries. This burden
  disproportionately affects impoverished women and
  children.

• Continue to integrate knowledge across the health
  disciplines, business, engineering, environmental
  studies, and anthropology to innovate a health
  prevention program that simultaneously promotes
  economic development, efficient energy use, and
  environmental sustainability.
• Consider local stove production to spur economic
  activity. Restrictions currently exist in local
  engineering knowledge.
• Use partner networks, e.g. with Puente de
  Amistad, to expand access to the Onil Stove
  throughout the region.
• Use existing structure to expand access to
  additional health promoting technologies such as
  water purification.
• Continue to encourage economic empowerment for
  women via credit mechanisms.
• Encourage wider cross-disciplinary involvement in
  the community and the University.

• Cojolyá a womens weaving cooperative promoting
  traditional Mayan textiles and economic stability
  in Santiago10. Cojolyá has distributed subsidized
  Onil Stoves to around 100 of its members.
• HELPS International nonprofit organization
  working to improve the quality of life of
  Guatemalans through development-oriented
  projects, such as the production of Onil Stoves9.
• Puente de Amistad a nonprofit microcredit
  institution with a portfolio of 16,000 loans
  totaling 16MM in Guatemala. Secondary
  educational opportunities in health and finance
  promote empowerment of female clients and their
  children11.

"Using a comal gives me respiratory infections
and throat infections. My infant always stays
with me when I am cooking. Due to the smoke he
always gets sick."
Microcredit Plus

• Women will form small credit groups or grupos de
  confianza and each receive an Onil Stove.
• Social guarantee among members, plus reduced
  fuel expense, will help promote reliable weekly
  repayment of microloans.
• Microcredit Plus integrates health education
  and loan payments into group solidarity meetings.
  A local health worker will act as educator, loan
  officer, and project liaison.
• Successful group repayment of stove credit will
  open access to a larger portfolio of generative
  loans.

References
1Ezzati J and Kammen DM. 2001. Indoor air
pollution from biomass combustion and acute
respiratory infections in Kenya an
exposure-response study. Lancet 358
619-624. 2Schel MA, Hessen JO, Smith KR, et al.
2004. Childhood asthma and indoor woodsmoke from
cooking in Guatemala. Journal of Exposure
Analysis and Environmental Epidemiology 14
S110-S117. 3Smith KR, Samet JM, Romieu I, and
Bruce N. 2000. Indoor air pollution in
developing countries and acute lower respiratory
infections in children. Thorax 55
518-532. 4World Health Organization. Global
burden of disease due to indoor air pollution.
http//www.who.int/indoorair/health_impacts/burden
_global/en/index.html 5World Health
Organization. Attributable deaths by risk factor
and WHO subregion, 2000. http//www.who.int/quant
ifying_ehimpacts/global/en/deaths.pdf 6World
Health Organization. Attributable DALYs by risk
factor and WHO subregion, 2000.
http//www.who.int/quantifying_ehimpacts/global/en
/dalys.pdf 7Gragnolati M and Marini A. 2003.
Health and poverty in Guatemala. World Bank
Research Policy Working Paper 2966.
http//www.interaction.org/files.cgi/2806_wb_guate
_and_health_3.03.pdf 8Schram J and Etzel N.
2006. Assessing community health in a Tztujil
Maya village upon the reconstruction of
Hospitalito Atitlán. Unpublished report.
University of Pennsylvania School of
Medicine. 9Helps International. The Onil stove.
www.helpsintl.org/programs/stove.php 10Cojolyá
Association of Maya Women Weavers. Our story.
http//www.cojolya.org/about/story/index.html 11Fr
iendship Bridge. Our programs. http//www.friendsh
ipbridge.org/nav_ourprograms.php