Fuelforlife Who Health Org

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Fuelforlife Who Health Org

  1. 1. Household Energy and Health
  2. 2. Household Energy and Health WHO Library Cataloguing-in-Publication Data Fuel for life : household energy and health. Written and coordinated by Eva Rehfuess– Acknowledgements. 1. Air pollution, Indoor. 2. Wood fuels. 3. Energy policy. 4. Environmental health. 5. Socioeconomic factors. 6. Developing countries. I. Rehfuess, Eva. II. World Health Organization. ISBN 92 4 156316 8 (NLM classification: WA 754) ISBN 978 92 4 156316 1 © World Health Organization 2006 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 3264; fax: +41 22 791 4857; email: bookorders@who.int). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; email: permissions@who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Printed in France
  3. 3. 4 Foreword contents 5 Acknowledgements Section 1: Household energy, indoor air pollution and health 8 Household energy: three billion left behind 10 Health at the heart of the matter 12 The killer in the kitchen Section 2: Household energy and the Millennium Development Goals 16 Energizing the Millennium Development Goals 18 Trapped by energy poverty 20 Women and children overlooked 22 Stripping our forests, heating our planet 24 The need for a quantum leap Section 3: The way forward 28 Coming clean: modern fuels, modern stoves 30 Investing in household energy pays off 32 Rolling out household energy programmes: learning from the past 34 New household energy horizons Key points 38 Further reading 39 Annex
  4. 4. Foreword Acknowledgements E F nergy is essential to meet our most basic uel for life: household energy and health was Maria Neira, Public Health and Environment, needs: cooking, boiling water, lighting and written and coordinated by Eva Rehfuess (WHO). WHO heating. It is also a prerequisite for good health It draws on many previously published as well as Hisashi Ogawa, WHO Regional Office for the – a reality that has been largely ignored by the world previously unpublished data. The latter include an Western Pacific community. updated assessment of the burden of disease Kevin O'Reilly, HIV/AIDS, WHO attributable to solid fuel use by Sophie Bonjour (WHO) Annette Prüss-Üstün, Public Health and More than three billion people still burn wood, and Annette Prüss-Üstün (WHO), solid fuel use Environment, WHO dung, coal and other traditional fuels inside their predictions by Sophie Bonjour and Eva Rehfuess, an Pierre Quiblier, United Nations Environment homes. The resulting indoor air pollution is analysis of World Health Survey data on solid fuel use Programme responsible for more than 1.5 million deaths a year according to income quintiles by Nirmala Naidoo Sumeet Saksena, The East West Centre, United States – mostly of young children and their mothers. (WHO), and a cost-benefit-analysis of household energy Hanspeter Wyss, Swiss Agency for Development Millions more suffer every day with difficulty in interventions by Guy Hutton (Swiss Tropical Institute), and Cooperation, Switzerland breathing, stinging eyes and chronic respiratory Eva Rehfuess, Fabrizio Tediosi (Swiss Tropical disease. Moreover, indoor air pollution and Institute) and Svenja Weiss (Swiss Tropical Institute). This publication was copy-edited by Susan Kaplan. inefficient household energy practices are a Design and layout was provided by Paprika. significant obstacle to the achievement of the The following individuals provided valuable contributions Millennium Development Goals. and comments on all or parts of this publication: Photo credits: cover: Nigel Bruce; page 3: Nigel Bruce; page 5: Nigel Bruce; pages 7/8: Prabir Mallik, World Fuel for life, food for thought. With this publication Grant Ballard-Tremeer, HEDON Household Energy Bank; page 9: Curt Carnemark/World Bank; page 10: we draw attention to a serious neglected public Network Ray Witlin/World Bank; page 10, black margin: Nigel health problem. Effective solutions exist and the Jamie Bartram, Public Health and Environment, Bruce; page 11: Karen Robinson/Practical Action; economic case for taking practical solutions to scale WHO page 12, black margin: Nigel Bruce; page 13/14, is just as strong as the humanitarian case. Making Liz Bates, The Intermediate Technology black margin: Nigel Bruce; pages 13/14: Crispin cleaner fuels and improved stoves available to Group/Practical Action Hughes/Practical Action; page 15/16: David millions of poor people in developing countries will Sophie Bonjour, Public Health and Environment, Lederman/Photoshare; pages 17/18, black margin: reduce child mortality and improve women's health. WHO Creative Collection; page 17: Nigel Bruce/Practical In addition to the health gains, household energy Verena Brinkmann, German Technical Cooperation, Action; pages 19/20 black margin: Nigel programmes can help lift families out of poverty and Germany Bruce/Practical Action; page 20 (top): Nigel accelerate development progress. Nigel Bruce, University of Liverpool, England Bruce/Practical Action; page 20 (bottom): Mark Lisa Büttner, Winrock International Edwards/Still Pictures; page 22 black margin: Anne We hope that Fuel for life will inspire and prompt Diarmid Campbell-Lendrum, Public Health and Tinker/Photoshare; page 22: Dominic Sansoni/World vigorous action to close the household energy gap. Environment, WHO Bank; page 23: Nigel Bruce/Practical Action; page 24, Jo Chandler, Shell Foundation, England black margin: Nigel Bruce/Practical Action; pages Carlos Corvalan, Public Health and Environment, 25/26: Ray Witlin/World Bank; page 26, black margin: WHO Jorgen Schytte/Still Pictures; pages 27/28: Curt Laura Cozzi, International Energy Agency Carnemark/World Bank; page 30 (top): Nigel Carlos Dora, Public Health and Environment, Bruce/Practical Action; page 30 (bottom): Nigel WHO Bruce; page 30, black margin: Nigel Bruce/Practical Brenda Doroski, United States Environmental Action; page 31: Nigel Bruce/Practical Action; page Dr LEE Jong-wook Protection Agency, United States 32, black margin: Creative Collection; page 33: Nigel Director-General Charles Gilks, HIV/AIDS, WHO Bruce; page 34: Nigel Bruce/Practical Action; page World Health Organization Bruce Gordon, Public Health and Environment, 35: Dominic Sansoni/World Bank; page 36: Curt WHO Carnemark/World Bank; page 36, black margin: Marlis Kees, German Technical Cooperation, Germany Chandrakant Ruparelia/Photoshare; page 37: Danielle Agnes Klingshirn, German Technical Cooperation, Baron/CCP/Photoshare. Germany Marcelo Korc, WHO Regional Office for the This publication was made possible by the generous Americas/Pan American Health Organization support of the Swiss Agency for Development and Michal Krzyzanowski, WHO Regional Office for Europe Cooperation (SDC), the United Kingdom Department Daniel Mäusezahl, Swiss Agency for Development for International Development (DFID), the Swedish and Cooperation, Switzerland International Development Agency (SIDA) and the John Mitchell, United States Environmental Norwegian Agency for Development Cooperation Protection Agency, United States (NORAD). 4 5 Fuel for Life: Household Energy and Health
  5. 5. section1 Household Energy, Indoor Air Pollution and Health 6 7
  6. 6. The health of the people is really the Household energy: foundation upon which all their happiness and all their powers as a state depend. Benjamin Disraeli, three billion left behind British statesman and writer (1804—1881) C ooking as an enjoyable pastime and passion Figure 1: Energy poverty in people's homes for a privileged minority – on an electric range Percentage of population using solid fuels (Millennium or a gas stove in a stylish kitchen in New York, Paris Development Goal indicator 29), 2003 or latest available data or Tokyo. Cooking as a chore and threat to the lives Reproduced with permission from: © Myriad Editions of the great majority – on an open fire in a shabby hut in rural Africa, south Asia or Latin America. 0%–25% Worldwide, more than three billion people depend 26%–50% on solid fuels, including biomass (wood, dung and 51%–75% agricultural residues) and coal, to meet their most basic energy needs: cooking, boiling water and 76%–100% heating (Figure 1). Opening the door to their homes makes for a hazy welcome: thick grey smoke fills the air, making breathing unbearable and bringing tears to the eyes. The inefficient burning of solid fuels on an open fire or traditional stove indoors creates a dangerous cocktail of hundreds of pollutants, primarily carbon monoxide and small particles, but also nitrogen oxides, benzene, butadiene, formaldehyde, polyaromatic hydro- carbons and many other health-damaging chemicals. Day in day out, and for hours at a time, women and their small children breathe in amounts of smoke equivalent to consuming two packs of cigarettes per day. Where coal is used, additional contaminants such as sulfur, arsenic and fluorine may also be present in the air. Yet, these families are faced with an impossible dilemma: don't cook with solid fuels, or don't eat a cooked meal. Being poor condemns half of humanity to dependence on polluting household energy practices. With increasing prosperity, cleaner, more efficient and more convenient fuels are replacing, step-by-step, traditional biomass fuels and coal. Climbing up the energy ladder tends Figure 2: The energy ladder: household energy and development to occur gradually as most low- and middle-income inextricably linked households use a combination of fuels to meet their cooking needs (Figure 2). Very low income Low income Middle income High income Electricity Increasing use of cleaner, more efficient and The problem of indoor air pollution has been around Natural gas since the Stone Age, yet international development agendas still fail to recognize that missing out on Gas, liquefied petroleum gas more convenient fuels for cooking clean energy equals missing out on life. Ethanol, methanol Kerosene Non-solid fuels Solid fuels Coal Charcoal Wood Crop waste, dung Increasing prosperity and development 8 9 Fuel for Life: Household Energy and Health
  7. 7. Health at the heart of the matter B lack soot covers the walls of the dwelling. It Moreover, some studies have linked exposure to Table 1: Health impacts of indoor air pollution is the pollutants in this black soot, as well as indoor smoke to asthma; cataracts; tuberculosis; many invisible pollutants in the air, that women and adverse pregnancy outcomes, in particular low birth Health outcome Evidence1 Population Relative risk2 Relative risk (95% children breathe in for many hours every day. Small weight; ischaemic heart disease; interstitial lung confidence interval)3 particles (with a diameter of up to 10 microns disease, and nasopharyngeal and laryngeal cancers. (PM10)) are the most widely used indicator of the New research is needed to shed light on how Acute infections of the Strong Children aged 0–4 years 2.3 1.9–2.7 S lower respiratory tract health hazard of indoor air pollution. Fine particles exposure to indoor smoke contributes to this long U Women aged ≥ 30 years (with a diameter of up to 2.5 microns (PM2.5)) are list of health problems (see also Box 1). Strong 3.2 2.3–4.8 F Chronic obstructive F able to penetrate deep into the lungs and appear to pulmonary disease I Men aged ≥ 30 years have the greatest health-damaging potential. It is Moderate I 1.8 1.0–3.2 C known that these particles can cause inflammation I Women aged ≥ 30 years E of the airways and lungs and impair the immune Lung cancer (coal) Strong 1.9 1.1–3.5 N response, yet the precise mechanism by which T Men aged ≥ 30 years exposure to indoor air pollution translates into Moderate I 1.5 1.0–2.5 disease is still unknown. Women aged ≥ 30 years I Lung cancer (biomass) Moderate II 1.5 1.0–2.1 N Burning solid fuels produces extremely high levels S of indoor air pollution: typical 24-hour levels of Asthma Moderate II Children aged 5–14 years 1.6 1.0–2.5 U PM10 in biomass-using homes in Africa, Asia or F F Adults aged ≥ 15 years Latin America range from 300 to 3000 micrograms Moderate II 1.2 1.0–1.5 I per cubic metre (µg/m3). Peaks during cooking may C Adults aged ≥ 15 years be as high as 10 000 µg/m3. By comparison, the Cataracts Moderate II 1.3 1.0–1.7 I E United States Environmental Protection Agency has N Adults aged ≥ 15 years set the standard for annual mean PM10 levels in Tuberculosis Moderate II 1.5 1.0–2.4 T outdoor air at 50 µg/m3; the annual mean PM10 limit 1 Strong evidence: Many studies of solid fuel use in developing countries, supported by evidence from studies of active and passive smoking, urban air pollution agreed by the European Union is 40 µg/m3. As and biochemical or laboratory studies. cooking takes place every day of the year, most Moderate evidence: At least three studies of solid fuel use in developing countries, supported by evidence from studies on active smoking and on animals. Moderate I: strong evidence for specific age/sex groups. Moderate II: limited evidence. people using solid fuels are exposed to levels of 2 The relative risk indicates how many times more likely the disease is to occur in people exposed to indoor air pollution than in unexposed people. 3 The confidence interval represents an uncertainty range. Wide intervals indicate lower precision; narrow intervals indicate greater precision. small particles many times higher than accepted annual limits for outdoor air pollution (Figure 3). The more time people spend in these highly polluted environments, the more dramatic the consequences for health. Women and children, indoors and in the vicinity of the hearth for many Figure 3: Smoky streets, smoky homes Box 1: Better household energy practices to mitigate the HIV/AIDS crisis? hours a day, are most at risk from harmful indoor air Typical 24-hour mean levels of small particles (PM10) in micrograms per cubic metre (µg/m3), early 2000s Winning the battle against HIV/AIDS calls for effective prevention and treatment. But it also requires that people maintain their pollution. energy levels and physical fitness. Household energy plays a crucial role in keeping patients and their caregivers going: It is Since the mid-1980s, epidemiological studies have indispensable for cooking safe, nutritious meals and for boiling water to ensure its safety for drinking. It is essential for preparing been investigating the impacts of exposure to indoor hot compresses, heating water for bathing and sterilizing utensils for patients. And it provides warmth for those who are ill and air pollution on health. The results of these studies suffering. 3000 have recently been reviewed by WHO (Table 1). Inhaling indoor smoke doubles the risk of In Africa, wood tends to be scarce where collected and expensive where purchased. The incomplete combustion of biomass fuels pneumonia and other acute infections of the lower indoors produces dense smoke, a major contributor to respiratory problems – even more so among immunocompromised HIV/AIDS respiratory tract among children under five years of patients. Therefore, more efficient, cleaner household energy practices can help families affected by HIV/AIDS as well as those not 240 age. Women exposed to indoor smoke are three affected by the disease to live a healthier life. times more likely to suffer from chronic obstructive USEPA annual standard 50 pulmonary disease (COPD), such as chronic Adapted from: 30 bronchitis or emphysema, than women who cook Gebert N. Mainstreaming HIV/AIDS: Participation or exclusion? Actors in the context of HIV/AIDS and project-induced measures (GTZ) for the optimized utilization of subsistence resources. German Technical Cooperation Programme for Biomass Energy Conservation in Southern Africa (GTZ ProBEC), in press. Available at: with electricity, gas or other cleaner fuels. And coal Berlin city centre Bangkok roadside Hut with open fire http://www.probec.org use doubles the risk of lung cancer, particularly USEPA, US Environmental Protection Agency. among women. 11 10 Fuel for Life: Household Energy and Health
  8. 8. Are we to decide the importance of issues by asking how fashionable or glamorous they are? Or by asking how seriously they affect how many? Nelson Mandela, The killer in the kitchen South African statesman and winner of the Nobel Prize for Peace (1918–) M alaria, tuberculosis, HIV/AIDS and many other Figure 4: Widespread solid fuel use ... diseases compete for newspaper headlines – Percentage of population using solid fuels, by WHO subregion1, 2003 or latest available data and the attention of the public. How should decision- makers prioritize one health problem against another? WprB The burden of disease combines years of life lost due to death with the years of life lost due to disability in a SearD single measure that applies across diseases and health SearB risks. WHO investigates the contribution of a range of risk EurC factors, such as malnutrition, smoking and lack of WHO subregion EurB physical activity, to the burden of disease. The results for the year 2000 unveiled cooking as a dangerous EmrD undertaking and indoor air pollution from burning solid EmrB fuel as one of the top ten global health risks. The kitchen AmrD killer turned out to be responsible for 1.6 million deaths AmrB and 2.7% of the global burden of disease. In poor developing countries, only malnutrition, unsafe sex and AfrE lack of clean water and adequate sanitation were greater AfrD health threats than indoor air pollution. 0 10 20 30 40 50 60 70 80 90 Percentage of population using solid fuels This wake-up call placed indoor air pollution on the international public health agenda for the first time. Yet, 1 WHO distinguishes between the following geographical regions: African Region (Afr); Region of the Americas (Amr); Eastern Mediterranean Region (Emr); European Region (Eur); South-East Asia Region the most recent and more accurate estimates show (Sear); Western Pacific Region (Wpr). WHO also differentiates between the following mortality strata: very practically no change. Globally, 1.5 million people died low child, very low adult (A); low child, low adult (B); low child, high adult (C); high child, high adult (D); high child, very high adult (E). from diseases caused by indoor air pollution in the year 2002. This figure includes children who died from pneumonia and adults who died from chronic respiratory disease and lung cancer – only those diseases for which Figure 5: ... translates into respiratory deaths current evidence for a link with indoor air pollution is Deaths attributable to indoor air pollution per 100 000 population, by WHO subregion1, 2002 sufficient (see Table 1). What if indoor smoke also turns out to contribute to low birth weight and tuberculosis? WprB Reliance on polluting solid fuels (Figure 4) and inefficient SearD household energy practices varies widely around the SearB world, as does the death toll due to indoor smoke (Figure 5). In 2002, Sub-Saharan Africa and South-East Asia led EurC WHO subregion with 396 000 and 483 000 deaths due to indoor smoke, EurB respectively. Widespread use of biomass and coal in EmrD China plays a key role in chronic respiratory diseases EmrB among adults, and was responsible for a large share of the 466 000 deaths in the Western Pacific in 2002. AmrD Although the majority of the population in Latin America AmrB and the Caribbean, the Eastern Mediterranean and AfrE Europe use gas and other cleaner fuels for cooking, the AfrD health burden disproportionately falls on the poorest countries in these regions, and on the poorest members 0 50 100 150 200 250 300 350 400 of society among whom solid fuel use is still common (see Deaths per 100 000 Figure 6 and Trapped by energy poverty). 1 WHO distinguishes between the following geographical regions: African Region (Afr); Region of the Americas (Amr); Eastern Mediterranean Region (Emr); European Region (Eur); South-East Asia Region (Sear); Western Pacific Region (Wpr). WHO also differentiates between the following mortality strata: very Indoor air pollution continues to ravage rural low child, very low adult (A); low child, low adult (B); low child, high adult (C); high child, high adult (D); high child, very high adult (E). communities and poor urban dwellers. And it continues to be largely ignored by the world community. 13 12 Fuel for Life: Household Energy and Health
  9. 9. section2 Household Energy and the Millennium Development Goals 14 15
  10. 10. We will spare no effort to free our fellow men, women and Energizing the Millennium children from the abject and dehumanizing conditions of extreme poverty, to which more than a billion of them are currently subjected. United Nations Millennium Declaration Development Goals I n September 2000, the largest-ever gathering Figure 6: Poverty and energy poverty go hand in hand Table 2: Cracking the energy code of Heads of State committed themselves to Percentage of population using solid fuels in some of the making the right to development a reality for Millennium Development Goals Contribution of improved household energy practices world's largest countries, by income quintiles in urban everyone. The Millennium Declaration promotes a (top) and rural (bottom) locations, 2003 comprehensive approach that tackles a broad range Goal 1: Eradicate extreme poverty and hunger Saving time spent being ill or having to care for sick children will cut x health care expenses and increase earning capacities. 100 of problems simultaneously. By 2015, the world Where fuels are purchased, increasing fuel efficiency and thus cutting x Percentage of urban population using solid fuels aims to have achieved eight goals for combating 90 down on the quantity of fuel needed will ease constraints on already poverty, hunger, disease, illiteracy, environmental tight household budgets. 80 degradation and discrimination against women. Improved household energy technologies and practices will open up x 70 opportunities for income generation. Access to electricity will provide a source of light for economic There is no Millennium Development Goal on 60 x activities in the evening and a source of energy for operating, for energy. Yet, energy poverty is one of the many 50 example, a sewing-machine or refrigerator. manifestations of poverty and a prevailing feature of 40 deprived rural and urban households in developing Goal 2: Achieve universal primary education With less time lost in collecting fuel and due to ill health, children will x 30 countries (Figure 6). Lack of energy, in particular have more time available for school attendance and homework. Better lighting will allow children to study outside of daylight hours and lack of access to modern cooking fuels and x 20 without putting their eyesight at risk. electricity, already represents a bottleneck, holding 10 back progress towards achieving the goals. Rather Goal 3: Promote gender equality and empower women Alleviating the drudgery of fuel collection and reducing cooking time will x 0 than squeezing through the bottleneck, the United free women's time for productive endeavours, education and child care. il a ia a o a sh n di az ic ric in tio op de ex Br Ch In Af Nations Millennium Project proposes to confront hi ra Reducing the time and distance that women and girls need to travel to la x Et de M ng h ut Fe Ba collect fuel will reduce the risk of assault and injury, particularly in So the energy issue directly (see The need for a an i ss conflict situations. Ru quantum leap). Improved energy services can Involving women in household energy decisions will promote gender x 100 reduce child mortality rates, improve maternal equality and raise women's prestige. Percentage of rural population using solid fuels health, reduce the time and transport burden on 90 women and young girls, and lessen the pressure on Goal 4: Reduce child mortality Reducing indoor air pollution will prevent child morbidity and mortality x 80 from pneumonia. fragile ecosystems (Table 2). 70 Protecting the developing embryo from indoor air pollution can help x avert stillbirth, perinatal mortality and low birth weight. 60 Halving the number of people without effective Getting rid of open fires and kerosene wick lamps in the home can x access to modern cooking fuels by 2015 and prevent infants and toddlers being burned and scalded. 50 making improved cooking stoves widely available 40 Goal 5: Improve maternal health Curbing indoor air pollution will alleviate chronic respiratory problems represents a stepping stone towards achieving the x among women. 30 Millennium Development Goals. A less polluted home can improve the health of new mothers who spend x 20 time close to the fire after having given birth. A more accessible source of fuel can reduce women's labour burdens x 10 and associated health risks, such as prolapse due to carrying heavy 0 loads. il a ia a o a sh n di az ic ric in tio op de ex Br Ch In Af hi ra la Et de M ng th Goal 6: Combat HIV/AIDS, malaria and other diseases Lowering levels of indoor air pollution levels can help prevent 1.6 Fe x ou Ba S n ia million deaths from tuberculosis annually. ss poorest quintile Ru richest quintile Goal 7: Ensure environmental sustainability Where biomass is scarce, easing the reliance on wood for fuel through x more efficient cooking practices will lessen pressures on forests. Moving up the energy ladder and using improved stoves can increase x energy efficiency and decrease greenhouse gas emissions. Goal 8: Develop a global partnership for development Recognition in development agendas and by partnerships of the x fundamental role that household energy plays in economic and social development will help achieve the Millennium Development Goals by 2015. 16 17 Fuel for Life: Household Energy and Health
  11. 11. Trapped by energy poverty E xtreme poverty remains a daily reality for Box 2: Too little wood for too many people: household Figure 7: Energy – a major expenditure more than 1 billion people who survive on energy and hunger for poor households less than 1$ per day1. Being poor means getting up hungry in the morning, anxious where to find Where wood supplies are scarce, unsustainable harvesting of fuel enough food to make it through to the evening (Box Percentage of household income spent on energy endangers agricultural production and threatens a stable supply 16 2). Being poor means being forced to accept any of crops. Deforestation and ensuing erosion damage formerly work there is and being denied a good school 14 fertile fields; this is particularly true where trees are felled for education. Being poor means living in an 12 charcoal production to supply urbanizing areas of Africa with overcrowded smoky dwelling that lacks sufficient fuel. Resorting to dung as a lower-grade fuel interrupts the 10 water for drinking, hand-washing and personal normal composting process and diverts the dung from being used 8 hygiene. Being poor means not having the freedom as a natural soil fertilizer. In the absence of any chemical to make choices. 6 fertilizers, this will ultimately reduce field productivity. 4 Millennium Development Goal 1, to eradicate For these reasons, improving household energy practices will also 2 extreme poverty and hunger, represents the essence boost agricultural productivity and food security. By restoring of the Millennium Declaration. Dependence on 0 natural soil fertility, they reduce expenditure on chemical ia a a da di ric polluting inefficient household energy practices op an In Af hi Ug Et fertilizers. Higher fuel efficiency frees women's time for growing h ut stops people from breaking out of the vicious cycle So food and tending animals. poorest quintile of poverty. richest quintile Good health is crucial as household livelihoods rely Adapted with permission from: International Energy Agency, OECD. World Energy on the health of family members. Being ill as a Outlook 2002. Paris, International Energy Agency and result of indoor smoke or having to care for sick for example, daily fuel collection time ranges from OECD, 2002. Table 13.1. children reduces earnings and leads to additional only 20 minutes per day in Andhra Pradesh to more expenses for health care and medication. Broken than one hour per day in Rajasthan, which is mostly bones, backache and snake bites endured during covered by desert. Cooking, serving foods and fuel collection add to the problem. Reports from washing the soot-laden pots adds to this time war zones and refugee camps provide sad testimony burden, eating up about three hours of women's Figure 8: Time ticking away of girls and women being assaulted when they leave time every day. Daily hours that women spend collecting fuel in different African the relative safety of their homes to collect fuel. geographical settings, by country, 1990–2003 Alleviating the drudgery of collecting fuel far from Where fuel is purchased, for example in urban home and easing the task of cooking through 4.5 slums in Africa and Asia, spending money on large ownership of more efficient devices can free 4 quantities of inefficient fuels places severe women's time for productive endeavours, education, 3.5 constraints on household budgets. Poor households child care and relaxation. With less time wasted on 3 Hours per day tend to spend a larger percentage of their income collecting wood and being ill, children will have 2.5 on energy than well-off households (Figure 7). more time available to attend school, do their 2 Where fuel is collected, women and children lose homework and enjoy childhood. Finally, involving many hours a week searching for wood branches women in household energy decisions promotes 1.5 and twigs (Figure 8). Fuel collection is not gender equality and empowers women. Owning a 1 necessarily a daily task, as the duration and less-polluting stove raises a woman's prestige – both 0.5 frequency of collection varies depending on the by being a sign of wealth and, indirectly, through 0 availability of wood for use as a fuel. In rural India, providing a soot-free kitchen environment. i r ia a o ia a a ia ia a a ia e an Fas iop han eny alaw ib Nige ger fric and zan mb abw tsw a Eth Ni th A Ug Tan Za mb m KM G Na Bo rkin Zi of u So Bu lic b pu Re d ite Un Sources: Dutta S. Energy as a key variable in eradicating extreme poverty and hunger: A gender and energy perspective on empirical evidence on MDG 1. In: Gender as a key variable in energy interventions. Draft background paper for ENERGIA/DfID/KaR Research Project R8346. 2005. Available at: http://www.energia.org/ 1 $ Purchasing power parities (PPPs): These conversion rates Hutton G, Rehfuess E, Tediosi F, Weiss S. Evaluation of the costs and benefits of household energy and health interventions at global and regional levels. Geneva, World Health Organization, in press. equalize the purchasing power of different currencies by eliminating the differences in price levels between countries. 18 19 Fuel for Life: Household Energy and Health

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