Smoke and health in Sudan

No fire without smoke?

Indoor air pollution from biomass fuels has become a worldwide concern. The burning of biomass fuels in traditional stoves is an inefficient process which results in the release of heavy smoke containing large amounts of toxic pollutants such as carbon monoxide, nitrogen oxides, sulfur dioxide, aldehydes, dioxin, polycyclic aromatic hydrocarbons and respirable particulate matter. The resulting human exposures exceed recommended World Health Organization levels by factors of up to 20 or more.

In Sudan, biomass fuel constitutes more than 80% of the total primary energy supply. In turn, 80% of biomass fuel is consumed in the household sector in the form of firewood, charcoal, and agricultural residues. Charcoal is mainly used in urban areas while firewood and residues are the dominant household fuels in rural areas and poor sectors of urban centres. Firewood is mostly burned on three-stone stoves, the efficiency of which is around 10%, while charcoal is burned on traditional metal stoves, with an efficiency of about 15%.

Prolonged exposure to biomass smoke is a significant cause of health problems, including acute respiratory infections (ARI) in children, chronic obstructive lung diseases such as asthma and chronic bronchitis, lung cancer and pregnancy-related problems. The prevalence of these diseases in Sudan indicates the need for changes in practices and attitudes with relation to biomass fuels. ITDGPractical Action Sudan’s Smoke and Health Project is the first of its kind in addressing these issues.

Kassala Smoke and Health Project

A poor residential part of Kassala, Wau Nour, was selected for the project's implementation as a typical representation of Sudan's urban poor sector. Thirty representative households were randomly selected as samples for the study. Firewood is the dominant fuel used for cooking by the households in this sample, while charcoal is mostly used to brew hot drinks. Both firewood and charcoal are burned on traditional, inefficient stoves. Depending on the household size, the average monthly expenditure on firewood ranges from SD980 to SD10,200.

By monitoring household indoor air pollution during 24 hours, carbon monoxide levels both in the kitchen and its inhabitants were measured. During the same time-frame, particulate matter concentrations in the kitchen were also recorded. Monitoring of indoor air pollution levels took place during the wet and dry seasons. The project incorporates testing and trials of alternative energy sources and secondary monitoring and evaluation.

The preliminary results of the first monitoring cycle indicated the presence of high levels of indoor air pollutants (carbon monoxide and particulate matter). The second project phase involves selection and implementation of smoke reduction interventions in order to test their effectiveness during the second monitoring cycle.

Smoke reduction interventions

Technical interventions:

• Smoke Removal
• Housing Design
• Clean and efficient burning fuels

Behavioural interventions:

• Promoting awareness of longterm health effects to users

Policy-level interventions:

• Local micro-credit facilities for upfront costs of switching to gaseous fuels like kerosene and LPG
• Training for stove development, housing design, and better education about health risks

Suitable interventions for Wau Nour households

A participatory discussion with household members revealed a high awareness about the health risks of smoke and about the possible interventions to reduce or eliminate smoke. Almost all households claimed that LPG is the best way to mitigate the smoke health risk. However, the issue of accessibility to LPG cylinders and burners was raised as the dominant constraint: the cost of buying and installing these ranges between SD9,200 and SD17,900.

Practical Action has helped the Wau Nour sample households switch to LPG by organising financial loans to cover the cost of changing to LPG. As a result of this project, 30 households have been using LPG since March 2003 and a second monitoring cycle is in progress to assess the effects of the change. Training in LPG use and safety measures has facilitated the transfer from biomass fuels to LPG. The project is now under pressure to meet demand from households in both Wau Nour and Kadugli IDP camps. The second batch of 30 households in Wau Nour received their LPG appliances by mid-July 2003.

This article appeared in issue three of Sharing, Practical Action Sudan's newsletter.

Update:

Sustainable and effective kitchen smoke alleviation – January 2005
A report on the outputs and achievements of Practical Action Sudan's Smoke and Health project in Wau Nur and Kadugli.