Microfinancing the reduction of indoor air pollution:

an access initiative for improved cookstoves

Nancy K. Etzel and Justin Schram
in Guatemala 1 2

University of Pennsylvania School of Nursing1, University of Pennsylvania School of Medicine2

Funding: GAPSA-Provost’s Award for Interdisciplinary Innovation

Problem Local Setting Project Goals and Methods Local Partnerships Future Direction
• Indoor combustion of biomass fuels • Guatemala has the third lowest life • Use Participatory Action Research • Cojolyá: a women’s weaving • Continue to integrate knowledge
such as wood and crop residues is expectancy and the third highest (PAR) via interviews and focus cooperative promoting traditional across the health disciplines,
the second most important infant mortality rate in Latin groups to integrate the ideas of Mayan textiles and economic business, engineering,
7
environmental risk factor for America . local community members and stability in Santiago10. Cojolyá has environmental studies, and
disease worldwide. • The prevalence of acute respiratory NGO leaders. distributed subsidized Onil Stoves to anthropology to innovate a health
illnesses among children <age 6 is • Increase access to the Onil Stove, around 100 of its members. prevention program that
estimated to be 51% in rural areas7. a plancha which produces less • HELPS International – nonprofit simultaneously promotes
• A 2005 community health smoke and uses up to 70% less organization working to improve the economic development, efficient
assessment8 in Santiago Atitlán, a wood than the traditional comal or quality of life of Guatemalans energy use, and environmental
Maya community in the Guatemala commonly-used plancha9. Such a through development-oriented sustainability.
highlands, adapted the WHO World stove will promote better health and projects, such as the production of • Consider local stove production
Health Survey to reflect local reduced energy costs. Onil Stoves9. to spur economic activity.
priorities, community input, and Restrictions currently exist in
• Puente de Amistad – a nonprofit
culturally salient issues. Findings local engineering knowledge.
microcredit institution with a portfolio
include: of ~16,000 loans totaling $16MM in • Use partner networks, e.g. with
• Pulmonary disease ranks second Guatemala. Secondary educational Puente de Amistad, to expand
overall in a combined measure of opportunities in health and finance access to the Onil Stove
"Using a comal… gives me respiratory infections and
throat infections. My infant always stays with me when I self-reported burden of disease. promote empowerment of female throughout the region.
am cooking. Due to the smoke he always gets sick."
• 49% of households cook over a clients and their children11. • Use existing structure to expand
• More than two billion people access to additional health
comal, or a metal cooking plate
worldwide use biomass fuel for
placed on rocks over an open fire.
“Microcredit Plus” promoting technologies such as
cooking and heating purposes1. water purification.
• 46% used a plancha, a masonry • Women will form small credit
• Chronic exposure to smoke • Continue to encourage economic
wood-burning stove with a chimney. groups or “grupos de confianza”
constitutes a major risk factor for • Partner with established institutions empowerment for women via
• In focus groups, women report a and each receive an Onil Stove.
respiratory diseases such as in Santiago Atitlán to build upon credit mechanisms.
strong preference for the plancha. • “Social guarantee” among
asthma2 and acute respiratory and synergize with pre-existing • Encourage wider cross-
1,3
infections in developing countries. • Perceived benefits include members, plus reduced fuel
local development expertise. disciplinary involvement in the
This burden disproportionately respiratory and eye health, expense, will help promote reliable
• Create a business plan in community and the University.
affects impoverished women and household cleanliness, comfort, weekly repayment of microloans.
children. durability, cooking efficiency, and coordination with local partners to • “Microcredit Plus” integrates health
increase access to an improved
References
fuel savings. education and loan payments into
• The single greatest cause of death cookstove among the poorer of the 1
Ezzati J and Kammen DM. 2001. Indoor air pollution from biomass combustion and

globally among children under five group solidarity meetings. A local acute respiratory infections in Kenya: an exposure-response study. Lancet 358:

poor. health worker will act as educator, 2

619-624.
Schel MA, Hessen JO, Smith KR, et al. 2004. Childhood asthma and indoor
years is pneumonia, and 800,000 woodsmoke from cooking in Guatemala. Journal of Exposure Analysis and

(or forty percent) of these deaths • Adapt established microcredit loan officer, and project liaison. 3
Environmental Epidemiology 14: S110-S117.
Smith 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.

are attributable to the adverse practices, usually used for • Successful group repayment of 4
World Health Organization. Global burden of disease due to indoor air pollution. http://
www.who.int/indoorair/health_impacts/burden_global/en/index.html

impacts of indoor air pollution4. generative loans, to fund a project stove credit will open access to a
5
World Health Organization. Attributable deaths by risk factor and WHO subregion,
2000. http://www.who.int/quantifying_ehimpacts/global/en/deaths.pdf

that will reduce household

6
World Health Organization. Attributable DALYs by risk factor and WHO subregion,
larger portfolio of generative loans. 2000. http://www.who.int/quantifying_ehimpacts/global/en/dalys.pdf
• Indoor smoke is responsible for 1.6 expenditures.
7
Gragnolati M and Marini A. 2003. Health and poverty in Guatemala. World Bank
Research Policy Working Paper 2966. http://www.interaction.org/files.
5
million deaths per year and 2.7% ENVIRONMEN 8
cgi/2806_wb_guate_and_health_3.03.pdf
Schram J and Etzel N. 2006. Assessing community health in a Tz’tujil Maya village

of the worldwide burden of disease .6 • In all, form a preventive health upon the reconstruction of Hospitalito Atitlán. Unpublished report. University of

intervention to help break the cycle T 9

Pennsylvania School of Medicine.
Helps International. The Onil stove. www.helpsintl.org/programs/stove.php

• Use of open fires contributes to • Fuel wood costs $1 to $2 dollars a 10

Cojolyá Association of Maya Women Weavers. Our story. http://www.cojolya.org/about/

of poverty, illness, and story/index.html

day – about a third of daily

11
Friendship Bridge. Our programs. http://www.friendshipbridge.org/nav_ourprograms.
high household fuel costs and environmental degradation.
php

greenhouse gas release due to expenses – when using an open fire.

poor burning efficiency. • The principal barrier to obtaining a POVERT HEALTH
plancha is the cost ($50 to $100). Y