Professional Documents
Culture Documents
Autoethnographies on
the Environment and
Human Health
Tara Rava Zolnikov
National University
San Diego, CA, USA
vii
Acknowledgments
I would like to acknowledge all the individuals who were with me dur-
ing all of the autoethnographies. This single experience for me is your
daily life, and these stories would not have taken place without you.
ix
Contents
2 Air Quality 13
3 Climate Change 27
5 Drinking Water 55
7 Toxicology 83
8 Infectious Diseases 99
9 Vector-Borne Disease 115
xi
xii CONTENTS
10 Foodborne Diseases 129
Index 151
About the Author
xiii
Photo of Tara traveling in Kenya
CHAPTER 1
References
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10 T.R. ZOLNIKOV
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Emissions from a motorcycle
CHAPTER 2
Air Quality
Abstract This chapter delves into air quality in the world, foundations
and history of air quality, and how indoor and outdoor air quality can
affect people. The story takes place in Kenya and describes living in a city
and cooking in rural areas.
Kenya
Sub-Saharan Africa is comprised of all the countries in Africa south of the
Saharan desert, including Kenya. Historically, this region has experienced
serious political, economic, and social challenges because it is considered a
low-income region and is subject to the residual effects of chronic poverty.
In Kenya, 33.6% of the population lives below the poverty line, classified
as earning an income of approximately $1.90 per day according to the
World Bank [1]. Poverty generates adverse situations; consequences of
poverty include economic, medical, social and behavioral challenges
resulting from premature morbidity, disability, and mortality [2, 3]. The
connection between poverty and air pollution is displayed by the dispro-
portionate adverse health effects in populations exposed to poor air qual-
ity [4]. For example, children exposed to poor air quality are more likely
to develop respiratory ailments, such as low birth weight, which is a risk
factor for a variety of health issues faced later in life; these health issues
become exacerbated with continued exposure and can ultimately prevent
future career and life success [4].
Indoor and outdoor air pollution in Kenya is worsened by population
growth—which is set at a rate of 1.81%—increased migration, and urban-
ization [4, 5]. Emissions largely result from vehicle usage, open air burn-
ing of waste and solid fuels, and uncontrolled waste incinerators [4].
Though monitoring and surveillance systems are currently unavailable,
reports indicate that suspended particulate matter (PM) are 1.5-fold above
1987 World Health Organization guidelines for air quality. Key pollutants
in Kenya’s air pollution problem include particulate matter, carbon mon-
oxide, hydrocarbon, nitrogen oxides, and sulfur dioxide [4]. As men-
tioned, Kenya does not have national air quality monitoring in place, so
AIR QUALITY 15
Living in the bush, farming, and gathering water takes a great deal of
physical effort. People who move to rural areas have made a sacrifice
between time-consuming household chores for the convenience of city
living. People who live rurally can walk miles to retrieve water and fire-
wood, spend hours cooking on small cook stoves, and be exposed to the
hot, unforgiving heat and dust of sub-Saharan Africa for months on end.
These individuals confront difficulties every single day—low crop yields,
poor access to quality water, difficulty attending school and paying for
school fees, low resources (e.g. healthcare), and high rates of diseases (e.g.
malaria). Many environmental hazards occur in both types of settings, but
those that happen in the bush are largely unassuming and inconspicuous.
The water is filled with contaminants and sediment, the cook stoves emit
indoor air pollution that is breathed in, unsanitary open defecation spreads
disease, and climate change has produced drought or provided too much
rain in rain-dependent farming communities. These are just some of the
problems faced by populations living in the bush.
But one major problem that is often discussed, but rarely changed, is
indoor air pollution exposure. This comes from breathing in the smokey
air from burning charcoal on a cook stove that is set inside a house with-
out proper ventilation. This is the usual way to cook food, not only in
Kenya but in many parts of the world. Since women have to maintain so
many roles, like child rearing, cleaning, washing clothes, it is likely that
convenience is why they are becoming exposed. Other reasons could be
due to poor alternatives for cooking stoves or available techniques aside
from cooking with fire. Unfortunately, this situation not only exposes
women, but children as well, who ultimately are faced with the choice
between being able to eat or breathing in polluted air.
In a completely different setting, other populations in Kenya are being
exposed to outdoor air pollution. Within this country is a bustling city
called Nairobi. The population of Nairobi is approximately 3.1 million,
although this number may vary due to the transient nature of the most
impoverished inhabitants [7]. Nairobi is made up of slum and non-slum
area. The slums crowd the city, straining resources in limited areas; the
most popular slums are Kibera and Mathare, which house approximately
1.6 million people [7]. The other half of the population is dispersed
throughout proper city limits. These residents live in anything from single
room, toilet-in-floor apartments to spectacular gated and guarded condos.
Overall, the city itself is downtrodden, speckled with various mid- and
high-rise buildings and apartment complexes. Large gates block the view
AIR QUALITY 17
of anything remotely nice, and in these more upscale areas, windows and
doors have steel bars over them, to protect the innards of the house and
the homeowners.
Nairobi is always moving. There are constantly people walking on
makeshift sidewalks. Construction workers pretend to tidy up the roads.
Police causally wave cars, motorcycles, vans, and tour buses through over-
crowded, completely non-functioning roundabouts because traffic lights
mean nothing in Nairobi—you follow the car in front of you or the police
at the intersection, if there happens to be one. “Orderly disordered”
defines the conglomeration of roadworthy vehicles moving about streets
in Nairobi; somehow, despite the city’s random bursts and halts of move-
ment, most people manage to make it to their destination.
Visiting and traveling in spanning, unkempt cities like this takes work.
Living in Nairobi is on par with one of the most exhausting form of exer-
cise that I have ever done—and I do not even do any actual exercise. It
takes an hour by car or moto (motorcycle) to get most places in the city.
And most movement occurs on heavy traffic-laden roads. The air is thick
with pollution and it is nearly impossible to avoid breathing it in. Air con-
ditioning hardly ever works in cars, and opening a car window also
increases the likelihood of having a phone, purse, and/or sunglasses stolen
right out from under your nose, as sneaky hands from street sellers may
find their way in. Every one of my senses was worked to the maximum
degree; going by car or wayfaring on the streets, breathing and tasting the
pollution, listening to the bustle, and feeling sweat mercilessly creep on
every inch of my skin is exhausting. But the worst part is the air exposure;
this level of pollution gave me swollen, red eyes, a sore throat, and a crush-
ing headache. And that happened almost every day.
upon smelling the sea-coal smoke, immediately left to preserve her health
[9]. Moving forward in time, but not place, in 1952 in London, one of
the most famous air pollution cases occurred. Cold weather enveloped in
windless conditions trapped airborne particles and created “the London
fog,” wherein the trapped air pollution contributed to over 4000 deaths
within a single week [10].
Air pollution has been part of history and continues to be an environ-
mental and human health hazard to this day. The two key environmental
health burdens from air come from either household or ambient air pollu-
tion. The World Health Organization estimates that 5.4% of all deaths are
attributed to ambient air pollution, while 2.7% of the global burden of
disease is from indoor air pollution [11].
Ambient (outdoor) air pollution is the outcome of fuel combustion
and is emitted from industries (e.g. power plants), households or people
(e.g. biomass burning), cars, and trucks. Small (10 microns or less in
diameter) or fine (2.5 microns or less in diameter) particulate matter con-
tributes to majority of adverse health effects in human populations [12].
Particulate matter is a conglomeration of solid and liquid contaminants
(e.g. dust, pollen, soot, smoke, etc.) suspended in air [13]. This exposure
can cause respiratory symptoms, including cough, irritation of the nose
and throat, and shortness of breath [14]. Chronic ambient air pollution
exposure also contributes to major illnesses, such as stroke, heart disease,
lung cancer, and both chronic and acute respiratory diseases (e.g. asthma)
[15]. In fact, exposure to this type of pollution was estimated to cause
three million premature deaths in 2012 globally [15]. Unfortunately, 87%
of that affected population lived in low- and middle-income countries,
confirming the disproportionately exposed population [15]. Consequently,
this situation is common for people who live throughout sub-Saharan
Africa. People who live in cities like Nairobi are particularly vulnerable
because urban areas have higher levels of air pollution. Per the latest urban
air quality database, 98% of these inhabitants are exposed to limits that
exceed World Health Organization air quality guidelines [16]. Nigeria is
northwest of Kenya and is also located in sub-Saharan Africa; Onitsha, a
port city, consistently has the worst air pollution in the world with an
average of 30 times the recommended amount of particulate matter in the
air [16].
There were clear days when I would sit on the rooftop balcony of the
bed and breakfast where I frequently stayed and enjoyed a beautiful view
of the city while drinking coffee. Then, there were days when all I could
AIR QUALITY 19
do was wash my eyes out with water and drink hot tea to soothe my sore
throat. Depending on weather patterns and whether visiting rural versus
urban areas, some days were worse than others. For example, a sizeable
temperature inversion (stable conditions with very little atmospheric mix-
ing) could trap surface air over a megacity, thereby affecting millions of
people. Thus, the number of people contributing to air pollution and
being exposed can be significant in this type of scenario. Every new day
was a surprise to the amount and type of pollution that I would be exposed
to.
The other type of air pollution, albeit necessary, can also be largely self-
perpetuated. Household air pollution comes from indoor smoke caused
by cooking on indoor stoves or open fires using charcoal, wood, dung,
biomass, or other fuel sources without proper ventilation. This type of
smoke contains small particulate matter and carbon monoxide. The par-
ticulate matter is particularly damaging, which may be more than 20 times
recommended exposure limits [17, 18]. Unfortunately, there are approxi-
mately three billion people worldwide who heat their homes and cook
inside using these techniques [19]. This type of exposure results in approx-
imately four million premature deaths attributable to indoor air pollution
from inadequate ventilation [19]. Smoke from indoor air irritants, carbon
monoxide, and other gases can cause many adverse health effects, includ-
ing conjunctivitis, upper respiratory irritation, acute respiratory infection,
acute toxicity, cardiovascular disease, chronic obstructive pulmonary dis-
ease, and cancer [20]. In fact, burning wood biomass for cooking contin-
ues to be the most used fuel in the world [21].
Moving away from the urban area of Nairobi and into the rural villages
of Kenya is where I most often found myself cooking in the kitchen. The
oven consists of a “jiko,” which is basically just a portable, ceramic stove
that you place coal or wood in to burn and use for cooking heat. One day,
I decided to cook for my host family. I wanted to pay homage to my
Italian heritage and make pasta with homemade sauce. I did not realize
how difficult this meal was going to be until I began the process. First off,
walking and catching rides to get into town to buy the groceries took a
total of three hours. By the time I returned home, it was nearly lunch
time. I realized that I needed to get my sauce started on the slow-cooking
jiko or dinner would not be ready on time. I used local charcoal to create
the heat for the jiko, which had been made by cutting down neighboring
trees, covering them with dirt, and burning them. Because it was a clear
sunny day, I had also moved the jiko outside to avoid being exposed to the
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hands of Abdi Nibbe-ben-Attaia Towerga, for the sum of thirty-six
Spanish dollars, which the said Abdi Nibbe has received—Rais
Khaleel giving freedom to the said slave, over whom he has no
power, nor any other person whatever; and the said Abdelahy is
in full enjoyment of all the privileges of Musselmans. In the
presence of us, the parties being in possession of their senses
and faculties. Given this 16 Rabbia-attani, 1240, di Hegira—
Mohamed-ben-Zein-Abeedeen-ben-Hamet-Ben-Mohamed-Ben-
Omeran, Mahmoud-ben-Hagi, Solyman.”
SUPPLEMENTAL CHAPTER ON BORNOU.
FOOTNOTES: