On Earth Day, we generally tend to focus on the impact of people on the planet. But it is equally important to consider the impact of pollution on people and health including non-communicable diseases (NCDs).
NCDs, which include cardiovascular disease, diabetes, cancers and chronic lung disease, are gaining much-needed attention this year in advance of the upcoming, pivotal, UN high-level meeting on NCDs on Sep 19-20. NCDs -- yes, the word is hard to pronounce and doesn't quite roll off our tongues easily, -- cause an alarming two out of three deaths in the world today, with a staggering 80 percent of them in developing countries. Earth Day has given us another opportunity to draw the world's attention to NCDs and what we can do about it. This essay is my personal act of green -- one of the billion the Earth Day organizers are asking for this year.
I don't intend to talk about carcinogens and the rising rates of breast cancer nor about the impact of outdoor air pollution and vehicle exhausts on NCDs.
Simply cooking every day -- something all women do all over the world, sometimes over open fires as I saw first hand growing up in India, in villages, and even many towns and cities -- this very basic everyday act can be extremely hazardous to women's health.
In many parts of the world, women spend three to seven hours a day preparing food, often in front of an open fire. Harsh economic realities force them to rely on cheaper fuels like firewood, coal and even dried cow dung. Their babies are sometimes strapped to their backs or are nearby. Young children in such cases spend many hours breathing indoor smoke during the first year of life.
The facts are frightening. Three billion people -- nearly half the world's people -- eat meals every day that are cooked over unclean stoves. And 1.9 million -- mostly women and children in developing countries -- die each year because of that. Globally, pneumonia is the single most significant cause of under-five childhood mortality. Exposure to cooking smoke doubles a child's risk for pneumonia, leading to more than 900,000 deaths in young children under five.
In high-income countries, tobacco smoke is the biggest risk factor for Chronic Obstructive Pulmonary Disease (COPD), a chronic lung disease. But in lower- and middle-income countries it is indoor air pollution from the use of solid fuels for cooking and heating. As many as 3 million people die from COPD every year, and a huge portion, 1.8 million, are from India and the surrounding South East Asia region. In India, in some regions, COPD is the number one cause of death, higher even than heart disease.
At a thought -- provoking talk at a recent conference in Boston, Dr. Sundeep Salvi, from Chest Research Foundation in Pune, India, showed that in a study comparing the health outcomes for women using solid fuels for cooking in villages in India and Thailand, 11.9 percent of the women in India got COPD as compared to 1.5 percent of the women in Thailand. During his talk, Dr. Salvi, commenting on the lower COPD rates in Thailand, remarked that though the data were unpublished, they had observed that women in Thailand cooked in homes on average with one more window than did the women in India.
Kudos to the Global Alliance for Clean Cook Stoves, an incredible public-private partnership led by the UN Foundation, for tackling this problem head-on and committing to provide clean cookstoves to 100 million homes by 2020.
But how about something else in the meantime: a public health campaign to educate women in rural areas in countries like India to cook in homes with one more window? It could be meaningful if it is accompanied with serious efforts to provide them with that one more window in their home. Of course it is an imperfect solution, and does replace indoor air pollution with outdoor air pollution, but may just help to reduce the burden of NCDs faster.
Cooking really shouldn't kill. But for women and children in many parts of the world, it leads to serious diseases, and it does kill. Let us pledge this Earth Day to do something about that. Perhaps we could work together on a global campaign -- One More Window. Simple, effective, and in its own ways, green.
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