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Kitchen smoke from open fires kills millions, but alternatives still costly

Bishnu Maya Dangal blowing to light up the fire for cooking. She coughs, takes a break and blows again. (Credit: U.N. Women/N. Shrestha)

Nepal’s government had hoped to tackle a monumental health crisis by 2017: smoky kitchens. According to World Health Organization (WHO) estimates, smoke from open cooking fires kills 4.6 million people globally and nearly 23,000 just in Nepal every year. Although Nepal’s target will not be met this year – though not for lack of trying – a new report suggests that a women-led market-driven approach may make it achievable by 2022.

According to the report, released last week by Practical Action, smoke from traditional cooking fires is one of the deadliest threats in the developing world, taking more lives than AIDS, tuberculosis and malaria combined. While Nepal’s devastating earthquake in 2015 took 9,000 lives, smoke inhalation from cooking fires takes two-and-a-half times that each year.

“The effects of cooking over open fires have been equated to breathing in the secondary smoke from 400 cigarettes an hour,” Lucy Stevens, one of the authors of the report, said in a press release. “But because the deaths are unspectacular and often marked by a slow decline in health, the issue is not adequately covered by the media, and there is not enough pressure on national governments to tackle the root causes of the problem.”

Nepal was one of the first governments to recognize this killer in its kitchens, introducing policies 35 years ago to encourage clean cooking. In 2013, the government set a target to make all homes “smoke-free” by 2017 with improved cookstoves. By all measures, it was an ambitious goal, but one made impossible after the devastating earthquake of April 2015. A five-month border blockade by India from Sept. 2015 to Feb. 2016 further exacerbated the economic and humanitarian crisis.

Those crises aside, Nepal would have had to install 550,000 improved stoves per year from Jan. 2013 to Dec. 2017 in order provide the 3.4 million necessary to achieve universal access. In 2011, before the campaign was launched, just over 100,000 stoves were being installed per year, which was already double the number being installed four years earlier.

Cumulative number of improved cookstoves installed, compared to required level to achieve clean cooking for all (Credit: Alternative Energy Promotion Center)

Cumulative number of improved cookstoves installed, compared to required level to
achieve clean cooking for all (Credit: Alternative Energy Promotion Center)

To be fair, “smoke-free” according to the Nepali government doesn’t technically mean zero smoke. Instead, the aim is to provide universal access to improved cooking solutions, most of which were mud and metallic stoves. According to the World Bank, these are considered Tier 1 cooking solutions, which are more energy efficient and therefore more cost-effective, but do not significantly improve health. To actually reach the Nepali government’s emissions targets, households would need to install Tier 4 modern fuel, electric or renewable energy stoves.

Still, it would be a significant achievement, and the political will definitely exists. However, what’s missing, according to the report, is a sustainable market.

In addition to a short supply of craftsmen to make the stoves, a natural consumer market has been undermined by aid groups giving out stoves for free. Even if people have the means to buys stoves, they often wait to see if they can get one for free.

According to the report, the weak market an in some ways be linked to the “over-enthusiasm (to a degree) of the government, which has perpetuated an NGO-led model.” That in turn has “hindered the development of a self-propelling stove market in which businesses take the lead in marketing their products.”

Additionally, some people choose not to use their new cookstoves, because it didn’t meet their needs. Particularly in the mountains, open fires not only serve as a cooking solution, but also heat homes in the winter, protect roofs from pests and smoke meats.

Still, the Nepali people are aware of the health risks of open fires, and for that reason most are willing to make the switch.

“People do want stoves. They don’t want their kids living in an environment where it’s dirty and it damages their health,” Andrew Heath, media officer for Practical Action, said in an interview with Humanosphere. “But what we find is that poverty effectively is the biggest barrier.”

Even with generous government subsidies, a $5 basic mud cookstove is too much of an added expense for families living in extreme poverty, and microcredit options are not available for both consumers and producers. The only cost of wood for an open cooking fire is a woman’s time (and health). In a society where men control the finances and a woman’s time is not valuable, traditional fires are by far the most affordable option.

To address all these issues, the report makes one primary suggestion: women.

“Absolutely!” Heath said. “The end user is a woman almost all the time. If they’re part of the design and the design is seen as something that is useful, people buy into it and you create demand straight away.”

Women not only know what they need in a cookstove, they’re also the ones who benefit from it the most. “It’s their health and the health of their children that’s been compromised,” Heath said.

Including women in the production of improved cookstoves not only bolsters a weak supply, but also provides women the financial liberty to purchase stoves for their home. Of course more financial aid, whether through donations or microcredit, would address the main barrier of poverty as well.

“We would commend the Nepali government for their efforts,” Heath said. “It’s by no means meant to be a criticism of the work the Nepali government has done. It’s just a really good case study to look at why it has continued to be difficult to achieve a smoke-free country, even when you do have government backing.”

That government backing will continue to be critical as policy makers move toward a new target of “smoke-free” kitchens by 2022.


About Author

Joanne Lu

Joanne Lu is a South Carolina-based writer and editor dedicated to global development, poverty alleviation and social justice. After a year in Rwanda, she now covers the Asia-Pacific and economics. Find her on Twitter @joannelu or email