Every year, air pollution kills seven million people worldwide – more than malaria, tuberculosis and HIV and Aids combined. World Health Organisation (WHO) estimates that four million people die each year from diseases caused by cooking-related air pollution. In 2016, household air pollution was the highest contributor to deaths in sub-Saharan Africa caused by non-communicable diseases. Over 95 percent of household in Malawi use firewood, charcoal and crop residues for cooking. Many households use inefficient stoves and poorly ventilated kitchens, resulting in household air pollution. Nearly 10 percent of deaths in the country can be attributed to cooking smoke. Household air pollution from solid fuels is a leading risk factor for the disease burden. But why are effects of air pollution on health neglected in the country?
Although household air pollution in the country is higher than the recommended WHO safe limits, efforts to reduce the public health hazard are generally non-existent. Studies show that household air pollution contributes to low birth weight, respiratory illnesses such as pneumonia and impaired lung function. Wood smoke, for example, releases hundreds of chemicals – small particulate matter, soot, carcinogens, carbon monoxide – that penetrate lungs and cause inflammation of airways. This initiates multiple chronic health concerns. However, women and children are heavily affected since they spend most time in cooking spaces. Although this overburdens the country’s public health system, surprisingly, there is a perception that air pollution is not a problem for developing countries. This is not true. Currently many African countries, including Malawi, are attaining urbanisation and consequently alarming levels of outdoor air pollution. The country needs to regulate emission levels. Awareness of the implication of air pollution to public health is low. It is important to know that inhaling smoke from firewood, living close to factories, heavy traffic roads, inhaling secondhand smoke are all threats to an individual’s health.
In developed countries, people are aware of the ambient air quality with high-tech monitoring systems used to analyse air pollution. Unfortunately, this technology is scarce in Malawi, where monitoring stations are only located at the Kamuzu International Airport and the Polytechnic – with limited capabilities. Worrisomely, there is no standalone law on air pollution despite some mentions in the Environmental Management Act and National Environmental Policy. Evidently, sold fuels remain a major source of cooking energy in Malawi and access to electricity remains low. Several clean cookstove interventions are underway in the country. They include Chitetezo Mbaula and the Malawi Global Alliance for Clean Cookstoves Initiatives. While these stoves offer environmental or climate benefits, they may not be effective to reduce emissions to the recommended WHO indoor air quality guidelines. Therefore, a public health perspective into the cleaner cooking stove interventions may solve this problem.
The first WHO Global Conference an Clean Air Pollution and Health, held in Geneva from October 30 to November 1, assembled policymakers, academics and international organisation to share evidence and solutions to combat air pollution. This underlines that air pollution is a global public health emergency that requires collaboration between governments and stakeholders to share effective solutions. The need for further localised research to inform policy is dire. However, unless the public, researchers, government and concerned stakeholders in Malawi recognise both outdoor and household air pollution as major public health problems, the importance of these exposures will continue to be neglected and efforts to curb diseases they contribute to, hampered.
(Source: The Nation Malawi, Monday 5, November 2018)