Smokeless Stoves(To Prevent Respiratory Illness)

Patanatic, GuatemalaMaddie Ehlers, N4

University of Kansas, School of Nursing

Course Objectives: ● Use evidence-based practices, health care technology, and effective

communication strategies to guide the essential public health interventions across the lifespan.

● Use data from population assessments to identify the influences of the determinants of health (environmental, social, political, legal-ethical, economic, behavioral, and cultural) on delivery of care to diverse populations.

● Assess the health status, health care access, and emergency preparedness needs of the defined population.

● Participate with healthcare providers and community leaders in the planning, implementation, and evaluation of health interventions.

● Collaborate with healthcare providers and community partners to promote clinical prevention and population-focused health. Apply knowledge from nursing and related arts and sciences to the care of selected community based aggregates.

The Clinic ● Located in Sector 2 of Patanatic,

Guatemala● Serves up to 300 families

(approx. 1,500 people)● Run by 2 nurses, Ana & Sonia● The communities first physician

will join the team after completing medical school in Guatemala City

● The clinic is being torn down and redone to become a Clinic/Surgical Center with a full functioning operating room

Background Information ● We spent 2 weeks assessing and caring for the

community members of Patanatic, Guatemala ○ School visits, Clinic visits, Home visits

● In the state of Solola where Patanatic is located, respiratory illness is represented as 6.7% of all deaths in Solola (Institutio Nacional de Estadisticas Guatemala)

● Nationwide respiratory illness accounts for 4.5% of all deaths in Guatemala (Institutio Nacional de Estadisticas Guatemala)

Background Information (cont.)● During our time in Patanatic, Guatemala we faced surprising numbers of

respiratory complaints when patients came in for clinic visits● We had a total of 45 respiratory complaints that included:

○ Cough and congestion○ Shortness of breath○ Upper respiratory infections/colds○ Sore throats (Guatemala Patients Seen, 2017).

● This made up 26% of the concerns patients we sought treatment for● While performing home visits I noticed the effect their living

environments had on our own respiratory health, even when spending such little time in their homes

SDG Goal #7 helps to address the issue of poor air quality in homes of Patanatic - “ensure access to affordable, reliable, sustainable and modern energy for all”

Healthy People 2020

Objective: Environmental Health

Topic: Targeting air quality and homes and infrastructure

(Healthy People 2020, 2017)

(United Nations Sustainable Development, 2017)

Plancha Stove● Definition: Wood-burning stove made of iron cured concrete, with a

brick oven core, flat-iron top, and chimney● Vented by a galvanized steel chimney, the stove uses an efficient

burning technology, and virtually eliminates smoke and deadly carbon monoxide in the home

● Reduces wood consumption by 70%, resulting in a long-term benefit to the environment and a better quality of life for families

● Globally, nearly three billion people use polluting, inefficient stoves or open flames to cook their food. Exposure to cooking fire smoke kills approximately two million people worldwide every year (http://www.guatemalastoveproject.org/)

● Excessive smoke inhalation is the leading cause of death in Guatemalan children under the age of 5 ( World Health Organization)

● "Plancha" - synonymous with flat metal plate - designed specifically for cooking tortillas

Reasons to Implement Smokeless Stoves● Respiratory illness remains an issue in Patanatic, Guatemala due to lack of resources, education and

awareness ● The plancha, or smokeless stove, has tremendous positive effects on reducing indoor air pollution

and is a practical option to replace the use of open fires in homes in Guatemala (Albalak et al, 2001)● Exposure to high levels of pollution are associated with acute respiratory illnesses that account for

9% of the global burden of disease (Albalak et al, 2001) ● 80% of those affected by URI’s are children under the age of 5 in developing countries (Albalak et al,

2001) ● A study done showed general acceptance of smokeless stove implementation - community women

(the main target audience) expressed different likes and dislikes, but all reported significantly less smoke in their home while cooking (Pandey et. al., 1990)

● Maintenance teams are essential to ensure optimal functioning of the stoves after the primary implementation was completed, and discusses the necessity for long-term motivational and educational aspects that contribute to continual use of the new stoves (Pandey et. al., 1990)

● High instances of facial and hand burns are due to children falling into open fires when playing or learning to walk (http://nowisthetimemission.com/Guatemala_2013/stoves.html)

InterventionsIndividual:

● Community members are to be educated on smokeless stoves● Individuals are asked during clinic visits if they have a smokeless stove in their home and if

the stove is functioning properly

Community:

● Woodland Public Charities has provided the stoves to many homes in Patanatic, Guatemala● Community Mayor is putting a large emphasis on educating the people of sanitation needs

System (still need to be implemented):

● Government funding for community coalition to check function and implementation of stoves in every home

● Advertisement such as brochures to inform community members of how beneficial the functional stoves can be and what they do if they need one or if theirs is broken

Suggestions:Formation of a community coalition who interacts with the community and with incoming volunteers

Standardized assessment and documentation of smokeless stoves in the community

Education - use of brochures or other social media tactics to address proper maintenance and utilization of smokeless stoves

Goals for the Future:● All families have functional smokeless

stoves in their households● An overall increase in the health and

well being of the community members○ Reduced respiratory illness○ Fewer secondary complications

● Decreased indoor air pollution● A greater state of health in the

community● Fewer complaints of respiratory illness

in the clinics

Most Profound Clinical Experience

Overcoming the language barrier

Traditions - using insects and plants to make scarves, blankets & moreMost

Profound CulturalExperience

References:Albalak, R., Bruce, N., Mccracken, J. P., Smith, K. R., & Gallardo, T. D. (2001). Indoor Respirable Particulate Matter Concentrations from an Open Fire, Improved Cookstove, and LPG/Open Fire Combination in a Rural Guatemalan Community. Environmental Science & Technology, 35(13), 2650-2655. doi:10.1021/es001940m

Healthy People 2020. (2017). Environmental Health. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/environmental-healthInstitute for Health Metrics and Evaluation. (2015). Retrieved January 30, 2017, from http://www.healthdata.org/guatemala

Institutio Nacional de Estadisticas Guatemala. (2017). Retrieved March 23, 2017, from http://www.ine.gob.gt/

Pandey, M., Neupane, R., Gautam, A., & Shrestha, I. (1990). The Effectiveness of Smokeless Stoves in Reducing Indoor Air Pollution in a Rural Hill Region of Nepal. Mountain Research and Development,10(4), 313-320. doi:10.2307/3673493

The University of Kansas School of Nursing (2017) Guatemala Patients Seen [Microsoft Excel spreadsheet]. Patanatic, Guatemala: Christine Lesniewski. [February 01, 2017]

United Nations Sustainable Development. (2017). Retrieved February 01, 2017, from http://www.un.org/sustainabledevelopment/energy/