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Mamphela Ramphele describes how collecting and burning wood and biomass damages womens health and the environment, and how household electricity revolutionizes their lives. |
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When we become ill, many of us will be treated by doctors with advanced technology. We will receive the latest drugs. If our doctors need to, they can research sophisticated databases, press a few buttons and consult anyone in the world. But as we all know, most of the world has no such access. Indeed, even in the richest countries, there are many who do not have access to adequate medical care. Access to critical medical services is socially determined.
We have become more aware of the intimate linkage between the environment and health outcomes. The breakdown of the water, sanitation and electricity infrastructure in Iraq and the anticipated effects on the health of a predominantly urban population are of serious concern. We have also recently been reminded of the importance of having strong public health infrastructure and core functions in place, through the effective, immediate response to severe acute respiratory syndrome (SARS) in Viet Nam, which limited the outbreak in that country through combined clinical and public health approaches.
Environmental risks disproportionately affect poor households, and it is poor children and women who are shouldering an unfair share of this burden. Acquiring and using biomass fuel and fodder for the household may take up anywhere between two and nine hours a day in developing countries, depending on their availability. In Lombok, southern Indonesia, women spend about three hours each day cooking, and four hours each week collecting dead wood or agricultural residues to be used as fuel. In some areas of Kenya, women spend seven hours a day on similar tasks.
A 1996-1997 study carried out by Jashodhara Dasgupta of Sahayog, a research and activist group, in Uttranchal, western India involving over 1,000 women in ten locations across 12 districts found the proportion of miscarriages to be 30 per cent, five times higher than the average rate reported in the National Family Health Survey of 1992-1993. It noted that women have a gruelling schedule during pregnancy including lifting heavy loads of wood, manure and grass which added to the risk of miscarriage. The women of Uttranchal are also under continuous mental stress from anxiety over how to sustain the household. There is high male migration to urban areas, while depleted forests have made the trek to gather fuelwood and fodder much longer and tougher.
Half the worlds population is exposed to indoor air pollution, mainly through the burning of solid fuels for cooking and heating. Biomass is still the main source of energy for 60 to 90 per cent of households in developing countries some 2.5 billion people. It is the mothers and their children, primarily in rural areas, who are mainly exposed to the effects of poor ventilation of biomass fuel while using primitive stoves, and who pay the price in illness and premature death. Much evidence has been documented, for example, that associates burning this fuel with the incidence of chronic bronchitis in women and of acute respiratory infections in children.
Policies for rural areas that encourage the uptake of petroleum fuels and efficient use of biomass fuels can effectively address the problems of indoor air pollution and womens physical labour. But women must be involved in planning these policies and interventions to ensure that they are implemented successfully and sustainably. Energy policies and projects by themselves will not change the plight of women in society, but they can be used as entry points for reducing a preventable burden of death and illness among women and in promoting greater fairness in allocating opportunities and resources between the sexes. The effectiveness of addressing this life-threatening issue will depend on three key considerations:
Government programmes need to include a component to inform, educate and communicate the health, environmental, energy and financial consequences of indoor air pollution and the different interventions that reduce exposure. There are typically three types of these:
Long-term sustainable solutions require full participation from local government, civil society, the commercial sector and local communities, particularly women.
A rural energy market study, sponsored by the joint United Nations Development Programme/World Bank Energy Sector Management Assistance Program (ESMAP), uncovered promising results about the impact of electrifying households on the lives of women. A survey of 5,048 women from six states of India in 1996 revealed that access to electricity directly affects the amount of leisure time they have, while providing channels to increase their knowledge and awareness through facilitating reading and watching television. It also found that women from households using electricity are likely to spend less time collecting fuel and are more likely to use fuels that are less debilitating to their health.
Electricity is available in almost all villages in India today. However, according to the ESMAP study, which surveyed six out of the 20 states of India, about 60 per cent of households do not have electricity from the grid. Based on a 2001 census of India, the statistic is as low as 40 per cent of the country with access to electricity.
As the Global Health Council emphasizes, the task facing us today is daunting. Each year, all around the world, tens of millions of human beings die needlessly, and hundreds of millions of lives are ravaged by ill health. The world has the resources to greatly reduce this loss and suffering. When it comes to global health, there is no them, only us
Dr Mamphela Ramphele is the retiring Managing Director of the World Bank and Senior Advisor to its President. PHOTOGRAPH: UNEP/Topham |
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