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"My younger daughter Megha has been sick since she was born. She has severe bouts of breathlessness. I feel so helpless. I can only cry seeing her unable to breathe."Sonia
Thirty-year-old Sonia is a resident of Bhadola village in North Delhi. The mother of three says doctors have told her that Megha's condition is linked to exposure to large amounts of smoke – not just the child herself, but also her mother during pregnancy.
The dangers of prolonged exposure to smoke are well-documented. However, a recent study conducted in Cornell University, USA, found that indoor air pollution may be far more dangerous than even outdoor air pollution, particularly to women and young children who are exposed to smoke from crude biomass fuel stoves.
According to the authors of the said study, in India, 27 of every 1,000 babies and children die due to exposure to dirty cooking fuels.
"This is the first paper out there that gives a robust causal estimate of the true cost of using these biomass fuels for households, in terms of the young lives lost."Prof Arnab Basu, First author of the study
Breathlessness, Stinging Eyes, Birth Complications: What Indoor Pollution Does to Women’s Bodies
Speaking to FIT, Sonia says that she spends upwards of six hours a day, every day, working on her wood-fueled biomass stove.
"We have a big family of nine people, including my parents-in-law, husband, three kids, and two brothers-in-law. I make rotis worth two kilograms of atta (wheat flour) twice a day (morning and evening)," she explains as she expertly rolls and cooks rotis on her stove as the thick smoke from the stove surrounds her.
"Of course I have trouble," she says when asked if constantly being exposed to the smoke affects her health. "I cough a lot, I get breathless, and my eyes burn. Sometimes when I'm done and get up after hours, I feel dizzy and get a blackout."
Her youngest child Khwaish is only three months old, and has had health issues since birth, says Sonia. "She has allergies all over her head. We don't know why. She's always disturbed and doesn't get proper sleep at night either."
"I know the smoke is not good for them, but I don't have a choice. My daughter wants to be around me constantly, and I need to feed her too, so I end up working with her on my lap."Sonia
This means not only was Sonia exposed to the smoke during her pregnancy, but her children have been growing up breathing the toxins every day since the day they were born.
This isn't just Sonia's story. Other women in the locality have similar experiences to share.
Asha, a mother of three, is one of the many women in the area who have experienced severe complications during childbirth resulting in the tragic loss of their babies.
"My baby Aaradhna died at just four months old. She had breathing issues since birth. I took her to several doctors and hospitals, but they couldn't save her," she tells FIT, adding that just a while before the tragedy, her sister-in-law lost her newborn due to stillbirth as well.
"To nurture a baby in your womb for nine months and then just to lose them in an instant, only a mother can understand that pain," she says, weeping.
The conditions under which they work are made worse during the summer when the heat and the scorching sun add to the smoke.
Why Not Switch to Gas Stoves?
There are several reasons why women, particularly in slums, continue to use biomass stoves instead of LPG gas stoves despite the health complications they face, says Neha Saigal, director, gender and climate change at Asar Social Impact Advisors.
Speaking to FIT, she explains, "Around 3.12 million deaths in the Global South are attributed to using solid fuels for cooking. There is enough data to show that there are detrimental health impacts on women and children – and that pregnant women are especially vulnerable. However, what this data means, and the true gravity of the issue, doesn't permeate to the ground always."
"Many of these women are also unaware of the health issues they are experiencing (beyond coughing and discomfort in the eyes), because they don't have access to healthcare. They only show up much later in life."Neha Saigal
'We prefer chula-made food'
"Oppressive gender norms that operate in the society is another major factor keeping families from making the switch," says Saigal.
Veer Singh, a resident of Sonia and Asha's neighbourhood in Bhadola village, tells FIT that he prefers the taste of food cooked on wood stoves over LPG gas stoves.
"We have 30 members in our family and roti for all of them is made on a chula. This is what suits us (everyone in the family). We don't like the other one (LPG gas stove)."Veer Singh
What about his wife's health? "There is no risk," he says. "The chula doesn't harm their health. Nothing will happen. They sit so far away from the fire, what can happen?"
His wife cuts in saying, "The men only eat. They aren't bothered about the woman's health."
Women's health is low priority
And when the families are aware of the health risks involved, shelling out more money solely for the sake of the health of the women in the household is not considered practical, especially in low-income households already struggling to make ends meet.
"Investing in LPG gas just because they make the woman's life easier is possibly not a priority for families who are already struggling financially," says Saigal.
LPG gas is still inaccessible to many
Even if they wanted to make the switch, "LPG still remains unaffordable to a large part of the population. In India, 41 percent of the Indian population primarily relies on solid fuels for their daily cooking. That means LPG prices are still not affordable to millions of people in this country," says Saigal.
"I would like to switch to a gas stove," says Sonia.
"I am very afraid for my children's health when they grow up. But my husband is a labourer. He makes around Rs 300 a day. We can't afford gas stoves."Sonia
Rama, an Accredited Social Health Activist (ASHA), who works as a change agent with Asar, tells FIT, "Because repeatedly refilling gas cylinders is unaffordable for many of these households, they don't use them even when they have the set up for it."
"Many buy small stoves with mini cylinders and fill them up with 1-2 litres of gas for use in case of emergencies only," she adds.
Changing Minds and Facilitating Access to Safer Fuel Options
The authors of the Cornell University study underscored the need to take indoor pollution just as seriously as outdoor pollution. They explain that switching from dirty cooking fuels to clean fuels like LPG is a vital step to mitigating the health risks linked to it, particularly when it comes to a section of the society that is already vulnerable to poor health outcomes due to other factors like sanitation and lack of access to clean drinking water and nutritional food.
The Pradhan Mantri Ujjwala Yojana (PMUY) was launched by the Union government in 2016 to provide deposit-free LPG connections to women from low-income households. However, not everyone who needs it is able to access it.
"The PMUY scheme is a step in the right direction but linking people who need them has been challenging," says Saigal. This is because many of the families settled in metropolitans like Delhi are migrant workers from other parts of the country, and don't have all their documents on hand.
"Each time they are accepting applications under the scheme, they (the government) require different documents, making it difficult for many families to get approved for it."Rama, ASHA
Moreover, while the first gas cylinder received with the LPG connection is free of charge under the PMUY scheme, subsequent cylinders are subsidised – but not free. "They get a subsidy of Rs 300, but even that is not affordable to many families here," according to Rama.
However, despite the challenges, Rama says that over the past few years, several families are making the switch. "I have worked in the slums of Delhi for the last two years. We conduct surveys, educate people on the harms of biofuel chulas, encourage them to make the switch, and even organise camps to assist them in getting access to the PMUY scheme."
"Just recently we helped 91 families get LPG connections. But there is still much more work to be done."Rama, ASHA worker
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