Unique photo project tells story of air pollution in informal settlements

Residents in slums in Malawi and Kenya have shared their experiences of using solid fuels and their perceptions of the harms of household air pollution (HAP) through a unique photovoice project led by researchers at the University of Stirling.

Nineteen participants living in informal settlements in Ndirande, Malawi and Mukuru, Kenya, were armed with android phones and trained to take photos to show their daily lives of cooking with solid fuels – including charcoal, wood and other biomass fuels – in order to capture the awareness and perceptions of the harms caused by smoke when cooking in their communities and the efforts residents take to minimise the impact of HAP.

Led by Dr Isabelle Uny of Stirling’s Institute for Social Marketing and Health in partnership with an international team of researchers from the Malawi University for Business and Applied Sciences and the Kenya Medical Research Institute, the community-based participatory method known as ‘photovoice’, provided academics with first-person accounts of the behaviour, priorities and concerns of those who rely on solid fuels, such as wood and charcoal, living in the impoverished communities.

Dr Uny said: “This photovoice study is unique in describing in detail, through the eyes of residents themselves, some of the economic, social and cultural determinants of solid fuel use in the informal settlements of Ndirande and Mukuru. 

“The use of solid fuel and the impact of HAP in informal settlements on health in Sub-Saharan Africa is poorly understood, and scarcely researched. The economic, environmental, social and cultural determinants of HAP are also poorly understood or acknowledged. Understanding those key factors, and their role in determining fuel choice, is key to developing contextual, effective and sustainable HAP mitigation interventions. 

“To our knowledge this is the first study to use photovoice to explore HAP in both Mukuru and Ndirande and through this method we were able to see what type of fuel is being used for cooking and why. 

“While firewood is commonly relied on in both communities, charcoal briquettes are gaining in popularity due to their affordability and ease of use. Due to financial and economic constraints, other ‘fuels of the last resort’ – such as maize residue or plastic waste – are also used as fuel in informal settlements, when households cannot afford to purchase other fuels to cook and heat.” 

Dr Uny added: “Our findings show that residents are aware of some of the dangers of the smoke arising from the use of these solid fuels to their health, and that they use a range of simple behaviours to try to limit their own exposure and that of their household members, where they can.

“What is fundamental is that the residents and their experience must be at the heart of the solutions that will reduce the health harms of household air pollution.”

3.2 millions deaths

Worldwide, almost 3.6 billion people – 47% of the global population – are still exposed to HAP and suffer major safety risks linked to the use of solid fuels for cooking. HAP is linked to diseases and chronic conditions including asthma, stroke, heart disease and lung cancer and people with low socio-economic status are the most vulnerable to the effects of HAP. 

Currently, this leads to approximately 3.2 million deaths per year, with HAP generated by solid fuel use accounting for nearly 700,000 deaths each year across Africa. In Sub-Saharan Africa, 51% of urban populations reside in informal settlements or slums, where residents often rely partially or totally on solid fuels for cooking and heating, because cleaner fuels—such as liquified petroleum gas (LPG) or electricity are either unavailable or unaffordable. 

Dr Uny added: “Through ‘photovoice’ we were able to understand the complexity of the issues around solid fuel use and HAP through the lens of those who live in informal settlements, enabling community participants to document their own issues and assets and support collective advocacy.

“This study highlights not only the need to understand the daily life, priorities and concerns of those who use solid fuels on informal settlements, but also the urgency to place them and their experience at the heart of the solutions that will reduce the health harms of household air pollution.”

Research

The photovoice project is part of a two year study funded by the UK Research and Innovation Arts and Humanities Research Council and carried out by the University of Stirling in partnership with the Kenya Medical Research Institute and Malawi University of Business and Applied Sciences.

The research, ‘Exploring the use of solid fuels for cooking and household air pollution in informal settlements through photovoice: The Fuel to Pot study in Ndirande (Malawi) and Mukuru (Kenya)’ is published in PLOS ONE.