About 3.8 million deaths from illness every year are attributable to use of solid fuels and kerosene for cooking, according to the World Health Organisation
Fatema lives in the Unchiprang refugee camp at Teknaf. To cook her meals, she uses an oven made of mud and fire wood collected from the forestland or bought from the market.
To cook each meal, she has to burn 10-12 pieces of fire wood that are about 1.5-2 feet in length.
“It is common for us to have breathing problem because using solid fuels and kerosene for cooking create a lot of smoke inside the house,” Fatema says. “I have no other option but to continue using them.”
Fatema is one of the estimated three billion people who use solid fuels and kerosene for cooking that produce high levels of household air pollution. About 3.8 million deaths from illness every year are attributable to it, according to the World Health Organisation (WHO).
Of these 3.8 million deaths, 27% are due to pneumonia, 18% from stroke, 27% from ischaemic heart disease, 20% from chronic obstructive pulmonary disease, and 8% from lung cancer.
The cramped Rohingya shelters are also susceptible to fire. Until August 14 this year, an estimated 80 refugees have been affected by 12 incidents of fire, according to Inter-Sector Coordination Group (ISCG).
Lack of options
The UN refugee agency (UNHCR) and the Food and Agriculture Organization (FAO) say four out of five Rohingyas rely on firewood for cooking and heating – a major cause of deforestation in surrounding areas.
About a year ago, both side of Cox’s Bazar-Teknaf Highway was full of greenery. After the Rohingya influx, 4,318 acres of forestland have been used to construct makeshift settlements for refugees, the Forest Department’s Cox's Bazar (South) Division said.
The relief material being distributed among the Rohingyas do not include firewood, forcing the refugees to cut down trees from government forests. An ISCG report estimated that the refugees need about 700 tons of firewood every day and that they have no alternative fuel.
“When cooking with solid fuels, inefficient stoves create a huge amount of black smoke which produces small carbon particles that penetrate deep into the lungs,” Environment Department Director Ziaul Haque said.
Indoor smoke can be higher than acceptable levels for small particles, especially in the Rohingya refugee camp where every household cooks inside the house, he said. Everyone living inside the shelter is vulnerable.
"Long-term exposure of these carbon particles increases the risk of lung cancer," he added.
Women, children most vulnerable
The WHO described household air pollution as “the world’s single greatest environmental health risk,” saying that it accounts for 7.7% of global mortality.
It said household air pollution causes non-communicable diseases including stroke, ischaemic heart disease, chronic obstructive pulmonary disease (COPD) and lung cancer.
Exposure to household air pollution almost doubles the risk for childhood pneumonia and is responsible for 45% of all pneumonia deaths in children less than 5 years, the WHO said.
Over half of the Rohingyas who fled to Bangladesh in the last one year are children. Sixty percent of women and children living in the refugee camps and host communities are vulnerable to respiratory diseases.
Cox's Bazar Surgeon Abdus Salam said: "Indoor air pollution can affect health and here in the camps, people are highly dependent on inefficient stoves. The smoke from firewood is increasing health risks. Respiratory infections, breathing problems are common among the camp’s residents.”
Md Kamal Hossain, the district’s deputy commissioner, said steps are being taken to address the issue.
He told the Dhaka Tribune that they have supplied 11,000 LPG gas cylinders in the camps.
"An estimated 200,000 households need to replace their cooking facilities,” he said. “It will take time.”