(To Prevent Respiratory Illness) Patanatic, Guatemala. Maddie Ehlers, N4 University of Kansas, School of Nursing

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1 Smokeless Stoves (To Prevent Respiratory Illness) Patanatic, Guatemala Maddie Ehlers, N4 University of Kansas, School of Nursing

2 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.

1,500 people) Run by 2 nurses, Ana & Sonia The communities first physician will join

3 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

4 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)

5 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

issue of poor air quality in homes of Patanatic - ensure access to affordable,

6 Healthy People 2020 Objective: Environmental Health Topic: Targeting air quality and homes and infrastructure (Healthy People 2020, 2017) 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 (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

families Globally, nearly three billion people use polluting, inefficient stoves or open flames to cook their food.

7 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 ( 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

8 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 (

9 Individual: Interventions 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

10 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

11 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

12 Most Profound Clinical Experience Overcoming the language barrier

14 Most Profound Cultural Experience Traditions - using insects and plants to make scarves, blankets & more

16 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), doi: /es001940m Healthy People (2017). Environmental Health. Retrieved from Institute for Health Metrics and Evaluation. (2015). Retrieved January 30, 2017, from Institutio Nacional de Estadisticas Guatemala. (2017). Retrieved March 23, 2017, from 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), doi: / 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

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