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Wang Yong Qing, from Qintou village, China, has fluorosis, a form of poisoning which affects people who burn coal in open stoves in poorly-ventilated houses. Photo: Lee Fitzroy/OxfamAUS.
Smoking out a health crisis
Remote communities in south-west China are learning how to protect themselves from fluorosis poisoning, as East Asia Senior Program Officer Louise Mooney discovered during a recent visit.
Sitting in a windowless and smoke-filled house in the remote and harsh landscape of northern Guizhou Province, Wang Yong Qing seems a world away from the China that has experienced the fastest economic growth rate of any country in history.
Qing and his family are part of the growing rural poor who are being left behind in China’s economic boom. They struggle to grow enough food to eat in their small village of Qintou and as a result experience food shortages for nearly six months of the year.1
All three of Qing’s children have been forced to live and work outside the village to support the family.
Qing and his family rely on locally grown corn as their staple crop, and even rice is seen as a luxury saved for special occasions. Ironically, this essential food, corn, along with another staple, chilli, is causing one of the region’s biggest health crises — a disease called fluorosis.
Fluorosis poisoning in this region occurs predominantly through eating contaminated food — most commonly corn and chillies — that have been dried by heat generated from burning coal on open stoves. Symptoms range from the comparatively mild, including fluorine-stained teeth, to severe skeletal poisoning and paralysis. There was anecdotal evidence in Qing’s community of very high rates of disease, for which there is no effective treatment.
This led Oxfam to establish a pilot project to address the causes of fluorosis. The project, implemented by Oxfam Hong Kong and jointly funded by Oxfam Australia, was developed in conjunction with villagers and government health and poverty alleviation office staff, as part of a broader strategy to improve living conditions for this impoverished region.
The project began a year ago with a comprehensive survey being carried out in five neighbouring villages. The survey confirmed fears of alarming rates of disease and poor knowledge about the causes, with morbidity rates of 100% for fluorine-stained teeth and 51.6% for severe skeletal poisoning.2
The local community and Oxfam jointly decided on four key measures to address the fluorosis problem: community health promotion and education in disease prevention; supplying villagers with anti-fluorine stoves; building concrete solar-drying platforms for food; and promoting alternative income-generating activities such as pig-raising, so that villagers can buy fluorine-free food such as rice.
For Qing and his family, having one of the safe, anti-fluorine stoves in their home would be a dream. The stoves are covered and have chimneys to remove harmful smoke from houses. Visiting his home in April this year, I can understand his desire to remove the thick, black, cough-invoking smoke that pervades most houses in the village. Even as the chill of winter eases and spring bursts across this mountainous region, most villagers are still burning coal in open stoves inside their poorly ventilated homes to prepare food for themselves and their animals.
The real strength of the project, according to villagers and government officials, is Oxfam’s participatory and flexible approach. Villagers feel engaged in the project and their opinions valued — aspects that are vital to the project’s success. At the request of villagers, income-generating activities have recently been expanded to include walnut production to supply a nearby factory that produces the local specialty, walnut milk.
For Qing and his community this type of initiative could have far-reaching benefits — a stable income to support their farm, a reduced need for family members to move away from the village to earn money, and improved health without fluorosis — all in a healthier, smoke-free environment.
1 “Clipping the Dragon’s Wings”, December 19th 2007 edition of the Economist.
2 Statistics taken from a PRA for Community Health Promotion findings, documented in “Rural Health Programme of OHK” presentation by Lei Guangqing, 3/4/2008