In late July, PIH and the PIH-supported Equipo Tecnico en Educacion y Salud Comunitaria (ETESC) assisted 140 families in Jacaltenango, Guatemala, as they learned to install, use, and maintain improved wood-burning stoves. In a region where wood is the main source of cooking fuel, kitchens are frequently thick with lung-damaging smoke and forests are steadily shrinking from the demand for fuel.

learn more about PIH’s manual to treat chronic diseases in developing countries.

Improved stoves decrease kitchen smoke by as much as 90 percent, significantly reducing both wood consumption and the smoke-related non-communicable diseases (NCDs) – asthma, chronic respiratory disease, lung cancer – affecting people in rural communities like Jacaltenango. This project is one of many PIH initiatives aimed at reducing the burden of NCDs in developing countries.

"Visitors to rural Guatemalan homes are often astounded by the thick smoke filling people’s homes,” says Lindsay Palazuelos, PIH’s project coordinator in Guatemala. Families spend a significant amount of time and money buying, chopping and hauling wood to cook meals and heat water, all of which has to happen multiple times a day.

“Because of this, it’s not uncommon to meet middle-aged women suffering from emphysema or chronic bronchitis, as if they were lifetime smokers,” continues Palazuelos. “But instead of a two pack a day habit, they’ve simply been making beans and tortillas in a smoky kitchen.”

Roughly 90 percent of rural households worldwide still use solid fuels such as wood for cooking. As a result, an estimated 1.5 million people die prematurely from smoke-related NCDs each year, making this the eighth most dangerous contributor to the global burden of disease.


Each stove includes a combustion chamber, chimney and concrete components that can be assembled by hand, without special tools or adhesives.


The amount of wood used by a family of four every two months.

Beginning an environmental movement, changing lives

In response to high rates of respiratory illness, PIH invited five communities to form environmental health committees – each consisting of 35 families, with 90 percent of representatives being women. Once the committees had been established, ETESC's ocal Environmental Health Promoters presented each of them with five environmental health projects that PIH could introduce into that community to improve their quality of life.

After receiving training on environmental health themes and analyzing their own communities, all five communities chose to introduce high-energy, low-smoke stoves. 

“I was excited that the community groups chose this project, because indoor smoke is closely associated in children with acute respiratory illnesses like pneumonia, one of the biggest childhood killer,” says Palazuelos. 

The improved ONIL stove, manufactured by HELPS International, will lower families’ wood use by 50-70 percent and decrease kitchen smoke by over 90 percent. As Environmental Health Promoter Francisco Pablo Francisco put it, “If we keep cutting down so many trees, there won’t be forests left to cut.” With the new stoves, he added, “The number of trees being cut is going to decrease, and so is the indoor smoke.”

Participant Catarina Mateo explained that the groups chose stoves because “it’s what we women most use when we work in the kitchen.” She also anticipates that with less smoke she won’t cough so often while cooking.

Combating the root cause of disease

Beyond comfort, these stoves will save lives. Lessening each family's exposure to smoke will result in fewer chronic and often fatal diseases. The closed stove and mesh-protected chimney also prevent accidental burns – a common risk when small children are near open cooking fires. 

The interactive training gave participants a chance to practice assembling the stove’s innovative ceramic combustion chamber, attaching the chimney and – most exciting – starting a cooking fire.

As the flame came to life on the test stove, the participants hovered their fingers an inch above its surface, and smiled approvingly at the temperature.

The stoves arrived and were installed in early August. 

PIH’s three-year environmental health initiative is supported by the Guatemalan nonprofit ETESC – Equipo Tecnico en Educacion y Salud Comunitaria – and funded by Green Mountain Coffee Roasters

Addressing NCDs is an integral part of PIH's work.
Learn more about PIH's work in Guatemala