Written by Chris Keil // 

I am seated with new friends and acquaintances in a small main room of a small home in Ethiopia. A wonderful mix of smells swirls around the group as we chat about family, professional projects, and world affairs. The fragrance of burning eucalyptus charcoal and incense permeates the space. Soon, coffee beans are roasting on an open pan and, when finished, the pan is brought around the room. Each person waves their hand above the beans to waft the scent-laden air toward their nose to appreciate the incomparable aroma. The beans are ground, water boiled, and coffee prepared all right there before us. This is hospitality and community at its best.

Yet afterwards and during subsequent coffee ceremonies (ቡና ማፍላት), my professional training started raising questions in the back of my mind. What is in this delicious air we are breathing? Air pollution is part of my trade as an environmental health professional. So while cherishing the people, the coffee, and the culture, I also wondered about the indirect costs of this beautiful experience. In fact, this scene provides a glimpse into an often unrecognized public health problem: indoor air pollution in the 2/3rds world.

Cooking with biomass, be it wood, charcoal, dung, or agricultural residue is a practical reality and a cultural norm in much of the majority world. Exposure to pollutants released from combustion is responsible for a significant portion of the burden of respiratory disease in these areas. Women are most often the ones doing the cooking and thus have the greatest exposures. Infants and children, whose respiratory systems are still developing, are often nearby, their lungs particularly sensitive to environmental insults. The women typically have no choice about the chore of cooking.

In the case of the coffee ceremony, women consider it an honor to do the coffee preparation. Yet this cultural practice increases their smoke exposures. In some Ethiopian households this is done two or three times daily. Whatincreased risk of health effects comes along with this distinctive cultural practice?

2A few years ago I and some of my students did a project to explore this question. We visited a number of homes in Addis Ababa and made the sacrifice for science of being served delicious coffee and snacks again and again. We ingested way more caffeine than is healthy. Did I mention that you must drink at least three cups of coffee each time? But at the same time we measured the general air quality in the room and took personal air samples of the woman who did the coffee preparation. As expected, we were able to document the increased risk of respiratory disease and other health effects from the particle and carbon monoxide exposures during the coffee ceremony, especially to the women preparing the coffee. But what can be done? What should be done?

From a technical perspective there are other heating methods for roasting beans and heating water. There are different fuels, but they may not be economically available. There are alternative stoves, but they may not acceptable to the coffee preparers. An engineering “fix” to a problem diagnosed by a group of outsiders is unlikely to be implemented with any enthusiasm. Particularly when half of the women we worked with didn’t consider smoke exposure to be a problem.

Social considerations also add complexity to finding a way to reduce health risks. Our follow up work clarified the use of incense was the main source of particles and thus respiratory disease risk. When asked about using incense some of the women cited religion and the advice of their priests as reasons for using incense. Others cited religion and the advice of their priests as reasons for not using incense. Much more than a scientific investigation and technical solution is needed to enter into those discussions.

To get the thoughts of those most directly affected, we asked the coffee preparers what they thought of using alternatives to charcoal. Almost half said they wouldn’t consider it, charcoal is the tradition and is what they like. Others expressed that they don’t have any choice in the matter, both for economic reasons and because they are told to use charcoal. Some of the women who were concerned about the exposures expressed creativity in pre-heating the water outside or with an electric kettle.

At the end of the project, I felt a little frustrated with conflicting feelings. I demonstrated what I expected, there is an increased health risk. But there was no way, given the complexity of the practice, that I was going to start making suggestions. So I find myself where I often do, sitting in the tension. I really enjoy the coffee ceremony the way I experienced it, indoor air pollution and all. The social value of it is undeniable. Stopping, talking, and resolving issues while drinking outstanding coffee is so civilized. But the women doing the cooking should have viable options for reducing their risks if they choose. It’s an unsatisfactory feeling knowing quantifiable risks and experiencing the realities of intangible benefits. At any rate, I long for my next coffee ceremony.

//

Chris Keil is a Professor of Environmental Science at Wheaton College in Illinois. He is director the environmental science academic program and is co-director of the Wheaton College Science Station located in the Black Hills of South Dakota. His area of technical expertise is Environmental Public Health with an emphasis on chemical exposure assessment. Chris likes to think about and talk about and practice ways to live well together in creation.

 

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