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Dear Tom</div>
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I don't want to contradict either of you on the various interpretations but I would like to check something with you, as it is mere opinion:</div>
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<span style="line-height: initial; font-family: Calibri, sans-serif; font-size: 18px;">"</span><span style="line-height: initial; font-size: 10pt; font-family: Arial, sans-serif; color: rgb(38, 38, 38);">According to the World Health Organization, household
air pollution from cooking kills over 4 million people every year and sickens millions more."</span></div>
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Do think think the average reader of that quote realises that the quote should be:</div>
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<span style="line-height: initial; font-family: Calibri, sans-serif; font-size: 18px;">"</span><span style="line-height: initial; font-size: 10pt; font-family: Arial, sans-serif; color: rgb(38, 38, 38);">According to the World Health Organization, household
air pollution from cooking contributes to the premature death of over 4 million people every year and sickens millions more."</span></div>
<span style="color: rgb(31, 73, 125); font-family: Calibri, 'Slate Pro', sans-serif, sans-serif;"></span>
<div><span style="color: rgb(31, 73, 125); font-family: Calibri, 'Slate Pro', sans-serif, sans-serif;">There is only one occurrence I can find in the WHO documents that says 'kills' and it misquotes another WHO document that says 'premature deaths'. </span></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><br>
</font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif">The 'kills' argument leads to [multiple cites] things like, 'cooking kills x-many women per day' and 'since we have been talking in this meeting y-many women and children have died
from cooking smoke'.</font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><br>
</font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif">The abuse of statistics is universal but I see nothing wrong with stating problems as they are, in a context, with realistic plans and expectations, and competent implementation of
appropriate solutions. That's just me. Maybe I am not 'Hollywood' enough. </font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><br>
</font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif">The 'creation of memes' centered on headline-grabbing alarm and calamity-mongering is a major distraction. I am saying
<i>nothing</i><span> against the central proposition about smoke and health. My father died from cigarette-induced lung cancer. Does that qualify me to make emotional appeals for lower performance tier target values? No.</span></font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><span><br>
</span></font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><span>There is a popular story in the press right now that surely no one can miss. It is that in Hollywood there is a serious problem of sexual violence against women who have to leave
their homes daily to earn a living, or at least make the attempt. Shall we stovers propose that if these women and girls were provided with a commercial quality stove, pot and training to make jam, and the opportunity to sell through a cooperative store, the
number of these assaults would be reduced? This seems to be a good proposal. There are lots of people around Waterloo who know how to make jam. </span></font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><span><br>
</span></font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><span>The number of exposures to violence could be reduced if these women at least had a coffee maker because a lot of these attacks apparently start in a coffee shop. We have a responsibility
to protect those vulnerable women who are only in Hollywood because of a lack of opportunities in the rest of the country. Some of them were already fleeing violence at home. </span></font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><span><br>
</span></font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><span>Please send $145 for each women you want me to save. I'll give them the kind that makes good cappuccinos. They like them (it's cultural).</span></font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><span><br>
</span></font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><span>This is the quality of argument that is being used to raise funding. There is a well-established correlation between young girls in Hollywood meeting producers for a drink and
sexual violence. Surely a cooking device of some kind is the solution. </span></font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><span><br>
</span></font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><span>Two more things:
</span></font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><span><br>
</span></font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><span>The 'all PM2.5 causes illness and or death' is based on an
<i>argumentum ad ignorantium</i><span> meaning proof from ignorance: 'all PM2.5 is equally toxic because we have not proven that it isn't.' That is the founding claim (and wording, paraphrased) of the EPA's regulations which serves as the basis for the WHO's
calculations. Nikhil traced that to source. </span></span></font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><span><br>
</span></font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><span>The Kyrgyzstan winter stove pilot proved beyond doubt that getting the smoke outside, alternatively not making as much
<i>and</i><span> getting it outside, reduces personal exposure, a conclusion reached without modeling any kitchens or dispersion. It also showed that men have higher exposure to PM2.5 than either children or women and benefitted the most from the improved stoves
and installations. </span></span></font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><span><span><br>
</span></span></font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><span><span>The inference here is that there is a lot more going on in Hollywood than we supposed. Details available in installments at the checkout till in your favourite store. </span></span></font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif"><br>
</font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif">Regards
</font></div>
<div><font color="#1f497d" face="Calibri, Slate Pro, sans-serif, sans-serif">Crispin <br>
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<p>Nikhil,</p>
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<p class="MsoNormal">You complain that there is no demonstrated causality between emissions metrics (HAPS, PM2.5) and mortality and argue that therefore a stoves program shouldn’t be based on models and estimates of mortality. For many years the doctors in
this community have advocated for more physiological studies. Direct causes are difficult to get from death records. For example, my father’s death certificate lists a cause that was the consequence of the treatment rather than the cancer that he suffered
from so he might not show up in a cancer statistic. I do know that wherever I travel people in industry and in government are concerned about PM 2.5 levels from any combustion source. Real or imaginary a relationship is assumed and PM 2.5 is regulated. </p>
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<p class="MsoNormal">The stove policies and programs are based on a strong statistical correlation between PM 2.5 and reported mortality due to respiratory or cardiovascular causes. That correlation has been validated for some developed and developing countries.
(Every study I have seen cautions about the shortcomings of the statistics but the correlations are strong.) If I were a policymaker I would find enough justification in the statistical correlation to promote healthier environments through programs like improved
cookstoves of all kinds. The estimates that you complain about are likely based on the global rather than local statistics.
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<p class="MsoNormal">You have told us at least weekly for almost a year that you are unhappy with using health indicators to justify improved stoves programs but you have not offered any alternative. (Listening to your complaints has been like listening to
a broken record.) What do you propose? And, what should the stoves community do about it? </p>
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<p class="MsoNormal">Tom </p>
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<p class="MsoNormal"><b>From:</b> Stoves [mailto:stoves-bounces@lists.bioenergylists.org]
<b>On Behalf Of </b>Nikhil Desai<br>
<b>Sent:</b> Thursday, October 12, 2017 10:50 AM<br>
<b>To:</b> Discussion of biomass cooking stoves <stoves@lists.bioenergylists.org><br>
<b>Subject:</b> [Stoves] Ghana news: Second Lady named GACC ambassador; HAP deaths "alarming"</p>
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<p class="MsoNormal" style="margin-bottom:12.0pt">On the one hand, we have GBD (2016) saying deaths attributable to HAP from solid fuels declined from 3.3 m in 2006 to 2.6 m in 2016 and DALYs attributable to HAP over these ten years declined from 109 m to 77
m. <br>
<br>
And here we see a claim not about attribution but causality - </p>
<blockquote style="margin-left:30.0pt; margin-right:0in">
<p class="MsoNormal">"<span style="font-size:10.0pt; font-family:"Arial",sans-serif; color:#262626">According to the World Health Organization, household air pollution from cooking kills over 4 million people every year and sickens millions more."</span></p>
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I would like WHO to give us HAP deaths by level of exposure, cause of death, and age/sex deciles by country for every 10-year interval since 1980. <br>
<br>
Coming to Ghana, from WHO data I have, in 2008 some 37% of Ghana households reported using charcoal, 46% wood, and 11% LPG. WHO has no data on fuel use shares since. <br>
<br>
What about deaths? World Bank says Ghana population is some 28 million, and crude death rate 8 per 1,000 which means a total of some 1.76 million deaths per year. So the alleged 17,000 deaths attributable to HAP are less than 1%. <br>
<br>
Ghana Statistical Service <a href="http://www.statsghana.gov.gh/docfiles/publications/CRVS%20Assessment%20Report%20Final_%2018.04.17.pdf" target="_BLANK">
reports</a> that its Civil Registration system is do deficient, </p>
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<p class="MsoNormal" style="margin-bottom:12.0pt">"Each year, about one third of births go unregistered, adding to the growing number of its population who live and die without leaving a trace of their existence and/or their characteristics on any legal document
or statistical record. Also, only one in five deaths each year gets recorded. " </p>
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<p class="MsoNormal">No worries. We have WHO to kill by assumptions and Ajay Pillarisetti to save by assumptions. <br>
<br>
Nikhil</p>
<h1 style="margin-right:0in; margin-bottom:5.25pt; margin-left:0in"><span style="font-size:10.0pt; font-family:"Arial",sans-serif; color:#262626; font-weight:normal"><a href="https://www.ghanaweb.com/GhanaHomePage/NewsArchive/Samira-Bawumia-named-ambassador-of-Global-Alliance-for-Clean-Cookstoves-589941" target="_BLANK">Samira
Bawumia named ambassador of Global Alliance for Clean Cookstoves</a> Ghanaweb 12 October 2017</span><span style="font-family:"Arial",sans-serif; color:#262626"></span></h1>
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