Featuring: Jonathan Sinton, Lawrence Berkeley National Laboratory; Robert P. Weller, Boston University

By Timothy Hildebrandt and Jennifer L. Turner

Randomly scanning several issues of the China Daily provides convincing evidence that the Chinese government is aware of the severity of urban air pollution. Besides regular articles chronicling the growing problem of smog and the government's efforts to control it, there are charts profiling the daily pollution levels in major Chinese cities. In the press and on television China's large urban centers report daily air quality readings that would alarm even the most smog-acclimatized Los Angeles resident. It is not surprising that many Chinese urban dwellers long for the country life, free from choking smog. However, there is a story often untold and rarely known in China's cities—rural areas, though free from large heavy industries and widespread auto traffic, are plagued by their own air pollution problems. Small township village enterprises have brought both economic growth and unchecked pollution of air and water. Human health in rural areas also is highly threatened by air pollution caused by widespread reliance on indoor coal and biomass cook stoves, which is made even worse by an uninformed public, ill equipped to solve the problem.

Though the Chinese government began to acknowledge the problem of indoor air pollution in rural China as early as the 1950s, the issue has only recently become the subject of long-term, widespread surveys and studies. Robert P. Weller of Boston University conducted a 1998 study that confirmed the acute health effects of indoor air pollution—linking the use of unventilated, unclean-fuel burning stoves to lung and heart ailments. Perhaps of greater concern, however, is the crisis of ignorance in rural areas—Dr. Weller's second study in 1999 in rural Anhui province indicated that residents know little of the health threats originating in their own kitchens. Over the past three years, Jonathan Sinton—together with China Centers for Disease Control, Tsinghua University, and Renmin University—has undertaken a comprehensive study assessing the effectiveness of government programs designed to mitigate indoor air pollution in rural areas. Both Weller and Sinton presented their extensive report findings, provided details on past and current challenges in solving indoor air pollution in rural China, and highlighted potential political and technical solutions. This ECSP China Environment Forum meeting on rural air pollution builds on previous meetings exploring the connection of health and environment.

Proving the Pollution-Health Link
The widespread health effects of rural air pollution are of little surprise to most researchers. Before undertaking a study in Anqing, a "medium-sized" city of five million, Robert Weller expected to find rural communities effected by pollution as much, if not more, than large city residents. As projected, the 1999 study found that, while not as polluted as the outdoor air of Beijing, rural Anqing indoor air averaged PM10 (airborne particulate matter) levels 1.6 times higher than the U.S. EPA accepted level—concentrations in the winter months are markedly higher. Like residents of Beijing, Anqing residents reported various respiratory symptoms, such as chronic cough and phlegm, wheezing, shortness of breath, and fluorosis. More acute health problems from carbon monoxide poisoning were particularly common during the winter months, when indoor stoves are used for both cooking and heating. The study directly correlated lung problems with cooking exposure—women, who fill the primary cooking role in most households, reported disproportionately high levels of health problems. Weller's research indicated that harmful fuels (e.g., biomass and coal) led to significantly higher instances of health problems than cleaner fuels such as electricity and liquefied petroleum gas (LPG).

Jonathan Sinton similarly sought to prove the negative health effects of indoor air pollution in rural areas by demonstrating better health in homes that used improved stoves. For the household surveys in his study, investigators interviewed 7,000 people on issues as diverse as socioeconomic level to health status. Lung function was tested with carbon dioxide breath tests, while sophisticated pumps examined water quality and performed indoor air quality tests in both summer and winter months. Because of their greater exposure to indoor air pollution, the survey also included an over sampling of women and children. According to preliminary results, there is indeed positive link between better health and improved stoves. Improved biomass stoves, for example, resulted in a 32 percent improvement in overall health. Other improved stoves, however, did not rate as successful; improved coal stoves, while more energy efficient, appear to effect health no more positively than unimproved varieties.

Towards Environmental Consciousness
While the impact of stoves on health was expected, Robert Weller's other study presented a great puzzle on the problem of rural air pollution. The 1999 attitudinal study of Anqing suggested that, despite widespread health problems in the area, residents showed little concern for the environment broadly, and indoor air quality specifically. Weller reported that:

  • 63 percent of the 244 residents surveyed were unfamiliar with the term huanjing baohu (environmental protection);
  • 58 percent would throw litter aside rather than search for a proper receptacle;
  • 70 percent felt biomass cooking posed no harm to their health; and,
  • Nearly 65 percent of respondents saw nothing wrong with burning fields, even though just days before the survey was conducted the local airport was closed due to smoke from burning fields.

    Even when health problems are identified, rural residents rarely make the connection to air pollution. Those that do see a connection have difficulty seeing a solution to the problem. Pollution, and the associated health disorders that come with it, are often viewed as simply a sad reality of rural life. Weller stressed that rural Chinese citizens need a change in their environmental consciousness and must be convinced that poor health need not be an inevitable fact of rural life.
    Past efforts of the Chinese government to address the problem of environmental consciousness have failed, according to Weller. Years of formal education and mass propaganda campaigns have done little to narrow the environmental knowledge gap. In primary and middle schools, students are taught to "cherish" the environment, but only in a very abstract or ceremonial sense. For example, tree planting is a regular, almost ritual, activity at schools throughout China, but investigations into the harmful effects of household fuel use are not on the agenda. Moreover, while environmental education in schools is somewhat effective in urban centers, Weller suggested that raising environmental consciousness in schools is less effective in rural areas where the level of formal education is low—39 percent of the total, and 48 percent of the female population in Anqing, have no formal education.

    In theory, mass propaganda campaigns on environment should be effective. Weller quoted the Anhui Environmental Yearbook that boasted 1,921 programs were undertaken in 1996 alone; with claims to have reached 10.5 million people. Nonetheless, among Weller's study respondents, only 12 percent had participated or even heard of the various programs. Weller theorized that the programs are either not reaching their intended targets or simply not attracting appropriate attention from the local populations. Too often in China the population only reacts when problems reach crises proportion. It is imperative, according to Weller, to present the problem and its solutions to the people before the crises hits.

    Towards Improved Equipment
    While propaganda campaigns and education programs have failed to educate rural citizens on pollution threats, a Ministry of Agriculture National Improved Stove Program (NISP) aimed at improving rural cooking and heating stoves has sparked some positive changes. The impetus of this program, begun in the mid-1980s, was not the negative health effects of indoor stoves—rather, economics lead the drive to encourage the use of more energy efficient stoves. The government has declared the program a great success, claiming that a decade after its implementation, NISP resulted in 180 million households switching to new stoves. Outside experts like Jonathan Sinton acknowledge the program's strengths: not only was the program cost effective, relying on little government subsidies, but it also has created a commercial market for improved stoves, thereby making the program's goals all the more sustainable. Sinton was not entirely convinced, however, by the government's claim that by the program's end, 70 percent of rural households were outfitted with improved stoves. With the assistance of China Centers for Disease Control, Remin University and Tsinghua University, Sinton embarked on a study assessing the effectiveness of NISP.

    Based upon two different types of surveys—a survey of national, provincial, county and township fuel use and a household study—Sinton sought to answer numerous questions: from the broad, "was the program as effective as claimed?" to the specific "what kind of implementation strategies were used?" Both surveys were extensive: Sinton's team traveled from Zhejiang to Hebei to Shaanxi to observe the different facilities responsible for implementing NISP. A total of 3,476 households were surveyed in the three provinces, with approximately 7,100 respondents.

    Sinton noted that while NISP was a central government directive, local groups had a prominent role in furthering the policy. A key role was played by rural energy offices, which pulled in research institutes, manufactures, energy companies, and hardware stores to contribute to local implementation of the program.
    Additionally, Sinton's team surveyed the various fuel sources throughout China. Household fuels vary greatly from region to region—in Shaanxi, because of little wood, most residents used coal or crop residue; Hubei residents, conversely, relied mainly on wood and in some cases illegally used charcoal; in the more wealthy Zhejiang, the local population preferred biomass fuels and LPG.

    Measuring success, the main goal of this study, was not an easy task. Sinton noted one of the biggest problems of analyzing NISP was confusion over the term "improved." Indeed, there were great discrepancies throughout regions and households over what made an improved stove improved. Because coal briquettes are cleaner than the coal previously used, the government often deemed these stoves "improved." In some instances a bellows added to a stove was characterized as an improvement even though these stoves were still often un-vented. Handmade chimneys, though rarely functional, also were often counted as an improvement.

    Despite these confusing definitions of "improved" Sinton reported that a preliminary analysis of the data show that NISP has been generally successful. However, the study did find that some government claims of improved cook stoves were:

  • Slightly overstated (the survey found 71 percent of Zhejiang stoves improved, not the government's 84 percent);
  • Understated (the government cited 77 percent of the Shaanxi stoves improved, while the study counted 81 percent); and,
  • Even grossly inflated (government numbers boasted 113 percent of stoves in Hubei were improved, while the study reported a more modest 80 percent).

    In addition, some stoves have been better improved than others. The study suggests that most biomass stoves have indeed been improved, while coal stoves have further to go—less than half of those surveyed boast a flue for proper ventilation. Unfortunately, there is little programmatic activity currently devoted to cleaner coal stoves or the kind of market development that was crucial for success in other areas of NISP. Despite these continuing problems, Sinton contended that 70 to 80 percent of the improved stoves now installed in China's rural kitchens and some indications of improved health are signs of NISP's success. The NISP study identified several factors important for the program's success:

  • Effective outreach by county rural energy offices. Rural energy offices devoted energy to educating the local populations—early public outreach efforts paved the way for acceptance of the new stoves. Unlike local environmental protection bureaus, these county rural energy offices are not regulatory bodies and therefore not viewed as a threat to local economic interests. Thus, they were given considerable autonomy to carry out their improved cook stove activities;
  • Training and certification of stove technicians. Training of mainly stove-builders and housing contractors already located in villages was main path for dissemination of know-how, and crucial to adapting technology to local
  • Subsidies for stoves were small. Stoves were not simply given away, assuring that households purchasing the stoves and invested their own money would actually use the improved stoves;
  • Cultural differences were taken into account. Given the fact that various regions have different cooking practices and use a diverse range of fuel sources, the program embraced area-specific stove designs;
  • Private business and industry were included in the program. NISP training and promotion activities left a legacy of private infrastructure for producing and marketing improved stoves, assuring that NISP would be truly sustainable.

    Though generally successful, there are limits to the program's success—most notably, though many are now aware of the harmful effects of unimproved stoves, some rural residents can simply not afford the costs of the new technology.

    Local Government and Air Pollution Control
    The execution of the National Improved Stoves Program was made easier in that it did not threaten local economic interests. National air pollution laws and regulations are more difficult to implement because some local officials view the pollution control legislation as a threat to local industries and their power. Local officials are often given few incentives to strictly enforce environmental regulations. Weller noted that currently the two main criteria for promotion within Chinese bureaucracies is enforcement of the birth control policy and economic growth. Shutting down a factory for pollution violations, for example, would be against economic interests and work against a bureaucrat's career advancement.

    Rural air pollution problems are thus not sufficiently addressed because of weak enforcement of environmental directives from the central government and little pressure from the public. In terms of public pressure, some changes are slowly emerging in China. For example, Robert Weller noted the pufa campaign geared at increasing the knowledge of Chinese legal systems among rural populations. Anhui officials suggested that some residents are exercising their legal rights to demand improvements in environmental quality—in 1996 rural citizens wrote 3,396 letters to officials and made 1,277 visits to government offices regarding environmental concerns. Nonetheless, Weller's survey indicates the population still suffers from a knowledge gap of the law: a mere seven percent of respondents had heard of an "air pollution law" while only six percent felt an attorney could positively affect the outcome of a lawsuit—only three individuals reported contacting a lawyer. Certainly, the act of simply passing legislation does not solve the problem of rural air pollution—residents must know and understand the law and it must be consistently enforced.

    Village elections also have the potential to affect environmental change in China. Elections, however, have not yet contributed to the environmental debate. Weller's study revealed a considerable amount of disinterest among potential voters: 34 percent of all those eligible actually voted and only 24 percent of eligible women took advantage of their right. Most Anqing residents were further skeptical of the usefulness of village committees—just 12 percent felt the committee had any influence while only 10 percent ever attended a committee meeting. The political apathy of the Anqing population can be explained by the overwhelming feeling that the village's true priorities are dictated by the government—villagers feel their voices will go unheard and do not usually bother expressing their concerns.

    To successfully reduce rural air pollution in China, Weller proposed broad policy changes that would address environmental consciousness, the ineffectual bureaucracy, and immature legal culture. Admittedly, each area is extremely difficult to change. When educating the public on environmental issues, officials need to use less abstract examples such as the negative effects of global warming, acid rain, and endangered species and make environmental consciousness relevant to rural life—villagers must be shown they could make more money with better irrigation or that their children would be spared from debilitating disease by using cleaner burning household fuels. More difficult a task is to change the performance criteria by which cadre are measured for promotion. One of the advantages of a strong central government is the ability to more effectively issue directives—if Beijing insisted on true enforcement of environmental regulations, Weller argued, the local officials would more quickly follow through. In the long term, Weller insisted that China must create a culture of law by establishing a truly independent judiciary, autonomous local environmental protection bureaus and independent statistical monitoring.