Globally, the Bill and Melinda Gates Foundation (“GF”) supports innovative applications of technology to work toward solutions for some of the world’s most daunting medical problems. In a medical context, the concept of a “regimen” is used primarily for a combination of diet, exercise and drug therapies that have been shown to be effective against a specific disease or condition. But what if all experts in a medical field agree that a specific condition is caused by a combination of behavioral, cultural and technological factors with the global result of millions of deaths every year? What if two or more recognized medical conditions are caused by the same set of factors and those medical conditions include the number-one killer of children under five globally, and specifically in the country of Haiti? It is time to expand the definition of a medical regimen to include technological, cultural and behavioral interventions which are required to create therapeutic change to conditions with recognized and identified preventions.

El Fuego del Sol S.R.L. (“FdS”) is a Dominican corporation owned and operated by Americans, Haitians and Dominicans that germinated from a project started in 2005 with the purpose of bringing ecological and social development to the Dominican Republic and Haiti. These two countries share an island in the Caribbean and have all the climactic benefits imaginable to assist in creating sustainable societies. However, poverty is a daily reality in both countries, especially in the border regions of the DR and in practically all of Haiti. The correct organization to identify and initiate the interventions required to save these lives is the FdS Network of non-profit (NGO), for-profit, educational, governmental, and individual participants, working together for the FdS goal of Dominican and Haitian development. FdS is Triple-Bottom Line, which means FdS works to be financially sustainable while actively creating social and ecological improvements to the society. Those are the triple bottom lines of People, Planet and Profit.

The following materials were submitted to the Bill and Melinda Gates Foundation, November 2011, with the goal of achieving the foundation’s support for this FdS initiative. While the foundation reviews the materials, FdS is sharing the research and proposed solutions with the public to maximize the potential benefit for the people of the DR / Haiti and to generate additional attention / support for FdS programs.

I. A. The Need. In developing countries, the underlying interconnected medical causations of the conditions: Acute Lower Respiratory Illness (ALRI) and Perinatal Mortality (i.e. stillbirth), due to chronic cookfire smoke exposure, are a complex matrix of: poverty, limited access to technological solutions, cultural resistance to change, nomadic populations, limited developmental interventions, and the problem’s grand scale.

B. The Action. Fuego del Sol implements the Eco-Cooking Test Kitchen / Family Health Center integrated systems approach to identify the best locally developed ecological cooking technology regimen for the specific region / cultures of Haiti and the Dominican Republic, and FdS engages implementation of this regimen’s associated introduction / adoption / sustainment methodology, with the purpose of reducing respiratory tract infections / perinatal mortality, and with the verification metric of an anticipated reduction in the incidence rate of established risk factors for these conditions. Subsequently, this methodology can be replicated globally.

Problem

The undisputed scientific consensus is that chronic exposure to cooking fire smoke is a cause for both ALRI and Perinatal Mortality, among other debilitating / fatal conditions. USAID (2007): “Globally, every year, 1.5 million people die from inhaling indoor pollutants. Children and women are disproportionately affected with nearly 800,000 deaths annually attributable to indoor air pollution occurring among children under five years of age, and more than 500,000 such deaths occurring among women. This issue is inextricably linked to poverty, as it is primarily the poor who rely on solid fuels and inefficient stoves, and many are trapped in this situation. Health and economic consequences contribute to keeping them in poverty, and their poverty stands as a barrier to change.” EPA (2011): “Indoor air pollution from household energy ranks as the fourth leading health risk in poor developing countries. Breathing elevated levels of indoor smoke from home cooking and heating practices more than doubles a child’s risk of serious respiratory infection and may also be associated with adverse pregnancy outcomes (e.g., stillbirth and low-weight babies).” USAID (2007): “Haiti’s health indicators are the worst in the western hemisphere with an annual death rate of 12.2 deaths per 1,000 population, infant mortality at nearly 72 deaths per 1,000 live births [and] a maternal death ratio of 523 women per 100,000 live births. In Haiti, the standard charcoal cook stove burns inefficiently with little ability to control air or conserve heat. Cooking with charcoal and firewood on crude stoves has a significant adverse impact on human health in Haiti. It has been estimated that the average life span in Haiti is shortened by 6.6 years because of the impacts of indoor air pollution caused by indoor burning of biomass. Acute Lower Respiratory Illness (ALRI), the global number one killer of children under five years of age is also the number one killer of under-fives in Haiti — with ALRI mortality estimated to be more than 40 percent. This mortality burden is undoubtedly related to the massive use of biomass as cooking fuel.” USAID (2007): “Large scale use of improved cook stoves in Haiti could have a significant impact on human health, particularly under-five mortality. Due to prospective savings on fuel, economic incentives exist to acquire improved cook stoves, especially in urban households. Women should be integrated into the design and execution of any behavior change or appropriate technology intervention that involves cook stoves. Imported fossil fuels supply no more than a fourth of Haiti’s energy but absorb three-fourths of energy costs and 35 to 50 percent of Haiti’s hard currency. Furthermore, imported propane gas (LPG) remains the most expensive form of cooking fuel in Haiti.” UNDP (2011): “Growth driven by fossil fuel consumption is not a prerequisite for a better life in broader human development terms. Investments that improve equity in access, for example, to renewable energy, water and sanitation, and reproductive healthcare could advance both sustainability and human development.”

Solution

Anse-a-Pitre (“AaP”), Haiti provides the optimum scenario for the sustainable introduction of the locally designed technology regimen to combat indoor air pollution as a risk factor for ALRI. AaP shares a Sister-City agreement with Pedernales, DR. Haitians and Dominicans travel back and forth between the two cities every day. The infrastructure of the DR, including the near-by port of Cabo Rojo can support the industrial development of AaP. With developmental funds targeted for Haiti, industrial operations can be located in AaP which benefit from the international goal of Haitian development. The GF funding would leverage and expand the current operations of FdS. This proposal’s integrated system design would associate the industrial location with health benefit because each new FdS location, starting with AaP would provide office/clinic space, free-of-charge to the family health clinics, ProFamil–Haiti and ProFamila–DR. The FdS sites would provide logistical support for all GF associated projects, including cel-phone facilitated banking. The family health centers would address all Haiti health issues, including family planning, Cholera, chlorinated water, mosquito net promotion, parasite conditions, HIV/AIDS and other STDs, nutritional deficiencies, food safety and vaccinations. FdS pioneered supporting DR / Haiti eco-development through GeoTourism. The additional exposure through GF support will likely dramatically expand this aspect of FdS business. The additional focus may leverage more resources in support of respiratory health programs, and FdS is prepared to help direct these resources in support of the village-wide adoption of the eco-cooking technology regimen. The current technology regimen (from the Eco Test Kitchen) combines three complementary products: the Global Sun Oven (which was tested by the Dominican National Energy Commission [CNE] and certified as an effective beneficial renewable energy product under Law 57-07), the Stovetec efficient household woodstove, and the Stovetec “Colgan” Industrial Stove. Both Stovetec stoves were rated tops in their respective categories, saving up to 72% of fuel over traditional Haitian cooking methods and saving up to 82% over the cost of cooking with propane and other fossil fuels. (USAID/Nexant 2011). The feedback loop allows for upgrading the current regimen when improved technology options are imported or developed locally, including locally produced renewable charcoal and/or recycled paper briquettes. FdS and GJ have developed the eco-cookstove introduction and adoption process which involves the entire family in the process of obtaining the integrated cooking system. Eco-stoves are not provided for free; recipients must work, pay, train and agree in writing to use each stove before they can receive it. Micro-financing assists in affordability and verifies compliance with the usage agreement. Where necessary, tax-deductible donations subsidize the costs of the eco-stove, but FdS is working, by manufacturing eco-stoves in the local FdS Fair-Trade-standards factory, to lower costs of delivery. FdS is the first company to be engaging the Gold Standard Methodology (GSM) in Haiti/DR to generate carbon credits so that long-term donations will not be required. The FdS process also includes sustainably supporting local artists through FdS site: haitianhands.net, and through the production of income generating products including solar-powered lights and cel-phone chargers. The FdS methodology will gradually transform AaP into a model ecological village, virtually free of the risk factors for ALRI and Perinatal Mortality. FdS will follow with a gradual project roll-out, across the Southern Peninsula of Haiti, and then north, replicating the process, one region at a time. Concurrent with the project expansion, the Eco Test Kitchens will be evaluating locally produced renewable fuels including recycled paper briquettes and ecologically produced charcoal. During the first proposed implementation phase, the decision will be made as to what type of factory would be most beneficial to the project, company and community. Possibilities include eco-charcoal, recycled briquettes, and Stovetec Industrial Stoves. Phase II funding would provide the expansion capital needed to assure the successful sustainable adoption of the ever-improving (life /lung saving) technology regimen by an ever growing Haitian /DR population.

Example

Innovation and Expanding Success. FdS is now implementing what the research recommends. FdS and Eco-NGO, Grupo Jaragua (GJ) are the first team to the achieve success (through the women-run Eco Test Kitchen) in developing an effective eco-cookstove regimen which is being implemented, is scalable, and will continue to evolve through the design / technology feed-back loop. FdS is Americans, Haitians and Dominicans, women and men. FdS is located in the border region of Haiti / DR, and has been here since 2005, working to introduce best-practice ecological solutions to issues that Dominicans and Haitians report are most crucial in their everyday life.

Marketplace

Petroleum related organizations have financed a current push for the United States government to subsidize the introduction of LPG (propane) gas as a cooking alternative in Haiti. While LPG is generally a more ecological cooking option than traditional charcoal cooking, due to the lack of LPG infrastructure in Haiti, the poor road conditions in most of the country, and the fact that all LPG must be imported into Haiti, with no prospect for domestic production in the foreseeable future, the fact is that for everywhere but the largest cities, LPG is an expensive, heavily polluting, invasive, and risky technology introduction. The LPG industry has every right to promote itself in Haiti, and LPG has a role in larger cities as one aspect of the multiple-technology solution. However, the technology, the gas and its infrastructure should not be heavily subsidized by the US or Haitian government as an attempted solution for deforestation or any other systemic problem. Local and sustainable programs must be developed and encouraged. The title of this page should not be seen as confrontational, rather we ask for the opportunity to constructively compete in the promotion of the best eco-cooking solutions for the people of Haiti. USAID and all other developmental agencies in Haiti need to follow the recommendations of USAID, the EPA and the UNDP and work to support ecological and sustainable solutions, such as the Fuego del Sol Ecological Test Kitchen methodology.