A woman cooks using firewood in Kibiro Village, Kigorobya Sub-county, Hoima District. In many households across Uganda, firewood and charcoal remain the primary sources of fuel for cooking and heating. PHOTO/ALEX ASHABA
For the last 25 years, Janet Katusabe has been smoking fish using firewood at Kanara Landing Site on Lake Albert, in Ntoroko District. The 68-year-old is unaware of the long-term effects of inhaling thick smoke from firewood. Now, what seemed like a normal cough has left her weak and dependent on medication.
“I never thought smoke could make one sick because it is my duty to cook for my family. Firewood is the only option available to us. I have always earned my livelihood from selling smoked fish, but now, even walking a short distance leaves me gasping for air,” she says.
In 2022, Katusabe developed chest pain, and she was diagnosed with lung complications at Rwebisengo Health Centre IV. Since then, she has spent all her savings on hospital visits and medication and yet the relief is temporary.
“I have been to hospitals in Fort Portal City and Bundibugyo District. Every visit is expensive, right from the transport fare to the medical tests. Sometimes, I must choose between buying food and buying medicine,” she laments.
Despite her struggles, Katusabe worries more about the young women in her community, who are doing a similar business, wishing better cooking options were available to them.
In many households across Uganda, firewood and charcoal remain the primary sources of fuel for cooking and heating. While these wood fuels are affordable and easily accessible, they come with hidden costs.
Cost of cooking with firewood
Burning firewood and charcoal releases carbon dioxide, black carbon or soot, and methane into the atmosphere, all of which contribute to climate change. On the other hand, wood burning contributes to air pollution through the release of carbon monoxide and smoke.
Every day, millions of people, especially women and children, are exposed to harmful smoke, leading to severe respiratory diseases and long-term health complications. According to the 2024 National Population and Housing Census, 65 percent of households use firewood as their main source of fuel, and 48.6 percent use charcoal as their primary cooking fuel.
Rural areas bear the brunt, with 80 percent of households relying on firewood compared to 41.2 percent of households in urban areas. On the other hand, the highest percentage of households in urban areas (48.6 percent) use charcoal as their main sourcea of fuel for cooking compared to 14.7 percent in rural areas.
Attempts at clean energy
The government, through the Ministry of Energy and Mineral Development (MEMD), is promoting the use of efficient cooking technologies to reduce the pressure on trees and forest resources, reduce pollution, and save the financial resources of households. Overall, 3.8 percent of households were using clean fuel and technology for cooking.
According to health experts, the smoke emitted from wood fuel contains dangerous pollutants such as particulate matter and volatile organic compounds. Over time, inhaling these toxic substances can lead to chronic obstructive pulmonary disease (COPD), asthma, pneumonia, and even lung cancer.
Dr Ezra Namanya, a medical officer attached to Nyahuka Health Centre IV in Bundibugyo District, says continuous exposure to indoor air pollution from cooking with firewood is equivalent to smoking multiple cigarettes a day. The damage the pollution causes to the lungs is often irreversible.
“Prolonged inhalation of wood smoke weakens the immune system. Wood smoke contains microscopic particles that can cause respiratory illnesses such as bronchitis and trigger severe asthmatic attacks. Smoke exposure increases airway irritation, which results in persistent coughing and difficulty in breathing,” he explains.
Dr Namanya adds that over time, smoke damages the epithelial cells in the lungs, which play a critical role in protecting the lungs from harmful pathogens and environmental pollutants and support the repair of damaged lung tissue.
“COPD is a particularly challenging disease to treat, especially in private health facilities where treatment costs are high. As such, many patients seek temporary relief, but their condition often worsens over time because the epithelial cells are damaged beyond repair. Once these cells are scarred, they cannot regenerate,” he says.
Dr Namanya says Nyahuka Health Centre IV receives numerous patients with respiratory conditions related to prolonged exposure to firewood smoke. Most of these individuals are above the age of 40. Due to their weakened immunity, such patients are at a higher risk of contracting tuberculosis (TB).
“Treatment of these conditions is provided free-of-charge in government health facilities. However, the burden is on the patient to frequent the facility for continued management. I urge people to adopt clean energy cooking methods and if they cannot, let them ensure proper ventilation when using firewood,” he advises.
Dr Oscar Kiiza Atwiine, a medical practitioner in Fort Portal City, says the tiny particles in wood smoke damage the air sacs (alveoli), where the oxygen and carbon dioxide exchange occur in the blood during the process of breathing.
“Continuous inflammation of the alveoli leads to decreased oxygen levels in the blood. This could result in shortness of breath, chest pain, and chronic coughing. Some wood smoke contains carcinogens that can expose one to a serious risk of cancer,” he says.
The symptoms of such diseases take time to manifest until one has had prolonged exposure. However, Dr Atwine says children are also highly vulnerable because their lungs are still developing.
“For those who cannot afford alternative fuels, it is important to use dry wood of at least less than 20 percent moisture. People should also minimise the time they spend in smoke-filled environments to reduce their exposure," he says.
Policies needed
The Sustainable Development Goal (SDG) 7 requires member states to ensure access to affordable, reliable, sustainable, and modern energy for all.
The use of clean energy and renewable energy sources would ultimately protect natural resources.
Uganda’s forest cover now stands at 12.4 percent. In the last 25 years, Uganda has lost about 60 percent of its forest cover despite the tree-planting efforts by both the National Forest Authority (NFA) and the private sector.
Dr Brian Emmanuel Guma, the team leader of the Albert Water Management Zone under the Ministry of Water and Environment, raises a clarion call, warning that an increase in demand for firewood and charcoal is threatening indigenous tree species essential for environmental conservation.
