Just 13 per cent of rural Indian households and less than 8 per cent of rural Nepalese households use clean cooking energy, meaning that tens of millions of women in rural India and Nepal are subject to indoor air pollution of black carbon. Many years ago, a Nepali cardiologist, Dr. Pandey, had estimated in a paper published in Lancet that such rural women were subject to as much lung damage as men smoking four packets of cigarettes a day.