03 Jul 2025

There is need for dissemination of key messages to prevent future tragedies related to carbon monoxide (CO) poisoning following the recent tragedy in Khawa.

In an interview, Tsabong District Chief Medical Officer Dr Thato Sarona, said carbon monoxide poisoning could be avoided if the community was aware of the dangers posed by this invisible threat including preventive measures.

Dr Sarona emphasised the insidious nature of carbon monoxide, noting, that the gas was colourless and odourless and one may not be aware that they were inhaling it, hence often called a ‘silent killer’.

He said the gas was  produced when there was incomplete combustion of organic matter such as wood, charcoal, paraffin, petrol, diesel, and cooking gas, noting that carbon monoxide poisoning often resulted from inhaling or breathing in this gas.

According to Dr Sarona, carbon monoxide could be produced in households from several common sources, particularly in areas where traditional heating or cooking methods were prevalent.

He cited “burning firewood (or cow dung in some communities) or charcoal in enclosed or indoor fireplaces without good air circulation” as a major culprit. Other sources include the use of heating or cooking appliances such as mbawula, paraffin stoves, gas stoves and heaters in poorly ventilated places.

Dr Sarona highlighted specific environmental and geographical factors in Botswana that elevated the risk of CO exposure. 

He said many households relied on the use of firewood and other biomass fuel for cooking and heating, emphasising that the use of these indoors without proper ventilation increased the risk of carbon monoxide poisoning. 

“The risk of exposure is high in houses without proper ventilation (small, few or no windows and overcrowded households) leading to build-up of carbon monoxide from cooking or heating appliances,” he explained.

Describing the physiological impact, Dr Sarona said, carbon monoxide impaired delivery of oxygen to the organs. 

Initial symptoms of the poisoning are often non-specific and can include body weakness, fatigue, headache, dizziness, chest pains, nausea, and vomiting and Dr Sarona warned that the symptoms were nonspecific and might be mistaken for other common illnesses such as flu or food poisoning. 

As exposure intensifies, more severe symptoms can manifest, such as confusion, seizures, transient loss of consciousness or even a coma, he said.

While everyone is at risk of carbon monoxide poisoning, Dr Sarona noted that certain groups were particularly vulnerable such as children, the elderly, pregnant women, patients with existing conditions such as anaemia, lung and heart diseases and smokers.

He explained that carbon monoxide poisoning could lead to what is called delayed neuropsychiatric syndrome, whereby one may develop variable degrees of deficits or changes in their memory, personality, mood, language, cognition and even develop movement disorders such as loss of balance, tremors or stiffness.

In an emergency, he stressed immediate first aid steps,  moving the person away from the source of the poisoning and placing them in an open space where they could breathe pure oxygen.

He said calling medical assistance or rushing them to the nearest health facility should be considered as soon as possible as the person might require supplemental oxygen.

Outlining the most crucial preventative measures individuals and families could take, Dr Sarona advised having fireplace in open spaces and avoiding fire or heating appliances such as mbawula indoors or in enclosed spaces.

Indoor fireplaces, he said should be have good and functional vents, adding it was crucial to open windows or doors when using gas or paraffin stoves and heating appliances. 

He warned against going to bed with fire, heating, or cooking appliances on and never running car engines in enclosed garages.

Dr Sarona addressed common misconceptions he encountered among the general public. “There is often an assumption that since it is a gas then one should be able to smell it,” he said, clarifying that the gas was odourless. 

He warned that everyone was at risk of poisoning without any warning when exposed, explaining the danger of dying during sleep as the gas could cause drowsiness increasing the sleepy state with continued exposure leading to a silent death”.

 In cases of suspected poisoning or if one was showing non-specific symptoms following exposure, he said they should seek immediate medical attention. ENDS