The city of Cusco in southeastern Peru is a World Heritage Site and a tourist attraction for those drawn by the Inca ruins nearby. But anyone who lives in or visits Cusco has to contend with its heavily polluted air. Trucks and buses belch clouds of diesel exhaust, and on the outskirts of town hundreds of family-run artisanal brick kilns send plumes of oily black smoke into the sky. Brick makers near Cusco fire their traditional kilns mainly with coal, but they also have a long history of burning plastic trash, used motor oil, and discarded tires. “They produce huge air quality problems,” says Jon Bickel, a Swiss development expert based in Lima. Most of the bricks that are made in Peru and other low-income countries are fired in artisanal kilns that pump greenhouse gases and other pollutants into the atmosphere, posing a health threat to brick workers, their surrounding communities, and even farther afield. And since brick production keeps pace with population growth, its environmental health impacts are likely growing throughout the developing world, says Jie Li, an energy and environmental specialist with the World Bank’s South Asia Region in Washington, DC. Workers cut firewood to light a brick kiln in Kabul, Afghanistan. The few health studies that have been conducted on kiln workers typically reveal musculoskeletal effects and health effects similar to those seen in other smoky, dusty occupations. A number of both small-scale and multinational development groups coordinated by the World Bank, the United Nations, and other organizations are now turning their attention to this important but poorly characterized industrial sector. Leading the charge in Latin America, Bickel directs a Swiss-funded group known by its Spanish acronym, EELA (for Eficiencia Energetica en Ladrilleras Artesanales) that aims to modernize artisanal brick making in Peru, Argentina, Brazil, Bolivia, Ecuador, Colombia, Nicaragua, Honduras, and Mexico. Bickel says EELA’s long-term goal is to reduce kiln emissions by 30–50%. But achieving that goal won’t be easy. Throughout Latin America and other countries in the developing world, artisanal kiln operators comprise an informal industry; they rarely pay taxes or obtain operating permits, and because of that, they often lack access to the financial credit and capital needed to purchase cleaner technology. Many also lack electricity (required for newer types of mechanized production) and access to roads and other infrastructure that could help in the modernization effort. Some are unwilling to change age-old manufacturing processes. Pakistani families prepare bricks at a fixed-chimney Bull’s trench kiln on the outskirts of Islamabad. Under debt bondage, an entrenched custom in South Asia, families can work at kilns for years paying off loans from the owners. Still, the associated benefits of modernization justify the effort, Li says. In addition to the environmental health impacts associated with artisanal brick kilns, these operations employ “the poorest of the poor, including, in many instances, women and children,” Li says. “So by promoting more efficient kilns and manufacturing, we can also address related development problems, such as poverty, child labor, and women’s issues.”