In Delhi and Karachi, a struggle to breathe

Air pollution 2

Akshata Mishra and Azam Abbas

KC Bhatia and Madhu Bhatia, both octogenarians, who live in South Delhi’s Hauz Khas area, are dependent on nebulisers. Bhatia, who is fond of long walks, now restricts himself to his house and avoids opening windows — courtesy Delhi’s air pollution.

The Bhatias don’t have to venture out for work; however thousands in India’s capital Delhi brave the toxic air everyday as they step out of their homes. Gouhar Ali, who works as a gardener, battles Delhi’s air every winter as he leaves home for work. A couple of years back, Ali had to be admitted in the hospital for three days and could only breathe through an oxygen mask.

Ali who moved to Delhi around 25 years ago, is suffering from asthma for the past 22 years. According to him, regular medicines, exercise and lifestyle changes, along with doctor’s consultation have helped him to bring down the dosage of medicines; but he still can’t overcome the horror of what he suffered earlier. He tries every precautionary measure to counter pollution, especially in winters.

Quite a few South Asian cities face deadly smog, particularly in the winter months. Amongst the most affected is Delhi in India and Lahore in Pakistan. Smog is just one of the most visible manifestations of the air pollution that silently kills around half a million Indians and Pakistanis every year. According to the World Health Organization, in 2012, 6,12,000 people in India and 60,000 in Pakistan died due to the air pollution. The most vulnerable people among the population have to deal with the risk of stroke, lung cancer and heart disease. A study by the Lancet Commission on pollution and health states that productivity, and as a result of annual economic output, goes down by 2 percent in developing countries due to pollution-related diseases. According to The World Bank, air pollution costs India $80 billion annually.

Air pollution 1

Doctors and experts say that apart from industrial fumes and vehicular pollution, overcrowding and dust are also huge factors which contribute to air pollution. They also state that certain areas in the city are more polluted. Children and people in their old age are the worst affected. People suffering from chronic illness can even die of sudden shock if exposed to polluted air in a traffic jam. Around 85% children who are affected by pulmonary diseases get cured of it if given proper treatment. But 15% of them go on to develop asthma and other respiratory diseases as adults. Even preventive healthcare measures are not entirely successful.

“Clean air has been commoditised to be a selling point by retailers and even real estate owners. Come winters, we see that people start wearing masks ” says Awadhendra Sharan, Associate Professor at Centre for Study of Developing Societies and author of ‘Out of Place: Nuisance, Pollution and Dwelling in Delhi’. “One can say that it began as a fad and it is only now that people are actually beginning to realise the importance of wearing face masks. Much more needs to be done,” Sharan adds.

“Before 2014, our customer base was largely factory owners in the industrial manufacturing area. Post that, we have started getting orders of face masks for daily usage. We have expanded the manufacturing process and tried to inculcate the specific needs of the users,” says Sanjeev Kapoor, Chairman of Shiva Industries which manufactures face masks.

Each day has become a struggle for Delhi residents. The Bhatias started off with one air purifier a year back. They now have six air purifiers, one in each room of the house. Experts suggest a few lifestyle and behavioural changes to stay protected.
Dieticians and health experts say that people must increase their intake of green vegetables and citrus fruits. They must not go out for morning or evening walks as the pollution is at its peak at those hours, especially in winters. There are activated carbon masks available in the market now with PM 2.5 filters which must be used instead of N95 and N99 masks, which are not entirely effective.

As a community, carpooling, usage of biodegradable products and minimum utilisation of resources must be done. This leads to less waste production and as a direct result leads to the decrease in toxic fumes that are released while burning the waste in the incinerator. However, without major policy shifts, poor air quality will continue to be a major concern for Delhi.

In Pakistan, A struggle to breathe

By: Ahsan Iftikhar Nagi & Noor Usman Rafi
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Syed Tanvir Hussain during his duty at the famous M.A. Jinnah Road – Photo by author

Pakistan has lost more than 63,000 people in the war against terror since the turn of this century. The figure, according to South Asia Terrorism Portal (SATP), is considered one of the worst in human history and the country uses the figure to display itself as a frontline nation in the world’s war against Al-Qaeda and the Taliban.

But there is another war being waged in Pakistan – a war that has claimed the lives of 135,000 people every year, according to data collected by the Pakistan Air Quality Initiative (PAQI) – a private venture aimed at raising awareness about the alarming rise in air-pollution levels in the country.

As many as a thousand deaths were reported in Karachi, Pakistan’s largest city, due to symptoms caused by air-pollution in 2015. The air in the port-city has 88 µg/m3 of PM2.5 particles on average – a figure 8.8 times higher than the safety levels set by the World Health Organisation (WHO).

The situation is much worse in Punjab, the country’s most populous province. In November 2017, the PM2.5 levels rose as high as 327 µg/m3 – which is considered hazardous – in Lahore, the provincial capital.

“At this level or anything above 150 µg/m3, you should lock yourself and your family indoors, roll up the windows, put on your face-masks, turn on the air purifiers, and don’t let anyone outside. No matter what,” remarked PAQI founder Abid Omar.

For Omar, several Pakistani cities were among the worst in the world when it came to air quality.  “The situation is even worse in Lahore with the pollution levels getting as bad as New Delhi. It seems the two cities are competing to be number one in the ranking of the cities with the worst air,” he said, adding that crop burning played an enormous role in polluting the air.

“Karachi and Islamabad are a little better,” he said, “but they aren’t where they should be. It is the pollution in Punjab make them look good.”

According to Omar, the average life expectancy in Punjab has been reduced by up to five years due to the cardiovascular diseases and cancer caused by the air pollution. “Their [citizens’] inability to contribute to the society is also being a burden on our economy.”

The PAQI estimates the burden this burden to be around $47.8b or 5.88% of the GDP.

The situation is the worst in the months of winter – between October and February – as the particles get denser and trap pollutants from the industries, motor-vehicles, and other sources in the ambient environment, causing breathing difficulties and leading to the development of respiratory diseases over time.

Statistics by Pakistan Air Quality Initiative (PAQI) from Jan 2017 till Feb 2018

“I had to take two weeks off from work due to chest congestion and eye-burning that I faced due to smog,” says Ali Raza, a 32-year-old Lahore resident who goes to work on his motorcycle. “It wasn’t like this some years back. I used to enjoy driving a motorbike in winter fog. But now, we experience fog less. We are inhaling toxicants whenever we step out in the smog months and there seems to be no signs of the situation improving.”

Like in India and Iran, smog, the combination of fog and smoke, has become the fifth weather in Pakistan. From September to November, the pollution levels in Punjab sky rocket.

“It is not like the buses or the trucks or the motorbikes that you see on the roads stop producing toxic waste in the summers. They are not visible because they don’t get trapped in the air like they do in winter,” Omar explained.

“Millions of new motor vehicles hit the roads every year. With that, there are new industries being set up. One of the major contributors to the air-pollution in Punjab are the cement factories. Economic development comes at a cost,” he added.

The Sindh Government has recently taken up some construction projects on the cities’ major thoroughfares like Shahra-e-Faisal, Mohammad Ali Jinnah road, and Submarine Chowrangi in Karachi. With the constant presence of dust particles in the air since the initiation of those projects, it is the traffic police personnel that have suffered the most.

“There are many people in our department inflicted by pollution-related diseases,” said Syed Tanvir Hussain, a head constable in Sindh traffic police. “Their condition is so bad that they cannot perform their duties anymore and are getting themselves treated. Thousands of cars are registered daily which, of course, leads to more pollution in the environment. Then we have innumerable potholes in our roads which further pollutes the air. The busses have diesel engines which exhale fumes and black smoke. Believe me, our white uniforms turn black after a day’s shift.”

Hussain, who was wearing a surgical mask to protect himself from the toxicants in the air, lamented the absence of policies in the traffic police department. “The pollution levels have risen significantly in the past 20-25 years, but nothing has been done to protect traffic police personnel,” he says.

“Our institution does not provide us anything. We buy facemasks on our own. Traffic police in Punjab is provided jaggery which helps in clearing the lungs from the toxic content inhaled on the roads, but that is not the case in Karachi. We buy jaggery from our own pockets. It is a necessity as we have to protect ourselves.”
Syed Tanvir Hussain during his duty at the famous M.A. Jinnah road
– Photo by author

With millions of people commuting on the thoroughfares on which the government is undertaking these development projects, doctors have put a great deal of emphasis on the usage of masks. “We tell our patients and people in general to use masks when they are traveling via Shahra-e-Faisal,” said Dr. Ismat Tahira, who runs a private clinic in Gulshan-e-Iqbal, one of the most populated areas of the city.

“The dust in the air is a major reason behind various allergies. Everybody requires proper protection, especially the ones that are being exposed to the polluted air regularly. The rise in the air pollution has led to an increase in skin diseases, bronchitis, asthma etc. The most cases that come forward are of bronchitis and asthma. Those who are affected either live in the areas near these construction sites or they travel through them.”

A preventive measure

A useful aid used in combating the effects of air pollution is the face mask that covers the nose and mouth. The face mask essentially acts as a barrier between the inhaled air and the pollutants in the environment.

Sarib Baig, owner of Health and Life Pakistan, was the first to bring these face masks for every day users when he realized the levels of pollution demanded such a product for the population. “My market research indicates that only 5 to 10 per cent of the people are realizing the effects of pollution and the need for this protective measure,” he said, adding that the demand for the masks is still not high as it should be.

According to a research study by PAQI, using a cotton handkerchief as a mask blocks 30% of the pollutants; the surgical mask blocks 40-60%, and the N95 mask blocks 95% of PM2.5.

Baig says that surgical masks are of good quality, but their life is very short. They are usable for only one or two hours whereas people use the same one for up to three days. “Every mask has its life. When you wear a surgical mask and breathe into it, it will definitely protect from germs or bacteria, but the filtration will stop working in a couple of hours.”

The material Baig uses for his masks is imported from China, and the product is manufactured and packaged in Pakistan. The mask’s most important feature is the net fabric on the front which is dust absorbent. On the back, a cotton cloth is used. “These masks easily work for five to six months – until they tear or wear down,he says.

3AM Distributers is another supplier which provides masks for the common consumer. The company has been supplying face masks to major hospitals and pharmaceuticals for seven years. Bilal, who owns the company, explained that the surgical mask was basically a paper mask, and not a filtering medium.

Their masks have a dual purpose; the air that is exhaled and inhaled both are filtered. These masks have been used all over the world, even in the crises of bird flu, swine flu and extreme smog.

According to Bilal, the white coloured mask begins to discolour from the front, turning black-ish, as particles are retained. Odour and congestion can be noticed which means the mask needs to be discarded. “The masks are activated by the body’s static charges and then the filter is used.”

Prices and sales

The face masks are sold for difference prices, depending on models, filters, material, and life. They start from less than 100 PKR and go up to 400 PKR.

Speaking on the price of the face masks, Baig, owner of Health and Life Pakistan, says it is still quite low in Pakistan due to relatively less demand. “If you look at other countries such as India and China, these masks are selling so much that the mask I am selling here for 70 to 80, it’s selling there for like 400.”

When Baig began his business in 2016, he kept prices low, as his intention was “to help people”. Since then, however, competition between new entrants has caused the prices to surge .

When the masks were first launched, people simply purchased them because “they looked cool.”

“Initially people really liked the idea, and the majority considered it to be a fashion statement,” said Baig. “Then with some awareness, they realized the actual benefit of wearing it.”

Most of their customers are bikers and college-going students. The masks are also marketed in different colors like black, white, red and pink to target both men and women.

“At first only bikers and people going out used them. Now people are understanding they can wear it walking around; women can wear them while cleaning or dusting the house,” said Baig.

Muzammil, a salesperson at Kausar Medicos, one of the most famous pharmacies in Karachi, says that the sales go up in the winter when smog takes over. The added benefit of comfort and warmth makes the demand even higher during winter.

The pharmacy has seen a staggering surge in demand by more than a 100 per cent in the last year. Kausar Medicos sells disposable surgical masks which cost as low as 2PKR per piece.

Health and Life Pakistan’s owner Baig concurs. The sales were highest last year but now they are decreasing.

“In Pakistan, we brought these masks extremely late. People still don’t have enough knowledge on the damage the air-pollution causes them. We have been needing the masks since a long time back.” Baig predicts the demand for the masks will increase as people become more aware.

The struggle continues

The provincial government and the municipal corporations are also adding to the problems of the residents of Karachi. The city produces 12,000 tonnes of solid waste of which only 4,800 is buried at landfill sites – which are nearing their maximum capacity.

There are only two landfill sites in the city in faraway areas like Surjani Town and Northern Bypass. Rather than dumping the rest of the waste, the municipal corporations burn the waste to save fuel costs.

The United Nations Association of Pakistan (UNACP) called on Karachi Mayor Wasim Akhtar to take steps to control the city’s air-pollution levels, according to a report published in The Nation, a daily newspaper in Pakistan, in October last year. The UNACP said it considered a campaign to plant 5,000 trees in the city to which the mayor assured complete assistance.

However, a crisis of such a magnitude requires steps to be taken at a broader level. It requires a comprehensive waste management policy with strict implementation, curbing the burning of waste, and a reduction of motor-vehicles on the road by encouraging the use of public transportation, which so far does not exist in the city.

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