Afghanistan Battles Air Pollution

Over the last 15 years, I have reported from over a dozen countries across Africa and worked in Europe, the Middle East, Asia and South America.

In the winter of 2019, I travelled to Afghanistan to document the deteriorating air pollution crisis in the country, focusing specifically on the capital Kabul as part of a larger ongoing project that sheds light on the effect of pollution on the most vulnerable in our societies – children.

I visited the Indira Ghandia Children’s hospital in Kabul, where I met six-month-old Zabiullah in the intensive care unit. Gasping for air in his mother’s arms, she held tightly onto the mask feeding him oxygen.

In the same room, a dozen children—all under the age of five—struggle to breathe as distressed mothers look helplessly at doctors carrying newly filled oxygen tanks into the ward. Most children have been diagnosed with pneumonia, like Zabiullah, while others have bronchitis or other respiratory infections.

In a country ravaged by years of conflict, pollution is now proving to be a bigger threat than war in Afghanistan – with more people being killed by toxic air than by bombs and bullets.

It is wintertime and outside, the temperature drops below zero. Through the clouded, uninsulated hospital window, Afghanistan’s capital, a city of some six million people nestled amongst the Hindu Kush mountains, lies blanketed in a haze of dark, toxic fumes.

Kabul is one of the most polluted cities globally – contesting India’s New Delhi and Beijing in China.

Zabiullah’s mother, Negar, 35, speaks to me about the daily struggle that she and her family endures. She describes the small tent they live in, with no electricity or adequate sanitation, in a camp for the internally displaced on the outskirts of the city. Here, hundreds of families that have fled the war from every corner of Afghanistan are living in absolute poverty.

“At night, I do not sleep as I fear my children can die of the cold. There is no wood. We burn rubbish that we find on the streets to keep warm,” she explains as she stares at the fast, rhythmic movement of her baby boy’s chest as he breathes. “We can smell the bad fumes of burning plastic in our home, in our neighbourhood. The smoke gets everywhere; the smell of it stays in my children’s clothes, in their skin.”

I speak to Doctor Farid Ahmad Andishmond, a paediatrician at the hospital. He believes that the spike in pneumonia and other lung infections among the many hospitalised children is directly linked to the increase of pollution in Kabul – especially during the winter months, when the temperature drops

According to the World Health Organisation, household air pollution is the single most dangerous health risk factor worldwide. Women and children are at the most risk of exposure as they are the ones that stay home the most, compared to men.

In Kabul and other cities across Afghanistan, it is not only household air pollution that is killing thousands of people every year: public bathhouses that burn tons of coal daily, poor city planning, a chronic lack of electricity, and dirty fuel with heavy lead concentrations, are all escalating the problem. During rush hour, you can feel the acrid smell of pollution stinging your throat.

I speak to Doctor Fazil Ahmed, who works for Unicef in Kabul. His tell me how he blames the lack of infrastructure and the economic state of the country for the rising and ever more alarming pollution crisis.

“To understand the pollution problem in Afghanistan, we have to look at how our cities are built and the poor state of the economy. We lack proper city infrastructure. Many can’t afford electricity. We use dirty fuel, full of lead, for our vehicles. Lead is very bad for the human body – especially for the development of the brain in children”, he explains. “Unfortunately, there has never been a comprehensive study on the impact on pollution. Such a study would take a lot of resources, which the government does not have”.

The research group State of Global Air offers analysis on levels and trends in air quality and health for countries around the world, and they paint a bleak picture. The group states that more than 26,000 deaths in 2017 can be attributed to pollution in Afghanistan. In contrast, according to the United Nations, 3,483 civilians were killed the same year by the ongoing war in the country.

According to the State of Global Air, long-term exposure to air pollution increases a person’s chances of developing and dying early from heart diseases, chronic respiratory diseases, lung infections, lung cancer, diabetes, and other health complications. Even short-term exposures too high pollution can trigger asthma and cause a spike in hospitalisations.

I visit another family in an internally displaced camp, on the outskirts of Herat, in the west of the country. The mother, Badungul, explains to me how she burns rubber from car tires, plastic, and any other cheap material they can afford to buy to keep their home warm during the cold winter days. They cannot afford coal or wood.

“I have to bring my children often to the doctor and spend the little money we can save to buy medicine,” she explains, as she lights a fire in her family’s stove and her four children play on a colourful carpet in the small room of their home. “The doctor tells me that we should stop burning plastic in our home, that the fumes from such material will make us very sick. But what other choice do we have? If we don’t burn these things, we will freeze to death.”

In another home in the same IDP camp, I speak to Narmagul, 45, and her son Nazzir, 11; both of them cough, as they light their stove with recycled plastic. Narmagul explains to me how the entire family is developing breathing problems due to the toxic smoke they inhale day in, day out. She had a throat operation that cost her all the family’s savings. “The doctor says that I became sick because of all the plastic we burn in our home,” she said.

Back in Kabul, at the Ibni-Sena hospital, 80-year-old Zulaikha is cared for by her daughter as she inhales oxygen administered through a face mask in the emergency department. She is suffering from a chronic obstructive pulmonary disease (COPD) and needs a regular intake of administered oxygen throughout the day. During cold days as pollution spikes, her health deteriorates. She has lived through decades of war, but it could be the air that she breathes that kills her.