Lahore’s dangerous smog: where disease and death stalk

With air quality hitting “hazardous” highs, Lahore is forced into survival mode — schools shut, hospitals overflow, and households resort to pricey air purifiers to keep the smog at bay.
Published November 14, 2024

“It’s been horrible; I’ve been sick on and off for the last 10 days,” said 29-year-old Natasha Sohail, who teaches A-Level students at three private schools in Lahore. She is asthmatic, and last week, her condition worsened with a vertigo attack and fever. “It’s criminal what is happening here,” said an incensed Sohail, referring to the “band-aid measures” taken by the Punjab government.

Lahore also has the distinction of being the world leader in the poor air quality index (AQI), with some neighbourhoods touching over 1,200 on the AQI this month. The AQI measures the level of fine particles (PM2.5), larger particles (PM10), nitrogen dioxide (NO2), and ozone (O3) in the air. An AQI of 151 to 200 is classified as “unhealthy”, 201 to 300 “very unhealthy” and more than 300 as “hazardous”.

For the past eight years, since Sohail was in college and since smog became an annual phenomenon, Sohail has relied on anti-wheezing drugs and inhalers. At home, there are four air purifiers to help her breathe cleaner air.

She’s not alone.

These two photos were taken at the same place; the clear blue sky was taken in September 2023 and the sepia skies in November 2024. Courtesy: Zaeema Naeem
These two photos were taken at the same place; the clear blue sky was taken in September 2023 and the sepia skies in November 2024. Courtesy: Zaeema Naeem

“The hospitals are crowded with tens of thousands of patients suffering from respiratory and heart diseases being treated at hospitals and clinics over the last few weeks,” said Dr Ashraf Nizami, president of the Pakistan Medical Association’s Lahore chapter. “The psychological toll the poor air is taking on people remains under the radar.”

Punjab’s senior minister, Marriyum Aurangzeb, revealing the government’s anti-smog action plan, informed journalists that Lahore endured 275 days of unhealthy AQI levels over the past year, with temperatures rising by 2.3 degrees.

After Lahore’s AQI exceeded 1,000 last week, authorities closed all primary and secondary schools. Punjab’s Secretary for Environment, Raja Jahangir Anwar, warned the closure could continue if air quality doesn’t improve. “Young children are vulnerable, and we want to avoid an emergency,” he said, adding that online learning, like during the COVID pandemic, can be adopted again.

Source: Analysis by CREA. Data source for Lahore AQI is Airnow
Source: Analysis by CREA. Data source for Lahore AQI is Airnow

Source: Analysis by CREA. Data source for Lahore AQI is Airnow
Source: Analysis by CREA. Data source for Lahore AQI is Airnow

Source: Analysis by CREA. Data source for Lahore AQI is Airnow
Source: Analysis by CREA. Data source for Lahore AQI is Airnow

Living in a world of air purifiers

Aliya Khan, 37, a mother of two boys — aged five and one, with the older one suffering from asthma — had installed four imported air purifiers in her home four years ago, each costing Rs31,000. They bought a fifth this year at Rs60,000. “It cost us a fortune, but that’s not all; the filters must be replaced every year, which costs Rs10,000 per machine,” she said.

The private school her five-year-old attends lacks air purifiers in classrooms, leaving parents with no choice but to pool together and buy one for their child’s classroom.

Khan, a development consultant, says air purifiers work best if the home is packed tightly to keep the air from outside entering. “Our windows and doors are poorly insulated and with elderly parents, domestic help and two kids — the air purifiers struggle to maintain their effectiveness.”

Smog brings business for some

Business picks up for 37-year-old Hassan Zaidi as soon as Lahore is covered in smog. He’s currently fulfilling an order for “hundreds of air purifiers” for a foreign school in Lahore.

A computer engineer with a passion for product design, Zaidi started building air purifiers in 2019 for his family after his baby daughter developed a cough. He purchased an imported air purifier, took it apart, and quickly realised that with the right materials, it was no “rocket science” to build one himself.

He claimed his “work better, look better, and cost just Rs25,000.” These air purifiers restart automatically after power outages, are nearly silent, and are easy to repair. The filter costs Rs2,400 and needs replacing each season. Each unit is good for a 500 square feet room if fully sealed.

Authorities take action

 Stubble burning in India and Pakistan. The blue line is the border between the two countries. Pakistan (left) and India (on the right).
Stubble burning in India and Pakistan. The blue line is the border between the two countries. Pakistan (left) and India (on the right).

Anwar said the government has introduced several measures to reduce emissions and improve air quality, adopting a whole-of-government approach with all departments working together for the first time.

Authorities have already banned barbecuing food without filters and use of motorised rickshaws.

The government distributed 1,000 subsidised super-seeders to farmers as an alternative to burning rice stubble and took legal action against over 400 farmers who violated the burning ban. “This carrot and stick approach will be very effective,” endorsed Dr Abid Qaiyum Suleri, the executive director of the Islamabad-based think tank, Sustainable Development Policy Institute.

Anwar said super seeders will convert residue into mulch, improving production and speeding sowing. Penalising a few farmers will deter others from breaking the law.

“But the government’s own figures show agriculture contributes less than 4 per cent to smog,” pointed out Hassan Khan, a farmer in Punjab, and added, “Why waste so much time and expense on it; why not focus on the bigger polluters like the transport industry?”

Another measure the government took involved demolishing over 600 of the 11,000 smoke-emitting brick kilns that hadn’t switched to zigzag technology, including 200 in and around Lahore.

Terming brick kilns the “low hanging fruit,” Dr Parvez Hassan, senior advocate of the Supreme Court of Pakistan and president of the Pakistan Environmental Law Association, who, in 2003 and again in 2018, was appointed the chairperson of the Lahore Clean Air Commission and the Smog Commission by the Lahore High Court to come up with the smog policy, did not approve the “arbitrary decision of dismantling” the kilns. In his view, supporting the kiln owners with “available concessional financing for conversion to zizag technology” would be a more effective way.

He added that it was well known that the transport (oil), cement and textile sectors were the bigger polluters, but they were very influential. “Power in Pakistan has always meant being above the law,” he said, adding that the “general lack of political will and effective capability to monitor compliance” also acted as roadblocks.

“No country in the world has succeeded in good environmental policies unless it has first built a capacity to implement! The journey must begin with capacity building!”

However, Anwar said, action has been taken with visits to 15,000 industrial units, sealing 64 mills, and demolishing 152 factories.

With 43pc of air pollution in the province caused by unfit vehicles, Anwar also held the transporters responsible for the smog. He shared that Lahore has 1.3 million cars and 4.5 million two-wheelers, with 1,800 motorcycles added daily. He also mentioned that the traffic police had been ordered to impound vehicles without fitness certificates. Last month, a fine of Rs16.09 million was imposed on over 24,000 substandard vehicles across the province.

“Getting a vehicle fitness certificate in Pakistan is as easy as a blind person getting a license to drive!” said a petroleum expert who requested anonymity. “We need to clean the fuel, scrap old vehicles, and make vehicle emissions testing mandatory,” he added.

Imran Khalid, a climate governance expert, emphasised that improving fuel quality alone wasn’t enough; vehicles and engines also need upgrades to fully benefit from better fuel. He noted that while Euro 5 fuel is available in Pakistan, it’s not widely accessible, and Euro 6 is the standard in India. “I haven’t seen any survey on how many cars in Pakistan have Euro 5 compliant engines,” he added.

“I think it would be far more effective to invest in mass transit, but there is no talk of this issue; we keep making more motorways, widening roads, and bringing in more vehicles on roads in the cities instead of investing in railways and commuter rails,” said farmer Khan.

The petroleum expert urged the government to approve the refinery upgrade policy, which has been delayed for two years, adding that upgrades will take up to five years.

Despite various actions, people in Lahore remain unconvinced, calling them too little, too late.

“The measures announced by the government should have been operationalised at least six months before the smog season and the 24/7 enforcement of these priorities should be rigorously monitored by a dedicated team with support of the public through awareness campaigns,” pointed out advocate Hassan.

Nizami called for year-round efforts against air pollution, questioning why no one is held accountable for cutting millions of trees for unplanned housing while the focus remains on controlling stubble burning.

The Pakistan Air Quality Experts (PAQx) group, a coalition of 27 professionals from public health, environmental science, law, and economics, has written to the prime minister, suggesting the establishment of a “comprehensive, nationwide real-time air quality monitoring network” for informed decision-making and responsive policymaking.

Anwar defended the smog plan, stating it’d been in progress since April and required public cooperation, including staying indoors and wearing masks. Punjab’s senior minister, Marriyum Aurangzeb, warned that failure to wear masks could lead to a complete city lockdown.

“I don’t see the plan working as the air quality is getting from bad to worse,” said Sohail.

Nizami criticised the government for making a lot of noise but taking little action. “It’s shameful how they’ve shifted health responsibilities to the private sector,” he said.

Sohail suggested cloud seeding for artificial rain, noting its positive impact last year. Nizami also supported using artificial rain to clear the haze.

Anwar explained that cloud seeding required the right clouds and humidity. “But we are quite ready and as soon as the timing is right, we will do it,” he promised.

Climate diplomacy

While 70pc of smog in Lahore is locally generated, nearly 30pc comes from India. Manoj Kumar, a scientist with the Finnish Centre for Research on Energy and Clean Air, noted that the Indo-Gangetic Plain formed an “interconnected airshed,” affecting air quality, but local sources played a major role in Lahore’s pollution levels.

The chief minister is keen to start talks with her Indian counterpart. “Maryam Nawaz will soon send a letter to the Chief Minister of Indian Punjab, expressing her willingness to visit India and invite him to Pakistan,” said Anwar.

Kumar praised the Punjab chief minister’s initiative, emphasising that long-term, coordinated efforts between both countries could lead to improved air quality through a unified approach. But the efforts should not stop at the Punjab regions alone, as the airshed is shared and goes beyond India.

Anwar said Pakistan is considering hosting a “regional climate conference in Lahore soon.”


Header image: Smog near the Ghanta Ghar (Clock Tower) in Faisalabad, a city about 120km from Lahore and the third most populous city after Karachi and Lahore. Credits: Khalid Mahmood/Wiki & handout.

This article was originally published in Inter Press Service and has been reproduced here with permission.