ONCE again Lahore has been enveloped in the same old thing: smog — now known as the city’s fifth season — is here to stay and there is no respite for the people.

The days are grey and dreary, with thick clouds of fumes hovering over the city horizon, drastically dimming the sight of buildings that can be seen easily on a clear day.

Generally, the nights are better; there are fewer cars and less pollution.

But since a few days, even late at night almost the entire city remains so badly affected by the poisonous mask of dust and smoke that it seems it has entered some kind of dystopic nightmare.

Shahid, a food deliverer, feels as if he has suddenly been transported into an eerie, claustrophobic other-world. “It doesn’t feel like the Lahore I grew up in,” he says. “There were always cars around, there was always bad air, but no one would have thought that we would end up like this. One can hardly breathe.”

Shahid’s duty hours begin late in the evening and last till 4am. With restaurants closing down, more and more orders for home delivery of food are being placed.

But for workers like Shahid, who are more exposed to the outside air, they may be relatively safe from Covid but are facing other serious threats to their health. It is said that air pollution is an ‘invisible killer’.

“We have been seeing so many more patients with respiratory illnesses,” says Dr Irshad, who works in the emergency ward of a large private hospital. “They are coming in with allergies, breathing problems — we have had to nebulise a person tonight — and there have been many cases of eye irritation or allergies, too.”

Patients are not restricted to emergency visits. Doctors have been observing an increase in the incidence of respiratory illnesses — a persistent smoker’s type cough, sore throat and lung infections — but some say health of mothers and children has also been compromised.

“Those mothers who live in low-income areas are usually more prone to pregnancy complications,” says Dr Shaheena, a maternal health specialist. “Babies born may be stunted or underweight — and even have brain damage — which are all consequences of lead poisoning.”

There has been an increase in the number of industrial units inside, outside and around Lahore. It is the same with vehicles. But the areas closer to the noxious gas-emitting factories are mostly inhabited by poor people. Residents of these areas are faced not just with industrial fumes but also heavy traffic. This is yet another socioeconomic divide.

Shehnaz, a domestic worker, is a resident of Haji Park, a low-income area that is adjacent to two or three large factories. Since the last two years, she has had a constant cough. At first she thought it was seasonal, but when months passed, she became worried.

Several medicines later she discovered the only way she could find some relief was by using an inhaler. “Sometimes I can feel the particles as I breathe in and it hurts when I inhale,” she says.

Families of the area became even more worried after Amjad, who lived very close to one of the factories died of a respiratory illness. But as they had little influence or power, not much could be done about it.

Amjad’s family, however, wants the factories to be shut down. “We live here, this is no place for an industry,” says his son Majid. “They should move into a proper zone so that people aren’t affected… by these toxins in the air (and water).”

In 2019, the Global Alliance on Health and Pollution put the total annual air pollution-related premature deaths in Pakistan at around 128,005, placing the country at number 3 out of the 10 worst countries.

In Lahore this week air quality reached ‘hazardous’ proportions (the last level shown on the Air quality charts), while it has consistently been subjected to ‘unhealthy’ levels, the main pollutant being PM2.5 or particulate matter that cannot be seen and is quickly absorbed into the bloodstream and is then carried to the organs, including the brain.

Tabitha Spence, who is part of the Haqooq-i-Khalq Movement, a social platform raising voice for the underprivileged and marginalised, has been helping to set up free medical camps in many working class neighbourhoods across Punjab. “Doctors who work with us note that the bulk of the illnesses they see in these communities are completely preventable, ranging from respiratory issues to waterborne diseases,” she says.

“Poor people are much more exposed to air pollution, as their communities are treated as dumping grounds for industrial waste. Many live in drafty homes in the industrial areas where they work, subjecting them to the non-stop assault of toxic air billowing out of factories and brick kilns, which are not checked by the scantily enforced air quality regulations,” she adds.

People who live in nicer neighbourhoods — usually areas away from the main roads, or the suburbs — tend to be protected to an extent by residential zoning laws that create some distance between their homes and the industrial units. They also have ‘social capital’, allowing them to take action (legal and otherwise) when a specific polluter is out of line. “While rich people still suffer the effects of pollution, they are able to insulate themselves with sturdier homes, costly air filters, and travelling by car,” she adds.

Meanwhile, it remains unclear as to why there has been a sudden spike in pollution, pushing air quality to hazardous levels. The dense cloud shrouding Lahore may be due to aerosols which, researchers say, lowers visibility. Unfortunately, this has still not become an electoral issue, mainly because of a lack of awareness and dearth of reliable data.

Published in Dawn, January 4th, 2021