Dr. Ranjeet Baral is a Senior Consultant Cardiologist, Aviation Medicine Examiner and Medical Consultant to NOC (Nepal Olympic Committtee).

Among all the problems plaguing the nation, one that still persists if not deteriorating, is air pollution, and it heads the health scenario one way or the other.

Needless to say, breathing in polluted air can be very bad for our health. Long-term exposure to air pollution has been associated with diseases of the heart and lungs, cancers and other health problems. That’s why it’s important for us to monitor air pollution. Air pollution in its most basic definition is the introduction of harmful substances into the earth’s atmosphere.

These substances linger and cause many adverse effects. As we all know, humans and other living creatures rely on the atmosphere for respiration. When air quality is degraded by pollution, immediate and long term consequences take place. In addition, air pollution creates an imbalance in the natural gases that make up our earth’s atmosphere. These imbalances slowly aid the depletion of the ozone layer, an essential region of the stratosphere that soaks up most of the sun’s damaging ultraviolet (UV) rays. As the ozone layer gets depleted, the rate of global warming increases. When enough air pollution clutters our environment, it creates the danger of more rapid deterioration of the ozone layer.

Basically, there are two kinds of pollution: invisible and visible. The smog you see lingering over a city is a good example of visible pollution.

Invisible pollutants aren’t as noticeable, but they can be just as deadly, if not more so. Examples of invisible pollutants include nitrogen oxides, sulfur dioxide, and carbon monoxide, to name a few.

Agreed, it’s not only a national but an international issue, but we have to solve it at our level when we can. Basically, air pollution in Nepal is regarded as pollution emanating from dust/road, industry and automobile. I have always been telling my patients that smoking is suicide, but pollution is homicide. Wearing a mask is just half the job done. It is unfortunate that till date, the concerned authorities have done very little to tackle the source of the problem.

Air pollution is caused by solid and liquid particles and certain gases that are suspended in the air. These particles and gases can come from car and truck exhaust, factories, dust, pollen, mold spores, volcanoes and wildfires. The solid and liquid particles suspended in the air are called aerosols.

The way we are seeing trees getting hacked down in the valley and around the country, do we realize that on average, one tree produces nearly 260 pounds of oxygen each year. Two mature trees can provide enough oxygen for a family of four. As you can see, overall, trees do a lot more for the environment and for us, than just producing oxygen. We are slowly losing the Amazon, the world’s largest green forest. By 2018, about 17% of the Amazon rainforest was already destroyed. Research suggests that upon reaching about 20–25% (hence 3–8% more), the tipping point to flip it into a non-forest ecosystems – degraded savannah will be reached. Savannah is a transitional zone between forest and desert or grassland.

On the other hand, let’s just take a look at an example of the impact of industrial pollution. Shenzen, for example, a grand metropolitan city was built in the middle of nowhere in China but at what cost? They built a Chinese boomtown. It has left hordes of its population dying of lung disease with nowhere to turn. Villagers from Hunan who came to work as laborers have been dying from pulmonary ailments that almost culminated in a mass suicide as a protest against government indifference. Industrial pollution is like slow poison. Gradually, walking and even talking becomes difficult. Lying flat creates the sensation of suffocation, so most patients sleep sitting next to a small oxygen machine. In the latter stages, they suffer heavy wheezing, steep weight loss, frequent bouts of colds and fevers. Pneumonia and tuberculosis can easily turn fatal. Sooner or later, the lungs simply give out.

Where do we stand? Nepal’s capital Kathmandu has been dubbed as the seventh most polluted city in the world. With pollution index 97.73, Kathmandu featured in the top ten along with Kabul, Afghanistan (103.92); Accra, Ghana (102.61); Tetovo, Macedonia (98.09); Faridabad, India (96.58); Cairo, Egypt (96.28) and Dhaka, Bangladesh (95.91); Ulaanbaatar, Mongolia (95.34); Karachi, Pakistan (95.29) and Ghaziabad, India (95.27).

According to the Department of Environment of Nepal, the particulate matter (PM 2.5) of Ratna Park is 103.5 µg/m³ marking Kathmandu as one of the unhealthy cities to live in. PM 2.5 indicates the matter present in the air that are 2.5 microns or below. These particles include dust, coal particles exited from power plants and home heating, car exhaust, and pollen from plants among others.

In conclusion, let’s put aside the statistics; what can we do at the basic level? Industrial pollution is not at the calamitous level at least in the capital. Dust pollution emanating from the messy roads primarily due to the Melamchi water supply fiasco and drainage pipe installation has to be the primary focus. But the least we can do is contain the vehicular pollution. The cops are meticulous at their job regarding alcohol tests for drivers. Well, they certainly can do the same for the rampant pollution emanating from vehicles. All they have to do is impound the two or four wheelers with visible exhaust fumes, fine them a sum and not return their vehicles till corrected. The traffic cops can easily patrol with their two wheelers. I have mentioned this in several of my TV interviews over the years, but apparently it has fallen on deaf ears. Over the years, a maximum number of patients have been going to the pulmonary medicine doctors and the reason is obvious. So unless we implement some corrective measures like I’ve mentioned above, the consequences are only going to get worse, and the result: a shorter life span for citizens.