Lt. Gen. Mahmud Ahmed Akhtar
Former Surgeon General Pakistan Army
Environmental Medicine
Smog is combination of smoke and fog. The city megalidis, Lahore was declared as calamity hit in November by the Provincial Disaster Management Authority (PDMA) due to smog. This is happening yearly on the onset of winter. Other cities like Multan, Faisalabad, Rawalpindi and Islamabad are also hit by this calamity but to lesser extent than Lahore. The smog just does not herald in cooler weather, it is accompanied by a public health crisis causing increase in upper and lower respiratory infections.
Lt. Gen. (Rt) Mahmud Ahmed Akhtar
The smog crisis occurred in London in 1952. The main cause was the burning of coal during the winter for warming purposes. It was overcome by tackling the cause. The ill-effects of smog are not limited to itchy throats, irritated throats and lungs infections, the particulate matter (pollutant particles suspended in the air) is known to cause lung problems like lungs cancer, renal failures, hypertension, heart failures, chronic obstructive-emphysema, pneumonia and respiratory failures etc. The World Health Organization (WHO) reported more than four million preventable deaths due to air pollution in 2016, alone.
Pakistan is afflicted with pollution of water, food (milk, vegetable and fruits etc.) and their consequences. Sadly, Pakistan has one of the lowest age-range, high morbidity/mortality rates from fetal loss, maternal, infant, child and adult not only in the region but even the sub-Saharan region. It is preventable by using preventive measures, health promotion, early diagnosis and early treatment mainly be prevention.
People in Pakistan are more vulnerable to ill-effects of air pollution. There are a number of reasons for this. Chief among them being lax environmental regulations leading to the use of poor-quality fuels. The absence of effective control on industry emissions, stubble banning, a general lack of knowledge about the ill-effects of breathing heavily polluted air and of course, the precedence, “the development” and “productivity” take over human health. In Pakistan, over 23 million children are out of school – in streets. There are in fact two Pakistan, one of elites with gated communities and other of shanty towns. Even Islamabad is an example of this. This is against the policy of Pakistan’s founder Quaid-e-Azam Muhammad Ali Jinnah who while addressing a large public meeting, pointing towards the general public sitting on the ground, said that “I am struggling to make Pakistan for you people” and while pointing towards where landlords and elites were siting, not for them. If it so, I would withdraw from it. He asserted that “I am for the democratic Islamic Welfare State. Alas, he died after few months of emergence of Pakistan and there was complete capture of Pakistan by the elite for the elite.
A 2013 study by the International Agency for Research on Cancer (IPRC) concluded that outdoor air pollution is carcinogenic for humans with particulate matters (PM) being most closely associated with increased cancer. Air quality measurements are reported in concentrations of particulate matter (PM). PM is a complex mixture of solid and liquid particles suspended in the air. It can include pollutants harmful to human health such as sulfates, nitrates, ammonia, sodium chloride, black carbon and minerals. Dust particles with a diameter up to 10 microns (PM 10) can penetrate and lodge deep in the lungs.
More damaging is the smaller particles with a diameter of 2.5 micron or less commonly known as PM 2.5. These particles can penetrate from the lungs into the blood stream. This increases the risk of renal failure, hypertension, cardio-vascular failure, stroke, carcinoma etc. Alarmingly PM 2.5 pollution has health impacts even at very low level. This means that any amount of air pollution caused by small particulates, no matter how small or seemingly invisible to the eyes, damages health. Consequently, the WHO global guide-lines do not have a lower threshold for PM 2.5 minimise its exposure.
The PDMA has been empowered to take such steps as necessary to formulate effective disaster risk management and mitigation policies, coordinate disaster response and financial management, increase public awareness, provide technical support and give directions to provincial department as deem necessary. In terms of tackling smog, PDMA has worked to introduce legislation for local industry in order to reduce overall pollution. Meanwhile, the provincial Environment Protection Department (EPD) has mapped out brick kilns and industries emitting air pollution and imposed fine on the owners. The government of Punjab has gone so far to provide loans for the refurbishment of the tradition brick kilns to zigzag technology in order to reduce air pollution.
Until last year, only one refinery in Pakistan had the capability to refine the fuel to Euro5 standards, which considerably reduces the air pollution from vehicles. Early this year, the Ministry of Energy granted refineries to five-year extension to comply with Euro 5 standards. This is akin to choking communities already gasping for air.
The Punjab government claimed to have drastically improved the air quality, not by addressing the root cause of pollution as was done by the UK government in 1950s by addressing the root cause i.e., by stopping the burning of coal for house-hold heating. Individual measures like wearing masks, avoiding polluted areas, closing schools and businesses harm children’s education and businesses etc. Instead, corrective measures should be taken. Pakistan’s economy is already in a mess. These measures further add to woos, particularly for the poor people, daily wage-earners. Most gimmicks like steaming etc. are unhelpful-waste of money and time. By tackling the root causes like stubble disposal through proper process using proper grade vehicular fuel, inspecting vehicles periodically and putting those off road emitting harmful gasses, not using wood and harmful fuels for cooking etc. harmful effects can be alleviated. Awareness should be created by all available means to the public so that people understand the causes and measure to tackle the menace.
