Increasing air pollution keeps Nepal's health sector and people's life expectancy at stake

Kathmandu [Nepal], April 7 (ANI): As the drone takes off, the skyline of Kathmandu is shrouded in a thick layer of polluted haze that has been lingering for weeks. Visibility has also dropped over the weeks, delaying the flights.
On the ground, a layer of grey haze has continued to linger in the atmosphere, and its inhalation has continued to affect the people with complaints of itchy eyes, sore throats and burning noses, becoming a common phenomenon.
"I just have recovered from a severe cold and cough, and I was completely bedridden for two to three days. It was really serious and my eyes were itchy and twitchy. After I return home and wash my face, I see a lot of dust on my face while oil-cleansing my face," Samikshya Sunuwar, a graduate-level student, told ANI as she strolled around Kathmandu Durbar Square along with her friends.
As per the Department of Environment Air Quality monitoring, the Particulate Matter 2.5 (PM 2.5) stands at 135.661 ug/m3 on average on a daily basis. The PM 10 stands at 267.839 ug/m3 while the total Suspended Particulate stands at 482.055 ug/m3 on a daily average.

The average readings of Kathmandu's pollution exceed the annual average concentrations of PM2.5 of 5 ug/m3, while 24-hour average exposures should not exceed 15 ug/m3 more than 3 - 4 days per year, as prescribed by the World Health Organization.
PM2.5 refers to particulate matter (solid or liquid droplets) in the air that is less than 2.5 micrometres in diameter. It is among the most dangerous pollutants that can get past the nose and throat to penetrate the lungs and even the bloodstream. PM2.5 particles are small and are also likely to stay suspended in the air for long, increasing the chances of people inhaling them.
According to the Environmental Protection Agency's air quality index, an air quality reading of 151-200 is considered unhealthy. This causes everyone to experience problems, and sensitive groups experience more severe effects.
When air quality reaches 201-300, it is considered a very unhealthy level, and health risks increase for everyone in the area. When it crosses 300, it becomes hazardous, meaning that the air is of extremely poor quality and poses serious health risks to everyone.
"Recently, I have been facing a lot of serious headaches, and I think it is the result of the redness and the itchiness that I've been feeling in my eyes. Also, it has hindered my assignments and college projects, and I cannot focus properly on my lectures. That is the major problem I have been facing," Suniva Hada, another student, told ANI.
For over a week, the air quality of Kathmandu has been switching from Very Unhealthy to Hazardous and vice versa. The AQI in the morning and late evening has always remained hazardous, while it remains very unhealthy during the daytime when the sun heats the atmosphere. But at times, the thick layer of polluted smog blocks the sun's rays, further deteriorating the quality of the air.
The depleting air quality has spiked respiratory difficulty cases at major government hospitals in the valley. The Tribhuvan University Teaching Hospital (TUTH), one of the largest government-run multidisciplinary hospitals, has seen a spike in the number of patients in its OPD (Out-Patient Department).
"In the last one week, the flow of patients has increased tremendously; we are struggling to manage the flow of patients," Kaliprasad Osiyara, Information Officer at the Tribhuvan University Teaching Hospital, told ANI.
"In recent weeks, the cases of children's suffering from viral fever, cough and cold, ENT (Ear-Nose-Throat) allergies has spiked along with the patients who have prolonged medical conditions- asthma, lung conditions and other having respi-problems has increased. In the OPD (each department), we have the capacity to attend 250 patients on a daily basis, which now has reached 300, and in an indirect way (after being referred from other departments), the number has continued to go up," Osiyara added.
Apart from OPD, the cases of patients being rushed into the emergency room with respiratory alienation have also increased to 25 on a daily basis as the hospital can host up to 300 patients a day. With recent environmental conditions, the hospitals, at times, have to turn back the patients, only admitting those with severe cases.
The polluted haze, which has continued to remain afloat in the atmosphere of the bowl-shaped valley, continues to test the healthcare system of the Himalayan Nation. As per Dr Niraj Bam, Head of Department (HoD) of Pulmonology, Critical Care and Sleep Medicine Department at the TUTH, some of the patients had to be referred to other hospitals due to a lack of beds.
"Those patients with prolonged illness of asthma, tuberculosis, bronchitis, patients with interstitial lung disease and others with respiratory diseases are coming to OPD after developing infection. The emergency ward is full, and patients with respiratory issues are on the rise, exceeding the capacity. In such conditions, some of the patients are being referred to other hospitals as well. The main reason behind it is the polluted haze that has continued to shroud Kathmandu's sky, which has further blocked the sunlight, smothering the visibility. It is one of the major factors contributing to the ongoing situation," Dr Bam told ANI.
"The chest department of this hospital has the highest number of patients inflow and admission. If we talk about the current statistics, then about 80 patients are admitted in ICU (Intensive Care Unit), Ventilator and those relying on oxygen. Due to the lack of enough beds, some of the patients have been referred to other hospitals, while some went on their own to other hospitals, that too on a daily basis," Dr Bam added.
Apart from the (Tribhuvan University) Teaching Hospital, other governmental hospitals have also seen a spike in cases of respiratory aliment with some reporting increase in patients flow by up to two folds.
The Bir Hospital, Nepal's oldest hospital, which has a capacity of 3200 patients for outpatient care daily, has continued to record a rise in the number of patients suffering from pollution-induced problems.
The Kanti Children's Hospital, the national referral center for ailing children, has also reported a spike in respiratory illnesses, skin diseases, and other health issues linked to air pollution.
Likewise, the Sukraraj Tropical and Infectious Disease Hospital and Patan Hospital have continued to record a rising number of patients with viral fever, skin diseases, seasonal flu, and respiratory diseases in recent days.
The Nepali capital, Kathmandu, has an area of 413.69 square kilometres and has become a hotspot of air pollution in the recent decade. According to the 2022 census data, it has a population density of 12,440 square miles and a population of 1,988,606.
Smoke from industries, houses, vehicular emissions, and haphazard waste burning have been contributing to increased pollution. The use of vehicles that have failed emission tests is further fueling the pollutants contributing to industrial smoke.
In a random test conducted by the Environment Department of Kathmandu Metropolis on January this year, 193 out of 261 buses, micro-buses and Tata pick-up trucks operating in the capital failed the emission test.
Seventy-four percent of diesel vehicles, including 20-year-olds still plying the roads in Kathmandu Valley, failed the emission tests carried out by the Kathmandu Metropolitan City in recent days. Similarly, 20 percent of petrol vehicles (both private and government cars), 14 out of 71, failed the emission test.
Though the government announced a ban on vehicles over 20 years old to reduce vehicle congestion, curb air pollution, and prevent road accidents caused by ageing vehicles, it has failed to be implemented.
The increase in air pollution has increased the risk and cases of lung cancer, which has been the contributing factor for deaths in recent times, as per the doctors.
"Air pollution has induced lung cancer, which has been one of the major factors for death due to cancer in recent times. There have been cases where a person who hasn't smoked in entire life have lungs cancer, the main reason behind it is environmental pollution. In the coming years, this will increase the fatalities and risk of diseases. It might further fuel cancer, high-blood pressure, diabetes, stroke, and heart attack. Along with infertility, other intestinal as well as bone-related problems may occur if exposed to such environments," Senior Doctor at the TUTH Dr Niraj Bam told ANI.
With pollutants dumped in the valley surrounded by high-edged hills on all sides, the Air Quality of Kathmandu within the past three months has remained polluted for 75/90 days, an analysis by ICIMOD has shown.
In a press release late last week, the International Centre for Integrated Mountain Development (ICIMOD), a regional intergovernmental learning and knowledge-sharing center, attributed the spike to pre-monsoon forest fires across Nepal, especially in the west, where many districts are in moderate to extreme drought.
"Notable emissions coming from forest fires include carbon monoxide, fine particulate matter in the form of PM2.5 and black carbon. When breathed in, these finer particles of this pollution can enter the bloodstream and lead to respiratory conditions, and even death," the release warned.
It further stated, "Black carbon or soot which is emitted from these forest fires, is part of a number of harmful pollutants that are also seen as powerful 'climate forcers.' These climate forcers have the ability to greatly impact climate systems, including those in the Hindu Kush Himalayas."
The Himalayan Nation's Ministry of Health reports that air pollution causes 42,000 deaths in Nepal annually 19 per cent of which are children under five and 27 per cent are individuals over 70. The data indicates that air pollution has decreased the life expectancy of Nepalis by 4.1 per cent.
Nepal's air quality is far worse than the World Health Organization's safe air standards, making this a growing public health crisis.
"In recent time those who don't smoke are also falling victim to Asthma and other chronic respiratory diseases. Nepal has a statistic as per which 80 per cent of the smokers have COPD (Chronic Obstructive Pulmonary Disease) and 20 per cent non-smoker have lung diseases that cause breathing difficulties. The ratio of non-smokers is slowly increasing to 30 percent," Dr Bam warned.
The city's air quality has been a major public health problem, causing air pollution-related morbidity and mortality. This places an economic burden on the country due to the loss of productivity and overutilisation of health system resources.
There has also been a lack of health impact assessment data to estimate the health and economic burden of air pollution as well as of the sectoral measures needed to tackle this environmental challenge. (ANI)