A month ago, Cebile Mkhwanazi’s doctor presented her with a difficult decision: leave eMalahleni or stay and watch her asthmatic children remain ill.
The mother of two lives in the township of Vosman in eMalahleni — the “place of coal” — an air pollution hotspot reported to have some of the worst air quality in the world.
The Mkhwanazi home is surrounded by open-cast coal mines, which spew dust, and a steel plant that unleashes smoke into the air.
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“The doctor told me the best medication is to take my kids to another place and not to stay here in Witbank [eMalahleni] or Middelburg because of the dirty air,” says Mkhwanazi, as she methodically irons a heap of laundry in her tiny lounge.
“My kids come first and I will do anything for them but we can’t move because my husband is working part-time here and I’m unemployed. We are stuck.”
While she irons, she keeps a careful eye on her quiet five-year-old daughter, Melokuhle, who was absent from school again. “She was crying that her chest was sore. Both my children developed asthma while living here.”
Mkhwanazi is pinning her hopes on the outcome of the landmark Deadly Air legal challenge brought by NGOs groundWork and Vukani Environmental Justice Movement in Action, who have sued the government for the toxic air pollution in the Mpumalanga Highveld in their case heard in May. Represented by the Centre for Environmental Rights (CER), they want the court to order authorities to clean up the region’s dirty air.
Mkhwanazi dirties her fingers as she runs them on her furniture. “See how black this dust is. This is what we are inhaling all the time … There has to be more action to stop this pollution. The government has to take us seriously.”
The applicants have commissioned research that has shown how Eskom’s 12 coal-fired power stations, Sasol’s Secunda plant and the nearby NatRef refinery are responsible for the lion’s share of pollution on the Mpumalanga Highveld.
Exposure to toxic chemical compounds emitted by the coal plants, such as sulphur dioxide (SO2), heavy metals such as mercury, and fine particulate matter cause chronic respiratory illnesses such as asthma, bronchitis and lung cancer, and contribute to strokes, heart attacks, birth defects and premature death.
New global air quality guidelines
Air pollution, according to the World Health Organisation (WHO), is one of the biggest environmental threats to human health, alongside climate change, and causes seven-million premature deaths each year.
For the first time in 16 years, it has recommended new air quality levels to save millions of lives, by reducing levels of key air pollutants, some of which also contribute to climate change, “in response to the real and continued threat of air pollution to public health”.
“By reducing air pollution levels, countries can reduce the burden of disease from stroke, heart disease, lung cancer and both chronic and acute respiratory diseases, including asthma,” the WHO says.
The new guidelines provide clear evidence of the damage air pollution inflicts on human health, at even lower concentrations than previously understood.
“When action is taken on these so-called classical pollutants — particulate matter, ozone, nitrogen dioxide (NO2), SO2 and carbon monoxide, it also has an impact on other damaging pollutants.”
According to the WHO, the health risks associated with particulate matter (PM) equal or smaller than 10 and 2.5 microns in diameter (PM10 and PM2.5) are of particular public health relevance. “Both PM2.5 and PM10 are capable of penetrating deep into the lungs but PM2.5 can even enter the bloodstream, primarily resulting in cardiovascular and respiratory impacts, and also affecting other organs.”
The WHO has cut the guideline for annual average exposure to PM2.5 from 10 to 5 micrograms per cubic metre, and for NO2, it has slashed the annual limit from 40 to 10 micrograms per cubic metre.
In 2019, more than 90% of the global population lived in areas where concentrations exceeded the 2005 WHO air quality guideline for long-term exposure to PM2.5. It says almost 80% of deaths related to PM2.5 could be avoided if current air pollution levels are reduced to those proposed in the updated guideline.
What the new WHO regulations mean for South Africa
As a medical doctor, Lwando Maki has directly seen the impact of air pollution and its contribution to respiratory sickness in children and cardiovascular disease in adults in South Africa.
Maki, the climate health lead at the South African Medical Association, cites how research commissioned by the CER has found 2 239 premature deaths annually can be attributed to air pollution from power plants in South Africa. Other research estimated that 7.4% of all deaths in South Africa can be attributed to polluted air, which costs the country 6% of its GDP.
“The government needs to prioritise actions and policies that make our air cleaner, that prevent extreme weather and that bring the balance back between nature and development. Healthy lives depend on a healthy planet and world leaders need to do what is best, not just for the short term, but for generations to come.”
Dr Caradee Wright, a senior specialist scientist from the South African Medical Research Council’s environment and health research unit, explains how the WHO guidelines can help inform a country’s national standards.
The department of forestry, fisheries and the environment recently called for an expert panel to review the country’s current national ambient air quality standards.
“No doubt, the panel will consider the WHO’s global air quality guidelines in their deliberations and consider air pollution management and interventions that will assist South Africa to best manage air quality and ensure health and wellbeing for South Africans,” Wright says.
Wright was the only South African who was an elected member of the WHO’s guideline development group.
“Of particular concern for South Africa, our standards for PM and for SO2 are far from the more stringent WHO guidelines that are derived from exposure/health response relationships.”
This means that South Africans, especially those living in air pollution hotspots, are exposed to air pollution concentrations that are harmful to their health, she says. “We need a mammoth, collective effort with all political and industrial will to improve air quality management in the country.
“We need to use the interim targets as means to steadily reduce air pollution levels. We need investment and finances to support interventions that reduce air pollution, such as clean energy on the national grid and in the domestic setting.”
The guidelines “provide a solid foundation of evidence to convince decision-makers that the time for change is now; the time to clean up our air has arrived”.
Back in eMalahleni, Precious Mokoena tells how two of her four children suffer from asthma, severe sinus problems and eczema. “The air we breathe here is not healthy,” says the 27-year-old, while breastfeeding her baby. “There are a lot of mines around us. The smoke pollutes the whole area and it’s killing us.”