Air pollution: Doctors report prolonged respiratory illnesses in Lahore’s children, risks from fatal diseases

Students cross a rail track amid smoggy conditions in Lahore on November 30, 2021. (AFP/FILE)
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Updated 05 March 2023
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Air pollution: Doctors report prolonged respiratory illnesses in Lahore’s children, risks from fatal diseases

  • One Lahore study that randomly sampled school children showed 20 percent of children had asthma
  • Doctors say Pakistan lacks national action plan on air pollution, warn kids can get heart diseases, cancer

LAHORE: Data and interviews with experts and paediatricians show Pakistani children are suffering from prolonged respiratory illnesses due to increasing air pollution, with health practitioners warning of a rise in cases of hypertension, heart diseases and even cancer among young Pakistanis in the absence of a “national action plan” to tackle worsening air quality levels.

Pakistan is the fourth most polluted country in the world, with almost all of it’s 220 million people living in areas where the annual average particulate pollution level exceeds the WHO guideline, according to IQAIR, which monitors air contamination worldwide.

The country’s eastern city of Lahore, the second largest by population and area and the capital of Punjab province, is among the world’s most polluted urban centers, with IQAIR recording an Air Quality Index (AQI) of 438 in the city in peak smog season last November, a figure that was globally the highest at the time. Compare this to the fact that air is only healthy up to an AQI of 50 and children suffer the most from pollution since they breathe more rapidly than adults and inhale more pollutants.

“We frequently put up the worst numbers,” Professor Waqar Hussain, a paediatrician at Lahore’s Shalimar Hospital, told Arab News, saying the AQI for Lahore frequently veered between 300 and 400: “This is a calamity of epic proportions.”

“Smog destroys respiratory cilia [which clean up debris in human airways], and once gone, the cilia can’t slow down a virus or an infection,” he said. “Our kids already have low immunity because of nutritional deficiencies, and when combined with environmental pollution, these infections become deadly.”

Hussain said air pollution caused more than 50 percent of lower respiratory infections among children, while pregnant women exposed to toxic air were also likely to give premature births with potential complications.

“The UK and the US have the same viruses and infections as us,” Hussain said, comparing Pakistan’s situation with developed countries. “Upper respiratory tract wise, we all see about 10 episodes per year in a child. But in the lower respiratory tract, in the lungs, our numbers [in Lahore] are four times higher. Pneumonia, for instance, asthma, childhood cancer, early age cardiac problems are all in higher incidence here.”

Smog can also lead to fatal complications with diseases like tuberculosis and prolong respiratory infections.

“America’s school going children get a lot of viral infections but they get better in a week,” he said, while children in Lahore suffered for months in such cases.

“IT’S A CRISIS“

Hussain said he was involved in a recent study that randomly sampled school children from different social strata in Lahore for medical checkup.

“From government schools to elite private schools like Aitchison, when the tests came back, 20 percent of the children were diagnosed with asthma,” he said. “Their families had no idea.”

In terms of children’s illnesses, he said last year was among the worst he had ever witnessed in his medical career.

“That’s why I conducted a seminar this January,” he added. “We called experts. It’s a crisis, we have to do something.”

“The mixture of surface level ozone, nitrogen dioxide, fine particulate matter, sulfur dioxide, lead, it’s a case of picking your poison,” Hussain said while explaining the effects of smog on children. “Fetal development is badly affected. Air pollution also impairs neurodevelopment and cognitive function. Autism is rapidly increasing. These are all things I’m witnessing every year now.”

Pakistan Pediatrics Association’s Punjab President Dr. Naeem Zafar said the rise in the number of serious diseases among children in recent years may also have something to do with the coronavirus pandemic that started spreading in late-2020.

“I think COVID-19 has exacerbated problems [of pollution] in a population with already weakened immune systems,” he told Arab News. “Then there are many influenza strains that have recently evolved.”

“Look, we have had smog for decades,” he added. “There were government commissions set up in the 70s, in the 80s, there were short term or aesthetic remedies, visible smog was reduced but the air quality remained bad. The surge in mortality you’re seeing these last few winters probably has more to do with the viruses. They’re much worse now, even in adults.”

However, Professor Hussain was not convinced and said viruses had been around for thousands of years while pandemics happened periodically.

“We said this in the seminars. It’s to do with smog. We are not doing anything, as a government, as a society. We invited everyone to the seminar, our association went to the health department, but no public policy promises were made.”

Hussain pointed out the United States, United Kingdom and China burned more fossil fuels than Pakistan, but they had also improved the overall environmental situation in the last many years as climate change became a reality.

“We join a committee, give a recommendation, then what? Where is the implementation? Pakistan lacks a coordinated national action plan on air pollution,” he said.

Arab News reached out to Syed Hammad Raza Bukhari, the Punjab health department spokesperson, several times to seek comment for this story but he declined. 

Noor Ahmed, a deputy director for the Environmental Impact Assessment (EIA), a research project launched by the Environmental Protection Department (EPD) to monitor Punjab province, was also unavailable for comment.

“THINGS ARE GOING TO GET WORSE“

Dr. Shahzad Khurram, a paediatrician with 15 years of experience running his private clinic, said his anecdotal experience was the same as Professor Hussain’s.

“I treat young kids with bronchitis, ear infections, problems in the nasal passage, and pneumonia every day,” he told Arab News. “I treated a three-year-old child who had asthma for almost two years. No family history, nothing wrong with the child at birth.”

And while it was difficult, he said, to pinpoint smog as a cause, it was not impossible:

“Sometimes the respiratory problems are genetic, sometimes they’re allergies, from pollen, sometimes it’s influenza, but oftentimes we are seeing coughs and shortness of breath without any apparent cause. That’s when we know it’s smog.”

Taken in isolation, he added, these barely constituted two percent of the cases.

“But we don’t exist in isolation,” the doctor said. “If you ask me, the diseases that smog has made much, much worse, that number goes up to 50 percent. Half the children I see are presenting with symptoms much more severe than their illnesses should be presenting with.”

“I see chronically inflamed tonsils. Narrowed nasal passages in growing children. Children using inhalers twice as often as before,” he added.

Preventively, one could wear a double surgical mask, use nebulizers, take steam, monitor the daily AQI and stay in if it was very high, but these were short term alleviations.

“There are going to be more and more young people with heart diseases, hypertension, cancer,” Khurram warned. “These are just the facts out there. Things are going to get worse. It’s not just the air either, it’s the water, the food. But we simply aren’t responding as a society.”


Pakistani military blames ‘Indian-sponsored’ militants for children’s death in northwest this week

Updated 21 May 2025
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Pakistani military blames ‘Indian-sponsored’ militants for children’s death in northwest this week

  • Protests broke out in North Waziristan after a suspected drone strike reportedly led to the killings of four children
  • The military says initial investigations have revealed the incident was carried out by ‘Fitna Al Khwarij’ militants

ISLAMABAD: Pakistan’s military on Wednesday denied responsibility for the death of four children in North Waziristan earlier this week, attributing the incident to a proscribed militant network which it said was operating on “the behest of their Indian masters.”

The incident occurred on May 19 in the Hurmuz village of Mir Ali tehsil, where a suspected drone strike reportedly led to the death of four children from the same family and injuries to five others, including a woman.

The tragedy sparked protests in the area, with locals staging a sit-in and refusing to bury the deceased until authorities provided clarity on the incident and ensured accountability for the loss of innocent lives.

In a statement released on Wednesday, the Inter-Services Public Relations (ISPR), the military’s media wing, dismissed allegations implicating Pakistan’s security forces in the strike, labeling the accusations as “entirely baseless” and part of a “coordinated disinformation campaign” aimed at discrediting the military’s counterterrorism efforts.

“Initial findings have established that this heinous act has been orchestrated and executed by Indian-sponsored Fitna Al Khwarij,” the statement said, using a term commonly employed by Pakistani authorities to describe extremist factions like the Tehreek-i-Taliban Pakistan (TTP).

The term “khwarij” is rooted in early Islamic history and refers to an extremist sect that declared other Muslims apostates.

“It is evident that these elements — acting at the behest of their Indian Masters — continue to exploit civilian areas and vulnerable populations as shields to conduct their reprehensible acts of terrorism,” the statement added. “Such tactics aims to unsuccessfully sow discord between the local population and the security forces, who together remain resolute to uproot the menace of terrorism.”

The military also reaffirmed its commitment to bringing the perpetrators to justice, emphasizing its ongoing efforts to combat militant violence in the region.


Afghanistan and Pakistan to work to upgrade diplomatic ties after trilateral talks in Beijing

Updated 21 May 2025
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Afghanistan and Pakistan to work to upgrade diplomatic ties after trilateral talks in Beijing

  • Pakistan and Afghanistan agree to work to extend China-Pakistan Economic Corridor to Afghanistan
  • Neighbors decide in principle to send ambassadors to each other’s capitals as soon as possible

ISLAMABAD: Pakistan and Afghanistan plan to upgrade diplomatic ties and will work to extend the China-Pakistan Economic Corridor (CPEC) into Afghanistan, Beijing said on Wednesday after hosting an informal meeting between Islamabad and the Afghan Taliban administration.

The announcement comes as Pakistani Deputy Prime Minister Ishaq Dar was in China on a three-day visit for trilateral talks with Chinese Foreign Minister Wang Yi and Afghanistan’s Acting Foreign Minister Amir Khan Muttaqi in Beijing.

Islamabad and Kabul had agreed in principle to send ambassadors to each other’s capitals as soon as possible, Wang said after his talks with Muttaqi and Dar.

The two countries “clearly expressed” willingness to upgrade the level of their diplomatic relations, Wang said according to a Chinese foreign ministry statement.

The officials also decided to hold the 6th Trilateral Meeting of Foreign Ministers in Kabul at a mutually agreeable date.

“Pakistan, China and Afghanistan have agreed to deepen cooperation on Belt and Road Initiative (BRI) and extend the China-Pakistan Economic Corridor to Afghanistan,” Radio Pakistan reported after Dar concluded his Beijing visit.

The Belt and Road Initiative, also known as the One Belt One Road or the New Silk Road, is China’s large-scale infrastructure development project aimed at connecting the world through land and sea trade routes. It involves investing in infrastructure like ports, railways, roads, and energy projects in over 150 countries. CPEC is a flagship of the BRI scheme under which China has pledged over $60 billion in infrastructure, energy, industrial, and agricultural projects in Pakistan.

Relations between Pakistan and Afghanistan have plummeted in recent months due to a surge in militant attacks that Islamabad blames on Afghan-based insurgents. Kabul denies it allows its territory to be used against other nations.

In December, the Afghan Taliban said bombardment by Pakistani military aircraft in Afghanistan’s eastern Paktika province had killed at least 46 people, most of whom were children and women.

Pakistan has not confirmed the strikes but said at the time it was carrying out “anti-terrorist operations” against militants with safe havens in Afghanistan, a charge Kabul denied.

In a statement on Wednesday, Pakistan’s foreign office said it “welcomed positive momentum in bilateral ties, including enhanced diplomatic engagement, trade, and transit facilitation.”

Afghanistan’s acting foreign minister “emphasized the importance of political and economic relations with both countries and expressed hope for further progress in these areas in the future.”

Tensions appeared to ease after a rare meeting between Muttaqi and Dar in Kabul last month where the Taliban’s acting foreign minister expressed concern over the deportation of tens of thousands of Afghans from Pakistan. Pakistan has expelled more than 80,000 Afghan nationals since the end of March as part of a renewed surge in a repatriation drive that began in 2023.

Wednesday’s meeting in Beijing signaled a further thaw, with all agreeing to a trilateral foreign ministers’ dialogue in Kabul as soon as possible.

Pakistan and Afghanistan have embassies in each other’s capitals, but they are led by charge d’affaires, not ambassadors. China was the first country to accept an ambassador from the Taliban-run administration in Kabul though it does not formally recognize its government. Several other states, including the UAE, followed.

During the talks, China and Pakistan voiced support for the reconstruction and development of Afghanistan, and are willing to expand trade exchanges with Afghanistan, said Wang.

The meeting also agreed on security cooperation, combating terrorist forces and safeguarding regional peace and stability, he said.

With inputs from Reuters


Beloved strongman: Support for Pakistan army chief surges after India conflict

Updated 21 May 2025
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Beloved strongman: Support for Pakistan army chief surges after India conflict

  • Government has promoted Gen Asim Munir to Field Marshal “in recognition of strategic brilliance and courageous leadership” in latest standoff with India
  • Survey conducted after the India conflict by Gallup Pakistan, a local pollster, found that 93 percent of respondents felt their opinion of the military had improved 

ISLAMABAD: Pakistan’s army chief General Asim Munir is the most powerful man in the country, but his popular support has surged after the worst conflict in decades with arch-rival India, shattering criticism of interference in politics and harshly cracking down on opponents.

A grateful government on Tuesday gave him a rare promotion to Field Marshal “in recognition of the strategic brilliance and courageous leadership that ensured national security and decisively defeated the enemy.”

The military has ruled Pakistan for at least three decades since independence in 1947 and wielded extraordinary influence even with a civilian government in office. But it, and its hard-line chief, have rarely received the widespread outpouring of affection seen this month that analysts say has reinforced the military’s dominance in the nuclear-armed nation.

“Long live General Asim Munir!” read placards held aloft in rallies in recent days in towns across Pakistan. His picture was put up on lamp posts and bridges, with some banners saying: “You are our savior!“

A survey conducted after the conflict by Gallup Pakistan, a local pollster, found that 93 percent of respondents felt their opinion of the military had improved.

Munir’s most bitter domestic foe, jailed former Prime Minister Imran Khan, also congratulated the military after this month’s clashes with India, claimed by both nations as a victory.

“It’s my country, it’s my army,” Khan said in a post on X last week. “I pay tribute to the Pakistan Air Force and all our military personnel for their professionalism and outstanding performance.”

Yousuf Nazar, a political commentator, said of Munir: . “He has emerged as Pakistan’s strongman with his military’s reputation restored as a formidable force.”

Six months after he took charge in November 2022, Munir was faced with the most serious challenge to the military’s hegemony when Khan’s supporters attacked and ransacked military installations.

Munir later faced sharp domestic criticism for the jailing of Khan and cracking down on supporters of his Pakistan Tehreek-e-Insaf party, as well as what critics alleged was rigging the general election last year to favor a rival party.

But the conflict with India has turned that around, said Ayesha Siddiqa, author of Military Inc, a book on the Pakistan military.

“It has made the general stronger than any other previous generals. He is a hero now,” she said, adding that the contest between the neighbors will be headed by two hard-liners, India’s Hindu nationalist Prime Minister Narendra Modi and Pakistan’s Munir, a devout Muslim.

“It’s an Islamist general versus a religious strongman,” she said.

The military did not respond to questions sent by Reuters.

FUNDAMENTAL DIFFERENCE

The spark for the latest fighting between the neighbors was an April 22 attack in Indian Kashmir that killed 26 people, most of them tourists. New Delhi blamed the incident on “terrorists” backed by Pakistan, a charge denied by Islamabad.

On May 7, the Indian military carried out air strikes on what it called “terrorist infrastructure” in Pakistan, in response to the attack in Kashmir.

Pakistan claimed to have downed at least 5-6 Indian fighter jets and carried out air strikes on Indian military bases. India has indicated that it suffered some losses and inflicted major damage on key Pakistani air bases and air defiance systems.

Munir, who has memorized the Muslim holy book, the Qur’an, has publicly underlined what he has said are fundamental differences between Islamic Pakistan and predominantly Hindu India.

“Our religion is different. Our customs are different. Our traditions are different,” he said in a speech in Islamabad a week before the attack in Indian Kashmir.

The Indian army “with all their wherewithal” cannot “intimidate” Pakistan, he said, peppering his comments with verses from the Qur’an.

“Pakistan needs to be a hard state.”

Pakistan’s counterstrike against India was named by him as “Bunyan Marsoos,” after a Qur’anic verse, which means Iron Wall, according to the military. It was launched on May 10 to coincide with dawn prayers, considered an auspicious time for Muslims.

Munir, the son of a schoolteacher, is an infantry officer and a former head of both the powerful Inter-Services Intelligence and Military Intelligence. He remains army chief until November 2027 and could be appointed for another five-year term at that point.

Husain Haqqani, a former Pakistani ambassador to the United States, said that even before the latest conflict, Munir was more hawkish on India than his predecessor General Qamar Javed bajwa as army chief, who had taken a more pragmatic and less ideological approach, seeking to improve relations.

“Conflicts with India remind Pakistanis of the fragility of their country and they rally to their army as the entity that will save the country,” said Haqqani.

“The recent show of strength and standing up to India has helped General Munir solidify his position within the country.”


Jumbo task: 400 pills a day for elephants with TB in Pakistan

Updated 21 May 2025
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Jumbo task: 400 pills a day for elephants with TB in Pakistan

  • Vets hide medicines inside food ranging from apples, bananas and Pakistani sweets
  • Sisters Madhubala and Malika were diagnosed with tuberculosis earlier this month 

KARACHI: A team of doctors and vets in Pakistan has developed a novel treatment for a pair of elephants suffering from tuberculosis that involves feeding them at least 400 pills a day. 

The jumbo effort by staff at the Karachi Safari Park involves cunningly administering the tablets, the same as those used to treat TB in humans, hidden inside food ranging from apples and bananas to Pakistani sweets. 

Dr. Buddhika Bandara, a Sri Lankan veterinary surgeon who is treating elephants Madhubala and Malika, said they did not have a “rare disease” as tuberculosis was common in elephants in Asia.

“Giving treatment of TB to elephants is always challenging whenever, whatever and wherever, is always challenging not only in our country Sri Lanka, or in Pakistan, it is challenging everywhere actually,” the vet said.

“Every day we have to think about new methods of giving medicine.”

Bandara said the elephants showed some stress when the treatment was first started but gradually adapted to the procedure and were now getting better.

Under the treatment plan, the elephants will receive medication and monitoring for ten months after the initial phase. They are being kept under round-the-clock supervision, and park officials have restricted access to the enclosure for one year to minimize stress and prevent any risk of disease transmission.

Ali Baloch, a 22-year-old mahout, said though he looked after the elephants, he was unaware that they had TB. 

“The team is saying now that they have the disease. That’s why we must wear mask, and boots, do not go without them. It can infect me and my children as well.”

The two elephants Malika and Madhubala took their medication differently, he added. 

“Malika takes medicine by her trunk while Madhubala can take it directly by her mouth,” Baloch said. “They eat in this way. Malaika smells medicine so she takes by its trunk. To change the taste, we give medicine in sweet potatoes, bananas and other sweet items.”

The novel methods had to be used to ensure the elephants did not reject the treatment.

“They will not eat these [pills] so easily, they are bitter in taste.”

Visitors to the Safari Park are currently only allowed to view the elephants from designated buses or a safe distance, as part of efforts to ensure a stress-free environment during their recovery.

The cautious approach follows years of concern raised by international animal welfare organizations over the treatment of elephants in Karachi.

In 2021, the global group Four Paws assessed the city’s elephants and called for urgent medical care, improved nutrition and enriched environments to support their wellbeing.

The issue gained further attention after the deaths of two elephants — Noor Jehan in 2023 at the Karachi Zoo and Sonu in late 2024 at the Safari Park — both of which highlighted systemic gaps in animal care.

Since then, local authorities have taken steps to improve conditions, including the formation of a technical committee and increased collaboration with foreign veterinary experts.

Madhubala, Noor Jehan, Malika and Sonu were caught in the wild at a young age and brought to Pakistan together in 2009 but were soon separated, with Noor Jehan and Madhubala moved to the Karachi Zoo and Malika and Sonu to the city’s Safari Park. 

Noor Jehan died in April 2023 at age 17, following a prolonged illness caused by neglect, leaving Madhubala alone.

In November last year, she was reunited with Malika and Sonu at the Safari Park. Sonu has since also passed away due to illness. 


A look at recent deadly attacks in Pakistan as it battles rising militancy

Updated 21 May 2025
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A look at recent deadly attacks in Pakistan as it battles rising militancy

  • Government facing insurgencies in northwest and growing separatist insurgency in southwest
  • Pakistan is also currently at loggerheads with both its neighbors India and Afghanistan 

Following are some recent deadly attacks in Pakistan, where the government is facing insurgencies on two fronts — militant attacks in the northwest and a growing separatist insurgency in the south.

MAY 21, 2025 
At least three children were among five people killed when a suicide bomber targeted an army school bus in the restive Pakistani southwestern province of Balochistan, in an attack the military blamed on Indian proxies.
The Indian government did not respond to a request for comment on the accusation.

MARCH 11, 2025
A total of 31 people, including soldiers, staff, and civilians, were killed by militants who hijacked a train as it traveled through a remote mountain pass in Balochistan. The Baloch Liberation Army (BLA), the biggest of several ethnic armed groups fighting the government, claimed responsibility.

MARCH 4, 2025
Suicide bombers drove two vehicles packed with explosives into a military base in the town of Bannu in the northwest, killing 18 people, including six children.
No group claimed responsibility for the violence.

NOVEMBER 1, 2024 
A blast targeting a police van in Mastung town in Balochistan killed seven people, including five school students, and injured 23 others.
No group claimed responsibility.

AUGUST 26, 2024 
At least 38 civilians and 14 soldiers were killed as separatist militants attacked police stations, railway lines and highways in Balochistan, and security forces launched retaliatory operations.
The BLA claimed responsibility for the attacks, the most widespread in the country in years.

DECEMBER 12, 2023 
At least 57 people, including seven children, died as suicide bombings ripped through two mosques in Mastung while believers marked the birthday of the Prophet Muhammed (pbuh).
No group claimed responsibility.

JULY 31, 2023 
A suicide bombing targeting a hard-line religious group’s political rally in Khyber Pakhtunkhwa province’s Bajaur region killed 56 people. The Daesh militant group claimed responsibility for the blast, which took place in northwestern Pakistan.