Inside a pulmonary ward for newborns in Ulaanbaatar’s bustling Maternity Hospital No. 3, Dr. Tungalag Lodon tends to a day-old infant just taken off his oxygen tubes. With relief, she notes progress in the little boy’s heartbeat. The prognosis for other patients with hypoxia -- a shortage of oxygen reaching the tissues -- is often grim.
Maternity hospitals across Mongolia’s smoggy capital have experienced a spike in birth defects and unhealthy newborns in recent years. “I suspect air pollution plays a major role,” said Lodon, who has seen a sharp increase in cleft palates, weak bones and underdeveloped vital organs in her 10 years at the hospital. One researcher estimated that congenital birth defects have increased up to 30 percent in the last decade due to Ulaanbaatar’s dirty air. Of children born with heart defects, a government study found 56 percent died within their first year.
According to the World Bank, Ulaanbaatar, a city of 1 million, has some of the worst urban pollution levels in the world, caused mainly by residents burning coal at home to stay warm during the long winter.
“There has been a surge in birth defects and while a single risk factor cannot be isolated, maternal exposure to air pollution is suspected to play a major role,” says Dambadarjaa Davaalkham, head of the Epidemiology and Biostatistics Department at the Health Science University of Mongolia. A study conducted by the government’s Public Health Institute, containing data covering 1998-2008, shows a strong correlation between the increase in heart defects among infants and higher concentrations of nitrogen dioxide and sulfur dioxide, gasses released by burning coal, in the city.
Among adults nationwide, respiratory disease is among the leading five causes of death, according to the Public Health Institute. The government agency has recorded a 45 percent uptick in the rate of respiratory diseases over the past five years.
Many hospitals are overburdened during the winter, when pollution levels are at their highest, says Dr. Naidansuren Tsendeekhuu, who works at the Pulmonary Disease Unit at a hospital in the Bayangol District. This winter, her 35-bed unit had to squeeze in 41 patients; the number of outpatients almost doubled between summer and winter. Bronchial asthma, chronic obstructive pulmonary disease and interstitial pneumonia were the most common ailments.
In January, President Tsakhiagiin Elbegdorj called the pollution’s destructive impact on public health a “disaster” and appealed for increased cooperation among government agencies to clean up the air.
Though donors such as the World Bank have spent tens of millions of dollars on projects to design cleaner stoves, produce alternative low-emission fuels and improve heat insulation, health experts feel a lack of coordination is hampering progress. “Everyone involved seems to be competing, not contributing,” says Dr. Bolormaa Purevdorj, executive director of the Mongolian Public Health Professionals Association. Residents are confused whether to invest in better stoves or better fuel, and usually end up unable to afford either, adds her colleague, environmental health researcher Enkhjargal Altangerel.
The lack of clear solutions, they say, has also left authorities confused.
A new pilot initiative seeks to give 6,000 households a 50 percent nighttime rebate on electricity in order to encourage the use of electric heaters. The initiative has generated excitement, but an official at the Energy Authority Implementing Agency says that $200 million is needed just to improve the distribution network. The money, he feels, would be better spent on producing and distributing low-emission fuels such as higher-grade coal and sawdust briquettes.
In addition, a “Law on Air Pollution Reduction in the Capital City,” passed in December 2010, establishes fines for people who don’t conform to new rules, while offering tax rebates to individuals and businesses who reduce pollution. Though implementation is a huge challenge, given the broad need and limited state resources, observers hope the law can serve as a critical to-do checklist that will finally help harmonize efforts to clean up Ulaanbaatar’s air. “Now that we have some sort of a policy in place, I hope things happen before we all get sick,” says Altangerel, the environmental health researcher.
Pearly Jacob is an Ulaanbaatar-based freelance journalist.