A Fight to Breathe

By Chisato Fukuda, University of Wisconsin-Madison

Mongolians protesting against air pollution in Ulaanbaatar. 01.30.2017. Photo credit: Giustino Di Domenico

“WE ARE SUFFOCATING!”

“WE ARE SUFFOCATING!”

“WAKE UP AND SMELL THE SMOG!”

On January 28th 2017, thousands of protesters chanted and marched through Mongolia’s capital city, enduring -27°C temperatures to demonstrate against air pollution. The protest movement, called Booj Ukhlee (Боож Үхлээ), which has a double meaning, “we are suffocating” and “we are extremely frustrated” had gained momentum over the course of the month. The protest was organized by the Union of Parents Against Air Pollution (Утааны Эсрэг Ээж Аавуудын Холбоо), an organization formed by journalists and public health researchers concerned about the health effects of air pollution. What started as a hundred demonstrators in late December grew to a few thousand protestors in a series of protests by the end of January. Hundreds of Mongolians living across the globe from New York to Virginia, Chicago to Paris also joined in on the cause, using social media hashtags “BreatheMongolia and #mongolsaresuffocating to call for immediate government action to combat air pollution.

These protests did not appear out of thin air. Prolonged public silence until this point does not mean people had been passive or apathetic about air pollution. Quite the contrary. Citizens have been actively making sense of the toxic air for over a decade.

My research shows that while epidemiological data correlating air pollution and health effects were in short supply, local citizens have long been collecting sensory and bodily evidence based on everyday engagements with pollution. Residents were not only detecting patterns within their own bodies, but were forming communities with others who suffered similar body burdens. In this short essay, I limit my focus to how air pollution’s toxic effects on pregnancy played a vital role in making smog an urgent public matter. Through this example, I show how it is precisely an attunement to these kinds of body burdens that pushed citizens to play an advocacy role in the fight for clean air.

My first breath of Ulaanbaatar smog came in 2006. It was cold, thick, and unfamiliar. But residents explained to me they had detected air pollution as early as 2000. They described a dense, grey “smoke” (утаа) that hung in the sky, and pungent odors that lingered outdoors and on their clothes and hair. These visual and olfactory manifestations of air pollution were a nuisance, but not a threat. Back then, there were rumors that vehicle exhausts were causing the pollution, due to the large influx of second-hand cars donated from overseas.

Over the course of several years, smog worsened in certain areas of the city. Apartment residents started noticing an increase in the number of chimneys in the ger districts, peri-urban neighborhoods cut off from basic infrastructure. In 2011, a World Bank study confirmed their visual tracings, claiming that the main source of Ulaanbaatar’s air pollution was coal-burning stove emissions among 170,000 households in the ger districts. Residents started to sense subtle changes in their bodies, tracing seasonal patterns in their symptoms such as coughs, headaches, sniffles, itchy and watery eyes, and swollen throats. In late fall, children would contract colds that wouldn’t leave their bodies until spring. These symptoms quickly became a predictable part of everyday life – urgency laid dormant.

In 2012, I worked with public health researchers and atmospheric scientists who were studying the correlation between air pollution and various health effects including blood lead levels and pregnancy loss. Although their professional research pointed to serious issues of morbidity and mortality, researchers did not see air pollution as having drastic effects on their own personal health. Pollution was serious, but not an emergency. When I asked Nasanjargal[1], a public health specialist working at a state-funded research facility if she wore a mask to protect against pollution, she answered, “No, it [air pollution] doesn’t affect me that much. I avoid going outside during times of peak exposure. So, I’m fine.” At the time, this puzzled me, as she knew that PM2.5[2] had negative effects on the lungs and heart. There was also already evidence that N95 respirator masks blocked 95% of small particles as small as 0.3 microns.

By the time I returned to the field in 2014, the same research scientists revealed a very different attitude to air pollution. Pollution was no longer just a research topic to them; it was affecting their personal lives in profound ways. Nasanjargal revealed to me that she had suffered three miscarriages since I had last seen her. During the first two miscarriages, her doctor dismissed it as a “side effect” of being pregnant at a later age (she was 36). But following her third miscarriage, the same doctor explained that the pattern could be linked to air pollution. He explained that a prolonged lack of oxygen could have caused hypoxia and killed the infant. Based on the local biomedical framework, regular airflow of clean oxygen was required to prevent the womb from “hardening” and suffocating the infant. The only medical advice Nasanjargal received from her doctor was to carry out her term and give birth in the countryside, as far from the capital city as possible. The doctors that I interviewed at First Maternity Hospital, the Child and Maternal Health Research Hospital, and district clinics all claimed to use the same guidelines, as there were no other “proven” effective measures. The art installation below depicts the dire state of air’s toxicity, showing how a mother’s only chance of supporting human life is now a gas mask life line.

“S.O.S.” by Munkhtsetseg Jalkhaajav. National Modern Art Gallery, Ulaanbaatar. Photo credit: Mark Leong

I quickly found that other women were experiencing pregnancy loss. When I asked women what the most serious health effect of air pollution was, most answered pregnancy loss and developmental issues in children. In fact, in 2014-2016, out of the 70 women that I interviewed, 61 women mentioned that they personally had a miscarriage or knew a close relative or friend who had. I was surprised, as just a couple of years prior, residents either did not articulate such a concise answer or responded with prolonged cold and bronchitis as their biggest concern.

Women were closely attuned to the process of pregnancy loss. One woman explained that her abdomen would stiffen, her back would ache, and that she would bleed heavily. She reiterated many times that “something just didn’t feel right.” Other women shared very similar experiences, claiming that they could “feel” when a miscarriage was going to happen. They felt not only bodily symptoms, but an overwhelming sense of grief that they had suffocated their baby to death. This loss was extraordinary because it was a loss that many women were suffering. A loss that pushed air pollution into crisis.

“I didn’t think the air could be this bad. But it killed my baby. Now, I’m afraid I’ll never get pregnant,” Nasanjargal cried.

What began as support from close family and friends transformed into a larger digital community, connecting parents on online forums and social media. Both mothers and fathers posted blog entries with titles such as “pollution is killing our future generation” and “Mongolians are suffocating.” Women also started to consult internationally-funded private clinics and began altering their family planning strategies in an attempt to time their pregnancies around less polluted months. Women started advising one other, suggesting that June to October was the optimal time period to get pregnant.[3]

Outer and Inner” by Tuvshinjargal Tsend-Ayush. 976 Art Gallery, Ulaanbaatar. Photo by author.

Giving birth and living life is now in a state of uncertainty. “Outer and Inner” reveals how the human body and pollution are now one. A lung X-ray and smoke emissions blend together, painting the inescapable state of toxic absorption and its unpredictable manifestations. Chinbat’s “EKG” illustrates the distressed rhythm of the nation’s heartbeat as it’s blackened with pollution.[4]

“Ulaanbaatar’s Electrocardiography (EKG)” by Chinbat Bayanbat. 976 Art Gallery, Ulaanbaatar. Photo by author.

What will Ulaanbaatar’s future look like? How will pollution affect the next generation of Mongolians? 

These are questions that have pushed middle-class[5] Mongolian families to debate in the online community and to take to the streets in public protest.

In public demonstrations, citizens have pushed for specific actions – they demand more hospital beds, better healthcare, and legal requirements for air filters in schools and hospitals. Furious with the Mongolian government for spending over 80 million USD to combat air pollution without effective results, the protesters gathered over 3,000 signatures on a petition to demand that the government take immediate action to implement better policies and interventions that would curb the air pollution.

In January, protesters took to the streets wearing gas masks, held signs with “we can’t breathe” slogans, and hung hundreds of black balloons (which symbolized the blackening lungs of young children) on the gates of the Parliament building. Suffocation of the senses was made explicit and air pollution was claimed a crisis.

Ulaanbaatar residents are planning a third protest at the end of February if the government does not meet the demands of the public. Citizens have been employing their body burdens as evidence that the air pollution has reached disastrous levels and that immediate, drastic measures must be taken to improve air quality. In such ways, sensory and bodily claims continue to shift people’s attitudes about the urgency of air pollution and definitions of health. As political demands, public health, and the urban environment become ever more entangled, anthropologists must stay attuned to what kind of claims are being made, how citizens organize around these claims, and how these movements reconfigure the relationship between citizen and state in the fight for social environmental justice.

 

[1] Nasanjargal is a pseudonym to protect the identity of my informant

[2] PM2.5 is the metric used to describe ambient particles that are less than or equal to 2.5 micrometers in diameter. Public health officials have declared PM2.5 the most dangerous to human health.

[3] A 2014 study by the Saban Research Institute of the Children’s Hospital of Los Angeles confirmed these personal experiences, claiming that the number of spontaneous abortions jumped from 23 per 1,000 lives births in May to 73 per 1,000 births in December, concluding a strong statistical correlation between season ambient air pollution and pregnancy loss in Mongolia.

[4] The art installations were part of an exhibition called “Lost Children of Heaven II” held at the 976 Art Gallery in Ulaanbaatar. This exhibition featured the work of local artists representing health concerns of the Ulaanbaatar public.

[5] These protests were organized by middle class journalists and public health advocates living in the city center via social media and online forums. These groups employed their professional networks in television broadcasting to create a movement. While concerns about air pollution-induced pregnancy loss were high among ger districts, these households did not make up the protesting majority. Thus, these protests are not a direct representation of ger district household opinions and demands.

 

This essay is part of Sensorial Engagements with a Toxic World, a special series curated by Chisato Fukuda.

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