Srinagar: The smoke coming out of the chulha, a traditional cooking stove, filled the one-room mud house and choked 40-year-old Saleema Begum. This wasn’t the first winter when her lungs struggled but this time, she said, it got worse.

Begum, who lives in the Chadigam area of north Kashmir’s Kupwara district, said that the fumes from the cooking stove hardly float outside in the cold season. Indoor air pollution (IAP), emitted from chulha’s burning solid fuels, has weakened her lungs for decades. “For the last few years, it started getting worse than ever in winters,” she said. “My lungs hurt.”

Earlier this month, she was diagnosed with Chronic Obstructive Pulmonary Disease (COPD), a long-term lung disease that causes trouble breathing, at Srinagar’s Chest Disease (CD) Hospital.

Outside the hospital’s Outdoor Patient Department (OPD), there was a ruckus: a number of patients were on wheelchairs – weak and panting – wearing oxygen masks, and others waiting for their turn to see a doctor. “There is a rush like this on daily basis,” said one of the patients, waiting in the corridor.

Dr. Hamid Malik, an OPD consultant, told The Kashmir Walla, “The OPD sees an overflow in winters. We saw 700 patients yesterday and 50 percent of them were suffering from COPD – and the numbers are increasing every day.”

Another doctor sitting nearby stared at an X-Ray film of a patient’s lungs on a white LED board. The film had smoke all over the organs.

Dr. Malik said that the cause of COPD is mainly smoking, environmental smoke, and biomass emission. “In the winter, we don’t only see the overflow of old age patients but the flow of youth also.”

As per a study titled ‘Winter Burst of Pristine Kashmir Valley Air’, which was co-authored by the representatives of the Department of Earth Science, University of Kashmir, the air quality of the capital city Srinagar (34.1°N, 74.8°E) deteriorated significantly during winter, where the level of PM2.5 touches a peak value of 348 μg/m3 against the Indian permissible limit of 60 μg/m3.”

The study further added: “The emissions due to domestic coal usage are found to be 1246.4 tons/yr, which accounts for 84% of the total annual emissions.” The cold temperatures with dry conditions along with the elevated levels of biofuel emissions from the domestic sector are found to be the major processes responsible for winter-period particulate pollution, as per the study. “Emission inventory for Srinagar was developed for the year 2013–2014. We identified biofuel burning and transport sector to be the major sources of emission of PM2.5 in this region.”

Earlier, The Kashmir Walla reported that “around 24 percent of the population of Jammu and Kashmir owns a personal car”, according to the statistics released by the union government.

Begum’s family collected a small amount of money from their relatives and neighbors to reach the hospital in Srinagar. “We are extremely poor and we couldn’t afford to travel to the city for her treatment before,” she said, in an interview earlier in the month. “I can’t breathe properly.”

Wearing a grey color pheran and blue headscarf, Begum has been on oxygen support. “The moment it’s removed, my saturation goes down.”

Dr. Naveed Nazir Shah, the Head of Departments at the CD hospital, said that winter triggers respiratory illness mostly in patients with already existing lung diseases. “The hospital sees more COPD patients in six months of winter than in summer.”

“The cold makes the conditions worse. Then the coal consumption increases in winter and the exposure to dust as well.”

In January, the Director Sher-i-Kashmir Institute of Medical Sciences (SKIMS) Dr. Parvaiz Koul on the sidelines of the launch of doctors for Clean Air and Climate Action, J-K chapter said: “Around 10 thousand deaths are attributed to particulate matter 2.5 (PM 2.5) exposure and there is need to control it by countering it.”

Dr. Mohammad Muslim, senior assistant professor at the University of Kashmir’s Environmental Science Department, said that the pollution distribution in the winter season is limited due to the lowering of the atmospheric boundary layer.

“The region witnesses an increase in pollution attributed to straw wood and coal burning towards autumn and winter. Also, the usage of private vehicles in the region has increased. The emission of smoke from industries and vehicles add up to this increased air pollution in winters,” he said. 

The professor said that the intervention of government is needed in putting surveillance on the hotspots of pollution in the Valley and industries, like brick kilns, “that hardly follow the norms”. 

“The situation will only worsen if steps aren’t taken to control the pollution,” he said.