The little space in Malawi's health facilities is consistently crammed with patients, most of them brought to their knees by ailments whose origin they understand very little about.
Practically every day, sufferers of non-communicable diseases (NCDs) are referred to main hospitals where their lives are saved if they are lucky to have responded to the pain in their bodies early enough.
For some of these diseases, the cause is a monster hidden in plain sight—not always the huge chunks of smoke billowing into the atmosphere from industrial plants and lining the skies of Lilongwe and Blantyre.
It is often some seemingly negligible particles filling the deceptively clean air that is killing people softly and silently.
Latest statistics about how many are actually affected by or dying from air pollution in Malawi are not available in the meantime, but thousands of people seeking medical help for acute respiratory infections are a testament of the existence of poison that is plunging many into states of anguish.
A Ministry of Health official concedes that for a country where the majority, especially women, are exposed to pollution in various places, including the kitchen and industries, NCDs thrive.
"We have cases of what we call chronic obstructive pulmonary diseases [COPD] which are as a result of pollution. In kitchens, women inhale smoke which has severe health implications," Deputy Director of Clinical Services responsible for NCDs, Kaponda Masiye, says.
In home and hospital sickrooms, most peaked patients presumed to be suffering from asthma only to be later diagnosed with an NCD sparked by air pollution have seldom been exposed to dark soot or dust which is common in some places.
And Masiye cites second-hand smoking as another silent killer that is prowling in plain sight.
According to the World Health Organisation (WHO), nine out of 10 people worldwide breathe polluted air while one in nine deaths are caused by air pollution.
The United Nations agency estimates that around seven million people die every year from exposure to fine particles in polluted air that lead to infirmities like stroke, heart disease, lung cancer, COPDs and respiratory infections, including pneumonia.
Air pollution, WHO states, causes 1.4 million deaths from stroke every year while 2.4 million deaths are due to heart disease caused by the same contamination. 1.8 million others succumb to pollution-induced lung disease and cancer every year.
By and large, the air in Malawi appears relatively clean but experts argue that there are more hazards in it than imagined and in homes and hospitals, evidence of a rise in NCDs—with some, of course, spawned by other lifestyles—is there for all to see.
The experts say that people in the country unsuspectingly inhale air replete with pollutants which increase the risk of negative health effects which are difficult to mitigate due to lack of resources.
In a 2013 Journal of Environmental Protection, on 'The State of Air Quality in Malawi', scholars Harold Mapoma and Xianjun Xie observed that air pollution in the country is recognised as one of the key environmental issues.
At that time, the two found that air quality in Malawi was still good but warned of the likelihood of problems which they observed would have an impact on health, global climate change and ozone layer depletion.
Writing for 'Climate for Health', US nurses Hannah Noel-Bouchard and Linda Bedker also advance that there is a direct link between air quality and climate change which must be addressed to diminish health challenges.
"Climate change is experienced as increases in the frequency and intensity of extreme weather events, such as wildfires, heat waves, hurricanes, droughts and flooding, all which contribute to serious health threats.
"Extreme heat, wildfires and droughts, made worse by climate change, are of most concern when considering air pollution and health. For instance, rising temperatures contribute to increases in ozone pollution and more intense and frequent wildfires worsen particle pollution," the nurses postulate.
They add that populations like pregnant women, children, the elderly and those with chronic conditions like diabetes and hypertension are more vulnerable to harm from drawing in polluted air.
The poor, often unable to afford regular check-ups and properly synchronised eating habits, are said to be more likely to experience higher burdens of exposure to particle pollution.
Programmes Manager for Malawi National Youth Network on Climate Change, Dominic Nyasulu, also states that despite that climate change, air pollution and health are often treated as separate issues, they are closely allied.
He says climate change is set to increase the amount of ground level ozone and fine particle pollution which people breathe, leading to various NCDs.
"Less rain and more heat means this pollution will stay in the air for longer time, creating more health problems," Nyasulu warns.
His biggest fear is that as climate change alters the air currents that move pollution across continents and between the lower and higher level of the atmosphere and that where air becomes more stagnant in a future climate, pollution stays near the ground in higher concentrations, health burdens will rise to frightening levels.
"Lung cancer and respiratory problems are some of the diseases that will rise drastically under the effects of climate change," the environmental rights activist says.
Health challenges emanating from climate change and air pollution and the scary future that the world faces have also prompted WHO to organise the first-ever air pollution and health global conference to take place from October 30 to November 1 in Geneva, Switzerland.
With participants expected from various sectors, it is envisioned that the conference will yield virtuous action plans to clean and save the troubled air.
The conference, which will also advance collaborations between WHO and other UN agencies, is further set to discuss ways of reducing the seven million deaths a year due to air pollution by 2030, as a contribution to achieving the Sustainable Development Goals.
"[It] will underline the links between air pollution and the global epidemic of NCDs and position the health sector to catalyse actions for health-wise policies on clean household energy, transport and waste," a note about the conference reads.
And for Malawi, Dr Masiye sees some sources of energy like wood fuel, which produce significant amounts of smoke, as perfect catalysts of NCDs which continue to affect both the young and the old.
Mabvuto Banda – who has written 66 posts on The Times Group.