I must admit that I felt pretty silly wearing this at first, but I would estimate that approximately 10% of the population in Kathmandu wears some sort of mask to filter out harmful pollutants when they are out and about on the streets. Thus, I gather more attention because of my pale white skin than I do by wearing this mask on the busy streets of Kathmandu. If people knew more about the health risks, the number wearing masks would probably be higher. My guess is that the majority of people wearing these protective masks already have asthma or breathing difficulty that make it necessary to try to protect themselves.
To understand how bad the air quality is, I've posted part of an article below from the Guardian dated March 2014. They had another dire article from April 2015 you can read also if you want to google it.
One topic that is not mentioned in the article and also contributes to the problem is that Nepali's must burn their trash as they do not have trash pickups like we do. Below is a picture of our clinic burning it's trash.
The Guardian Article (excerpt).
Nepal generally evokes images of a pristine mountain nation on top of the world. The thick cloud of pollution that threatens to suffocate Nepal’s largest city, however, provides a stark contrast to this reputation. While there are several environmental crises converging here – severe water shortages, for instance, have become status quo – none is as dire as air quality. In the past 10 years, the number of vehicles on Kathmandu’s streets has risen threefold. The problem has become so acute that many of its 1.74 million residents are left wondering: at what point will their city become unliveable.
Nepal’s air quality ranks 177th out of 178 countries, according to Yale’s 2014 Environmental Performance Index (EPI), better only than Bangladesh. As a physician working in one of Kathmandu’s main teaching hospitals, I see a disproportionate amount of patients with respiratory ailments who are admitted to the wards on a daily basis, the victims of dirty air. Walking to and from work along the crowded, exhaust-choked streets, I sometimes wonder how more people are not sick.
The view from my Kathmandu rooftop certainly seems to bear the EPI findings out. On many days, the relatively close Himalayan mountains are obscured by smog, the brick apartment buildings that form Kathmandu’s skyline shrouded in an oppressive cloud. Those new to Kathmandu frequently complain of sore throats and itchy eyes within a few days of arrival.
“I see rapid changes each time I return,” says Anobha Gurung, a Kathmandu-born doctoral candidate at Yale who is studying the air quality in her home city. “Now it is a common sight to see a gray haze for the valley, especially during the winter months, and city residents venturing out of homes wearing masks.”
Gurung and her colleagues have found that during surges in Kathmandu traffic congestion, the level of small particulate matter can measure over 500 micrograms per cubic metre, or 20 times the World Health Organisation’s safe upper limit. By comparison, the recent smog alarm that led Paris to ban cars peaked at just over a fifth of that level: 110 micrograms per cubic metre.
The sight of Kathmandu residents wearing masks is an increasingly common sight.
Further data is hard to come by. Nepal’s government has several monitoring stations throughout the city, but they have been abandoned for at least six years. Samir KC, a Nepali researcher based in Vienna who has studied pollution and monitoring in Kathmandu, says the monitors were allowed to fall into disrepair. “During our [study], we found that the repair was done and it was up to the government to pay the bill and start the monitoring,” he said. “Nothing happened.”
Most of the research on air quality in Nepal focuses on indoor pollution: cooking fires are ubiquitous in the countryside. In the capital, however, this may be misleading. “Cooking fires are definitely not the cause, as most households use [propane] gas,” says Samir KC. “Suspended particles including dust, exhaust from vehicles and diesel generators are the main culprits.” Of these, it is vehicle congestion that is most strongly correlated to worsening air quality, according to Gurung’s research.
Findings such as these pose a developmental conundrum for governments intent on modernising. It is one thing to stamp out indoor cooking fires as part of the path towards progress. It is quite another, especially in Asian cities that are increasingly oriented around cars, to try to reduce the emissions that come hand-in-hand with industrialisation and urbanisation.
What’s more, modernisation has also fuelled the appetite for electricity, yet infrastructure has not kept pace. Kathmandu endures daily, scheduled “brownouts”. This has had the predictable consequence of driving people to use generators: when the power goes off, their dull roar can be heard throughout the city, pumping yet more toxic fumes into the air.
At present, the Nepali government is either unwilling or unable to make changes. Urban planning of the kind that addresses ecological issues is largely absent. But the situation is not lost on ordinary Nepalis. Daily, newspapers print letters decrying the situation and demanding better from elected officials. Air quality is a frequent topic of conversation here; facemasks are so commonplace, they are now sold in trendy designer styles made of patterned cloth. Other people use scarves to shield their faces.
In the hospital, for the time being Ajay continues to gasp for air. For smokers with COPD, one of the only effective interventions that improves longevity is to quit smoking. But Ajay and those like him have no cigarettes to give up. The air they breathe is making them sick. For them, the question of whether the city will become unliveable is moot. It already is.
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I meant to note that the air quality outside Kathmandu has been fine outside of the occasional whiff of burning trash which is only once or twice a week.
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