A patient killer, air pollutants degrade the body without its victim's knowledge. Fully aware of the catastrophic circumstances, Hanoi has little to offer. 

Hanoi's iconic Long Bien Bridge is in a shroud of haze as air quality
reached very unhealthy level in the morning of December 14, 2019.
Photo by VnExpress/Giang Huy.

Taxi driver Nguyen Gia Thang has spent a decade in Hanoi, the thought of dying at 37 never once crossing his mind. Last month, however, he was submitted to hospital, the only warning signs of his possible demise being the odd cough.

Watched over by tearful partner Nhung, Thang remembers waking in the emergency ward of Bach Mai Hospital following nine days in a coma.

His taxi shift would usually commence at 8 a.m. and end at 2 a.m. the next day. In 2016, after six years at a local agency, he finally bought his own car. To save on gas, Thang often dropped the windows to avoid using the air conditioner, inhaling 12-15 hours' worth of toxic air each day.

Thang, who contracted asthma at age 7, experienced an early bout of coughing in small, infrequent bursts, using various meds to alleviate the condition, with little effect. To cope, doctors prescribed him bronchi dilating nebulizers and shots that kept him going the next four days.

Until one rainy day last month.

In a state of deep sleep, Thang was jolted awake by a suffocating sensation in his throat, as if being strangled. "I’m going to die," he whispered to his wife. On the way to the hospital, Thang fainted, falling off the motorbike and losing consciousness. Doctors said he would have certainly died if he failed to make it to the hospital in time.

In another room, Nguyen Manh Ky, 64, was admitted three weeks after Thang with chronic obstructive pulmonary disease (COPD). Like many neighbors in Van Ha Craft Village of Hanoi's Dong Anh District, Ky has been employed at a carpentry workshop for the past four decades.

Upon admittance, Ky realized face masks are not enough to keep air pollution from ravaging the human body.

Hanoi suffers extreme air pollution around 300 days a year, with over 60,000 related deaths, a 2016 report by the World Health Organization stated. The top 10 most common and the top 10 most lethal diseases contracted across medical facilities in 2016 are those resulted from respiratory and cardiovascular infection, according to the Ministry of Health.

With records toppling in 2019, the capital’s Air Quality Index (AQI), a metric to determine how polluted the air is, was recorded at more than 200 for four consecutive days starting November 7, reaching over 300 on November 12, according to the Hanoi Department of Natural Resources and Environment. An AQI level above 100 is considered unhealthy for humans.

In response, authorities recommended people stay indoors, with multiple schools temporarily suspending outdoor activities. Demands for air masks and air purifiers skyrocketed due to concern over how extreme air pollution would affect family health.

Last year, Vietnam ranked 159 out of 180 countries and territories surveyed by World Bank on air quality. The same year, WHO estimated about 4.2 million early deaths globally were caused by air pollution, many related to cancer, strokes and other cardiovascular and respiratory diseases.

Motorbike drivers wear protective masks at a red light in Hanoi, December 14, 2019.
Photo by VnExpress/Gia Chinh.

While respiratory illnesses could have multiple causes, ranging from smoking to genetics, air pollution is regarded a common factor in many diseases, including those of the respiratory system, said Vu Van Giap, general secretary of Vietnam Respiratory Society.

"Air pollution is a silent assassin," said Giap, due to its impact on the human body over the long-term. It is why many patients fail to recognize the severity of their condition early on, only attending hospital when their bodies have suffered serious damage, he added.

And yet, many Vietnamese are well aware of the health risks posed by air pollution. In a 2018 survey on 1,400 people by Mekong Delta Development Research Institute, 17 percent of respondents regarded air quality their biggest concern, second only to unemployment at 24 percent.

Several reports on poor air quality in Hanoi and Saigon have made headlines since September. But not until October did the capital name sources of local air pollution to include traffic emissions, coal, construction sites, and even the stench produced by sewage systems and animal farms.

Not until December did the Ministry of Health issue a 14-step guideline to help deal with air pollution, including close supervision on air quality, wearing masks or improving personal hygiene.

Hoang Duong Tung, president of Vietnam Clear Air Partnership, said last week Hanoi's air quality returned to 'hazardous levels' in early December, only worsening.

"It is necessary to have a serious talk about possible sources and seek emergency measures to tackle pollution," he noted.

He said Hanoi is not taking the matter seriously enough, approaching air pollution as a natural occurrence instead of detrimental health issue we are ourselves responsible for. Identifying the main culprits of pollution should be prioritized, it was stressed.

Meanwhile, Thang expects to remain in hospital an additional six weeks, partner Nhung refusing to let him drive a taxi ever again.

However, both know the solution won't carry, similar to Hanoi suggesting its people keep indoors to escape pollution.