Waking up early in the morning on Sunday and seeing a blanket of smog in Ho Chi Minh City, Nguyen Thi Tuan knew she would have a tough day.

The city’s air quality index (AQI) was 153 at that time, or ‘unhealthy for everyone’.

The 47-year-old, who sells noodles and sticky rice at a stall on Dien Bien Phu Street in the city’s downtown, has no idea about the AQI but is sure that "the dirty air can be felt by everyone in this city."

"My son told me this mask cannot prevent tiny particles from entering my lungs, but I can’t stop doing my job because of air pollution; this is my livelihood."

She wears a mask while sitting on the sidewalk for seven hours every day.

Tuan had not known that the tiny particles in the air could be detrimental to her health until last week, when she heard the Ministry of Health’s advisory on pollution, which exhorted people to stay indoors on polluted days.

A motorbike taxi driver in Ho chi Minh City in a mask.
Photo by VnExpress/Hoang Huy.

On December 16, after urban residents had been gasping amid the pollution for months, the ministry issued a 14-step guideline to deal with the smog, including keeping a close eye on air quality, wearing masks, improving personal hygiene, and staying indoors on days with high air pollution levels.

"They told us to stay at home when the air is too polluted, but it is polluted every day, and it is unrealistic to stop working and stay indoors every day," Tuan says, using a piece of cloth to clean a glass case in which she puts cooked food.

Though her throat is uncomfortable and she coughs sometimes, she says Saigon, where the AQI was around 100 last week, is better than her hometown because she can earn more money in the city.

"I would rather die slowly due to air pollution than having no money."

Tuan is not the only one to think that dirty air is better than being unemployed. While middle-class and affluent people in Hanoi and HCMC can remain at home or in an office with air purifiers and masks designed to keep out PM2.5 particles, described as superfine particles measuring 3 percent the diameter of a human hair, the underprivileged often do not have that luxury.

Le Thi Hoa, 39, of Hanoi is one such. She sells vegetables and pork in Long Bien District every morning, always wearing a mask to protect herself, but it does not stop triggering a cough or irritating her eyes, nose and throat. It is not easy to breathe while wearing the mask, and so she sometimes takes it off. 

She also covers her wares with a thin layer of cloth to "make customers feel safe about buying."

This month Hanoi has experienced days of very high pollution, with AQI levels exceeding 200 in some places. For days it was blanketed by a thick smog, with particulates that can cause respiratory diseases and cancer floating in the air. 

An AQI level above 100 is considered polluted or unhealthy for humans. When it reaches 150 children, seniors and individuals with respiratory and heart diseases are recommended to avoid sustained and high-intensity outdoor exercises. An AQI level above 200 is deemed very unhealthy for humans.

"But staying away from air pollution is more challenging than co-existing with it," Nguyen Hoang Ha, a motorbike taxi driver in HCMC, says.

A street vendor in Hanoi. Photo by Shuttlestock/Cesare Palma.

"I tried to find an alternative but couldn’t, I have no choice but stick with this job. I am an asthma patient, and suffered an attack once in October, but income comes first." He was making a delivery to District 12.

Ha once looked for an air purifier for his family, but could not afford it. Worried more about having food to eat than clean air to breathe, he can only afford a cheap surgical mask.

Solutions not in sight

Thick, gray air is synonymous with Hanoi, a sprawling city with eight million people, five million motorbikes and 550,000 cars.

In 2019 air pollution is more severe and more regular, according to Hoang Duong Tung, chairman of the Vietnam Clean Air Network.

A WHO report in 2016 said Hanoi suffered from extreme air pollution for around 300 days a year and over 60,000 related deaths.

From December 7-12, average PM2.5 levels across the capital has been measured at up to three times the safety limit, according to the Ministry of Natural Resources and Environment.

In HCMC, on many days since September, the AQI has been above 150.

Authorities in both cities have claimed the pollution is a seasonal phenomenon and episodic.

In October they named the sources of pollution: traffic emissions, coal-fired power plants, construction sites, and animal farms. 

Merely listing the sources of pollution is pointless, Tung of Vietnam Clean Air Network said. "It is important to have a comprehensive plan to solve it."

But neither Hanoi nor HCMC has done so.

"The administrations should have forecast the situation and come up with quickly with long-term solutions to control air quality and protect the public," he said.

At a regular government meeting in October, Prime Minister Nguyen Xuan Phuc instructed the Ministry of Natural Resources and Environment and other authorities to propose effective solutions to tackle the pollution.

Two months later the government has ordered the ministry to resolve the problem in the two cities.

Meanwhile, Ha fears his coughing and dry throat are here to stay.

"Living without money is worse than living with polluted air."