As Air Quality Worsens, Kampala Citizens Find It Difficult to Breathe

KAMPALA, UGANDA — There’s something in Kampala’s air. Philomena Nabweru Rwabukuku’s body could tell even before she went to see a doctor. The retired teacher and her children used to get frequent asthma attacks, especially after they had been up and about in the city where there were many vehicles. It was worse when they lived in Naluvule, a densely populated Kampala suburb where traffic is dense.

“We were in and out of hospital most of the time. [The] attacks would occur like twice a week,” Nabweru says.

Her doctors blamed the air in Kampala, which is nine times more polluted than the World Health Organization’s recommended limit, according to a 2022 WHO report. By comparison, Bangladesh, the country with the world’s worst air pollution, is 13 times the recommended limit.

Nabweru’s case isn’t isolated. Data shows a worrying number of morbidities and mortalities in Uganda due to high levels of air pollution. Experts blame an increase in automobiles and rapid industrialization, among other factors. But government stakeholders are employing various approaches in a bid to alleviate the situation.

The WHO reports that 43% of deaths in Uganda from strokes and ischemic heart disease (narrowed heart arteries) are caused by air pollution. People living in cities are even more affected. In a survey of over 3,000 Ugandans, 13% of those living in urban areas reported wheezing (a symptom of asthma), compared with about 9% in rural areas, according to a 2019 study published in the journal BMC Public Health. The global average of wheezing in adults is 8.6%.

The problem is apparent in the streets of Kampala, says David Kureeba, program officer at the National Association of Professional Environmentalists, an environmental conservation nonprofit. Ugandans in the city have accumulated too many private cars, he says, a main contributor to air pollution.

Statistics from Uganda’s Ministry of Works and Transport confirm Kureeba’s concerns. Between 2010 and 2019, the number of vehicle sales in Uganda increased by 35%. In the East African region, the country’s rate of 13 vehicles per 1,000 people is the second highest, according to a 2018 report from Deloitte, a United States-based consulting agency.

Rapid industrialization is another cause. While Uganda aims to strengthen its local industries, the environment has suffered. This is largely because some industrial sites are in residential areas without woodland around them to absorb dust and other harmful emissions, Kureeba says.

To address the increasing level of air pollution in the city, the Kampala Capital City Authority has been collaborating with stakeholders. Together with AirQo, a research network affiliated with Makerere University, the authority has been monitoring air quality in the city and has found that the “air quality [in Kampala] is poorest in the evenings during traffic jam,” says Alex Ndyabakira, supervisor of medical services at the Kampala Capital City Authority.

One of the challenges African cities encounter in monitoring air quality is the cost of devices and expertise, but Macklina Birungi, marketing communications lead at AirQo, says for the last three years, the organization has been providing the city authority with cheaper air monitoring devices, costing about $200 compared with the usual $50,000. Communities, schools and government offices host these devices, Birungi says.

To share experiences and findings, the authority has also established an air quality working group with other stakeholders, including the National Environment Management Authority, the Ministry of Works and Transport, the Uganda Manufacturers Association, the Uganda Lung Institute in Makerere University and the Uganda National Roads Authority.

As part of this working group, the Lung Institute has been compiling data since January on the increase of air pollution-related ailments, says Ivan Kimuli, head of the department for clinical services at the institute. Researchers have noted an increase in cases of asthma, which swells the airways in the body and can be triggered by environmental irritants, respiratory infections and extreme weather conditions. Kimuli says the data will help the organization advocate for better policies to combat air pollution and improve health care for those affected.

Martha Agama, public relations officer at Uganda’s Ministry of Works and Transport, says the ministry is also working with the Kampala Capital City Authority and the Uganda National Roads Authority to install a functioning public transport system in the city. The system would reduce the number of private cars and, as a result, cut air pollution. Plans are underway to secure 12 city buses within the next year, she says.

It is a move that Kureeba — who is concerned about the number of cars in the city — welcomes. “If we use [buses], we will have reduced 75 cars to one vehicle and reduced on the emissions,” he says.

Other efforts are directed toward sensitizing the public. Tony Achidria, senior public relations officer for the National Environment Management Authority, says in the last six months, the agency has been encouraging motorists to service their cars and insisting that those constructing roads use water bowsers to curtail dust emitted during the process.

AirQo has also been meeting with automobile mechanics. “We educated them on transport pollution so they can advise clients on servicing cars and tell taxi operators not to change oil with old oil,” says Birungi.

Despite the country’s high levels of air pollution, Uganda lacks legal standards for the amount of particulate matter in the air. However, Achidria says a draft law is in the works. Meanwhile, the National Environment Management Authority ensures that companies and individuals observe the principles of environmental management established in the National Environment Act to protect the environment by avoiding or minimizing pollution.

While these efforts continue, morbidities and mortalities remain a risk for many living in Kampala. Donah Tiberondwa, a single mother, says that her 12-year-old daughter has recurring breathing difficulties and a dry cough that worsens at night and in the morning. Doctors told her that her daughter’s condition is due to tightened bronchioles in the lungs. They explained that living in a polluted environment is one of the causes, she says.

“We had to relocate from the mid of town where we lived in Bukoto and now live in Kira municipality, a bit far from the dust,” Tiberondwa says. Although her daughter still has respiratory problems, they aren’t as severe.

Nabweru also had to relocate to the Mutundwe neighborhood. Although still in Kampala, it is a little distance from the city, and there are fewer vehicles. Trees and manicured flower gardens dot her compound. Since she moved, the asthma attacks have decreased. Now she experiences them only when she visits the city. But in her new home, the air is fresher, and she breathes easily.