16 Children Died Within Days. Experts Blame This Megacity’s Toxic Air.

KARACHI, Pakistan – In a small, dense and low income neighborhood with a crop of illegal factories in its midst, fear, injustice and grief clings to the air. Over three weeks in January, at least 16 children and three adults from the community of 935 died. The eldest was a 30-year-old woman, and the youngest, only 18 months old. Dozens more got very sick.

The area in Karachi, Ali Muhammad Goth, is close to the coastal city’s shrinking mangroves, surrounded by industrial zones, and only 10 miles from its tallest skyscrapers. The megacity of 22 million is one of the most polluted in the world—a fact that Sindh province’s police and high courts are looking to explain the mysterious deaths.

The victim’s symptoms were strange, according to the city’s police surgeon, Dr. Summaiya Tariq. “They developed coughs and fever for about three days, stopped eating, got asthma-like attacks, and then they died,” she told VICE World News.

Following the deaths, the province’s Department of Health and Environmental Protection Agency played tug of war. The health department blamed the illegal factories in Ali Muhammad Goth, which, the department alleged, released toxic fumes into the environment. The environmental agency carried out their own investigation, took air samples, and ruled out air pollution, gesturing instead towards a measles outbreak and swathes of unvaccinated children susceptible to complications and comorbidities. 

But these findings are outrageous to Khadim Hussain, an Ali Muhammad Goth resident, who lost his wife and three children within days of getting sick in January. He is convinced they died from inhaling toxic fumes from some of the 25 factories that operate around his home that produce grease oil, talcum powder, plastic recycling and iron ore.  

“These factories killed my wife and children,” he said. “My 18-year-old son died just six months after his wedding. We have been alerting authorities for years and it took these deaths to alert their conscience. These factories need to be bulldozed.” 

Ali Muhammad Goth residents told VICE World News that agency officials, who are now claiming air pollution had nothing to do with the deaths, took samples after the most toxic factories in the area had been sealed shut. “I want them to come here when these factories are open,” said Hafeez Leghari, a longtime resident. “If they survive after spending 24 hours breathing in the air we breathe in everyday, they can get themselves treated.”

Doctors also agree that blaming the sudden spike of asthma-related deaths in one neighborhood on measles is unlikely. Measles is a routine occurrence in many of Karachi’s impoverished communities home to malnourished and unvaccinated children, according to pediatrician Dr. Aisha Mehnaz. “Measles outbreaks are not unusual in winter,” she said. “The condition isn’t great in this particular part of the city. At least in the village, they get clean air. Over here, they don’t even get that."  

But the scale of deaths is unusual, Dr. Zafar Fatmi, a professor of environmental health at the Aga Khan University in Karachi, told VICE World News. 

“If a large measles outbreak occurs in a densely populated neighborhood, some children may die, but it will likely be random deaths and not 16 in one go,” he said. “I am certain that these deaths are because of exposure. But what is the exposure? No one knows, because we don’t have the technical and laboratory capacity to measure it.” 

The police surgeon, Dr. Tariq, sent skin samples and lung swabs from the child victims to the government’s lab in the capital Islamabad on Jan. 31, to see if there are any specific lethal toxins that could draw a link between their deaths and pollution. She has not received the results back at the time of publishing. 

Pakistan’s scant and overwhelmed lab facilities make answers slow to reach, but this week the Sindh High Court ordered the province’s police chief to launch an investigation into the deaths. On Wednesday, police sealed more factories in the area and arrested the owner of a recycled plastics factory suspected of releasing toxic fumes. Police plan to charge him with manslaughter and negligent conduct with respect to the poisonous substances emitted from his factory, but locals believe he isn’t the only one responsible. 

“We want justice, and are willing to comply with the demands of authorities, including allowing bodies of our loved ones to be exhumed, but will this make any difference?” said Ali Hussain, a longtime Ali Muhammad Goth resident and brother, Khadim Hussain, also lost four members of his family. 

“There are at least 25 factories surrounding our homes, all of them need to be held accountable.”

Every day Karachi’s citizens breathe a cocktail of toxic gasses released from thousands of under-monitored factories and tens of thousands of unmonitored diesel-run cargo trucks. Experts say 128,000 lives are lost every year due to air pollution in Pakistan, while also shaving an average of 4.3 years off life expectancy too. 

According to IQAir, a Swiss company that tracks air pollution globally, Karachi was breaking world records in January when the children died. IQAir measures PM2.5 concentration, or particulate matter 2.5 micrometers or less in diameter. Many nights in January, PM2.5 levels hit above 400, a level classified as “hazardous” and 80 times the WHO air quality guideline. 

Those winter nights—when air pollution peaks in the seaside city, as temperatures drop and fuel combustion is slower and releases more pollutants—Karachi was often ranked the world’s most polluted major city. During the day, it would come down to 150, a concentration still considered unhealthy at 28 times the WHO maximum guidelines.

Studies indicate that consequences of poor air quality are disastrous—with increased risk of developing a laundry list of illnesses and ailments. These include cardiopulmonary diseases, lung cancer, diabetes, tuberculosis, neurodegenerative diseases such as dementia and Alzheimers, worsening mental health, pregnancy losses, and reduced birth weight for babies.

Fatmi says that the elderly and children are the most vulnerable to these effects. “They’re the ones contracting diseases [such as asthma], and whose pre-existing conditions get exacerbated due to air pollution,” he said. 

“Incidents like [the January deaths] require exposure measurements and emissions monitoring. We need to know which emissions are toxic, and what their concentration was.”

Factories had been sealed; mounds of plastic wrappers—which residents claimed were burnt inside factory compounds—lay on the streets, handfuls picked up by the occasional gust of wind. Representatives of Sindh province’s health department milled about Ali Muhammad Goth’s hazy streets—distributing masks, administering vaccines, and escorting children towards a makeshift clinic where a doctor could check their temperature. 

Pulmonologist Dr. Mosavir Ansarie draws strong connections between exposure to toxic gasses from vehicle and industrial emissions, and the rise in obstructive airway diseases among Karachi’s residents. 

“Anecdotally, we are seeing a huge rise in asthma cases, particularly pediatric cases with no family history of the disease,” he told VICE World News. Each day, families line up at his clinic at a private hospital in the city—wheezing children, coughing parents, and aging grandparents. 

Back in 2014, architect and urban planner Marvi Mazhar was put on a cocktail of cortisone and salbutamol by the city’s leading pulmonologists. She had no family history of asthma, and no history of pollen allergies. This January, for the first time in her life, she couldn’t breathe at all. 

“I thought I was going to die. Someone rushed me to the emergency [room] where I was administered oxygen,” she said. “It’s a constant cough, so much worse now [than it was before].”

Over the past three years, Mazhar has seen a significant increase in cases of adult asthma among her friends and family. 

“Everyone’s coughing now,” she continued. “But there is no push towards awareness or advocacy about pollutants and toxicity. We need more air quality monitors, more green corridors, more industrial zone monitoring. In the informal settlement behind the Korangi Industrial Zone, everyone is coughing, everyone has chest infections.” 

In Ali Muhammad Goth, lung disease is chronic, among both adults as well as children. 36-year-old Abdul Hafeez Leghari, a longtime resident, calls it ghuttan—a feeling of perpetual suffocation, an inevitable byproduct of living next to plastic and rubber factories, breathing in toxic fumes, day in and day out.  

Dr. Haider A. Khwaja, a professor of environmental health sciences at the State University of New York at Albany, and one of the authors of the Environmental Monitoring and Assessment study, told VICE World News that air pollution spells dire consequences for Karachi’s inhabitants.

“Short-term exposure to gaseous pollutants may lead to reduction of lung function in children, and may also cause gastrointestinal disorders and inflammation of blood vessels,” he said. 

In Karachi—an industrial hub and Pakistan’s main port city—air pollution is worsening, particularly in its industrial areas. There are at least 20,000 textile, automobile, chemical, plastics factories within the city’s ten industrial sites, and an absence of zoning laws—and a burgeoning population—has meant that residential areas often develop near factories. 

In Karachi’s industrial and residential area of Paramount Ground, a 2018 study by environmental researchers found dangerous levels of sulfur dioxide emissions—higher than the annual average recommended maximum amounts specified by the WHO. A 2023 study also found that Karachi has the highest levels of nitrogen dioxide and sulfur dioxide in its air in Pakistan.

On Karachi’s busy streets, smoke-emitting diesel fuel trucks, private bus services and motorcycles are a common sight. 

Diesel cars are 10 times as polluting as petrol cars, but they remain the vehicle of choice in the country. Pakistan’s gas stations also sell amongst the lowest quality of petrol in the world. Consequently, a 2022 study found that the city’s commuters risk significant exposure to black carbon—a PM2.5 pollutant found in diesel combustion engines and industrial processes that causes respiratory disorders when inhaled. Black carbon also triggers cardiovascular diseases after short or long-term exposure. 

The government only recently launched environmentally friendly public transport options, including 50 electric buses and 80 hybrid-electric buses; their impact on reducing toxic road traffic will take time to see. 

At an event in Karachi earlier this week, a panel of experts called upon Sindh province’s Environmental Protection Agency to investigate and document the release of hazardous emissions in the city. At the event, the secretary-general of the Pakistan Medical Association, Dr Qaisar Sajjad, said that the certification system of vehicles in the city was bogus and that there should be effective checks of smoke-emitting vehicles to reduce harmful emissions.

Some at the forum pointed to neighboring China for inspiration. The country’s urban centers used to have some of the worst air quality globally, but this has been steadily improving in recent years, driven by emission control on roads and in industry. China's annual average PM2.5 concentration and sulfur dioxide concentration fell by about 56 and 78 percent from 2013 to 2021. Pollution levels within the capital city Beijing continued a nine-year trend of improved air quality this year.

Since 2014, the Sindh Environmental Protection Agency has been tasked with receiving Environmental Monitoring Reports from Karachi's industrial units on a monthly, quarterly and biannual basis. The agency is supposed to compile, analyze and manage the data gathered from environmental monitoring reports and develop “an environmental database.” The agency’s director general, Naeem Ahmed Mughal, did not respond to VICE World News’ requests for comment on the agency’s findings from these reports, nor did he grant access to the database. 

Karachi-based nature campaigner and climate activist Yasir Husain told VICE World News that the province’s environment laws are excellent—except, no one follows them. He pointed to the laws of the province, which state that there should be a supervisory body set up with at least 25 members from various groups, including medical and legal professionals, activists, technical experts and scientists. The last time this body convened was five years ago.

“Where is the government’s annual report? How are they reading air quality? We demand answers,” Husain said. “Everyone who breathes this air—every second, day and night, is already sick. We are living in a bowl of poisonous air, and are stuck in it. Karachi is a gas chamber city.”

Back in Ali Muhammad Goth, children with dry, hacking coughs pour into a local clinic—a dim, ramshackle room with a rickety table laden with bottles of cough syrup and acetaminophen. Locals say the area’s air quality has been terrible this winter, but worsened after an iron ore factory started operating a month ago. 

But for now, that factory has been sealed. Empty barrels are perched atop its boundary wall that it shares with a home and children play outside its gate. The plastics factory owner is behind bars awaiting the results of the police investigation and then possibly a trial. While locals say the factory is just one of many, part of a larger problem of unmonitored industrial sites allowed to operate in their neighborhood, longtime resident Hafeez Leghari is relieved for the temporary respite they have while some remain shuttered. 

“The air feels lighter. After months, now, I can breathe without choking.”

Sahar Habib Ghazi contributed reporting.

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Correction: An earlier version of this story incorrectly attributed a comment from Dr. Qaisar Sajjad of the Pakistan Medical Association to Naeem Qureshi. We regret the error.