Mother of asthmatic children fights for air in dirty shadow of coal power stations

It is a struggle to support two children with severe asthma, says Mbali Mathebula. Her children are immunocompromised, and constantly exposed to high levels of air pollution. Daughter Asemahle, 4, demonstrates how the nebuliser works. (Photo by Alet Pretorius)

If you follow the coal trucks on Schonland Drive in Emalahleni, you can easily access a multitude of coal waste mountains, just a stone’s throw away from the entrance to the Witbank TB Specialised Hospital. This is where Vosman’s informal coal collectors gather low-grade coal rejects. It fuels many local households when there are power outages in the area.

Although Mbali Mathebula, 25, can buy a bag of cheap coal for R40 from these collectors, she cannot use it for cooking or warming. Burning either coal or wood would suffocate her children.

She sets her alarm to ring three or four times a night so that she can check whether her children are still breathing. Both Princess Nondumiso, 8, and Asemahle Angel, 4, suffer from severe asthma. Princess, in particular, has been in and out of hospital since she was a toddler.

Asthma is a common chronic lung disease affecting children living in the Vosman area. It involves inflammation and narrowing of the airways, making it difficult to breathe. Mbali explains: “An asthma attack starts with shortness of breath and coughing. Princess sometimes gets so weak (from it) that she can’t even stand or walk.”

She was diagnosed with this condition at an age at which other children were running, hopping, climbing, and swinging with ease. Princess’s breathing becomes faint when she attempts such games. During severe flare-ups, Mbali says, “it sounds like drowning without water.”

Respiratory failure could occur if the air fails to spread throughout her lungs. This is Mbali’s worst nightmare – there have been times when she has feared for her child’s life.

“At first, the doctors told me it was just the flu,” she recalls. “But it wasn’t. So, after three days, I went back because Princess was starting to get weak. She stopped breathing, you see?

“I was pregnant at the time and stayed with her in the hospital for a month,” Mbali recalls. “Now she goes back there every month for treatment.”

Mbali Mathebula, 25, will go to great lengths to fight for clean air for Princess, 8, who has severe asthma. They live in Vosman, Emalahleni. (Photo by Alet Pretorius)

Asemahle (meaning ‘still beautiful’) was also diagnosed with asthma, in her case at only six months. “I recognised the signs the moment she struggled with breathing the first time,” Mbali says. She took the infant to the hospital, where she was admitted for five days and treated with oxygen.

Princess’s condition flares up more often than that of her sister, and results in more hospitalisation, often for extended periods of time.

Last year, she spent six weeks in hospital, following a particularly severe episode. “She gets sick very quickly; it is very unpredictable,” Mbali says.

The siblings, like their mom, were born in Vosman in Emalahleni (the ‘place of coal’), located 120 kilometres east of Johannesburg. This is the nation’s most coal-intensive region. Its 12 coal-fired power stations (including Kendal, Duvha and Kusile) provide most of South Africa’s electricity. However, this coal fleet also contributes to the health-related costs and unfolding climate-related risks in the area.

The part of Vosman where the Mathebulas live is wedged between electricity pylons, a wetland used for illegal dumping and a tsotsi hideout, and the town’s main road. The overhead power lines transect the landscape, transmitting electrical energy from this part of Mpumalanga across large distances.

Mbali’s one-bedroom house is situated on the same plot as that of her parents and twenty-two-year-old brother. All three are unemployed.

The children’s social grants add up to R920 a month, covering medicine, school fees, travel costs and after-hour hospital visits. Her mom and brother’s social relief grant (allotted during the Covid-19 pandemic) adds R700 to their household budget for food and other expenses.

Grey, filthy air from the coal industry

Residents of Vosman and other communities in this industrialised swath of the Highveld are well acquainted with air pollution and its toll on their health. The area has 4,5 million inhabitants and is perforated with coal mines, coal-fired power plants, steel and chemical manufacturing plants and petrochemical facilities.

Vosman, Emalahleni, in Mpumalanga, is perforated with coal mines and coal-fired power plants. (Photo by Alet Pretorius)

Living so close to the power plants, coal mines and their discarded overburden, Mbali and her children are breathing some of the country’s most polluted air. Grey mountains on the horizon are, in fact, the spoil heaps of the region’s coal-intensive economy.

It is mid-morning, and Vosman is covered in a dusty, putrid haze. “It looks like this almost every single day,” Mbali says. The smog lingers over her house and life, and that of her family. Constantly.

Mbali says they often find their windows, floors and even toilet paper covered in a layer of fine black dust.

Inside her house, hairline cracks caused by recent mine blasting in the area are visible. The previous week, a neighbour’s window cracked during one such explosion, she says.

“In June last year, Princess got sick at around 11pm one evening,” she recalls. “I phoned the ambulance, but they said they could only come to our area at that time to fetch a woman in labour. I remember I was fighting with someone over the phone about this. In the end, they did not come. I had to borrow money for a taxi to rush her to hospital.”

Local healthcare facilities are often inundated with patients and generally under-resourced in terms of the appropriate medicine and equipment to assist them. Reportedly, many of Vosman’s hospital patients have been complaining about poor treatment at the facility.

“On arrival, there was no bed available,” Mbali remembers. “We slept in a chair that night. Princess sat on my lap, and that is where she got her oxygen – while sitting in a chair.”

Mbali gets emotional as she recalls what happened. “Sometimes, I wonder if my children will live to see their twentieth birthdays. Sometimes, I also dream they will become doctors. Princess once told me she wants to become a doctor and open a special hospital for children with asthma.”

(Photo by Alet Pretorius)

Princess is in Grade 2 this year and enrolled in Nancy Shiba Primary School, the school her mother attended. She is small for her age and struggles with the workload. Her condition causes her much physical and emotional distress, with many missed school days and regular hospital visits. This also means that her mother has had to miss work.

June of last year was a difficult month altogether. Mbali lost her job at Shoprite in the nearby KG Mall. “They (the management) accused me of absenteeism. They didn’t understand my situation.

“I felt very bad about this, as I was trying very hard to keep my job so that I could afford to go to a private hospital or doctor.

“My Princess… she is not good. She is sick. So, when they told me that my job is finished, it was very, very bad for me. I kept thinking: what are we going to eat?”

Mbali’s emotions overflow and tears drip down onto her blouse. Asemahle, now standing next to her, touches her mother’s wet cheek with her forefinger.

It isn’t easy to find a job in the current economic climate. But in some ways, Mbali says, she has also given up looking for opportunities. “Who is going to take care of my children if I don’t do it?”

Both children are immunocompromised and therefore not allowed to play outside for longer than 20 minutes at a time. This means they spend most of their day inside four brick walls. The time is spent colouring in, singing or watching television.

A rattling noise escapes Princess’s throat. “She is like this – always sneezing, always coughing, always with sinus – always, each and every hour, every day,” Mbali says. “So, I am using this nebuliser to give her medicine,” Mbali adds, unpacking it from its pouch. Mbali couldn’t afford a nebuliser and received this one second-hand as a gift.

(Photo by Alet Pretorius)

The corrugated iron roof of their house does not provide much isolation against the elements. When it rains, the single sheet above them leaks. When temperatures soar outside, it becomes sweltering inside. In winter, the room becomes freezing.

It is the colder months, especially, that Mbali dreads. “Every year, probably during June and July, I know there’ll be a time that we will need to go to the hospital,” she says. “Maybe Princess will stay there for a week or longer.

“Sometimes, I feel overwhelmed by the situation. It is a feeling of being without hope and not being able to improve it. At night, I lie awake with worry. I then ask myself: why are some people and their children living a good life? I don’t live what feels like a good life.

“My children, they are not living a good life. Even Princess… Sometimes she asks me why she has to live a life like this, while other kids are living a normal life. So this thing, the asthma, it is very bad.

“I even ask myself why… Why this?” It’s a question she prays about often. “I have not received an answer yet.”

From time to time, when the situation becomes too overwhelming for her, Mbali withdraws. “I close the door and don’t even want to see people. Sometimes I cry, or I pray.”

Mbali is a member of a local church group. The preacher has helped save her life, literally: When her house caught fire in September last year as a result of a high-voltage surge, he and other neighbours managed to bring her family to safety and smothered the fire with soil.

Mbali gets up daily around 5am and joins a prayer group at the local Source of Life. In Vosman, there are almost as many church groups as coal heaps.

The church is run by her neighbour who is the lay preacher. Church services are often held in someone’s front yard. If many people arrive, plastic chairs are lined up outside in the open, amid mountains of coal waste. Praise and worship take place here, even if the conditions of constant pollution and daily blasting would lead you to believe otherwise.

Fighting for normality and clean air

From Princess, another rattling sound is heard as she rests her head on her mother’s knee. “This is not a normal life,” Mbali says, her frustration now almost palpable. “My children are not living a normal life,” she says, using the back of her hand to wipe away the tears.

(Photo by Alet Pretorius)

Mbali’s anger has turned into resolve, driving her to take action. She is currently involved in a court case aimed at halting the government’s plan to build another 1,500MW power station in her area.

The environmental and climate justice organisations bringing the #CancelCoal case are the African Climate AllianceVukani Environmental Justice Movement in Action, and groundWork. These organisations, represented by the Centre for Environmental Rights (CER), argue that plans to develop new coal plants threaten not only the environmental rights of present and future generations but also their rights to life, dignity and equality, as well as the best interests of children. The organisations are looking for a just transition away from fossil fuels, and want the courts to give clear direction now.

Mbali has to constantly negotiate for room to breathe. “I participate in this case because air pollution causes my children’s asthma,” she says. “We are living in this dirty area. When I go to Gauteng to visit my grandmother, I realise again just how dirty the air is here.”

Mbali did not vote in the recent local government election. She says she feels betrayed by the councillors and government institutions. “I do not believe the government is doing enough to improve health and living conditions in the area, or to deal with the pollution.”

Instead, she now puts her faith in fellow activists and the courts, fighting for climate justice. “We are spreading the gospel about the need to cancel coal. Our electricity needs can be met by available and less harmful renewable energy alternatives, which are also cheaper than the proposed new coal-fired power plant,” she says.

Further coal-fired power will have a disproportionate, unfairly discriminatory impact in terms of race, gender and social origin. Poor, black South Africans, particularly women and children, are the primary victims of ecological degradation and air pollution caused by the country’s coal-fired power stations, she says.

It has been a long, hard battle to deal with not only the burning of coal in this area but also with the cumulative harms caused by the full life cycle of coal, including extraction (mining), transportation and waste.

For instance, in 2019, groundWork and the Vukani Environmental Justice Movement in Action launched the Deadly Air case. The latter is a constitutional challenge, asking the court to declare that the poor ambient air quality in the Highveld Priority Area is a violation of the right to an environment not harmful to health or well-being. The case was heard in the Pretoria High Court in 2021. Mbali and other climate activists now eagerly await the judgement.

Hidden hunger and poverty

Princess coughs slightly. Sporadically, crackling and rattling noises travel through her thin frame. She blows her nose loudly and then hides behind her mom.

The collar of her school shirt is brown, and her black Buccaneer babydoll shoes and grey socks are covered in dust. She is tired after her school day and getting hungry.

Mbali Mathebula says she will do anything to protect her daughter Princess, 8. (Photo by Alet Pretorius)

Mbali opens the fridge. She hands Princess a sweet, raspberry-flavoured drink and slices of polony. The children have many food allergies and cannot eat anything from a tin, she says. But healthy food is expensive and not always available.

During the pandemic, they sometimes had to reduce the size and frequency of their meals. Sometimes they ran out of food entirely, went to bed hungry, or had nothing to eat for an entire day.

The fridge, charred on one side, is sealed with black plastic tape to help insulate it. The appliance caught fire in September due to voltage spikes after an unexpected power outage and load shedding. The house almost burnt down in the process, a neighbour tells us. In Vosman, they are often without electricity. After a local transistor exploded, they went three weeks without power just before Christmas.

It is another two long weeks before the social support grants will be paid out again. The fridge contains a stack of polony, margarine, cough medicine and probiotics. A quarter loaf of white bread sits atop the fridge.

At the moment, Mbali has no money to buy medicine or sterilised water for the nebuliser. She boils water, adds salt and then uses that in the nebuliser. “We cannot drink the tap water because it makes us sick,” she says. “We can bath with it, but we have to buy our drinking water.

“Sometimes, I have to ask my grandmother or my family for money for food and medicine. My uncles, who know the situation, help out when they can.”

The nebuliser can only be used when they have electricity at home. “If we have power cuts or load shedding, it’s basically useless,” she says. “That means that when Princess gets sick, I need to go straight to the hospital.”

Mbali spends many sleepless hours in the dark, worrying. She says not knowing what will happen is sometimes even scarier than dealing with an actual crisis.

“I worry about Princess getting sick. I think about this all the time. When will it happen? What will I do? Will I have money to pay for the taxi to the hospital?”

The closest hospital is about 20 minutes away. She has to pay a taxi R200 to get there. These travel costs all add up. Mbali pays R320 a month for school transport because it isn’t safe for Princess to walk to school.

(Photo by Alet Pretorius)

In Vosman, unattended children disappear from time to time, and sometimes get abducted, she says. In a recent incident, a girl with albinism was murdered, allegedly for her body parts. Serious crimes have reportedly been on the rise in the area. “I definitely don’t want the girls walking around on their own,” Mbali says. “Princess gets tired very quickly anyway, so it is better to drop her off at school safely.”

Mbali’s story is evidence of a greater systemic imbalance, according to the plethora of court papers filed. Many people living in Vosman and other townships in Emalahleni are not experiencing the prosperity and development that the government often portrays in relation to coal. In fact, they know nothing but hardship as a result of coal-fired power stations.

The burden of climate despair

Globally, South Africa is among the 15 most significant contributors to greenhouse gas emissions, which cause climate change. This is due to the country’s reliance on coal for electricity generation.

Coal-fired power is also the single most significant contributor to global warming, with coal combustion accounting for at least a third of global temperature increases experienced to date.

There are many concerns about the impacts of climate change on this part of Mpumalanga. The area already has lethally high levels of air and water pollution; climate change exacerbates the health and mortality impacts of such pollution. Rising temperatures could make manual labour harder and agriculture less productive in this area.

With every tonne of carbon dioxide emitted, we are adding to global warming. This means that every new coal power plant that enters the system will aggravate the existing problem.

Climate change is already impacting significantly on children and their caregivers’ mental health and well-being, says Dr Garret Barnwell, community psychology expert. He recently produced a specialist report on the mental health effects of climate change. The report was commissioned by the CER on behalf of the same organisations involved in the #CancelCoal case.

Mbali Mathebula and her daughters Princess and Asemahle walking through the streets of Vosman where they live. (Photo by Alet Pretorius)

The report’s findings are clear: Climate change poses a severe threat to the mental health and well-being of present and future generations. People living on the Highveld are particularly vulnerable to these threats.

Barnwell points out that communities already exposed to adverse environmental and living conditions, such as those caused by air pollution, express a sense of constant psychological distress about their inability to prevent exposure. In addition, they live in highly polluted communities without the means to move because of their socioeconomic status.

This means that poverty and privilege continue to reproduce themselves in vicious cycles, driven by dire levels of inequality. Barnwell also describes the various ways in which people experience climate change: through a range of traumatic events or exposure to climate change, including natural disasters, food insecurity and air pollution. These exposures lead to well-understood psychopathologies, including anxiety, depression and suicide. It could also decrease work productivity and increase hospitalisation.

Experts say the link between hunger and mental illness is well known. Maternal hunger and poor mental health can also have profound long-term consequences for both mother and child.

Increasingly, the unfolding climate emergency risks are becoming a mental health emergency in South Africa, Barnwell warns.

According to a recent Unicef report, children are more vulnerable to climate and environmental shocks than adults for several reasons, including physical and physiological vulnerability. Compounding these risks is the fact that many children live in areas that experience multiple, overlapping climate and environmental hazards.

Moreover, Barnwell projects, “the vast majority of South Africans will have difficulty adapting to climate change, given the country’s legacy of apartheid, marginalisation, inequality and poverty, which already provides additional burdens.

“Climate change multiplies the threats that individuals already living on society’s margins have to face, and will have profound impacts on society as conditions worsen.”

The planetary health implications of climate change are widely acknowledged. Moreover, research on the health consequences of climate change is rapidly growing due to global urgency and the particular vulnerabilities countries like ours have to adapt to.

“We are looking towards a very scary future if global emissions aren’t dramatically cut,” Barnwell adds. “And the clock’s ticking.”

In Vosman, the drivers of air pollution are the same as those of climate change. Princess and Asemahle live in an area where air pollution levels often exceed acceptable standards, causing them to breathe toxic air and put their health and development at risk.

Mbali is determined to help negotiate, on their behalf, for more room to breathe.

“We need to cancel coal,” she concludes.

**This reporting was supported by the International Women’s Media Foundation’s Gender Justice Reporting Initiative. The article was published on 27 February 2022 by Daily Maverick.

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