Breathing Cement Dust

By Saqr Al-Sneidi

Sana’a, Yemen (Al-Thawra), February 2015 

Althawra: Abdul Qader al-Salawi, a 54-year-old employee at the Amran Cement Factory, tries to stifle his continuous cough to avoid waking up his eight children who share a four-room house.
He soon realizes that his efforts are unsuccessful as he hears the approaching footsteps of his daughter, Shafiqa, who hands him a glass of water to calm him down.
The next morning, no one talks about last night’s routine episode. But Salawi’s eyes seem apologetic as he prepares for the one-km walk, to join 1,500 workers in this factory.
Al-Salawi is like everyone else living near the cement factory, 50-km north of the capital Sana’a, cannot sleep properly because of the dust they breathe day and night.
As soon as Shafiqa, 28, finished high school in 2004, she told her father she wanted to pursue her higher education in medicine at Damascus University. She wanted to follow in the footsteps of her older brother, Rafiq, who graduated from Sana’a University’s Medical School.
Shafiqa and her brother are now treating hundreds of Amran patients for respiratory diseases. The life of Amran residents is hellish. They live around the largest cement factory in the country and have to put up with tons of polluted air emitted by the company since its establishment in 1981, according to environmental studies and assessments conducted by the Environmental Protection Authority (EPA).
“Half of the patients, estimated at around 40 cases per day, complain of various respiratory disorders ranging from cough to chronic lung infections”, says Shafiqa, who works at the private Alpha Medical Center near the factory.
Her brother, Rafiq, who works at the factory’s clinic, says that he receives an average of 20 patients a day, including workers and neighboring residents.

The older a resident is, the more serious the effect of cement dust becomes on the respiratory system and eyes of people living near nine cement factories in Yemen, including three that are government-owned. This reporter focused his investigation on two government-owned factories; Amran and Al-Barh to assess the damage inflicted on the local population.
Results of a random survey conducted by this reporter showed that the areas surrounding the two factories contain the highest percentage of eye and respiratory diseases: Five times higher than patients living in farther areas.
Meanwhile, cement factories fail to meet environmental protection standards due to the EPA’s weak role as the latter cannot enforce pollution reduction. It lacks measuring devices, preventing the technical measurement of emissions to prove violations by these two factories.
In addition, inefficient legislation does not specify the party authorized to license and regulate the cement factories.
In 2007, the EPA recommended amendments to the Environmental Protection Law, but its efforts have so far failed to reap any results. Some 20 years after amendments to the law were drafted, it remains stashed away in the drawers of the Legal Affairs Ministry, according to the former EPA chairman, Mahmoud Shidiwah. The draft amendment seek to give the EPA “greater powers and exclusive authority to issue licenses.”

Shidiwah says that the draft amendments have not left the Legal Affairs Ministry although the document states that it should be “sent to the concerned parties for their opinion”.
Dr. Mutie Jubeir, deputy minister for Legal Affairs does not give a reason for the delay. He tells this reporter: “If you have good contacts with EPA employees, tell them to come and discuss the proposed amendments.”
Alarming Figures
The Amran Cement Plant produces 1.5 tons annually along with tons of pollution carried by winds moving at an average speed of 8 meters per second, according to a 2005 environmental assessment study financed by the US Agency for International Development (USAID) and conducted by Dr. Mutassem al-Fadel from the Environmental Engineering Faculty at the American University of Beirut, environmental expert Ibrahim Alamuddin, and EPA expert Dr. Mohammad al-Mashjary.
In 2009, the factory made a profit of 3.8 billion Yemeni rials ($14 million), but lost YER 1 billion ($4.66 million) in 2012.
The study estimates the daily amount of dust emitted at 1,820.3 upg (units per milligram in one cubic meter of air), which is 364% higher than the permitted 500 upg set in the 1995 Environmental Protection Law.
In a study presented during a conference in Aden in May 2013, Dr. Ahmad Khanshour, engineering professor at Aden University, said that carbon dioxide — the biggest harming element affecting the health of workers and nearby residents — constitutes 40% of the gases emitted in cement production.
Over a period of six months, this reporter monitored the effects of pollutants on patients receiving treatment at the government-run Arman Hospital.
Medical records show that the hospital received a total of 41,968 patients in the first half of 2013, including 1,369 complaining of different respiratory problems. Amran has a population of 96,375, or 10 percent of the Governorate’s 1.05 million, according to 2011 official estimates.
The number of patients suffering respiratory disorders increased from March to June, despite the end of winter and stable weather. According to official data, the number increased from 206 cases in January to 235 in March, 241 in April, 289 in May, and 217 in June.
The medical records also show that 70 percent of patients suffering respiratory problems live within a 5-km radius of the source of dust — a hazardous zone as determined by the World Health Organization’s (WHO). According to copies of reports obtained by this journalist from the WHO office in Sana’a, the organization deems the safety zone beyond a 15-kilometer radius from the source of dust.
Pediatrician Dr. Ahmad al-Souhi does not stop reproaching parents for failing to keep their children away from the dust, the cold, and gases. After putting down a child on a bed, he says: “most children have respiratory infections because of the factory. Other factors include pesticides used in farming. But factory emissions are much more dangerous because of their durability”.
With a little girl on his lap and a little boy besides him, Naji Hassan, 55, sits on a concrete chair carved with the message: “Amran Cement Plant wishes you recovery.” He shakes a toy to distract his son from crying before going in to see the doctor. Hassan says: “We left him at home coughing for three weeks, but he didn’t improve.”
Dr. Al-Souhi’s diagnosis of the little boy, came as follows: “The child is vulnerable to external factors. One child per every medium-sized family is prone to allergies due to genetic factors”.

According to Health Ministry 2011 statistics, 59,134 patients in the province of Amran suffered respiratory diseases, around 23.8% of a total of 248,789 patients who were treated in the same year.The cases of respiratory patients in Amran constitute 10.6% of a total of 559,585 nation—wide respiratory cases registered in the Health Ministry’s records. Yemen has a population of 22.8 million.
Accordingly, Amran has the highest rate of respiratory diseases: 5.63% compared to an average of 2.45% in the rest of the provinces.
The growing number of respiratory patients prompted doctors to flee the city of Amran, leaving it with only 13 physicians serving over one million people, according to a 2011 report by the Health Ministry. This is 100 times less than the world average of 13 doctors for every 10,000 people, according to the WHO office in Sana’a.
Dr. Khaled al-Ahnoumy, a respiratory diseases specialist who moved his family to the capital, says: “We could no longer bear it, but I return every day for the patients, half of whom suffer respiratory diseases such as chronic asthma, bronchitis, lung diseases, tuberculosis, chest pains, and silicosis.”
According to a questionnaire distributed by this reporter to 100 residents living within a 5-Km radius of the Amran Cement Plant, 50% said they suffered coughs with over 20% percent afflicted with nonstop coughing. This is five times higher than a similar survey conducted in Sallaq, 50 kilometers from the nearest cement factory, where the percentage was no higher than 10 percent.
Al-Barh Cement Plant
The same health problems face residents around Al-Barh Cement Plant, 15 kilometers from Taiz (265 kilometers southwest of Sana’a). The factory began operations in 1993 and produces 500,000 tons annually, according to factory records.
Six percent of residents living within a 5-kilometer radius of Al-Barh factory suffer respiratory diseases, according to a survey conducted by this journalist, compared to 1 percent in Sallaq in the governorate of Ibb.
Eye Diseases
Cement factory pollution is not only causing respiratory disorders but also eye diseases, according to Dr. Amal al-Thabhany, an ophthalmologist at the government-owned Kuwait Hospital in Sana’a. She says that she conducts dozens of conjunctivitis (pink eye) procedures every week, adding that five to seven of these patients come from the governorate of Amran.
She explains: “Dust leads to irritation of the eye membrane and forms pink eye, which affects eyesight on the long term. The closer you live to the source of dust, the greater the infection.” On treating those living near the Amran factory, she says that “we remove the pink eye, but we cannot remove the cause.”
According to Health Ministry 2010 statistics, 10,194 cases of eye diseases were reported in the governorate of Amran alone, or 21 percent of 48,568 eye patients registered in Yemen in the same year.
Damaged Air Purifiers
The management of Amran and Al-Barh factories did not provide this journalist with their respective annual profits on grounds of fluctuating production, market recession, and higher operating budget linked to fuel hikes. But they believe that the pollution problem stems from the limestone mine.
During a tour in a pickup truck around the Amran cement extraction mine, this reporter noticed that the driver had to use the windshield wipers more than three times every eight minutes to remove the dust. The driver, speaking on condition of anonymity, says that he “visits the hospital for treatment every three months.”
Mohammad al-Salamy, production director at the Amran plant, says: “The damages are not as bad as they were before because we now have 3,200 air purifying filters, known as Baghouses, at a cost of $120 each.”
Al-Salamy blames the residents, saying that “the factory was built here before there were residents. Today, the area has become crowded because of available electricity, water, economic activity, and sometimes employment,” citing the same reasons that prompted residents to move closer to the Al-Barh plant.
Al-Salamy points to the factory chimney from his office window and says: “Look at the little amount coming out of this chimney, which is regularly maintained, to reduce damage to a bare minimum. There aren’t that many cases of disease anymore.”
Factory statistics obtained by this reporter indicate that 260 patients were sent abroad for medical treatment while 507 were treated in Yemen between 1997 and 2002 at a cost of over $26 million. They all fall under work-related injuries, including accidents and unidentified diseases caused by industrial pollution.
Dr. Omar al-Absy, a US-educated General Practitioner at Al-Thawra Hospital in Sana’a, estimates the average cost of drugs and regular examinations of a single respiratory patient at YER 24,000 to YER 30,000 ($115-$140) a year.
Al-Absy says: “This amount doubles as the patient’s health deteriorates and he/she would have to stay in hospital or require a lung transplant.”
Meanwhile, the government does not spend more than YER 15.23 per person a year on medical treatment, according to the 2011 state budget.
Salim Hadi, deputy director of the Environmental Protection Bureau at the General Investment Authority, says that the dust emission is caused by damaged filters that need replacement. But Al-Salamy says that a complete filter system was installed less than two years ago, adding that occasionally damaged filters are replaced because they cause dust emissions. He says that the filter’s functional span is three years.
Engineer Mohammad Baker, manager of Arman plant’s second production line, says that dust is mostly emitted from open sites during the separation of the components to extract raw cement.
In his study titled “Cement and Pollution 2005,” Engineer Fouad Abdul Jalil recommends a “green ring” around the factories to absorb the bulk of emitted dust. But such rings were not seen around both factories.
Abdul Jalil’s study also recommends that the management of Al-Barh Cement Plant should conduct regular maintenance on the purification system, cover the open source of dust and adopt national legislation regulating the amount of dust emissions permitted, reducing it from the current 500 milligrams per cubic meter of air.
Yousef H, 50, who lives near the factory, shows the level of pollution in the city by wiping his television screen with his arm and closing all the room’s windows and doors. Only one hour later, another layer of dust covers the screen. He wipes it with a white piece of cloth that gradually changes color. He wonders: “How did the dust pass through with all the windows closed? Can it not also pass into our lungs?”
Winds Aggravate Problem
Dr. Tawfiq al-Khuleidi, pulmonary specialist at the government-owned Al-Barh Hospital and head of the tuberculosis program, says: “Residents and their children do not enjoy clean technology that ensures directing dust against the wind; therefore, respiratory diseases top the list with dozens of cases a week, but we advise them to go to Taiz Hospital”.
The hospital is equipped to receive only 10 cases in the emergency room, according to deputy director Mutie Abdul Ghaffar. However, it receives 20 to 30 cases a day from traffic accidents, making it unable to treat respiratory patients. Abdul Ghaffar adds: “All we can give them is our sympathy for their lungs breathing polluted air.”
A father explains his child’s case to Dr. Al-Khuleidi: “He hasn’t stopped coughing, especially at night, since his birth in 2011”. As the doctor examines the child, he says: “The area changed in 1993 with the opening of Al-Barh factory and dust started seeping into people’s chests.”
M. Al-Sulhi, 55, sells local cheese in a market near Al-Barh Cement Plant and keeps her Ventolin inhaler with her at all times. At the private Al-Hayat Hospital, Dr. Ahmad Hindawi says that her condition is deteriorating. He adds: “Since she uses the inhaler three times a week and other medications, she now has bronchial asthma.”
Al-Barh Cement Plant manager Abdul Rahman al-Mansy says that he trusts the environmental efficiency of the equipment because they are modern and connected to the air purification system, (the Baghouse), which can function for three years and is changed regularly whenever it expires.
According to Al-Mansy, specialized engineers assess their function and efficiency and change the damaged ones. In less than a year, several were changed, he said. The factory advertises in newspapers for filters, requesting private companies to submit their quotations.
This reporter could not measure the pollution to verify the manager’s statement on the filters’ efficiency.
Nabil Shamseddine, environment director at the Investment Protection Authority, acknowledges the difficulty of determining the level of dust in the air “due to lack of badly-needed devices that measure the level of pollutants in the dust.”
Salem Baqhizel, director of environmental monitoring at the EPA, talks about measuring devices that the authority was supposed to obtain, but “instead went to another party that has nothing to do with the environment.” He says that a cooperation agreement between the Amran Cement Plant and EPA “has not been activated and the factory has not been tested” because of the lack of measuring devices. Baqhizel wonders: “How can we determine the pollution levels without the devices?”
Toothless Law
The two investigated factories were established before Environment Protection Law 26 of 1995 was issued. But that “does not absolve them from adhering to the health standards,” says Amin al-Hamadi, head of assessment at the EPA. He adds: “The real problem was with the Amran plant, but we convinced its management to set up purifying filters and they adhered.”
Al-Hamadi says: “After the law was issued, we addressed the government and the highest authority in the country regarding the need to adhere to the standards of environmental protection, but no one responded.”
Salim Hadi says: “The two factories did not obtain licenses from the EPA because they were established decades earlier. But they are bound by EPA regulations with an environmental impact assessment upon opening new production lines.”
Ali Abu Haliqa, head of Parliament’s Constitution Committee says: “There is no justification for not applying the law on all factories, even if they were established before the law.”
According to the law, a commission — comprising the EPA, Investment Authority, Sana’a University’s Faculty of Science, and the Industry Ministry — is tasked with regulation and loose procedures related to implementation, inspection, tests, confiscation, demolition, closure, stopping, cancelling, and ending. But the law does not elaborate on causes, enforcement, or how to carry out these measures.
The law’s penalties range from financial fines to closing down a facility. Article 11 of the law stipulates a number of penalties against offenders, starting with notification of the offender and granting a 60-day period to rectify its status. If that fails, the project is shut down and its breached activities are stopped. However, not a single closure has been ordered to date. Furthermore, no complaints have been filed at the EPA, whose task also includes “backing the affected seeking justice in the court and acting as an expert witness in the cases.” According to Hadi, “residents do not file complaints in return for favors such as water, electricity, and jobs in the factory.”
Powerless ‘Environmental Protection’
Although the law authorizes the EPA to monitor cement factories, it does not give it the exclusive right to issue licenses, thus weakening its supervisory role.
The EPA’s powerlessness grows with the size of the problem. According to a “review of the environmental impact assessment study in 2010 for a project expanding cement production of Bajil Plant,” a document signed by the joint commission reveals negligence by the concerned parties, including “local councils, the Ministry of Industry, and factory management.” It accuses the factory, inaugurated in 1973 in Al-Hudaydah District (western Yemen), of completing a new production line despite its “negligence to meet important conditions.”
The document says that the study for the expansion of the factory, which is currently not operating, “neglected the methodological standards in the field studies to reduce the current and potential environmental effects. The soil, surface and ground water was not analyzed and neither was the climate. It did not mention the potential number of affected (people) and how or where to dispose of 330 tons of solid and alkali waste.”
Regulation negligence, governments turning a blind eye to the integration of cement factories in residential areas, and lack of monitoring and measuring devices force the neighbors of cement factories to accept their diseases as fate, despite the state’s failure to treat them or ease their pain.
* This investigation was conducted with support from Arab Reporters for Investigative Journalism, ARIJ: www.arij.net, and under the supervision of coach Khaled al-Harouji.