What is interesting is that the majority are experiencing coughing. They cough continuously before waiting to be called by the doctor. Unfortunately, not everyone wears a mask. There is a woman, who looks like an employee, coughing continuously but without wearing a mask. According to the doctor at the clinic, for the past few weeks, the patients who come are mostly those who have upper respiratory tract infections or ISPA. Such as coughing and shortness of breath. For the past month, air pollution in Jakarta has been continuously worsening.

"In the midst of worsening air pollution in Jakarta, the community is indeed starting to complain about a number of respiratory diseases such as Acute Respiratory Tract Infection (ISPA) and symptoms of coughing and shortness of breath. As stated by the Director General of RSUP Persahabatan Jakarta, Agus Dwi Susanto, at the national respiratory center hospital where he works, there has indeed been an increase in the number of patients experiencing respiratory diseases, one of which is ISPA. 'It cannot be assessed in relation to pollution, because it has not been scientifically studied with pollutant data around the hospital,' said Agus when confirmed by Liputan6.com through a text message. Regarding air pollution, Agus revealed that there has been a research study at RSUP Persahabatan Jakarta in 2019."

Meanwhile, for the impact of air pollution that is currently occurring in 2023, there is no study yet. "As for asthma and Chronic Obstructive Pulmonary Disease (COPD), I have a study from 2019 at Persahabatan Hospital," he said. Based on a study from 2019, there has been an increase in asthma and Chronic Obstructive Pulmonary Disease (COPD) patients admitted to the Emergency Department of Persahabatan Hospital in Jakarta. This condition, according to Agus, occurs when the concentration of air pollutant PM10 increases. Particulate Matter (PM10) is air particles that are smaller than 10 microns. The Ambient Air Quality Standard (NAB) is the limit of air pollution concentration allowed in the ambient air. NAB PM10 = 150 µg/m³.

In Indonesia, a study at Persahabatan Jakarta Hospital and Dharmais Hospital showed that four percent of lung cancer cases were related to air pollution in 2013. This study, titled "Air pollution and human health," was published in the Medical Journal of Indonesia in 2020. Air pollution has been reported to be associated with cardiovascular and cerebrovascular diseases. The risk of these diseases is associated with PM (particulate matter) with a size of less than 10 and 2.5 microns (PM10 and PM2.5). PM can penetrate the respiratory tract and alveoli and then enter the bloodstream, causing cardiovascular and cerebrovascular disorders.

"Password, Jokowi admitted that this is the first time he has experienced a cough like this. "The President requests concrete steps to be taken within one week because the President himself has been coughing for almost four weeks. He has never experienced this before," said Sandiaga at the Presidential Palace Complex in Jakarta on Monday, August 14, 2023. "And possibly, the (presidential) doctor mentioned that there is a contribution from unhealthy and poor air quality." Previously, President Jokowi held a limited meeting to discuss air pollution in the Jakarta, Bogor, Depok, Tangerang, Bekasi (Jabodetabek) area. Jokowi highlighted the very poor air quality in Jabodetabek."

"Today we had a meeting regarding the air quality in Jabodetabek, which has been very poor for the past week," said Jokowi when opening a limited meeting at the Merdeka Palace in Jakarta, Monday, August 14, 2023. He mentioned the air quality in DKI Jakarta, which reached 156 on August 12, 2023. This indicates that DKI Jakarta is ranked first as the most polluted city in the world. "On August 12, 2023, yesterday, the air quality in DKI Jakarta was at 156, categorized as unhealthy," he said. Jokowi stated that there are several factors causing air pollution in Jabodetabek. One of them is the long dry season in the past three months, which has led to an increase in high pollutant concentrations."

Referring to data from the World Health Organization (WHO), air pollution contributes to 24 percent of all stroke-related deaths worldwide, 25 percent of all deaths and diseases caused by ischemic heart disease. Long-term exposure to air pollution is also associated with chronic ischemic heart disease and heart failure, especially in patients with a history of coronary artery disease. A higher risk of atrial fibrillation when exposed to air pollution such as PM2.5 has also been reported.

The 22-year-old asthma sufferer often wears a mask and carries a nebulizer, but the poor air quality in the city does not help. The capital city of Indonesia, which has long been fighting against air pollution, ranks as the most polluted city on the global chart almost every day. Last week, the concentration of pollution particles known as PM2.5 in the air in Jakarta exceeded other highly polluted cities such as Riyadh, Doha, and Lahore, according to real-time data from Swiss air quality technology company, IQAir. The company provides real-time pollution rankings for major cities every day. Jakarta has also consistently ranked among the top 10 most polluted cities globally since May. The capital city and its surrounding area are home to about 10 million people.

Currently, Farah also brings an oximeter - a device that is usually placed on the fingertip to measure the oxygen level in someone's blood to monitor their condition better. "For asthma sufferers, even a slight decrease in oxygen levels can be very noticeable. And it's not just shortness of breath, my chest hurts a lot. So it's difficult to breathe," said Farah, who is interning at a marketing agency. "My asthma is severe and hereditary as well. Every doctor tells me to move out of Jakarta. 'If you want to get better, you have to leave Jakarta, otherwise it will continue like this,' they say." "I'm quite tired because I can't do anything. But this is where I live. Besides wearing a mask, there's not much I can do," said Farah.

Local authorities blame this pollution surge on the dry season and vehicle emissions, and will soon conduct random vehicle inspections and force drivers to undergo emission tests. President Widodo urges weather modification to produce artificial rain in Jabodetabek, and suggests companies implement hybrid work systems. The city government is also considering ordering half of its civil servants to work from home. However, Jakarta residents like Juan Emmanuel Dharmadjaya face a dilemma. "I really want to stay in Indonesia because this is where I was born and my family is here. But air pollution is a silent killer."

The following is the translation of the provided text from Bahasa to English while preserving any HTML tags: "The 22-year-old man previously suffered from tuberculosis and now suffers from sinus problems. He said that the poor air quality has a negative impact on his health. "I can't focus on daily life because my nose is always runny and itchy," said Juan, who works in the IT industry. Referring to his experience as a student in Germany, he said, "In Europe, I never had a runny nose or cough, even during winter when the temperature was below freezing. But when I returned to Jakarta, my nose immediately started running. It's very bad and congested." Sigit Reliantoro, a senior official at the Ministry of Environment and Forestry, told reporters at a press conference that dry air in June, July, and August "always" causes an increase in air pollution in Jakarta."

Amrin (not his real name), who lives near a coal-fired power plant, is among those affected. He told the BBC that his family used to collect rainwater for bathing and consumption. However, it is no longer possible after the factory started operating in 2009. "We dare not do it anymore because the stored water is black in color and contaminated with thick black dust on the roof," he said. If the water is like that, imagine how it feels to breathe the air near a coal-fired power plant.

Based on data from the Global Burden of Diseases 2019 Diseases and Injuries Collaborators, there are 5 respiratory diseases that are the leading causes of death in the world, namely Chronic Obstructive Pulmonary Disease (COPD), pneumonia, lung cancer, tuberculosis, and asthma. According to the data, COPD has a total of 209 cases with 3.2 million deaths, pneumonia has 6,300 cases with 2.6 million deaths, and lung cancer has 29 cases with 1.8 million deaths. Tuberculosis (TB) has 109 cases with 1.2 million deaths, and asthma has 477 cases with 455,000 deaths. In Indonesia, out of the 10 diseases with the highest number of cases per 100,000 population, 4 of them are respiratory diseases.

Referring to data from the Indonesian Ministry of Health as of April 2023, there were 145 cases of Chronic Obstructive Pulmonary Disease (COPD) with 78.3 thousand deaths, 18 cases of lung cancer with 28.6 thousand deaths, 5,900 cases of pneumonia with 52.5 thousand deaths, and 504 cases of asthma with 27.6 thousand deaths. The risk factor of air pollution for respiratory diseases is quite high. COPD has a risk of 36.6 percent, pneumonia 32 percent, asthma 27.95 percent, lung cancer 12.5 percent, and tuberculosis 12.2 percent. Professor of the Faculty of Medicine, University of Indonesia, and Chairman of the Honorary Council of the Indonesian Society of Pulmonology (PDPI), Tjandra Yoga Aditama, wrote that the danger of air pollution can lead to death.

WHO specifically states that air pollution is one of the greatest environmental risks to health. Air pollution is an environmental risk to health. "By reducing air pollution levels, countries around the world (including Indonesia, of course) will be able to reduce the burden of disease from stroke, heart disease, lung cancer, as well as acute and chronic respiratory diseases," explained Tjandra.

"So as to cause losses for the plaintiffs and the people of DKI Jakarta, including the emergence of various diseases related to air pollution. Considering that based on the aforementioned considerations, the High Court concluded that the Decision of the Central Jakarta District Court Number 374/Pdt.G/LH/2019/PN Jkt Pst dated September 16, 2021 can be upheld and strengthened," reads the copy of the verdict from the Jakarta High Court, led by Abdul Fattah. On September 16, 2021, the Indonesian Court has ruled that President Joko Widodo and other high-ranking officials have been negligent in addressing air pollution in Jakarta."

The prolonged haze in this city with a population of 10 million people is caused by heavy traffic and coal-fired power plants that are not equipped with filters. The district court has instructed President Jokowi to improve the national air quality standards, and added that the provincial government must conduct regular inspections such as emissions testing for old vehicles in Jakarta and outdoor air quality testing. This information must be made public, said the court. Frustrated residents, concerned about the impact on their health, have taken legal action against President Widodo, the Ministry of Environment, the Governor of Jakarta, and others.

One of the plaintiffs, researcher Khalisah Khalid, said she participated because her 10-year-old son often experiences nosebleeds and allergies. "This is what motivates me. I want my child to live a healthier life, to have clean and healthy air," she told BBC Indonesia. "I believe all parents, all mothers, want their children to grow and develop... in a clean and healthy environment." Other plaintiffs said the court's decision is a good start.

Until now, there are at least 16 coal-fired power plants (PLTU) located not far from Jakarta. The distribution consists of 10 PLTUs located in Banten, while the other six are in West Java. As for the manufacturing industry recorded in 2019, a total of 418 facilities were found within a 100-kilometer radius of the Jakarta metropolitan area. Out of that number, 136 of them are in sectors with very high emissions such as cement and steel, glass, oil and gas refining, coal-fired power plants, metals, petrochemicals, and plastics. If further analyzed, 86% of these high-emission facilities operate outside the administrative boundaries of Jakarta; where 62 facilities are in West Java, 56 in Banten, 1 in Central Java, and 1 in South Sumatra within a 100-kilometer radius of Jakarta.

Then, during the dry season (June to October), the wind trajectory from West Java brings emission sources to the eastern and southeastern regions of Jakarta. CREA's research also found that the next source of pollution comes from the transportation sector, followed by housing and commercial sectors, and finally domestic sources such as waste burning. Muhammad Aminullah, the Chairman of Walhi DKI Jakarta Campaign, said that although CREA's research was conducted three years ago, the reality has not changed. In fact, the current condition is even worse. Walhi cited the manufacturing industry in the Marunda area of North Jakarta, which still uses coal for its electric energy fuel.

The environmental NGO claims that the ash from poorly managed coal combustion is causing pollution near residential areas. For example, at the end of 2022, residents of Marunda low-cost apartments complained about coal dust pollution, which they said came from a company. "The company should use filters to trap fly ash and prevent it from spreading, and the location should be far away from residential areas," said Muhammad Aminullah to BBC News Indonesia. "The same goes for coal-fired power plants. Their activities are conducted in open spaces, making them susceptible to being carried by the wind. They should be in enclosed spaces and have sprinklers to cover the coal dust."

"We see the reason for it because of economic and political interests. When emission regulations from industries are tightened, businessmen will surely protest. That's why our observation shows that there are economic and political interests that degrade environmental policies. In essence, the government is not brave enough to tighten environmental regulations for companies, and in the end, it is the community that becomes the victim. In recent days, several policies have been implemented, including implementing work from home (WFH) for 50 percent of civil servants (ASN) in DKI, modifying the weather to reduce rain in order to bring down pollutants in the air in Jakarta. What are the results? Until Monday morning, September 11, 2023, the blue sky of Jakarta is still not visible."