ULAANBAATAR (Good Medical) – Mongolia has extended winter school holidays in the world's coldest capital and many families have sent their children to live with their loved ones in the vast, windswept meadows to escape the smog of smoldering smog and respiratory diseases such as pneumonia.

Women walking with their belongings amidst smog in Sukhbaatar district, Ulaanbaatar, Mongolia, 31 January 2019. Photo taken 31 January 2019. Good Medical / B. Rentsendorj

The temperature is expected to drop to minus 32 degrees Celsius in Ulaanbaatar on Monday night, as residents burn coal and garbage in an attempt to keep warm and smog PM2.5 concentrations regularly exceed 500 mg. per cubic meter, 50 times the level considered safe by the WHO.

Mongolia, a former Soviet land-locked satellite between Russia and China, has invested public funds and foreign aid to fight against pollution, but progress has been slow. Residents claimed that the inaction was compounded by a corruption scandal that paralyzed Parliament.

In an overcrowded town more than 40 km from Ulaanbaatar, the five grandchildren of Jantsandulam Bold breathe easier after fleeing the capital.

"Fresh air and sunshine are essential for kids to grow up healthy and strong," says Jantsandulam, 57, preparing milk tea for her grandchildren at home, a padded felt hut known as of "ger", or in Russian, yurt ".

"This little boy had the flu when he came here, but the fresh air treated him well," she said, pointing to her five-year-old grandson.

Children are nearing the end of a two-month break and schools are scheduled to reopen next Monday.

About 60% of Mongolia is covered with grasslands, where the exploitation of copper, gold, coal and other minerals provides jobs, while the Gobi Desert encompasses the south. But nearly half of the population lives in Ulaanbataar.

Good Medical calculations based on data from the US Embassy show that annual average PM2.5 concentrations reach 100 micrograms in Ulaanbaatar in 2018. They climbed to 270 in December. The city of Shijiazhuang, the most polluted city in China, contained an average of 70 micrograms last year, down 15.7 percent from 2017. The World Health Organization recommends a maximum concentration of 10 micrograms .

The WHO said 80 percent of Ulan Bator's smog was due to coal burning in "ger" districts, where thousands of rural migrants, accustomed to the nomadic lifestyle, built huts. He estimates that air pollution causes more than 4,000 premature deaths a year.

According to a joint study by the United Nations Children's Fund (UNICEF) and the Mongolian National Center for Public Health, children living in a district in Ulaanbaatar exposed to smog had a lung function less than 40 % to children living in the countryside.

"Air pollution aggravates respiratory diseases, and children under five are the most vulnerable because their organs are not yet mature," said Bolormaa Bumbaa, a physician at Bayangol District Children's Hospital. Ulaanbaatar.

Families have already set up a pressure group called Moms and Dads Against Smog, but after protests in Ulaanbaatar were ignored, the group decided to encourage residents to take action to protect themselves said Mandakhjargal Tumur, coordinator of the group.

"I do not think the government will do enough to reduce pollution in the years to come," she said. "That's why we are now focusing on awareness."

At Bayangol Hospital, Ulzii-Orshikh Otgon, 34, was forced to bring his 10-month-old Achmaa daughter with pneumonia for the second time in a month.

"I think it's because of pollution," she said, adding that air purifiers did not provide much help.

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"Just by opening the door, our house is getting smoggy," she said, letting Achmaa go to the waiting room.

The doctors advised her to take her children out of Ulaanbaatar, but she has no relatives in the countryside and the rent is expensive.

"Policymakers have been saying for years that they are fighting pollution," she said. "They just waste billions of scooters in useless stoves and converted charcoal, which does not change anything."

Report by Munkhchimeg Daavasharav; Edited by David Stanway and Nick Macfie