The hills that circle Skopje keep citizens safe when smog grows thick, but they also trap the toxins that make its air among the most menacing of any city in Europe.
The mountains are the only escape, says Katarina, a 33-year-old accountant, as she walks home from an evening hike. “I was wearing a mask for air pollution before Covid.”
Dirty fuel, bad design and tricky terrain have for decades choked the capital of North Macedonia, a former Yugoslav republic of 2 million people in the middle of the Balkans. The city sits in a valley where ageing factories whirr next to homes and offices. In winter, when people stoke stoves with waste wood and rubbish, warm air rises up to meet the cold and heavy mountain air above, forming a lid that traps pollution close to the ground.
The clouds last for days if the wind does not blow. “It feels and tastes like burnt plastic,” says Dragana Gjurcinoska, a 29-year-old event manager at the Panoramika hotel at the foot of the Vodno mountain.
Skopje is home to three of the most polluted districts on the continent, a Guardian analysis based on modelling of European air quality data has revealed. Together with cities across the western Balkans and in Poland, it is one of Europe’s hotspots for particulate matter smaller than 2.5 microns in diameter, known as PM2.5. Some of these fine particles slip through the lungs and into the veins, riding the bloodstream through the body and wreaking havoc on the organs they meet.
A study in 2018 found the air in Skopje was so clogged with pollutants that residents died two to three years earlier on average than they would without this “largely preventable” environmental factor.
If you convert it into economic terms, the cost to society “is very, very high”, says Mihail Kocubovski, a co-author of the study and the head of the environment team at Macedonia’s institute of public health, which pegged the social cost of Skopje’s air pollution between €0.5bn and €1.5bn. “It is much better to pay €1 [on prevention], let’s say, and to save €5 or €10 not spent on health issues like morbidity, mortality and sick days.”
By cutting PM2.5 pollution to the EU’s recommended limit micrograms per metre cubed, the researchers found, Skopje would avoid one in every five hospital trips for heart and lung disease. If it hit a stricter limit of 10 micrograms per metre cubed from the World Health Organization – which has since lowered its limit to 5 micrograms per metre cubed and declared no level of air pollution to be safe – the city would halve such hospital visits.
On the streets of Skopje, people say they fear not just for their own health, but also that of their families and friends.
“My mother has asthma, my husband has upper respiratory problems, and me as well,” says 30-year-old Sara Carikj Jakimovska, a technical adviser at a waste management consultancy and mother of a two-year-old. “The last three years my nose has been clogged all the time and I have trouble breathing.”
Angela Zdravkova, a 25-year-old medicine student who works part time in a bookshop by an intersection of two seven-lane roads, says it is common for vulnerable people to wear masks in winter. “I mostly worry for the kids and the elderly.”
For some residents, bad air is an extra reason to leave the country, along with the low wages and corruption that have fuelled a brain drain to the EU. More than 90% of young people in North Macedonia want to move abroad, a survey from the nonprofit Youth Alliance found last year. The economy is hit further because the air deters foreign workers and tourists, and keeps residents stuck at home.
From the Panoramika hotel’s sixth floor Sky Bar, Gjurcinoska says the bar’s biggest advantage is the view. But on the worst days, she says, gesturing toward the city’s terracotta roofs and rolling hills, the pollution is so bad “you cannot see Skopje at all”.
A small comfort for older residents is that the smog is now grey, not black. A few decades ago, Skopje burned even dirtier fuels that spewed sulphur dioxide. During what scientists call temperature inversions, when a layer of warm air forms a lid over the city, the sticky sulphur clung to water vapour in the air and made black smog that caked cars with a layer of soot. The city has since banned petrol that contains sulphur and swapped its district heating plants to run on gas instead of oil.
“It was terrible,” says Kocubovski, remembering the last big black smog event in January 1993. “It was very difficult to breathe, the people were suffering.”
PM2.5 pollution has also fallen slightly in recent years as warmer winters mean people need to heat less. But experts say there has been little effort to help households swap to cleaner fuels. Between a quarter and a third of people in North Macedonia cannot keep their home warm. Two-thirds of Skopje’s residents burn wood, often using low-quality fuel in inefficient stoves, with some burning rubbish when they cannot afford anything else.
Bojana Stanojevska Pecurovska, the president of the nonprofit Centre for Climate Change, says the city should extend its district heating network to all settlements, help people make their homes more energy efficient and regulate the moisture content of firewood. “It’s a social issue, and no one is dealing with it as a social issue.”
As well as heating houses cleanly, experts have called for stricter controls on factories and traffic. They have also criticised haphazard construction. When Skopje was destroyed by an earthquake in 1963, the city was rebuilt with corridors that let air flow from east to west, blowing pollutants out through the valley. But in recent decades, locals say, buildings have sprung up in places they shouldn’t, blocking crucial airways and leaving residents to choke.
From a bench at a crossroads in the industrial Aerodrom district, the 30-year-old software engineer and opposition city councillor Gorjan Jovanovski points to three white skyscrapers whose top floors poke above the smog in winter. “They’re the only ones tall enough to rise above the temperature inversion, so if you’re rich enough, you can buy your way out.”
What is harder to understand, he says, is that the children of the elites still breathe the same air when they go to school.
Jovanovski rose to prominence after developing an app to aggregate air quality data that became popular in Skopje and several other Balkan cities. But the increased citizen awareness did not translate into cleaner air, he says. In 2021, he and other disillusioned environmental activists ran for local office and won two of the 45 seats on the city council.
With air pollution, he says, “we’re all aware, we know how to track it, particularly during winter time. The problem is the awareness seems to have stopped at the gates of the government.”
The city council did not respond to a request for comment.
Still, it is not just Skopje’s problem, says Jovanoski, opening up the air quality app and pointing to other cities in the Balkans and Eastern Europe. “If you look at the map during winter, in Europe you see the iron curtain in air quality.”
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