He vividly remembers the first dust cloud he was engulfed in. “The entire sky turned red. My throat started burning like hell. I couldn’t see because of the tears in my eyes. I was shocked, speechless, totally not understanding what just happened,” said Mohamad Madadi.
He was then just a child in his school playground but the choking smog clouds have only worsened in Ahvaz, in Iran’s western province of Khuzestan, his home –and one of the world’s most polluted cities.
Now 28, the self-taught photographer has made it his work to capture the eerie atmosphere of the heavily polluted city, as a symbol of Iran’s wider environmental crisis that is having an effect on the nation’s health after years of systemic negligence.
Cars travel along a road through a thick haze in Ahvaz, consistently ranked as one of the world’s worst cities for air pollution
In 2011 Ahvaz was ranked by the World Health Organization as having the worst air quality of any city globally. It remains one of the world’s most polluted cities and its air has been proved to have increased deaths, and been linked to a rise in cardiovascular diseases.
The last decade has brought little change to a region that lies on the outer edges of what was once known as the Fertile Crescent. Trees that had hung heavy with dates and citrus since the days of Mesopotamia now crumble to ash under the slightest touch, due to a dust-borne fungus.
Quick GuideA common condition
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The human toll of non-communicable diseases (NCDs) is huge and rising. These illnesses end the lives of approximately 41 million of the 56 million people who die every year – and three quarters of them are in the developing world.
NCDs are simply that; unlike, say, a virus, you can’t catch them. Instead, they are caused by a combination of genetic, physiological, environmental and behavioural factors. The main types are cancers, chronic respiratory illnesses, diabetes and cardiovascular disease – heart attacks and stroke. Approximately 80% are preventable, and all are on the rise, spreading inexorably around the world as ageing populations and lifestyles pushed by economic growth and urbanisation make being unhealthy a global phenomenon.
NCDs, once seen as illnesses of the wealthy, now have a grip on the poor. Disease, disability and death are perfectly designed to create and widen inequality – and being poor makes it less likely you will be diagnosed accurately or treated.
Investment in tackling these common and chronic conditions that kill 71% of us is incredibly low, while the cost to families, economies and communities is staggeringly high.
In low-income countries NCDs – typically slow and debilitating illnesses – are seeing a fraction of the money needed being invested or donated. Attention remains focused on the threats from communicable diseases, yet cancer death rates have long sped past the death toll from malaria, TB and HIV/Aids combined.
'A common condition' is a Guardian series reporting on NCDs in the developing world: their prevalence, the solutions, the causes and consequences, telling the stories of people living with these illnesses.
Tracy McVeigh, editor
“It’s a poor city,” says Madadi, “One that has always faced issues as long as I can remember, but where people are always kind and welcoming.”
A street next to a market in Ahvaz. Each year, thousands of people seek medical treatment for respiratory conditions
The surrounding plains, where many of the world’s first cultivated crops were grown, are now barren, poisoned by oil refineries and other extractive industries that have accelerated the region’s ecological breakdown.
The growing prevalence of illness that pollution has inflicted on the people of Ahvaz has been examined by several research groups. One 10-year study confirmed growing levels of noxious fumes were behind a rise in cardiovascular hospital admissions, and Madadi has found himself drawn to documenting an increasingly desperate situation. Last year, he was a finalist in the Sony World Photography awards for a series on urban life under Ahvaz’s oppressive orange skies.
Swaddled in its sepia haze, when the smog descends, Madadi’s city is one in paralysis, streets deserted. “When these dust storms arrive everything goes into chaos. Even the most simple tasks become impossible. You can’t see a short distance in front of you, you can’t drive, you can’t function. I’ve seen cars collide with each other.”
Less than 100km from the Iraq border, in a province containing the third largest oilfield in the world and most of the country’s Sunni Muslim and Arab minorities, Ahvaz has a difficult relationship with the capital, Tehran, perceived as largely indifferent to the city’s struggles.
“Tehran looks at Ahvaz as an object,” says Madadi, “As something they can rely on for selling fuel and making money and that’s pretty much it. They take and take from us and they don’t give us anything in return.”
When he speaks of the future, Madadi’s lack of optimism is notable. “I don’t see myself living here for the rest of my life,” he says. “And if other places in the world: cities, countries, don’t look at us as a warning and learn from us, soon everything, everywhere will be a ruin like we are.”
Ahvaz is a victim of pollution from the vast petrochemical industry in Khuzestan province, as well as massive dust storms