Failed promises to clean air in South Africa’s coal belt take toll on public health

eMALAHLENI, South Africa — Elisabeth Moutloang, 49, lives in the shadows of Duvha Power Station, a 3,600-MW coal-fired power station owned and operated by Eskom, South Africa’s national energy provider. Between it and her community of Masakhane, in the south of eMalahleni, is a coal mine where she used to work twenty years ago as a weighbridge clerk, monitoring the weight of coal-laden vehicles entering and exiting the mine, before it was abandoned.

She left the job after seven months but in that time had developed a serious lung problem, which was detected because the mine conducts a health screening before starting employment and when an employee leaves.

“When I went to have my exit medical done, I was told that I have a hole on my left lung. That’s when I started having sinus problems, that’s when I started having chest problems. At one stage I had bronchitis,” Moutloang says. “I thought I was going to die.” At the time, she had health insurance from her employer and was able to get the right medicine for the condition.

Hers is not a unique story for a resident of eMalahleni (which translates to “place of coal”) located in South Africa’s eastern province of Mpumalanga, 130 kilometers (81 miles) east of Johannesburg. The town lies in the heart of the Highveld Priority Area (HPA), spanning 31,100 km encompassing 12 municipalities, which was designated in 2007 as a priority area for tackling air pollution, because the air quality was very poor.

A report by the South African Medical Research Council (SAMRC) released this year has provided further scientific evidence linking health impacts to HPA’s air pollution.

Among the sources of pollution are 12 coal-powered stations owned and operated by Eskom. These plants account for approximately 60% of South Africa’s electricity grid capacity.

Experts argue weak emissions regulations that are poorly enforced are making residents, like Moutloang, sick, while a lack of concerted action means plans to cut emissions by 2030 will likely fail.

“It’s been 20 years of air pollution that has exceeded our national norms and standards, even though those norms and standards aren’t as progressive as many other jurisdictions around the world,” says Rico Euripidou, chemicals and campaigns support coordinator at groundWork, an environmental nonprofit focused on just energy transition.

Under its plan to transform its energy sector, South Africa requires the retirement of 8.4 GW of its coal generation by 2030. Yet it is very uncertain whether it will achieve that, as the industry currently employs 85,000 people, while the country already experiences power cuts because of insufficient electricity generation. So, there is pressure from more than one direction to keep burning coal.

Public health at risk

But public health research is adding urgency to the campaign for cleaner air. Air pollution in the priority areas (including HPA] are “dangerously high,” says Chantelle Howlett-Downing, one of the authors of the SAMRC report.

The report says it “has uncovered important and statistically robust associations between air pollutants and mortality in South Africa. … With consistent patterns of elevated risk for PM10 and SO₂ [sulfur dioxide] across multiple seasons and lags, particularly in HPA.”

The SAMRC report used historical air quality data and health data from hospitals and clinics in the areas to conclude that residents in the HPA have elevated mortality risks. It shows that residents are at higher risk of health conditions like respiratory diseases, cardiovascular diseases and tuberculosis in the HPA due to air pollution.

Moutloang, who now runs a community center in Masakhane, estimates that the overwhelming majority of its 6,000 residents have respiratory, chest and sinus problems along with some cases of tuberculosis. For her, the responsibility of the mining and power industry based in the region for the community’s health problems has always been clear.

Vukani Environmental Movement (VEM), a nonprofit organization created to address air quality issues in the HPA, and groundWork have taken legal action in their fight for cleaner air. In the 2022 Deadly Air case, as it was dubbed, the High Court agreed with VEM and asserted residents had a constitutional right to live in a safe environment, and the mining and power generating activities were violating that.

They had originally taken then-Minister of Forestry, Fisheries and the Environment Barbara Creecy to court for allowing the industrial activity that is denying residents this right. In April 2025, the Supreme Court also compelled the environment minister to outline concrete steps of how they are going to improve the air quality within a year.

In March 2025, a new HPA Air Quality Management Plan was declared, by the Ministry of Environment, with a target for all industrial and energy generation sources in the HPA to reduce their emissions by 40% by 2030, from the 2019 baseline. This includes sulfur dioxide (SO₂), PM10 (particulate matter) and PM2.5, as well as nitrogen oxides, carbon monoxide and other pollutants. Particulate matter refers to particles suspended in the air with a diameter of 10 micrometers or under, referred to as PM10, while PM2.5 refers to particles 2.5 micrometers or smaller.

“There’s no way that they’re going to achieve this reduction. The clear signal to us that they won’t achieve this reduction is that they keep providing Eskom with minimum emission standard postponements and effective exemptions,” Euripidou says. This is the source of the latest legal battle as groundWork seeks to end these exemptions.

Particulate matter pollution

“The mines and power stations are killing our people to give us the power we need,” says John Mthembu, 33, co-founder of VEM. It was founded 10 years ago due to a lack of engagement with the local communities from the authorities, mine owners and Eskom.

Mthembu lives in eMpumelelweni in the northern outskirts of eMalahleni with the nearest coal mine only a few hundred meters away. He moved to the area as his dad worked in the mines. He noticed his sinus problems getting worse and headaches that developed into migraines. They would disappear when he left eMalahleni and returned home to Mbombela, about 200 km (124 miles) east of eMpumelelweni, away from the coal belt.

“I will experience this sharp pain that comes at the back of the eye. I feel like the eye just wants to burst,” he says about his sickness.

Mthembu knew the air was the problem. “Any dust that I smell, it’s another severe headache,” he says. And dust is one thing not in short supply around eMalahleni.

As well as mining dust, the power stations also generate a lot of dust when the coal is transported on conveyor belts, crushed for burning or after the burning process, when ash is left behind.

Eskom’s standards say stations have dust management plans, including rehabilitating ash disposal sites to reduce the impact of wind-blown dust on communities. However, at Duvha, “they have a very huge space at the back of the power station where they throw their ash,” Moutloang says. “In August when there’s a lot of wind, that dust from the ash there makes the whole place white. So, the power station is equally responsible for our chest issues.”

Caradee Wright, chief specialist scientist at the SAMRC and co-author of the report, say these fine particles are what they, and the World Health Organization (WHO), are extremely worried about.

Due to their small size, these fine particles can cross over into your bloodstream and other organs, including the brain. These particles can also cross the placenta and impact the development of unborn fetuses.

“It is why we see effects like congenital birth defects, or anomalies like orofacial cleft lip and palate associated with air pollution exposure,” Wright says.

The WHO has air quality guidelines of less than 15 micrograms (μg) of PM2.5 per m3 in any 24-hour period. It has also laid down four interim targets to meet along the way for regions struggling with air pollution. The first interim target is 75 μg/m3.

In March this year, the background PM2.5 count at one air monitoring station in eMalahleni hit 187 μg/m3. That same station recorded PM10 pollution above 800 μg/m3 for every day in June 2025. The WHO air quality guideline is 45 for 24 hours, with a first interim target of 150.

Residents are aware of the town’s dangerous air. Everybody knows “this is not a town you live in for too long,” says Umqubisi, a trainee car mechanic, who declines to give his last name for fear of losing business and has been in eMalahleni for almost two years. He will leave in a few months once he has his trade certificate from a local university.

Pollution from the chemical sector

In Secunda, approximately 75 km (47 mi) south of eMalahleni, within the Highveld Priority Area, Tshepiso Mtsweni, 34, lives along with her daughter in the vicinity of a coal-to-liquid refinery operated by Sasol, a chemicals company partly owned by the South African state.

Pollution from the refinery often forces them to wear masks even inside their house. “It’s worse when it’s raining because that’s when Sasol releases a lot of chemicals and the smell is terrible,” she says. The mask “doesn’t help 100%, but at least you can breathe.”

The refinery turns coal into synthetic liquid fuels used in vehicles, as jet fuel and generates other by-products used in the production of chemicals. It is the world’s only commercial coal-based synthetic fuels manufacturing facility and is often cited as the world’s largest single point source of carbon.

Mtsweni and her daughter both suffer from sinus issues, eye irritation and breathing difficulties while others in the area, such as her grandmother, have asthma.

On top of this, “If the rain touches your skin, you’ll itch a lot,” she says. Mtsweni saw a dermatologist about her itchy skin, who diagnosed it as acne, and after a few months of treatment it went away. But after a couple of years it returned, and now she tries to avoid the rain. When she’s away from Secunda, she notices that her skin is better and the rain doesn’t irritate it.

Excessive sulfur dioxide in the atmosphere can make the rain more acidic. The WHO’s Air Quality Guidelines aim for fewer than 15 parts per billion (ppb) of sulfur dioxide (SO₂), in any given 24-hour period. South Africa’s national guideline says 48 ppb for 24 hours.

Earlier this year, an air monitoring station in Secunda recorded SO₂ levels of 370 ppb.

“Across multiple districts, statistically significant associations were found between PM₁₀, SO₂ and mortality,” the SAMRC report says.

South Africa’s National Air Quality Officer found Sasol was not in compliance with national ambient air quality standards in Secunda and compelled it to limit SO₂ emissions from its boilers by 2025. However, Sasol successfully appealed this decision in 2024, arguing it was not possible to carry on operating with those restrictions.

Then-Minister of Forestry, Fisheries and the Environment Dion George permitted Sasol to measure its SO₂ emissions on load-based emissions rather than concentration-based emissions, so it measures the total volume of SO₂ it releases rather than the concentration in the atmosphere.

Campaigners argue this effectively lets Sasol decide how its emissions are measured, allowing it to pollute in excess of what is permitted by South Africa’s emissions standards.

Sasol has subsequently sought legal clarification on the target of reducing emissions by 40% by 2030. The company has said it will seek to have any legally binding limitations placed on its emissions at Secunda set aside.

“They are consistently seeking to delay and weaken the requirements for reducing the SO₂ emissions from the boilers at the Secunda plant, saying compliance is not technically or financially feasible,” Euripidou says.

“Sasol interprets the 40% target as an industry-wide collective goal, not a mandate for each individual facility,” a Sasol spokesperson tells Mongabay. Sasol’s own emission reduction plans “may not result in a 40% reduction in emissions from Sasol Mining or Sasol Secunda Operations, individually.”

But reductions at Sasol’s other plants will not better health conditions for residents leaving around Secunda’s coal-to-liquid refinery.

No way out

Mtsweni says many are scared to speak out about the problems Sasol causes. “People work with Sasol to tame community members, they threaten you, they beat you,” she says.

She is not the only one. Across the Highveld Priority Area, people are reluctant to talk, often because of fear of retaliation or jeopardizing employment opportunities if you’re known as a troublemaker.

“If you start talking too much, like I do, they [Eskom] try and shut you down or try and bribe you,” Moutloang says.

Sasol, however, insists it doesn’t tolerate any intimidation of community members raising concerns. “We have formal grievance, whistleblowing and stakeholder engagement channels in place to ensure concerns can be raised safely and confidentially,” says MJ Khan, a spokesperson for Sasol.

Ephraim Maseko, a petrol attendant in eMalahleni, has asthma from years spent outside in the surrounding area of the various power plants. He is turning 60 and looking forward to retirement and going where the air is better.

Not everybody has that option. Mtsweni would like to move away from Secunda with her daughter permanently but cannot currently afford to.

Doctors have told Mthembu he has sinus pressure, the nasal passage is closing and he needs either an operation or to leave eMalahleni. Neither option is feasible for now.

Even for those who work in the mines, the health impacts can derail lives in more ways than one as employers can simply cuts loose those now too sick to do the work.

“When [my dad] went to get his medical check-ups they said, no, he’s no longer fit enough to continue working in the mines,” says Mthembu on how his dad’s time as a coal miner came to an end.

Although moving away to where the air is cleaner can bring improvements, spending significant time living in heavily polluted areas means risks persist, particularly from damage to the lungs and increased risk of stroke.

Jobs often go to those not from the area. Having lived by the power stations their whole lives, people from eMalahleni are often deemed not healthy enough for the jobs, Mthemba says.

Banner image: Kusile Power Station, South Africa’s largest plant at 4,800 MW, on the outskirts of eMalahleni. Image by Joe Walsh for Mongabay.

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Cite this article

Joe Walsh (2026). Failed promises to clean air in South Africa’s coal belt take toll on public health. Mongabay Conservation news. DOI: https://doi.org/10.66709/news-321552

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