Residents of Bosnia and Herzegovina have rallied across the country this week to protest government inaction in the face of dangerously high levels of air pollution.

Bosnia is one of the most polluted countries in Europe. Since the start of the year, residents of Sarajevo and other major cities have been choking on a thick fog made up of toxic fine particles, including PM 2.5. These particles are linked to long term health problems like lung cancer and heart disease, as well as autism and childhood obesity. While peaks in PM 2.5 are common in the wintertime in Bosnia, a lack of wind has exacerbated the problem.

Last week, the Swedish embassy in Bosnia tweeted that Sarajevo was “in a category of its own when it comes to bad air quality.” At the time of this writing, Sarajevo’s Air Quality Index found the level of PM 2.5 per cubic meter in the city was 144, which is deemed “unhealthy for sensitive groups.” Earlier this month that measure reached close to a “hazardous” level of 500.

Local officials have urged residents not to burn coal and wood, and banned the use of diesel cars. They have also offered free public transportation and free masks and air purifiers to children and the elderly.

But protesters say the government is not doing enough to tackle an issue that has now plagued the small Balkan country for decades. In a recent analysis (pdf, p. 156), the European Commission found that the Bosnian government lacks a “national or countrywide strategy or program” to monitor and address air quality and has not allocated enough funds to maintain devices that monitor air quality. The country also has no defined process for reporting air pollution levels to European and international authorities, it said.

The problem has been made worse in recent years as the Bosnian government welcomes Chinese investment in infrastructure projects, including coal-fueled power plants. In the northeastern city of Tuzla, the Export-Import Bank of China loaned the Bosnian state power utility $681 million to build a 450-megawatt coal power plant. Activists have accused the government of tampering with feasibility studies in order to get approval for the plant, which they say will increase toxic gas emissions, including ash and sulphur dioxide, and contaminate local water sources with mercury and coal slag. The EU Energy Community Secretariat is disputing the loan on the grounds that it is not compliant with the EU’s Energy Community Treaty. (Standardizing energy policies is a precondition for applying for EU membership.)

Experts say China is often the only country willing to still fund coal-based projects in the Western Balkans. The European Union, the World Bank, and other lenders have worked to phase out coal subsidies and cut emissions to meet global targets set by the 2015 Paris climate accord. A report published by the 2019 Munich Security Conference (pdf, p. 35) shows that in 2017, Bosnia owed 14% of its total foreign debt to Beijing.

There are 16 Communist-era coal power plants spread out across Bosnia and Herzegovina, North Macedonia, Montenegro, Kosovo and Serbia. According to a report (pdf, p. 5) published earlier this year by five European environmental nonprofits, those plants emitted more sulphur dioxide in 2016 than all of the European Union’s 250 coal power plants combined. The group said that emissions from the Balkan plants cost between €6 and €11 billion ($6.7 to $12.2 billion) a year in productivity losses and healthcare expenses, and are linked to up to 3,900 deaths across Europe each year.