On May 29th, 2009, Michelle Dugan and her family began the 600-mile trip from El Centro, California to the Bay Area, where she was set to attend her college orientation. They left late Friday evening, driving through the dusty Imperial Valley landscape and its endless fields of onions, spinach, and alfalfa. Then on to Highway 86, past the desolate shores of the Salton Sea, toward Michelle’s grandmother’s home in nearby Coachella, where they would spend the night before the next day’s long drive.

But at around 9PM, Michelle’s mother received a call: Michelle’s younger sister, Marie, was suffering a severe asthma attack back home and had been rushed to the emergency room. Michelle’s mother hurried back to the hospital, leaving Michelle at her grandmother’s and telling her not to worry.

It’s unclear what triggered Marie’s episode that day, but it was so severe that the nebulizer she used to inhale medication — sometimes five times a day — had no effect. Her airway constricted until she was no longer able to breathe and, choking on her saliva, she lost consciousness. Marie made it to the hospital with a faint pulse, but efforts to deliver CPR failed. Just after 11:30PM, Michelle received the call that Marie had died. She left for El Centro immediately. The drive back, she says, was the longest hour and a half of her life.

Michelle was shocked by her sister’s death — between the two of them, Marie was supposed to be the healthy one. It was Michelle who had been hospitalized for asthma since she was an infant. “Lung infections, bronchitis — everything,” she says. “You name it, I’ve had it.” Though she’s only 27, she’s been told she has the lungs of an 80-year-old; doctors have talked about listing her for a lung transplant.

Asthma in Imperial County is rampant. More children are admitted to the emergency room here for asthma-related cases than anywhere else in the state; almost 1 in 5 children suffer from the condition. There’s a long list of reasons why the county is home to such staggering rates of asthma: the fine layer of dust that coats nearly every surface; the gentle mist of pesticide sprayed across acres of produce; the black towers of soot emanating from crop burns; emissions from cars stalled at the border; and fumes from the Mexican maquiladoras wafting over the border. Kicked up by the strong desert winds, microscopic particles from each of these sources fill the air.

There’s another source of pollution in the valley that poses a major risk, though it’s only starting to make itself felt: the Salton Sea. An enormous blue void at the north end of the Imperial Valley, the Salton Sea once attracted more visitors than Yosemite. But California’s largest lake is now mostly forgotten, and those who know of it don’t have flattering things to say: they’ll tell you about vast beaches where the sand is made of fish bones; about eerie, half-abandoned Mad Max-esque communities; and most of all, its noxious emissions. In 2012, the Salton Sea burped up a cloud of sulfurous odor so thick that residents in Los Angeles 150 miles away were hit by the nauseating smell of rotten eggs.

Though it’s been shrinking for decades, on January 1st, 2018, the Salton Sea entered a nosedive. Thanks to a water transfer agreement with San Diego, 40 percent less water will now flow into the sea. It will recede dramatically, and its already shallow surface level will drop 20 feet. By 2045, its waters will be five times as salty as the Pacific Ocean, killing whatever fish still live there and scattering the birds that feed on them.

Though we often think of lakes as permanent landmarks, global warming, irrigation, and our constant thirst threaten these resources around the world. Terminal lakes like the Salton Sea, bodies of water that have no natural drain, are particularly vulnerable. Iran’s Lake Urmia — once the largest body of water in the Middle East — has shrunk by almost 90 percent over the last 30 years; Africa’s Lake Chad is also 90 percent smaller than it was in the 1960s; and Kazakhstan’s Aral Sea, once the fourth largest salt lake in the world, has practically been wiped off the map.

When these lakes evaporate, they can upend industries and erase surrounding communities. For residents near the Salton Sea, the most pressing problem is the threat of toxic dust. The receding Salton Sea will reveal at least 75 square miles of playa, the lake bed that the water once hid. When that soil dries, it will begin to emit dust laced with industrial runoff from the surrounding farms: up to 100 tons of dust could blow off the playa daily. If it isn’t captured, that dust will push the area’s asthma crisis from bad to dire. The Salton Sea is a dust bomb that has already begun going off.

Marie’s death shifted the course of Michelle’s life. She never made it to the Bay Area and today she lives in Coachella, where her day-to-day is constrained by the limitations of her asthma: she uses a nebulizer three times a day, and straps on a vibrating vest to shake the mucus from her lungs every morning and night. She spends as little time outside as possible, moving quickly between her home, car, and office. She’s terrified of leaving her two children behind. In turn, they are vigilant about her condition. Her daughter, who is named after Marie, runs to start the nebulizer the moment she sees her mother is out of breath. “For a six-year-old to do that, it’s really heartbreaking.”

Michelle says she knows the sea is a threat to her, and everyone in her community. When the hot desert wind blows through the valley, through the date palms and up into Coachella, the sea’s stench is undeniable. “It smells like death,” she says.

Randy Brown became the first person to walk the perimeter of the Salton Sea after deciding that hiking through Death Valley wasn’t enough of a challenge. “Anybody can walk across Death Valley in the summer,” he tells me. The Salton Sea was another matter: a Death Valley walker had attempted something similar in 2005, but settled for walking the nearby highway. And for good reason.

Temperatures around the Salton Sea can climb to over 120 degrees Fahrenheit in the summer — in 1902, the nearby town of Volcano set an all-time US heat record for the month of June: 129. Humidity from the evaporating sea can make the air feel closer to 150 degrees. The earth here is gassy and, combined with the massive bacterial colonies that live in the water, can create a suffocating potpourri.

The sea’s northern shore is covered in deep banks of dead barnacle shells and pulverized fish carcasses. “The best I can describe it as is like trying to walk through snow,” Brown says. Other parts of the shore are covered in mud and silt so fine it resembles quicksand. Brown remembers his dad telling him stories of duck hunters dying here of exposure, sinking deeper into the mud as they struggled to pull themselves out.

Once, the Salton Sea was an oasis. It formed in 1905, when flood waters breached a nearby canal, sending the entire volume of the Colorado River into what was then a dry, ancient lake bed called the Salton Sink. It took two years to patch the break; in that time, a lake almost twice the size of Lake Tahoe had sprung to life. By the middle of the 20th century, developers had recast the accident as a miracle, dubbing the area “the Salton Riviera.” Palm trees were planted and marinas were built; President Eisenhower shot a round at the Salton City Golf Course and the Beach Boys docked their boat at the North Shore Beach and Yacht Club. Completing the atomic era fantasy, dozens of pink flamingos took up residence at the sea — escapees from the San Diego Zoo or live attractions brought in by a nightclub owner, depending on who you ask.

Randy Brown was familiar with the sea from childhood. Growing up in the ‘70s, he and his family would make the 150-mile trek from Monrovia, California to the Salton Sea every summer weekend. The area was still booming then. “If we didn’t get there Friday night or early Friday afternoon, there would be no room at the beach,” he says. Stocked fish populations had exploded, and fishermen spent days angling for Gulf croaker, tilapia, and orangemouth corvina, a prized game fish that can grow to over 30 pounds. “We would come home with 80–100 fish every weekend,” Brown recalls.

Those fish attracted enormous flocks of ducks, grebes, and even bald eagles; 450 different bird species and subspecies have been spotted here. Eighty percent of the continental population of American white pelicans wintered at the sea, grateful to find refuge in a state that was in the process of ruthlessly paving over its wetlands.

A 1960s promotional video for the Salton Sea.

But by the end of the ‘70s, it was apparent that something was deeply wrong. “One year we went and the beaches were covered in dead fish — it was a real oddity,” Brown says. Then it happened again the next year. Two freak tropical storms in the late ‘70s flooded the area, washing away investments that never returned.

Like thousands of others, the Browns stopped coming, though Randy says that had less to do with the conditions at the sea: as a teenager, he “discovered girls, partying, and alcohol,” and lost interest in family vacations. His parents moved away into California’s high desert.

By the ‘80s and ‘90s, the sea was trapped in an intense cycle of ecological collapse. With only the rare desert rainstorm and salty, nutrient-rich farm runoff to feed it, the seawater grew more saline by the year. Large algae blooms starved the water of oxygen, causing fish to drown. Their decomposing bodies fed more algae, kickstarting the cycle all over again. In the summer of 1999, almost 8 million tilapia died in a single day, their silvery corpses spread along the shore in a band that measured three miles wide and 10 miles long.

“They stood still while gulls tore into their flesh and began eating them on the spot.”

In turn, the birds that relied on these fish suffered from botulism and other diseases. Just in 1996, 15–20 percent of the Western population of white pelicans died here. Reporting for the Smithsonian that year, Robert H. Boyle wrote that 150,000 eared grebes had also died, with the surviving population “so disoriented that they stood still while gulls tore into their flesh and began eating them on the spot.”

As the sea decayed, so did vacation communities like Salton City, Desert Shores, and Bombay Beach. A 2004 documentary about the Salton Sea, narrated by John Waters, captured a cross-section of the residents who now populated these towns: retirees clinging to the dreams they’d bought into, refugees from Los Angeles looking for a cheaper existence away from urban violence, and offbeat recluses who were fond of the sea’s latest incarnation. “It’s the greatest sewer the world has ever seen,“ said one resident. “Leave it that way.”

In 2003, the Imperial Valley and San Diego signed the largest agriculture-to-urban water transfer agreement in US history. The Valley would now be selling much of its water to thirsty communities along the California coast, at a handsome profit. That meant less water going to farms, and less runoff flowing into the sea. The agreement included an easement period which expired at the start of 2018. It was thought that 15 years would be more than enough time to develop a solution for the sea, and the dust beneath it. But no solution came.

An ambitious 2007 proposal to build a healthy lake inside of the dying lake was shelved because of its $8.9 billion price tag. The state balked at the cost of two more proposals in 2015, costing $3.1 billion and $1 billion, respectively. More creative proposals to desalinate the sea or even pipe water from the Pacific Ocean or Mexico’s Sea of Cortez have gone nowhere.

“It was not quite dead, but it was dying.”

In 2014, Randy Brown traveled to the Salton Sea for the first time in decades. Instinctually, he returned to the beach where he’d spent so much of his childhood. He was taken aback by the sight. “It was not quite dead, but it was dying,” he says. Around the perimeter of the sea, establishments had been burned out, left vacant, or wiped from the landscape as if they’d never existed. Because of the high salinity, the fish populations had begun to collapse — it’s rumored the last corvina was caught here sometime in the mid-2000s — and fewer birds were coming, too. One flamingo still remained, though she would disappear soon after. The sea had receded 100 yards from where he remembered it.

Over the course of six days in June 2015, Brown completed the 116-mile walk, becoming the first person to successfully circumnavigate the shore on foot. When I asked him what stunned him most about the experience, Brown kept coming back to the receding shoreline.

On one of his first training walks in 2014, he came across a speedboat halfway out of the water. It was black and orange, and emblazoned with the name “Godzilla.” He liked it so much he took a picture of it. As he did the final walk one year later, he passed Godzilla again and took another photo. But now, the boat was 50 yards from the water’s edge. In between was nothing but soft, dusty playa.

When the wind blows in the Imperial Valley, a faint haze of dust rises from the earth. You can taste it on your tongue. Harder gusts summon clouds that shroud the sun, blinding drivers and forcing residents indoors. The dust kicked up by 65 mph winds this April delayed camping at the Coachella music festival for days. The air in Imperial County is some of the worst in the country, a dense blend of ozone and particulate matter. In 2015, the air here failed to meet California’s daily safety standards for more than a third of the year.

You only need to spend a few days in the Imperial Valley to see signs of the asthma epidemic. Many children are born asthmatic here; a recent study found that 30 percent of parents at a Calipatria elementary school said their children had been diagnosed with the condition. Three elderly women standing in front of their home in the town told me that even healthy children under the age of one should remain indoors. Cindy Aguilera, who’s lived in El Centro for 11 years, has six children ranging from ages nine to 18, all of whom have asthma. Her nine-year-old has been hospitalized over 100 times, once for 15 days. Humberto Lugo, who works for a nonprofit that focuses on economic and environmental justice called Comite Civico Del Valle (CCV), says that his 10-year-old son goes to baseball practice with a glove in one hand and an inhaler in the other. “It’s a way of life here.”

These communities have tried to adapt to the air pollution. The Respira Sano program, a joint effort between CCV and San Diego State University, sends health workers on home visits to consult families on how to best protect themselves. If you live by a crop field — as many here do — windows and doors should be kept shut, especially when the spraying starts. Parked cars should have their windows closed to keep particulate from settling in the upholstery. Even dogs and cats need to be kept inside to keep their fur from soaking up pollutants.

Above all, it’s important to minimize how much time children spend outside on bad days. CCV’s Lugo and his colleague Esther Bejarano drove me out to Meadows Union Elementary school, which takes part in the nonprofit’s School Flag Program. Meadows sits on the outskirts of El Centro, and is boxed in by three fields and a highway. Bejarano went to school here, and she says she and her sister would dance in the spray of crop dusters, pretending it was fairy dust. (Though she is asthma-free, Bejarano’s two sons have asthma, as do her mother-in-law, sister-in-law, and two nephews.)

Schools then raise green, yellow, orange, or red flags

Using a network of 40 monitors developed by CCV and dispersed through the Valley, the school can see real-time readings on air quality throughout the region. Depending on conditions, schools then raise green, yellow, orange, or red flags. If a red flag is up, teachers and school administrators know to keep kids indoors. The school’s janitor told me that the number of orange and red days has gone up in recent years.

But educational programs like these are stopgap solutions — knowing risks doesn’t protect you from them. Saima Khan is a pediatrician and the associate medical director at Clinicas de Salud del Pueblo, a clinic for families with low incomes. She briefly left the Imperial Valley to treat patients in a private clinic in upscale Rancho Cucamonga just outside Los Angeles, but eventually came back, she says, because she felt a responsibility to attend to a population in greater need. That decision has come at a cost.

Both of Khan’s daughters have developed asthma and six years ago, Khan was diagnosed with it herself. She has a 15-month-old child, who she says is fine for now, though she pays close attention to his breathing. Her husband wants to leave the area; he has recently developed severe allergies and Khan says she can hear him wheezing. When I ask whether she feels the pressure to leave, she tells me she’s torn. “Why are you still here and making us all sick?” her family asks her.

The option of leaving is a luxury few here can afford. One in four live in poverty in the Imperial Valley. As demand for housing in California continues to outstrip supply, middle and lower-income families are forced to move to less hospitable corners of the state. Many of the people I spoke with expressed a desire to leave, but almost none had the means of doing so.

I met Carolina Villa, another asthma patient in the Valley, in front of her old high school. Holtville High also participates in the School Flag Program, and on the day of my visit, I could see a green rectangle hoisted high up the flagpole. Villa tells me she was a former track star, and once ran a 5:54 mile before asthma and the general stresses of age slowed her down. “The reality of it is,” Villa says, “most people can’t afford to move out of where they live.” Leaving behind your community, and family, is hard. So instead, they learn to make do. “Kind of like those chameleons that change colors.”

But ocean breezes help her asthma, and Villa says she’d like to live by the water one day. “I think about buying property by the beach,” she says with a raspy laugh. “Right by the Salton Sea. It’s the only beach I can afford.”

Dry lake beds are some of the largest sources of dust on the planet. It’s estimated that every year, the Sahara Desert exhales 28 million tons of nutrient-rich dust that travels across the Atlantic Ocean to fertilize the Amazon rainforest. That dust migration creates plumes so large they can be seen from space. But half of that dust comes from less than 0.5 percent of the Sahara — the dusty lake bed of what was once Lake Chad.

No matter what it’s made of, particulate matter poses a hazard to those with respiratory problems. But when it’s laced with a century’s worth of fertilizers and pesticides, as it is on the playa of the Salton Sea, it’s more dangerous. There is simply no way to make this dust safe. The best thing to do is keep it on the ground — or better yet, underwater. As drying lakes generate new and problematic dust sources, dust control has become a big industry.

From the Salton Sea, I drove 300 miles through California’s high deserts to the edge of the Eastern Sierra mountains, home to the largest dust mitigation project in the world. On the standard Google Maps view, Owens Lake appears as a large, baby-blue body of water. Switch to satellite view, though, and you’ll see Owens Lake for what it really is: a discolored scab left behind by a lake that no longer exists.

Owens Lake was made famous by the story of its plunder: in the early 20th century, Los Angeles piped its water south to slake the thirst of its growing metropolis. The draining of Owens Lake crippled the surrounding communities, but it was nothing compared to the calamity that followed. Once the water left, dust rose from the lake bed at staggering volumes, with thick walls of soot traveling up Owens Valley for up to 60 miles. Residents hid indoors, unable to see homes on the other side of the street.

Phil Kiddoo, the air pollution control officer now in charge of Owens Lake, says that on some days the lake bed emitted more than 100 times more dust than the federal government considers safe, spewing 75,000 tons of particulate matter every year. In the second half of the 20th century, this sparsely visited corner of the Sierra mountains became the single largest source of dust in North America.

In 1997, Los Angeles finally agreed to make amends by funding a massive dust suppression effort here. The 100 square miles of lake bed was divided by berms into roughly 75 cells, each one employing a slightly different dust mitigation technique: one cell might consist of a miles-long blanket of gravel, while another is planted with sprinklers, keeping the ground moist. A third cell might be covered by a shallow layer of hyper-saline, Pepto-Bismol-pink brine. These efforts have come at a significant price: the Los Angeles Department of Water and Power has paid out $2 billion so far and continues to fund air quality monitoring and year-round management. If these efforts were to be paused for as little as two weeks, Kiddoo says, the area would begin to dry up again, and the dust would return.

Residents hid indoors, unable to see homes on the other side of the street

It’s ugly and expensive, but it works. It’s estimated that the mitigation efforts now capture between 95 and 98 percent of the playa’s dust. Although a hard, 30 mph wind blew on the day of my visit, the air quality was no worse than what you’d find in Los Angeles. In fact, the air was brilliant: I could see clear across miles of lake bed, into Owens Valley, and off to the distant snow-capped peak of Mount Whitney.

Kiddoo is proud of what he and his team do, but he also admits, “You don’t want to end up here if you don’t have to.” As we drove across Owens Lake’s shattered landscape, I asked him what advice he’d give to those at the Salton Sea. He sighed deeply.

Before he worked in air control, he was an EMT. The experience taught him to triage injuries — weeding out the critically wounded from bellyachers. With the Salton Sea, Kiddoo says, “You’ve got a dying patient, and if you don’t act now, he’ll be dead.”

In March 2017, just nine months before the easement period expired, the state of California finally released a 10-year plan to address the Salton Sea. As the sea shrinks, the plan envisions diverting the remaining farm runoff and mixing it with Salton Sea water to create shallow, dust-suppressing pools along the shores to sustain wildlife and vegetation. Elsewhere, the state will dig ridges into the earth to trap fugitive dust, similar to techniques employed at Owens Lake. Depending on who you ask, the plan is either a case of “too little too late,” or “better than nothing.”

For one, the plan doesn’t address the sea’s central body of water. It will continue to shrink and concentrate until it becomes almost barren. (One official suggested to me that the exposed earth could be used to build a solar power farm.) In addition, the plan only addresses the sea’s north and south ends; there are no dust suppression projects for the significantly longer eastern and western shorelines, home to the struggling seaside communities of Desert Shores, Salton City, and Bombay Beach. As the shoreline recedes by miles, these waterfront communities — replete with docks and marinas — will be left marooned. Though it’s estimated almost 60,000 acres of playa will be exposed over the next decade, the state only outlines dust mitigations for less than 30,000 of them.

It will continue to shrink and concentrate until it becomes almost barren

After decades of empty promises, money is finally starting to come in for restoration efforts. The 10-year plan will cost almost $400 million, and 80 million of those dollars have already been appropriated; a ballot proposition passed in early June of 2018 allocated another $200 million. A November water bond could deliver $200 million more. Those are big numbers, but they pale in comparison to water projects the state has agreed to fund elsewhere.

And as residents here know, a plan — even a funded one — is no guarantee of action. “We have a plan, we have money, there is additional money lined up, and we have a constituency — myself included — that is running out of patience,” California assemblyman Eduardo Garcia said at a recent hearing established to address the continued delays. Though the plan was only introduced a year ago, state officials admit they are already running severely behind schedule. A recently published progress report indicated the state would miss its already modest 2018 goal of suppressing 500 acres, and only complete suppression on the 300 of 1300 acres planned for 2019.

One late afternoon, I traveled to the Red Hill Bay Restoration Project at the southern end of the sea. What was supposed to be a model for the rest of the sea has become mired in some of the complications and inertia that have plagued restoration efforts here from the beginning. Project lead Chris Schoneman gave me a tour of the area in his white Dodge Ram. After cresting a seawall now located hundreds of feet from the water, we made our way toward a boat launch that sits a third of a mile away from the shore.

The Red Hill Bay Restoration Project will divert nutrient-rich water from the Alamo, mix it with hypersaline water pumped from the sea, and release it into a large, shallow pool to create habitat for migratory wildlife. Alongside the pool, Schoneman’s team tilled dry playa to suppress dust. But because of unforeseen construction challenges and fiscal constraints, Schoneman admits the project is now $380,000 over initial budget. Originally slated to open in early 2017, he hopes it’ll be done by the end of this year.

Under the dust hid dirt the color of dried blood

As we walked past the outcropping for which Red Hill Bay is named, Schoneman kicked at the small dunes of dust that had gathered at his feet. Under the dust hid dirt the color of dried blood.

Unless wide-scale dust mitigation measures are put in place soon, the cost of the Salton Sea will continue to mount, both financially and in the health of the tens of thousands who live around the Imperial Valley.

Back in Coachella, sitting in the home she shares with her parents, two children, and her brother, Michelle Dugan says that she thinks about leaving Coachella, and maybe California altogether, though it’s expensive to move with children and she would miss her family. She says she’d like to go to Montana. She’s never been there, but she’s heard the air is clean.

Correction 6/6/2018 11:05AM EST: Patient John Paul Castro was incorrectly identified as John Paul Aguilera.