Indonesia’s wildfire haze is turning daily life in Borneo into a respiratory emergency
When smoke from the burning forests of Indonesian Borneo drifts through Palangkaraya, the air changes color before it changes breath. Streets fade into a rust-red fog, and by nightfall the fear inside homes often outweighs the heat outside. For parents like Dianyra Eka Nastiti, whose baby was hospitalized with bronchopneumonia at just six weeks old, the haze is not an abstraction. It is a nightly check for rattling chest sounds, coughing, and the possibility that another trip to hospital is coming.
The health toll is already large. Indonesia’s Health Ministry has recorded more than 277,000 cases of chronic cough and acute respiratory infections amid the smoke, and more than 62,000 of those cases involved infants and toddlers under five. The number points to a population-wide exposure event, not a series of isolated infections. In a setting where peatland and forest fires continue for weeks, the burden falls first on the smallest lungs, then on anyone with limited reserves: older adults, pregnant women, outdoor workers, and children who cannot simply stay behind sealed doors.
The scale of the burning helps explain why local clinics are filling. Some 1.9 million hectares have burned across Indonesia since the start of the year, according to open-access satellite monitoring, with roughly 1 million hectares burned in September alone. The flames are only part of the problem. Smouldering peat and forest generate a dense mixture of microparticles and carbon monoxide that hangs over communities and travels beyond Indonesia’s borders, reaching Singapore, Malaysia and the Philippines. In clinical terms, this is a prolonged inhalational assault: fine particles penetrate deep into the lungs, trigger airway inflammation, and in some cases enter the bloodstream. Over time, that exposure raises the risk of chronic lung disease and premature death.
One sentence explains the fear that keeps families indoors: the smoke is making children sick while their lives still have to continue.
Natari Victoria, 22, was admitted to a health centre in Palangkaraya after coughing for more than a week. Her story mirrors what physicians and public health workers are seeing across Central Kalimantan: repeated respiratory symptoms, persistent irritation, and a sense that the air itself has become hazardous. In nearby Ramang, 37-year-old Lola Macitri describes a household rhythm shaped by the smoke. Her children attend school online. Adults work in short shifts when they can. Outdoor movement has become a calculation about whether food, medicine, and school supplies are worth the exposure.
The official advice in haze-hit areas is straightforward: stay indoors and limit outdoor activity. Real life is not. Nastiti still has to shop for vegetables and other essentials. Macitri and many others must keep earning where possible, even when the atmosphere feels poisonous. For farmers, daily-wage earners, and small vendors, the choice is often between respiratory risk and lost income. Public health guidance can reduce harm only when people have the means to follow it, and in many villages that safety margin does not exist.
Children are the most visible casualties of that gap. They should be at school, playing outside, and recovering between episodes of ordinary childhood illness. Instead, many remain locked inside homes for long stretches as haze intensifies. Prolonged exposure is especially dangerous in the very young because their airways are smaller, their respiratory rate is higher, and their reserve against inflammation is lower. When particulate load stays elevated day after day, even minor infections can tip into more serious illness, as the cases of cough and bronchopneumonia make painfully clear.
Firefighters are confronting a different but equally punishing injury pattern. Juni has spent more than 100 days battling blazes that appear to weaken at the surface while continuing to burn underground through peat and dense organic matter. He describes shortness of breath, a persistent cough, and eye pain, along with a single need: air. Peatland fires are especially difficult because they do not behave like ordinary surface fires. They can smoulder beneath the soil line, consume deep reserves of carbon, and demand large volumes of water for long periods. Fauzi Rahman, another firefighter in Palangkaraya, said areas on regular land may be cleared in a day, while peatland fires can take months because water must be injected deep into the ground.
Weather has amplified the crisis. A Super El Niño has sharpened drought conditions and delayed the rainfall needed to suppress peat fires. Water scarcity then feeds the fire cycle, leaving responders with fewer tools and more ground to cover. In response, Indonesian authorities have deployed more than 60,000 personnel, using aerial waterbombing, weather modification, and land operations aimed at suppressing new fires. Officials say they have achieved an 80% success rate in extinguishing new blazes. Even so, smoke continues to rise, and some fire teams are now reporting flames in areas with no prior fire history.
The spread into new territory matters because it suggests the problem is no longer confined to familiar hotspots. As peatlands dry and burn in places that had not previously been vulnerable, the human and environmental cost expands with each ignition. Dr Nisa Novita, a forestry expert and peatland researcher with conservation NGO Yayasan Konservasi Alam Nusantara, argues that every safe and effective method should be used to suppress the fires before more damage accumulates. Her warning matches what the hospitals are seeing: every day of delay adds more inhaled toxin, more sick children, and more exhausted responders.
Riduan, head of the Palangkaraya Health Office, says the sky has turned yellow and hazy and that residents are breathing pollutants rather than fresh oxygen. His description is blunt, and the physiology is familiar. Reduced oxygen availability, combined with particulate injury and carbon monoxide exposure, can strain the brain, the lungs, and the cardiovascular system. The immediate crisis is not theoretical. It is measured in coughs, admissions, sleepless nights, and the repeated hope that rain will come before the next child worsens.