Every winter morning workers wrap scarves around their faces and emerge from the pea soup fog that engulfs their town of Obiliq, stuck between two coal-fired power stations on the outskirts of Kosovo's capital.
If nothing is done, "this place will become a new Chernobyl…. We will have to leave", said Agim Ibrahimi, 46, a manual worker who lives in the town.
"Three members of my family have died of cancer... It's a cancerous land."
Regardless of the wind's direction, the pungent smell of burnt coal permeates Obiliq, where 30,000 residents live between and around the plants, known as Kosovo A and Kosovo B.
Built between 1965 and 1975, the plants produce more than 95 percent of Kosovo's electricity but, combined with the coal heating of individual homes and busy urban traffic, heavily impact the air quality.
No monitoring takes place in Obiliq. But in the capital Pristina, 15 kilometres (nine miles) away, the U.S. embassy measures pollution levels, publishing data on its website, and places it high among the most polluted cities in the world.
Residents of Pristina, who often go out wearing a mask, don't need official data to voice their concerns about the pollution.
"Breathing seriously damages health," read a placard at a recent protest.
On February 17, Kosovo will mark 10 years since its declaration of independence from Serbia.
But pollution remains a huge stumbling block for the young country, one of the poorest in Europe.
Minister of Economic Development Valdrin Lluka told AFP that Kosovo lacked other energy options such as hydropower facilities.
"We don't have gas, we cannot create nuclear power plants. We have coal," said Lluka, who emphasised the importance of energy independence in Kosovo.
Haki Jashari, director of the small hospital in Obiliq, tells AFP that, while he obviously understands the importance of electricity, "we can't violate people's right to good health and a proper environment."
- Premature deaths -
Kosovo's national electricity company KEK owns 72 percent of the land in Obiliq and employs 4,700 people in the power plants or its mines, according to the mayor.
Sahit Zeqiri, head of the local technical school, says everything is contaminated: "The air that we breath, the soil that we cultivate, the water which we drink".
Every day in winter, he says, five to 10 students are missing, victims of bronchitis.
Outside sports are banned, and this year, owing to a lack of snow or rain, particulate matter remains suspended in the air, he adds.
No epidemiologists have come to calculate the full health impact of the two plants that relentlessly belch out smoke.
Kosovo A is originally a Soviet design that has been refurbished many times, while the more modern Kosovo B used ex-East German technology for coal mining during the Cold War era.
In 2013, the World Bank estimated that the annual cost of pollution for Kosovo and its 1.8 million inhabitants came to 223 million euros ($275 million) -- equivalent to 5.3 percent of its gross domestic product.
"Air pollution is estimated to cause 852 premature deaths, 318 new cases of chronic bronchitis, 605 hospital admissions and 11,900 emergency visits each year," said the report.
- International aid ? -
Retired librarian Ruzhdi Mirena, 63, chants a litany of the dead and sick, pointing a finger at the houses of Hade, a hamlet backing on to a coal mine.
"There are 85 families here, and believe me or not, there is not one there who has not been affected by cancer."
Jashari said he registered 88 new cancer cases in 2017, also noting cardiovascular diseases and various other conditions.
"Those who can, leave, to get away from disease and protect their children," he said.
Minister Lluka has announced plans for swift improvements. With the help of the European Union, the filters at the Kosovo B plant are to be changed.
In December, Kosovo signed a deal with a U.S. power generator for a 1.3 billion-euro plant to replace Kosovo A, which Lluka said would ensure 25 times fewer dust emissions and four times less carbon dioxide.
"We are not only faced with the current challenges, but with accumulated pollution," said Edmond Nulleshi, a manager at KEK, which invested 60 million euros in the environment between 2012 and 2015.
Under a law passed in 2016 but as yet not implemented, KEK will pay Obiliq 20 percent of the value of the coal it mines, which will triple the town's budget.
This could help to measure the air quality, clean the soil and strengthen medical prevention, according to Mayor Xhafer Gashi.
For Kosovo B to introduce brand new technology and meet EU standards it would take 300 million euros, said Nulleshi, who hopes for the help of international donors.
"It is not that we lack environmental awareness, but we are not at the level of western Europe in terms of capabilities," he said.
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