Breathing Through Dhaka's Air: Managing Asthma in Bangladesh
With some of the worst air quality in the world, millions of Bangladeshis struggle with asthma. Here's how to manage it properly, not just survive it.
Dhaka consistently ranks among the most polluted cities on Earth. And if you have asthma, every breath can feel like a battle — especially during winter when the AQI regularly crosses 300 (anything above 150 is 'unhealthy').
Asthma affects an estimated 7% of the Bangladeshi population. That's roughly 12 million people. But the way most people manage it here — reaching for a Salbutamol inhaler when they can't breathe and ignoring it otherwise — is dangerous.
The Inhaler Misconception
There's a deeply held belief in Bangladesh that 'inhaler asukt' (inhalers are addictive). This is categorically false. An inhaler delivers medicine directly to your lungs, which means lower doses and fewer side effects than tablets.
There are two types and people confuse them:
Reliever (Blue/Salbutamol): Use during an attack. Opens airways quickly. If you need this more than twice a week, your asthma isn't controlled.
Preventer (Brown/Orange — steroids): Used daily to prevent attacks. This is the one most Bangladeshis skip because they 'feel fine.' Then they get a severe attack and end up in the ER.
Managing Asthma in Bangladesh's Environment
- Check AQI daily (apps like IQAir or the Bangladesh government's CASE portal). Stay indoors when it's above 150.
- Use your preventer inhaler daily, exactly as prescribed.
- Keep windows closed during brick kiln season (October-March).
- Wear a proper mask (N95, not surgical) when outdoors in high pollution.
- Identify your triggers: dust, mold, pet dander, cold air, exercise.
- Get a flu shot annually — respiratory infections trigger severe attacks.
When to Go to the Emergency
- Reliever inhaler isn't helping after 15-20 minutes
- Can't complete a sentence without stopping to breathe
- Lips or fingernails turning bluish
- Breathing rate above 25 breaths per minute
Asthma can't be cured, but it can be controlled so well that it barely affects your life. Talk to a pulmonologist or medicine specialist about an asthma action plan.