Wildfires have scorched roughly 1.9 million hectares across Indonesia since the start of the year, blanketing Central Kalimantan and much of Southeast Asia in hazardous smoke.
The burned area is comparable to the US state of New Jersey or the entire landmass of Fiji, according to the open-access satellite platform Nusantara Atlas.
About 1 million hectares are estimated to have burned in September alone.
Haze Reaches Neighboring Countries
The fires have released fine particulate matter, carbon monoxide and other pollutants into the atmosphere.
The resulting haze has spread across Indonesia and reached Singapore, Malaysia and the Philippines.
Indonesia's Health Ministry recorded more than 277,000 cases of chronic coughs and acute respiratory infections as of mid-October.
More than 62,000 of those cases involved infants and children younger than five.
In Palangkaraya, Dianyra Eka Nastiti said the pollution has made her anxious about her youngest child, who was hospitalized with bronchopneumonia at six weeks old.
"Sometimes at night my baby's chest makes a rattling sound," she said, describing her nightly worry about whether her child will cough the next day.
Natari Victoria, 22, received treatment at a health center in Palangkaraya after coughing for more than a week.
She said the fires have hit everyone's health hard, including young cousins and babies who are also coughing.
Fine particles in wildfire smoke can penetrate deep into the lungs and sometimes enter the bloodstream, potentially causing inflammation, chronic lung disease and a higher risk of premature death.
Children, older adults and pregnant women face particular risks during prolonged exposure.
Riduan, head of the Palangkaraya Health Office, said the sky over the city has turned yellow and hazy.
He warned that residents are breathing carbon dioxide and pollutants rather than fresh oxygen, leaving the body and brain short of sufficient oxygen.
Indoor Advice Hard to Follow
Health officials have advised residents in affected areas to stay indoors and limit outdoor activities.
Nastiti said household duties make that guidance difficult to follow consistently, citing the need to buy vegetables, stock food and purchase school supplies.
When the smoke becomes particularly dense, she brings her children inside to reduce their exposure.
The restrictions have also kept children from ordinary outdoor activities and in-person schooling.
In Ramang, a rural village about 50 kilometers north of Palangkaraya, 37-year-old Lola Macitri and her family have also spent much of their time indoors.
She said the haze shifted from dusty gray to amber yellow and then burnt orange over several weeks.
Children in heavily affected areas have been attending classes online, while farmers, daily-wage workers and small vendors face difficult choices between earning a living and limiting their exposure.
"If you ask whether we are afraid of the health risks, of course we are. But where else can we go?"
Macitri said.
Authorities have used aerial water bombing and experimental weather modification to suppress fires, alongside ground operations.
Last week, the government said it had deployed more than 60,000 personnel for a land operation and claimed an 80% success rate in extinguishing new fires.
Dr. Nisa Novita, a forestry expert and peatland researcher at Yayasan Konservasi Alam Nusantara, called for every safe and effective firefighting option to be used.
She likened the effort to saving a sinking ship, urging urgent action to prevent further damage while it is still possible.
Firefighters continue to face difficult conditions as underground peat fires persist even after surface flames are extinguished.
Juni, who has spent more than 100 days fighting wildfires, described the physical toll of prolonged smoke exposure as truly exhausting.
