The smoke now has a patient count, and 40,000 of them are toddlers

The fire season now has a national health tally. Indonesia's Health Ministry counted 174,694 cases of acute respiratory infection between August and 21 September, in the regions worst covered by smoke across Borneo, Sumatra and Papua. That term covers infections of the nose, throat and lungs, the coughs and fevers that fill a clinic waiting room. More than 40,000 of the patients were toddlers.

Then Suyanti, an official at the ministry, pointed to PM2.5 as the reason, the fine particles in smoke that she described as smaller than a human hair and able to carry health risks such as respiratory infection. Particles that small are not stopped by the nose and throat. They travel into the lungs and, in small bodies with small airways, they do more damage per breath. The ministry has been handing out oxygen canisters in affected areas, which says something about the stage this has reached: the response is no longer only masks and advice, it is help with breathing.

The smoke is not staying inside Indonesia either. The Agence France-Presse report carried by the South China Morning Post says haze from the fires has spread over parts of Malaysia and Singapore, and air quality readings have fallen in both. Indonesia's own population is more than 280 million, spread across the islands where the fires burn, so the counted cases are a floor rather than a ceiling. They only include the people who reached a clinic and were recorded.

Why it matters

A counted case is what moves supplies, so if your local health centre has run out of oxygen or masks while cases in your district are rising, that gap is now documented and worth pressing your puskesmas and district health office about. Parents of children under five have the strongest reason to go early rather than wait a cough out, since small children make up a large share of the cases already counted. Watch whether the tally keeps climbing once the rains arrive, since that is the real test of whether the fire response worked.