THE FOREIGN SERVICE JOURNAL | JULY-AUGUST 2025 45 Antananarivo. Worldwide, many low-income nations are experiencing rising air pollution and health impacts, especially in the most populous urban areas. Madagascar relies on slash-and-burn agriculture; woodburning stoves for cooking; and fossil fuels for cars, trucks, and buses that share the road with pedestrians. Typical sources of air pollution also include smoke from industrial facilities, brick and charcoal manufacturing, and forests, which are frequently burned to create agricultural land and charcoal. Many vehicles do not meet international emissions standards, burning diesel, leaded, or low-grade fuels that are not permitted in higher-income countries. Combined, these sources create troubling levels of emissions. Special training for embassy health units on the effects of air quality on health would provide a consistent and well-informed response to this serious issue. ESTH officers like me could work with medical unit staff and health technicians at post to promote air quality awareness, perhaps with a week of social media, news briefings, events, and speakers—similar to EPA’s annual Air Quality Awareness Week in the United States. Just as the military tracks health risks for those who serve, the Department of State should track long-term exposure to unhealthful air quality over the course of a career for Foreign Service members. The department, perhaps through OES, could work with health experts and our counterparts at the EPA and the U.S. Department of Health and Human Services to analyze the effects on vulnerable family members and share their findings. The State Department recognizes our service at hardship posts, but are the long-term detrimental effects of poor air over the course of our overseas service factored into this equation? What We Can Do Although we cannot control foreign government policies, the State Department does ensure new embassies are built with highquality air circulation to provide clean air while at work. We have an opportunity to build on this department effort. For example, the EPA and the department could work together to create a threshold for air quality exposure by post and over the course of a career. As I learned in Madagascar, a yearly average masks seasonal and daily fluctuations to which we are exposed during our commute, our daily jog, and when our children play outdoors. Setting a threshold would help to inform and protect us and our families while we serve our great nation abroad. But a threshold is not enough—we want to do everything we can to protect Foreign Service members and our families when they leave the embassy or consulate compound. Just as the EPA provides standards for emissions back home in the U.S., the State Department could provide air filters to every household that meets a threshold of pollution during any given day or season. We could work with embassy schools to purchase air filters and schedule outdoor sports and play during lower pollution times of the day. In this way, we could promote clean air both at work and at home, for ourselves and our loved ones. With my Madagascar tour behind me, I find myself reflecting on the many Foreign Service members and their families serving in cities with high levels of air pollution. When serving our country abroad, we must also look after ourselves and our health. While the Department of State might send us wherever the wind can take us, we can all do our part to increase awareness and mitigate health risks to ensure that wind is safe to breathe. n If we could procure air quality measurements elsewhere in Madagascar, we would understand how air quality varies from place to place and learn where and how often Foreign Service members on the island were being exposed to poor air quality. Air Quality Monitor Program Paused On March 4, 2025, the IoT Network, which is used to transmit data from the Air Quality Monitoring Program to the EPA’s AirNow and other websites, was paused due to funding issues. U.S. citizens abroad, including U.S. diplomats and their family members, have relied on this data in more than 80 cities globally to understand local air quality conditions and better assess their risks of both short- and long-term pollution-related illnesses.
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