Erduana Smailbegovic Dzaferi meticulously lays out the pills, syrups, liquids, and equipment that she fears have become a regular part of her life, as well as the lives of many other Sarajevo residents, once winter rolls in.
As she does so, her child lies in bed, coughing and wheezing, the result, her mother insists, of another day breathing the air in one of Europe's most-polluted cities at a time when many are starting to reap the benefits of significant efforts to curb emissions.
The situation, which leaves Balkan cities conspicuously overrepresented on lists of the world's dirtiest, is being blamed by residents on bad government and anger is spurring accusations and calls for change.
"This is my life. This hurts. In the next room lies a child who hasn't stopped coughing for 48 hours, with the exception of yesterday's visit for a few hours to a mountaintop.... Is this picture normal?" she asks after a torrid period of poor air quality in December.
"It hurts me to know that two-thirds of the city hasn't got enough money to buy their children everything necessary to get healthy," she adds.
One of Smailbegovic Dzaferi's twins fell sick on December 3, a Monday. The preceding weekend, Bosnia-Herzegovina's capital had suffered through a heavy bout of pollution, one the region has become known for.
According to the World Health Organization (WHO), residents of nine out of 10 European cities are experiencing health effects due to their exposure to elevated levels of air pollutants.
At most risk? Those in the Balkans.
In the 2017 WHO survey of air quality in Europe, three of the top five most-polluted cities on average were found in Macedonia. The other two were in Bosnia and Montenegro.
Sarajevo didn't crack the top five, placing a distant 21st.
Still, the first weekend of December saw the Bosnian capital hit number one on the continent.
Air quality measurements by the U.S. Embassy in Sarajevo put the Air Quality Index (AQI) at 386. Any reading that exceeds 300 qualifies as hazardous -- at times the reading has risen to above 400 in the city -- and prompts government warnings of potential serious health effects for residents.
'Every Hour Is Precious!'
Almir Imsirevic, a professor at the University of Sarajevo's Academy of Performing Arts, is so upset by the air quality that he started a petition on Change.org that calls for government officials to get their act together to control pollution, and quickly.
"The issue of pollution in Sarajevo is not an impossible mission. It's not a question of going to Mars. It's a matter of simple things," he says.
"The government urgently must engage professionals and find a solution. No delay. Engage the best, study the experiences of successful countries, and redirect investments toward our health. Every hour is precious!"
The petition's demands may be a step in the right direction, but the problem runs deeper than a tweak of government policy.
To start, places like Sarajevo and Skopje are topologically challenged.
Mountains ring the cities, helping trap smog in low-lying areas during inversions, a weather phenomenon where temperatures actually increase with altitude. The resulting spikes in air pollution blanket cities, making visibility difficult and breathing even tougher.
Then there's the legacy of communism and the subsequent breakup of Yugoslavia that stunted economic and industrial development, leaving decades-old lignite-fired coal power plants to spew toxins into the air while underdeveloped transportation links see cars clogging overburdened roads.
While the United Nations said in October that to limit the rise in global temperatures, emissions from fossil fuel must plunge by half by 2030, governments across the Balkans have proposed building new power plants.
Rudo Josipovic knows the result of it all too well.
Though he suffers from asthma, Josipovic just shrugs as he admits to using chunks of soft coal to heat his house and water in winter.
It's not that he wants to exacerbate his breathing problems. It's that he believes he has no alternative.
Municipal and federal authorities have failed to extend services to Mala Solina, a village 5 kilometers from the Bosnian city Tuzla, number two on the WHO worst-air-quality-in-Europe list, trailing only Tetovo in Macedonia.
The UN says poor air quality lops a combined 44,000 years of life from Bosnian residents annually.
"I feel it," he admits.
"Sulfur dioxide and all that is bad is in coal. But I don't have anything else."
Crucially, pollution may be hitting wallets as hard as it is lungs, compounding the problem in a region already buckling under the weight of woeful economies.
WHO says lost work days, health-care costs for the treatment of illness due to pollution, and fuel costs equal about one-fifth of Bosnia's economic output.
Macedonia, meanwhile, loses about $360 million annually because of costs associated with pollution, according to the World Bank.
Help On The Way?
Most Balkan residents struggle to make ends meet on salaries averaging around $400 a month, making them sensitive to price increases for foodstuffs caused by toxic, air-damaging crops.
"Highways are being built for the super-poor population that will not have the money to ride those highways, and yet there is nothing for the air," says Anes Podic of Eko Akcija in Sarajevo.
"Measures are not being taken, and some of these things are relatively easy to do," Podic adds, arguing that introducing incentives for people to purchase more efficient heating methods "would be sufficient to dramatically improve air quality in many urban environments...but it's not considered a political priority."
Help may be on the way, albeit slowly.
Sweden has pledged to help improve air-quality monitoring through a four-year joint project with officials in Bosnia.
Macedonia is hoping to halve pollution in Skopje after launching a $1.8 million plan -- an amount analysts says is woefully inadequate -- that cuts taxes on major emissions sources such as heating, traffic, and heavy industry to give them incentives to improve efficiency.
For Bozana Vilusic Tomic, help won't come quickly enough to cover the evidence of another winter in a country where the mortality rate from air pollution is surpassed only by North Korea.
Next to her house in Lukavac, Bosnia, runs a pipeline from the Tuzla thermal power plant. But neither she, nor her neighbors, were given access to the heating source by municipal authorities, leaving them no choice but to use coal when temperatures plummet.
"Factories in our area have no filters, nothing. We have a black snowman from all the fog and smog in our village," she says glumly.
