The old man is desperately gasping for air in the Labbafi Nejad Hospital's Internal Medicine Ward for male patients.

The elderly Shah-Ali Naeimi, suffers from asthma -- a disease that affects children and old people more than others and could be deteriorated by air pollution."I was fine for three nights before I had another attack of the disease," says Naeimi who has been in the hospital for a week now.

Almost out of breath by an acute attack of asthma, Shah-Ali is handed the inhaler by Dr. Sohrab-Pour, an internist and pulmonalogist, who also runs the hospital. "Inhale deeply and then exhale," says the doctor, advising him to do this every 10 minutes until he feels better. "Despite the fact that there is doubtlessly a link between an acute attack of the disease and air pollution," says Dr. Sohrab-Pour, who keeps us company to the ward where a couple of other asthma patients are under treatment, "you cannot tell exactly if the attack has been caused solely by that." "It is one of the factors that may lead to the attack and that's why people suffering from asthma, cardiovascular and lung diseases are advised to stay indoors on the days that the pollution is high," he adds. Over the last 10 years more people have come down with the disease in this metropolitan city, which is home to some 2 million cars, many of which produce a lot of pollution due to technical faults and low-quality fuel they burn. Many people who have come from other cities like Isfahan or Shiraz to live here are suddenly struck with an acute attack of asthma. "Currently 7 to 10 percent of Tehran's population is affected by asthma, which should normally range between 3 to 5," laments the physician, adding that the situation could worsen "if drastic measures are not taken to counter air pollution immediately." Tehran, among the three most polluted cities of the world, used to have a rich and complex ecology. Surrounded by mountains from three sides, rarely does the city -- with a daytime population of some 10 million -- find an outlet for the air pollution. The air pollution in Tehran is caused mainly by mobile sources that contributed an estimated 71% to the pollution in 1994. Unofficial statistics disclose the fact that citizens have died every year due to lung and cardiovascular diseases mainly caused by air pollution, even though relevant environmental activists and executives inside the government have been attaching more importance during the recent years to tackling this environmental tragedy in Tehran through initiating various plans and agendas.

"The Tehran Municipality, Air Quality Control Company and the Japanese Jaika Company conducted a research in 1997 in which they revealed that every year around 4,000 people are dying of diseases related to and caused chiefly by air pollution," says the Managing Director of Green Front of Iran, Dr. Siamak Moattari.

Green Front of Iran, the biggest Iranian NGO involved in environmental activities, acts as an information center, which dispatches air pollution-related news to the mass media but also sends its people to kindergartens, schools, and universities in order to enhance public awareness in this respect. "As an NGO we are doing well on the ground and I think that the government has the intention to suppress pollution in Tehran but is still hindered by obstacles," says the head of Board of Directors of the GFI, Dr. Moeini, adding that it's a huge work that also needs the help of people to be accomplished. Iran's Department of Environment, aided by the government and municipality and in association with environmental NGOs and activists, has been striving to surmount the existing obstacles. It has started a series of concrete measures to curb air pollution in Tehran such as collecting aging and dilapidated cars, offering unleaded petrol in the stations, and gradually replacing petrol by gas as a cleaner source of energy.

"We have a national system strategy for energy efficiency, which is part of the third development plan, said vice president and chairwoman of the Iranian Department of Environment Ma'soumeh Ebtekar, adding that another strategy to get rid of air pollution in the large cities of the country "is to shift from heavier types of fuel to natural gas."

"So I think this is a step forward and in fact we have come to know that natural gas is both more efficient and environment friendly in terms of usage and also in terms of greenhouse gas emissions," Ebtekar went on to say. To combat air pollution, Iran established a comprehensive 7-stage plan 2 years ago after 3 large-scale studies had been conducted. "The plan undertakes different factors involved in air pollution trying to mobilize standardization of fuels, improvement of the quality of automotive industry and public transportation system, as well as deals with passenger cars and taxis and in general with all mobile sources of air pollution," explained Ebtekar. "During the first year of the plan," she stressed, "we have achieved between 50 to 60 percent of our goals. "We have persuaded the Ministry of Petroleum to offer unleaded gasoline in Tehran and I think over 70 percent of the gasoline consumed in Tehran today is unleaded," she said. Iran does not only look for sources to deal with internal environmental hassles but is also engaged in international negotiations on environment. Earlier this week Mrs. Ebtekar met with the visiting Dutch Minister of Housing, Spatial Planning and Environment Jan Pronk with whom she signed an memorandum of understanding on mutual cooperation in environmental arena. The two emphasized the need for extensive cooperation between the two nations to help resolve national environmental problems.

The Dutch minister, who headed a delegation for a day-long visit to Iran, also met with Tehran's Mayor Morteza Alviri. They emphasized that Iran and the Netherlands need to pave the way for environmental cooperation and exchange of information.

"I think there are proper grounds for us to cooperate in the fields of waste disposal and anti-air pollution campaign in Tehran," said Mr. Pronk. Stating that his country has made considerable advances in curbing air pollution, Mr. Pronk said, "We have managed to control air pollution in an industrialized city like Rotterdam to a great extent." The main objective of Mr. Pronk's visit was to discuss the issue of the G77 and the Kyoto Protocol with Mrs. Ebtekar.

Iran currently chairs the G77, the group of 133 developing countries who aim to unite their position within the UN. Along with the European Union and almost the whole global community, it is in favor of implementing the Kyoto Protocol concluded in 1997. The protocol obliges the signatories to carry out international cooperation in order to prevent climate change and global warming through reducing greenhouse gas emissions. In spite of her efforts to provide this megacity with better quality air, Mrs. Ebtekar is convinced that a lot more needs to be done. "I live in an apartment in a 12-story building and sometimes I look out the window early in the morning to see the landscape, I get a bird's eye perspective of pollution," laments the vice-president, wearing a different hat as a regular citizen.

"I don't really feel comfortable breathing in Tehran," says Ebtekar, an idea also shared by the Dutch minister who said in Dutch language: "Anywhere I go I take my sneakers to go jogging but I would not recommend anyone to do it here in Tehran."