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Propped up on a pillow, with an oxygen tube hooked in his nose, Muhammad Ipandi glanced around the room.
Half a dozen people lay on army-style stretchers opposite him. Children's toys were scattered at one end of the room. At the front, behind the nurses' desk, a framed photo of Indonesian President Joko Widodo smiled down at him.
"I'm here because of the haze," the 56-year-old said, drawing a deep, even breath — a luxury after months of inhaling toxic fumes. "I can't stop coughing."
Over the past three months hundreds of residents in Palangkaraya, the capital of Central Kalimantan, have been forced to take refuge in oxygen relief centers like this.
Thanks to a long dry season and the impact of a particularly intense El Niño, Indonesia's annual forest fires have been especially destructive this year.
Large parts of Kalimantan and Sumatra — as well as neighboring Singapore and Malaysia — have been blanketed with a thick haze caused by slash-and-burn techniques used to clear land for plantations.
Schools have been closed, flights cancelled, and a state of emergency called in six provinces.
In Palangkaraya, where the air standard pollution index has reached 1900 (anything over 300 is considered hazardous), scientists have recorded dangerous levels of carbon monoxide, cyanide, ammonia, and formaldehyde in the air.
Since July 1, more than 500,000 cases of respiratory illness have been recorded on the two Indonesian islands, according to Indonesia's disaster mitigation agency (BNPB), and local media have reported 19 deaths from haze-related illnesses.
Ipandi said he has struggled to breath — and has rarely worked — for more than a month.
Indonesia's meteorology and climatology agency said more than 40 million people have been breathing dangerous fumes from the fires, prompting agency spokesman Sutopo Puro Nugroho to call the crisis a "crime against humanity."
President Widodo has sent more than 21,000 people to fight the fires, and deployed aircrafts to water bomb hotspots.
Late last week, Widodo also signalled greater protection of Indonesia's carbon-rich peatlands — something environmentalists say is long overdue.
Still, many critics contend the government is not doing enough.
"I see the the effort, but it's too little too late," said Bustar Maitar, head of the Indonesian forest campaign at Greenpeace International. "Experts have been warning us about El Niño."
This year's El Niño, a climate phenomena that sees drier than usual weather across Indonesia and parts of the Pacific, is on track to be the most powerful since 1997-98.
That period saw similarly large forest fires and haze in Indonesia.
While air pollution remains the biggest threat to people, the fires are also taking a significant toll on wildlife.
About 19 miles from Palangkaraya, at Nyaru Menteng orangutan rehabilitation center, the staff is struggling to deal with an influx of the iconic apes.
Monterado Fridman is communications coordinator at Nyaru Menteng and said the center is designed to care for 350 orangutan at a time, but it was housing close to 100 extra.
Since the fires started three months ago, orangutan forced out of the forest have been arriving almost daily, he said, and many of them were suffering from the haze.
"Orangutans that are affected have the same symptoms as humans — a cough, crying, and sometimes asthmatic symptoms," Monterado said.
As if to underline the threat posed by the fire, less than one kilometer away from the rehabilitation center — separated by a buffer of forest — a block of land has been freshly burned and planted with oil palm.
"We have no power," Monterado said. "Only government has the power to stop them doing that. [But] the government has not been doing enough to stop the fires."
Multiple climate models have predicted that El Niño will continue into 2016.
That will exacerbate the impact of peatland and forest fires and cement Indonesia as one of the largest emitters of greenhouse gases this year.
Analyzing data from Global Fire Emissions Database, the World Resources Institute has calculated that emissions from the roughly 100,000 fires in Sumatra and Kalimantan, which have reached 1.62 billion metric tons of CO2, have bumped Indonesia from the sixth-largest emitter in the world up to the fourth-largest in just six weeks.
Daily emissions have dropped substantially since October 26 after heavy rain, but Indonesian diplomats will head to climate talks in Paris in December with little to boast about, according Maitar.
"The only way Indonesia can save face in the Paris meetings is if President Jokowi calls for full protection of forests and restoration of peatlands," he said.
About 60 percent of Indonesia's greenhouse emissions are caused by the conversion of forested land for agriculture, and the government's climate plan has already been labelled inadequate by some observers.
Maitar said the only strong commitment Indonesia could make was that it had learned from the fires and was taking steps to ensure there was no repeat.
In the meantime, residents in Palangkaraya will continue to deal with the impacts of haze, and wait hopefully for more rain.
Most locals that VICE News interviewed said they expected more from the government, and some, like Ayu Puspita Sari, an architecture student at the University of Palangka Raya, were noticably frustrated.
"It's only lip service. I want the government to care more about the issue [and] I hope they arrest people who start the fires."
Follow Harry Pearl on Twitter: @Harry_Pearl
Photos by Nyimas Laula