Kastriot, Kosovo -  Sixty-four-year-old Avdullah Selimi-Raci breathes through a hole in his throat.
In 1969 he started working at the state-owned Kosovo Energy Company (KEK), which operates the Sibovc coal mine and Kosovo A and Kosovo B, the two thermal power plants which generate 97 percent of the country's electricity.
AVDULLAH SELIMI-RACI, 64 AND HAVA SELIMI, 63 IN DARDISHTE VILLAGE
Selimi-Raci had his larynx and vocal cords surgically removed to eliminate a cancerous tumour.
'I used to work for KEK but the Serbs forced me out of my job in 1990 and I lived here. I stayed and breathed smoke and dust 24 hours a day. Afterwards, I couldn't breathe.
'KEK doctors knew that I had to have surgery. They said that I have these problems because of the environment and because I transported coal.
'When it's foggy outside, you can tell that the air is filled with coal dust. 
'Everyone here dies from lung cancer. All the people in this village here die from cancer. They're not natural deaths - it's cancer.
'Newborns have to start inhalation, they have problems with breathing. My grandson [Bleart] did inhalation for one year after he was born.
'Do you know what environment means? Environment is the No 1 reason for living. My time is done but I feel bad for the youth and the kids - they're the ones who will have disabilities.' 
[Valerie Plesch/Al Jazeera]
 Sometime in the mid-1990s, however, he started having trouble breathing. The doctors found a tumour in his throat. 
"After the war I had a surgery in the throat where I had my larynx and my vocal cords removed - all of this because of the air pollution," he says, while covering the void in his throat with a finger - the only way he can speak - to gather enough air in his stomach to utter just a few words at a time. 
Selimi-Raci comes from the Kosovan farming village of Dardishte, which for nearly 50 years was the dumping ground for the ash from Kosovo A, the country's oldest coal-fired power plant, built in 1962. 
Residents lived in homes facing hills of the brown ash. On windy days, the ash dispersed into the already polluted air. Although the dumping ended last year, the countless brown hills - now covered with dirt - and polluted air are not all that the village has inherited from Kosovo A. 
Dardishte is also known as the "cancer village". 
From the two-lane highway heading north from the capital Pristina to Kastriot municipality where Dardishte is located, the chimneys and smoke from Kosovo A and B, built in 1983, appear almost immediately in the distance. 
They have become part of the landscape in the small nation of 1.8 million, and a scourge for the 21,600 people living in Kastriot. 
New Kosovo 
Kosovo has the fifth largest reserves of lignite coal in the world. Lignite, also known as brown coal, is considered the dirtiest fossil fuel. Locals call it "black gold" because there is so much of it. In the Sibovc Southwest mine there's enough lignite to be mined until at least 2024. 
Then there is the rest of the Sibovc coal field, which the Kosovo government has declared a "special interest area", according to Edmond Nulleshi, executive director of corporate services at KEK. 
It's been allocated for future mining operations to supply lignite to a proposed third thermal plant called Kosova e Re, or "New Kosovo".
Ten years ago, the Kosovo government requested a new plant. Contour Global, a New York-based international power-generation company that operates dozens of power plants overseas, was the single bidder on the  one billion euro ($1.1bn) project. 
For the last year it has been in negotiations with the Kosovo government and the World Bank, which supports the project, primarily to come up with an agreement on the internal rate of return, the rate at which Contour Global's benefits and investment would be realised. 
The Kosovo B power plant serves as a backdrop as cows graze a field in a village near Kastriot, home to Kosovo’s two coal-fired power plants [Valerie Plesch/Al Jazeera]
Despite decade-long efforts of pressure groups to halt the project and push for developing renewable energy sources available in the country, the new plant is closer to being realised.
In late November, the Ministry of Economic Development, which oversees the mining and energy sector, announced that it would be going forward with Contour Global as the preferred, and only, bidder. 
Lorik Fejzullahu, the ministry's project manager for New Kosovo, told Al Jazeera he is confident the new coal plant is the only option, despite concerns raised by pressure groups that the existing plants contribute to climate change. 
"Kosovo's global impact on the environment compared to some of the larger economies - it's minuscule. For us, it's an issue of having energy or not having energy," Fejzullahu said, adding that they have chosen "the most environmentally-friendly plant that is available to the world today". 
He argued this plant, unlike Kosovo A and B, would burn less coal for the same energy output, and will have "the newest technology which surpasses even current EU legislation."
Fejzullahu anticipates that the 500MW project, down from an initial proposed size of 2,100MWs, would create thousands of jobs during the building phase and 500 permanent jobs once the plant goes online in the next five to six years. 
"[New Kosovo] will be the largest FDI [foreign direct investment] investment in the Republic of Kosovo after the war," Fejzullahu said. 
Yet experts familiar with Kosovo's dependency on coal say the new plant will only prolong the half century-old practise of coal burning with its harmful effects on the population and environment. 
"They [the World Bank] claim that with new technology, new standards, the emissions will be way low and the particle matters will be eliminated as well to a certain point," said Visar Azemi, coordinator of the Kosovo Civil Society Consortium for Sustainable Development (KOSID), the biggest group in Kosovo fighting the proposed plant. 
"It's still the nitrogen oxide. If it's not going up, it's going somewhere." 
The hole made by a bucket wheel excavator shows the layers of lignite that are removed from the Sibovc Southwest coal mine [Valerie Plesch/Al Jazeera]
Living in coal country 
VLORA HOTI-MIRENA, 30, HADE VILLAGE
'Living conditions in Hade are pretty bad, and I think that it is not worth living here.
'The media report about the problems of infrastructure, like roads and sewage, but the essential issue is that the environment is very polluted.
'The most important thing is first, the health condition. As far as I am informed, the municipality of Obiliq [Kastriot] has the biggest number of people suffering from cancer compared to the other municipalities.
'The problem is the [coal] plants and the mines in this area. Maybe people from outside won't believe us, but living here, when you wake up in the morning you feel the polluted air and it smells a lot - the coal and the sewage.
'Or when it's windy and rainy here - to see that dust storm is horrifying.'
 [Valerie Plesch/Al Jazeera]
In the heartland of Kosovo's coal country, a network of tracks for transporting lignite crisscross the soft earth of the Sibovc coalfield. 
A seemingly endless supply of jagged, dark brown clumps of lignite coal lies strewn on black conveyer belts as they make their way under a bridge and to their final destination a few kilometres away - Kosovo's two coal-fired thermal power plants. 
There is no one in sight apart from the occasional guard manning the various checkpoints surrounding the tracks and the entrance to a set of three massive quarries - the Mirash and Bardh open-cast lignite coal mines that were emptied of 310 tonnes of lignite and are now being refilled with earth removed from the nearby Sibovc Southwest mine. 
Around one billion tonnes of lignite lies between 100 and 200 metres below the Sibovc coal field.
 A community of tight-knit families live side by side in at least seven villages right on top of the vast reserves. 
In Hade, the village most affected by Sibovc mine's continual expansion,  the population has dwindled over the past decade, as many have been relocated, some forcibly, away from the encroaching mine. 
Three hundred families once lived here, said one resident. Today, only 50-odd families remain. 
Day and night, Hade's residents endure the rumbling noise of lorries roaring down the road next to the conveyer belts and excavators working at the mine, a 24-hour operation. 
"The biggest source of air pollution here is from the mines," said 30-year-old Vlora Hoti-Mirena, who moved to the village after she married a man from the village. 
"The trucks now work very near us and some of the villagers are saying that they're having trouble opening their windows because of the trucks down there … and during the night, you can hear lots of noise from the trucks working in the mine and also the belts which transport the coal." 
Hoti-Mirena runs Hade's sole grocery store and worries about her family's future, especially her two-year-old daughter's education.  
In the village's only school, classes are shrinking each year as families are relocated away from the mine. 
This year, the first grade class has only one pupil, six-year-old Diar Praniqi. He shares a classroom with six third-graders and a teacher who divides her attention between the two groups. 
Diar Preniqi, six, speaks to a nurse from the Kastriot municipality family health clinic at his school in the village of Hade. Doctors and nurses recently implemented a policy to provide free medical check-ups to all pupils living in the municipality twice a year [Valerie Plesch/Al Jazeera]
Winter heat
As the temperatures start to dip in Kosovo, the thick smell and smoke from burning coal and wood wafts through the air. Many Kosovars still burn both in their homes during the cold months to stay warm, including those who do not have access to central heating in Pristina. 
At the high school in central Kastriot, piles of large lignite slabs clutter the yard. The school still uses coal from the nearby mine to heat the building, burning about 12-14 tonnes of it each year in a central furnace. 
The air pollution and living conditions have taken a toll on the health of many Kastriot residents. 
"The number of the people with respiratory difficulties is increasing every day. The number of the people suffering from cancer is increasing every day. Approximately every month we have four new cases of lung cancer," said Atifete Shulemaja, the director of the main primary family health centre in downtown Kastriot. 
This year alone she has seen 34 new cases of lung cancer.  
"Although we have electricity, we also need healthy people. Health is more important, and I am personally against New Kosovo because this population is in extreme danger, not only the old people, but even new mothers," said Shulemaja at the health centre, where Kosovo A's chimneys can be seen from her office window. 
A view from an open window shows the skeleton of an abandoned home in Hade, where residents live on the fringes of the expanding Sibovc coal mine, a few kilometres away [Valerie Plesch/Al Jazeera]
'Kosovo A is the cancer of Obiliq' 
Kosovo A, the smaller but more notorious of the two plants, is viewed as a relic -  an ancient power plant that continues to run only because of the care of the workers inside. 
"It's still running, and it's almost the only thing that is producing electricity which is insane," said Nezir Sinani, an environmental activist and a consultant at the Bank Information Center in Washington, who has been monitoring the developments of the New Kosovo project. He calls Kosovo A "the single most polluting source in Europe". 
"[It's a] contributor to climate change because it is considered to be one of the highest polluters in the region," said Azemi from KOSID. 
Not all of the plant's units are functioning and in June 2014 an explosion inside the facility killed two workers. 
Besides these deadly occupational risks, Europe's youngest nation faces other significant health problems associated with the air pollution, of which the KEK plants are the biggest contributors.
According to a World Bank report released in 2012 based on 2010 figures, air pollution causes an estimated 835 premature deaths, 310 new chronic bronchitis cases, and 11,600 emergency visits each year. 
"Kosovo A is the cancer of Obiliq," said Burim Gerguri, referring to Kastriot by its commonly used name, a Yugoslavia-era holdover that persists despite government efforts to introduce Albanian names after the 1998-1999 war with Serbia. 
AHMET DEMAKI, 66, DARDISHTE VILLAGE
'It's all a dump, there's nothing here, no one takes care of you.
'I've been here for 32-33 years. My wife is sick, my sons are in Fushe Kosove, I'm alone here and I do not know what to do.
'There's nothing here. [My health is] not good at all. My blood pressure is bad, all my pockets are filled with pills.
Now look at the five towers [from Kosovo A]; they're not [spewing out] dust anymore.
'If you would have come here before the war you wouldn't believe it, if you would park the car outside it seemed like you had thrown sand on top of it.
'Half of the population here is sick from cancer. After the war many died [from cancer]. Everyone is sick.'
  [Valerie Plesch/Al Jazeera]
Gerguri is a neighbour of Selimi-Raci and the director of public services and emergency for the municipality of Kastriot. 
His family has lived in Dardishte for generations, leaving only during the war to return to a village of destroyed homes. 
He has lost three family members to cancer, and would like to see Kosovo A shut down. 
On the road from Dardishte heading towards Kosovo A lies a row of dilapidated and dusty homes. Many of them are abandoned as residents have moved away from living in the shadow of the ageing coal plant and its smoke-spewing chimneys. 
On one street corner stands a home with crumbling, dusty wooden roof and dirty eggshell-coloured walls where the paint has peeled away revealing exposed brick. 
The yard is overrun with weeds and shrubs. Two tall rose stems with pale pink petals jut out from the otherwise dried-out vegetation surrounding the house. 
An elderly man emerges from the back. Ahmet Demaki, 66, lives alone as his sick wife now stays with their sons in another town, not too far away.
He attributes his wife's heart problems to her 37 years working as a cook at Kosovo A. Demaki was a track worker at the plant for 32 years and retired six months ago. 
Families used to live all around him, he says, but many have since left. 
"[For] all of us that are nearby [Kosovo A], if you could see when the wind blows from the north, it becomes foggy here and it looks like that, the smoke there," he said, pointing to the chimneys in front of his house. 
Demaki has no plans to leave. He said he has nowhere to go, not even the homes of his sons, who have families of their own. 
There were plans to shut down Kosovo A by 2017, but the government hasn't confirmed when it will be decommissioned. 
Smoke is released from one of the functioning chimneys of the Kosovo A power plant, considered to be the single most polluting source in Europe and at one point, the biggest power plant in the Balkans [Valerie Plesch/Al Jazeera]
Renewable energy 
Kosovo's push for a third coal plant contrasts with President Obama's rejection of the Keystone XL project - a proposed tar sands oil pipeline that would start in Canada and end in refineries in Texas - in early November and the recent United Nations climate summit COP21, in Paris. Governments from 190 nations met to discuss ways to reach an agreement on climate change, with an aim on how to reduce greenhouse gases. Kosovo, however, is not a member of the UN. 
"America is now a global leader when it comes to taking serious action to fight climate change," President Obama said in his speech at the White House when he announced that he would be rejecting Keystone. 
Local and international pressure groups have been lobbying in Kosovo and around the world for New Kosovo not to proceed, especially as it goes directly against US policies for funding new coal projects.
But government officials, like Fejzullahu, believe that the World Bank made an exemption for Kosovo, despite numerous reports about the available renewables in the country that would generate the same power as New Kosovo.
Fejzullahu, the New Kosovo project manager, disagrees with such studies. "Unlike other countries that might have other options, [Kosovo] has limited options on the table," Fejzullahu said.   
"For the Kosovo project, they're using the language in the policies," Sinani, from the Bank Information Center, said.  "Both Obama and the World Bank, that says in very rare circumstances, when there are no alternatives and countries need to develop more coal to develop the economy, that they would support it." 
AVDI PRENIQI, 47 AND DJELLZA PRENIQI, 13, HADE VILLAGE
'We don't have a hospital. We do not have a school for pupils. The excavators are nearby, loud noise, when the excavators are active at night they wake you up from sleep, it wakes up my kids and the kids scream and ask, "What happened Dad? This noise? Who came inside our house?"
'My body shivers and I sleep in fear in my house.
'Noise and dust and all the bad things. There is no employment here at all.
'The best thing that could happen would be to relocate the village, and to take the kids to school just like everyone else.
'Are they [the government] sane to leave people like this? You do not have roads, you do not have buses, you do not have a school. There is noise, you can't even put your clothes [to dry] on the [washing line] outside. This is horror.
'Even if they would give me billions, I would never leave the village if the village would have been as it was before.'
[Valerie Plesch/Al Jazeera] 
He believes the government is "putting all the eggs in one basket - basically into coal". 
Kosovo's first hydropower plant was built in 1935 and experts believe that there is real potential to develop renewable energy in Kosovo. 
Currently, there are three hydropower plants that contribute three percent of Kosovo's energy, and in October the country launched its first solar power plant.  
Daniel Kammen, Professor of Energy at the University of California, Berkeley and a climate adviser to the Obama administration, is confident that if the same amount of money planned for New Kosovo went into renewable energy projects, Kosovo "could have solar and wind projects, biomass energy, up and running in a matter of months". 
"So while the need for power in Kosovo is critical, the options to base more on solar, wind, geothermal, biomass, has ramped up very quickly in the last ten years," he told Al Jazeera.   "And what that means is that the value of doing a coal plant has just gone down and down." 
Kammen helped draft a recent report identifying available renewable energy sources in Kosovo: "Six hundred megawatts is all really Kosovo is looking for right now, so this is not even a very hard project. 
"We identified almost a hundred megawatts of easy-to-build micro hydro in Kosovo. Those could be done in a matter of months. And we identified plenty of wind and solar potential so that [New Kosovo] plan just doesn't even make sense on an energy basis," he said.
For now, the country's prospects of paving the way for a greener and cleaner future remain  uncertain  even though the technology for renewable energy evolved and become more affordable. 
The government has put the mechanisms in place to facilitate renewable energy sources, but according to Fejzullahu, Kosovo's size is too small to accommodate projects such as wind. 
"Maybe you'll save on emissions but then you destroy the land," he said, adding that there isn't enough water in Kosovo to meet the energy demands. 
"Unfortunately there is no affordable or reliable way to replace the dirty energy that is coming from Kosovo A and Kosovo B, other than investing in lignite power plants - building a new one or rebuilding the existing ones," said Nulleshi, KEK's executive director of corporate services.
With the real possibility of New Kosovo coming online in about five years, and supplying coal-based energy for another 40 years, there might be less of an incentive for Kosovo to develop renewables, even though the government has laws in place for the private sector to invest in them. 
Rinora Gojani, a senior researcher and policy analyst at the Institute for Development Policy, a think-tank and pressure group in Pristina, calls the need for New Kosovo a "fake demand". 
"[It's] because of [the] lack of alternatives for heating and renewable energy produced in Kosovo, therefore we've come to this point and pushing a project which does more harm than good," she said. 
Sinani agrees. "What is Kosovo going to do to develop the energy sector, should be the question," he said. "And a third coal power plant is certainly not the answer." 
Abdurrahman Qerkezi, 45, used to work for the company that operates Kosovo’s two coal plants including Kosovo B, which is seen in the distance. Now Qerkezi herds cows, sheep and horses and says the coal plants have damaged this land. 'The environment is a catastrophe here,' he said. [Valerie Plesch/Al Jazeera]