Lingering smoke in the Amazon caused concern on Tuesday among Brazilians who say that respiratory problems — particularly among children and the elderly — have increased as fires in the region rage.

“The kids are affected the most. They’re coughing a lot,” said Elane Diaz, a nurse in the Rondonia state capital of Porto Velho, as she waited for a doctor’s appointment at the city’s 9 of August hospital with her 5-year-old-son Eduardo.

“They have problems breathing. I’m concerned because it affects their health.”

The number of people treated for respiratory issues increased sharply in recent days at the local Cosme e Damia Children’s hospital.

“This period has been very tough. The dry weather and the smoke causes many problems on children, such as pneumonia, coughing and secretion,” Daniel Pires, a pediatrician and the hospital’s adjunct-director told the Folha de S. Paulo newspaper.

“From August 1 to August 10, the median (number) of cases was about 120 to 130 children with respiratory problems. From August 11 to (August 20) it went up to 280 cases.”

Growing fears over the health impacts are emerging as the number of fires in Brazil surges, with more than 77,000 documented by the country’s National Space Research Institute in the last year.

About half of the fires occurred in the Amazon region, with most in the past month.

But as breathing-related ailments appear to be on the rise, attention to the issue has largely been overshadowed by growing acrimony between Brazil and European countries seeking to help fight Amazon fires and protect a region seen as vital to the health of the planet.

At a summit in France this week, G7 nations pledged to help fight the flames and protect the rainforest by offering $20 million, in addition to a separate $12 million from Britain and $11 million from Canada.

But Brazilian President Jair Bolsonaro, a far-Right climate sceptic who took office this year with a promise to boost development in Latin America’s biggest economy, questioned whether offers of international aid mask a plot to exploit the Amazon’s resources and weaken Brazilian growth.

On Tuesday, he said that his French counterpart President Emmanuel Macron had called him a liar and would have to apologize before Brazil considers accepting rainforest aid.

Macron has to retract those comments “and then we can speak”, Bolsonaro said.

In a video message, Brazilian novelist Paulo Coelho offered an apology to France for what he called Bolsonaro’s “hysteria”, saying the Brazilian government had resorted to insults to dodge responsibility for the Amazon fires. AP