I have practiced clinical medicine and public health in India for over 20 years in a number of roles, including academic researcher, educator, corporate medical director, and patient-centered clinician. In 2015, after six years of living and working full-time in New Delhi, I thought I had undertaken every precaution to keep my family healthy: pesticide- and hormone-free food, purified water, mosquito protection… you name it, I had probably investigated it and figured it out.
The one thing I completely neglected to protect against was the air pollution. In fact I was oblivious to India’s air pollution until, in our final month in New Delhi, my then 9-year old daughter required emergency room care for sudden-onset asthma attacks. Coincidentally, in that same month, the World Health Organization announced that New Delhi was the most air polluted city in the world. We had no choice but to move away, not just for an upcoming job transfer, but simply to protect our children.
I was grateful that we were moving to live in clean air, but both professionally and personally, I felt I had left behind a huge problem, affecting everyone I knew and loved there. I could not let it go. I now travel to India every few months, in part to support a non-governmental organization that raises awareness and advocates to mitigate India’s air pollution crisis.
A few days ago, a young New Delhi-based reporter asked me for my “expert opinion” on how air pollution harms children in India. Here is an excerpt of what I wrote:
“Children born in air pollution face shorter life expectancies compared to their counterparts born in cleaner air… Children suffer physical health harms, including diminished lung growth and development, and increased prevalence and severity of pneumonia and asthma… [they] risk functional health harms including suboptimal cognitive development and sports performance. Air pollution is associated with depression, anxiety… and contributes to cancer and lifelong chronic diseases in adulthood including diabetes, cardiovascular disease, and dementia…”
These health facts are easy to summarize, but they do not convey the whole story. What is more difficult to articulate is the stress and suffering that air pollution has created for millions of Indian people. Including me.
I hate all the coughing. It starts within three days of my landing in New Delhi. Every friend is coughing or suffering some respiratory symptom. The plane is full of coughing passengers when I depart.
I cannot fully enjoy Diwali anymore. I dread the futile arguments my friends and family will have with neighbors who insist it is their “right” to set off illegal firecrackers. I dread the off the charts toxic air my friends and family will breathe in the subsequent weeks. I mourn the loss of elderly neighbors and relatives who have died of respiratory illness in the post-Diwali smog.
I hate that I discouraged my 75-year old father from visiting India for his elementary school reunion last November, because I was worried that the toxic air and ill-equipped health care system would seriously harm him.
I feel sad for scheduling my children’s India visits only during the monsoon season, when the heavy rain reduces the air pollution. I feel guilty for limiting if and how long my children can play outside for those few weeks, knowing that their friends practice sports in worse air, every day.
Air pollution is not just a health problem harming our bodies. Air pollution compromises our moods, how we celebrate weddings and holidays, and how we live, work, play and travel. It is a crisis, affecting families just like mine, every single day.
Ultimately, for me, the only marker of success in this fight is India achieving clean air, for every person, every day.
I now know many of the experts and activists in India engaged in this fight, and I join forces with them. We lack a sure path to clean air. Yet, we know that solving this crisis is entirely possible. Other countries have successfully cleaned up their air. And Indian history has proven the country’s will and capacity to dramatically change.
India can and must overcome its air pollution crisis. We have to believe it is possible, bring our skills to it, and keep at it. Not just life, but more importantly quality of life, is at stake, and worth fighting for.