Toxic Cities: When People Are In Mood To Celebrate, Mothers Like Me Are Anxious

Pollution is a global crisis but nowhere has it been felt more acutely than in India. The worst sufferers of this pollution are the children who from the womb itself are being exposed to toxins and toxicity that lead to a lifetime of ailments, and a shortened lifespan. In this new series, we examine how pollution impacts our children and hope to champion why we must consider it a national health emergency. 

It was in 2013 that Rashmi Menon, Managing Editor, Amaryllis: an imprint of Manjul Publishing House and a Delhi resident, realised that her infant daughter Mrinalini’s bouts of wheezing, cough and cold every few months were getting too frequent, becoming almost chronic.

Her daughter, now six years, was barely one then. “In the year 2013, during the months when Delhi suffers the worst case of pollution due to crop burning in the nearby states of Haryana and Punjab, my daughter, who was barely a year old then, got her first attack of breathlessness. It was an early morning attack. As a relatively new mother, I got really scared. On taking her to the doctor, she was immediately nebulized. This was also the time when Delhi was gearing up for the festival season---when people are in the mood to celebrate, mothers like me are usually anxious thinking about when the environment will attack their children.”

"When people are in the mood to celebrate, mothers like me are usually anxious thinking about when the environment will attack their children.” - Rashmi Menon

Surbhi Rastogi, blogger and Communities Editor at SheThePeople.TV has a similar story, “I have two daughters- both started facing allergy like symptoms when they were around 1.5 years old. The symptoms include stuffy nose, cough, cold, loss of appetite. These were difficult to manage as the normal cough and cold medication is not able to solve it. And within a month, two weeks would go like this... a week of normal health and then back to the same symptoms. These symptoms would aggravate around October time (season change time, also coinciding with the crop burning time in Haryana and Punjab). They would carry on till December and January, get okay when it was extremely cold and kids were indoors pretty much all the time, except in middle of the day when it was sunny. And then they would be the same in February and March.”

Research just out from Lancet shows that 3.5L Indian children have been made asthmatic in 2015 by vehicle exhaust. This is second to China. The study examined 194 countries and 125 cities across the world to come to this conclusion. More than one childhood asthma case can be linked to traffic related air pollution, according to this study.  The pollutants damages airways, leading to inflammation which then triggers asthma in children who might be genetically prone to it.

"I have two daughters- both started facing allergy like symptoms when they were around 1.5 years old. The symptoms include stuffy nose, cough, cold, loss of appetite. These were difficult to manage as the normal cough and cold medication is not able to solve it." - Surbhi Rastogi

Children are particularly vulnerable because they breathe faster than adults and are closer to the ground where some kinds of pollutants concentrate and they’re also outdoors playing for longer stretches of time. Exposure to pollution in children may manifest immediately as respiratory illness, but can also play out as a lifetime of disease. It could put children at risk for diabetes, cardiovascular disease later in life. According to the WHO there is substantial evidence that traffic pollution exposure in early childhood leads to increased risk of childhood leukaemia. Apart from this, there is the danger of neurodevelopmental issues and possible behaviour disorders.

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A large-scale study conducted by the Central Pollution Control Board and National Chittaranjan Cancer Research Institute has found that one in three children in Delhi has impaired lung function. Patel Chest Institute in Delhi has found that children in Delhi have smaller lungs due to pollution.

Pollution levels in the capital city have been on the upswing since, dangerously so. Delhi is ranked sixth on the list of the most polluted cities in the world by the World Health Organisation. And there has been “laziness” on part of its elected caretakers in tackling air pollution in the city,  according to the recently released ‘Political Leaders Position and Action on Air Quality in India 2014-2019’ report released by Climate Trends.

Delhi is ranked sixth on the list of the most polluted cities in the world by the World Health Organisation.

According to a Greenpeace global report released in March this year, Delhi has the distinction of being the most polluted capital in the world. According to the Greenpeace study, Delhi has an average yearly PM2.5 concentration of 113.5 per cubic metre. The election manifesto of the Congress party declared pollution in our cities a national emergency. And a national emergency it is and needs to be treated as one. For parents like Rashmi though, the fact that there is no escaping the pollution is an unwelcome fact they have come to terms with. And all they can do is to try and make sure that their children get all the medical treatment they can get them.

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“After going through many treatments including regular nebulizing, allopathic medicines like anti-allergic tablets, antibiotics, homeopathy and then finally understanding that asthma is going to be a regular affair, my daughter's paediatrician recommended using the 'Huf-puf Kit' - it's a contraption that helps the child use inhalers,” she says. “During March-April, October-November, and whenever pollution is particularly high, I use the Huf-Puf kit twice a day to give doses of an inhaler called 'Furacort'. This helps prevent asthma attacks. And in case she starts wheezing, it helps in controlling it.”

My younger daughter was only four when she was diagnosed as asthmatic and it was terrifying to see her when she had an attack. - Vaishali Mathur

The symptoms exacerbate during change of weather or when pollution levels begin to rise says Rastogi, “The treatment is anti-allergy - Montair tablet 4 mg throughout six months of the year. Every night steam needs to be inhaled. Still with all this, there are times when the symptoms aggravate. Then I need to shift to Montair LC kid- 4 mg and start nebulisation. Apart from this, to build immunity, I give Tulsi water to both my kids every day. I also give ginger-honey regularly, flaxseeds, jaggery to combat pollution effects with meal, and dates - cardamom and clove chutney. These have slowly helped build immunity in my elder daughter who after six years of age has not needed any medication. I continue to do this with my younger daughter who is four.”

Vaishali Mathur, editor at a publishing house and a Delhi resident, says, “My younger daughter was only four when she was diagnosed as asthmatic and it was terrifying to see her when she had an attack. I refused to put her on the steroids prescribed and shifted both of my children to homeopathy. It did take some time, but the frequency and intensity of the asthma attacks did go down over time.” She adds, “It is an urban kid disease so to say, and the doctors do tell you to put the child on mild steroids to manage the asthma but I did research it up and read that it does leach calcium from the bones and a case I read of a boy who had been using steroids to manage his asthma ended up with his bones as mush, so I was determined to not use them on my daughter.”

Most children in Delhi are kept indoors during winter, with air purifiers on in every room, wearing masks when they step out. The joy of winter, which most adults in Delhi grew up with, has almost been erased by the toxic gas chamber the city becomes in the season.

The fact remains that come winter, Delhi is a city where the children must wear face masks. Rooms must have air purifiers so that even air indoors is breathable. The pollution in Delhi a couple of years ago was so bad that it had hit 30 times the WHO safe limit of PM2.5 reaching 700 mcg per cubic metre. This is an index that has 500 as its upper limit. Anything over 300 is considered hazardous. In November 2018, the air quality in Beijing had hit 376, leading China to declare a yellow alert for a health emergency. In Delhi, life goes on even when these levels have been well crossed.

Most children in Delhi are kept indoors during winter, with air purifiers on in every room, wearing masks when they step out. The joy of winter, which most adults in Delhi grew up with, has almost been erased by the toxic gas chamber the city becomes in the season. What is scary are the statistics. In 2017, India saw over 1.2 million people die due to air pollution according to the State of the Global Air report released earlier this month.

To quote from the report, “Each year, more people die from air pollution-related disease than from road traffic injuries or malaria.”

Air pollution was the third highest cause of death in India and children born in this region will have a life expectancy that is 26 months lower than if they had lived in a region with better air quality. Apart from the more obvious manifestations of air pollution related ailments like respiratory problems, the other more subtle ones are the effects of pollution on neurodevelopment on children, leading to cognitive issues.

Delhiites need to adhere to rules of segregating waste. I have come across many people who are quick to complain about how polluted Delhi is but never make the small effort of having two dustbins and use one for biodegradable waste and the other for non-biodegradable waste - Rashmi Menon

Like most mothers of young children living in the NCR region, Rashmi dreads the arrival of winter. Mrinalini’s attacks flare up during change of seasons, festivals like Diwali and the extreme winter season when Delhi is covered with a thick layer of smog. She has considered relocating to escape the pollution, but is bound by her job which requires her to be in Delhi. She does try to go away when she knows AQI index will worsen. “I am considering going to Kerala this Diwali season though. Just to escape the toxic air during the worst days.”

As soon as the pollution levels begin escalating, Rashmi begins preventive measures. “Start using the Huf-Puf Kit, make her inhale steam, keep her away from dusty playgrounds, avoid travelling on the roads, try every home remedy possible, and pump her with immunity-boosting supplements like Chyawanprash.”

Though this is a health emergency, citizens need to be part of the effort to reduce pollution levels in the city rather than purely rely on the government to keep taking steps. “As citizens, we can do a lot of things like using public transport as far as possible, car pooling, switching over to CNG (I drive a CNG car), not burn crackers for Diwali and any occasion like weddings and other celebrations. We should switch off the engine of our vehicles at traffic lights whenever there is a bit of waiting period. We have to learn to cooperate with the government's efforts in waste management too. The Delhi government has done a decent job in at least introducing and to a certain extent implementing the idea of waste segregation.”

We aren’t bothered about proper garbage disposal, about segregation of waster, about emissions, about reducing our carbon footprint. We don’t care about what we’re leaving behind for the next generation to deal with. - Vaishali Mathur

She adds, “Delhiites need to adhere to rules of segregating waste. I have come across many people who are quick to complain about how polluted Delhi is but never make the small effort of having two dustbins and use one for biodegradable waste and the other for non-biodegradable waste. The people who come to pick up the waste very conveniently dump it in some corner, where more often than not, it is burnt - as there is no other way for them to get rid of it. Needless to say, the toxic fumes affect children and adults alike. The government needs to think of more ways to efficiently manage waste. Delhi government's 'ODD EVEN' scheme, according to me, was a good idea. I think it should be implemented more often.” Surbhi adds, “Also, there can be artificial rain which can help the situation when so many elders and children are suffering, charcoal buildings like the ones which have been built in China.”

Will on the part of the authorities to rein in air pollution, cooperation by citizens to take the little measures to control pollution and a concerted effort might just help. Says Vaishali, “The trouble is that we as citizens are not looking at it as an emergency. We don’t realise the seriousness of the issue. We aren’t bothered about proper garbage disposal, about segregation of waster, about emissions, about reducing our carbon footprint. We don’t care about what we’re leaving behind for the next generation to deal with.”

While baby steps are in place and a little awareness is just about beginning to spread amongst people about the long term ill effects of pollution, for those parents who see their children suffer for no fault of theirs, this might be too little, and the unstated fear is that the damage to their children’s lungs might already be done, setting them up for a lifetime of ailments.

Kiran Manral is the Ideas Editor at SheThePeople.TV