The New Pollution Migrants: Choosing Health Over City Life

The air in our cities has been consistently going off the charts for some years now. The effects on the health of the citizens have been quite alarming. In cities like Delhi and Mumbai, respiratory ailments are now the norm rather than the exception for children. The children and the elderly are the ones who suffer the most when the air pollution levels spike. Over the past few years, many folks have decided to move out of the cities to smaller towns and places where they can breathe a purer air. This reverse migration, from city to small town or rural, triggered purely by pollution and health issues, or pollution migration as some call it, is a decision that is not taken easily. Moving cities, especially with young children, is a loaded decision, where one needs to factor in convenience, availability of good educational facilities and more which often aren’t available in smaller locations. It also does mean giving up lucrative jobs and settling for reduced incomes, given that job opportunities are few and far between in smaller towns. Those who remote work can manage to get by a fair bit, but the pay cut for those who can’t freelance or remote work is pretty substantial.

We saw quite an outcry when the South Asia correspondent for the New York Times wrote an editorial about how living in Delhi had aggravated his son’s asthma to the extent that he had to choose to leave the country. The outcry was symbolic of how we’ve dealt with the toxic pollution that has been engulfing our cities. Being ostrich-like about it. Some measures were put in place in Delhi, bringing in the odd-even days, for instance, to reduce pollution, the change in pollution levels has been less than discernable. The fact remains that expats continue to refuse postings in Delhi due to concerns about air quality levels and the subsequent impact on their health and the health of their children.

Moving cities, especially with young children, is a loaded decision, where one needs to factor in convenience, availability of good educational facilities and more which often aren’t available in smaller locations.

Doctors advise those with pulmonary and heart diseases that they would be better off out of the city during the months when pollution peaks. Most folks do so for a month or two until things settle down and the air clears a bit. Others pack their bags and move out. These are the new pollution migrants, for whom it is often a tossup between their health and living in the city, either their own or that of their children. Many of them tried to follow the prescribed course of action to minimise the health risks from pollution, namely stay indoors as much as possible, use a mask when outdoors, use an air purifier indoors, but when the pollution levels are so off the charts, all these don’t really work.

“It is really unfair on the children,” says Mira Bharadwaj*, a homemaker, who is seriously considering shifting cities. “When I was growing up we looked forward to winter because it meant cold crisp days, picnics in parks, but now winter is the season where we have to compulsorily keep the kids indoors as much as possible. My heart breaks when I see my kids cooped indoors with masks on their faces. And then the constant red alert at home for when they will fall ill and need to be rushed to the hospital. ” When the AQI shot up to 999, which basically meant it was ricocheting off the charts, Mira told her husband that they seriously needed to consider moving to a less polluted city. “This is not how I want my children to grow up, to be constantly indoors and falling ill.”

A survey conducted by Local Circles, a social networking site for civic cooperation found that almost 35 percent of residents of Delhi and the NCR were seriously considering moving out from Delhi because of the effect pollution was having on their health. The survey found that the respondents didn’t have much hope about how the authorities were dealing with the issue and didn’t see pollution levels coming down anytime soon. Around 26 percent of the respondents opted to stay back in Delhi but have armed themselves with air purifiers and masks, and 57 percent stated that they have faced health issues because of the pollution.

Those who can migrate to purer air in the mountains, looking at homes in Uttarakhand or near the beach, with Goa being one of the most popular places to move to. Others move to smaller cities like Bhopal or Nasik, in a bid to retain the comforts of city living, albeit at a smaller scale. Yet others move to cities where the pollution is not as bad as it is in cities like Delhi/NCR.

 These are the new pollution migrants, for whom it is often a tossup between their health and living in the city, either their own or that of their children.

Swetha Dua, 36, Project Manager, moved to Bangalore from Delhi in 2019. She had been living in Delhi for 11 years post her wedding. Her husband was born and brought up in Delhi. “We made the decision to move to Bangalore post winter 2018-19 and moved here three weeks ago just in time before my son’s new school starts. We made this move for our child hoping that we could give him better air and health during his growing up years.”

It was an exacerbation of the health issues her son was facing that pushed Swetha to look at moving to Bangalore where her parents resided. She says, “Kunal has dust allergies since his childhood which gets triggered at any time of the year. At home we already take precautions for him, so we don’t do too much cleaning and dusting around him. And in winter this just gets worse as the smog levels go up. His sneezing increases exponentially. And constantly the only world he sees every day is the house, go straight to the basement to the car and then the workplace.

It all started when we moved to Noida in 2016. That winter the PM levels went beyond 1000 and there was no device to even properly verify that by any institute checking pollution levels in India. Every device just showed 999 because maybe that was the highest it could record.” It wasn’t just her son who was suffering ill health because of the pollution, it was also her husband and her. “All of us picked up a really bad cough by the end of that year and the cough prolonged for weeks. We were on antibiotics and all kinds of meds for three to four weeks. This pattern went on every winter for three years in a row. And even during summer, my son would get bouts of cough, cold and fever very frequently, and the fever went up to 104 degrees almost every time. He also faced cramps in his calf muscles because of dehydration issues both in summer - due to sweating because of playing in the park followed by AC usage round the clock and in winter because one doesn’t adequately drink water because it is cold weather. We have woken up many nights with his cries and spent all night massaging his legs so he can go back to sleep. This past year in September I experienced some weird kind of cough and completely blocked nose, which lasted more than a month, and the doctor was upset that I didn’t visit her in the first three days. With any cough, one would first resist meds and see if it would go away in a few days. So I went to her after seven to eight days maybe, after I was almost unable to sleep in the nights because of blocked nose. This was in spite of using steam many times a day, which only gave temporary relief.”

All of us picked up a really bad cough by the end of that year and the cough prolonged for weeks. We were on antibiotics and all kinds of meds for three to four weeks. This pattern went on every winter for three years in a row. - Swetha Dua

The scariest part for them was the realization that while one could protect oneself to a certain extent at home with air purifiers, stepping out meant exposing oneself to hazardous levels of pollution every single day, despite the face masks.

“It was a combination of increasing temperatures, very frequent and deadly dust storms, along with really bad air to breathe. We had purifiers in the house which definitely helped within the house but then how do we protect ourselves when we go out? Schools don’t have purifiers, buses don’t and workspaces don’t. And many of my son’s school friends either needed the nebulizer frequently and even worse some had to get operated for tonsils removal because of finding no way to slow down the occurrence of cold, cough and fever happening throughout the year.”

While they did chose Bangalore because Swetha’s parents live there, despite the traffic issues the city faces, she does feel it has some advantages over Delhi. “So at our home, we have been discussing pollution and its impact on our health for many years and we were toying with the idea of moving to Bangalore. It was always an option as my parents live here. But we all loved Delhi too much for our friends and family who still live there, for the infrastructure it offered (way better than any city in India) and the beautiful winter weather (which is now plagued with smog) and the food options it offers which mesmerize me till date. Bangalore, on the other hand, has its own issues with traffic and also increasing temperatures during the summer months, but highest temp doesn’t go beyond 35-36 C which is 12-13 degrees lower than the worst day in Delhi. Also, the air quality index for Bangalore is always moderate throughout the year, never deadly or hazardous for breathing. My husband goes for 10 km walks each day when he is here without worrying about his lungs or at what time should he wake up so it is okay to take a walk. In Noida, even when he wakes up at 5 am, it would be 35 degrees Celsius, not to forget the heat and humidity.”

One of the major factors holding people back from moving is the lack of education facilities in smaller centers. Sensing this places like Goa are seeing new schools crop up to meet the growing demand for schools the children are used to. Smaller towns are seeing a growth in the facilities they offer in order to cater to the demands of these new immigrants. And those who move too, are scaling down their expectations to adjust to the slower pace of life and lack of instant facilities they are used to in the cities.

Samarpita Mukherjee Sharma, Freelance Editor and Writer, moved from Mumbai to Nagpur after a particularly bad health scare in 2008. She now lives in Bhopal, which she says is “kinder to her lungs.” About what prompted her to move, she says, “Back in 2008, I had gone home to Nagpur for a week. I was fit and climbing three to four floors was a regular practice for me at both my apartment and at the office. But the day I reached home, I had to climb three floors and I was panting and crawling by the second floor. Once home, I'd needed to lay flat on the floor, panting and trying to catch my breath. I was 27 and had never been unwell before this. I also had a bad cold and cough so I was treated for that over the next few days. I couldn't sleep, I had to sit all night because I would be coughing all night. The day I was diagnosed with Koch's Pleural, I was admitted immediately and put on oxygen and medication. I was hospitalized for 15 days. Two bottles of water had to be drawn out from one lung with a thick syringe inserted to the organ between two rib bones."

"I was informed that pollution and being a passive smoker were the main reasons I ended up with this. I decided to not go back to Mumbai and resume my position in a leading media house in the city. My hometown is Nagpur, it offered me the better air quality to I needed heal. I live in Bhopal now and the air here is kinder to my lungs.”

Geetha Narayanaswamy moved from New Delhi to Pondicherry with her husband and son in November 2015. Her reasons for moving? “The overall air quality gets vitiated further by highly localized activity, notably when the DMC Karmachari burns the fallen leaves - a common occurrence and school buses who keep their engines on idle early in the morning spewing smoke. And Diwali! Despite being a green area - it looks really gorgeous on Satellite view - acrid smoke entered the apartment in copious amounts. Noise, ranging from automobile sounds to extremely loud music at weddings nearby. During Diwali, even after all the actions taken on crackers, there were neighbours burning long strings of patakas (‘ larhis’ ) that would just go on and on! And dust. This was not so pronounced in our area (Hauz Khas Enclave ) but frenetic new home construction, the building of the new Metro line, and of late on-site mixing of concrete, throw up a lot of dust. All of these add up.”

Her primary reason was the health of her special needs son, who has a rare neuro condition called Sturge Weber Syndrome which makes him prone to seizures and needs him to be on anti-convulsants. “The pollution intersects with this in many ways - particularly in respiratory problems and infections that weaken him further. All of us were affected actually. Moreover, PM 2.5 is nasty no doubt. But metallic contamination in the air from the auto exhaust is worse, when one is seizure prone and metallic imbalances create electrical disturbances, in short, a seizure.”

It was in the winter of 2014 that Geeta and her husband decided they would have to move out of the city. “After a gap of five years, there was a severe seizure episode in the winter of 2014. The doctors pointed to the high lead content in the air as one possible culprit. My mother-in-law also was with us in Delhi. She was fine, but with the pollution, she also developed respiratory allergies and asthmatic condition. Plus the slowly accumulated stresses -- traffic in Aurobindo Marg was becoming worse every day; the construction activity in the colony and the ‘malba’ everywhere, very dispiriting. During one medical emergency, it took us an hour to reach Max Hospital Saket from the IIT intersection. That too at 10 pm on a Saturday.”

Everyday something or the other reminded us that Delhi was becoming simply unliveable and unlovable. To quote Chief Seattle (where he is talking of their rivers) ‘… the end of living and the beginning of existence.’ That was Delhi circa 2015 for us! - Geetha Narayanaswamy

They had already bought a villa in Pondicherry in a senior living resort with all managed facilities some years ago, with the plan to eventually move base there in 2025, but this episode in the winter of 2014 made them decide to move immediately. “Everyday something or the other reminded us that Delhi was becoming simply unliveable and unlovable. To quote Chief Seattle (where he is talking of their rivers) ‘… the end of living and the beginning of existence.’ That was Delhi circa 2015 for us! So we decided to bring the date forward, and make the move proactively.”

The shift has been very beneficial to Geetha and her family. “First, the clean air has made seizures less of a worry. Respiratory allergies are now a thing of the past. Moreover, the complex has trained nurses, a medical center, some of the residents are also senior retired doctors, so the vague disquiet in the mind has also gone. It also helps that there is a gigantic medical college and hospital nearby which is truly excellent! We get c.l.e.a.n drinking water off the tap and they have testing protocols to ensure it meets standards. A range of other things helps to brighten the mood and create a state of peace and wellbeing. We have a large garden and it’s filled with birds and butterflies. Housekeeping is handled by the management - so we simply don’t worry about domestic workers. When it rains, it is insanely beautiful. My husband picked up the thread on all his hobbies, notably astronomy. Delhi’s pollution by dust and light made it impossible to see anything and you also had to fight for breath outside. Indeed, we rediscovered the beauty of rain. Over the years it had come to symbolize flooded roads, traffic jams, blocked drains, absent workers, etc. and not a thing to cheer. So much so, that after seeing all this, my mother also relocated into the community, moving in from Bombay.”

Most of those who have moved decry the apathy from the administration and the government to change this. Dua says, “Delhi and the Central Government’s complete apathy to this issue is also one of the reasons we moved away. All the big names in politics and government live and work out of Delhi NCR and the way they have “not” at all acted on this issue is appalling. They know that children being born in this region are struggling to breathe and are facing various respiratory illnesses. There should be a census shown every week/month at hospitals all over the region of people struggling or even worse dying out of respiratory problems. It will most definitely be the worst stat for India.”

Perhaps it would be apt to end with Geetha’s words. “A solution to all the problems of large cities is unlikely to emerge soon. This is because people continuously bring down their expectations and then massage their own mind that the status quo is just fine. So no one even tries to pin accountability, and so the situation simply does not change. This is verily a pollution of the mind as citizens, probably the one ‘pollution’ we should really worry about.”

Also Read: Who Is Responsible When Pollution Causes Illness And Death?

Kiran Manral is the Ideas Editor at SheThePeople.TV