Children in India’s capital worst affected by toxic air

No one has been spared from the toxic smog that has enveloped India’s capital, Delhi, but the city’s children are counting the biggest toll from the city’s worsening and recurring pollution problems.

Nowhere is this more apparent than in the pediatrician’s office. On a weekday morning a few days ago, the BBC visited one such facility in Noida, near Delhi.

In crowded waiting rooms outside doctors’ consultation rooms, anxious parents queued alongside children who sneezed, coughed or complained of difficulty breathing.

Most people started getting sick in October, when air quality in the capital dropped to hazardous levels and wait times for doctor appointments were longer than usual.

Toxic air is a recurring problem in Delhi and parts of northern India during winter.

The reason behind this problem is not a single one, but the result of a combination of factors, such as low wind speeds, industrial emissions, vehicle exhaust, falling temperatures, and seasonal burning of crop residues in neighboring states.

Delhi’s air quality index (AQI) – which measures levels of different types of pollutants, including PM2.5, the fine particulate matter that can clog the lungs – has been hovering between 300 and 400 since last month. This is more than 20 times the limit recommended by the World Health Organization.

Readings above 400 can affect all healthy people and seriously affect those with existing medical conditions, but high concentrations of PM2.5 affect children and the elderly most severely.

Across the capital, many hospitals are seeing an influx of children sickened by the difficulty of breathing the air.

Dr Shishir Bhatnagar, a pediatrician at Noida Clinic, told the BBC: “These particles can affect children’s immunity, especially because their systems are still developing and the cells are learning immune responses at an early age.”

“These cases have increased tenfold in recent years. In my experience, if I usually see an average of 20-30% of patients with such complaints, during pollution season this number jumps to 50-70%.”

Every year, governments introduce emergency measures – halting construction and banning polluting vehicles – to curb the smog. This year, it even tried to artificially increase rainfall, but failed.

But none of this will help ease a pollution crisis that has stoked anxiety among the city’s 20 million people, especially parents of young children.

Khushboo Bharti, 31, said she shudders every time she thinks about the night of November 13, when she had to rush her one-year-old daughter Samaira to emergency care.

“I remember she woke up with a violent cough that caused her to vomit several times,” Ms. Batty said.

She tried common home remedies, but nothing worked. Eventually, she took her baby to the hospital in the middle of the night.

“On the way there, Samaira didn’t react to anyone or anything. It was so unlike her, she was an active child. She wouldn’t even look up. It was the worst moment of my life.”

At the hospital, the toddler was treated with strong nebulized steroids and received oxygen support for two days. She was later diagnosed with pneumonia.

Ms. Bhatti has been on the fringes ever since.

“Even if she just coughed a few times, I would panic.”

Samarra has now recovered, but other parents like Gopal* fear the deadly air could cause irreparable damage to their children’s health. Gopal* had to take her two-year-old daughter Renu* to a government hospital last week because of chest tightness.

“The doctor told me she might need to use an inhaler for a while,” Gopal told the BBC.

Years of research have highlighted the devastating impact of air pollution on young children around the world – leading to developmental delay, weak immunity and lower cognitive abilities.

A recent study from the University of Cambridge, which included data from nearly 30 million people, also found that exposure to certain pollutants is associated with Higher risk of various types of dementiaincluding Alzheimer’s disease.

These growing risks have many parents like Ms. Bhatti considering moving out of Delhi.

“What’s the point of living in a city where even my daughter can’t breathe safely?” she asked. “My husband’s business is in Delhi, so we can’t leave everything behind. But as soon as we get the chance, we will move.”

For now, Delhi has taken steps to limit children’s exposure – postponing outdoor sports and moving primary school classes to a hybrid model.

The relatively privileged will benefit, but for the hundreds of thousands of economically disadvantaged children who are born into working-class families and live on roadsides or in shantytowns, “the attack on their lungs is huge,” Dr Fateh Harding, a pulmonologist in Kerala, told the BBC.

Living in cramped homes also exposes them to greater pollution from cooking fuels, traffic and poor ventilation. Toxic air outside makes the situation worse.

“These children are continuously exposed to high levels of pollution, due to which their lung defense systems weaken. If infections in such children are not treated, permanent damage to the lungs may occur,” said Dr. Fathahudeen.

He noted that several studies have shown that early childhood infections due to exposure of “immature lungs” to air pollution may lead to chronic obstructive airway disease in adulthood, similar to what occurs in smokers.

Dr Fathahudeen said those who are able should strictly keep children indoors, ensure they are properly hydrated and wear N95 masks (which filter 95% of pollutants) when outdoors.

But parents question how long they can keep their children indoors.

“They are growing, they need space to play and while they do have a brief moment in nature, we are now forced to hold them back,” mother Seema* said.

“They sometimes protest, but what choice do we have? We know how important physical activity is, but not at the expense of breathing this toxic air,” she said.

*Name has been changed

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