Indians slowly choking under clouds of air pollution

Promilla Butani, a leading New Delhi pediatrician, suffers from asthma and dreads the clouds of pollution that blanket India's capital city on a regular basis.

Bhutani has been hospitalized twice this year due to poor air quality and was put on an extra dose of oral steroidal asthma medication to stay functional.

"I had to go to Mumbai last week for an important function and stepped out with an N95 mask that is highly effective at filtering out airborne particles. But before I could reach the airport, I felt sick and had to cancel the trip," Bhutani told DW.

At the other end of the city, Manish Paswan, a tuk-tuk driver, struggles with a violent cough outside the new clinic for pollution-related illnesses at the Ram Manohar Lohia Hospital.

"It has been a horrible time, and I have been facing breathing issues for the last two weeks, especially after [the light festival] Diwali. For a few days, I even had panic attacks and came to see the doctor for help," Paswan told DW.

Air pollution goes beyond New Delhi

The recently opened clinic has already become a lifeline for those grappling with pollution-induced diseases, including bronchitis and breathing difficulties.

Doctors in this and other hospitals report cases of breathlessness, asthma, and chronic obstructive pulmonary disease (COPD). They say there are more patients than last year.

"The elderly and those with heart conditions are particularly susceptible, experiencing heightened symptoms and requiring hospitalization," pulmonologist Kailash Gupta told DW.

New Delhi has been dealing with air pollution for a long time, earning it the label of the world's most polluted city.

However, experts and doctors warn that air pollution also threatens huge swaths of India outside the capital.

The primary problem is airborne particulate matter, especially fine particles that are 2.5 microns or less in diameter, designated as "PM 2.5," which are small enough to enter air sacs in the lungs. 

The issue transcends jurisdictions and individual sectors of industry — agriculture, industry, power plants, households, and transport all contribute significantly to air pollution in India.

Pollution affects children

A study published in 2021 found that 1.67 million people died due to air pollution in 2019.

Researchers from the Global Observatory on Pollution and Health (GOPH) at Boston College, the Indian Council of Medical Research, and the Public Health Foundation of India described it as the largest pollution-related death toll in any country in the world, adding the costs amounted to $36.8 billion (€35.12) in economic losses.

"It is also having a profound effect on the next generation of Indians," GOPH director Philip Landrigan told DW.

"It increases future risk for heart disease, diabetes, and respiratory disease for today's children when they become adults. It is reducing children's IQ and it will be very difficult for India to move forward socially or economically if they don't do something about the problem," said Landrigan, who is a pediatrician. 

A more recent study linked air pollution to some 2.1 million deaths per year in the world's most populous country. The "State of Global Air Report 2024" says 12,000 deaths every year can be specifically linked to air pollution in New Delhi.

"464 children under 5 die daily in India due to air pollution, surpassing tobacco, and diabetes as the leading cause of death," the report says.

Other studies, however,  report lower overall casualty figures.

'Nobody can escape'

Surgeon Arvind Kumar described air pollution as a silent pandemic.

"We have serious and unacceptable levels of air pollution that not only affect people's lives and unborn children in the country, but will destroy ecosystems. Nobody can escape the ill effects of bad air as its affects every organ of the body," Kumar told DW.

After seeing the growing impact of air pollution first-hand in his patients, Kumar decided to set up a medical non-profit called Lung Care Foundation in India

"There is unambiguous data, but nothing is being done to hit at the sources of pollution," he added.

What is the way forward?

A report published by the World Bank in 2023 called for a so-called "airshed" approach to air pollution problems.

An airshed is defined as a region that shares a common flow of air, which may become uniformly polluted and stagnant.

The global organization says India needs airshed-wide coordination in regions where a significant portion of PM 2.5 pollution originates from sources outside the cities.

"India, therefore, needs to look beyond its cities and take action at the sub-national level for effective air pollution control strategies and apply new set of tools for airshed-based management," the World Bank said in a June statement "Catalyzing Clean Air in India."

Grassroots-level for major benefits

Doctors for Clean Air (DFCA), a network of doctors who advocate for clean air and raise awareness about the health effects of air pollution, has been expanding its grassroots engagement with communities in the hardest-hit regions.

"Finally, one realizes that a citizen-led initiative and people's movement to be most beneficial. It takes time but has provided results," Surgeon P S Bakshi told DW.

He pointed to the example of farmers in the Bajra village of Jalandhar district in Punjab.

The villagers, like so many others in northern India, used to burn stubble and straw after harvesting crops of rice and wheat.

The practice is a quick and cheap way to clear their fields for the next crop cycle, but it also contributes to air pollution.

Bakshi said farmers in Bajra agreed to banish the practice after the surgeon explained the negative health impact.

"The number of farm fires in Punjab has fallen sharply but more needs to be done to change the narrative on health and air quality," said Bakshi.

Edited by: Darko Janjevic