A hazy India Gate in New Delhi. Photo: Rajesh_India/Flickr CC BY NC ND 2.0
Humans of Air Pollution: India’s Growing Tribe of Environmental Refugees
This is the first of a three-part series on India’s small but growing tribe of environmental migrants. Currently, these “pollution refugees” come from the privileged class of the educated aware. But as awareness grows and people connect the dots around the health harm pollutants trigger – in this case, the human cost of air pollution – the country will see a greater migration from extremely high to relatively low pollution areas, says Jyoti Pande Lavakare, who has been tracking this space since 2014. Read part 2 here and part 3 here.
New Delhi: Every October, I start monitoring my city’s air quality index levels more closely, my dread mounting along with the mounting numbers of microscopic particulate matter reflected in the Air Quality Index (AQI). I begin my Diwali festival preparations, not by buying tiny terracotta oil lamps to light as I used to traditionally, but fresh N99 pollution masks. I seal all my windows with duct tape, and change the filters of all my indoor air purifiers, as well as those in the home of my elderly father, even as I remind my close friends to do the same.
This is how I’ve been preparing for Delhi’s toxic winters since 2014, after an aware friend opened my eyes to the invisible particulate matter smaller than 2.5 microns that I was involuntarily – and ignorantly – inhaling. Barun used his trusty DustTrak machine to measure their real-time concentration in front of me and showed me the catastrophically high reading, thus beginning a journey I wish I had never needed to take.
This year, the city’s air quality deteriorated to “poor” for the first time on Thursday, October 12, a warning that the pollution season has begun early and in earnest. Neighbouring Gurugram, with its glittering chrome and glass towers that house leading multinational corporations, saw a 63% increase in pollution levels in the first 12 days of October compared to the same period last year.
On October 23, the AQI fell further to “very poor” and a familiar grey haze started settling into my city, shrouding it with pollution – and disease.
Knowing how poisonous the ambient air will soon become – and the serious health harm that those PM2.5 particles will trigger – makes me nervous. Unfortunately, I happen to know that air pollution is the greatest threat to human health globally, whose impact on life expectancy is comparable to that of smoking, more than three times that of alcohol use and unsafe water, six times that of HIV/AIDS, and 89 times that of conflict and terrorism.
Air pollution triggers mortality and morbidity not just through respiratory diseases, but has been found to affect every organ in the human body. Peer-reviewed journal Neurology’s September issue published research that showed a strong and significant correlation between air pollutants and death from strokes.
So even as my eyes start watering, my throat starts its familiar stinging and that dull, pollution headache kicks in, each October, I pray that this winter will be better. But each year, my government fails me. Year after year, neither the state nor the federal government takes any serious, proactive, long-term steps to bring down emissions. By early November, when smoke from burning agricultural fields around Delhi peaks and engulfs the capital and other north Indian urban centres, taking PM2.5 levels to over 40 times the WHO 24-hour guideline limits or after Diwali, when this number can shoot to nearly 100 times these limits, politicians and government officials will begin trotting out the same old useless, ineffective arsenal of excuses and red herrings that they fall back on – anti-smog towers, anti-smog guns, temporary construction bans, odd-even road sharing directives, school closures and other reactive “emergency response action plans“. A few days after implementing these reactive bandaids with fanfare – many of which have been scientifically proven to be ineffective – even these will quietly be withdrawn, normalising high levels of pollution yet again.
It’s no surprise that each year, I feel let down, helpless. Hopeless and angry.
In the past two winters, I’ve added one more negative feeling – guilt. Because, unable to bear the high pollution, I have begun fleeing my landlocked city of birth and residence around Diwali to take refuge in a tiny village close to the sea. The relief and gratitude when my train pulls into Tivim, a sleepy village in Bardez taluka in the western Indian state of Goa, is overshadowed by guilt. Guilt for abandoning loved ones unable to flee, due to age or economics or because they are tethered to their children’s schools or jobs that can’t be done remotely, guilt that my privilege allows me to flee when others are forced to remain within that cloud of toxic air – and guilt that I have chosen flight over fight in the face of clear and present danger.
This is the story of what led to my becoming a pollution refugee. I’m not alone – there are many of us, those who have been forced out of our homes because of toxic air – and each year, our tribe is growing. I keep returning to my home city, an area of morbidity and mortality – a city that also happens to be the capital of India – because my family and friends there still make it feel like home. But I wish the pollution hadn’t pushed me out.
Forced out of familiarity, a feeling of dislocation.
It isn’t as if my rural refuge has zero pollution. People, industry and governments are the same everywhere. This means I see similar daily open waste and biomass burning, smoke from the small patches of farm fields around my refuge village and chimneys that dot the industrial estates as well as kitchens of the shacks, cafes and restaurants that dot the tourist hubs. The red dust that the village kuccha dirt roads throw up intermingles with the road dust from the tarred, concrete but potholed pucca roads, making me cough, reminding me of Delhi.
But despite all this, unlike Delhi’s hazy skies, the sky above my Goa village is still a clear, deep blue in the day and at night, I can see the stars shine bright because the sea pulls away all the pollution, smoke, dust and dirt. But something is always missing. The familiar feeling of home, of family, of rootedness.
This is what refugees must feel like, only much worse, when forced to leave their homes and familiar spaces, I thought to myself as my train chugged out of Delhi’s railway station early one smoggy October morning last year. Diwali firecrackers had added not just more smoke, but additional toxicities through the metals that give fireworks their colour to the already poisonous air, and I could smell the acrid air through my mask.
We looked out of the sealed Indian Railways window into the grim, grey sky, both my husband and I coughing and sneezing, the congestion of the past few days built up in our chests irritating our respiratory systems, his allergies flaring, my fever rising, as the train picked up speed, carrying Delhi’s pollution in our lungs and anger, hopelessness and guilt in our hearts.
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I used to love Delhi’s bright winter sunshine, its crisp, cool mornings. My childhood memories include picnics under blue skies and playing in the rolling greens of public parks. But those colours have turned grey with smog. I am now part of a growing tribe of environmental migrants, deserting my elderly father, extended family and closest friends, forced out of my city of residence and choice. The city in which my mother died of pollution-triggered lung cancer.
If one isn’t aware of the human cost of air pollution, one could be forgiven for assuming a certain glamour associated with migrating from the northern winter to a warmer coastal location. But what if the move isn’t a choice but a compulsion, a push factor, not pull, something you must do to stay healthy, stay alive, avoid disease and even death? That is when this sort of migration due to environmental toxins makes pollution refugees out of ordinary people.
Pollution is still on the rise across all India, not just North; Mumbai worse than Delhi
But this isn’t just about New Delhi. Across India, pollution continues to be on the rise this year, as it has been for over 22 years, with no region escaping that increase. North India leads, and cities across the Indo-Gangetic plain – from Pakistan to Calcutta, bounded by the grand Himalayas in the north – are among the most polluted places on this planet. IQ Air’s 2021 World Air Quality Report (based on updated annual WHO air quality guidelines for PM2.5) found that 35 of the 50 most polluted cities in the world were in India. Nearly all are in the north.
What this means is that over half a billion people in some of the most populous – and poorest – states of India are currently smoking the air, involuntarily and without any choice or even awareness of what harm it is doing to them. North India’s 510 million residents are on track to lose 7.6 years of their life expectancy on average, according to the University of Chicago. A resident of New Delhi would lose nearly 12 years of their life expectancy.
While alarming, perhaps even more troubling is the rate at which this pollution is rising – and, the resultant increasing health disparity within India. A 2020 study by the Central Pollution Control Board and IIT Delhi concluded that although north India continues to have the highest levels of air pollution, pollution is rising faster in south and eastern India. It is also rising faster in rural India, according to a 2023 IIT Kharagpur study.
The list of those driven out of north India due to pollution just keeps growing. However, shockingly, in recent years, the geographically advantaged western coastal city of Mumbai is increasingly seeing a similar trend. Like the previous year, the winter of 2022 saw Mumbai, India’s financial capital, beat Delhi’s pollution on several occasions in December and January, spooking residents into considering a winter migration away from the city.
Meteorologist Gufran Beig, founder and project director of India’s air quality forecasting system Safar, attributes this breakdown in Mumbai’s self-cleaning from ocean breeze to increased construction dust, slower surface wind speed. Activists add the chopping of trees as another reason. “All the construction that was stalled due to the COVID-19 pandemic is now taking place in full swing. This pent-up demand along with the cutting of trees and forests in this region has added to the pollution load, tipping it over and making it worse than even Delhi,” says environmentalist Vimlendu Jha.
This winter is even worse, with Mumbai’s air quality levels worse than Delhi’s from October itself, three weeks before Diwali and falling temperatures. Mumbai’s usual geographical advantage no longer offers reliable protection, and weakening sea breezes due to the La Nina effect have added to other factors, say experts.
The coastal finance hub has experienced its second full-blown consecutive post-monsoon air quality crisis this year. “Mumbai basically looks like a construction zone these days. All you can see on the horizon are mechanical cranes against hazy skies,” rues Anita Bhargava, co-founder of investment analytics start-up BharosaClub, who moved from Delhi to Mumbai partly to get away from the capital’s poor air. “If we don’t do anything to clean the air, all our cities will end up this way. Where do we run to? It’s a race to become the worst city to live in.”
As for southern India, although its geography (high altitude) and weather (rain and wind) ensures most of its particulate matter is washed or blown away, Bengaluru topped the State of Global Air’s list of polluted cities for nitrous oxides in September 2023, followed by neighbouring Hyderabad. NOx exacerbates respiratory diseases, and a recent AIIMS study found it can lead to an increase in the number of emergency room visits by 53%.
However, pollution doesn’t just affect the lungs. Bengaluru has the youngest population of heart patients. The city’s Jayadeva Institute of Cardiovascular Science and Research treated 2,200 heart attacks of patients under 40 in 2 years, the youngest being 16 years old. These were mostly software professionals and auto/cab drivers who spent longer than an hour in traffic and since these patients didn’t have the usual risk factors like smoking, obesity and diabetes, doctors believe air pollution caused artery blockages. Jayadeva Institute has since joined hands with the St John’s Research Institute and Centre for Human Genetics to conduct a research study to prove this.
It isn’t just pollution-triggered short-term respiratory illnesses – bronchitis, asthma, viral infections, flu and pneumonia made worse by dirty air – that concern me. It is the long-term, irreversible diseases that the ambient PM2.5 will trigger as it bypasses our bodily defences and sinks into our lungs and bloodstream, travelling to every organ, leading to cardiac arrests, strokes, diabetes, hypertension, cognitive harm, depression, dementia, obesity, Alzheimer’s, dementia and different cancers.
As far as public health researchers, and some of us who have been tracking pollution’s impact on human health, are concerned this is an unacknowledged public health emergency, a silent pandemic of non-communicable diseases triggered by the involuntary act of breathing polluted air. Even clinicians and doctors are finally validating this.
Dr Randeep Guleria, pulmonologist and former director of India’s top research hospital, the All India Institute of Medical Sciences reiterated recently that air pollution is increasing, worsening underlying diseases, and is a silent killer. The most frightening prediction is a lung cancer epidemic in the coming years, made by lung surgeon Dr Arvind Kumar. Lung cancer. For which there is no palliative measure, not even morphine, because what can you give to someone who is gasping for every breath?
Read part 2 here and part 3 here.
Jyoti Pande Lavakare is the author of Breathing Here is Injurious to Your Health: The Human Cost of Air Pollution, published by Hachette in November 2020. The second part of the story will be carried on Wednesday, November 1.