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Putting life in jeopardy in Delhi

Did I put my family in peril by moving to New Delhi, one of the worst public health disasters in the world?
Last Updated 01 June 2015, 20:31 IST

For weeks the breathing of my 8-year-old son, Bram, had become more laboured, his medicinal inhaler increasingly vital. And then, one terrifying night nine months after we moved to this megacity, Bram’s inhaler stopped working and his gasping became panicked.

My wife called a friend, who recommended a private hospital miles away. I carried Bram to the car while my wife brought his older brother. India’s traffic is the world’s most chaotic, and New Delhi’s streets are crammed with trucks at night, when road signs become largely ornamental. When we arrived, doctors infused him with steroids (and refused to provide further treatment until a $1,000 charge on my credit card went through). A week later, Bram was able to return home.

When I became a South Asia correspondent for The New York Times three years ago, my wife and I were both excited and prepared for difficulties - insistent beggars, endemic dengue and summertime temperatures that reach almost 49 degrees C. But we had little inkling just how dangerous this city would be for our boys.

We gradually learned that Delhi’s true menace came from its air, water, food and flies. Delhi, we discovered, is quietly suffering from a dire pediatric respiratory crisis, with a recent study showing that nearly half of the city’s 4.4 million schoolchildren have irreversible lung damage from the poisonous air.

For most Indians, these are inescapable horrors. It is an eclectic community of expatriates and millionaires, including car executives from Detroit, tech geeks from the Bay Area, cancer researchers from Maryland and diplomats from Dublin. Over the last year, often over chai and samosas at local dhabas or whiskey and chicken tikka at glittering embassy parties, we have obsessively discussed whether we are pursuing our careers at our children’s expense.

Foreigners have lived in Delhi for centuries, of course, but the air and the mounting research into its effects have become so frightening that some feel it is unethical for those who have a choice to willingly raise children here. Similar discussions are doubtless underway in Beijing and other Asian megacities, but it is in Delhi - among the most populous, polluted, unsanitary and bacterially unsafe cities on earth – where the new calculus seems most urgent. The city’s air is more than twice as polluted as Beijing’s, according to the WHO.

So many of our friends have decided to leave that the American Embassy School – this city’s great expat institution – is facing a steep drop in admissions next fall. We nearly left two years ago, after Bram’s first hospitalisation. Even after his breathing stabilised, tests showed that he had lost half his lung function.

My wife seriously considered flying home immediately, and at the end of a summer visit to the United States with the kids months later, sobbed for hours on the return flight to Delhi. But after our second year here, Bram seemed fine. His earlier difficulties, though, led me to call some leading air pollution experts. The conversations were sobering.

“Knowing that I was putting my kids in a place that compromised their health for their lifetimes would be very difficult given all of the scientific evidence,” said James Gauderman, a professor of preventive medicine at the University of Southern California.
Sarath Guttikunda, one of India’s top pollution researchers, who moved to Goa, on the west coast of India, to protect his two young children, was unequivocal: “If you have the option to live elsewhere, you should not raise children in Delhi.” These and other experts told me that reduced lung capacity in adults is a highly accurate predictor of early death and disability - perhaps more than elevated blood pressure or cholesterol. So, by permanently damaging their lungs in Delhi, our children may not live as long.

And then there are nascent areas of research suggesting that pollution can lower children’s IQ hurt their test scores and increase the risks of autism, epilepsy, diabetes and even adult-onset diseases like multiple sclerosis. And children are by no means the only ones harmed. Many adults suffer near-constant headaches, sore throats, coughs and fatigue. Arvind Kejriwal, Delhi’s chief minister, had to leave the city for 10 days in March to cure a chronic cough.

It’s not just the air that inflicts harm. At least 600 million Indians, half the total population, defecate outdoors, and most of the effluent, even from toilets, is dumped untreated into rivers and streams. Still, I never thought this would come home to my family quite as dramatically as it did.

We live in a four-year-old, five-story apartment building that my wife chose because its relatively new windows could help shut out Delhi’s appalling night-time air. Its cookie-cutter design – by the same developer who built dozens of others in the neighbourhood – gave us confidence that things would function, by no means assured for new construction here.

Sewage invasion

About six months after we moved in, one of our neighbours reported that her tap water suddenly smelled like sewage. Then the smell hit another neighbour and another. It turned out that the developer had dug open channels for sewage that had gradually seeped into each apartment’s buried water tank. When we pulled up the floor tiles on the ground floor, brown sludge seemed to be everywhere.

I was in the shower when this sewage mixture arrived in our apartment. Sounds horrible, but I shrugged and towelled off because that smell is such a frequent presence here. For much of the year, the Yamuna river would have almost no flow through Delhi if not for raw sewage. Add in the packs of stray dogs, monkeys and cattle even in urban areas, and fresh excretions are nearly ubiquitous. Insects alight on these excretions and then on people or their food, sickening them.

Most piped water here is contaminated. Poor sanitation may be a crucial reason nearly half of India’s children are stunted. The list of health threats sounds harrowing when considered together, but life goes on and can be quite nice here. Our apartment building eventually installed aboveground water tanks. My children’s school and travel in the region are terrific, and many expats are far more influential here than they would be in their home countries.

Yet, one afternoon this spring, someone in our neighbourhood burned something toxic, and an astringent cloud spread around our block. My wife was out walking with a friend, and their eyes became teary and their throats began to close. They bolted back inside our apartment where they found Bram gasping again, for the first time in two years. In some places in Delhi, the levels of fine particles that cause the most lung damage, called PM2.5, routinely exceed 1,000 in winter in part because small trash and other fires are so common, according to scientists.

But Bram notices. He spent the next five days at home, with my wife giving him heavy doses of inhaled steroids through a mask. He has a quiet sadness during these crises, perhaps because they force him to accept the idea that his health is more fragile than that of his brother or friends. Before coming to Delhi, Bram had had a couple of breathing episodes that doctors assured us he would most likely outgrow. Now he has full-blown asthma and must take powerful daily medications.

We are moving back to Washington this week. “My asthma will go away,” Bram said recently. “I hope so, anyway.”

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(Published 01 June 2015, 18:52 IST)

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