I have practiced clinical medicine and public health in India for over 20 years in a number of roles, including academic researcher, educator, corporate medical director, and patient-centered clinician. In 2015, after six years of living and working full-time in New Delhi, I thought I had undertaken every precaution to keep my family healthy: pesticide- and hormone-free food, purified water, mosquito protection… you name it, I had probably investigated it and figured it out.
The one thing I completely neglected to protect against was the air pollution. In fact I was oblivious to India’s air pollution until, in our final month in New Delhi, my then 9-year old daughter required emergency room care for sudden-onset asthma attacks. Coincidentally, in that same month, the World Health Organization announced that New Delhi was the most air polluted city in the world. We had no choice but to move away, not just for an upcoming job transfer, but simply to protect our children.
I was grateful that we were moving to live in clean air, but both professionally and personally, I felt I had left behind a huge problem, affecting everyone I knew and loved there. I could not let it go. I now travel to India every few months, in part to support a non-governmental organization that raises awareness and advocates to mitigate India’s air pollution crisis.
A few days ago, a young New Delhi-based reporter asked me for my “expert opinion” on how air pollution harms children in India. Here is an excerpt of what I wrote:
“Children born in air pollution face shorter life expectancies compared to their counterparts born in cleaner air… Children suffer physical health harms, including diminished lung growth and development, and increased prevalence and severity of pneumonia and asthma… [they] risk functional health harms including suboptimal cognitive development and sports performance. Air pollution is associated with depression, anxiety… and contributes to cancer and lifelong chronic diseases in adulthood including diabetes, cardiovascular disease, and dementia…”
These health facts are easy to summarize, but they do not convey the whole story. What is more difficult to articulate is the stress and suffering that air pollution has created for millions of Indian people. Including me.
I hate all the coughing. It starts within three days of my landing in New Delhi. Every friend is coughing or suffering some respiratory symptom. The plane is full of coughing passengers when I depart.
I cannot fully enjoy Diwali anymore. I dread the futile arguments my friends and family will have with neighbors who insist it is their “right” to set off illegal firecrackers. I dread the off the charts toxic air my friends and family will breathe in the subsequent weeks. I mourn the loss of elderly neighbors and relatives who have died of respiratory illness in the post-Diwali smog.
I hate that I discouraged my 75-year old father from visiting India for his elementary school reunion last November, because I was worried that the toxic air and ill-equipped health care system would seriously harm him.
I feel sad for scheduling my children’s India visits only during the monsoon season, when the heavy rain reduces the air pollution. I feel guilty for limiting if and how long my children can play outside for those few weeks, knowing that their friends practice sports in worse air, every day.
Air pollution is not just a health problem harming our bodies. Air pollution compromises our moods, how we celebrate weddings and holidays, and how we live, work, play and travel. It is a crisis, affecting families just like mine, every single day.
Ultimately, for me, the only marker of success in this fight is India achieving clean air, for every person, every day.
I now know many of the experts and activists in India engaged in this fight, and I join forces with them. We lack a sure path to clean air. Yet, we know that solving this crisis is entirely possible. Other countries have successfully cleaned up their air. And Indian history has proven the country’s will and capacity to dramatically change.
India can and must overcome its air pollution crisis. We have to believe it is possible, bring our skills to it, and keep at it. Not just life, but more importantly quality of life, is at stake, and worth fighting for.
Gita Sinha MD MPH is a physician specialist in Internal Medicine and Infectious Diseases and an independent consultant in clinical medicine and public health. She currently serves as a member of the executive team leading strategy and evaluation for a non-governmental organization dedicated to fighting India’s air pollution crisis.
Gita completed her undergraduate and medical degrees at Stanford University, Internal Medicine residency at Brigham and Women’s Hospital/Harvard Medical School, and Infectious Diseases fellowship and Masters of Public Health degree from Johns Hopkins University School of Medicine, where she served as Assistant Professor of Internal Medicine/Infectious Diseases for over 10 years. Throughout her career, Dr. Sinha has led programs in clinical and public health education, and health services delivery for rural and urban populations in India as well as other South and Southeast Asian countries. Her roles have included Principal Investigator for an NIH-funded community clinical trial of HIV clinical services in rural Maharashtra, Visiting Faculty and Research Director in clinical medicine and public health in Jodhpur, Rajasthan, and co-Medical Director for a New Delhi-based primary health care start up company.
Her work-life motto is a quote by MLK Jr. which is present on her refrigerator as a reminder, “Never, ever be afraid to do what’s right, specially if the well-being of a human or an animal is at stake. Society’s punishments are small compared to the wounds we inflict on our soul when we look the other way.” Born and raised in the United States, she divides her time between New Delhi and Milwaukee, Wisconsin, where she lives with her family.