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People’s Movement – A Must for Achieving Clean Air Goals

Citizen awareness and action alone will bring about the change that is needed.

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The World Health Organisation (WHO)’s first ever global meet on the health impacts of air pollution is currently underway in Geneva, Switzerland. Ironically, at the same time, Delhi’s annual air quality crisis looks to be all set to repeat itself.

Media reports suggest India is likely to be put on the spot at the event for its spiralling air quality crisis. The battle against air pollution wasn’t won in a day, yet India is at a stage where we need to make a start in right earnest.

The capital woke up to an AQI of 367 on Monday (29 October), which falls under the “Very Poor” category. But apart from a frenzy of media reports linking it to instances of crop burning further north, the issue has failed to garner the attention it deserves, and there is an uncomfortable silence from the ones most affected – the people of Delhi.

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Indian Govt’s Refusal to Address the Pollution Crisis

As a practising chest surgeon, I have operated upon several thousand pair of lungs over the last 30 years. However, when I started, a large majority of the lung cancer cases I handled were in men aged 50 years and above. Most of them were known smokers – who had been voluntarily smoking since their early 20s.

Citizen awareness and action alone will bring about the change that is needed.
I operate upon lung cancer cases in adults as young as 29 years old. A large number of them have never smoked.
(Photo: iStock)
Today, I operate upon lung cancer cases in adults as young as 29 years old. A large number of these are both men and women who have never smoked a cigarette. In fact, there is a 50 percent rise in lung cancer cases (the most prevalent type of cancer in the country) in non-smokers.

Of course a small percentage of these are people affected by second-hand smoke, but the spike is clearly indicative of the toxic air quality they grapple with every single day.

Studies by reputed international institutions corroborate this. WHO’s 2018 rankings found:

India to be home to 14 of the 20 most polluted cities in the world

Meanwhile in 2017, the Lancet Commission on Pollution and Health ranked India as the number 1 country in air pollution-caused premature mortality, and found that:

2.51 million Indians died in 2015 due to the ill-effects of air pollution

Yet, the government as well as the Central Pollution Control Board (CPCB) – has on several occasions rejected the WHO’s findings on India’s air quality crisis, saying that the findings do not reflect Indian conditions.

The government has also dismissed the findings of the Lancet Commission, saying that there was no conclusive link between air pollution and mortality rates in the country.

While there could be differences on numbers, there can not be any doubt about the ghastly effect polluted air is having on people’s health.

Citizen awareness and action alone will bring about the change that is needed.
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Inaction on Pollution Control Worsening the Situation

The WHO mandates that the daily average levels of PM2.5 (the fine particles that can reach the most peripheral parts of lungs and stay deposited there and release chemicals which enter our bloodstream through the lungs) across any region must not exceed 25 μg/m3. This implies that concentrations beyond that threshold are likely to cause health complications in human beings not just in Western Europe or the United States, but anywhere across the world.

But perhaps because India is a developing nation, the CPCB’s acceptable standard for daily average PM2.5 concentration stands at 60 μg/m3. Medically, however, the laxer standards are quite unfortunate. Regardless of where we stand economically, Indians are not more immune to air pollution.

Incidentally, PM2.5 concentration for Delhi for the week of 28 October averaged over 200 μg/m3.
Citizen awareness and action alone will bring about the change that is needed.
A ragpicker boy stand next to burning garbage on the outskirts of Delhi.
(Photo: AP)

Moreover, all of our major cities suffer from heavy vehicular pollution, emissions from industries and power plants in an around their perimeters, dispersion of dust from unauthorised construction activities and manual sweeping, and the burning of all sorts of litter on the roads itself.

Faced with mounting pressure to take action, the government did notify the Graded Response Action Plan (GRAP) across Delhi NCR in 2017. But lack of coordination between various civic bodies and poor enforcement of the plan has failed to bring pollution down to medically prescribed limits.

This year too, Delhi’s air quality is likely to plummet after Diwali, since the Supreme Court’s ruling on 23 October – that restricts the sale and burning of firecrackers outside certain times – will be difficult to enforce.

The apex court has only allowed the sale of firecrackers with lower emissions, and has even encouraged communities to burst crackers together – to reduce the sheer number of crackers burnt across the country.

But without an appreciation for the activity’s toxic after-effect – both by civil society and officials tasked with enforcing the court’s directive – air quality across Delhi and other cities will deteriorate.

The Centre’s draft National Clean Air Plan (NCAP) restricts itself to tackling air pollution as a city-specific issue. It is not, as clearly evinced by Delhi’s attempts to dissuade farmers in Haryana and Punjab from burning their crop residue.

In fact every city, town and village within approximately a radius of 300km from heavily polluted areas has to battle air pollutants. If the NCAP is notified without addressing these shortcomings, it will be another wasted opportunity.

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Citizens Demanding Action from the Govt Will Bring Change

Citizen awareness and action alone will bring about the change that is needed.

Thus as a doctor, I am very worried. My experience with patients has shown that every organ in our body is affected by this cocktail of air pollutants. Exposure to such inhumanly high levels over sustained period will lead to disastrous complications in lungs, heart, brain, reproductive system as well as other organs – in short a volcano of diseases.

Air pollution will prove to be far more harmful than smoking, because smoking damage was restricted to smokers alone but air pollution damage will involve ALL of us, because the only requirement will be breathing – if you breathe you will be affected.

However, this also leads me to the only solution I see to the crisis – mobilsing every Indian to demand a lot more from their politicians. Citizen awareness and action alone will bring about the change that is needed.

Every man, woman and child must educate themselves on the perils of air pollution, understand guidelines on what constitutes healthy air, and then demand that their constituency’s representatives enforce immediate, unambiguous action plans on slashing air pollution. Simply expanding the air quality monitoring network across India will not mean much if the serious figures they record fail to lead to corrective actions.

Along the lines of the National Green Tribunal’s ruling on 11 October, people must also call for holding government officials and politicians accountable if the plans are not fully implemented. If they do not, losing their health to pulmonary and cardiac diseases and cancers brought on by toxic air will be too high a price to be paid.

(Dr Arvind Kumar is Founder Trustee, Lung Care Foundation and Chairman, Centre for Chest Surgery, Sir Ganga Ram Hospital. Hes also a partner of Health Care Without Harm, an international organisation that works to address the health impacts of air pollution and climate change.)

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