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Neerja Deodhar profile imageNeerja Deodhar

With the AQI riding higher each day, the closure of schools in Delhi seems to be an easy solution. But are we ignoring the consequences that come with it?

Air pollution in India isn’t just making children sick. It’s choking their education

Now considered a public health emergency, air pollution in India is to be blamed for growing absenteeism in schools, a compromised shift to online education, and widening social divides among children

The year is 2018. It’s the middle of the academic year in New Delhi, and school students have settled into the routine of classes and examinations. As winter approaches, it brings with it the familiar warmth of the festive season, but not without a nasty reality check: the air quality index (AQI) has climbed to a troubling 450.

Amid the setting up of air filters in classrooms and a mandate to mask up for outdoor activities, 25 educational institutions in the capital introduced ‘Breathe Easy Stay Tough’ clubs in 2018—dedicated to  help students better understand air pollution and improve their lung health. An initiative devised by the Lung Care Foundation, it  places particular emphasis on asthma and its management by school leadership. One of the key objectives was ensuring that the participating institutions would become safe spaces, says Abhishek Kumar, CEO and co-founder of the Foundation. 

The AQI in Delhi hit a peak of 494 in November 2024. Image: Unsplash

The AQI in Delhi hit a peak of 494 in November 2024. Image: Unsplash

Source: Hindustan Times

Source: Hindustan Times

“Many children who aren’t diagnosed with asthma or airflow obstructions, don’t know they have these underlying conditions and hence won’t possess inhalers or medications. We designed manuals that outlined symptoms and triggers, as well as [devised] steps schools themselves could take, whether it was tackling dust and pollen on campus, or identifying asthma attacks,” explains Kumar. A club focused on air pollution may not be as cool as a debate society or robotics team, but it can be the very reason a fatality is prevented on school grounds. Six years on, as the AQI in Delhi hit a peak of 494 in November 2024—the second highest recorded value since the index’s inception—the Lung Care Foundation’s 80,000 student-strong initiative only becomes more relevant.

Asthma, bronchiolitis, and other respiratory conditions have been on the rise, caution doctors, who have been witness to increasingly younger children frequently visiting the Emergency departments at hospitals—some even needing immediate hospitalisation. Adhering to government regulations in times of severity, schools remain shut for weeks on end, shifting classes online and eagerly awaiting the weather to clear. Worried parents debate whether they should keep their kids at home, in safe, purified air, or allow them to play outdoors. The collateral damage? Children’s education, which remains disrupted, and, in some cases, a far cry from the normal, offline schooling experience. Through conversations with pulmonologists, parents, and stakeholders in public health, what emerges is an urgent need to look beyond rinse-repeat tactics.

Out of breath

In the winter, the sound of a classroom in many parts of north India is the sound of a teacher’s instructions, interjected by constant coughing. “On days when the AQI is high, a cough is the human body’s protective reflex against pollutants,” says Dr Harish Bhatia, a Delhi-based interventional pulmonologist and the founder of Rebreathe Clinic. “Students exhibiting such a cough are either discouraged from coming to school, or often sent home.”

“WHAT IN-PERSON SCHOOLING DOES, ONLINE CLASSES SIMPLY CANNOT DO—ESPECIALLY FOR YOUNGER CHILDREN”

Dr Mala Kapoor

Until about 15 years ago, the majority of young asthmatic patients who consulted Dr Dev Kumar Jha tended to be above the age of six. Since 2019, the pediatric pulmonologist has noticed an alarming number of toddlers coming in for treatment. “Asthma is brought on by a number of factors, including genetic ones, but pollution is a major trigger. Children aren’t just uneasy when pollution levels rise; pre-existing asthmatic conditions are exacerbated, and the age at which the first symptoms are showing in undiagnosed cases is reducing. Pollution damages the airways of young kids, which makes them more vulnerable to pneumonia and other respiratory disorders,” shares the Ghaziabad-based specialist. Whether they’re recovering at home or in hospital ICUs, students are bound to remain absent from school for anywhere between two days to a week. 

Sustained exposure to high concentrations of fine particulate matter (PM2.5) puts young, unmatured lungs, which are still developing, at greater risk of chronic conditions like Chronic Obstructive Pulmonary Disease (COPD). “Children also have a higher respiratory rate [number of breaths taken per minute] than adults, making them more susceptible,” explains Jha.

“On days when the AQI is high, a cough is the human body’s protective reflex against pollutants,” says Dr Harish Bhatia

“On days when the AQI is high, a cough is the human body’s protective reflex against pollutants,” says Dr Harish Bhatia

Sustained exposure to high concentrations of fine particulate matter (PM2.5) puts unmatured lungs at greater risk of Chronic Obstructive Pulmonary Disease (COPD)

Sustained exposure to high concentrations of fine particulate matter (PM2.5) puts unmatured lungs at greater risk of Chronic Obstructive Pulmonary Disease (COPD)

The picture only turns grimmer when we consider the effects on academic performance and social development. One study found that air pollution can be linked to declines in reading and mathematics outcomes; another found that PM2.5 was contributing to rates of stunting in childhood, with adverse impacts on health and earnings in adulthood; a third showed that the pollutants a mother was exposed to in the latter period of her pregnancy could have an association with infant and neonatal mortality. School will perhaps never be the same for kids who suffer cognitive impairment and the beginning signs of Attention Deficit Hyperactivity Disorder (ADHD).

In the face of these life-altering health complications, it is no shocker that air pollution is termed a public health emergency in India. “Five years ago, it was an ‘issue’; five years since, we call it a ‘public health emergency’. To me, this is an accurate description of the circumstances that have unfolded, and a call for immediate action,” says Dr Mehak Segan, a public health worker based in Noida. “Five years later, if emissions aren’t cut down, if a switch to cleaner energy is not made, and if there isn’t a stronger implementation of rules, we’ll be watching a public health disaster unfold,” warns Segan.

‘Band-aid’ measures

Year on year, whether kids should pack their bags, lay out their uniforms, and be excited about their tiffin boxes on any given day between September and January is determined by the AQI—and Graded Response Action Plan referred to by the Commission for Air Quality Management (CAQM), set up for the National Capital Region and adjoining areas. 'Severe' air quality (AQI ranging between 401-450) means state governments could shut schools for the primary section; 'Severe +' air quality (AQI > 450) calls for all classes to be shut down in-person. For context, AQI above 201 itself is considered 'poor'.

“IF EMISSIONS AREN’T CUT DOWN, IF A SWITCH TO CLEANER ENERGY IS NOT MADE, WE’LL BE WATCHING A PUBLIC HEALTH DISASTER UNFOLD”

Dr Mehak Segan

“What in-person schooling does, online classes simply cannot do—especially when it comes to younger children,” says Dr Mala Kapoor, founder-principal of the Silverline Prestige School, Ghaziabad. She clarifies that this is true even of students in class five and above, who are no strangers to dissecting poems or balancing equations by looking at a screen.

Many of the e-learning challenges thrown up during the COVID-19 pandemic persist: In households where parents own two—or worse, one—phones and no laptops, one or more children may not even be able to attend classes. “Often, two siblings take turns to log in from the homemaker’s phone… Another hurdle is the internet speed; if it isn’t strong, they cannot be expected to turn their cameras on. Above all, focus and concentration are affected. Even with those students who have access to laptops of their own, or computers owned by their families, there's no telling if they're truly paying attention,” adds Kapoor. 

School will perhaps never be the same for kids who suffer cognitive impairment and the beginning signs of Attention Deficit Hyperactivity Disorder (ADHD)

School will perhaps never be the same for kids who suffer cognitive impairment and the beginning signs of Attention Deficit Hyperactivity Disorder (ADHD)

Even with those students who have access to laptops of their own, or computers owned by their families, there's no telling if they're truly paying attention, says Dr Mala Kapoor. Image: Getty 

Even with those students who have access to laptops of their own, or computers owned by their families, there's no telling if they're truly paying attention, says Dr Mala Kapoor. Image: Getty 

Criticism for the shift to e-learning is hardly new. In December 2021, the then chairperson for the Delhi Commission for Protection of Child Rights, Anurag Kundu, wrote a letter to the CAQM, requesting the immediate opening of schools. His reasons ranged from the worryingly high levels of indoor air pollution—which were not starkly different from the outdoors—to the learning losses that had taken place over 600 days, owing to COVID-19 lockdowns, then followed by the smog. 

Arunesh Karkun and Abinaya Sekar of the think-tank Sustainable Futures Collaborative said the justification behind school closures “lacks scientific evidence”. In 2023, they wrote: “Closing schools, instead, absolves educational institutions and government agencies of their responsibility to ensure that children breathe clean air and puts the onus on parents and guardians,” highlighting that supervision by parents or guardians is poorer in low-income households. “Air pollution, far from being a ‘great equaliser’, is, in fact, the exact opposite with school closures, as it worsens the divide between households from different socio-economic backgrounds. It also goes against the very idea of a school, which is to act as a levelling ground for all its students, irrespective of their backgrounds.”

“AIR POLLUTION, FAR FROM BEING A ‘GREAT EQUALISER’, IS, IN FACT, THE EXACT OPPOSITE WITH SCHOOL CLOSURES”

Arunesh Karkun & Abinaya Sekar

The purchase of air purifiers for the home may now be a norm among families that are able to afford them, but it is an unlikely prospect for those who live at the margins, as well as schools—even private ones. The presence of these devices is likely to be effective only if they are built into the institution’s inherent design, says Lung Care Foundation’s Abhishek Kumar, who maintains that the devices are a financial drain. “Filters are a recurring cost, and if they’re not replaced in a timely manner, they can be health hazards in themselves,” he explains.

For the collective, not the individual

Bhavreen Kandhari is one of the founding members of the nation-wide, parent-led group Warrior Moms, which has been among the loudest voices against air pollution for the last four years. The group’s interventions range from lobbying schools to refrain from planning picnics during smoggy days, to keeping tabs on garbage being burnt in neighbourhoods, to preventing traffic build-ups near schools in an effort to curb emissions. Kandhari, a Delhi-based copywriter-turned-environmentalist recalls a frantic call from a parent who enquired about the best purifier for a car; in the face of rising pollution levels, they wanted to opt out of bus transport for their child. Segan calls stop-gap measures such as this one, “consumer solutions”—meant to operate at an individual level.

“It’s the more convenient way out, rather than attempting to make bus transport safe… The belief that it is possible to pay one’s way out of a problem is the reason air pollution hasn’t become an electoral issue. The needle will shift only when peoples’ votes are determined by it,” says Kandhari. In the run-up to previous elections, members of Warrior Moms have met with political candidates to ask if pollution is on their agenda. This past Children’s Day, she recalls, when five of the parents walked to the Health Ministry to talk about their cause, they were greeted by the presence of over a hundred security personnel.

Across interviews, what becomes evident is that those who are directly responsible for the well-being of children—parents, doctors, educators—seem most moved by and mobilised for the cause. Their fight then lies in making everyone else—particularly the apathetic and powerful—recognise its urgency. “No one will empathise with data or scientific studies. Our work is an attempt to humanise it,” she says.

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