Parents in Delhi need to educate children on how to tackle pollution, not just escape it; outdoor activities key to wholesome development

China’s schools would hang red flags outside on days when the air would be too polluted for children to play outdoors. But when Delhi’s pollution levels goes “off the charts”, how many red flags can children really take? How do young bodies cope with this health crisis? And what happens to children’s mental and emotional health when they are trapped inside their homes and school buildings and cannot go out? Respiratory diseases are not the only kind caused by atmospheric pollution Lung cancer is the most common type of cancer leading to deaths (1.76 million). But respiratory problems are not the only damage the human body suffers in a polluted environment. The respiratory tract travels from the nose to the throat, all the way to the lungs. The lungs get divided twenty-three times from larger airways to smaller airways. [caption id=“attachment_7545001” align=“alignleft” width=“380”]  Representational image. AP[/caption] In the smallest of these air sacs, called alveoli, gas exchange takes place. Then the air gets distributed to the rest of the body. The natural filter in our nostrils can filter particles up to 10 micrometres (for a healthy individual). But when pollutants sized 2.5 micrometres (called particulate matter or PM 2.5), or smaller, enter, they do not damage only the lungs. These ultra-fine particles go straight to the alveoli. This polluted blood can then go anywhere in the body, from the eyes to the brain. Explaining this process through a chart of the respiratory system in his clinic, pulmonologist Azmat Karim uncovers the multi-layered impact of pollution, especially on children. “In 1952, one knew industrial pollution was the main cause of the Great Smog of London. In India we could link household pollution to smoke from wood stoves. But the air that surrounds us today contains so much more  . . . from plastic to drugs to unidentified elements. Some of these could be cancerous, and by inhaling them an unhealthy generation is being prepared. Children are all the more vulnerable. Some of their organs are developing till as late as 18 years of age.  That is why so many young people are having heart and liver issues. This is only set to increase if the situation continues. In the past five years, there has been a clear increase in the number of patients with airway diseases. Earlier they used to be smokers or asthma patients. Now it is hard to tell the difference,” says Karim. While healthy people can lose their good health because of pollution, it is worse for people who already have medical conditions. The same is true for newborns and growing children. Not just their physical but their mental development is disturbed. Click here for Coronavirus outbreak LIVE Updates When asked about the feasibility of staying indoors or the use of purifiers by those who can afford it, Karim says, “Purifiers are for airtight apartments, for countries where windows are permanently closed. At times we have advised parents to shift to a different city. Some have moved away but for others, it is tougher. Shutting down schools or limiting children’s activities are not sustainable solutions either; even if we are inside we still have to breathe. And there is not enough research on how this affects children’s mental health.” Parents need to be more responsible and aware of the problem Neha Rai teaches at Delhi Public School, Noida. She talks of how technology has made it difficult for children to look up and gaze at the world flanking their screens. With parents keeping children indoors to avoid the pollution outside, their interaction with the world gets weakened further. “The environment has faced challenges earlier too but instead of finding ways to protect it we have decided to divorce our children from it. Parents think they have money so they can buy masks and air purifiers. They do not think of carpools or walks. After Diwali, I asked my class about how many of them had burst crackers. One student told me he had made clear he did not want crackers but his father got them anyway, saying one child not bursting crackers is not going to save the environment,” says Rai. The Supreme Court had banned the sale of non-green (causing less pollution) firecrackers but they were still sold on the sly. Rai continues, “With festivals comes the assertion of religious identity, when people feel that a ban on firecrackers is an attack on their religion. They resort to whataboutery, starting with how stubble burning in Haryana and Punjab is the main cause of pollution.” But the fact remains that in 2019 Delhi’s air quality saw a further decline on the day after Diwali. Rai believes that awareness programmes in schools have made children more sensitive to the environment, but often parents are the ones who prevent children’s good thoughts and intentions from translating into action. There are more efforts to escape pollution than to stop it Though Neha Misra Mutluru is a parent herself, along with being a birthing coach, she agrees that the solutions parents are grasping at are short-sighted. There has been some awareness among parents and children about reducing their carbon footprint. “But the focus is on how they can cope with the problem rather than collective efforts to eliminate it because the problem itself seems so huge,” Mutluru says. As a parent, Mutluru is conscious that her wish to safeguard her daughters’ health should not take away their right to play outside. They regularly spend several hours in the park. “Children should be out playing and not worrying about falling sick. Pollution levels in NCR are high all year round. What will my kids do at home all the time? In winter when the schools were shut due to the smog our family went to Hyderabad. I am aware that residing here could have long term effects on health and that is the only reason we would not want to live here permanently, though the city has been so good for our family personally and professionally,” says Mutluru. Impact of isolation on children’s behaviour, and a small effort to address it In her work as a school teacher, Rai gets to observe children’s behaviour closely. “Being with nature, playing with cats, dogs and birds make children more compassionate. Playing with each other develops team spirit and teaches them to take both winning and losing in their stride. By staying inside and isolated, they do not learn acceptance. It becomes hard for children to cope if something does not turn out the way they had wanted. The sense of there being a world outside the self is now limited to moral science and environmental science textbooks,” she says. Child counsellor and family therapist Karishma Mehra understands this only too well. “If kids stay out of school for long periods, they have to rebuild relationships with their peers when they go back. In vocal children, we see aggression and in the quieter ones it takes the form of suppression and self-harm,” says Mehra. To combat this, Mehra runs a centre in Delhi called Happiness Quotient, which is especially full on days when schools remain closed due to high pollution levels. Her classes are aimed at creative expression, analysis, mindfulness and cognitive behavioural therapy, which focuses on children’s beliefs and thoughts rather than trying to discipline their actions. These classes are held indoors and so to a limited extent children are protected from polluted air. But with the Covid- 19 outbreak that has not only shut down schools but requires isolation, parents and families would have to make more concerted efforts to engage with children creatively and meaningfully, especially with metro cities having the highest number of adolescents who face mental morbidity.