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Submitted by PatientsEngage on 2 December 2021

Jyoti Pande Lavakare has enough data to make us aware how harmful the air we breathe in is. She put it all together in a book, which is also driven by a personal loss. A relentless activist, she advocates mindful consumption and slow living and wants us to realise and act on air pollution, which is increasingly proving fatal.

How far do you think spreading awareness about air pollution will help in stemming it?

Awareness precedes action. Unless we know how harmful air pollution is to our health and life, how will we take any action on it? Spreading awareness is critical. It is the reason I wrote the book "Breathing Here is Injurious to Your Health: The Human Cost of Air Pollution." Despite being a fairly private person, I felt it was important to share my lived experience as the daughter of someone who got pollution-triggered lung cancer and was diagnosed at the terminal stage. I was already working in this sphere, along with other concerned parents - professionals who had young children who would get sick every winter. We were going to schools, hospitals and RWAs making presentations on what pollution was doing to our bodies and what we could do about it. Despite knowing so much about air pollution, it still came as a shock to me to discover that this was in my own back yard, affecting my own mother in this terminal way. It is one thing to know the theory in your head, totally another to feel it in your heart. To see my beloved mother struggle for every breath in her last days is something I can never forget - I wrote this book so that others wouldn't have to go through something similar, to make meaning out of her death, "to take my broken heart and turn it into art," as Princess Leia said.

How close do you think is the connection between pollution and the growing number of lung cancer cases in our country?

There is a direct and close connection between the toxic air non-smoking Indians breathe and cases of lung cancer. I have cited numerous studies, quoted different doctors in my book and there is absolutely no doubt that air pollution triggers several non-communicable diseases including lung cancer, breast cancer, diabetes, strokes, cardiovascular harm, dementia, alzheimer’s, obesity - you name it, and air pollution triggers it. The reason for this is that the tiniest, most lethal particles of pollutants, PM2.5, bypass all the body's natural defences and enter our lungs and then through the lungs, into our bloodstream, thus travelling to every cell in our body. These particles trigger disease in every part of the human body through inflammation and oxidative stress. I have cited all the research that backs these in my book - but there is loads more. Actually, there are 70,000 scientific research papers that link air pollution to health harm. As I said in my book, our genetic predispositions are the loaded gun, but pollution pulls the trigger. For example, if your parents had diabetes and hypertension and you have a genetic predilection towards these diseases, you may never get them if you live in a clean air environment. But if you live in an area of high pollution for a long period, chances are you will probably get one or both the diseases.

What does an individual need to do to reduce pollution in his/her own capacity?

Every individual is a victim of air pollution - and a perpetrator. As I said in the book - we are all complicit and we are all suffering from the health harm of air pollution. The first thing an individual needs to do is become aware - then vote with his ballots and his wallet. Governments and corporates have an important role and responsibility to reduce pollution. We as individuals can begin with segregating our waste, ensuring our municipalities are disposing it responsibly, composting our wet waste at sources, using public transport as much as possible and electric vehicles by active choice. We can also reduce, reuse, recycle and repair - and shun industries that plan obsolescence in their products to indirectly urge us to consume more. Did you know cheap fashion is one of the most polluting industries? Next time you want to buy that new dress or sari - ask yourself - do you really, really need it, or is it just a quick luxury, something you're buying because you're bored or have extra cash to spend? Mindful consumption, conscious consumption and slow living are the only ways we can as individuals make a difference.

What, according to you and your study, is the most important contributor to air pollution in India?

Air pollution in India comes from several sources, but one can't homogenise these. Each geographical area has its own hyperlocal top source – e.g., in cities it may be vehicular pollution and garbage burning, in the coal belt, it may be mining activities, in rural areas, biomass burning, Also, it differs from season to season - in the winters, outdoor fires may be the highest contributors. During November, the highest contributor in Northern India is smoke from crop stubble burning and fireworks; in industrial areas, the highest contributor will be industrial emissions from factories etc.

Some estimates suggest that every year, stubble-burning contributes 5-8% of Delhi’s particulate pollution on average. But in the winter of 2019, the number of fires peaked to around 4,000 per day by October 31, and crop-residue burning in Punjab and Haryana accounted for 44% of the air pollution on November 1, 2019, according to the Central Pollution Control Board.

How do season changes affect air pollution in your opinion?

Cooler temperatures cause inversion which collects all the dispersed PM2.5 particles closer to the ground where human beings can inhale these - this ambient air pollution increases in the cooler temperatures of northern India. North India’s unique geography, with the Himalaya as a physical barrier to the north, prevents poor air from dissipating quickly. So pollution generated in the region remains trapped there for long periods. As the monsoons recede and the air becomes cooler and drier over the winter months, wind speeds also come down. The temperature inversion – when lighter, warmer air rises over cooler, denser air and traps it underneath – it further confines pollution to the ground level, and keeps atmospheric particulate concentration high.

Indeed, air pollution in this region is bad all year around – but during autumn and winter, the Indo-Gangetic plain’s (IGP’s) geographical and meteorological misfortunes combine with anthropogenic reasons, like stubble-burning, to create a perfect storm. And with nothing to wash or blow away particulate matter, smoke from the fires adds to the already high pollution load, and settles closer to the ground. As a result, the northern plains together become one gigantic bowl of pollution that its residents are forced to breathe for months on end.

What are the areas that you have tried to focus with your book? What has been the response like?

I have tried to cover all broad areas - the causes of air pollution, its sources, its measurement and data, its health, economic, political and equity implications - and the solutions. The response has been mixed. On one hand, it has been shortlisted for some literary awards, on the other, because it is a grim book to read, with dense information and lots of scientific citations, I feel people shy away from reading it - after all, who likes to hear bad news?

There is a personal impetus for you to write the book. Would you like to talk about it?

I moved back to New Delhi from California in 2009. I was born and raised mainly in Delhi, had my children in Delhi, but never really noticed the pollution and smoggy skies until I lived under the legendary Californian blue skies. After breathing such fresh, clean air, coming back to Delhi's pollution immediately made me aware that something wasn't quite right. But I couldn't immediately put my finger on it. One accepts one's childhood environment unquestioningly. But this time, two things were different - one, I had tasted and experienced clean air, and two, this time, I was a young mother, responsible for two little ones, so I was more alert and aware.

The first two winters I was back, I noticed many of my children's new friends, all young children who seemed to be falling ill with respiratory issues - this seemed to occur every single winter. Some parents - mostly expats whose children were going to international schools - were beginning to talk about air pollution, and told me I was a fool to bring my young children back into such toxic air. I couldn't help wondering if there was something in what they said. But my desi friends, local folk I had grown up with pooh-poohed me, saying I had turned into a paranoid firangi. So I did the only thing I was qualified to do as a former journalist - investigated the issue myself to figure out whether I was over-reacting (like my desi friends accused me of doing) or under-reacting (as my horrified expat friends said). Luckily, by this time, the internet made in-depth research super easy - and very soon I realised how lethal the very air we breathe was. There was a tonne of information freely available and I devoured research papers, science, data and evidence. At first I couldn't believe the things I was reading- I was almost in denial - but by 2015 with the help of the expat parents, joined by aware Indian parents, some public health researchers and atmospheric scientists, we had formed a clean air awareness and advocacy group and called it Care for Air, and were going to schools, RWAs and hospitals to talk to students, their parents and teachers about air pollution and how it harms human health.

Then, in October 2017, my mother unexpectedly got diagnosed with lung cancer. It was terminal - and doctors said it had been triggered by air pollution. The irony of the situation wasn't lost on me. When my mother passed away, struggling to breathe in her last days, I was determined that others should know about this invisible killer, so that perhaps they could save their loved ones. I wrote the book to make some sense of my mother's passing and to process my grief ("take your broken heart and turn it into art") But my main mission was to educate ordinary people like myself about the human cost of air pollution and make us aware about how it is taking away years of our life, killing us quietly and insidiously.

As a journalist and communicator, I knew stories draw people and engage them better than dry science and research would. So despite my initial reservations about sharing my own story - I'm a fairly private person - I just decided to craft this as a personalised non-fictional narrative, with a solid core of air pollution science, evidence and data. Onthe surface, you are just reading a grief memoir, which cites research papers and science to prove its basic premise, but by the time you finish reading the book, you will emerge hugely aware about this unacknowledged public health emergency which is sickening and weakening our entire population and setting up our young for failure at every step.

My mother passed away on Jan 13, 2018, and I started writing the book in October 2018, finishing it in roughly 18 months. But by then the Covid-19 pandemic had hit the world, so its publication was delayed. However, I took that as an opportunity to add an entire, new chapter on the link between air pollution and Covid and the book was finally launched in November 2020.

What are your future plans in this area?

I continue to work to drive change in this area, advocating for our right to breathe clean air. My non-profit Care for Air has recently got its section 80G and we plan to raise funds to take some of our existing programmes working with students in schools and colleges further. I also have plenty of writing lined up, on the pollution levels, as well as lighter fiction and short stories.

Jyoti Pande Lavakare is the author of ‘Breathing Here is Injurious to Your Health: The Human Cost of Air Pollution’ which has been shortlisted for the Tata LitLive Award.

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