In this third and final instalment of Logically's interview series with former WHO epidemiologist and current consultant at CDC-TEPHINET, Dr Deepak Kumar, we discuss some of the perceptions surrounding air pollution in India— its causes, impacts and controversies—and receive critical insight into how this problem can be tackled at local, regional and national levels.

Logically: Do you have any observations about the discussion and communication efforts that are taking place in India around pollution?

Dr Kumar: Normally you see the international media looking into the air pollution status in Delhi around September, October, November—usually when the winter begins. Why is that? Is it because the daily PM 2 level has only been high during this period of time? No. In Delhi, every month of the year, the level of air index is far below the WHO standards. So it's a question—if emissions are a issue, if air quality is the issue, then shouldn’t the media or the government be ensuring that the right communication efforts continue throughout the year? It doesn't happen.

Formal recommendations are only released in October or November, when people are advised not to burn crackers, or the field staple which usually causes smoke in Delhi. I agree that this aggravates the situation, but it is not the only problem. You’re dealing with a situation where in Delhi and the surrounding areas, there are industries which operate 24 hours. While the situation is better now, it used to be worse. The government has made a lot of positive efforts to remove these industries from Delhi and peri-urban areas, but wherever they are, it is not as though Delhi has a boundary that stops the atmosphere. If there is an issue in the neighbouring village, it will affect Delhi also.

Usually when there is a crisis you see miscommunication usually happening, and people taking a lot of wrong solutions [sic]. Last year when there was a huge smog in Delhi, all these air purifiers sold like hotcakes. But is an air purifier a permanent solution? Air purifiers only decrease the segmented particles the air. It doesn't increase the oxygen concentration. It doesn't look into the sulfur dioxide level, it doesn't look into the arsenic level, it doesn't look into the lead level. It doesn't look into any of the toxins which are in the air.

And why are we only glued to the terminology ‘PM 2.5’? I think the WHO [World Health Organisation] and whoever suggests the indicators for air quality mapping should look into comprehensive indicators. PM 2.5 is, in my opinion, not the right indicator to say whether the air is breathable or not.  

They need to be looking into more indicators of air quality —oxygen levels, carbon monoxide levels, sulfur dioxide levels—these things are never looked into. People will only talk about 2.5, 2.5. And this is again an example of misconception. You read the newspaper, I'm sure even in today's newspaper there will be a comment about PM 2.5. The common man reading would understand that if PM 2.5 is down, that means the air quality is fantastic. Is it like this? It is not like this. This is the same issue we saw with the MDG [Millenium Development Goals].

One of the MDGs was to ensure that water is available. This is the only MDG goal that was achieved when it comes to the health aspect., and this was because the indicator was bad. The indicator was placed at drinkable water available, but whether the available drinking water was safe or not was not looked into, you see. So when we talk about an issue we need to look into the different parameters. It's like fighting a war. You know, when we are fighting a war, we need to have strategies in place. We need to understand which strategy would best work in which situation, and I think public health is similar. In public health you may have ten strategies, but just because one is working in some places, it doesn’t mean that it should be enforced elsewhere.

In India, more than one million deaths occurred [in 2017] just because of bad air, and importantly, over seventy percent of these one million pollution-induced deaths in India happen in rural areas. So they may be unable to talk to the government, and what they need is a question which has not been fully addressed.

When we talk about an issue we need to look into the different parameters. It's like fighting a war. You know, when we are fighting a war, we need to have strategies in place. We need to understand which strategy would best work in which situation, and I think public health is similar.

Logically: What are the key disagreements and debates in public discourse on pollution? When people talk about it, where do they lay the blame and how do they advise one another to deal with it?

Dr Kumar: I can tell you about my perception and the perception of my family members to begin with. In general when it comes to air pollution, the media will relate this issue to stable burning. In the neighbouring states of Delhi, particularly in Punjab and Haryana, there is wheat and rice cropping that is done. In order to shift from wheat and rice, the farmers would need to burn the stable so as to mature and prepare the field for the next crop, and when they do so, because the rains finish between September to October, the stable are usually lying out in the field. When they are burned there is a lot of smoke.

Had they been dried properly, it would be different, but when they're a little wet this usually leads to smoke. So this is the first approach of my close friends, when they think about the PM level rising. Secondly, most of them are not aware about the PM 2.5 concept. If you screen the newspaper three or four times from the last week or last month, you will see that there are only some places where they have made community members understand what PM 2.5 can cause, the health issues we're talking about.

From my perspective, I think that this smoke issue is very complex. There are two parts to this problem. One is reversible and one is irreversible. The irreversible component is that the geography of Delhi has a particular meteorological and climatic disadvantage to it. You know that Delhi is situated in the northern part of Ganges plain, due to which especially when the winters are approaching, the airspeed is one third of its rate during the summer days.

So whichever emissions are in the air, it takes longer for them to be cleared from Delhi and neighbouring areas. We all know that during winters when the humidity levels are higher and the airspeed has deteriorated, the smoke does not easily go away. This is something which you cannot change, it will always remain the same.

Then there are some things which can be changed, but it is very difficult. Number one is the thermal power plant which is near to Delhi and which leads to a lot of emissions. Number two is that Delhi has one of the largest levels of vehicular traffic and vehicular pollution in the world. Around 10,000 vehicles are added every month in Delhi, so you can imagine the number of vehicles leading to emissions. Number three is that because of the stable issue every year, around the months of September, October and November, people in the neighbouring states burn the crops and this leads to a smog that infiltrates Delhi atmosphere.

Fourth: you see that there are medium to small scale industries which are not necessarily located within Delhi but in the peri-urban areas, like Haryana, Uttar Pradesh and Rajasthan. So the emissions from those industries also come here. Delhi and neighbouring areas are facing an infrastructural boom these days, for last one or two decades. So you see a lot of highways coming, a lot of new buildings and roads being built. Due to this there are a lot of bricks required, and there are ten of thousands of brick links which are working in and around Delhi. These brick links lead to emissions, and again, contribute to the poor air quality.

The last and most important factor is that some studies have found that more than 30 percent of this air issue is because of household utilisation of biomass. Not necessarily in Delhi, but there are a lot of villages around Delhi where people are dependent on biomass for their cooking. So when they use the biomass, they produce emissions and gases that then negatively influence Delhi's atmosphere. So there are many reasons contributing to the poor air quality in Delhi, and this reason is so complex that one simple solution, or maybe one bylaw, is not going to help.

Logically: What do you think would help?

Dr Kumar:  So one of the good things happening is that the recent attention to the poor air quality by average Delhi people is at least ensuring that the government is recognising this problem. This is evident from the fact that the government has tried to create recently the DPCC—Delhi Pollution Control Committee. They have produced the GRPA Graded Response Action Plan. It takes specific actions in response to PM 2.5 level of a particular degree. So, if it is more than a particular level then industries will be shut, if it is further beyond that, then such and such actions will be taken.  

So it's regional...if action has to be taken, Delhi alone will not make much of a dent. All the neighbouring states need to participate through a framework that must be agreed upon together.  

What the government is not understanding, what the media is not looking into seriously and the reason why people are still failing to take correct action is because they think that this air pollution problem has to be addressed by Delhi. No, Delhi having the headquarters of the central government is not going to make changes—change has to be regional. If you look at one of the NASA density studies [NASA Visible Earth: Smog and Fog in India] which was released last year, and which tries to show that the smoke in Delhi is not only limited to Delhi boundaries, it is extending right from the central part of Uttar Pradesh to some of the southern states.

So it's regional—almost all of the northern part of India is affected by smog during this period of time. Which means that if action has to be taken, Delhi alone will not make much of a dent. All the neighbouring states need to participate through a framework that must be agreed upon together.  

Logically: Is there anything that can be done from a grassroots level, or do you think that local actors will be ineffective in that space?

Dr Kumar: When it comes to community, I can only see a scope where people should not be allowed to burn landfill. So whatever paper and whatever waste they are collecting from the houses and from the neighbouring area, they usually dump it in one place and then will simply burn it. So that should be—at least communities should feel that they should not, at any cost, burn the waste. There has to be a system where the community participates in waste management, waste segregation. And they ensure that the paper waste, the food waste, the degradable waste, and nonnegotiable waste are separated and are recycled or are managed effectively.

This is not the situation in India, including in Delhi—waste segregation is limited to healthcare settings. If we could go to particular sites around Delhi, where there are mountains, you would say: “Oh, there is a fantastic mountain.” But that is not a mountain. That mountain is only landfill, and sadly, when there is a landfill there is both dry and wet waste. In summer, when there is a hot sun, the dry waste sometimes catches fire because of the methane that is released, and then it automatically starts burning, so it’s difficult to control that fire. It leads to another level of air pollution. So if there is a system in which community members can be forced to participate through the means of bylaws, that should be segregating waste, and a proper waste management system—they should not simply be burning it.

Another area I could see is that they should at least ensure that if the vehicle that they're using is producing a lot of smog and pollution, at least to ensure that they go take the vehicle to a mechanic and ensure that those [faults] are repaired. These are immediate contributions which community members can make.

This article's header image is by Sam Jotham Sutharson from Unsplash.