Holding your breath in India

FOR weeks the breathing of my 8-year-old son, Bram, had become more labored, his medicinal inhaler increasingly vital. And then, one terrifying night nine months after we moved to this megacity, Bram’s inhaler stopped working and his gasping became panicked.

My wife called a friend, who recommended a private hospital miles away. I carried Bram to the car while my wife brought his older brother. India’s traffic is among the world’s most chaotic, and New Delhi’s streets are crammed with trucks at night, when road signs become largely ornamental. We undertook one of the most frightening journeys of our lives, with my wife in the back seat cradling Bram’s head.

When we arrived, doctors infused him with steroids (and refused to provide further treatment until a $1,000 charge on my credit card went through). A week later, Bram was able to return home.

When I became a South Asia correspondent for The New York Times three years ago, my wife and I were both excited and prepared for difficulties — insistent beggars, endemic dengue and summertime temperatures that reach 120 degrees. But we had little inkling just how dangerous this city would be for our boys.

We gradually learned that Delhi’s true menace came from its air, water, food and flies. These perils sicken, disable and kill millions in India annually, making for one of the worst public health disasters in the world. Delhi, we discovered, is quietly suffering from a dire pediatric respiratory crisis, with a recent study showing that nearly half of the city’s 4.4 million schoolchildren have irreversible lung damage from the poisonous air.

For most Indians, these are inescapable horrors. But there are thousands of others who have chosen to live here, including some trying to save the world, others hoping to describe it and still others intent on getting their own small piece of it. It is an eclectic community of expatriates and millionaires, including car executives from Detroit, tech geeks from the Bay Area, cancer researchers from Maryland and diplomats from Dublin. Over the last year, often over chai and samosas at local dhabas or whiskey and chicken tikka at glittering embassy parties, we have obsessively discussed whether we are pursuing our careers at our children’s expense.

Foreigners have lived in Delhi for centuries, of course, but the air and the mounting research into its effects have become so frightening that some feel it is unethical for those who have a choice to willingly raise children here. Similar discussions are doubtless underway in Beijing and other Asian megacities, but it is in Delhi — among the most populous, polluted, unsanitary and bacterially unsafe cities on earth — where the new calculus seems most urgent. The city’s air is more than twice as polluted as Beijing’s, according to the World Health Organization. (India, in fact, has 13 of the world’s 25 most polluted cities, while Lanzhou is the only Chinese city among the worst 50; Beijing ranks 79th.)

Sarath Guttikunda, one of India’s top pollution researchers, who moved to Goa, on the west coast of India, to protect his two young children, was unequivocal: “If you have the option to live elsewhere, you should not raise children in Delhi.”

These and other experts told me that reduced lung capacity in adults is a highly accurate predictor of early death and disability — perhaps more than elevated blood pressure or cholesterol. So by permanently damaging their lungs in Delhi, our children may not live as long.