air pollution

How many deaths will it take for India’s environment minister to admit air pollution is a killer?

The minister Harsh Vardhan has questioned existing evidence on pollution-related deaths and said Bhopal in 1984 was an emergency, Delhi’s smog is not.

Even as air pollution continues to smother Delhi – air quality moved from “severe” to “ very poor” on Wednesday – Union Environment Minister Harsh Vardhan has downplayed its role in causing severe health problems, even deaths. In comments to news organisations, Harsh Vardhan has repeatedly said that air pollution can cause illness and distress in people who already have respiratory problems. He has also called for India-centric scientific studies to estimate the effects of air pollution on people living in India.

What the minister has ignored is that air pollution can kill, even if it kills slowly, and that there is plenty of scientific data to show its role in premature deaths.

In an interview to News18, Vardhan said that “no death certificate has a cause of death as pollution”.

In an interview to NDTV last week, he emphasised the need for studies conducted in India, to evaluate the extent of mortality in India in the Indian context using Indian parameters. “I do not think we can generalise and say so many people die of pollution,” he told NDTV.

His recent statements contradict his remarks from February this year when he had said that when pollution affects the lungs, especially in little children, it can be a killer. He had then also referred to pollution as “slow poison”. He was speaking in context of the release of a report by The Lancet Commission on Pollution and Health, which showed that that environmental pollution caused 25 lakh premature deaths in India in 2015.

Another Lancet analysis released this week shows that air pollution is the second biggest risk factor for disease in India. Air pollution mainly contributed to cardiovascular disease, chronic respiratory disease, and lower respiratory infections. Ischemic heart disease and chronic obstructive pulmonary disorders are, in fact, the leading cause of death and disability in the country.

In 2015, the Ministry of Health and Family Welfare formed a 16-member steering committee “to frame an action plan for mitigating the adverse health impacts of indoor and outdoor air pollution”. The report concluded that cities across India need a drastic clean up of air. This conclusion was drawn from evidence cited in the the Global Burden of Disease report of 2010, which shows that air pollution had caused of millions of premature deaths. According to the Global Burden of Disease, in 2010, household air pollution from the use of solid cooking fuels resulted in approximately 1.04 million premature deaths in India. About 6,27,000 lives were lost due to ambient air pollution, the kind caused by dirty emissions from vehicles and is causing the smog in Delhi right now. The 2016 Global Burden of Disease shows that 9,20,000 premature deaths occurred in India due to household air pollution and 5,90,000 premature deaths due to ambient air pollution.

“I agree we need to have Indian studies that monitor long term benefits,” said Dr Damodar Bachani, who works with John Snow International, a public health management consulting organisation. “But based on the current evidence, we have no excuse to postpone action against pollution.”

Bachani worked at health ministry on control of noncommunicable diseases till last year and helped formulate its air pollution report.

“Where is the evidence that Indians have special set of lungs?” said Kirk Smith, professor of Global Environmental Health at the University of California, Berkeley. “In fact, the scientific evidence is that Indians are more vulnerable. An average Indian has less nutrition and less access to medical care.”

Smith also agrees there is no need to wait for more studies to be completed in India to ascertain that air pollution causes premature deaths.

“If anything, the burden of proof is on [people who dismiss pollution as a cause of mortality] to show how Indians are not as vulnerable,” he said.

Cause of death

Pollution is not cited as cause of death in death certificates because it kills slowly, said Dr Arvind Kumar, chest surgeon from Sir Ganga Ram Hospital in Delhi. “It affects your lungs, heart, brain and other parts of your body slowly before causing death. You see the effects of pollution 20 years later.”

Diseases have multiple causal factors. For instance, respiratory diseases may be caused by both smoking and air pollution.

“In such multifactorial diseases, there is no other way of attributing risk than using mathematical modelling,” said Bachani, indicating that further studies are not likely to change the estimates of disease and death due to air pollution.

Dr Arvind Kumar's patient who is a non smoker had black sports in his lungs.
Dr Arvind Kumar's patient who is a non smoker had black sports in his lungs.

No emergency?

Harsh Vardhan also told News18 that the spike in pollution levels in Delhi last week should not be treated as an emergency and that there was no cause of panic among the people. The minister’s standard for an emergency seems to be the world’s worst industrial disaster, the Bhopal gas tragedy of 1984 when thousands of Bhopal residents were exposed to the deadly chemical methyl isocyanate that leaked from a Union Carbide pesticide plant. The disaster killed more than 2,000 people.

“I am talking in practical terms. You see, what happened in Bhopal when there was a gas leak and hundreds of thousands of people fell acutely sick and had to be rushed to the hospital. We call that an emergency situation where you have to panic and you have to see what you have to do. I’m not saying we shouldn’t do anything about it (Delhi smog); everyone has to respond to what he is supposed to do. But there is no need to spread panic among the people.”

However, do residents of Delhi and other pollution affected cities in India really need to wait for thousands of people to die sudden deaths before authorities declare a health emergency and undertake clean-up measures on war-footing?

To some doctors in Delhi, this denial of the severity of air pollution sounds like the denial of tobacco-linked mortality 30 years ago.

For instance, Kumar has found that over the past five years, he started seeing black spots on lungs scans of Delhi residents, even those who are not smokers.

“Earlier we would see black spots only in the lungs of smokers,” said Kumar. “Now we see this in teenagers.”

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Swara Bhasker: Sharp objects has to be on the radar of every woman who is tired of being “nice”

The actress weighs in on what she loves about the show.

This article has been written by award-winning actor Swara Bhasker.

All women growing up in India, South Asia, or anywhere in the world frankly; will remember in some form or the other that gentle girlhood admonishing, “Nice girls don’t do that.” I kept recalling that gently reasoned reproach as I watched Sharp Objects (you can catch it on Hotstar Premium). Adapted from the author of Gone Girl, Gillian Flynn’s debut novel Sharp Objects has been directed by Jean-Marc Vallée, who has my heart since he gave us Big Little Lies. It stars the multiple-Oscar nominee Amy Adams, who delivers a searing performance as Camille Preaker; and Patricia Clarkson, who is magnetic as the dominating and dark Adora Crellin. As an actress myself, it felt great to watch a show driven by its female performers.

The series is woven around a troubled, alcohol-dependent, self-harming, female journalist Camille (single and in her thirties incidentally) who returns to the small town of her birth and childhood, Wind Gap, Missouri, to report on two similarly gruesome murders of teenage girls. While the series is a murder mystery, it equally delves into the psychology, not just of the principal characters, but also of the town, and thus a culture as a whole.

There is a lot that impresses in Sharp Objects — the manner in which the storytelling gently unwraps a plot that is dark, disturbing and shocking, the stellar and crafty control that Jean-Marc Vallée exercises on his narrative, the cinematography that is fluid and still manages to suggest that something sinister lurks within Wind Gap, the editing which keeps this narrative languid yet sharp and consistently evokes a haunting sensation.

Sharp Objects is also liberating (apart from its positive performance on Bechdel parameters) as content — for female actors and for audiences in giving us female centric and female driven shows that do not bear the burden of providing either role-models or even uplifting messages. 

Instead, it presents a world where women are dangerous and dysfunctional but very real — a world where women are neither pure victims, nor pure aggressors. A world where they occupy the grey areas, complex and contradictory as agents in a power play, in which they control some reigns too.

But to me personally, and perhaps to many young women viewers across the world, what makes Sharp Objects particularly impactful, perhaps almost poignant, is the manner in which it unravels the whole idea, the culture, the entire psychology of that childhood admonishment “Nice girls don’t do that.” Sharp Objects explores the sinister and dark possibilities of what the corollary of that thinking could be.

“Nice girls don’t do that.”

“Who does?”

“Bad girls.”

“So I’m a bad girl.”

“You shouldn’t be a bad girl.”

“Why not?”

“Bad girls get in trouble.”

“What trouble? What happens to bad girls?”

“Bad things.”

“What bad things?”

“Very bad things.”

“How bad?”

“Terrible!!!”

“Like what?”

“Like….”

A point the show makes early on is that both the victims of the introductory brutal murders were not your typically nice girly-girls. Camille, the traumatised protagonist carrying a burden from her past was herself not a nice girl. Amma, her deceptive half-sister manipulates the nice girl act to defy her controlling mother. But perhaps the most incisive critique on the whole ‘Be a nice girl’ culture, in fact the whole ‘nice’ culture — nice folks, nice manners, nice homes, nice towns — comes in the form of Adora’s character and the manner in which beneath the whole veneer of nice, a whole town is complicit in damning secrets and not-so-nice acts. At one point early on in the show, Adora tells her firstborn Camille, with whom she has a strained relationship (to put it mildly), “I just want things to be nice with us but maybe I don’t know how..” Interestingly it is this very notion of ‘nice’ that becomes the most oppressive and deceptive experience of young Camille, and later Amma’s growing years.

This ‘Culture of Nice’ is in fact the pervasive ‘Culture of Silence’ that women all over the world, particularly in India, are all too familiar with. 

It takes different forms, but always towards the same goal — to silence the not-so-nice details of what the experiences; sometimes intimate experiences of women might be. This Culture of Silence is propagated from the child’s earliest experience of being parented by society in general. Amongst the values that girls receive in our early years — apart from those of being obedient, dutiful, respectful, homely — we also receive the twin headed Chimera in the form of shame and guilt.

“Have some shame!”

“Oh for shame!”

“Shameless!”

“Shameful!”

“Ashamed.”

“Do not bring shame upon…”

Different phrases in different languages, but always with the same implication. Shameful things happen to girls who are not nice and that brings ‘shame’ on the family or everyone associated with the girl. And nice folks do not talk about these things. Nice folks go on as if nothing has happened.

It is this culture of silence that women across the world today, are calling out in many different ways. Whether it is the #MeToo movement or a show like Sharp Objects; or on a lighter and happier note, even a film like Veere Di Wedding punctures this culture of silence, quite simply by refusing to be silenced and saying the not-nice things, or depicting the so called ‘unspeakable’ things that could happen to girls. By talking about the unspeakable, you rob it of the power to shame you; you disallow the ‘Culture of Nice’ to erase your experience. You stand up for yourself and you build your own identity.

And this to me is the most liberating aspect of being an actor, and even just a girl at a time when shows like Sharp Objects and Big Little Lies (another great show on Hotstar Premium), and films like Veere Di Wedding and Anaarkali Of Aarah are being made.

The next time I hear someone say, “Nice girls don’t do that!”, I know what I’m going to say — I don’t give a shit about nice. I’m just a girl! And that’s okay!

Swara is a an award winning actor of the Hindi film industry. Her last few films, including Veere Di Wedding, Anaarkali of Aaraah and Nil Battey Sannata have earned her both critical and commercial success. Swara is an occasional writer of articles and opinion pieces. The occasions are frequent :).

Watch the trailer of Sharp Objects here:

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This article was published by the Scroll marketing team with Swara Bhasker on behalf of Hotstar Premium and not by the Scroll editorial team.