Originally published in The Wire on November 7, 2016

A month after the Olympic Games, our baby boy was born in a Beijing hospital. First-time parenthood engendered a siege mentality in us. We moved out of the charming but less-than-hygienic hutong neighbourhoods we had lived in for six years, and bunkered down in the double-glazed safety of the Diplomatic Compound. We began to navigate the quotidian as though under attack, spotting enemy forces everywhere: in the food we ate, in the water, in the milk and in the air.

Contamination scandals were a constant in China. We had largely ignored these till now, but Baby changed this ability to look the other way. In 2008, 3,00,000 people fell victim to an adulteration racket in which the chemical melamine, which appears to boost protein content, was added to milk and infant formula. Several infants died from resulting kidney problems and tens of thousands of babies were hospitalised.

The food in China was a problem as well, laced with excessive pesticides. But there was much worse. Stories abounded about aquatic farmers feeding fish ground-up birth control pills to make them grow faster. Directions were available on the Internet on how to make cheap fake eggs out of a gelatinous compound composed mostly of sodium alginate. The steroid clenbuterol was repeatedly used in pork production.

We began eating organic food grown in special farms that cost a fortune. I had trouble breastfeeding, and Ishaan was topped up with outrageously expensive imported formula.

But we could not import the air.


Childhood nightmares

Children are among the most vulnerable groups when it comes to pollution. Due to their faster respiratory rates, they breathe in a proportionately greater volume of air than adults, thus inhaling more pollutants per kilo of body weight. They have narrower airways and their lungs are still developing. Consequently, air pollutants that produce only a slight response in an adult can result in significant obstruction of the airways of a young child or baby.

It was bound to happen. As Ishaan approached his six-month birthday he began wheezing like a grandma on a mountaineering expedition. At the hospital he was diagnosed with a lower respiratory disorder, bronchiolitis, that our paediatrician said was common in babies born in Beijing. I looked up this ominous-sounding ailment and found it described as a ‘chronic airflow obstruction syndrome associated with inflammatory lesions of the small airways’. Chronic! My heart plummeted. Breathing can be very difficult for children with bronchiolitis as the lungs swell and fill with mucus.

Our nights became nightmarish as we stayed up watching over our boy gasping even in his sleep. He would constantly wake and scream in frustration. But the crying only made it harder for him to breathe.

Ishaan was hooked up to a nebuliser for two hours every day. This was a small machine connected to a tube and mask that we had to hold over the squirmy six-month-old’s mouth as it slowly converted a liquid decongestant into inhalable mist. The doctor said the infection would likely recur throughout his childhood, and that it strongly increased the likelihood of his developing asthma. A few weeks later, in April 2009, we moved to Europe, to the Belgian capital of Brussels. Ishaan spent the next four years of his life frolicking in (relatively) clean air. He never developed a case of bronchiolitis again.

We had moved to Brussels so that my husband, Julio, could take up a new job at the European Commission. He had lived in China for eight years and felt ready for a new challenge.

Our family was almost indecently fortunate. We were relatively well off. And we were geographically mobile. I was cognisant of these privileges. I was eighteen years old before our family could afford an air conditioner, despite summer temperatures in Delhi soaring to almost 50 degrees centigrade. I had not grown up globally mobile. I had an Indian passport, which meant cumbersome visa procedures before I could travel or study abroad.

The cover of 'Choked!'. Credit: Juggernaut

The cover of ‘Choked!’. Credit: Juggernaut

Now, thanks to a European husband, and the combination of our well-compensated jobs, I was part of that often-annoying elite: the expatriate. Expats have choices that most locals do not. They have resources, in terms of both information and money, that most locals do not. Most importantly, they have an exit, which most locals do not. If push comes to shove they can pack up and leave. I well appreciated why expat moaning about pollution could feel so egregious to those for whom toxic air was not just a hardship posting, but life.

This divide between the ‘tourists’ and those serving a life sentence in the acrid megalopolises of the developing world is the unfair result of the throw of some cosmic dice. Yet the role of the foreign community in drawing attention to the health effects of air pollution, and in creating knowledge of the ways to mitigate pollution’s worst effects (through the use of air purifiers, masks, pollution monitoring devices, etc.), was crucial in Beijing, as it would be in Delhi later.

It was expats who first acknowledged the pollution. Unlike locals, they have alternative frames of comparison and are not as desensitised by the everydayness of the dirty skies. They also have fewer problems and are better fed, clothed and housed than the majority of ‘natives’. Consequently, there are fewer issues competing for their attention. In contrast, for most people in the developing world pollution is only a grain of sand in a dune of urgent problems, and one with delayed and diffused effects at that, which makes it easy to ignore.

I had mixed feelings about our move to Europe. There was an almost painful nostalgia for what I had lost in leaving Beijing. I missed the sound of people cracking sunflower seeds. I missed watching elderly men painting ephemeral water calligraphy on the pathways of public parks in the evenings. I missed the saltiness of my hutong neighbours. And I missed the energy and optimism of China.

But I did not miss Beijing’s air. I did not miss Beijing’s tap water. I did not miss China-grown food. And I did not miss Chinese hospitals. The move to Brussels made it clear that the real gap between the so-called developed and developing world was no longer about the availability of consumer goods or innovative technologies. It was about the availability of clean air, safe water and equitable access to quality healthcare. Given the economic slowdown in the West, and the corresponding rise of emerging economies, the wealth gap that had long divided the world was arguably being replaced with a health gap.

We adjusted to Brussels with relative ease, in part because of friends who also happened to live in the city. Among these was a Norwegian–Scottish couple that had lived in Beijing since the late 1990s and moved to Brussels only the year before us. They were the parents of two – soon to be three – young boys. Air pollution had ranked high among their list of reasons for leaving China.

The mother, whom I shall call Matilde, admitted that daily life in Brussels was tough. In the absence of a domestic helper, she had to manage all the housework, while nursing an infant and taming a toddler. She’d been forced to become a dab hand with the drill and was spotted frequenting hardware stores while pushing a double-stroller. But the breathable air made it worth it, she said.

Matilde had lived in Beijing off and on since 1998, but it was only after her first child was born in 2007 that she had gone out and bought an air purifier. At the store the shop assistant had shown her a handheld machine that tested PM levels outdoors, and then again inside with the purifier on. The point was to demonstrate why buying such an expensive gadget was a good idea (the Swiss-made premium brand IQAir, which Matilde eventually bought, retails at around $1500). The assistant and Matilde stepped outside to measure the pollution and even the salesperson looked shocked when the device showed the PM levels at 800. ‘It was off the charts,’ Matilde recalled.

Relocating to Brussels in early 2008 had been a welcome opportunity for my friends. But barely a year into their stay in Europe, Matilde’s husband was offered an excellent job back in Beijing. His professional expertise was largely China-oriented, and it was in China that he could find the best, and most interesting, work. By late 2009 our friends were back in Beijing, despite their serious misgiving about the pollution.

The yo-yoing of public consciousness on air pollution was similar to that in India. Starting with Diwali and lasting through the winter cold, the smog has over the last few years become a pressing concern. But once spring is in the air, all thought of pollution is tucked away to the back of the mind, to be dusted off and brought out just in time for next year’s Diwali.

Excerpted with permission from Choked by Pallavi Aiyar, exclusively available on the Juggernaut app.