Every morning on the walk to their South London school, Agnes Agyepong and her son and daughter used to pass a tunnel with a long line of cars, their engines humming, backed up and queuing on their way to work.
When her youngest daughter, who was four at the time, kept getting ill she thought little of that tunnel. After repeated trips to her GP, where Agnes, who was pregnant with her third child at the time, explained it could be asthma, she was told to try eliminating eggs or dairy, to see how that went, and to come back if she continued feeling unwell. ‘Each time the onus was on me to do something about it,’ says Agnes. ‘The weather was also changing and getting colder around this time, and I wondered if it was asthma or just a bad cold. Then one day her school called me to say she was slumped lethargically over her desk. I went to pick her up and offered to treat her to a McDonalds to cheer her up but she said she didn’t want one, and I knew then something was wrong.’
Agnes drove her daughter to the nearby Lewisham hospital, in South East London, and like most parents expected to be in for a five hour wait. ‘Instead, they took one look at my daughter and we bypassed the rest of the waiting room, and she was taken straight to a hospital room.’ Along with feeling reassured she was getting help she needed, the speed at which she was getting it panicked Agnes. ‘They then told me she had community acquired pneumonia, which is one of the leading causes of death among children. I still didn’t make the correlation and then I thought about the local girl, Ella, who died a year before my youngest daughter was born.’
Ella Adoo-Kissi-Debrah lived close to Agnes and her family, near the busy South Circular Road in Lewisham, south east London, and died in 2013 aged just nine. At the inquest into her death, it was found that air pollution ‘made a material contribution’ to her death, making her the first person in the UK to have air pollution listed on a death certificate as a cause of death.
In response, Ella’s mother, Rosamund Adoo-Kissi-Debrah, called on the government to act warning that ‘children are dying unnecessarily because the government is not doing enough to combat air pollution. As a parent of a child suffering from severe asthma, I should have been given this information but this did not happen.’
Professor Stephen Holgate, an expert who gave evidence at Ella's inquest, also called on the government to act and said, of the impact of pollution on health, ‘If this was happening to water and 40,000 deaths were being brought forward due to poisoning in water, we'd be outside Parliament shouting.’
‘Because of a lack of information I did not take steps to reduce Ella’s exposure to air pollution that might have saved her life,’ added her mother. ‘I will always live with this regret. But it is not too late for other children.’
Since Ella’s death local parents, including Agnes, began campaigning, not just for cleaner air but for there to be more awareness of how Black people – and particularly pregnant Black mothers and their children – are disproportionately affected by pollution.
Earlier this month, new research found people of colour in England are three times more likely to live in neighbourhoods with higher air pollution, putting them at higher risk of heart attacks, cancer and strokes. Rosamund has called this new research ‘shocking, but unsurprising’, and said: ‘It re-emphasises the urgency with which our country, and London particularly, needs action on air pollution. Everyone deserves a right to breathe clean air, particularly children, who are worst impacted because their lungs are still developing.’
Since her own daughter's experience, Agnes is now the founder and CEO of Global Black Maternal Health and a maternal health advocate campaigning for research into pollution and climate change to be more diverse and inclusive.
‘I grew up in South East London in an affluent road, but in London – as in many other parts of the country – two roads down from an affluent road is a deprived one, which is usually closer to a main road. And who typically lives on deprived or main roads? Black people, who are more likely to live in areas with dangerously high levels of nitrogen dioxide. In London, some roads are becoming car-free in a bid to battle pollution, but then you start to see these little bubbles with nice, car-free roads but this just drives more traffic to other roads that are typically less affluent.’
Agnes points to research that shows how air pollution can change the cells of your baby, and just this week researchers from the University of Aberdeen in Scotland found what they called ‘very worrying’ proof that toxic air pollution particles have been found in the lungs, livers and brains of unborn babies, who are yet to take their first breath. Previous studies have shown that pollution can lead to an increased risk of miscarriage, stillbirth and premature birth, and the experts that led the study urged governments to move to cut air pollution, and also suggested people avoid busy roads when possible.
‘When I was pregnant I was told about tangible things like alcohol, and what foods to eat,’ says Agnes. ‘I wasn’t even thinking about air pollution. Yet we know that Black women are twice as likely to experience stillbirth. Is this a determinant of our surroundings? Studies show that our environments play a larger role in our health than our genetics. And we know that Black people are often living in areas with higher pollution levels. I’m not saying that all Black people live in shabby conditions, that’s not the case. But a disproportionate amount of people from ethnic minorities are living at the forefront of the pollution problem.’
Agnes says that a 2016 report from the Mayor of London’s office found that black communities were three times more likely to be more adversely impacted by air pollution. ‘When Global Black Maternal Health launched a study on Clean Air Day on September 7th this year we were blown away by the responses. We heard from mothers who had been hospitalised during pregnancy, and others who lived in houses with damp who couldn’t alleviate the problem by opening their windows because of the air quality outside.
‘There is so much work being done on the impact of climate change, but what we want to hear is the experiences of Black and brown mothers. How are they being impacted, where their knowledge is? The climate change movement is a very white, middle class movement. We need to look at it through the lens of equality and hear the voices of those living on the main roads, and walking to school by the tunnels. We owe it to our children to bring about change.’