A landmark inquest has finally put a name and face to the human cost of air pollution – an environmental crisis estimated to kill up to 36,000 people in the UK and 7 million globally each year. On 16 December, a UK coroner found that the death in 2013 of 9-year-old Ella Kissi-Debrah was caused by asthma that was contributed to by her exposure to “excessive air pollution” in London.
The verdict marks the end of a seven-year journey for her mother, Rosamund Kissi-Debrah, and family. It is also the first time a person in the UK has had air pollution listed as a cause of death, with potential wide-ranging consequences for action to clean up air by local and national governments (see “Legal action”, below).
The inquest heard from Rosamund that Ella played many musical instruments, was a great dancer and swimmer, and wanted to be a pilot. New Scientist spoke with Rosamund to hear what she thought of the verdict, Ella’s legacy and what should happen next.
How are you feeling? It’s been a fortnight-long inquest, and six years since the original inquest, which listed acute respiratory failure as Ella’s cause of death.
Shock, really. It’s so enormous, you can’t really take it in. It will take a while, because I’m like that, I just don’t rush these things. I feel relief that it’s finally happened but I didn’t wake up feeling like a different person. There was never going to be any big celebration. This was about getting justice and getting it on her death certificate. There was nothing to celebrate, but there was a sense of victory.
We know thousands of people die in the UK every year because of air pollution. What is the significance of an individual having it listed as a cause of death?
One of Ella’s doctors felt respiratory failure did not really do her justice. It does not say to us what she has been through. The filthy air she was breathing in was suffocating her, and ultimately she died, so that needs to be on her death certificate. I wasn’t really interested in people saying “oh no one’s done this before”. This is my daughter, this is what happened to her, and we have proved it, so this is what she should get. As a mother, you would want the real reason your child died on their death certificate.
What do you hope the wider impact of this verdict will be?
1952 was the last time we had a new clean air act. That might be too much to ask for [a new act], I don’t know. We will consider all sorts of things.
What do you think of the idea of an “Ella’s law”?
I don’t mind that. That would be a deep honour to her. If it would save lives, I would do everything I can to campaign for it. It’s all about saving lives, anything I can do for no child to go through what she went through I’m more than happy to support.
This inquest was about establishing cause of death, not who’s to blame, but the coroner did say inaction by authorities to cut toxic nitrogen dioxide (NO2) gas levels had “possibly contributed to her death”. What did you think of that?
It does make you angry. When you are sitting in court and you realise all the failures where people were meant to act and they didn’t. It’s just that the public health emergency wasn’t there. It has similarities with covid sometimes. I think “come on, you’re too slow”. People knew [air pollution was a problem]. But where was the urgent action?
Air quality in London has gradually got better and London mayor Sadiq Khan is expanding the Ultra Low Emission Zone (ULEZ) in October 2021, to the North Circular and South Circular roads, near where you live. What do you think of his record?
He’s trying. He has done some very good things, but I would like the ULEZ to be London-wide so we are all breathing the same air.
Now the inquest is over, will you keep campaigning on air quality?
Now I can say what I truly want, you’re damn right I will. I need to talk to some people in parliament about WHO [World Health Organization] targets in the new environment bill. In order for me to take it seriously, they need to enshrine it in law.
What would Ella have thought of all this?
She knew regarding her asthma she was going to be in the medical books. Her asthma was so severe and so rare. What was her response? Cool. What would she make of this? The type of person she was, if you showed it would save lives, she would like that. One other thing is she liked being popular with her siblings and friends. One of the things she used to worry about is they might forget her and move on. From that point of view, the fact people will remember her for something good, she will take that. The sad thing is she never got to live out her dream of flying.
How would you like Ella to be remembered?
I would want her to be remembered for how funny she was. How caring she was – she was always bothered about other people, she would help someone to read in her class. She loved her friends, she was incredibly loyal. How bright she was. Her sense of duty, she went to Beavers, Cubs, wanted to go to Air Cadets. Also, a very serious side to her. She used to play chess. She used to laugh, and that smile. To remember her as a happy child. As I said to her, sometimes bad things happen to good people.
The UK is divided into 43 areas for air quality monitoring purposes, and three-quarters of these areas breach annual mean legal limits of nitrogen dioxide (NO2), a toxic gas that comes mostly from diesel vehicles. Of these areas, only London has implemented a clean air zone (CAZ) so far, with charges to discourage the most polluting vehicles in an effort to get levels down.
“It’s these zones that have been shown to be the most effective way of tackling the problem,” says Katie Nield at ClientEarth, an environment law group that has successfully challenged the UK government in court over the rate at which it is acting on toxic air. Cities including Leeds, Nottingham and Southampton rejected CAZs, while Oxford and Birmingham have used the covid-19 pandemic as justification for delays to theirs.
Nield says the verdict on Ella’s case should make the government sit up and take notice. “It is really quite momentous,” she says. Nield hopes the inquest’s conclusion will trigger renewed public and political pressure to meet existing limits that the UK has breached for a decade – and to set targets to meet even tougher World Health Organization guidelines.
Pressure is building. Simon Birkett at the Clean Air in London campaign has called for an “Ella’s law”, a new clean air act akin to the 1956 one, which helped clean up London’s great smogs, but targeted at modern problems such as NO2. Some MPs have already given their backing to the idea.
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