The toxic haze shrouding the Indian capital, Delhi, spares no one, but its children are counting the biggest cost of the city's worsening and recurrent pollution problem. Nowhere is this more evident than at paediatricians' clinics. The BBC visited one such facility in Noida, near Delhi, on a weekday morning a few days back.

In a packed waiting hall outside the doctor's consulting room, anxious parents stood in line with children sneezing, coughing or complaining of breathing difficulties. Most started falling ill in October, when the capital's air quality dipped to hazardous levels, and waiting times for doctor's appointments had stretched longer than usual.

Toxic air is a recurring problem in Delhi and across parts of northern India during the winter. There isn't a single cause behind the problem, but a mix of factors like low wind speeds, industrial emissions, vehicle exhaust, dropping temperatures, and the seasonal burning of crop stubble in neighbouring states.

Since the last month, Delhi's Air Quality Index (AQI) has been hovering between 300 and 400, which is more than 20 times the limit recommended by the World Health Organization. Readings above 400 affect all healthy individuals, but high exposure to PM2.5, a harmful particulate matter, hits children and the elderly hardest.

Dr. Shishir Bhatnagar, a paediatrician at the Noida clinic, mentioned that cases of respiratory complaints have surged from an average of 20-30% to 50-70% during pollution season in recent years. Each year, the government attempts emergency measures like halting construction or banning polluting vehicles, but these efforts have had limited success.

Parents like Khushboo Bharti are left in despair, recalling the harrowing night when her young daughter, Samaira, had to be rushed to the emergency room due to a severe cough. Following treatment for pneumonia, Khushboo is now on high alert each time her daughter coughs.

Research shows that air pollution can lead to stunted development and lower cognitive abilities in children, raising serious concerns among families. Many parents are contemplating leaving Delhi altogether to safeguard their children’s health.

As children’s exposure to hazardous air is curtailed through postponed outdoor activities and a shift to hybrid classes, economically disadvantaged families bear the brunt, living in conditions that alleviate neither indoor nor outdoor pollution. Experts are urging parents to keep their children indoors and utilize protective masks, yet the question remains: for how long can families stay confined while striving for a healthy environment?