In 2010, three Months before her seventh birthday, Ella Roberta suddenly developed a chest infection and a severe cough. Her mother, Rosamund Adoo-Kissi-Debrah, took her to the local hospital in Lewisham, south-east London, where she was initially diagnosed with asthma.
In the following months, he worsened and began to suffer from cough syncope, coughing spells so violent that they caused him to faint due to a lack of blood supply to the brain. “She had one of the worst cases of asthma ever recorded,” Kissi-Debrah recalls. “They didn’t really know what was wrong since she didn’t present like a normal asthmatic. She was tested for everything from epilepsy to cystic fibrosis. Her condition was extremely rare.” In fact, it’s so rare that Kissi-Debrah couldn’t find a single case of a child suffering from cough from syncope in the scientific literature. “It was only common among long-haul truckers,” she says.
Over the next three years, Ella was admitted to the hospital about 30 times. On February 15, 2013, shortly after her ninth birthday, she suffered a fatal asthma attack.
His original death certificate said he had died from acute respiratory failure. “In the investigation it was established that some of this could be due to ‘something in the air’,” says Kissi-Debrah. None of the medical experts consulted had mentioned the possibility that air pollution had caused Ella’s syncope. That possibility came to light only after a local newspaper reader contacted Kissi-Debrah and suggested she check the air pollution levels on the day Ella died. In fact, that day the levels of nitrogen dioxide caused by traffic on the congested South Circular Road, near where they lived, had far exceeded the established limits.
With the help of her lawyer, Kissi-Debrah applied to the High Court to quash the verdict of the first inquest and request a second one, which was granted. “My lawyer, Jocelyn, charted out all the times Ella had been admitted to hospital and then got the data from monitors near the house,” recalls Kissi-Debrah. The pattern was clear: there had been a spike in air pollution before Ella suffered a coughing syncope. “Twenty-seven times out of 28. As far as I’m concerned, that’s scientifically significant.” They also showed that, on average, carbon dioxide emissions and particulate levels in Lewisham far exceeded World Health Organisation (WHO) guidelines.
After nine days of deliberations, the investigation concluded that “She died of asthma contributed by exposure to excessive air pollution.” She added: “Her mother was not informed about the health risks of air pollution and its potential to exacerbate her asthma. If she had been given this information, she would have taken steps that could have prevented Ella’s death.” The cause of death listed on Ella’s death certificate was changed. To date, she remains the only person in the world to have air pollution on her death certificate.
Given the evidence from the investigation, the coroner also issued a Future Death Prevention Reportwhich contained a number of recommendations, such as ensuring that national air pollution levels were in line with WHO guidelines, that the public in England and Wales were aware of the risks of air pollution and that healthcare professionals were educated about the health impacts of air pollution and informed patients accordingly.
“The coroner considered that other children were at risk of dying,” says Kissi-Debrah. “In fact, he made it very clear that unless the air was cleaned up, more children would die.”
At the moment, 600,000 children die around the world every year from breathing contaminated air. Only in London, a quarter of a million Children suffer from asthma. “The only time in this country that no child died from asthma was during the first lockdown,” Kissi-Debrah says. Ten years after her daughter’s death, she continues to campaign for the legal right to clean air. As part of her campaign, she is lobbying for the passage of the Clean Air Bill in the UK, also known as Ella’s Law – a parliamentary bill establishing the right to breathe clean air.
“We have a right to clean air, and it is the government’s duty to clean up the air and ensure that the UK’s targets are in line with the WHO’s targets, which they are not at present,” he says. “This is not a party political issue. This is about our health. This is about our future.”
This article appears in the July/August 2024 issue of UK WIRED Magazine.
