WORLD ENVIRONMENT DAY SPECIAL WEBINAR

追加: 2026-06-06

[00:00:00]I'll invite you ma'am. Yeah. Yeah. Thank good evening all. A very warm welcome for this very auspicious day of World Environment Day wherein we are celebrating and getting aware uh about the climate change and other environmental factors. On behalf of Indian Academy of Pediatrics and API environment and child health chapter along with IPG Academy, I warmly welcome all of our distinguished guests, faculty members and delegates to this special world environment day. Uh we will have a discussion on environmental hazards and child health. And a world environment day reminds us that protecting the environment is not merely an ecological responsibility. It's an investment in the health and future of every child. to formally invite I would request our honorary secretary general Dr. Utira Gupta ma'am to deliver your welcome address >> please unmute ma'am sir >> thank you am I audible >> yes >> yes >> oh okay so thank you Dr. Prayer. Dear friends, nature provide us everything we need for life but not everything we want. The responsibility of preserving it rest with all of us. With these words, it's my proud privilege to uh welcome you all in the presence of dignitaries uh of Indian Academy of Pediatrics. Our president Dr. Nam moan madam president-elect Dr. Singravel Vevelu sir the immediate past president Dr. Wasant Kalatkar sir are all five vice presidents both the joint secretaries our treasurer Dr. Singraus sir along with that uh our APDG coordinator Dr. Ganesh Kulkani and uh joint uh coordinators for APDG team DOPIRA and all the respected uh panelist who are present over here today. Especially I would like to mention about uh Paramesha the father of environmental chapter and allergies in India.

[00:02:15]A very good evening to one and all and uh again it is uh it is really a proud day because it's the first time I celebrating environment day involvement day today and uh as we are we have gathered here to discuss this impact of environment for child health definitely uh this shows celebration of this particular day shows that our leadership is willing to work on it very consciously and with a focused approach and I'm sure with today's uh celebration all our members will be benefited and will be uh will act consciously with a focused attitude of saving our environment. Thank you.

[00:03:02]Thank you very much. And again my uh I would like to uh welcome our chief guest none other than the great dignitary Dr. Swami Swaminatan. Madam and uh our uh uh guest of honor Dr. Arvin Kumar sir.

[00:03:19]Thank you very much sir uh madameans for joining us today's evening. Thank you very much.

[00:03:25]>> Thank you ma'am. It's indeed a proud privilege to have Dr. Swami Natan ma'am and Dr. Arvind Kumar sir. Thank you for your gracious presence for this auspicious day of celebrating environment day from and environment chapter. The chairperson Dr. Sati Shagarwaler and his team. Thank you so much for collaborating with IAP. I would now request our visionary national president the dynamic uh Dr. Nila Moan ma'am for your presidential address and to introduce our respected chief guest ma'am Dr. Somia Swaminatan. Over to you ma'am.

[00:04:01]>> Uh thank you so much Priya. It's indeed an honor today uh to say that uh I be better late than never but realize we're very grateful to the environment chapter who has been working consistently uh to ensure that the pediatricians have appraised about the changes that is happening in environment and it is time that the leadership tries to uh take environment related issues at a national level. So it's a proud privilege that we are starting with this journey of celebrating every year an environmental rel to uh appraise not only the pediatricians but the parents at large.

[00:04:47]>> What I would say is that in pediatrics when we think it is most of the time we think of developmental trajectories. So what happens in the first years of life actually shapes the biological architecture of the adult. That is why to me pollution is not simply um something like an environmental exposure. I think it is it intersects directly with the growth uh you know and the development and so it's the organ maturation which is the organs like lungs brain and therefore it has this impact on lifelong diseases and sadly it still remains insufficiently integrated into our routine pediatric practice. It is not very often that we take history related to environment or we counsel our parents about this and it is time and why children are vulnerable. We all know it is generally because you know they're closer uh to the ground where there is high pollution they breathe faster and what science has shown us is something unbelievable that now we are saying the you know the statistics have shown that literally 26% of all neonatal deaths globally were linked to environment issues. issues and air pollution which was a shock when even I read that report which talked about it and 7 lakh children under 5 years died due to related to air pollution and India itself in the same report which is talking about it is 1.7 lakh children in India died due to under five died due to pollution so you can see the magnitude of it uh newborns because of its effect on pregnancy, pre-term delivery, low birth weight etc. So how each clinic of us is impacted the Delhi study which showed us that there was a increase in 29% increase in the cases um you know that came uh to the pediatrician and a large cohort of 19,000 plus children. They showed that 29% increase on high pollution days. You know this was a study which was conducted by as leadership. So these facts are just making things clear that there is so much that needs to be done while we've been talking all the time on infections and you know uh related and you know we trying to improve our survival mortality but we are stuck around there and this is because of issues which are related either to environment or uh to disabilities to uh congenital issues. So it's time now pediatrician me to focus on these issues and with those few words I take privilege uh to introduce Dr. Somia Shaminatan among us. Uh we've all known Dr. um uh somia somatrin and I think I know from the era when uh she was doing major research in tuberculosis but the highlight which is there I think she's among the first to serve as the first chief scientist of uh world health organization and she has been the director of ICM which is shaping evidence-based health policies in India >> and she's globally recognized for her pioneering work uh in tuberculosis HIV child health and what is very interesting is despite a lot of offers Dr. Swami Natan uh decided to come back uh to work as a chairperson in her father's uh foundation which is the research foundation and it focuses on two most important challenges of our time which is the impact on climate change and which is especially on women and children as I said uh you know more than 26% and the latest report was close to 30 uh% that uh globally we are having related to the changes in pregnancy and women and this and the transformation of food systems to ensure um nutrition sec uhity and sustainable development and with that I would say Dr. Swami and my interest is uh hugely in uh the nutrition as a public health issue. how we can address that and that is something which ties me with you and uh so she does co-chair our common air reflecting a deep commitment to the environment health and that is why we thought being a pediatrician she could address and uh make us understand where we went wrong and what is the present situation if we do not act today as pediatricians who are the first line what it would be. So your powerful connection with science, health, nutrition and environment is for us an opportunity to celebrate with you on this environment day. A very warm welcome uh to you and we look forward to your inspiring speech.

[00:10:34]Thank you very much uh Nam and uh good evening everyone and thanks to all the office bearsers of IAP and the environment uh chapter of uh the IAP um for organizing this and congratulations to you all. I think it's such an important um step forward um to just mark this day world environment day.

[00:10:58]It's true that you know when you mark some days once a year it doesn't mean that we should forget about it for the rest of the year but maybe today we can discuss a few ideas and uh actions that should be followed up. I think uh already uh Nam has given a very good uh introduction into why we should be worried uh and um especially about uh air pollution. uh more than 95% of the world's uh people including children are breathing air which is unsafe um or toxic for us according to the WHO. As you know the cutff the PM2.5 cutoff uh is is 5 micro g per uh cubic meter. Um the national air quality standard of India uses 40 microgram per cubic meter of PM2.5.

[00:11:54]But if you look at um the status of uh all the cities which have the air quality monitors generally you know they're very few in rural areas.

[00:12:05]Unfortunately it's mostly cities that have been the focus of the national clean air program. you'll find the majority of them don't even meet the Indian air quality standard let alone the uh WH1 particularly those which are in the northern half of the country and the indogangetic plane is very badly impacted now um air pollution consists of a number of components and a number of sources of those pollutants PM2.5 is the most dangerous uh being 2.5 microns in size it's able to from the lungs get into the bloodstream and then uh gets goes to all parts all organs and when you think about a baby or a child which is a growing um uh body uh the organs are underdeveloped PM2.5 sets up inflammatory responses and it's today it's been linked with a very large number of poor health outcomes um when pregnant women are exposed osed then there are higher chances of uh intrautrine um growth retardation of small babies being born of um there's been studies showing that the lungs are smaller when babies grow up in polluted environments cognitive development is impacted higher chances of diabetes developing in later life because of the inflammatory responses and now most recently association between PM2.5 and dementia and other neurological diseases in older adults. So there's no doubt that apart from exacerbating acute respiratory illnesses and asthma that um air pollution is impacting every organ uh every aspect of development and is probably leading to much more of a impact than has currently been estimated. In fact, Gita Gopinat who was the chief economist of the IMF said in Davos this year that India should worry more about air pollution than about Trump's tariffs in terms of the impact on the economy and she is like one of the world's top economists saying that so as doctors of course we worry about health but as an economist she has also told the country that it's shaving off maybe four to 5% of our GDP because of the impact on health of on productivity and also on businesses and people moving away and not wanting to um live in parts of the country which are so polluted.

[00:14:46]So there are many reasons why we should tackle air pollution and I think for one pediatricians must >> speak up. we because our children, our patients don't have a voice. They're not a constituency. Very recently, I've seen there's a group called Warrior Moms who's on social media. These Warrior Moms are putting out a lot of good scientific information on pollution. I really appreciate that. But I think um you see what happened in London was that there was a young girl of 13 who died of uh acute asthma. And um uh she was a poor uh child who belonged to uh a black family living in a poor part of London.

[00:15:29]And um the mother went to court um blaming the government for her child's death. And in the coroner's report, that is the autopsy report, air pollution was mentioned as one of the factors that might have led that had led to this child's death because it exacerbated her asthma so much that it could not be controlled. Based on that the court declared that air pollution in London needed to be con contained and instructed the government and the mayor to do something and this was Sadi Khan.

[00:16:02]This happened about 10 years ago and Sadi Khan in the last 10 years the mayor of London has made amazing progress through a number of different interventions in significantly improving the air quality. already it wasn't as bad as what we have here but even from there has gone much much better and we have many other examples Beijing being another one Mexico City and many other cities which have made concerted efforts to clean up the air uh for me it's very u disappointing and distressing that our government does not see air pollution as uh something that uh needs you know a big national program to address and I think the more that doctors will speak about it uh the more the proof the scientific data like what Nam was pointing out earlier we give um and case based data particularly because uh it's not enough to just have epidemological evidence it seems the government does not u needs more than that so every kind of evidence that we can collect uh would be in the in at least helping to make a push uh towards I believe what we should have is a national clean air program or a swatch vayou mission like we had a swatch bhat mission with very good funding a large amount of funding will be needed and it has to be multis sectoral action on the transport sector industry energy agriculture solid waste management as well as household air pollution. Now again pediatricians we are more um worried about the health of mothers and their children and indoor air pollution or household air pollution mainly due to the burning of biomass unfortunately still very common uh in India because of the cost and nonavvailability of LPG in rural areas any village you go to you walk into a home you will see that there uh they have a gas connection uh and maybe an empty LPG cylinder, but they would also be having um the firewood and um a lot of the cooking would be done on firewood and maybe once in a while they use their LPG. So, we need to move uh you know to more clean ways of cooking, clean energy for cooking. Uh it has to be affordable, it has to be uh equitably accessible to everyone. So, I think air pollution certainly is one of the biggest environmental health risks that I can think of. Um there are of course other environmental health risks which have even less attention and uh one example is lead uh and other heavy metals in different parts of the country. We have different heavy metals which are found in the uh in the soil and the water and so on. But lead is pretty uh ubiquitous.

[00:18:55]But again it's found more in those part those states where uh there are more poor people you know there are uh there's battery recycling is a is a big cause of uh lead in contamination especially where the battery recycling is happening in an informal setting in a way which is very unsafe. Quite often children are working there or even if the parent is working they come back they carry lead on their clothes contaminate the children. The other one is lead in paint while all the big companies of course have moved to um um having no lead in the paint. There's still a lot of paint in the market which has lead toys etc which have lead paint and lead as a contaminant in turmeric which um lead chromate is added to make it look yellow. This is a very common and under um recognized and Bangladesh actually took very good action on adulteration of turmeric and they brought down uh lead poisoning by uh by doing that. So again we need more research we need we don't have a point of care le test which is being uh developed I think there are efforts going on but as pediatricians what can we do we can um in our history taking and in our investigations u start uh looking for environmental risk factors which could be associated with the child's condition you know it could be anemia uh it could be neurodedevelopmental delays. It could be cognitive disorders. We should think about uh lead and heavy metal in the differential diagnosis and try and get a bloodled um uh test done. Similarly uh in our diagnos uh when we write our diagnosis if we can write you know exacerbated by evolution um and so on this actually helps um you know because it's it's there in the documentation.

[00:20:55]Um uh and then of course systematic studies um currently there are a few studies I'm aware of across the country that are looking at uh prevalence of lead uh poisoning in children u in rural and urban areas and I know from preliminary data that for example Bihar and UP have much higher levels the children they have much higher levels of lead than say Tamil Nad so it's it's also related to poverty and um development status of the state Um I would say that environmental risks to health today are um uh the number one uh risk to health plus nutrition. I think if uh poor nutrition, poor diet leading to both uh under and uh under nutrition as well as obesity uh which as you know is growing. The NFHS 6 data just came out two days ago and obesity in adults has grown up uh dramatically in the last four or five years, but also obesity in children is on the rise. Um and in urban uh areas particularly um but when you're looking at women uh in the 30s and 40s, they have very high rates of obesity. So uh starting with adolescent girls and of course anemia is still very prevalent.

[00:22:15]So on the one hand we have childhood still stunting at about 30%. Uh wasting at about 19%. Uh so that's still pretty high. We have uh obesity in adults, NCDs going up and anemia, micronutrient deficiencies. So what is the common factor in all of these? It's a diet.

[00:22:36]It's a poor nutritional quality of the diet. too much carbohydrate, refined cereals, sugar, salt, less of um uh vegetables, protein, fruits, nuts and animal protein, milk products, all those are deficient in the diet. Uh partly because of ignorance and partly because uh these are more expensive. So to get a good balanced diet, you have to spend more. Uh and the PDS the rations which most pe uh people 800 million Indians are getting rations. Um a lot of them are getting a lot of rice. So nobody's starving but very few states are giving dal or millets or any other healthy um food. It's mostly carbohydrate rice or wheat. Uh some states uh give oil. uh it's mostly palm oil uh some give sugar and a few uh give dal so uh from my perspective and then we have the school meals and the ICDS so if you look at these three big programs the PDS the school meals the noon meal scheme which is the world's largest scheme that India runs and the ICDS which is the uh Porsche Naban program um together you are a huge um sort of nutrition program could be a very effective nutrition program if we could improve the quality of what we are giving uh give more proteins and microins >> particularly for uh school meals. So since you mentioned uh nutrition nam I think it's a very very important uh and again as pediatricians we know that malnutrition in childhood leads to a lot of uh problems later on. um apart from growth retardation and cognitive you know uh lack of cog full cognitive development it also predisposes the adults to develop diabetes and other NCDs so it's a lifelong u we have to look at nutrition really as a life cycle approach um but for us as pediatricians the adolescent girl the pregnant woman and the young child and I was looking at NFHS6 uh hardly 15% of babies between the ages of 7 months and 24 months are getting what would be an adequate uh nin um compliant diet. Uh only 15%. So that means 85% of our babies are not getting the right complimentary feeds. So again we're failing right? we're failing as pediatricians or as a society. Um either we haven't been able to educate our mothers or uh it's an affordability problem or a combination of both. We don't have crashes in most most parts of the country. The young bodies start at the age of three and by that time stunting has already set in. As you know the brain development occurs very early.

[00:25:51]So uh we need to um again document generate evidence and um ensure that it influences public policy. I think the Indian Academy of Pediatrics is in a good position in a very good position to um have an influence on policy by bringing out policy uh papers by bringing out um uh you know writing to u the the authorities uh minister and secretary and and and so on and and then by doing public education. Uh I think nutrition is one area where people have a lot of misconceptions and so we could be doing uh much more and um I was disappointed with NFHS 6 data to not see uh much progress in nutrition. In fact uh in some of the parameters we are stuck in some of the parameters we've very marginally improved and in some others we're actually getting worse. uh and of course the NCD situation in the country is getting worse and that you know trajectory of NCDS is is something that u starts in childhood as we know so I I don't want to uh go on and on about uh about this um u but I just wanted to make these few points and the fact that with climate change we're also seeing a large number of uh impacts on women and children in particular uh direct impact lacks of heat uh but also indirect impacts through nutrition through uh vector-born diseases and um and and also on mental health.

[00:27:36]So these are things where studies are currently going on and I think we're going to get a lot more data but again not many studies in children. most of the studies that are going on are in adults and so we also need to look at um and I I met a psychiatrist recently who was telling me that uh she saw uh or she's often seeing young girls or young children uh or in their early teenage years who have climate anxiety who who worry about uh what the world is going to be like for them when they grow up and often have nightmares about it or anxiety about it. So, so it is turning into also mental health uh um you know sort of challenges. One of the additional stress factors I think for children um today um what is uh is there any reason to be optimistic? So I I I think that is a good question and I often ask myself that u we don't have a choice I think but to be optimistic and hope u that things will change but we have to work towards it. it will not change on its own. The more of us who talk about it, who are doing things or generating data, talking to people uh in um situ in you know authority that those who have the decision-m authority um and of course also talking to parents, children, counseling them, schools, you know, working through schools and teachers. Um so awareness is increasing on climate change and many of these issues but the actions are actually uh not as as um much as they should be. You know we we need to step up um and do a lot more a lot faster because things uh the climate is changing extremely fast and we we need to start responding also much faster. So it's great that AP and um is taking this up. We it's a great network. It's a very strong network across the country and uh if the IAP president and office bearsers decide that this could be a priority for the next two years and you see it's not going away. It is going to be with us for some time. So if we could commit for the next couple of years of some kind of a sustained action then I do think that things will change. They have to change and they've changed in other countries and uh they should change in India also.

[00:29:57]Now thank you. Thank you Nam for inviting me and back to you >> ma'am I know it's uh uh if if may I be allowed to ask you a question please >> okay so if you had because pediatricians are pretty stress if you had one minute with every parent in India because that's what a pediatrician is >> right >> what is the single most important environmental message you would want them to hear for their child's future.

[00:30:37]You see, it's very very difficult to tell something to a mother when the air is polluted outside. What do you tell her? Can she put a mask on the baby?

[00:30:46]Yes, for older children, you know, we are all saying put on a mask when you go out. Don't play outdoors. So, it's things which are actually going against what we should be saying. We encourage children to play and be more physically active but now we being forced to say don't go outdoors in the polluted environment. I think for parents we we can definitely give good nutrition advice that is something they can act on. Every mother, every needs to know what complimentary feeding actually is, the quality and quantity and you know a good diet does protect you against a number of other and the other thing we could caution them about I think is is lead you know to buy for example turmeric uh to only buy turmeric which is in a in a sealed package because most of the adulterated turmeric is sold uh loose to to also watch what toys the child is playing with ensure that there's know lead paint on the toy. So these are things which you know they can control. Um unfortunately the air is not something that an individual family or a parent can control. But if they are aware that it is harmful for their child then perhaps a parents also I mentioned warrior moms parents will also become activists.

[00:32:02]So I think I I'm happy to share that we did amazing when it comes to complimentary feeling because this was something which was disturbing me for last years I've been working. So we came up with an app and I've been working on it for long but I want to share with you because you are a powerful voice. So this is an app we launched yesterday called AP Care and it is meant for parents and four pillars. We just talk about nutrition. We talk about the growth chart. It talks about development and vaccine. So any child they I mean parent puts the age and sex and that the app will tell you what is the growth chart and how it is and they just have to show the photographs of what they're eating. It tells you what is your diet, calories, protein etc. Or you can voice it or you can uh do it. So I given an opportunity I'll send you a WhatsApp.

[00:32:52]Please download care and give me commence moment.

[00:32:56]just launched yesterday if Kale it's a on any mobile app that's a small step from >> excellent uh this and uh thank you so much Dr. Somia over to Priya.

[00:33:10]>> Thank you.

[00:33:11]>> Thank thank you Nila ma'am for making uh June 5th as world environment day and celebrating from IAP the first uh this year. Thank you so much for that uh uh making an awareness day and thanks to Dr. Somia ma'am for creating a great awareness on the intensity of environmental hazards which is causing uh child health issues and be optimistic, be positive, hopeful and definitely time to act from all of us.

[00:33:42]Thank you. Thank you so much ma'am for your uh golden words and I would say we were indeed proud privilege of all of us to listen to your address today. Thank you.

[00:33:52]>> Thank you very much.

[00:33:54]Now I would request >> you to meet Dr. Advid Kumar before you leave. Uh he's doing a lot of work uh in doctors for uh >> Yes. Yes. I know >> he does amazing work.

[00:34:10]>> Hello uh Dr. >> Hi. Hi Dr. Somia. Good evening. What a pleasure it was to listen to your very wide range covering talk. You started from PM2.5 and in a few minutes you about covered everything related to air pollution, nutrition, lead toxicity issue.

[00:34:32]Beautiful talk. It was a pleasure.

[00:34:35]>> Thank you so much. I'll listen to yours.

[00:34:36]I'll just stay on. Yeah.

[00:34:38]>> Thank you ma'am. I would now request our respected president-elect Dr. Singarua for your address and to introduce our respected guest of honor Dr. Arvin Kumaras. over to you.

[00:34:50]>> You thank you madam and our respected president nam and secretary HSG and past president Khaler and all our office bearers of AP and EB members and stalwarts of our environmental chapter.

[00:35:08]It is a proud moment that though we are talking about environmental all other things through various forum our taking this day as creating awareness along with our environmental chapter under the leadership of parame is there and lo and raania bala so many people who are working for environmental thing for quite long years and it's a proud moment that s ma'am and uh Arvin are here. See here I want to add before going to Somia ma'am gave a wonderful lecture. Apart from that she met our recently elected agriculture minister and how much her commitment who is my good friend that minister is from my place and she met and he was telling yesterday when I met him and he was telling that so ma'am came and it was a proud moment for him because she went and met him in the secretary thanks madam and sharing about concern of nutrition how agriculture can improve and all that madam Yesterday we had an opportunity to interact with thank you madam your commitment to to us apart from health and other things meeting officials and discussing is a good thing. So and madam has covered entire aspects only one more thing which I added where as na was asking one question it cannot be it is a ongoing uh thing it cannot be environmental thing cannot be done in one day or one minute it has to be a lifestyle thing which has to embibe from day one of their life and it has to continue till the the amount of environmental hazards we are facing starting from plastic. If you start plastics alone, we are trying to make our temple big temple where it is one of the world monument and we made a plastic free zone for five years back at least to some extent we are able to do that.

[00:37:13]So like that everyone has to involve every day. Today we got one interesting thing our how our efforts are making a change from director of industries of Tamil Nadu because I want a industrial unit for me a mail came today you should plant five plants in your unit and the photograph and has to be sent to the directorate today. This is a first time in the history that the government is insisting otherwise we will make a mark of your industry. So the government has take the giving the pressure on that really it is a welcome change. I think permission and our swimmers are all will be proud that something is getting some changes. Definitely it will make a change otherwise it is a good thing which I wanted to share without wasting much time. Our great stalwart has come here as our guest of honor profit kumar sir. Welcome sir and your commitment as a chairman of lung surgery and lung transplant chest surgery and all that and he is in magenta hospital Guran I think nam unit he is with her and he was in for more than three decades and as a pro of surgery he created a unit of thoracic surgery and after that he moved to Gangaram Hospital where he introduced the diploma in thoracic surgery. Hats off to you sir and it is still is continuing the teaching. Apart from that his academics he has produced lot of papers he has done lot of innovative surgeries and introducer and we are really proud that because whatever we talk about environment the prime organ which is getting affect is lung.

[00:39:11]Whatever lung is affected, you are the person who is going to wherever medical management fails and it is go to surgically you have done a lot and that you are a hot person to be here with us for this world environment day where our in chapter is celebrating sir. Thank you sir have having come and gracing the occasion. Thank you ma'am over to you sir. Thank you for >> s doctor. Yes sir. Sorry, >> just wanted to say that he's the founder chair for the Lancave Foundation of India and also doctors for clean air and I've been consistently seeing his major efforts and he's affiliated with lot of clean air association uh internationally trying to increase the awareness of air pollution especially over to Dr. Abind Kumar.

[00:40:09]>> Thank you. Uh respected Dr. Dr. Nilam moan the president Dr. Singarau the incoming president distinguished past presidents secretary vice presidents Dr. Somia Saminatan distinguished members of IAP friends ladies and gentlemen first of all a very warm good evening to all of you and my sincere thanks to Dr. Nilam Moan for giving me this opportunity to share my thoughts regarding air pollution with all of you.

[00:40:42]Thank you Dr. Nilam and thanks to all of you for this opportunity. I'm a chest surgeon and as a chest surgeon I get to see the lungs three four times every day when I operate in the theater and this is exactly the moment which actually brought a surgeon into this field. A lot of people ask me what a surgeon is doing in the field of air pollution and I'll show you in the next 6 7 8 minutes a couple of three evidences that I see with my own eyes uh on the lungs. You know all of you see patients who have problems from early childhood till late teens. But I'm going to just show you the evidence that I see every day in my theater which hurts me every day and forces me that no remaining in the theater is not the duty of a doctor.

[00:41:41]It's a health problem. A lot of people consider air pollution as just an environmental problem or a chemical problem. Whereas truly it's a health problem. And friends, you'll be amazed that despite so much of talk in television and everywhere about this issue, how much of lack of awareness people still have about prevalence of uh this thing air pollution. A lot of people think that you know they equate optical quality with air pollution. So October, November, December when the air is really bad, foggy they think air pollution is there. But rest of the months when the optical quality is not bad, everybody says no no no in my area there is no air pollution. And when we tell them it's impossible to make them accept that no it's a round the ear problem. It's an across the country problem. Earlier it was only a north or indogetic plane but now there is hardly any area in the country which is spared and it's a pan country problem and as was repeatedly said I think doctors probably need to play a much bigger role in spreading this awareness not just pediatricians I think it's the duty of every doctor to rise to the occasion and bring it to the notice of people there's no point in talking about industrialization and all other things if the health of the people is bad. So I'll can I request the IT tomb to just share the slide. So I'll just show three evidences some Yeah. Next one.

[00:43:19]Next one sir. Yeah. Next one.

[00:43:23]So friends, this is the photograph from the theater of the lung as we are born with a pristine pink lung. We all see it during our anatomy dissection but after that we don't really get to see it. But I because of my profession see it every day. And in the next picture friends you will see what the color of people I'm seeing in my theater every day. Next slide please.

[00:43:51]See this is the color of lungs of a nonsmoker.

[00:43:56]Can you believe it that this is what I see every day? Lot of people keep asking okay where is the evidence that you know air pollution is causing some damage and I keep telling them please come to my theater and just look at any lung. What more proof of damage do you need? And even more troubling than this is the next picture. Next one.

[00:44:21]This is how it looks in a smoker. Next one. And this is something which will interest all of you friends. This is the photo of the lungs of a teenager. Now this should really interest all of you because they are the these are the patients you see and this is what I see nowadays in 5 6 7 8 9 10 11 12 year old kids also mostly I operate on adults but every now and then we have patients who have diseases which need care and we do get to see and this is the color so see if at early teen if they are having this kind of deposits and mind you these These deposits when they are there in the lung are in the tissue forever.

[00:45:08]Nothing can wash them away. They not only have silica but they release a lot of chemicals which not only causes damage to the lungs but the chemicals go into the blood and from brain to toe there is no organ of the body which escapes. Next one it is it was told by Dr. Somia also that this now there is enough proof that the damage is actually starting from uh the pregnancy time only. And next one and couple of years back. Next one. Next slide. I made a state next slide.

[00:45:48]Yeah. Couple of years back I made a statement on the television that in a polluted city newborns become smokers.

[00:45:56]And I was actually reprimanded for being a very sensational person. And I said that 22 microgram of PM2.5 is equal to one cigarette. So if a child is born in a city with a AQ with a PM2.5 of 200 or so, he's act he or she is actually inhaling air equal to 10 cigarettes from the very first breath of his or her life. So what's wrong if we make a statement that in a polluted city newborns become smoker? It's a reality.

[00:46:28]Dr. Swamia mentioned it. This damage starts from the first breath of our life and it continues till the end of our life and it takes a heavy toll on our development. Uh next slide. Often times lot of people feel and this includes lot of doctors also to whom I have talked as a part of lungare foundation. Lot of people feel that the damage restricted only to the lungs but they need to know that no from brain to toe there is no organ which is spared the ill effects.

[00:47:02]Lungs may be the portal of entry but every organ gets affected and every month there is more and more evidence coming where hardly any disease even breast cancer now is being associated somewhere or the other with lung air pollution. Next one. This is a slide of my 30 years experience and this actually will tell you what is happening in the society. On your left is a a demography of lung cancer as I saw 30 years back at on your right is what we see today. Just summarizing back then 90% of the patients were smokers mostly men mostly in their 50s and 60s. So this was known as a disease of elderly smoker men and what is happening today friends 50% of our patients are non-smoker the age has come down 40s is the peak now 10% patients are in 30s and a few in late 20s 40% lung cancer patients today are women mostly non-smokers so from smoker elderly men it is shift shifted to men and women uh younger and non-smoker and smoker equal. Why? Because from smoking the focus is now shifted to breathing. I would say that it should now be called a breather's disease. If you breathe in a polluted city, you are prone to lung cancer. And mind you, majority of these are diagnosed in stage four. Because when hemoptsis occurs in a younger person, no one thinks of lung cancer.

[00:48:47]90% of our patients are given anti-tubercular treatment initially before they are diagnosed. Next slide.

[00:48:54]So, and children, elderly, unborn babies are the most vulnerable and they bear the brunt of the attack. Next one.

[00:49:05]So we created this doctors for clean air and I would really compliment IP and request that all of us doctors we have a huge duty to engage people to educate them and to support them in spreading awareness about this. I think when doctors start talking about this being a health issue people will listen because we are talking from a position of strength. If a scientist talks about air pollution being a health effect, then they would not accept it. But when a doctor says it, it would be accepted. So I think we all of us doctors have a huge role to play. Next one.

[00:49:46]Next one.

[00:49:51]Next slide. Yeah, this is the last slide I want to share. Couple of years back we conducted a study amongst nearly 3,200 school children in the age group of 11 to 14 across 35 schools in Delhi and we did their uh respiratory symptoms assessment onsite. Our teams went to the schools and we did on-site spyometry using very standardized techniques and very strong quality controlled method and we were amazed to find overall 29.3% but 37% boys and 19.9% adolescent school children in Delhi to be having amma/airflow obstruction as proved by onsite spyometry.

[00:50:46]This was done about 6 years back. It's already published in lung India and couple of months back we repeated the study in different schools and horrified to find that despite whatever has been done in the last five six years the numbers are more or less the same. The problem continues to be there and as Dr. Somia very elegantly mentioned this is the problem present across the country we don't pay enough enough attention and most surprisingly when we go to the policy makers everybody says us oh give us the Indian evidence give us the Indian evidence but when you give the evidence they say no no no no this needs to be verified so usual bureaucratic method and it's just brushed under the tree so last slide so I would end by making a very humble plea. First of all, I compliment Dr. Nila Moan and everybody in Indian Academy of Pediatrics for taking up this important cause. I must also compliment you that out of almost 20 professional associations that I'm aware of. You are probably the only association which has a separate environmental chapter. I have been associated with Dr. Romesh Pania, Dr. Alo Gupta and many of you for quite some time and you pay a lot of attention but now it's time I think where every association should take this up should form a environmental or air pollution chapter should take it up as an important issue and I think it's the duty of every doctor in the country to bring this notice to the people of our country that if you are worried about children's tomorrow please worry about the air they breathe today. Don't worry about leaving a big house or lot of cash for them. It's of no use. Please do worry about ensuring clean air for them to breathe because that will give them the best future that we as parents can give to our children. Thank you so much and once again I thank Dr. Nila Moan and everyone in for this wonderful opportunity. Thank you so much. Thank you so much Arvin and it brought me nostalgic memories. I think I've never shared this even with pediatricians.

[00:53:11]It's a very small group. Today I'm sharing if you have seen in my CV there is a line which says Forbes powerful performer in 2021.

[00:53:22]Nobody asked me but it was then postco that I accumulated 2 cr of rupees through my friends and I went in to give it to the UP governor because we wanted to run buses uh to help you know people in postcoid state and at that time I got to know u aren gi more closely because the medicines that were provided free in the buses which were run in UP. I don't know whether you remember or you know heartbre they provided by the lung care foundation and that's how I could probably work a lot during that time in co I'd forgotten till you showed it and thank you for you know your team being generous to support during the covid times too over to >> thank you thank you so much sir uh indeed it was an eyeopener It was scary to uh over that I can say it's the need of the hour for all the doctors uh to be the ambassadors for clean air. Thank you. Thank you so much sir for your gracious presence. Now I would request >> Now I would request our immediate past president Dr. Vasant Kalatkas for your address please. Sir Vasan sir yes >> thank you Bria for giving me chance really I want to first congratulate Dr. Nam and team 2026 IP for celebrating this day which is a need of the day.

[00:55:00]Dr. Som as well mesmerizing. I met her in Glasgow also there I had a talk and I listen really it's always I think there knowledge on TV and like environment it's always there. Thank you Dr. Somia and Dr. Arvin what to say the your slides are super super it's eye opener I think it should not be limited to only only for Delhi or our pediatrician or our medical it should become viral if you permit IP will make it viral it's really eye opener though scary but it's eye openener every parents every doctor will learn and we should take the mantra that engage educate and support But >> what I say as charity begins from home, we have to start from home. We have to show that we are not smoking. We are not using a chula. We are we want to not to use recycle and all this. So we we we should be a role model for parent all public as people always listen see that what doctor does like a teacher. So thank you once again Arvin and it 8 is 26 IP for this good task. Let's hope tomorrow will be better as S said is not a problem of Delhi but across the country. Thank you once again and wish you all the best for a good environment.

[00:56:40]>> Thank you so much Dr. Vasand and Dr. Vasant as the past president have always been supportive and he is the team 2026 because we are a driver of 2026 who working together uh to improve the healthcare infrastructure of the state and uh Priya we move on to the uh the session now with your permission because >> yes ma'am as >> so may I request Dr. uh uh uh Mayang from IAP uh to showcase like we did yesterday highlight >> pin only the panelist pin only the panelist >> panelist so we are uh six panelist Mayak Dr. Psh Dr. Sukumar Dr. Alok Dr. Satish and Dr. Romesh Bad maybe you can raise your hand in case he doesn't recognize uh Satish G >> you can >> I here >> no you have to raise for Bayang to recognize you >> and now Ram Romesh you have to raise your hand Romesh Bajana yes so thank you so much uh so it's a rapid fire chat because I've been hearing you all for decades now on environment and I must confess that it is not one but all of you together whether it is Satish whether it is aloo whether it is Romesh three of them could absolutely mesmerize me and convince that nam zindadhur if you don't do the environ so as I said earlier that I was I had a flight in the evening at 5:00 when I was supposed to reach uh Ahmedabad the flight got delayed I said I can't she thought to the environment team and cancelled the flight and came back for this so it's indeed a pleasure rapid fire Dr. PH um we have already heard about 2.5 micron which gets into the blood and uh we often think air pollution is a lung problem.

[00:59:04]What is the strongest evidence today that air pollution is a whole body disease rather than a lung problem?

[00:59:18]I sincerely thank Mam taking it forward environmental issue dignitaries and my brother sisters of let me start instead of wasting time here the theme of this year is inspired by the nature for climate for our future and also he's been told air pollution is a silent killer nearly 48% of the chronic lung problems 29% % of lung cancer 25% of the heart attack 24% of stroke are related to that it's a silent killer and also if you look at the 10 countries what do all this thing I think India comes number one where 70% of the pollution is come from the air pollution 20% from the water 10% the from the soil chemicals and whole lot of thing nearly 70% of the disease caused by the airution for non-communicable diseases and also 70% non-communicable diseases are air pollution and in them earliest onset non-communicable disases are the allergic airway diseases and having said that air pollution has got various chemicals particulate matter and also gases one has to keep it any particulate matter more than 10 micron and also water soluble gas sulfur dioxide and all this thing affects upper respiratory tract, rhinitis, sinusitis, millar infection and all the things and the less than 10 micron up to micron you have langitis, tracheitis, bronchitis, bronchilitis and asthma less than 2 micron that is more important. That is the one process the seven layers of the lung enter the bloodstream. Once they enter the mucous membrane of the bloodstream, small clots will be formed that will be circulated all over the all the vital organ will be affected including the placenta. Depending on the seriousness of the uh deposition they have a still birth and if it is less you can have the premature babies. If it is less small for date babies and these children born with small airway caliber they are going to suffer repeated we of asthma and pneumonia and all this thing and they become continuous airway obstruction respiratory cripples your body later on this is what causing this problem madam I think and also all the organs will be vital organs will be affected and also neuro development cognitive develop everything develop brain get affected too very badly In addition to that behavior problem also comes from that one. We have enough evidence to support all these things.

[01:02:05]Two days ago we had Indian of science.

[01:02:09]Two days we organized this one. All these chief secretary pollution control board everybody has come there. Only thing they blame you doctors are the one not agreeing each other. Each one talk ill of that one and a different one and politician take you there. They come only for five four years five years.

[01:02:26]they like to lock on this one. I think you when you come there make sure you present your data properly together rather than one telling this one don't tell this one. This is what causing you are professional people. I think knowing this many people don't know in science we started through the who training program for for the first five years. So people are coming there. We continue to do the same thing and because of the time gap any other question I'll more than happy to answer.

[01:02:55]Thank you >> so much. That was so eyeopening. And can you repeat these statistics of adult NCD 25% heart attack?

[01:03:07]>> Yes. Yes. I think nearly 48% of the chronic lung problem, 29% of the lung cancer, 25% of the heart attack, 24% of the uh stroke are related to that. Uh what about obesity?

[01:03:25]>> Yes, it also comes the obesity endocrine disruptor and other things they're all coming there.

[01:03:31]>> Thank you so much Dr. Sukumaru. Besides Dr. Pesh being called as father we we have both of you as fathers uh who have done a lot of work in environment and I'm so privileged that I'm in the center in the screen with both of you uh uh next to me on either side and I seek your blessings uh and I promise that I'm going to work in environment and we are going to start with some of this uh information whatever is being gathered today from Dr. Somia's talk and Dr. wins and you all and we'll compile to make it something which we will make an article and send it to child India to across all 50,000 pediatricians in there there the two things which will be covered will be complimentary feeding and environment and now Dr. Sukumar climate change is described as the greatest health threat of 21st century. From a pediatrician's perspective, what are the biggest risk that today's children will face over the next two decades?

[01:04:40]>> See, thank you madam. My job have become very easy now because our chief guest Dr. Somia Samadan has covered all aspects of climate change. She has covered all aspects and the ch the main enemy of my our children is climate change. Not only for children our anti mothers also the main problem in climate change is again global warming because of high temperature the anti mothers are also affected. They can have pacio toxmia, toxmia, pregnancy, increase in gestation, diabetes that can lead to prematurity and early neal deaths. And in the newborn as somebody has said it can also produce the climate change can produce even congenital malfformation.

[01:05:28]Spina is increasingly reported increases of heart disease is reported in in in newborn. Then you know air pollution I am not going to air pollution Dr. Verisha said everything about air pollution but the PM 2.5 can produce other problems also as adolescence and older children there's a high high incidence of autism spectrum disorder spectrum disorder hyperactivity behavioral problems due to this climate climate change then as you know there's a high incidence of all waterborn disease vector vector bone disease and also footbone diseases are very high because of the this climate climate change and also madam dr has again highlighted the importance of mental changes psychological problems because of the climate change that is our children develops psychological problems like psychosis and they will have a post-traumatic stress is reported post-traumatic stress is reported due to the lo loss of school days loss of schools and and like like is and all this can affect the agriculture agriculture and it can lead to malnutrition again Dr. Somia was highlighting the importance of malnutrition the the loss of all nutrients can have psychosocial problems and also cognitive impairment and all these problems. So to summarize what I want to say is the main enemy of our children for the next decade should be climate climate change. Unless we interfere this problem by all sector at community level at governmentman level our children are having will have lot of problems including respiratory problem psychological problem and mental problems. Thank you m >> thank you so much and Dr. Alo Gupta.

[01:07:30]>> Yes ma'am.

[01:07:31]>> We have been talking about like as the cities grow urbanization lives become increasingly indoor.

[01:07:41]Now there is clean there is sedentary lifestyle and we are saying so how much of the current epidemic of obesity, diabetes, allergy, mental health disorder could be linked to environmental change associated with a mass.

[01:08:03]Thank you uh ma'am and with due respects to all dignitaries and uh the IP and environment Dr. Somia Saminatan and Dr. and Kumar.

[01:08:16]Well, when we first entered into the second MBBS, >> we studied that uh 20% of the population of India resides in cities and the 80% of were in the villages.

[01:08:33]30 years back it was 40% in the cities and 60% in the villages. In the NHS uh six data it is nearly 50% or rather more than 50% of the population of India is in the urban areas and it is projected by 2020 2030 that will rise to 70%.

[01:09:02]So it is basically a complex mechanism where the urban cities are increasing and the peri areas are increasing the rural areas are decreasing and the semi-ural areas are increasing and uh the distance between the rural and the urban areas becoming short.

[01:09:28]I would like uh to imagine a family or a medical student for examples who comes from a rural background and gets admitted in say Jaipur or Delhi or any city and uh he has got lot lot of expectations and when he lands there he is in awe it is all glitters.

[01:09:58]But soon the family and the teenager or adolescent realized that all that glitters is not cold from a free rural area which was green and better with less air pollution. They land up suddenly in a very lighted atmosphere with noise pollution, overcrowding and uh what uh Madame Som has already talked the stress sets in the shock sets in and the child or the family becomes comes on a back end and they become very very afraid of this situation because their diet, their habitat has changed. The house is small. It is not uh well ventilated.

[01:11:00]that that which they used to have the fresh diet, fresh green fruits and vegetables and all that uh good diet is now restricted to calorie dense ultrarocessed junk foods, beverages which are high in salt and sugar and unhealthy fats.

[01:11:23]Then they uh they transition themselves into the especially the children into indoors which are no uh less worse than the outdoors and the screen time increases.

[01:11:39]They rely on private transport rather than walking to the schools. The decreased open spaces and the academic pressures lead them to a largely sedentary life in the urban and the perurban areas.

[01:11:59]The air environment factors and the triggers have been talked about which trigger asthma and the respiratory disease and the air pollution affects every other organs heavy metals. Yes, lead madam has already talked about um hour back I was in the lead consultative meeting with the WH webinar and we were talking about how to diagnose and how to measure blood lead levels in mass situations where we can at least have a a baseline level of what a mother or a newborn has so that we can have our own bloodlet levels, the nightlight, the noise, the thermal radioactive pollution, they have got their own effects. And then the NHS 6 data shows that 20% of their population including the children are undernourished or have got a micro nutrient deficiency.

[01:13:10]while 28% of the childhood and adolescent obesity has settled.

[01:13:18]So early onset obesity metabolic shift early onset stage 2 diabetes high blood pressure high triglycerides pre-diabetes sets in at the age of 10 to 14 years. Asthma and respiratory diseases have already been mentioned by everyone. mental stress disorders. I have also spoken Dr. uh super also >> I think I'll summarize with your permission. The the summary is that it is not only directly but direct and indirectly it becoming a difficult choice for people living in urban areas.

[01:13:59]As I said the way children now eat, move and uh associate the air they breathe and the way they interact all of this are making uh this and there is a strong cons uh uh it's time for us to understand the impact of that because the latest studies are also saying that uh the insulin resistance is somehow related to uh urbaniz uh related to pollution and this insulin resistance is giving rise to obesity, fatty liver disease, metabolic liver disease. And now I would move on to Dr. >> I would like to add one thing that >> Dr. Satish Tari let's I'll come back to you sir. Dr. Satish Tari uh I I just wanted to ask you uh that what is it now we know that there is a huge impact of water. So we heard Dr. Pame saying 10% uh is related to uh uh food and 10% I mean soil and 10% water he said and 70% he wanted to talk about air but let us talk about children if I think about children uh this uh uh water park do you think has a major impact in children or is it just the same 10% that Dr. Pesh was talking about. So are children more susceptible? If yes, why?

[01:15:26]And what is it that you want to talk about water pollution to us?

[01:15:32]>> Thank you. Uh President Ma'am, uh if you permit me, so I say just a sense of gratitude thanks to you that our environmental day got included in IP list one. Second thing, thanks to you for accepting our request to become auditor of the section in spite of your busy schedule. Two things. Now, third thing, you honored me calling me as Dr. Satishari. Although my name is Dr. Sophi Shakra.

[01:15:59]My apologies.

[01:16:00]>> That's what I was wondering what happened.

[01:16:05]>> I'm honored because it usually happens.

[01:16:08]>> My apologies.

[01:16:10]>> It usually happens after my lecture is over then the thanks is given by the Dr. I'm used to it now.

[01:16:19]>> As you said about the importance of water, I'll just say even in a culture, one of the component is water.

[01:16:36]Importance of water in children because it is more important in children than the adults. One thing because children they consume more water than the adult per kg per kg their body weight. One thing second thing is the children their immunity immune system is still growing. It is not yet developed.

[01:16:54]Internal organs are developing. They are not yet developed. And the most important thing is that the whatever effects they occur because of the water pollution they will remain more wasting than the adults. Hence to save our children from contaminated or polluted water is more important. Now the second part of the question is what are the effects of water pollution. Now we can divide this into two immediate and long-lasting.

[01:17:21]The polluted water contains all sorts of name there in the water. Maybe it be bacteria, maybe virus, maybe fungi, it proges, it can cause diarrhea, dentry, pora, blood, anything. These are all the ill effects. But the long-term of the effects are the innocution. M also say there is a incidence of 30% of strengthening in our children and the main cause is malnutrition and we all know malnutrition is the biggest cause of marketing and one now second thing is about the long-term effects which we really don't make attention to that it is because of the contamination of the heavy metals. Studies in Delhi they showed about 80% of the water is contaminated with heavy metals like arsenic grade mercury. Just take the example of arsenic. It causes skin regions. It causes cancer. It causes neurological disorders also. So I'm just giving example because we are having short of time. So I'm not going in details.

[01:18:24]And now the most important thing is the most important the antimicrobial resistance we are all talking about. Now I want to ask you one question.

[01:18:33]>> Uh Aro water is it completely safe? I mean uh to drink in or mineral water or arrow water. What what are your thoughts?

[01:18:45]>> As such as such the term in chapter is as you go away from nature you go become more sick. The more and more you are near the nature you are more healthy.

[01:18:56]Now arrow water you process arrow water.

[01:18:59]If you are processing in the proc but most of the times we all see that the processing after some time it becomes routine one thing and the second thing you ask for mineral water again the same thing applies to the processing so if you go away from all these things if you keep that water in our urban pot with all safe water it becomes the most safest water in your I think I'm clear >> bra >> yes ma'am >> thank you so much. Yeah, I've heard the statement always last but not the least and the name Romesh is very dear to me because I'm not sure whether I ever told you. My father's name is also Ramsh.

[01:19:41]>> So you know I hesitate to call you Romesh but you're a colleague and it gets you. So Romesh G there is now everyone is talking of global warming.

[01:19:55]Now what is this global warming? Why are people saying that if you don't protect the environment and what is all that they're hopping and especially when you talk about global warming?

[01:20:09]>> Yeah.

[01:20:09]>> In a country like ours where the poor people I mean there is there is a difference in uh uh you know uh the poor people have to separate because they need um they need to survive. They need to be having money. So they have to be whether it is you know the guy who uh whose business is dependent on that. So what is it you want to talk about the global warm?

[01:20:38]>> Yes ma'am. Thank you so much uh first of all ma'am for sensitizing all of us and taking a true leadership at the highest level because in this year maximum people they are talking about environment. So we are grateful to you.

[01:20:52]Now uh basically global warming affects everyone but as a custodian of pediatrician we should be worried that it harms children more. Uh now the temperature has been rising steadily since pre-industrial level. Chakra say invention.

[01:21:12]So 1.2° above pre-industrial level as of 2024.

[01:21:19]Now temperatures are rising. The summers are hot, they are longer, the uh children suffer from heat stress, dehydration, heat related diseases.

[01:21:29]Approximately 1 billion children they are exposed to climate extremes annually and the weathers are becoming extreme.

[01:21:37]We are now witness because 70% of the uh time on front page the news are related to uh climate change. So flood, droughts, storms and all you name it all the sorts of calamities they are taking place air quality is declining and the disease process I mean they are slowly expanding. So why why we should be worried because it affects the child children development at every level like in prenatal age the risk of freedom birth the low birth weight then still birth fetal brain development is disrupted by heat and toxin exposure as a baby grows older during infancy they cannot self-regulate the body temperature and diarrheal disease plus they surge leading again cause of infant death similarly malnutrition also So worsened by food system disruption and respiratory illnesses from wildfire, smoke and ozone. Then when further baby uh a child grows up in early childhood there's a stunting which increases with climate related food insecurity. Malaria and denu we all know that 30 years back malaria was more now dangu is overtaking late and chemical exposure rises with flooding events. Cognitive development impact by chronic heat and toxins. And again that child when goes to school then 3 to 9% drop in learning process on hot school days we all know that the school hours they are kept closed as double during wildfire smoke events and school disruption anxiety what Somia said is very right because nowadays even smaller children they are also worried anxiety and eco grief and the most important is adolescent age group there the rates of climate anxiety and depression are the maximum even reproductive health impacts from endocrine disrupting toxins which is least talked uh about violence and displacement risk rises in climate stress regions and not to forget the current warlike situations where the children they bear the brand and labor exploitation of youth in climate disrupted economies. So children everywhere they suffer. I mean this if you talk about subsaharan Africa or small island nations or urban lung develops ultimately the brunt is born by children and plus it is compounded in those children who already have ama malnutrition or immuno deficiency.

[01:24:00]>> So what is greenhouse gases and greenhouse effect?

[01:24:04]>> Yes. Yes ma'am. Green green greenhouse gases are the one which are released in the atmosphere regularly. But like everyone knows the uh greenhouse.

[01:24:17]Everyone that whenever the sunlight uh enters the stratosphere and when it reaches to the earth majority of the sunlight is reflected by the glaciers but some of the sunlight is absorbed into the earth. But with the presence of greenhouse gases like methane, nitrous oxide etc. they are heat trapping. So the heat is trapped through this gas and this is how the atmosphere around us becomes hotter and it it because it resembles to green house where the vegetables etc they are cultivated the name is greenhouse uh effect. Yeah, that was something we keep reading it and uh thank you so much. And there is only one question I wanted to uh ask you with, you know, we have to just finish. One practical action everybody has to give you one or two words. One practical action every pediatrician can take tomorrow in their clinic to help address the environment threat to child health. Dr. Parmish, I repeat, what is one practical action a pediatrician can take tomorrow in his or her clinic to address environmental threat to child health?

[01:25:41]>> Oh, think locally, act locally, propagate the results globally while taking the good values that one let us concentrate on that one. So this is what I want to say that I think let us representing >> yeah see the what I want to highlight is that according to WH they say that in more than 40% of childhood illness some environmental problem is there so when you see a child it is very important that you must take a detailed environmental history detailed envirmental history pollution in pollution >> you are muted Dr. Al Dr. Satish Agraal >> I make it back to you.

[01:26:30]>> My simple answer is not a sentence a word awareness. Awareness in public awareness in community >> Dr. Alo back to you were muted. Yes.

[01:26:41]What you want >> the environment history and the occupation history of the parents and the residential and the workplace environment of each and every person of child we see in the clinic and we should imagine ourselves into their situation and then give advice about the disease as well about how to improve their dr. >> Yes. As a pediatrician, first priority would be to vaccinate the child against all possible diseases. Second, educate families on heat safety and every time before the starting of season, we should come out with the information flyer like in this season before the month of May starts, we should come out with instructions how one can avoid defects of a hot temperature. We should have a look at local AQI and if it is disturbing then we should advise the children with co-orbidities like ama to avoid going out I mean within and reduce recycle and reuse is always the theme whichever patient you come across but we are the in a best position we are pediatricians as a custodian of the children's health we are the most respected and we have got maximum influence on the parents so we should not waste any visit be it for vaccination Beat it for co be for like treating any message that my panelists have given are very nice start from your clinic. It is you need to sensitize you need to bring awareness sensitization preemptive. So you need to know who are your patients of ama before the season changes. You need to connect to them and probably optimize the doses and believe in one health. Talk about one health to them. Talk about the water and the safety. Talk about the role of nutrition. How it is important. Talk about how each one of us can do and as we said how we can say no to plastics.

[01:28:41]How should we take care of the environment? How can children be used to plant trees? How can uh we uh start telling them about conserving energy, conserving electricity, conserving water? Every small thing. Let us start talking from home and it was such a big delight for me uh to moderate this show.

[01:29:05]It could not have been possible but for one essay Satish Adrian thank you for allowing me to moderate this show. Uh and it was my pleasure to have done it and there are so many messages uh and all of them have talked about history what all you have said. Uh thank you plastic uh uh stopping Siri everybody has said thank you so much and I would request Dr. Alo Bandari uh our official thank giver uh to give his word of thanks on behalf of I over to Dr. Alog Bandari.

[01:29:40]>> First of all thanks ma'am for the compliments and I really appreciate the greenery in your dress also today.

[01:29:47]>> Yes >> and and also Priya also the team was and Dr. Paramesh sir leading from the front with a bright green suit. So it's been a day started ma'am for us our West Delhi team started at 6:00 a.m. tree plantation drive. Right.

[01:30:07]>> Today I am proud to feel that doctors have been leaders of profession since time immemorial. And today again when it was for the cause of environment at least I received 10 invites at least 10 of various environment related activities by various associations of the doctors whether it was IMA branches local branches state branches of IMA and AAP in Delhi and at national level under your leadership and that also reminds me that how Dr. Somia has traveled. She was a resident senior to me at Savajjang Hospital maybe 45 years ago and now today after finishing a glorious carrier now she's looking after another chapter of social work and all and Dr. Arvind was an excellent par excellence talk and deliberations and our distinguished panelists our own Dr. Sukumaran sir Romesh Bajananya G Al Gupta G and Sati Shagaral. Obviously when moderator was such an active person the panelist had to do very nicely and the audience we had a galaxy of audience our singer sir Basan sir and lots of senior people and all types of strata people. I thank you all on behalf of IAP for sparing time and carrying out such a large ex excellent session. Thank you. Thank you please.

[01:31:36]>> Thank you so much. Uh we I would like to respect Dr. Madu Ratri. She's a senior member and a president of WB. She has one question though I can answer but I'll ask the panelist. Besides stop smoking, what are the measures to reduce air pollution indoor?

[01:31:56]So I think I can just say you are in we have to talk more on the air pollution indoor k I want to talk about apati about using the fuel the right gas and uh these are the various exhaust fans that you can talk uh trying to talk about even there is a huge discussion especially in a place like Delhi where our AQI goes 350 we are forced uh to have uh the uh the systems which help uh to get in this those who can afford that's what I said it is about social equity sadly but those who can afford it is that we talk about the purifiers in ETA and especially in a place like ours we have to work and where you sleep how you breathe all this needs to be looked into thank you so much uh for this wonderful show a group photograph if somebody's there can be taken with all of us and ma'am ma'am that we can no longer treat the symptoms of extreme weather in the clinic while ignoring the atmospheric drivers outside right as a climate advocacy is not outside the scope of pediatric medicine in fact today fighting for a stabilized climate is the most fundamental act of pediatric care >> absolutely sir thank you so much >> one more point one more point the most important aero allergen in indoor is first is dust mite, second is molds, fungus, even cockroach. Uh these are the main things you must look at. You must prevent.

[01:33:35]>> So how do you do that sir?

[01:33:37]>> Yeah, >> what to do that for that dust mite or cockroach?

[01:33:40]>> The most important thing is that the room there should be very good lighting in the room. Sunlight should come inside the room. You must change the bed sheet frequently. You should uh clean the uh bed bed sheet in hot water. that keep the bed once once in a while outside and also you must remove all the carpets and furniture should be removed. very important tips and all the panelists you can't get away. Uh the questions that I asked you please prepare a short draft not too big because pediatricians don't have time to read much clearcut messages of the question that I asked you small messages you make so that I can share it across to the country. Bless you all.

[01:34:23]Good night. Thank you Priya. Thank you so much. You're so wonderful uh in doing all the shows. Thank Thank you so much ma'am for such a wonderful meaningful uh with uh world environment day celebration with so much of enthusiasm purpose and hope for a better tomorrow.

[01:34:42]Thank you so much. Thanks to Ganesh Kulkarnis who has cured the whole program the convenor of DJ Academy and Mayang the backup IT team. Thank you so much. Good night to all. Thank you.

[01:34:57]>> Thank you all.

[01:34:58]>> Thank you. We're nice.