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) - which measures different types of pollutants, including the level of fine particulate matter PM2.5 that can clog lungs - has been hovering between 300 and 400. This is more than 20 times the limit recommended by the World Health Organization.
Readings above 400 affect all healthy people and seriously impact those with existing diseases, but high exposure to PM2.5 hits children and the elderly the hardest.
Across the capital, many hospitals have seen an influx of children who are sick because of the unbreathable air.
These particles can affect the child's immunity, especially because their system is still developing, and the cells are learning an immune response in the early years,” Dr. Shishir Bhatnagar, the paediatrician at the Noida clinic, told the BBC.
“These cases have increased tenfold in recent years. In my experience, if I normally see an average 20-30% of patients with such complaints, that number shoots up to 50-70% during the pollution season.
Each year, the government rolls out emergency steps - halting construction, banning polluting vehicles - to curb the smog. This year, it even tried cloud seeding to trigger artificial rain, without success.
But none of it has helped ease the pollution crisis that sparks anxiety among the city's 20 million people - particularly among parents of young children.
Khushboo Bharti, a 31-year-old mother, recounts the panic she faced when her one-year-old daughter, Samaira, woke up with a violent cough that led to her vomiting. After a harrowing hospital visit, Samaira was diagnosed with pneumonia, leaving her mother in a constant state of worry.
Parents like Bharti and Gopal, who rushed their children to hospitals due to respiratory distress, are grappling with the long-term implications of their children's exposure to hazardous air. Concerns of stunted development and chronic ailments loom large, prompting some families to consider leaving Delhi entirely for better prospects.
The government has begun imposing restrictions on outdoor activities for children, yet economically disadvantaged families continue to suffer from relentless pollution. Pediatricians warn that untreated respiratory issues could lead to permanent lung damage, especially among vulnerable children living in poor conditions.
In the midst of despair, parents seek effective strategies to protect their children's health while balancing the necessity of outdoor activity. As the crisis continues, the question remains: how long can families endure living in a city suffocated by pollution?
