On a cold, crisp Saturday morning, Rosamund Kissi-Debrah made a special trip to a cemetery in South London, to visit the grave of her nine-year-old daughter, Ella.
Rosamund had important news and, after clearing the leaves and litter, she crouched down, patted the earth her little girl lays beneath and told her proudly: ‘We did it baba! We’re through to the next stage — and I shall keep fighting for you.’
Afterwards, this grieving mum allowed herself a ‘celebratory weep’, tears of relief that all her hard work to secure official recognition that Ella’s death six years ago was caused by illegally high levels of air pollution is finally beginning to pay off.
The previous day Rosamund had received the welcome news she had feared may never come: the Attorney General, the Government’s chief legal adviser, granted permission for the family, and their human rights lawyers, to request a new inquest into Ella’s death.
The ‘funny, busy, clever, curious, sporty and musical’ little girl died on February 15, 2013, after succumbing to the severe asthma that blighted her childhood.
Ella Kissi-Debrah, from Lewisham, south east London, died age nine from an asthma attack which may have been caused by pollution
‘I miss my daughter every single day — the pain is as acute as it was the moment we lost her — and it breaks my heart that nothing I can do will ever bring her back,’ says Rosamund, a former psychology and RE teacher.
‘But we’ve now cleared the first hurdle and I will keep fighting for justice on her behalf, recognition that she would still be here were it not for the dangerous levels of pollution caused by traffic on our roads. Once this is officially recognised as the root cause of her death, it will send a clear message to our Government that it must finally tackle the deadly impact of air pollution.
‘This could mean the difference between life and death for thousands of other children and adults.’
Rosamund is an extraordinary woman who, while grieving the loss of her own little girl, is doing everything in her power to reduce the noxious fumes in our atmosphere and prevent other children, including her own 11-year-old twins, suffering a similar fate.
Over the past four years, she has written hundreds of letters and emails, spoken to thousands of people about her daughter’s tragic death, collected 178,000 signatures for her petition to the Attorney General and held her own against some of the most lofty scientists and politicians in the land.
Not bad for a single mum from Lewisham, one of the capital’s poorest boroughs.
Since the 2014 inquest into Ella’s death returned a verdict of acute respiratory failure and severe asthma, scientists — prompted by Rosamund — have uncovered convincing evidence showing her death was the direct result of a spike in pollution near her home, near London’s South Circular Road.
The Attorney General, Geoffrey Cox, was persuaded to consider giving permission for a High Court appeal to have the verdict quashed and a new inquest held after being presented with Rosamund’s petition last August.
Reaching his decision, he considered evidence from Professor Stephen Holgate, an expert on asthma and air pollution, who uncovered a ‘striking association’ between most of Ella’s 27 emergency hospital admissions over the three years before her death and spikes in nitrogen dioxide (N02) and PM10s, the most poisonous pollutants.
His report pointed out that pollution is a ‘major risk factor for childhood asthma’, going on to explain that: ‘It is noteworthy that the very severe illness that culminated in her death occurred during one of the worst air pollution episodes in her locality.’
Significantly, Professor Holgate concluded there was ‘a real prospect that without unlawful levels of air pollution, Ella would not have died’.
He had studied data from two air-quality stations, managed by the Department for Environment, Food and Rural Affairs (DEFRA), close to Ella’s home, monitoring nitrogen dioxide and ozone levels which showed that from September 2010, around the time of Ella’s first admission, until her death in February 2013, pollution levels were ‘well above’ EU limits.
And it is not just London where this is an issue; other areas in the UK are known to exceed EU air-quality limits regularly, particularly for nitrogen dioxide, with 44 out of 51 cities — including Leeds, Nottingham, Oxford, Southampton, Stoke-on-Trent and Glasgow — having fallen foul of the annual thresholds set by the World Health Organisation.
Her mother, Rosamund, has been fighting for the past four years for a second inquest into her death which has just been granted by the attorney general
Air pollution contributes to ‘many chronic health problems’, especially respiratory and cardiovascular disease, according to a 2016 report by the Royal College of Physicians and the Royal College of Paediatrics and Child Health.
It is also increasingly being linked to other diseases, including stroke, dementia, cancer and diabetes, leading to more than six million sick days and an estimated cost to the economy of £22.6 billion a year.
This week, charity Asthma UK revealed the scale of the problem, saying someone has an asthma attack every three seconds.
A lot of the blame for our shocking levels of pollution has been placed at diesel’s door, with it being the main source of poisonous nitrous oxides in polluted areas. This has had devastating health effects. Nitrogen oxides caused 11,940 premature deaths in the UK in 2013, according to the European Environment Agency.
Yet back in 2001 Tony Blair’s government introduced tax incentives to encourage people to switch to diesel cars. The changes were made following the advice of Sir David King, then the government’s chief scientist, who has admitted convincing Mr Blair diesel engines were better for the environment than petrol because they emit less carbon dioxide, the greenhouse gas blamed for global warming.
By 2015, nearly every other car in Britain was a diesel.
However in 2017, Sir David controversially admitted that by the time diesel tax incentives were brought in, scientists were aware diesel was a ‘dirty’ fuel that led to more dangerous fumes than petrol.
A study published in the European Respiratory Journal in 2001 found diesels emitted 100 times as much particulate pollution than equivalent petrol engines.
He said he was misled by car manufacturers that they were developing technology which could ‘manage the problem’. As the ‘Dieselgate’ scandal showed, this was far from the case.
In an attempt to row back on the emergency, in recent years diesel drivers have been hit by punishing tax rises and charges.
From April, London mayor Sadiq Khan will introduce an ‘Ultra Low Emission Zone’, with drivers of diesel cars registered before 2015 paying £24 a day to go into the centre of the capital.
If the High Court gives the go-ahead for the second inquest into Ella’s death, as now seems highly likely, Jocelyn Cockburn, the lawyer acting on behalf of Ella’s family, will be seeking a new verdict of ‘severe asthma secondary to air pollution exposure’, making it the first time pollution has been recorded on a death certificate.
In announcing his decision, the Attorney General said: ‘I have concluded that there is new evidence which may alter the substantial truth of Ella’s death.
‘I am therefore able to give my permission for an application to the High Court to request a new inquest, based on the evidential test being met.’ Mr Khan could be among those called to give evidence, as could representatives from the local authority, Defra and the local NHS trust.
Professor Stephen Holgate, an expert on asthma and air pollution, uncovered a ‘striking association’ between most of Ella’s 27 emergency hospital admissions over the three years before her death and spikes in nitrogen dioxide (N02) and PM10s, the most poisonous pollutants (file photo)
During the three years before she died, Rosamund had to resuscitate her daughter up to ten times while waiting for ambulances and, although Ella was treated at five different hospitals, no medic ever suggested pollution could be triggering her attacks. Consequently, it was not part of evidence presented at her inquest.
It was only when Professor Holgate began researching Ella’s death that it began to make sense to Rosamund.
The family lives in Hither Green, Lewisham, 80ft from London’s congested inner ring road. Ella showed no signs of ill health until October 2010, when, just before her seventh birthday, she developed a chest infection, then a persistent cough. Her GP diagnosed asthma, prescribing a Ventolin inhaler then a steroid inhaler. As 5.4 million people in the UK are currently receiving treatment for asthma — 1.1 million (one in 11) of them children — Rosamund wasn’t too concerned.
However, she didn’t know then that an average of three people die each day from asthma in the UK, one of Europe’s worst records.
In December 2010, a severe bout of coughing, known as coughing syncope, led to Ella suffering the first of 27 hypoxic seizures, each of which dangerously cut off her oxygen supply.
One was so severe she had to be put into a medically-induced coma to relieve pressure on her brain. However, between hospital admissions, Ella was always a healthy, active child who excelled at swimming, football and gymnastics and often starred at her Jigsaw drama and dance school. She never suffered breathlessness and her coughing fits appeared to come entirely out of the blue.
There was nothing apparently unusual about her final attack, which happened in the early hours of February 15, 2013.
‘I can’t bear to talk about it, to save my sanity,’ says Rosamund. ‘But this seizure seemed no different to any of the others and we made it to Lewisham hospital, so she didn’t die at home. I tell myself, to try to make sense of it, that a child can only regain consciousness so many times, and on this occasion, Ella didn’t come round.’
The first two years after her daughter’s death are a blur for Rosamund, who is separated from her children’s father.
‘I was in so much pain it felt physical, like I’d been badly cut and was bleeding,’ she recalls.
‘Everywhere I looked there were reminders of Ella — clothes, musical instruments, toys, books — and I couldn’t get my head around how those useless, inanimate objects could still be there when my little girl had gone.’
Feeling stronger, in 2015 Rosamund began to question how Ella had become unwell and, when Professor Holgate said he would like to investigate a possible link between her acute asthma and pollution, she started her own research.
In fact, once the legal case is complete, she is planning to embark on a PhD in public health, specifically looking at the effects of pollution. Rosamund has been selected as the Green Party candidate for Greenwich and Lewisham Constituency to run for the London Assembly.
Shortly before Ella’s death, Rosamund was made redundant from her role as head of sixth form when her school closed. Initially she intended to return to teaching, but now feels unable.
‘I loved my job, but I have to be kind to myself,’ she says. ‘There would be pupils who look like Ella, or who share her birthday, so many encounters that would be too painful.’
Instead, Rosamund set up a charity in her daughter’s name, The Ella Roberta Family Foundation, with the aim of improving the lives of children affected by asthma in South-East London.
Its purpose is to campaign for better treatment of asthma and an improvement in air quality ‘as it is everyone’s fundamental right to breathe clean air’.
Rosamund would like to see the Government offer financial incentives for people to trade in diesel cars, so this fuel can be quickly phased out, while at the same time taking necessary steps to ensure electric cars become the norm.
Rosamund set up a charity in her daughter’s name, The Ella Roberta Family Foundation, with the aim of improving the lives of children affected by asthma in South-East London (file photo)
While she charges a ‘small fee’ for the talks she delivers on asthma and air quality, money is tight and she does not have enough to cover the substantial legal fees involved in seeking justice for her daughter.
A fundraising page has, therefore, been set up via the website Crowdjustice, where almost £15,000 of the £25,000 needed at this stage has been raised.
Rosamund is willing for her daughter to become ‘the poster girl’ who raises awareness and helps bring about change.
Tomorrow would have been Ella’s 15th birthday and, instead of celebrating with a cake, her mother and siblings will visit her grave.
However, Rosamund remains hopeful the second inquest will have concluded, and a new death certificate will have been issued, before what would have been her 16th birthday next January.
While her life was cut tragically short, by nine Ella, a quite remarkable child, was already a talented dancer, had a reading age of 13, played several musical instruments and had even been scouted by Millwall football club.
A fan of the Red Arrows, she had her heart set on becoming a pilot.
Her mother is determined she will make her mark by improving the lives of future generations.
‘This isn’t just about Ella,’ says Rosamund. ‘Air pollution causes around 40,000 premature deaths per year in the UK, and levels of nitrogen dioxide have been illegally high since 2010 in the vast majority of urban areas in the UK.
‘The Government has been taken to court three times over the illegal levels of air pollution in the UK and lost each time. And yet still the authorities are failing to act.
‘The statistics do not show the human impact of these Government failings — I believe that Ella’s inquest will demonstrate her suffering over three long hard years and will provide the impetus for change.’
To contribute to the legal fund please go to www.crowdjustice.com/case/airpollution