Pollution Past and Present: Ella Adoo-Kissi-Debrah

By Frankie Lloyd

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Between 2010 and 2013, Ella Adoo-Kissi-Debrah was admitted to hospital twenty-eight times. Her symptoms included breathing difficulties, asthma attacks, coughing fits, and seizures. In 2013, Ella sadly passed away aged only 9 years old. Seven years later, an inquest into the cause of death found that air pollution was a significant contributing factor to Ella’s condition. 

This tragic loss of life occurred in London, UK. More precisely, in south-east London near the South Circular Road in Lewisham where Ella lived with her mother, Rosamund, and two siblings. In the years leading up to her death, Ella’s condition became so dire that she was placed into a medically induced coma for three days in an attempt to stabilise it. Following this, Ella was classified as disabled and heavily relied on her mother to carry her to get around. Oftentimes when Ella was hospitalised, she was barely breathing, so Rosamund was trained to resuscitate her own daughter. 

Rosamund had promised her daughter that they would find out why she was so sick. However, medical professionals could not provide the family with an explanation for the severity of Ella’s condition. So, following the death in 2013, Rosamund made it her mission to get to the bottom of what had happened to her daughter. However, she had not entertained the thought that air pollution was a possible culprit for the sickness. That was until 2014, when the first inquest into Ella’s death stated that the trigger to her asthma was likely ‘something in the air’. But what in the air was capable of doing this?

Rosamund reached out to the media to share her situation. With her story gaining traction, a member of the public contacted the bereaved mother and suggested she investigate the levels of air pollution surrounding Ella’s childhood home. Rosamund’s lawyer, Jocelyn Cockburn, took this suggestion and plotted Ella’s hospital admissions against the historical air pollution levels in south-east London. They discovered that air pollution levels had been at a peak during 27 of Ella’s 28 hospitalisations - and at its highest peak during the night she passed away.

The pollution levels in question refer to atmospheric levels of nitrogen dioxide - NO2. Nitrogen oxides are known to be one of the most dangerous forms of air pollution, and the levels of NO2 surrounding Ella’s home in south-east London far exceeded the guideline thresholds introduced by the World Health Organisation and the European Union. A 2018 report found these levels of pollution to be unlawful, indicating that authorities should have done more to reduce pollution levels in and around London. 

With this new evidence, the High Court granted a second inquest into Ella’s death. On the 16th of December 2020, coroner Philip Barlow announced that Ella had indeed been exposed to ‘excessive’ levels of pollution. He acknowledged the recognised failure to reduce levels of nitrogen dioxide in London and concluded that Ella died of asthma, which was contributed to by exposure to excessive air pollution. Therefore, in a historic decision, Ella Adoo-Kissi-Debrah became the first person in the world to have ‘air pollution’ written as a cause of death on their death certificate. 

Rosamund Adoo-Kissi-Debrah giving her TED talk ‘The Tragedy of Air Pollution - and an Urgent Demand for Clean Air’ in October 2021

Rosamund Adoo-Kissi-Debrah’s actions brought justice for her daughter and pioneered a landmark decision through the second inquest into her daughter’s unjust death. The coroner’s verdict shines a spotlight on the severity of air pollution even within the Western world. The case also raises awareness for environmental justice — as 20-30% of residents within Lewisham live within poverty yet are more likely to suffer sickness from the levels of pollution they are exposed to. Environmental injustice is not limited to low- and middle-income countries. Even within western countries, those of disadvantaged backgrounds are more likely to suffer adverse health as a result of exposure to pollution than their more privileged counterparts. 

It is hoped that Rosamund’s efforts have made pollution and environmental injustice more difficult for Governments to ignore, and that her actions will protect children from pollution in future generations. To achieve this, we must see changes in government legislation, a transition away from fossil-fuel powered transport, and increased investment in the green economy. However, whilst world leaders promise to move towards these goals (see previous blog, COP26: The Outcomes), many fear that more needs to be done to ensure that we are all protected from the health effects of dirty air. 

Sources - BBC news and EPHA interviews with Rosamund Kissi-Debrah, The Time’s Lawyer of the Week: Jecelyn Cockburn