Ella Kissi-Debrah: how a mother’s fight for justice may help prevent other air pollution deaths

Landmark ruling that toxic fumes killed nine-year-old Londoner follows long campaign for truth

Until now, the statistics on air pollution deaths have been presented in black and white – numbers on a page that estimate between 28,000 and 36,000 people will die as a result of toxic air pollution every year in the UK.

But the life and death of nine-year-old Ella Kissi-Debrah is in full colour: from the pictures of her wearing her gymnastics leotard hung with medals, to the image of her mother and siblings holding aloft her photograph, when they no longer had her to hold on to, as they campaigned for the truth.

As Prof Sir Stephen Holgate told the coroner, behind the often-quoted statistics lie individuals whose lives have been cut short. “Every single number that goes into these studies is a single person dying,” he said.

Holgate paid tribute to the resilience of Ella’s mother, Rosamund Kissi-Debrah, for her tenacity, which on Wednesday helped to make legal history when for the first time air pollution was recorded as a cause in an individual death in the UK.

The last two years of Ella’s life were punctuated by severe asthma attacks that led to her collapse and admission to hospital almost 30 times. Her lungs collapsed, or partially collapsed, on five occasions, as she struggled to survive what the coroner heard was a form of asthma that flooded her lungs with fluid.

Kissi-Debrah has launched a charity in Ella’s name to improve the lives of children with asthma in south-east London.
Kissi-Debrah has launched a charity in Ella’s name to improve the lives of children with asthma in south-east London. Photograph: Claire Cox/PA

It was Holgate’s examination of these years, recorded in medical notes from a range of experts whom Kissi-Debrah turned to for help, that led to a pattern emerging.

Unlike most people with asthma, Ella’s attacks were not triggered by pollen or respiratory infections but something else. Holgate’s work exposed that pattern as a seasonal one: it was in winter when air pollution levels spiked that Ella was brought down with coughing fits, which triggered secretions in her lungs that in turn triggered her collapses.

Ella and her family lived just 25 metres from South Circular Road in Lewisham, south-east London, where levels of nitrogen dioxide air pollution from traffic constantly exceeded the annual legal limit of 40µg/m3 between 2006 and 2010.

The scale of the crisis was a public health emergency, the hearing was told, and the efforts of the authorities to tackle it were glacial.


But as she walked to school along the main road and sometimes the back streets, Ella and her mother were in ignorance of the damage the toxic air was causing. No one had told them.

Kissi-Debrah said she knew almost nothing about air pollution or nitrogen dioxide while her daughter was alive. “I knew about car fumes, the phrase, but nothing else.”

The first inquest into her daughter’s death in 2014 recorded that Ella had died in Februrary 2013 of acute respiratory failure. There was no mention of any environmental factors causing the fatal collapse.

It was only when Kissi-Debrah launched a charity in her daughter’s name to improve the lives of children with asthma in south-east London that she started to make connections.

“I got a call from someone who told me [that] in the two days around Ella’s death there were big spikes in air pollution locally,” Kissi-Debrah said. From there the evidence grew, and the case was taken up by the human rights lawyer Jocelyn Cockburn.

The first inquest into Ella’s death recorded that she had died of acute respiratory failure.
The first inquest into Ella’s death recorded that she had died of acute respiratory failure. Photograph: Rosamund Kissi-Debrah/PA

When Holgate produced a report for the family last year linking air pollution levels to Ella’s death, the attorney general quashed the first inquest.

Over the past two weeks a very different inquiry into what took the nine-year-old’s life has been played out in the coroner’s court.

This time government departments, officials from the local authority and the mayor of London were questioned about what they did – or did not do – to reduce illegal air pollution levels around the area Ella lived.

Crucially, they were interrogated about whether they informed the public of the risk to their lives from the air they were breathing, and whether their failings might have breached Ella’s right to life.

In heartrending evidence, Kissi-Debrah, a former teacher, told the coroner that had she known the air her daughter was breathing was killing her, she would have moved house immediately.

“We were desperate for anything to help her. I would have moved straight away, I would have found another hospital for her and moved. I cannot say it enough. I was desperate, she was desperate,” she said.

The impact of leaving the toxic surroundings could have led to a different outcome for Ella, Holgate told the hearing.

He referred to a case in France last year, where a mother successfully sued the French state over the impact of living near Paris’s traffic-choked ringroad in Saint-Ouen. The mother and daughter moved to Orléans on doctors’ advice and their health improved considerably.

For Ella, that did not happen. But the finding this week by a London coroner that air pollution was to blame for her death, after her mother’s long fight for the truth may help to prevent other children in her daughter’s situation from suffering as she did.


Sandra Laville Environment correspondent

The GuardianTramp

Related Content

Article image
Asthma deaths rise 25% amid growing air pollution crisis
Doctors urge ministers to act as 1,320 killed by asthma in England and Wales last year

Sarah Marsh and Matthew Taylor

18, Jul, 2018 @5:04 PM

Article image
Lower UK air pollution limits to prevent deaths, says coroner
Report following 2013 death of Ella Kissi-Debrah, 9, calls for Britain to follow WHO recommendations

Sandra Laville

21, Apr, 2021 @10:00 AM

Article image
Scores more heart attacks and strokes on high pollution days, figures show
Data reveals acute impact on people’s health and the strain it puts on emergency services

Fiona Harvey Environment correspondent

20, Oct, 2019 @11:01 PM

Article image
It’s been a decade since Ella Kissi-Debrah died. But Rishi Sunak still drags his heels on clean air for all | Caroline Lucas
The PM sent ‘thoughts and hearts’ to the nine-year-old’s family but his environment secretary refused to back clean air targets, says Green MP Caroline Lucas

Caroline Lucas

15, Feb, 2023 @10:00 AM

Article image
Sadiq Khan triggers alert for high air pollution in London
Capital is given emergency warning as polluted air from the continent combines with toxic air at home

Matthew Taylor

27, Sep, 2017 @10:29 AM

Article image
UK refuses to commit to immediate lowering of air pollution limits
Government accused of disregarding coroner’s words about death of Ella Kissi-Debrah, aged 9

Sandra Laville Environment correspondent

17, Jun, 2021 @1:31 PM

Article image
Air pollution linked to ‘huge’ rise in child asthma GP visits
Exclusive: consultations for asthma and other respiratory infections go up with increased dirty air, finds study

Damian Carrington Environment editor

18, May, 2021 @11:00 AM

Article image
Mother of girl who died after asthma attack ‘knew nothing’ about pollution risk
Rosamund Kissi-Debrah ‘would have moved house’ if aware of pollution threat to her daughter

Sandra Laville

07, Dec, 2020 @2:25 PM

Article image
Air pollution killed my daughter – and now I can prove it | Rosamund Kissi-Debrah
If illegal levels of air pollution had a role in Ella’s death, a new inquest could help save other children, says the campaigner Rosamund Kissi-Debrah

Rosamund Kissi-Debrah

31, Aug, 2018 @7:07 AM

Article image
I breathe the same polluted air that Ella Kissi-Debrah did. Change must be her legacy | Anjali Raman-Middleton
For the first time, air pollution has been recognised as a cause of death, says Anjali Raman-Middleton, co-founder of Choked Up

Anjali Raman-Middleton

17, Dec, 2020 @12:34 PM