When breathing clean air becomes political

Rosamund Adoo-Kissi-Debrah's daughter Ella died in February 2013 a few weeks after her ninth birthday, following an asthma attack. An inquest stated she had been exposed to excessive levels of nitrogen dioxide and particulate matter due to traffic emissions. It is estimated that in London alone 8-12 children with asthma are dying each year – likely to be as high as 24 across the UK.

Rosamund, a Psychology graduate, has campaigned tirelessly through the foundation she established in her daughter's name, to raise awareness of the harm pollution is causing to human health. Ten years on, Rosamund is petitioning for a debate in the UK Parliament that could introduce the Clean Air (Human Rights) Bill, or 'Ella's Law', to ensure 'every child, regardless of their background or where they live, can breathe clean air'.

Did you have a role model in terms of political matters?

My stepfather ran for Vice-President when we were in Ghana, so that was my first taste of politics. He used to speak about politics all the time – but African politics is quite brutal and quite different. When he came to the UK, he was involved with local politics but unfortunately, that was for a party I didn't support, so I never really got involved. However, Dad and I had many, many conversations about politics. He was a scholar and very well-travelled. Even in the 80s and 90s, he would go to places like Israel and Russia. He had a very good view about the world.

I was intrigued to learn that you did a Psychology degree. How do you feel your background in the discipline has helped you?'

Dad was very motivational when it came to education. He wanted us to do very well, and university was almost a 'must' without even saying it. He wanted me to go into law or medicine… I think he was disappointed when I chose psychology, which I found far more interesting, especially psychopathology.

I went on placement working for Chris Oliver and Professor Glenn Murphy on projects including self-injurious behaviour – monitoring the control groups in South-East London and Kent – and another on police and vulnerable people, interviewing managers of safe houses. I don't know how much things have changed, but whenever there was a crisis, they called the police and rather than one van coming, there'd be ten! 

I found the project with autistic children really interesting. I went all over the place with my camera, filming the control group at home and at school. Glenn was looking at their behaviour, making sure they were following protocols while arranging interventions.

That was my first big breakthrough project and then I joined our profession, teaching nurses in college… but it wasn't very stable and I thought I'd rather go and work in a secondary school. That's how I started off, in a school with a sixth form where I could teach psychology.

Both your parents had been teachers, and so I believe your own ambition was to become an Educational Psychologist?

During those days, if you wanted to become an educational psychologist, you had to teach for two years. When I went to teach, they made it so easy for me that I ended up staying and never went back to train as an educational psychologist.

After only a year my headteacher summoned me into the office and said 'I think you'd be great at pastoral [care] actually, because of the way you are. I think the students here could do with your support'. So, I became deputy head of year very early on in my career and my focus was behaviour management. I became a head of year when Ella was only six months old in 2004.

At that time, I was the first Black head of year at my school, so it was unusual. That was 19 years ago and back then a lot of Black women didn't go into management in school. There were teachers, but to go into a management role... I believe my background in psychology also helped.

I continued teaching psychology to sixth formers and I was always aware of The Psychologist and developments in the profession, but I wasn't expecting to last in education as long as I did. I think coming from a background of behaviour management, I found classrooms quite easy to manage and I also enjoyed teaching. I mean, what's not to like about teaching psychology?!

Soon I became head of sixth form and things launched suddenly. There was a lot of pressure – not in a negative way, but when you're good at what you do, you are given roles. I have to admit if Ella hadn't died or got ill in the first place, I would have ended up in management. For me it was a very, very good job and I got quite a decent wage. So I was quite happy and Ella becoming ill just happened, as these things do, out of the blue.

As you say, life events (re)shape us. I realise Ella's tragic loss has resonated with so many people.

When she died suddenly in August 2013, I lost the nerve to teach. I had no desire. I'd gone from being head of year and head of sixth form, and actually loving it, to leaving education. At that point I had no intention ever of walking into a classroom again. I was so traumatised by Ella's illness and death.

After the pandemic, when someone gave me an offer to teach and I walked into the classroom, I thought it would be very strange but it wasn't. It was a bit like getting back onto a bicycle again. I was back teaching, but this time to university students, which is quite different from secondary school.

After the terrible loss of your daughter and the trauma accompanying this, you set up a foundation in Ella's name…

I have to give credit to Dr Colin Wallace of Great Ormond Street. The idea of the charity was his: he felt it would be good to establish the charity in Lewisham so that children like Ella could benefit. Some of her doctors got involved in setting it up – everyone wanted to do something to help. We launched it at her primary school and the charity marked its tenth anniversary on 24 January earlier this year.

You are often seen in the vanguard for progressing the cause of clean air. I wonder whether you were aware of being a leader?

Initially, we focused on how treatment of asthma can be improved because Ella died from a severe asthma attack. In 2015, I started to work with the asthma teams and respiratory teams in London and we discovered what her trigger was. When she was alive, we didn't know, but science has moved on and when we realised the trigger for her asthma was to do with air pollution, it made sense.

Since then, I have been involved in publicising the role of air pollution in asthma. It wasn't the issue which it is now. Even three years ago, when we had the second inquest and Ella won that, I think people were not as aware of air pollution as they are now.

It was seen mainly as an environmental issue, but Ella changed the course of that and allowed people to look at it from a health point of view. That is something completely and utterly different.

How have you navigated being a campaigner?

For years people have run campaigns on this as an environmental issue, but also doctors were not aware of air pollution and the impact it has on their patients' lives. One very helpful thing that came out of the inquest was that doctors needed to be educated about the impact of air pollution on the organs in the body and that's where for me, having a background in teaching helped. I gave lectures to doctors, structuring it just like a normal lesson, but this time talking to them about the impact of air pollution on the lungs and the rest of the body.

As we know, air pollution, especially, has become a worldwide issue, but it wasn't until COP26 in Glasgow that climate was even established as a health concern! The World Health Organization have continued to push this so at COP28 in 2023, they held the first dedicated health day. They also produced a report dedicated to Ella. Now, public health has really changed. When you go to some hospitals now with asthma issues, they will actually look at your postcode and at air pollution in your neighbourhood.

How much do you feel this progress has helped you after losing Ella?

Ella's probably brought in more changes than I even imagined. You must watch a little documentary on BBC iPlayer. It's called 'Ella's fight for clean air', documenting all the changes that have come in since her death. That's quite powerful. You think, 'OK, this will help another family out there'. There are moments when it's rewarding, but you know, coming up to Christmas and then her birthday, we still really, really miss her.

The ideal situation would be to record zero deaths from asthma, which we are nowhere near. If you'd said to me three years ago, when I walked out of court, that air pollution would end up being a central issue in the next election, I don't think I would have believed you.

In April 2021, Philip Barlow, the coroner at the second inquest into Ella's death, published a 'Prevention of Future Deaths Report', citing the need for national air pollution limits, targets that at least meet the World Health Organization [WHO] guidelines (the UK's exceed these), greater public awareness to help people reduce their exposure to air pollution and education for healthcare professionals and patients on the impact of air pollution on health. How have you been campaigning for this kind of progress?

I was out this morning as we're trying to get a law to make clean air a human right. I've produced some leaflets and I was just out walking in the park and distributing these with QR codes. I think the pandemic has really moved things on. We went through a period in lockdown when there were no cars on the road and you had a whole generation of people who hadn't considered clean air, suddenly realising what clean air is. 

Also, no child died from asthma during lockdown. Although Covid was terrible for asthmatic children, there was no rush to hospital [as a result of pollution] during the lockdowns. Now when I say 'clean air', people tend to understand what I am talking about as they have actually experienced it.

I read that you had joined the WHO… could you say how that came about, for readers who may be thinking about how to get involved in policy-making?

Oh goodness, I wouldn't know how to approach the WHO – they approached me after seeing me on social media and were keen to work with 'this mother'. Dr Maria Neira, WHO's Director of Environment and Climate Change, had seen me speak I believe, but WHO had no real idea who I was, except for this image of a grieving mum – they had no idea about my teaching background. They tend to have doctors, ex-presidents and Prime Ministers who become ambassadors for them.

I must admit psychology really benefited me. I was really good at research methods, so you can imagine when suddenly I had to read all these studies, this was like bread and butter to me. I was familiar with things like correlation and causation, and I guess people weren't aware of that.

The aim of what I do with them now is to educate – see how we're back there, educating everyone in health about the impact of air pollution on human health?!

I saw coverage of the Ultra-low Emission Zones (ULEZ) and the strength of feeling from residents in Greater London. You were interviewed on the television… how did you face potential opponents?

I didn't see the battle coming over ULEZ last summer. Ultimately, I lay the blame at the Government's door… and I don't mean that from a party political point of view, because I actually remain neutral when it comes to clean air, it is not a partisan issue, it affects us all. I felt that unfortunately, the broader health messaging was lacking. I realise I'm not in control of it, but ultimately education is key.

I have been in talks with the government about doing a public health campaign for as long as I can remember, even before Ella's inquest. They're still dragging their feet and part of me felt that there is a lack of education, not so much about air pollution, but about pollutants like PM2.5, nitrogen dioxide, dust – all those things that have devastating impacts on the body.

From a psychological point of view, you're not always going to persuade everybody. That's what psychology is ultimately about, and I have always known there is a grouping on either side who are unmovable, and so I tend to go for the people in the middle who you can persuade. You need to look at how things progressed with tackling tobacco smoking and also the response to the Covid vaccine. I am absolutely not saying that everyone who's anti-ULEZ is anti-vax, but there were some similarities in how people expressed their views, especially using minority influence.

I had such a situation when Sadiq Khan launched his book on climate change. I remember a gentleman had infiltrated the launch event and was blowing a whistle constantly to interrupt. He got thrown out and when the event finished, he was outside talking to the police.

Suddenly he didn't look so menacing, because now he was by himself. I remember speaking with him and it just reminded me how people are when they are in groups. If you know this from social psychology, you know they have an identity and that's why I am not as bothered about meeting opposing views. Also, I know that those who can't be persuaded will end up being in a minority, so my focus will be the people in the middle.

Psychology really does help me in my day-to-day in what I do, and especially when it comes to human behaviour. When you know that before you start, it makes it easier. I endured all the noises, but I knew the majority would always come on board. It doesn't make me cocky, it's just something that I have learned from very early on, that you won't persuade everybody. Also, people don't like being told what to do, so that's another thing to consider, isn't it?

Is your educational role now the principal aim for you?

30 per cent of lung cancer cases among non-smokers are due to air pollution; 20 per cent of strokes and all non-communicable diseases like cardiovascular, depression and dementia are linked to air pollution.

I have spent hours and hours reading up on things like that. I know the general public hasn't, nor should they have to – journals can be off-putting and there are about 70,000 papers out there linking air pollution and health. It is up to me to summarise it and to go out there and tell them.

I think as time goes on, I have gone full circle. After running away from research, I am ending up going back to it. It's good for me not just to have read other people's research, but to get involved in it. I have written a number of things for journals, so despite everything, I will probably end up doing research, which is when I was at my happiest. I see myself eventually not going into politics, but ending up probably teaching at a university and conducting research.

Would you now say you're a political person? I remember you standing as a candidate for the Greens...

Politics isn't what I thought it was. As much as I am passionate about clean air – and the Green Party seemed the natural home to choose – you very quickly realise there are so many other issues than climate change, some of which I didn't necessarily agree with. I prefer where I am, influencing people rather than being in a political party, trying to turn clean air into a human right.

One of the things I learned watching the likes of Theresa May was if you want something to happen, you need to get it into legislation. Wisely, she put net zero into legislation, so people can't change that. So I'm trying to get back with the British public again, asking them to sign my petition to put the right to clean air into law. I'm saying to all politicians, no matter what political party comes in, you still have to look at clean air.

Maybe you can call it politics with a small 'p', but I would call it psychology with a small 'p'.

On a personal note, we both have daughters interested in psychology...

For me, the greatest thing will be if my daughter, Ella's sister, becomes a clinical psychologist, then we definitely would have gone full circle in this house. There's nothing like your daughter emulating or passing you.

Visit the website for more information about Clean Air for All and the Ella Roberta Foundation.