Two-year-old Sumaiya Ansari, a resident of India's Byrnihat town, which is ranked the world's most polluted metropolitan area by Swiss Group IQAir, was battling breathing problems for several days before she was hospitalised in March and given oxygen support.
She is among many residents of the industrial town on the border of the northeastern Assam and Meghalaya states - otherwise known for their lush, natural beauty - inflicted by illnesses that doctors say are likely linked to high exposure to pollution.
Byrnihat's annual average PM2.5 concentration in 2024 was 128.2 micrograms per cubic meter, according to IQAir, over 25 times the level recommended by the WHO.
PM2.5 refers to particulate matter measuring 2.5 microns or less in diameter that can be carried into the lungs, causing deadly diseases and cardiac problems.
"It was very scary, she was breathing like a fish," said Abdul Halim, Ansari's father, who brought her home from hospital after two days.
According to government data, the number of respiratory infection cases in the region rose to 3,681 in 2024 from 2,082 in 2022.
"Ninety percent of the patients we see daily come either with a cough or other respiratory issues," said Dr. J Marak of Byrnihat Primary Healthcare Centre.
Residents say the toxic air also causes skin rashes and eye irritation, damages crops, and restricts routine tasks like drying laundry outdoors.
"Everything is covered with dust or soot," said farmer Dildar Hussain.
Critics say Byrnihat's situation reflects a broader trend of pollution plaguing not just India's cities, including the capital Delhi, but also its smaller towns as breakneck industrialisation erodes environmental safeguards.
Unlike other parts of the country that face pollution every winter, however, Byrnihat's air quality remains poor through the year, government data indicates.
Home to about 80 industries - many of them highly polluting - experts say the problem is exacerbated in the town by other factors like emissions from heavy vehicles, and its "bowl-shaped topography".
"Sandwiched between the hilly terrain of Meghalaya and the plains of Assam, there is no room for pollutants to disperse," said Arup Kumar Misra, chairman of Assam's pollution control board.
The town's location has also made a solution tougher, with the states shifting blame to each other, said a Meghalaya government official who did not want to be named.
Since the release of IQAir's report in March, however, Assam and Meghalaya have agreed to form a joint committee and work together to combat Byrnihat's pollution.
(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)
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