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NEW DELHI — FOR weeks the breathing of my 8-year-old son, Bram, had become more labored, his medicinal inhaler increasingly vital. And then, one terrifying night nine months after we moved to this megacity, Bram’s inhaler stopped working and his gasping became panicked.
新德里——在接连几周的时间里，我八岁的儿子布拉姆(Bram)的呼吸变得越来越吃力，他的药用吸入器也变得越来越重要。然后，在我们搬到这个大都市九个月后的一个可怕夜晚，布拉姆的吸入器不再管用，他开始喘不过气来。
My wife called a friend, who recommended a private hospital miles away. I carried Bram to the car while my wife brought his older brother. India’s traffic is among the world’s most chaotic, and New Delhi’s streets are crammed with trucks at night, when road signs become largely ornamental. We undertook one of the most frightening journeys of our lives, with my wife in the back seat cradling Bram’s head.
我妻子打电话给一个朋友，她推荐了一家数英里之外的私立医院。我把布拉姆抱进车，我妻子带着布拉姆的哥哥也上了车。印度是世界上交通最混乱的地区之一，新德里夜间的街道上挤满了卡车，交通标志基本上是摆设。妻子在后座上揽着布拉姆的头，那是我们这辈子最可怕的旅程之一。
When we arrived, doctors infused him with steroids (and refused to provide further treatment until a $1,000 charge on my credit card went through). A week later, Bram was able to return home.
我们到达医院后，医生给布拉姆输了类固醇（并且拒绝提供进一步的治疗，直至我用信用卡支付的1000美元到账）。一周后，布莱姆才得以回家。
When I became a South Asia correspondent for The New York Times three years ago, my wife and I were both excited and prepared for difficulties — insistent beggars, endemic dengue and summertime temperatures that reach 120 degrees. But we had little inkling just how dangerous this city would be for our boys.
三年前，当我成为《纽约时报》的南亚通讯员时，妻子和我感到很兴奋，同时也做好了迎接困难的准备——纠缠不休的乞丐，四处肆虐的登革热，高达华氏120度的夏季温度。但我们全然没有料到，这个城市对我们的孩子会有多么危险。
We gradually learned that Delhi’s true menace came from its air, water, food and flies. These perils sicken, disable and kill millions in India annually, making for one of the worst public health disasters in the world. Delhi, we discovered, is quietly suffering from a dire pediatric respiratory crisis, with a recent study showing that nearly half of the city’s 4.4 million schoolchildren have irreversible lung damage from the poisonous air.
我们逐渐了解到，德里真正危险的地方是它的空气、水、食物和苍蝇。在印度，这些危险因素每年导致数以百万计的人患病、残疾和丧生，这是世界上最严重的公共卫生灾难之一。我们发现，德里正悄无声息地遭遇着一场可怕的小儿呼吸道疾病危机，最近的一项研究显示，在该市440万学龄儿童中，有将近一半因有毒的空气遭受了不可逆转的肺部损伤。
For most Indians, these are inescapable horrors. But there are thousands of others who have chosen to live here, including some trying to save the world, others hoping to describe it and still others intent on getting their own small piece of it. It is an eclectic community of expatriates and millionaires, including car executives from Detroit, tech geeks from the Bay Area, cancer researchers from Maryland and diplomats from Dublin. Over the last year, often over chai and samosas at local dhabas or whiskey and chicken tikka at glittering embassy parties, we have obsessively discussed whether we are pursuing our careers at our children’s expense.
对于大多数印度人而言，这些恐怖之处是不可避免的。但也有数以千计的人们选择居住在这里，其中就包括一些试图拯救世界的人，一些希望讲述这里的故事的人，还有一些热衷于在这里拥有一片自己的小天地的人。这是外籍人士和富豪组成的混杂社区，他们中有来自底特律的汽车高管，湾区的科技业人士，马里兰州的癌症研究人员，以及都柏林的外交官。过去一年里，我们在本地饭馆品尝印度奶茶及三角饼时，或者在五颜六色的使馆派对上享受威士忌和鸡肉串时，常常着了魔似地讨论一个话题：我们是否罔顾孩子的利益，来追求自己的事业？
Foreigners have lived in Delhi for centuries, of course, but the air and the mounting research into its effects have become so frightening that some feel it is unethical for those who have a choice to willingly raise children here. Similar discussions are doubtless underway in Beijing and other Asian megacities, but it is in Delhi — among the most populous, polluted, unsanitary and bacterially unsafe cities on earth — where the new calculus seems most urgent. The city’s air is more than twice as polluted as Beijing’s, according to the World Health Organization. (India, in fact, has 13 of the world’s 25 most polluted cities, while Lanzhou is the only Chinese city among the worst 50; Beijing ranks 79th.)
当然，数百年来一直有外国人在德里居住，但空气和越来越多的关于其影响的研究已经变得如此触目惊心，以至于有些人觉得，如果有人有选择的机会，却情愿在这里抚养孩子，那是不道德的。类似的讨论无疑也正在北京等亚洲大城市展开，但在德里——地球上人口最稠密，污染最严重，最不卫生，病菌肆虐最甚的城市之一——这个问题似乎最为紧迫。世界卫生组织的资料显示，该城市的空气污染程度超过北京的两倍。（世界上25个污染最严重的城市中，有13个是印度城市。兰州是前50名中唯一的中国城市；北京位列第79位。）
So many of our friends have decided to leave that the American Embassy School — this city’s great expat institution — is facing a steep drop in admissions next fall. My pastor, who ministers to a largely expat parish here, told me he feared he would lose 60 percent of his congregants this summer.
因此，我们的很多朋友都决定离开。美国使馆学校(American Embassy School)是德里一家很棒的外籍生学校，今年秋天它面临着生源的急剧下降。我的牧师负责这里一个主要由外籍人员构成的教区，他告诉我，他担心今年夏天自己会失去60%的教众。
We nearly left two years ago, after Bram’s first hospitalization. Even after his breathing stabilized, tests showed that he had lost half his lung function. On our doctor’s advice, we placed him on routine steroid therapy and decided that as long as his breathing did not worsen again, we could stay in Delhi.
两年前，在布拉姆的首次住院之后，我们也几乎离开了这里。但他的呼吸状况稳定下来后，测试结果显示他已经失去了一半的肺功能。在医生的建议下，我们让他进行常规的类固醇治疗，并决定只要他的呼吸状况没有再次恶化，我们可以就留在德里。
Or at least I decided that. My wife seriously considered flying home immediately, and at the end of a summer visit to the United States with the kids months later, sobbed for hours on the return flight to Delhi.
或者至少我决定这么做。我妻子当时就认真考虑过立即飞回家去；而且在数个月后，当我们与孩子结束了回美国探访的夏季行程，在回德里的返程航班上，她抽泣了好几个小时。
But after our second year here, Bram seemed fine. His earlier difficulties, though, led me to call some leading air pollution experts. The conversations were sobering.
不过，我们在这里度过了第二年之后，布莱姆显得一切安好。但是鉴于他之前遇到的状况，我和一些顶尖的空气污染专家通了电话。我们之间的交谈发人深省。
“Knowing that I was putting my kids in a place that compromised their health for their lifetimes would be very difficult given all of the scientific evidence,” said W. James Gauderman, a professor of preventive medicine at the University of Southern California. He is the co-author of a landmark 2004 study showing that children raised in parts of Los Angeles — where pollution levels are a fraction of Delhi’s — face significant and probably permanent losses of lung function. Even children who move to less polluted places during childhood never seem to entirely recover from earlier high pollution exposures, another study found.
“考虑到有各种科学证据，知道自己让孩子住在某个地方，可能损害他们一生的健康，会让我非常难受，”南加州大学的预防医学教授W·詹姆斯·高德曼(W. James Gauderman)说。他是2004年一份具有里程碑意义的研究的合著者，该研究显示，在洛杉矶部分地区——污染程度远低于德里——长大的儿童，遭受了明显的、可能是永久性的肺功能损失。另一项研究发现，如果孩子早年在高污染环境中生活，即使在儿童时期搬迁到了污染较低的地方，他们似乎也无法完全恢复健康。
Sarath Guttikunda, one of India’s top pollution researchers, who moved to Goa, on the west coast of India, to protect his two young children, was unequivocal: “If you have the option to live elsewhere, you should not raise children in Delhi.”
为了保护两个年幼的孩子，印度最顶尖的污染研究人员之一萨拉斯·古提昆塔(Sarath Guttikunda)举家搬迁到了印度西海岸的果阿。他明确地说：“如果你可以在别处居住，就不该在德里抚养子女。”
These and other experts told me that reduced lung capacity in adults is a highly accurate predictor of early death and disability — perhaps more than elevated blood pressure or cholesterol. So by permanently damaging their lungs in Delhi, our children may not live as long.
他们和其他专家告诉我，成人肺活量不足，对于预测早逝和残疾来说准确度非常高——可能高于血压或胆固醇升高。因此，由于在德里遭受了永久性的肺损坏，我的孩子的寿命可能缩短了。
And then there are nascent areas of research suggesting that pollution can lower children’s I.Q., hurt their test scores and increase the risks of autism, epilepsy, diabetes and even adult-onset diseases like multiple sclerosis.
在一些方兴未艾的领域，研究表明：污染可能会让儿童智商降低，影响他们的考试成绩，并增加罹患自闭症、癫痫、糖尿病的风险，甚至像多发性硬化症等成年后才发作的疾病，患病风险也会提高。
C. Arden Pope III, a professor of economics at Brigham Young University and a leading expert on the health consequences of air pollution, noted that accurate pollution monitors have existed only since the 1980s. “If Delhi’s readings aren’t the highest ever, they’re among the highest ever,” he said. “Certainly no city in the United States, including Los Angeles, has ever come close.”
杨百翰大学(Brigham Young University)的经济学家C·阿登·波普三世(C. Arden Pope III)是研究空气污染对健康的影响的权威专家，他指出，准确的污染监测仪器直到20世纪80年代才出现。“就算德里的读数值不是有史以来最高的，也是有史以来最高的之一，”他说。“包括洛杉矶在内的任何美国城市肯定都与那样高的读数值相距甚远。”
That means the extent of the damage Delhi is doing to our children can only be guessed, he said. Several medical ethicists said it would be impossible to get approval for a clinical trial to send a group of children to Delhi to monitor their health. “Not a chance,” said Adil E. Shamoo, editor in chief of Accountability in Research and a bioethicist at the University of Maryland School of Medicine. “It’s O.K. to survey people already there, but moving children into harm’s way? No.”
这意味着，我孩子在德里遭受的损害严重程度只能靠猜测，他说。几位医学伦理学家称，送一群孩子到德里去，并监测他们的健康状况，这样的临床试验是不可能得到批准的。“绝对不可能，”《研究中的问责》(Accountability in Research)的主编、马里兰医学院(Maryland School of Medicine)的生物伦理学家阿迪尔·E·萨莫(Adil E. Shamoo)说。“调查已经在那里的人是可以的；但把孩子搬迁到有危害的地方？不行。”
And children are by no means the only ones harmed. Many adults suffer near-constant headaches, sore throats, coughs and fatigue. Arvind Kejriwal, Delhi’s chief minister, had to leave the city for 10 days in March to cure a chronic cough.
受到危害的不仅是孩子。很多成年人几乎常年头痛、喉咙痛、咳嗽，以及疲劳乏力。今年3月，德里首席部长阿尔温德·凯杰里沃(Arvind Kejriwal)为了治疗慢性咳嗽，不得不离开了这里十天。
It’s not just the air that inflicts harm. At least 600 million Indians, half the total population, defecate outdoors, and most of the effluent, even from toilets, is dumped untreated into rivers and streams. Still, I never thought this would come home to my family quite as dramatically as it did.
危害健康的不只是空气。至少有六亿印度人在户外排便，占总人口数量的一半，而大部分的污水，甚至来自厕所的污水，都未经处理就倾倒入江河。但是，我从来没有想过，它们会戏剧性地来到我的家中。
We live in a four-year-old, five-story apartment building that my wife chose because its relatively new windows could help shut out Delhi’s appalling nighttime air. Its cookie-cutter design — by the same developer who built dozens of others in the neighborhood — gave us confidence that things would function, by no means assured for new construction here.
我们住在一栋四年前修建的五层公寓楼里，我的妻子选择这里是因为它配备了相对较新的窗户，有助于将德里的可怕夜间空气隔绝在外。公寓楼平凡无奇的设计——同一家开发商在附近修建了数十栋这样的建筑——给了我们信心，觉得它的设施会运行良好；不是所有德里的新建筑都能保证这一点的。
About six months after we moved in, one of our neighbors reported that her tap water suddenly smelled like sewage. Then the smell hit another neighbor and another. It turned out that the developer had dug open channels for sewage that had gradually seeped into each apartment’s buried water tank. When we pulled up the floor tiles on the ground floor, brown sludge seemed to be everywhere.
搬进去大约半年后的一天，一名邻居说她的自来水突然散发污水味道。然后邻居们一个接一个遇到这种情况。原来是开发商把下水道挖开了，污水逐渐渗透到每间公寓埋在地下的水箱里。当我们揭开一楼的地砖时，褐色污泥似乎到处都是。
I was in the shower when this sewage mixture arrived in our apartment. Sounds horrible, but I shrugged and toweled off because that smell is such a frequent presence here.
混合了污水的自来水抵达我们公寓时，我正在淋浴。这听起来很可怕，但我只是耸耸肩，擦干了身体，因为那种味道在这里经常都能闻到。
For much of the year, the Yamuna River would have almost no flow through Delhi if not for raw sewage. Add in the packs of stray dogs, monkeys and cattle even in urban areas, and fresh excretions are nearly ubiquitous. Insects alight on these excretions and then on people or their food, sickening them.
如果不是未经处理的污水倾倒入亚穆纳河，那么在一年中的很多时候，这条河在德里几乎是断流的。再加上德里城区中也时常看到的一群群流浪狗、猴子和牛，新的排泄物几乎随目可见。昆虫在这些排泄物上落足，然后再在人类或他们的食物上停留，传染疾病。
Most piped water here is contaminated. Poor sanitation may be a crucial reason nearly half of India’s children are stunted.
这里的大多数自来水都遭受了污染。恶劣的卫生条件，可能是近一半印度儿童发育迟缓的一个关键原因。
The list of health threats sounds harrowing when considered together, but life goes on and can be quite nice here. Our apartment building eventually installed aboveground water tanks. My children’s school and travel in the region are terrific, and many expats are far more influential here than they would be in their home countries.
综合考虑这些威胁健康的因素，你会感到痛心疾首，但这里的生活还在继续，而且也可以过得相当不错。我们的公寓楼最终把水箱安装在了地面上。我孩子的学校和在该地区进行的旅行都很棒。很多外国人在这里拥有了比在本国远远更大的影响力。
Yet one afternoon this spring, someone in our neighborhood burned something toxic, and an astringent cloud spread around our block. My wife was out walking with a friend, and their eyes became teary and their throats began to close. They bolted back inside our apartment where they found Bram gasping again, for the first time in two years. In some places in Delhi, the levels of fine particles that cause the most lung damage, called PM2.5, routinely exceed 1,000 in winter in part because small trash and other fires are so common, according to scientists. In Beijing, PM2.5 levels that exceed 500 make international headlines; here, levels twice that high are largely ignored.
然而，今年春天的一个下午，有人在居民区里焚烧有毒物质，气味酸涩的浓烟在我们的街区蔓延。我妻子和一位朋友当时在外面散步，她们被呛出了眼泪，感觉快要窒息。于是狂奔回我们的公寓，结果发现布拉姆又在喘息，这还是两年里的第一次。在德里有些地方，名为PM 2.5的细颗粒物的水平导致了非常严重的肺损伤，在冬季，该数值经常超过1000，科学家表示，部分原因是对小件垃圾和其他东西的焚烧在这里极为普遍。在北京，PM 2.5水平超过500会成为国际头条新闻；而在这里，比北京高出一倍的污染水平基本上被人们无视。
But Bram notices.
但布拉姆注意到了。
He spent the next five days at home, with my wife giving him heavy doses of inhaled steroids through a mask. He has a quiet sadness during these crises, perhaps because they force him to accept the idea that his health is more fragile than that of his brother or friends.
接下来的五天里，他一直待在家里，我妻子让他透过口罩服用了大量吸入性类固醇。在这些危机期间，他有一种静默的忧伤，因为他要被迫接受，自己的健康比哥哥或朋友更脆弱。
Before coming to Delhi, Bram had had a couple of breathing episodes that doctors assured us he would most likely outgrow. Now he has full-blown asthma and must take powerful daily medications.
来德里之前，布拉姆也出过几次呼吸方面的问题。医生曾向我们保证，布拉姆很有可能会随着年龄的增长而摆脱那些问题。但现在，他真的得了哮喘病，每天都必须服用强效药物。
Would he have developed asthma if we had stayed in the United States? Pediatric asthma is far more likely to start and worsen in polluted locales. The sidelines at kids’ soccer games here are littered with inhalers.
如果我们留在美国，他还会得哮喘吗？在受污染的地方，小儿哮喘发病和恶化的可能性要大得多。在这里的足球场外，散落着许多吸入器。
Ruth R. Faden, director of the Johns Hopkins Berman Institute of Bioethics, said children have a special claim to protection. “First, because they are so dependent on us for their well-being, and second because deprivations in childhood have such an outsize effect,” she said.
约翰·霍普金斯大学伯曼生物伦理学研究所(Johns Hopkins Berman Institute of Bioethics)主任鲁斯·R·费登(Ruth R. Faden)说，孩子特别需要保护。“首先，因为他们的健康很依赖我们，其次因为童年时期健康受损的影响非常大，”她说。
There is a growing expatriate literature, mostly out of China, describing the horrors of air pollution, the dangers to children and the increasingly desperate measures taken for protection. These accounts mostly end with the writers deciding to remain despite the horrors.
外籍人士撰写的相关文章越来越多。它们大多来自中国，描写了对空气污染的恐惧、对孩子的危害以及所采取的越来越夸张的保护措施。在这些文章的结尾，虽心怀恐惧，但作者大多还是决定留下。
Not this one. We are moving back to Washington this week.
但本文不同。我们将于这周返回华盛顿。
The boys are excited. Aden, 12, wants a skateboard and bicycle, accouterments of freedom in a place he is allowed to wander by himself. His younger brother’s wish may be harder to realize.
孩子们很兴奋。12岁的亚丁(Aden)想要滑板和自行车。在一个允许他独自闲逛的地方，那是享受自由的装备。他弟弟的愿望则可能更难实现。
“My asthma will go away,” Bram said recently. “I hope so, anyway.”
“我的哮喘会消失，”布拉姆前不久说。“总之，希望如此。”
