As pollution rises and people stay at home or wear masks, those on the streets have no way of protecting their lungs.

New Delhi, India – Towards the end of every year, the air quality in New Delhi deteriorates and the city gets engulfed in a thick haze.

As the air falls into the “severe or hazardous category”, people wear masks and install air purifiers in their homes. Some prefer to stay indoors and avoid even stepping out for morning strolls.

However, there are no options for the homeless.

Late in November, the air quality in Delhi-National Capital Region (NCR) deteriorated. According to the Central Pollution Control Board, the overall air quality index was recorded at 320 – in the “very poor” category.

The level of PM2.5 (particles in the air with a diameter of fewer than 2.5 micrometres) was recorded at 179, while the PM10 level was recorded at 338.

One early morning, 40-year-old Meena sits on an old mattress laid outside a tent. Her husband Mohammad Saleem, a rickshaw driver, earns $3 a day.

Meena’s two sons and other children sit nearby. Her nine-year-old daughter sleeps under a blanket.

“She is suffering from an eye infection,” Meena told Al Jazeera.

Her family lives on a street near the Jama Masjid in old Delhi, one of the largest mosques in India. They are among the thousands of homeless people who are exposed to the city’s air pollution.

A group of homeless people is pictured while sitting on a pavement of a road in New Delhi [Nasir Kachroo/Al Jazeera]

Last week, Meena and her husband had to rush to the hospital after their 18-month-old son, Mohammad Irshad, suffered from sudden breathlessness.

Doctors said the toddler had a chest infection and kept him in for three days, warning the child would become ill again if he were kept in the dust.

“We got very scared and thought something is seriously wrong with him. It looked as if we might lose our son,” said Meena. “Doctors say we should stay indoors and keep our children away from dust. How is that possible? We live on the streets and there is so much exposure to pollution here.”

Meena has been living on Delhi’s streets for more than 20 years. She has seen the city grow in terms of infrastructure and has also been witness to the intensified pollution.

After her daughter goes to the nearby school, Meena takes her two sons and begs outside the mosque.

“What else can I do? Who will give me work in this city,” she asked. “I always dream of a home and of a better life for my children, but then I realise such dreams will never get fulfilled.

“I’ve been breathing the dust and polluted air in this city for two decades now and that is what my children will also have to live.”

Mohammad Akbar, his wife Afroza and their four young children are also homeless.

A stray dog recently bit Akbar while he was sleeping. His five-month-old son has had a cough and throat infection for more than a month now.

“This pollution is making our children fall sick. Every now and then, they have a bad throat, cough and cold,” Akbar told Al Jazeera. “We don’t care much about ourselves now but we want our children to have a better future. We don’t want them to live all their lives on the streets like their parents.”

Delhi, the home to homeless

According to the 2011 census, New Delhi has around 46,000 homeless people – among the most of any Indian city. The United Nations Development Programme (UNDP) estimates there are more, around 56,000.

“Homeless people are the most vulnerable people to this crisis and as a doctor, I believe they are in grave danger,” said Prashant Saxena, a pulmonologist at Max Hospital in Saket.

“They are exposed to hazardous air pollution all the time and they can’t even afford pollution masks as they are too expensive and the government doesn’t provide them for free.

“The only solution is that the government should provide them shelters, equipped with air purifiers.”

Last month, the New Delhi government began distributing cloth masks to homeless people in shelters run by the Delhi Urban Shelter Improvement Board (DUSIB). The plan was to distribute at least 10,000 masks but so far only 1,000 masks have been distributed.

“We had asked the Delhi Health Services to provide us 10,000 masks but only 1,000 masks were provided so far, which we have distributed among the homeless people in several parts of the city already. We are waiting for the rest of the masks and hope they will reach to us very soon,” said DUSIB board member Bipin Rai.

New Delhi has 261 homeless shelters including permanent facilities, cabins, and tents. In some cases, subways have been converted to shelter people at night.

“These shelters can accommodate 21,000 people,” said Rai. “Last year also, we had arrangements for 21,000 people but only 13,500 people turned up at these facilities.”

Every year this time, the air quality in New Delhi worsens to alarming levels because of crop or stubble burning in neighbouring states Punjab and Haryana, along with firecrackers during Diwali and pollution from vehicles and construction activities.

“Due to the severe air pollution in the city, the patient flow to the hospital has increased by almost 25 percent in the past month. Every day … is full with patients complaining of bad throats, asthma and chronic obstructive pulmonary disease,” said doctor Neeraj Jain, who works in New Delhi’s Sir Ganga Ram Hospital.

Tackling pollution

The 2015 Global Burden of Disease report, funded by the Bill and Melinda Gates Foundation, attributes about more than a million deaths to pollution.

The World Health Organization says India topped the list for child deaths linked to air pollution in 2016.

Last year, the Supreme Court temporarily banned the sale of firecrackers in and around New Delhi during the festival of Diwali. However, this year the top court allowed them to be sold, albeit the greener versions.

New Delhi’s primary pollution control and prevention agency, EPCA, has suggested prohibiting all non-CNG vehicles if pollution remains at severe levels.

Experts, however, want the government to have both emergency and comprehensive plans to fight the pollution in Delhi-NCR.

Anumita Roy Chowdhury, head of the Centre for Science and Environment, an advocacy group based in New Delhi, said efforts are being made to contain the smog.

“The emergency plan is what is happening right now, which is when the pollution levels go very high. As per this plan – coal power plants, brick kilns, industries running on coal and biomass have been shut down.

“Trucks are not allowed to come inside the city and construction activities have been stopped.”

She added that there is also a “comprehensive action plan”, a year-round strategy.

She added: “The government is giving incentives to farmers to buy equipment which will help them to mix the straw – a major agricultural waste – with the soil and not burn it.

“Officially [the government is] saying that there has been some reduction [in the crop or stubble burning this year].”