Two-year-old William Sanchez picks up his asthma machine, a daily presence in his life

East Harlem—Signs of life are appearing at the once dusty construction site in the heart of East Harlem. Inside, cubicle desks and water fountains are in place awaiting staff. After a two-year delay, the East Harlem Asthma Center of Excellence—a free educational and referral facility—is scheduled to open in a few weeks.

It’s not a moment too soon for a community that suffers from the worst asthma rates in the city. One in four children in East Harlem has the respiratory condition, according to authorities.

Two-year-old William Sanchez is one of them. At his home 10 blocks south of the center, William is a typical toddler, except for a 60-year-old man’s cough that erupts from his chest. Asthma has become a part of everyday life in his family’s small apartment across from a bus depot, a hub of fumes and air pollution. He misses an average of two days of school per week and his mother, Carmen Sanchez, frightened by his constant wheezing and inability to catch his breath, frequently rushes him to nearby Mt. Sinai Hospital’s emergency room.

Medicating kids is just one step to combating asthma. Understanding how the medicine works and what triggers an attack is another vital component. When the center opens, staff will not disperse or prescribe medicine like the neighborhood hospital. Rather, they will educate community members about the condition and explain what negative impact environmental factors—like living next to a bus depot—can have.

Mayor Bloomberg announced plans for the center in 2007. “The asthma rate among our city’s children is unacceptably high and the Center of Excellence and the PlaNYC agenda will take steps that we know will reduce it,” he said. Manhattan Borough President Scott Stringer followed, saying the Center “will set the bar for comprehensive coordinated services and provide the children of El Barrio with the support they need and deserve.”

City permits taped to windows indicate long overdue activity at the Asthma Center of Excellence in East Harlem

Fast forward two-and-a-half years and the community continues to wait. The 10,000 sq. ft education center was scheduled to open in 2008, according to Mr. Stringer’s website.

The reason for the delay is unclear. “Unfortunately, we’re not going to comment on this issue,” said Joan Vollero, Deputy Press Secretary for Mr. Stringer’s office, when pressed for explanation. “The center is under construction and will open soon,” was the comment Jason Post, press secretary to Mayor Bloomberg, relayed through an assistant.

Some say “soon” isn’t good enough. “We need it open now,” said Robert Rodriguez, East Harlem Community Board Chairman, at a recent meeting. The city moves with “a little fatigue” when it comes to this neighborhood, he says.

“They’re slower to address our issues. We’re always frustrated,” said Anthu Hoang, Director of Environmental Health and General Counsel at WE ACT, a non-profit organization focused on environmental justice. “East Harlem is probably not the highest on the city’s priority list.”

Meanwhile, resident families seek treatment at other neighborhood options, like Mt. Sinai Hospital, which offers free half-day chest clinics twice a week. On one of William’s recent visits, doctors conducted a routine check-up and provided Ms. Sanchez with a sheaf of re-fill prescriptions. They also pressed her to stop smoking and urged her to remove any pets—both triggers that can exacerbate William’s condition.

Although Ms. Sanchez knows the home environment is crucial to keeping asthma under control, she insists that her three parrots are part of the family and that her smoking habit—a pack a day between her and her husband—is hard to quit.

Once the facility opens, Ms. Sanchez and other parents in the neighborhood will have a forum to learn how triggers affect their children’s conditions and what the various prescriptions mean. Among its programs will be themed workshops, like “understanding the difference between a rescue medication versus a quick-release medication,” explains Priscilla Toral, asthma social worker at Mt. Sinai, who is optimistic about the center’s potential impact. “It’ll be an amazing resource to help translate what doctors say to (patients).”

Ms. Sanchez is just now learning about the center’s services and she’s optimistic it may help her deal with William’s medical problems. For now, his play activities are restricted to the indoors, where his mom is on standby with a five-pound breathing machine to regulate his breathing in case of a flare-up. “As soon as he goes outside, forget it,” says Ms. Sanchez. “I feel bad for him. So many kids are playing in the park and he can’t go. His lungs are so weak.”