'Heat wave' is not the killer

There is nothing unusual in the current heat wave in parts of Rajasthan, Gujarat, Jharkhand, Odisha and the Deccan plateau. Temperatures routinely hover between 45 and 49 degrees Celsius every year during May-June in these States. The highest temperature ever recorded was 50.6 degrees in Alwar, Rajasthan, on May 10, 1956, which is much more than the highest of 47 degrees recorded in Palamau, Jharkhand, this year.

What is unusual this year is that more than 2,200 persons have so far lost their lives during the heat wave, the second highest recorded since 1998 when 2,541 persons died. And the numbers could rise.

Why have there been so many deaths? Could they have been avoided? What should be done to prevent such deaths in the future?

The casualties pattern

While a detailed analysis of the casualties can be made after studying each case history, information in the public domain so far indicates certain trends.

First, more than 98 per cent of the deaths have taken place in Andhra Pradesh and Telangana which did not necessarily face the most intense heat wave this season. Second, most of the deaths appear to have taken place due to dehydration - the easiest to prevent since over 90 per cent of the population is said to have access to safe drinking water.

Third, most of the deaths are reported to have taken place in urban areas and among workers in the informal sectors, exposed to working in hot and humid conditions without adequate shelter and drinking water facilities.

Similar heat wave deaths, but in smaller numbers, routinely take place in many countries of Africa and South and South East Asia. European countries faced the worst heat wave in 2003 when as many as 71,310 people, mostly in old age homes in Italy, France, Germany, Portugal, Spain and Switzerland, died in temperatures ranging between 35 and 40 degrees celsius. Some 55,670 elderly people died in Russia in 2010.

This led to a massive makeover of old age homes in Europe countries with the introduction of ceiling fans and air conditioners there. The geriatric healthcare system introduced heat related stress management. East European countries and Russia also took similar measures.

Odisha and Gujarat, the two pioneering states in disaster management, introduced many proactive measures that have helped reduce heat wave casualties. In Odisha school and office timings were advanced to reduce exposure to heat. Timings were changed at construction work sites. Water distribution booths were opened across the State.

The Ahmedabad Municipal Corporation developed the Heat Action Plan (HAP) in 2013, which is based on four key strategies: (a) an outreach programme to communicate the risks of heat waves and implement practices to prevent heat-related deaths and illnesses; (b) an early warning system and inter-agency coordination to alert residents; (c) capacity building among healthcare professionals to recognise and respond to heat-related illnesses; and (d) reducing heat exposure and promoting adaptive measures by launching new efforts including mapping of high-risk areas of the city, increasing access to potable drinking water and cool spaces during extreme heat days. All these measures helped bring deaths in the city almost to zero. These strategies have been adopted across Gujarat.

There is definitely a strong case for replicating the good practices of Odisha and Gujarat in States like Bihar, Jharkhand, Rajasthan, Andhra Pradesh and Telangana with appropriate modifications as required. The heat wave death of a normally active person can be easily prevented without significant investments and efforts.

National guidelines

The National Disaster Management Authority should come up with national guidelines for the prevention of such deaths for immediate implementation by the States.

The guidelines should include provision of of drinking water facilities to travellers, street vendors, footpath dwellers and construction workers, the regulation of working hours, healthcare facilities, shelter for workers, and a publicity campaign for protection from heat wave.

These minimal facilities of social protection that every welfare state is expected to provide to its citizens can simultaneously reduce risks and further help to adapt to extreme temperatures in changing climatic conditions.