Climate change is a ‘public health emergency’
Recent searing heat waves in the sub-continent have proved fatal to hundreds. The unforgiving heat has spared no one. The very young, the very old and those in the prime of their lives have all been scorched.
Over four thousand people have died of severe heat strokes in Pakistan and India in two distinct heat wave events during May and June. While the extreme weather event has subsided, thanks to declining temperatures, the number of the heatstroke victims in Pakistan has only continued to spike.
Though the 1.4 billion people of India and Pakistan are no strangers to long spells of sizzlingly hot and humid weather at this time of year, it is clear that both local populations and their governments were unprepared for the severity of impacts.
The heat waves have led to enraged public protests and officials have been flayed for their inability to supply electricity and water to avert deaths and sickness. What made the matters worse was the inadequate response to forecasts by meteorological departments of both countries and official failure to spread alerts through the mass media.
The human body maintains a core temperature of 37.6 degree Celsius and skin temperature of 35 degree Celsius. When temperatures rise, people sweat and the body cools down because of evapotranspiration.
When high heat is accompanied by high humidity, perspiration doesn’t dry up and skin temperature increases, raising core body temperatures. This explains the recent high mortality in coastal areas such as in India states of Odisha and Andhra Pradesh, where temperatures may be lower than the hinterland, but humidity is high. This may also explain the deaths that occurred in Karachi.
As earth’s temperature warms because of the continued growth in climate-altering carbon emissions, there is an increasing likelihood of occurrence of severe heat waves in the years to come. The latest fourth IPCC assessment report warns that the climate change is likely to be accompanied by an increase in the frequency and intensity of heat waves, as well as warmer summers and milder winters.
There is also evidence showing that a warming climate increased the probability of the occurrence of individual ‘heat’ events such as the 2003 European heat wave, the 2010 Russian heat wave and the 2013 Australian summer heat.
The trend toward more extreme weather events, combined with expanding urbanisation, means that an increasing number of people in countries such as Pakistan and India are exposed to higher temperatures. This makes climate change a ‘public health emergency’.
The heat waves have led to enraged public protests and officials have been flayed for their inability to supply electricity and water to avert deaths and sickness
The heat wave events underline the need for the viable heat wave crisis management plans to avert further loss of lives.
After a heat wave in 2010 killed an estimated 1344 people in the Indian city of Ahmedabad, the administration established a ‘Heat Health Action Plan’.
The plan consists of four pillars: educating the public about heat-related illnesses and preventative measures and an early-warning system for the public, local governments and local medical officers. City officials worked with scientists to develop a forecast system.
There is strong need for Pakistan to learn lessons from such experience and replicate the Heat Health Action Plans in different vulnerable urban areas of the country.
Another strategy that would be relevant for Pakistan, is the action taken by the Odisha Government in India. The state of Odisha has actually witnessed a reduction in mortality per heat wave day in recent years due to some interventions, even though the number of heat wave days has remained high.
In 1998, an extended period of heat and humidity killed some 2040 people in Odisha. In response, the state government launched a heat wave awareness campaign focusing on behavioural changes. State agencies widely disseminated heat wave related tips through newspapers, radio, television, local volunteers, health and Anganwadi workers etc.
Heat stroke symptoms and precautions identified by the government of Odisha
Feeling of tiredness;
Headache, body ache and vomiting;
Dry throat Blurred vision;
Abnormal increase in body temperature; and
Increased palpitation and loss of consciousness.
Eat enough food and drink enough water before going out;
Consume a variety of liquids like water rice, belapana, sarbat, curd water, ORT solution etc;
Eat vegetables and fruits such as watermelon, cucumber etc;
Carry water if going out;
Wear light coloured cotton clothing;
Avoid travel during noon time;
Use items such as umbrellas, caps, turbans, wet towels, shoes and if possible; goggles, when walking under the sun;
Work more during the morning and afternoon and less during noon time;
Remain alert about children, elderly, over-weight people, pregnant women and persons with high blood pressure, diabetes or epilepsy;
Do not give water if a person faints due to a heat attack;
Do not imbibe alcohol; and
Consult a doctor if there is any dis-comfort due to heat.
Right now, awareness generation about simple behavioural changes will go a long way in offering protection
In 2010-11, the South Asia Network for Developmental and Environmental Economics (SANDEE) sponsored a study to evaluate the effectiveness of awareness generation on heat wave mortality.
Heat wave mortality data of the 16 districts of India, where the disaster risk management (DRM) project was implemented, were statistically examined and compared with mortality in other 14 districts of India where no such programme ran.
Initially, the DRM districts had more deaths from heat waves compared to non-DRM districts. However, after the DRM project that ran for six years, the scenario reversed and DRM districts had lower death rates.
Based on this analysis, it can be asserted that there is indeed a strong connection between awareness campaigns, behavioural changes and heat wave mortality. Exposure and death can be minimised through some simple actions.
Hot weather and high humidity distress everybody, but the poor are the worst affected. The rich and the middle class respond and adapt to the heat. The poor, who are without cars, air conditioners or fans and even water, are unable to change their work patterns and get badly exposed to severe heat.
Yet, here too, government action goes a long way. A recent survey indicates that 99 percent of rickshaw pullers, cobblers and other lower income workers surveyed in two cities in Odisha were aware of the Odisha government’s continued heat wave awareness campaigns.
On average, during very hot weather, 73 percent of the workers reported that they drink water, 65 percent eat cucumbers and onion before leaving their homes, 63 to 64 percent carry water bottles and an umbrella, 26 percent wear light-colour cotton clothing, 21 percent do not walk barefoot and 33 percent do not work during noon hours.
Conclusively speaking, there is a link between information provided by the government and lower deaths. Thus, programmes such as the one in Odisha need to be replicated in other states that are struggling with heat related mortalities.
The world and South Asia are likely to face more hot days and hot nights in the coming years. In the long run, adjustments such as increased use of air-conditioning or dense green cover may be possible.
However, right now, awareness generation about simple behavioural changes will go a long way in offering protection. Governments need to also start preparing their official public systems and media outlets to inform the public about symptoms and precautions.
We also need to give thought to our own actions. Our actions that influence global warming may well result in affecting our lives and health or, at least, that of our children.