Op-Ed: Handling Heat Stress - The Hindu (06.03.18)

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High noon (06.03.18)

The India Meteorological Department’s forecast of above-normal maximum and minimum temperatures across the country during the pre-monsoon March-May period is a timely alert for State authorities to review their preparedness. Even a marginal rise above the normal will lead to enormous heat stress for millions of Indians, given the deprived conditions in which they live. Moreover, there are distinct groups at particular risk for health-related problems during a heat wave, such as senior citizens and people with pre-existing disease, mental illness or disability, which prevents them from being able to care for themselves. It is the responsibility of governments to ensure that community-level interventions are taken up to help vulnerable groups. The advent of hot weather this year is marked by temperatures rising between 1.6° Celsius and 5° C above normal in States such as Rajasthan, Jammu and Kashmir, Uttarakhand, Uttar Pradesh, Himachal Pradesh and Madhya Pradesh; other northern, central and eastern States also show a small increase from March 1. Of course, Tamil Nadu, Puducherry and parts of Rayalaseema have begun the season with a slight decrease in minimum temperatures, and will possibly have less oppressive temperatures in coming weeks. For most other States, though, the summer of 2018 may pose a public health challenge, for which they must prepare with the experience gained during the many previous heat waves. One scientific estimate of annual mortality attributable to heat waves between 2010 and 2015 ranges between 1,300 and 2,500.

A spike in summer temperatures in India is not new, but some scientists contend that a half-degree rise in average temperature in recent decades has resulted in a higher probability of extreme heat waves and caused a lot of deaths. A heat event thus has serious implications for public health: it can lead to fatal heat stroke in a small percentage of people, while many more could encounter exhaustion, cramps and fainting. It is vital for governments to ensure that all stakeholders, including the health-care system, are prepared to deal with the phenomenon. The World Health Organisation recommends that countries adopt heat-health warning systems, including daily alerts to ensure that people are in a position to deal with adverse weather, starting with reduction of exposure. Water stress is a common and often chronic feature in many States: arrangements should be made to meet scarcity. There is some hope that the southwest monsoon this year will benefit from an expected moderate La Niña condition in the equatorial Pacific, marked by cooler-than-average sea surface temperature. Taking the long-term view, India has to pursue mitigation of greenhouse gases vigorously, since there is a perceived link between increases in average temperature caused by climate change and the frequency and intensity of extreme weather events.

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Older Op-Eds

Hotter, longer, deadlier summers (21.04.16)

Climate change is expected to cause an > increase in the frequency and intensity of heatwaves. For India, 2015 was the third hottest year on record (since 1901) and the > heat claimed over 2,000 lives. This year, the India Meteorological Department (IMD) has issued warnings for northwest and central India (Rajasthan, Punjab, Haryana, eastern Uttar Pradesh, West Bengal, Odisha and Jharkhand) about heatwaves happening sooner than in previous years. Further, government schools have been shut down in Kolkata, parts of West Bengal, Odisha, and Madhya Pradesh on account of heatwaves.

Adverse health outcomes (hospitalisations or death) are a complex interaction of frequency, duration and intensity of a heatwave and population-level factors, which include acclimatisation to the temperature profile of certain geography, poverty, lack of shelter, pre-existing disease, age (children or elderly) and access to health facilities. In addition to heat stroke, extreme temperatures can exacerbate pre-existing cardiovascular and respiratory illness.

The days ahead

A joint study by the Council on Energy, Environment and Water (CEEW), Indian Institute of Management Ahmedabad and Indian Institute of Technology Gandhinagar found that about 345 districts in India (700 million people) are following a trajectory where average temperatures are likely to rise more than 2°C by the end of the century. The same study also finds that over the next three decades, India may experience increase in annual mean air temperatures of 1°C-1.5°C and substantial increases in night-time temperatures. Higher night-time temperatures are correlated with increased incidence of heat-related illness.

Findings from the first Global Climate Change Risk Assessment (a joint study by CEEW, Harvard University, Tsinghua University and the U.K. Foreign and Commonwealth Office) highlight that hotter summers make it extremely unsafe for citizens, especially labourers, to undertake heavy outdoor work. Of course, there remain associated impacts such as higher risks of crop failure. Concomitant consequences of farmer financial distress, poverty traps and, in extreme cases, suicides cannot be overstated.

Adaptation measures

If hotter, longer and deadlier summers are to be the new normal under a changing climate, proactive adaptation measures are required. This implies policy intervention and coordination across three sectors — health, water and power.

First, scale up heat-health warning systems (HHWS). At their core, such warning systems include providing weather forecasts in advance, issuing warnings to people, providing readiness of emergency response systems, and preparing doctors and health facilities to handle a sudden influx of patients. Warnings facilitate people in taking appropriate actions against heat-related harm. Though the IMD does issue heat warnings, often the coordination with emergency response systems and health facilities is missing.

Globally, studies show that implementing HHWS results in fewer deaths. The most quoted example is that of France where 4,400 deaths were avoided due to HHWS during the 2006 heatwave. Closer home, Ahmedabad, Nagpur and Odisha have made pioneering efforts in this direction. These systems need to be expanded to other cities across the country.

Second, expedite the rollout of the heat-health warning systems that was launched last year. Preventing temperature-related morbidity and mortality could be a key programme under this mission.

Third, ensure an adequate supply of water. Dehydration is a key outcome of heat exposure which can cascade into life-threatening conditions and ultimately death. Timely access to drinking water can help mitigate this escalation. In areas where heat extremes coincide with water scarcity, the risk of heat-related illness remains highest. Areas like Latur, Osmanabad and Beed, which are already experiencing acute water shortages, could face large casualties if hit by heatwaves. Water is also required for electricity production that helps provide access to cooler environments through use of fans and air conditioners. Therefore, strategic planning in the water sector is of paramount importance to protect human lives.

Fourth, provide reliable electricity for adequate duration. Access to cool environments remains the mainstay of preventing heat stress. Use of fans, air conditioners or functioning of medical centres is contingent upon electricity supply. Further, many communities depend on electricity to draw groundwater for drinking. This requires planning to meet peak loads in summer, when power outages are most common. In rural areas, where electricity access is a challenge, supplementing power supply of primary health centres with solar-based systems should be undertaken. Chhattisgarh, Maharashtra and Tripura have already deployed such systems.

Finding policy alignment and coordination across these sectors remains a daunting, yet much needed exercise. The romance of the seasons may be lost in the years to come. Lives need not be.

Hem H. Dholakia is a Research Associate at CEEW, a not-for-profit policy research institution in New Delhi. Email: hem.dholakia@ceew.in

Coping with summer (03.04.17)

Torrid summers, when the mercury soars 4°C to 6°C above the average and produces heatwaves in several States between April and June, may become more frequent in coming years. Not only will there be more hot days, the spells of heat stress sweeping across much of India are likely to grow longer. The scientific consensus is that heatwaves will grow stronger and expand their geographical spread in the south, influenced by the sea surface temperature in the Indian and Pacific Oceans. With rising greenhouse gases, their impact can only intensify. Though the number of people dying due to heat stress last year was half of the previous year’s toll of 2,040, the need to evolve detailed action plans at the level of States, districts and cities is now critical. It is encouraging that the National Disaster Management Authority is guiding States, in partnership with the India Meteorological Department, to evolve heat action plan protocols. The response to distress caused by excessive heat has to be both speedy and professional. Europe upgraded its preparedness to handle a crisis after a crippling heatwave in 2003 killed thousands of people, over 14,800 of them in France alone. In the Indian context, crop failures and disruption of electricity supply due to sudden peak demand are common. People experience dehydration, heat cramps and deadly heatstroke. The elderly are particularly at risk, since higher temperatures affect blood viscosity and raise the risk of thrombosis.

Better meteorological forecasting can provide an early warning about a coming hot spell during the summer window. This gives the NDMA and the States sufficient opportunity to launch an action protocol: to inform the public as soon as the temperature crosses the threshold fixed by the IMD, advise on precautionary measures, and aid those who are most vulnerable, such as older adults, farm workers and those pursuing outdoor vocations. Ahmedabad, for instance, drew up a city-level action plan in the wake of its 46.8°C heatwave of 2010 with support from public health institutions. Preparing the health system to identify symptoms of heat stress and providing treatment through urban health centres is one intervention it decided upon. Reviewing school timetables, rescheduling work timings to cooler hours, making water widely available and reserving religious sites and libraries as cooling centres were others. European and American policy responses, such as creating green and blue urban spaces to provide tree shade and higher moisture, as well as housing design that cuts heat through the albedo effect of reflected solar energy, hold universal appeal. Some of these passive defences are actually integral to vernacular practices and will serve everyone well. It is essential to study the efficacy of heat action plans and share the results across States to achieve best practices.

The urban heat island effect (19.12.17)

Rapid and unplanned urbanisation of cities and concomitant reduction in vegetation results in increased rise in temperature compared to non-urban areas. To explain how this happens, a team of researchers from IIT-Bhubaneswar studied the warming of Bhubaneswar, a tier-2 city, due to rapid urbanisation compared to non-urban areas that surround it. The study was recently published in the journal Proceedings of the National Academy of Sciences ,India Section A: Physical Sciences.

Rapid urbanisation combined with changes in land use pattern between 2000 and 2014 led to about 1.8°C warming of Bhubaneswar compared with surrounding non-urban areas (called the urban heat island effect), the researchers say. The team, which was led by Debadatta Swain from the School of Earth, Ocean and Climate Sciences at IIT-Bhubaneswar, found that increase in urbanisation has been rapid at 83% in the last 15 years. This has led to about 89% decrease in dense vegetation, about 2% decrease in water bodies and nearly 83% decrease in crop fields during the same period. Decrease in crop areas could either be due to urbanisation or fields remaining fallow. These changes have led to increase in the urban heat island effect. The central part of the city has not witnessed much change in land cover, while the adjoining areas have witnessed major changes due to expansion of the city, leading to the warming of the city.

“Bhubaneswar was once well covered by three forests. The 1999 Odisha super cyclone destroyed many trees, and many trees have been cut for road expansion. Today, only a very small percentage of forest cover is remaining,” says Debadatta Swain. All the losses mentioned negatively impact the thermal and radiative properties of the surface and make cities hotter than surrounding non-urban areas. With heavily built-up areas and concrete structures, most cities in India and in the world are warmer than surrounding non-urban areas due to the urban heat island effect. For instance, Delhi is 4-12°C warmer due to the urban heat island effect.

“With proper planning we can minimise the impacts. So urban dwellers may not suffer from excessive changes to heat and rainfall patterns,” says V. Vinoj, one of the co-authors of the paper.

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