Why we should worry more about the poor during extreme heat events?

The month of May is generally the hottest time of the year in India. This time it has been unbearable. Certain parts of India are suffering from extreme heat - soaring temperatures (40C to 50C) have been reported in Andhra Pradesh, Telangana, Delhi, and Maharashtra resulting in more than 1000 deaths in less than one week, and the numbers continue to rise. Alarmingly, this is not a rare occurrence. Higher peak temperatures and longer periods of heat waves are becoming increasingly common in many parts of the world  as it does in India where it seem  to be recurring with regularity.2014 witnessed high temperatures in Andhra Pradesh, Delhi and Odissa. Similarly in 2013, 2012, and 2011, heat wave gripped many parts of the country with  2014 the hottest year on record in India.

Records from the National Climatic Data Centre indicate that the average global temperature across land surfaces was 1.68°C (3.02°F) above the 20th century average of 3.2°C (37.8°F). The Earth's surface temperature has shown accelerated warming during the last two decades due to the cumulative effects of human activities in the past 50 years, which have altered the atmosphere’s chemical composition by the accumulation of greenhouse gasses that trap heat. Exploitation of our forests and unrestrained development have led to deforestation resulting in the removal of trees-our planet's  natural heat moderators. Rampant urbanisation has led to increased temperatures due to urban heat islands. When tree cover is replaced by concrete buildings that naturally absorbs heat and retains less water, temperatures rise concomitant with the rise of urban sprawls.

Consequently human activities lead to extreme heat events - weather that is different from the usual, is abnormally hot and humid, and sustained over longer periods. Extreme heat events are increasingly being reported in many parts of the world in recent years often resulting in heat-related illnesses and deaths and  disproportionately affects the poor in developing countries.

 The casualties in the ongoing  Indian heat wave are largely  construction workers, elderly and the homeless.

Why are the poor affected more?

Lack of access to drinking water

In developing countries, people living in poverty generally have poor access to clean drinking water. Extreme heat events often goes hand -in-hand with general water shortage which limits the amount of water available to the poor contributing to severe dehydration. 

Inadequate shelter from heat 

Often the poor live in dwellings that lack adequate protection from heat, with many urban poor living in makeshift houses in slums devoid of  heat alleviating devices such as electric fans.

Occupational exposure to heat 

Whilst the advice during extreme heat events is to stay indoors, away from the heat, many poor engage in outdoor manual work for sustenance, often in urban areas where temperatures are higher which makes them increasingly prone to sunstroke and dehydration. Regardless of the danger posed by outdoor work in extreme heat, they are forced to labour in potentially lethal conditions, ironically, to survive.

Limited access to healthcare

The poor lack access to healthcare for heat-related illnesses which sometimes leads to fatal consequences.

Vulnerable elderly

Increased age (65 and over)  is a primary risk factor for heat- related illnesses regardless of socio-economic status, but the elderly poor are adversely affected to the greatest extent. This is due to the restricted ability of the older people  to change their physical environment and  their limited ability to access facilities such as water, re-hydration drinks, and medical aid, that local authorities might provide during times of extreme heat events.Additionally the elderly poor may have untreated health conditions like cardiovascular diseases and kidney diseases which predisposes them  to heat-related illness and death 

Homeless marginalised

Homeless people are highly vulnerable to heat -related illnesses due to a plethora of reasons – Often there is a high prevalence of untreated physical and mental illnesses, substance dependence, and mental health issues all of which contributes to their susceptibility. They may be less likely to take effective precautions from heat and may have poor access to medical help . Further, they may have no place to take shelter during periods of extreme heat.

 How can we help the poor before and during an extreme heat event?

• The authorities must generate extreme heat event management plans far in advance, detailing how the poor would be taken care of during extreme heat events
• Alert the poor using awareness campaigns before an impending extreme heat event so that they are prepared, can take precautions, and know what to do to protect themselves.

The points below can be used as a guide in generating extreme heat event management plan.

• Make provisions for water, re-hydration solutions, and food aid to reach the poor
• Provide emergency medical camps where the poor can seek medical aid. Additionally take  medical care to the point of need using mobile clinics- to the homeless and the elderly who may not visit the medical camps 
• Provide emergency heat refuges  where the poor can take relief from heat. In times of extreme heat events large public outdoor spaces like stadiums and parks could be adapted to provide shelter from the sweltering heat.
•  Provide financial relief that would help the poor to refrain from outdoor manual labour until the extreme heat events passes  .
•  Provide appropriate clothing, sun hats, umbrellas to provide shade etc.

With increase in global temperature, extreme heat events will continue to reappear regularly. Nevertheless, virtually all of the extreme heat- related illnesses and deaths can be prevented by taking appropriate measures to ensure that the public stays safe during an extreme heat event, and that absolutely should include the poor.

Authors of this post - Ruth Stephen and Tim Whallett