Delhi: Inside India’s first heat stroke emergency room

By Soutik Biswas@soutikBBCIndia correspondent
EPA An Indian worker drinks water from a bottle while others rest on the pavement in the shadow of an overpass on a hot day near New Delhi, India, 18 June 2024. EPA

In one of the largest institutions in India’s capital, Delhi, a doctor says he has never seen anything like this earlier.

” This is an exceptional heat. In my 13 years of working here, I do n’t remember signing a death certificate for heat stroke. This year, I’ve signed several”, says Ajay Chauhan of the Ram Manohar Lohia Hospital ( RMLH).

Delhi has been reeling under a prolonged heatwave, with daily temperatures crossing 40C ( 104F ) since May, peaking at nearly 50C. Temperature is made worse by humidity and warm winds, which are further compounded by water shortages and power outages as a result of soaring need. And in the money, people have begun to die from temperature.

A heat stroke, the most severe heat illness, is identified by three key signs: exposure to high heat and humidity, a core body temperature of 40.5C ( 105F ) or higher, and mental changes like mild confusion or impaired consciousness. Heat stroke is a motionless killer as well, and patients may start to get sick days after being exposed to the sun. India’s National Centre for Disease Control calls heat stroke a “life- intimidating” state with a deaths level of 40- 64 %.

Seven people have died of heat strokes since Dr. Chauhan’s hospital in Delhi’s late May opening a heat stroke office, and more than 40 have received treatment for heat-related illnesses.

AFP Dr. Ajay Chauhan, head of the heat stroke ward, speaks during an interview with AFP at the Ram Manohar Lohia hospital in New Delhi on May 30, 2024AFP

The majority were men working outdoors and in small, unregulated factories with poor conditions, enduring extreme heat exposure. To be sure, the heatwave is not restricted to Delhi: dozens have died from heat-related illnesses since March, with more than 50 deaths in just three days in early June in the states of Uttar Pradesh and Odisha.

The efforts to protect people with heat injury at the RMLH center, which is perhaps the first of its kind in India, highlights the problem posed by sudden weather and health crises.

A man was wheeled in a few days ago with body temperatures reaching 42C ( 107.7 ). A brain’s normal base temperature is 37- 38C. He had a temperature injury, too.

At this temperature, a human body begins to shut down, cell deteriorate, and there’s a risk of tissue loss. As blood circulation stops to the body, which causes it to become cold and damp.

A 250-litre concrete tub with a temperature range of 0 to 5C was dunked into the icy waters of the office by doctors. ( The office is equipped with two ceramic buckets, a 200kg glaciers- making device, rectal thermometers, snow boxes and inflatable tubs. ) Before being moved to the hospital for additional treatment, the individual took about 25 minutes to great down and begin to recover.

Reuters riyanshi Fakirbhai Patel, 20, who according to medical staff suffers from heat exhaustion, is helped by medical staff at the hospital during a heatwave in Ahmedabad, India, May 24, 2024. REUTERS/Amit DaveReuters

” First heating saves lives. Every minute qualifies”, says Dr Chauhan. A delay can lead to catastrophic bleeding, kidney damage, or kidney damage.

In Delhi, it is not difficult to fall ill. Life is strong. Subpar and crowded cover is where a third of the population resides. The town’s 6, 400- strange slums, house to more than a million households, absence sufficient cooling and face annual livelihood crises. People fall ill after spending long periods in kitchens with traditional heaters, and people fall ill while working outdoors.

Green spots are limited. The area becomes a blistering furnace as the city reaches its summertime peak, suffocating between the blazing heat of the city’s upper reaches and the searing, above-ground temperatures.

Anjana Kumari, the wife of a daily wage worker admitted at RHML with heat stroke, told The Indian Express that their slum hutment’s only fan wasn’t working due to a power cut. Her husband, exhausted from working all day on Monday, couldn’t sleep and later suffered seizures, vomiting, and diarrhoea. She rushed him to the hospital at night. “Doctors have told me he won’t be able to walk for some time and need a lot of care,” Ms Kumari said.

Those who work outdoors suffer the most. A large majority of respondents in a new Greenpeace survey on how heat impacts street vendors in Delhi reported health issues due to hot weather. Irritability was the most common (73.44%), followed by headaches, dehydration, sunburn, fatigue and muscle cramps. Most faced challenges accessing medical care due to lack of money.

AFP A medical staff prepares an immersion ice bath tub at a heat stroke ward of Ram Manohar Lohia hospital in New Delhi on May 30, 2024. IAFP

” Every day the temperature gets higher. We reside in the open horizon. What resources does I collect? If feasible, there should be some trees and plants outside, so that fresh air keeps blowing and the brain gets some relief”, Guddi, a sugar wine merchant who operates a regular shredder, told Greenpeace.

I do n’t feel like eating dinner at night because I’ve been exposed to the sun all day. She said,” All I can think about is stretching my limbs and going to sleep.”

And all over India, people are falling sick due to the heat. A new nationwide survey by Centre for Rapid Insights (CRI) offers some startling insights into how heatwaves hurt people and cripple productivity.

According to the survey, 45 % of the visited communities reported that at least one family member had died last month from heat.

Among those affected, over 67 % had family members sick for more than five times.

Mainly severe was this effect among the poorest. Members of 32.5 % of households with motorcycles and 28.2 % with no vehicles had illness for more than five days, compared to the lowest figure of 21.8 % for households with cars.

Getty Images Homeless people seen staying inside a night shelter amid extreme hot weather conditions at Lodhi Road on June 18, 2024 in New Delhi,Getty Images

Some three-fourths of India’s workers work in heat-exposed jobs like construction and mining. This becomes worse during heatwaves as there are fewer safe and productive work hours during the day. A Lancet study reported a loss of 167.2 billion potential labour hours in India due to excessive heat in 2021.

” The performance loss is staggering”, says Neelanjan Sircar, producer of CRI.

Heatwaves killed more than 25, 000 persons between 1992 and 2019, according to official statistics. As India does n’t assemble mortality data properly, researchers reckon the true burden would be much higher.

India’s heat action plans are also not working well, as a study found. Tellingly, 68% of the vendors in Delhi had also not even heard about heatwaves, according to the Greenpeace study. No wonder then that the heat emergency doesn’t figure in the political discourse.

” Several view a thunderstorm as an ongoing act of nature, with little expectation from the government to take any action.” It reflects a wider concern of small expectations in India, according to Mr. Sircar.

Things look dire in Delhi. In 2022, India saw 203 heatwave days, the highest on record, with Delhi experiencing around 17 of them. March marked India’s hottest month recorded by the the weather department, while Delhi had its second-hottest April in 72 years.

” This is going to get worse. We need to be very careful”, says Dr Chauhan.