Recently, the Tamil Nadu government made a gazette notification that heatwave is a state disaster, clubbing it with 13 other eventualities such as deaths caused by electrocution, thunderstorm and lighting, floods and snakebite. Families of victims including relief workers who died due to heatwave, would be eligible for an ex-gratia of ₹ 4 lakh.
These are significant steps as greater onus is now on the State Government to take various measures to reduce heatwave-related causalities in the State (remember, heatwaves are not yet notified as a disaster at the national level under the existing disaster relief policies).
Anup Kumar Srivastava, former senior consultant, National Disaster Management Authority (NDMA), says prevention, preparedness, mitigation, monitoring and relief, in that order, are the main pillars of any disaster management.
“The next step for the Government is to start working on building capacity, which must be a continuous and ongoing process,” says Srivastava.
Healthcare professionals and administrative staff must be trained on how to detect signs and symptoms of heatwave among patients and the public. He says a good heatwave action plan must have nodal officers in every district who will be responsible for driving initiatives and monitoring them.
While most notifications insists on providing ORS packets, setting up drinking water kiosks at public places and rescheduling working hours to protect outdoor workers, governments must look beyond the basics.
“Compensation for agriculture loss and death of livestock must also be included,” says Srivastava.
Director of Ahmedabad-based All India Disaster Mitigation Institute Mihir R. Bhatt says a notification shows the commitment of the state government and will help its citizens legally and monetarily.
Extreme death due to heat is avoidable, for which more steps should be taken on the ground including at district level and through city level heat action plans. Heat protection strategies, cooling projects, and insurance coverage for individuals and businesses are among other initiatives. “Participatory and bottom up planning will make vulnerable populations aware and active,” says Bhatt, who was coordinating lead author of IPCC Special Report on Extreme Events.
He says heatwave preparedness must happen when there is no heatwave and between two heatwaves. “It need not just happen during the heatwave,” he says.
Bhatt says compensation plays out differently in various contexts and situations and it is important to study heatwave-related payments from different States.
The challenge of tracking heatwave death data
Varying definitions of heatwave, co-morbidities in individuals and lack of any clinical test make classifying deaths due to heatwave a challenge.
Medical professionals typically only record the immediate cause of death, and do not record environmental triggers such as heat. Doctors say deaths due to extreme heat can be classified as exertional or non-exertional.
“Heatwave is a spectrum and you do not know if it was the only cause or there were co-morbidities. There are no laboratory parameters to declare that the death was caused by heatwave, making it tricky,” says a senior doctor.
While the National Disaster Management Authority has spelt out guidelines to identify heatwave deaths, doctors say there is need for more sensitisation. “Doctors also need to adapt to treating those conditions and recognise them early,” says the doctor.
Although there are medical guidelines to help doctors declare or rule out suspected cases of heatwave illness, training and sensitisation are needed.
“Autopsy Findings in Heat Related Deaths” prepared under National Programme on Climate Change and Human Health, National Centre for Disease Control, Ministry of Health and Family Welfare, discusses the need for guidance in identifying and categorising heat-related deaths.
“We want thermal discomfort to be notified as a disease ”G. Sundarrajan member of Tamil Nadu Governing Council on Climate Change
In certain States that offer compensation to victims of heatwave the official process to certify a heatwave-related death is so complicated that even genuine cases become difficult to prove.
According to Indian Meteorological Department (IMD), when actual maximum temperature remains 45°C or more irrespective of normal maximum temperature, a heatwave should be declared. It varies in coastal regions.
“We want thermal discomfort to be notified as a disease,” says G. Sundarrajan, coordinator of Poovulagin Nanbargal and member of Tamil Nadu Governing Council on Climate Change.
The environmental group, which has been working with the government, feels that doctors rarely certify a death as heat-induced. “Unless the State also notifies heat or thermal discomfort as a disease nobody will be eligible for this ex-gratia,” says Sundarrajan, adding that the State health department must mull over how it can be made less ambiguous.
On the varying definitions of heatwave, Sundarrajan says temperature is not the only factor that determines heatwave for a city like Chennai where humidity is high.
“Indian Metrological Department should take into consideration the heat index which takes into account the relative humidity and not just the ambient temperature,” he says. Poovulagin Nanbargal has written to the State Government on this inclusion and is planning to hold meetings with various stakeholders.
Published – November 18, 2024 04:25 pm IST
