‘Man-made disaster’: Could the 13 heatstroke deaths at Maharashtra state event have been prevented?

On Sunday, an hour after midnight, Gulab Patil packed two litres of chilled water, some laddoos, chapatis and a vegetable dish and boarded a bus from her village in Virar in Maharashtra’s Palghar district.

With her were 31 others from her neighbourhood, all travelling to Kharghar, 80 km away, to watch their spiritual leader receive Maharashtra’s highest civilian award.

“Our entire family follows him,” said Baban Patil, Gulab Patil’s husband, of their faith in the Raigad-based spiritual leader Dattatreya Narayan Dharmadhikari, also known as Appasaheb Dharmadhikari.

At 2.30 am on April 16, by the time 55-year-old Gulab Patil arrived in Kharghar, where a long queue had already formed to enter the massive open ground where the awards ceremony was being held. Patil and her neighbours were among the estimated 15 lakhs-20 lakh crowd that had gathered to watch Dharmadhikari receive the Maharashtra Bhushan award from Union home minister Amit Shah at an event organised by the state government.

Twenty-four hours later, after a frantic search of many hospitals, Patil’s sons found her at the intensive care unit of Mahatma Gandhi Mission hospital in Kamothe, 5 km from the Kharghar ground.

The sons do not know in what condition she had been found, or who took her to the hospital.

By the morning of April 17, Patil was dead. Her post-mortem report suggested death due to “acute renal failure due to dehydration caused by sunstroke”.

“We don’t know who to blame,” said Yogesh Patil, who had rushed to Kharghar when multiple phone calls to his mother went unanswered.

Patil was among 13 people – the youngest aged 30 and the oldest 65 years – who died of heatstroke after prolonged exposure to the sun at the event. Over 300 required immediate medical aid. The Kharghar police has registered a case of accidental death. Assistant police inspector Dhiraj Patil told Scroll “no authority was at fault if people died due to heatstroke”.

Until Monday night, 12 people were still in hospital, two of them in critical condition.

Environmental and health experts as well as Opposition leaders have criticised the state government for organising such a massive event at the height of summer.

“This is a man-made disaster,” said Dr Vidya Venugopal, an expert in heat-stress from Sri Ramachandra Institute of Higher Education and Research in Chennai.

Leader of the Nationalist Congress Party Jitendra Awhad said the Bharatiya Janata Party had organised the event for “political gain”.

Devastating heat

When Union minister Amit Shah addressed addressing the gathering from the stage on Sunday, he acknowledged the high temperatures.“As far as my eyes can see, there is a big ground, then a road and then another ground and simmering 42 degrees heat,” Shah said. “In all this, you all are sitting on an open ground... this shows your respect for Appasaheb.”

A social reformer who works in Raigad, Dharmadhikari has millions of followers in Maharashtra, who could prove to be politically influential. His father, Nanasaheb Dharmadhikari, had also been a prominent figure who worked to dispel superstition and regressive social practices.

Sunday’s event had been organised by Maharashtra’s ministry of cultural affairs with support of Shri Nanasaheb Dharmadhikari Pratishthan, which provided buses and other transport to bring crowds to the 200-acre open ground. Maharashtra Chief Minister Eknath Shinde, deputy chief minister Devendra Fadnavis, and Union minister Kapil Patil also attended the event.

“Whatever precautions required were in place,” said Dr Yogesh Mhase, the Raigad collector. The authorities had anticipated that 20 lakh people would attend the ceremony, and arrangements had been made to provide water and medical aid for that number.

While politicians, the media and VIPs were seated in a covered hangar, the crowd sat in the sun. The volunteers of the Pratishthan distributed bottles of water and food to attendees.

Though the ceremony started at 10.30 am and finished by 1.30 pm, many of the attendees, who had arrived at the venue the previous night or early in morning, had been in the sun for at least seven hours.

Experts to whom Scroll spoke said the Maharashtra government’s decision to hold an open-air event between noon and 3 pm was a fatal mistake.

“Such events cannot be planned during the afternoon when solar radiation is at its highest,” Venugopal said.

According to Dr Babasi Kalel, the forensic expert who performed autopsies on the 13 dead, the heat had a devastating effect on their bodies.

“Their kidney, liver, lungs and brains had shrunk,” he said. “This seems to be the effect of sun exposure for at least six to seven hours.”

Kalel was among the medical staff stationed at the event to handle any emergencies. “We were in a shaded booth and even then we required a lot of water to keep ourselves hydrated,” he added. “Those on the open ground were dehydrated.” Some suffered from anuria, a condition in which the kidney is damaged and the body cannot pass urine.

Heat ignored

Professor Dileep Mavalankar, the director of Indian Institute of Public Health, Gandhinagar, which helped the Gujarat government frame a heat action plan in 2013, said that the event should have been organised either early in the morning or late in the evening. “The local authorities should not have given permission for such an event in the afternoon,” he said.

But Raigad’s deputy collector Padmashri Bainade told Scroll that the collector’s office had not been contacted for any permissions. “The entire event was organised by the cultural ministry,” she said. “There were 35 committees formed to look into management of the event. We were just part of one of those committees.”

Collector Mhase said that the schedule had been provided by the cultural ministry and there was no scope to change the timings.

However, he said the district officials anticipated the possibility that some attendees might suffer from sunstroke if the event was prolonged. “We had kept 5,000 beds ready at nearby health centres in case people fell ill.”

The district authorities said there had not been any warnings about a heat wave nor any alerts from the India Meteorological Department.

According to the India Meteorological Department, the nearest observatory from Kharghar to record temperatures is at Rabale, 20 km away. On April 16, it recorded a maximum temperature of 37.6 degrees.

That may, however, not be an exact measure of how hot it was in Kharghar, experts said.

“The IMD records temperature with a thermometer kept in a white box under a shade,” Mavalankar said. “If the thermometer is brought out under the sun, the temperature reading would be higher. It is quite possible that the temperature soared over 40 degrees in Kharghar.”

Under the guidelines issued by the National Disaster Management Authority, temperature above 40 degrees calls for an orange alert – and advice to avoid stepping out at noon. Moreover, the humidity on April 16 was at 45%, slightly above normal levels. High humidity levels can cause heatstrokes even at relatively low temperatures.

An official from the state disaster management cell said during such large events, permissions are required from the local police, the traffic police, the fire department and the civic body. “But there is no provision to look at heat and temperature while okaying an event,” the official said. “This should be added.”

‘Not everyone knew where to find water’

Panvel health officer Dr Sunil Nakhate said government doctors from Mumbai, Thane, Navi Mumbai and Raigad were asked to set up medical booths to cater to the anticipated crowd of 20 lakh people.

“Our corporation set up 32 booths,” Nakhate said. “Each booth had six doctors and 50 volunteers from the Pratishthan. Whoever came to us, we gave them oral rehydration solution.”

He added that most attendees were carrying one litre to two litres of water with them.

“But if you are exposed to heat for six to seven hours, you would need five-six litres of water,” said Nakhate. “Several had come a day before to get a spot closer to the stage. They ran out of water sooner.”

Nakhate also said while the supply of drinking water and taps was adquate, not everyone could access it.

Taps were installed outside the ground and linked to tankers with drinking water. Volunteers distributed tiny bottles of water across the massive ground.

“But not everyone knew where to find water,” said Kashinath Sawadhkar, who had accompanied his wife Kavitha to Karghar. “At 11.30 am, she complained of giddiness,” he said. “We took her to the nearest medical booth and they transferred her to a hospital.”

Many others felt dizzy and fainted while leaving the ground and walking in scorching heat to the buses that would ferry them back home.

Jayshree Koladkar, 63, had travelled from Nashik the previous night to attend the event. Her son Nitin said she fainted after walking for half an hour to reach the bus after the event.

Ajinkya Patil believes his mother, Jayshree Patil, died due to dehydration and suffocation. “First, she sat under the sun for several hours, then she had to walk in a crowd for a long distance. She fainted on the way,” Patil said.

Jayshree was taken to the Tata Memorial Hospital in Kharghar where she was declared dead.

Chief Minister Eknath Shinde has announced a compensation of Rs 5 lakh to the kin of the dead.

A big jamboree

Local officials said they had been preparing for the event for the past few weeks, following a government announcement of the award.

Previous recipients of the award include Asha Bhosle, Ratan Tata, Sachin Tendulkar and Lata Mangeshkar. But never before has the event been organised on such a grand scale.

Hoardings were put up in Navi Mumbai and Panvel publicising the date and venue of the event.

Some politicians asked why it has been necessary to bring in lakhs of people for the event.

Opposition leader Ajit Pawar and Maharashtra Navnirman Sena leader Raj Thackeray criticised the timing of the event.

“The time that they decided was in the afternoon,” Pawar said. “Everybody knows April and May are peak summer months.”

He added: “Whether the government took enough measures to prevent such a big mishap must be inquired.”

Raj Thackeray said: “There was no need for the government to call so many people for the award function.”

Nationalist Congress Party leader Awhad added: “Even the Bharat Ratna award is given in a hall and broadcasted on television. There was no need to gather such a large crowd.”

Congress leader Kanhaiya Kumar on Monday told media that the deaths amounted to “culpable homicide”. Maharashtra Congress leader Nana Patole said that the police should register a criminal case against the Bharatiya Janata Party-Shiv Sena government.