Soaring Mercury

As heatwave kills more than 600 across India, Ahmedabad action plan shows how lives could be saved

The Gujarati city is the only place in the country with a strategy to combat heat-related problems.

A searing heatwave has hit large parts of India with parts of Telangana and Uttar Pradesh seeing temperatures as high as 48°C. More than 600 people have been killed by the heat this summer, as per news reports.

The Indian Meteorological Department, on Monday, reported severe heat wave conditions in parts of Odisha and Andhra Pradesh. Parts of Madhya Pradesh, Uttar Pradesh, Rajasthan, Maharashtra, Jharkhand, West Uttar Pradesh, Bihar and Chhattisgarh were classified as suffering from a heat wave.

At temperatures above 40°C, a “heat wave” refers to a departure of between 4°C-5°C from the normal temperature while a “severe heat wave” refers to a departure of more than 6°C.

At these temperatures, chances of a heatstroke, a possibly fatal illness which results from the overheating of the body, are high for people outdoors.

Heatwave impact

Andhra Pradesh, the state most affected by this heatwave, has seen 42 deaths from heatstroke alone. Following the death of two taxi drivers in Kolkata, also from heatstroke, taxi unions have decided to shut down cab serviced between 11 am to 4 pm.

This the most severe heat wave in India since 2010, when an estimated 250 people died from heat related causes. The 2010 heat wave was part of a global summer heat wave which was one of the most severe heat waves since temperatures started being recorded.

Governments in India, though, seem to have learnt little from past heat-based natural disasters. The Central government and the National Disaster Management Authority have not put in place preventive measures for the summer nor do they have any curative plans lined up after the large number of casualties. The union home ministry has not even declared a heat wave as a “national disaster”.

This inaction is matched by state and local governments. Chandrababu Naidu, chief minister of the worst affected state, Andhra Pradesh has not gone beyond offering his personal advice to for people going out into the sun to take preventive steps in order to prevent heat damage.

The lone exception

The one exception to this general trend of government inaction, though, is Ahmedabad, where the city’s municipal corporation has taken concrete steps to prevent deaths and injury due to heat exposure. Starting from assigning different alerts for different levels of heat to a mapped out action plan to save lives on the ground, the Ahmedabad Municipal Corporation has had a comprehensive Heat Action Plan in place since 2013.

Currently, Ahmedabad is the only city in India to have a operational heat alert system. The plan was developed by the Ahmedabad Municipal Corporation, the Indian Institute of Public Health, the Natural Resources Defense Council (a non-governmental organisation based in New York) and the Georgia Institute of Technology (an American university).

The Heat Action Plan is a four-pronged strategy. The first involves a communications outreach which informs people about the risk of heat illness and preventive measures to take. This year, new media such as mobile messaging service, WhatsApp, will also be used to as a dissemination channel along with more traditional means such as posters and inter-personal communication.


Information posters to prevent against heat illness. Source: Ahmedabad Heat Action Plan 2015


The second involves a warning system in the case of a heatwave with actionables mapped out for various governmental agencies.


Communication plan when a heat alert is activated. Source: Ahmedabad Heat Action Plan 2015.


The third step involves training health care professionals to better respond to heat illness while the fourth involves adapting the physical plan of the city to better cope with heat: mapping high-risk areas, making potable water easily accessible and building temporary cooling spaces during periods of extreme heat.


Governmental strategies to combat excessive heat are the global norm. After the 2003 heat wave in France, which killed almost 15,000 people, the French government formulated a heat health watch warning system, a nationwide system of combating heat illness in case of abnormally hot weather. One study estimates that during the 2006 heat wave, 4,400 deaths were avoided as a result of this system being in place.


The UK and Australia also have heat warning systems in place.

India’s current heatwave is predicted by the Meteorological Department to go on for a few days more, which would lead to hundreds of completely avoidable deaths simply because India’s governments do not have any systems in place to warn of heat waves or fight heat illness.

We welcome your comments at letters@scroll.in.
Sponsored Content BY 

Changing the conversation around mental health in rural India

Insights that emerged from discussions around mental health at a village this World Mental Health Day.

Questioning is the art of learning. For an illness as debilitating as depression, asking the right questions is an important step in social acceptance and understanding. How do I open-up about my depression to my parents? Can meditation be counted as a treatment for depression? Should heartbreak be considered as a trigger for deep depression? These were some of the questions addressed by a panel consisting of the trustees and the founder of The Live Love Lough Foundation (TLLLF), a platform that seeks to champion the cause of mental health. The panel discussion was a part of an event organised by TLLLF to commemorate World Mental Health Day.

According to a National Mental Health Survey of India 2015-16, conducted by the National Institute of Mental Health and Neurosciences (NIMHANS), common mental disorders including depression, anxiety disorders and substance use disorders affect nearly 10% of the population, with 1 in 20 people in India suffering from depression. The survey reported a huge treatment gap, a problem that is spread far and wide across urban and rural parts of the country.

On 10th of October, trustees of the foundation, Anna Chandy, Dr. Shyam Bhat and Nina Nair, along with its founder, Deepika Padukone, made a visit to a community health project centre in Devangere, Karnataka. The project, started by The Association of People with Disability (APD) in 2010, got a much-needed boost after partnering with TLLLF 2 years ago, helping them reach 819 people suffering from mental illnesses and spreading its program to 6 Taluks, making a difference at a larger scale.

Play

During the visit, the TLLLF team met patients and their families to gain insights into the program’s effectiveness and impact. Basavaraja, a beneficiary of the program, spoke about the issues he faced because of his illness. He shared how people used to call him mad and would threaten to beat him up. Other patients expressed their difficulty in getting access to medical aid for which they had to travel to the next biggest city, Shivmoga which is about 2 hours away from Davangere. A marked difference from when TLLLF joined the project two years ago was the level of openness and awareness present amongst the villagers. Individuals and families were more expressive about their issues and challenges leading to a more evolved and helpful conversation.

The process of de-stigmatizing mental illnesses in a community and providing treatment to those who are suffering requires a strong nexus of partners to make progress in a holistic manner. Initially, getting different stakeholders together was difficult because of the lack of awareness and resources in the field of mental healthcare. But the project found its footing once it established a network of support from NIMHANS doctors who treated the patients at health camps, Primary Healthcare Centre doctors and the ASHA workers. On their visit, the TLLLF team along with APD and the project partners discussed the impact that was made by the program. Were beneficiaries able to access the free psychiatric drugs? Did the program help in reducing the distance patients had to travel to get treatment? During these discussions, the TLLLF team observed that even amongst the partners, there was an increased sense of support and responsiveness towards mental health aid.

The next leg of the visit took the TLLLF team to the village of Bilichodu where they met a support group that included 15 patients and caregivers. Ujjala Padukone, Deepika Padukone’s mother, being a caregiver herself, was also present in the discussion to share her experiences with the group and encouraged others to share their stories and concerns about their family members. While the discussion revolved around the importance of opening up and seeking help, the team brought about a forward-looking attitude within the group by discussing future possibilities in employment and livelihood options available for the patients.

As the TLLLF team honoured World Mental Health day, 2017 by visiting families, engaging with support groups and reviewing the successes and the challenges in rural mental healthcare, they noticed how the conversation, that was once difficult to start, now had characteristics of support, openness and a positive outlook towards the future. To continue this momentum, the organisation charted out the next steps that will further enrich the dialogue surrounding mental health, in both urban and rural areas. The steps include increasing research on mental health, enhancing the role of social media to drive awareness and decrease stigma and expanding their current programs. To know more, see here.

This article was produced by the Scroll marketing team on behalf of The Live Love Laugh Foundation and not by the Scroll editorial team.