Meltdown 2016

'Heart attack (not sunstroke)': Telangana may be undercounting heat deaths

The negligence of officials is making it difficult for people whose relatives have died of sunstroke to claim compensation.

At the beginning of April, as temperatures soared in Telangana, the state government released a report saying that 66 people had died because of the heat wave. Two weeks later, it backtracked, pegging the number at just 19 instead.

The government’s explanation was reasonable. The numbers reported initially were based on reports in newspapers and gathered from villages and towns to the office of the mandal, as tehsils are referred to in Telangana.

But fixing an accurate number is vital because families of victims of sunstroke – a condition when the body overheats and critical organ functions collapse because of exposure to the sun – are entitled to government compensation of Rs 50,000. On Friday, Chief Minister K Chandrashekar Rao announced that victims of any age, not just between 18 and 65 years as previously specified, would be eligible for this compensation.

To facilitate this compensation, the government has set up three-person committees in each mandal to investigate these deaths. The committees, consisting of the mandal revenue officer or tahsildar, the medical and health officer and the sub inspector of police, are supposed to verify reported cases of sunstrokes. This process is still continuing.

This is the second consecutive year of a heat wave in Telangana. Last year, 585 deaths from sunstroke were confirmed in this state. This year, as temperatures have crossed 46 degrees Celsius in some places, 366 of 585 deaths of reported sunstroke have been inquired into and 131 confirmed.

But this official number seems to underestimate the actual number of heatwave casualties in the state since it only focuses on deaths by sunstroke. Deaths that have been caused by underlying health issues aggravated by the heat are uncounted since they are impossible to verify, said Vinod Ekbote, Assistant Commissioner of Telangana's disaster management department.

However, even when considering just sunstroke deaths, disturbing questions emerge about how exactly these cases are being recorded and whether the numbers are indeed far higher than what the government has counted. That became clear as took at look at the working list of the collectorate of Mahbubnagar, the Telangana distrct where until recently the largest number of suspected heat-related deaths has taken place.

A mysterious lapse

Mahbubnagar is a district from which migrants span out across India. Sunder Raj, 45, was one of them. As a manual labourer who has spent his life doing work in other parts of the country, he decided to remain in his village in Mahbubnagar’s Maldakal mandal with his wife Sathyamma, 37, this year to see if they could make their living there.

On the morning of March 30, Sunder Raj told his wife to stay at home while he went out to fetch firewood for her cooking. He left at 10.30 am and returned home at 3 pm. The temperature reported by the India Meteorological Department in Mahbubnagar that day was 40 degrees. On his return, he said he was feeling weak and thirsty and asked for water three times. He also had fever and vomited. That night, Sunder Raj went to sleep and did not wake up in the morning.

Sunder Raj’s symptoms might align with those of sunstroke, but according to the government, he died due to toddy consumption. There have been no cases of spurious liquor deaths in his village, Kurthiravulachervu. As for liver trouble, his family says that he drank toddy only occasionally.

“Allah does this only to gareeb log, not ration log,” Sathyamma said, contrasting the truly unfortunate with the better-off people who at least have ration cards. “We worked ten years to build this house and only this year he said let us try working here. So we did that and now he has gone.”

Sathyamma, 37, a migrant worker living in Kurthiravulachervu, Mahbubnagar. Photo: Mridula Chari
Sathyamma, 37, a migrant worker living in Kurthiravulachervu, Mahbubnagar. Photo: Mridula Chari

Complicating the matte, Sathyamma and her relatives say that no government official ever visited her family to record their testimony. Village sarpanch Patel Sulochanamma said the mandal’s auxiliary nurse midwife enquired about Sunder Raj’s death over the phone, but did not visit the village. The sarpanch said that she reported that he had died due to sunstroke.

Somewhere between this phone call and the final report filed with the tehsildar’s office, this cause of death changed. Srinivasa Chari, deputy tehsildar of Maldakal mandal, was unable to explain the lapse in the revenue office’s records.

More dodgy reports

The entire list in this district seems to be populated with such mysteries.

Dubbanna, 60, who went to grind jowar in the weekly market and to collect his weekly pension in the blazing heat of April 2 and who died with the symptoms of sunstroke the next day, was recorded to have died of natural causes.

Boya Chinna Raju, 29, of Dhanwada, is recorded as having died of “consumption of alcohol/tobacco chewing”. Also in Dhanwada was Billakala Balaiah, 65, who died of “consumption of alcohol, paralysis & old age” all together. Patlavath Jamulamma, 66, a resident of Ammapally village in Pebbair, died of “dehydration (not sunstroke)”.

T Munnaiah, 31, a resident of Pebbair, is recorded as having died of a heart attack, not a sunstroke. Munnaiah was a field assistant for the National Rural Guarantee Scheme, in charge of 103 groups in the mandal. Each day, he would take attendance for up to 20 groups, travelling from one work site to another on his motorbike.

As a mitigation measure for the heat wave, the Telangana government had announced that it would stop employment guarantee scheme work between noon and 3 pm.

“He had been working very hard for three days continuously,” said journalist P Raju, Munnaiah’s best friend. “Because of the changed timings, he felt that he would have to complete work even faster and tried to cover more places in less time.”

On April 6, Munnaiah finished his attendance work at 11, but wanted to give the data to the office so he worked there until the afternoon. On his return, he complained of a headache. That night, he slept on the roof, but he woke up at 6 am with convulsions and high fever. His family took him to a private hospital in Pebbair, then another one in Kurnool and finally to a government hospital in Kurnool, where doctors give him seven packets of saline intravenously. By 6 pm on April 7, he was dead.

No government official visited his family to record their testimony, though local MLA Chenna Reddy came to speak to them and the sarpanch of Pebbair promised that he would recommend that Munnaiah’s wife be appointed as a field assistant in her husband’s place.

T Chennamma, 50, mother of T Munnaiah, and T Anjanaiah, his younger brother. 'He used to leave at 7 am and return only at 6 pm,' she said. 'When it came to work, he never looked at the time. He was always in touch with EGS workers even when at home.' Photo: Mridula Chari
T Chennamma, 50, mother of T Munnaiah, and T Anjanaiah, his younger brother. 'He used to leave at 7 am and return only at 6 pm,' she said. 'When it came to work, he never looked at the time. He was always in touch with EGS workers even when at home.' Photo: Mridula Chari

This is indeed what seems to be common to the families visited – news of their relatives' deaths had either been featured in local newspapers or they had been visited by politicians.

Even people whose deaths due to sunstroke had been confirmed by these committees said that they had not actually been visited by any government official.

This was the case with Sheshamma, 66, a resident of Chelimilla in Pebbair, who went to attend a festival in a neighbouring village on April 7 and died after too much exposure to the sun. This was also confirmed by the family of Kavali Narasimha, 68, a daily wage labourer from the same village. Narasimha died after taking his two goats to graze in a nearby field on the afternoon of April 6, in the face of his family’s requesting him not to do so. He had bought the goats just a week before his death. On the morning of’s visit to Chelimilla, a third person had died after exposure to the sun.

Cold response

It is possible that some of these official reports have been prepared with due diligence and the causes of death recorded by the authorities are indeed genuine. visited six families of the 69 people in Mahbubnagar whose deaths were being examined for evidence of sunstrokes. Of these, only one had been visited by a government officer, and that too, by a revenue inspector and an auxiliary nurse midwife.

Anupama James, Medical and Health Officer of Pebbair, where the largest number of deaths in Mahbubnagar has been recorded, said that she did not have on file any reports of the midwives or Asha workers who had been sent out to record their statements.

“When people work in the fields, there is dehydration,” James said. “Deaths happen when this is not taken care of by the people. They are negligent and do not take enough minerals or vitamins. Most of these cases are actually manipulated by the families.”

People who succumb to heat, whether because of underlying conditions or dehydration at that moment or because the temperature has already touched 45 degrees in Mahbubnagar in April, are very often poor.

Like countless migrants, Sathyamma, the wife of manual labourer Sunder Raj, is desperately poor. She has no official documents, not even a Below Poverty Line card or a job card under the National Rural Employment Guarantee Scheme. She applied for an Aadhar card only after her husband died.

While she worked as in the beedi industry in Gadwal and Wanaparthy and even in places as far as Mumbai and Madhya Pradesh, Sathyamma now plans to remain in her village for some time. Her oldest son, who works on the sarpanch’s farm and is the only breadwinner of the family, broke his leg a month ago. He is only 14.

Most of the people on the government list are Dalit or backward-caste daily wage labourers attached to the National Rural Employment Guarantee Scheme or people below the poverty line. None of the families visited by knew that they were eligible for government compensation of any kind.

Official response

District Medical and Health Officer, P Parvathi, said that she was unaware that reports were being compiled without any officials actually visiting the affected families and that she would look into the matter. According to her, the midwives and medical health officers were overworked and spread too thin, which could explain the discrepancies.

“It is also possible that ANMs [auxiliary nurse midwives] are confusing the symptoms of heart attack and sunstroke,” she said.

AD Ramesh, sub inspector of police at Pebbair in Mahbubnagar, said that no police representative had gone to verify whether these were indeed cases of sunstroke as he had received no instructions to this effect.

“We did not know there was a three-member committee,” Ramesh said. “We just sign what the MRO [mandal revenue officer, or tehsildar] sends us. But I came only a week ago after training so I have no exact idea of this.”

Joint collector of Mahbubnagar, Ram Kishan, said that he was aware there were certain lapses in how the reports were filed. Just two days before this reporter spoke to him, he said, he had sent the superintendent of police a stern message to ensure that station house officers do indeed accompany the three-member committee on their investigations.

This is the first of a two-part series on the heat wave in Telangana. Read the second part here.

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