Heat wave

How a timely alert helped Karachi cool a deadly heatwave threat

This was the first warning of its kind issued by the Pakistan Meteorological Department.

When an unseasonal and potentially deadly heatwave loomed on weather forecasts last month, authorities in this port city took an unusual step: they issued a public warning a full week in advance.

Before the heat hit, text message warning of the danger went out to Karachi residents. Hospitals set aside extra beds for heat stroke victims. Water and power company officials were put on alert.

Ultimately the heatwave, with temperatures that reached 41 degrees Celsius, passed without claiming lives, Karachi Mayor Waseem Akhtar said.

But the warning – the first of its kind issued by the Pakistan Meteorological Department for Karachi – may set the stage for more lifesaving warnings next summer as climate change drives temperatures higher.

October temperatures in densely populated Karachi normally rise no higher than 35℃ or 38℃, said Abdul Rashid, director of the Pakistan Meteorological Department office in Karachi. Heatwaves in October are “extremely rare incidents”, he said.

But being unprepared for extreme heat can be deadly.

In 2015, a June heatwave killed about 1,500 people in Karachi, Pakistan’s largest city, and left over 70,000 hospitalised, most with heat stroke.

Officials are now working to try to avoid a repeat of that heat disaster – a particular challenge as climate change brings ever-hotter years, particularly in already boiling South Asia.

“We now keep a closer watch on temperature, air, humidity (and) sunlight parameters of the Bay of Bengal and Arabian Sea, and register these parameters regularly in the weather charts, which helped predict the October heat wave more accurately and timely,” Rashid, of the met office, told the Thomson Reuters Foundation.

The Karachi office also has its own heatwave forecast division, with advanced computer systems connected to five heatwave monitoring stations recently installed around the city, he said.

The system was set up following World Meteorological Organisation warnings that more frequent and intense heatwaves were becoming a possibility in the region.

Warning, then action

In October, after spotting heat-producing weather conditions moving toward Pakistan from Mumbai and India’s Gujarat state, the office issued a warning to the Sind provincial government, the Karachi commissioner and provincial disaster management authorities, Rashid said.

For Karachi’s mayor, the alert provided time to send out text alerts, contact media, warn hospitals and water and power utility officials and set up special units for heat victims in 13 city hospitals.

Dr Seemi Jamali, head of emergencies at the state-run Jinnah Postgraduate Medical Centre in Karachi, said the warning gave time to stock extra medicine, set aside beds and put medical staff on high alert.

“This really helped quickly arrange medical care facilities in hospitals for heat wave victims and avoid possible deaths,” she said in an interview in her office.

Residents of Karachi said the unusual October heat is a worry.

“Octobers have remained always warm in the port city, but I never experienced this blistering heatwave in all my life in this month, which made our home feel like a furnace,” said Saba Karim, a 43-year-old garment factory worker. “We all five family members, including my husband, stayed indoors during the heatwave days and would go outside only during night hours to buy groceries.”

Ghulam Rasul, head of the Pakistan Meteorological Department in Pakistan, said the country may be seeing a change in its traditional pattern of onshore winds blowing cooler air into Karachi over the summer months.

The lack of that wind was one driver behind Karachi’s October heatwave, he said.

“Temperatures in the Arabian Sea are showing gradual rising trends for the last six years because of strange weather patterns, which mostly likely increase the frequency and intensity of cyclones, heatwaves, and torrential rains in months in which these were never or rarely seen before,” said Rasul, who is also Pakistan’s permanent representative to the World Meteorological Organization.

This article first appeared on Thomas Reuters Foundation News.

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There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

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  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

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This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.