A heatwave is like the COVID-19 virus. During the pandemic, the virus infected and killed many people. When vaccines became available, the mortality rate dropped even though the virus continued to spread. But vaccines weren’t the only way to keep people from dying. The COVID-19 virus killed more people if the people were already unhealthy

In India, an important cause for people being unhealthy is the state itself. In many places, the roads are poorly laid, kicking dust exposed by traffic use up into the air, where it joins the PM2.5 particles emitted by industrial facilities allowed to set up shop near residential and commercial areas without proper emission controls. If this is one extreme, becauses these experiences are so common for so many Indians, at the other is the state’s apathy towards public health. India’s doctor-to-patient ratio is dismal; hospitals are understaffed and under-equipped; drug quality is so uneven as to be a gamble; insurance coverage is iffy and unclear; privatisation is increasing; and the national government’s financial contribution towards public health is in free fall.

For these reasons as well, and not just because of vaccine availability or coverage, the COVID-19 virus killed more people than it should have been able to. A person’s vulnerability to this or any other infection is thus determined by their well-being — which is affected both by explicit factors like a new pathogen in the population and implicit factors like the quality of healthcare they have been able to access.

A heatwave resembles the virus for the same reason: a person’s vulnerability to high heat is determined by their well-being — which in turn is affected by the amount of ambient heat and relative humidity as well as the extent to which they are able to evade the effects of that combination. This weekend, a new investigative effort by a team of journalists at The Hindu (including me) has reported just this fact, but for the first time with ground-zero details that people in general, and perhaps even the Tamil Nadu government itself, have thus far only presumed to be the case. Read it online, in the e-paper or in today’s newspaper.

The fundamental issues are two-pronged. First, Tamil Nadu’s policies on protecting people during heatwaves require the weather department to have declared a heatwave to apply. Second, even when there is no heatwave, many people but especially the poorer consistently suffer heatwave conditions. (Note: I’m criticising Tamil Nadu here because it’s my state of residence and equally because it’s one of a few states actually paying as much attention to economic growth as it is to public health, of which heat safety is an important part.)

The net effect is for people to suffer their private but nonetheless very real heatwave conditions without enjoying the support the state has promised for people in these conditions. The criticism also indicts the state for falling short on enforcing other heat-related policies that leave the vulnerable even more stranded.

The corresponding measures include (i) access to clean toilets, a lack of which forces people — but especially women, who can’t urinate in public the way men are known to — to drink less water and suppress their urges to urinate, risking urinary tract infections; (ii) access to clean and cool drinking water, a paucity of which forces people to pay out of their pockets to buy chilled water or beverages, reducing the amount of money they have left for medical expenses as well as risking the ill health that comes with consuming aerated and/or sugary beverages; and (ii) state-built quarters that pay meaningful attention to ventilating living spaces, which when skipped exposes people to humidity levels that prevent their bodies from cooling by sweating, rendering them more susceptible to heat-related illnesses.

And as The Hindu team revealed, these forms of suffering are already playing out.

The India Meteorological Department defines a heatwave based on how much the temperature deviates from a historical average. But this is a strictly meteorological definition that doesn’t account for the way class differences create heatwave-like conditions. These conditions kick in as a combination of temperature and humidity, and as the report shows, even normal temperature can induce them if the relative humidity is higher and/or if an individual is unable to cool themselves. The state has a significant role to play in the latter. Right now, it needs to abandon the strictly meteorological definition of heatwaves in its policy framework and instead develop a more holistic sociological definition.

Featured image credit: Austin Curtis/Unsplash.

The maximum daytime temperatures in the Kalaburagi and Belagavi districts of Karnataka this week are expected to be 41º C and in the late 30sº C, respectively. Research has found that if the relative humidity is high enough to render a wet-bulb temperature exceeding 30º C, outdoor exposure of even a few minutes can prove fatal.

Yet many workers, especially in the country’s informal sector, routinely work outdoors in extreme heat with poor access to clean cool water, breaks from work, and medical attention. State-level policies and district-level heat-action plans are crucial to catch individuals who ‘slip’ through the protections available to the formal labour force.

In this spirit, Tamil Nadu and Telangana recently notified extreme heat as a state-specific disaster. Earlier this month, Karnataka also said government offices would close by 1.30 pm in April and May and that workers employed under the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) in the Kalaburagi and Belagavi revenue divisions — comprising 14 districts — would receive a workload concession of 30% without any reduction in wages. From The Hindu:

“Labourers who work in open fields during the summer months are advised to take precautions such as wearing loose cotton clothes and consuming buttermilk, coconut water, and green vegetables instead of spicy food, tea, coffee, and junk food. They should drink enough clean water. The officers concerned are also directed to provide the workers with clean drinking water, first aid box, tent, and other basic facilities at the MGNREGA worksite,” [State Rural Development and Panchayat Raj Minister Priyank Kharge] said in a press note.

The decision aims to protect rural labourers from the harshest heat during working hours.

These initiatives are all on the right track because they’re cognisant of the fact that climate change will force the cost of economic growth to increase. For example, sans the concession granted by Karnataka — a notably substantive state-level policy for working in less-than-ideal conditions — workers may have had to set aside a larger fraction of their incomes to pay for medical care for heat-related injuries.

However, some media outlets have since cited a recent survey by a non-governmental organisation, ActionAid India, to report that many workers in Belagavi were unaware of the state’s announcement nor had been accorded the promised infrastructure. From Deccan Herald:

Out of 124 recently surveyed workers in 10 villages from Chikkodi taluk, Belagavi, 72.5 per cent of people work between 10 am and 5 pm and in 68.5 per cent of cases, no tented or shaded areas were provided where workers could take a break. …

In Raichur, where temperatures in the day can reach anywhere between 42 to 45 degrees Celsius, Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) workers continue to start their shifts only at 10 am, working through peak-time heat. …

Additionally, considering extreme heat conditions, the government had announced a 30 per cent concession on workload, with full payment, for workers in the Belagavi and Kalaburagi revenue divisions. This includes Belagavi, Dharwad, Gadag, Haveri, Bagalkot, Vijayapura, Uttara Kannada, Bidar, Kalaburagi, Raichur, Yadgir, Koppal, Ballari and Vijayanagar. However, the survey notes that 75 per cent of surveyed workers were not aware of such a provision and were not provided with any concession.

“We have found that when such workload concessions are announced, only those who are aware and ask are provided with concessions,” says Mahantesh Hosamani, an activist from Bagalkot.

Aside from leaving the Act’s beneficiaries bereft of social protections, the lacuna recalls that the enforcement of state- and district-level plans remains at the mercy of local bureaucrats and that there is no democratic mechanism to ensure state governments keep their promises. In this way, the additional cost imposed by extreme weather is passed to a population already dangerously vulnerable to high heat and the social welfare dimensions of climate adaptation efforts continue to stay on paper. As science journalist Mahima Jain reported in Mongabay India in 2022:

Despite the strong evidence of climate impacts, the state and central governments are not ready to combat these issues as there are institutional changes required to fight against, Prakash said. … During summer, workers avoid working in the heat by starting before dawn and finishing by late mornings. “We need an MGNREGS plus. We need to move on from such a knee-jerk solution, as this can’t go on for years. People need to be upskilled, we need agro-based or other industries set up in the vulnerable areas so that people have alternate employment,” Prakash explained…

Goswami too said that during heatwaves, the nature of work has to change. “We need to provide work which can be done in some shade. The working conditions are inhuman. How does one work in 49-50C?” he asked. Prakash explained, currently none of India’s social protection programmes have a climate angle. These are general programmes protecting people from different vulnerabilities. But given India’s diverse ecological zones, the impacts are different, and a one-size fits all social protection programme won’t work, and there’s a need to re-evaluate programmes from a climate lens.

Ultimately, the Act’s goals are themselves ill-served. To quote developmental economist Gerry Rodgers writing in Economic and Political Weekly in 2024:

… [MGNREGA] was an important part of Indira Gandhi’s 20-point programme to eliminate poverty in the early 1970s. Later in that decade, the Maharashtra Employment Guarantee Scheme changed the underlying premise from one of emergency relief to one of the right to employment, with the obligation of the state to satisfy that right. But that too was not new. The notion of the right to work has a venerable history. It is a key element of Gandhian philosophy, it is addressed in the Indian Constitution, and it is included in the United Nations International Covenant on Economic, Social and Cultural Rights. …

In the literature and news reports, there are also suggestions that the MGNREGA has also been used by the central government as an instrument of pressure on states governed by opposition parties, for instance, delaying allocations; or that it has been used as a vehicle to support other state policies, such as financial digitalisation or the extension of the Aadhaar card system, even when these interfered with the operation of the MGNREGA programme. Another important question about a programme such as MGNREGA is how well it integrates with other government social and redistributional policies.

Today, rather than epitomise the ‘right to employment’, and thanks to the Centre’s repeated interference with its conduct and both the Union and state governments’ failure to upskill workers to look for less injurious employment, its workers now risk a ‘right to exploitation’.

From ‘Tamil Nadu heatwave policy is only a start’, The Hindu, November 21, 2024:

Estimates of a heatwave’s deadliness are typically based on the extent to which the ambient temperature deviates from the historical average at a specific location and the number of lives lost during and because of the heatwave. This is a tricky, even devious, combination as illustrated by the accompanying rider: “to the reasonable exclusion of other causes of hyperthermia”.

A heatwave injures and/or kills by first pushing more vulnerable people over the edge; the less vulnerable are further down the line. The new policy is presumably designed to help the State catch those whose risk exposure the State has not been able to mitigate in time. However, the goal should be to altogether reduce the number of people requiring such catching. The policy lacks the instruments to guide the State toward this outcome.