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As The Scorching Heat Wave In India Kills Many, Is The Govt. Prepared For Action?

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By Shreeshan Venkatesh:

Note: This article has been republished from Down To Earth.

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Image credit: DTE/Sunil Kumar Singh.

For the first time in its 140 year history, the India Meteorological Department (IMD) has issued temperature advisories for heat waves from April to June. The advisories include an early warning, akin to the ones issued for heavy rains and cyclones. The forecast is for 15 days at a time, with updates every fifth day. It also includes specific temperature forecasts and alerts for up to 100 cities and towns across the country.

While governments and researchers have focussed on the changes in monsoon patterns due to climate change, efforts to counter the impacts of heat waves had been virtually non-existent. The National Disaster Management Act, 2005, and the National Policy on Disaster Management, 2009, do not consider them to be a natural calamity.

The government, therefore, does not devote financial and infrastructure resources to the problem. This despite the fact that heat waves are the third biggest cause of death in India (see ‘Natural killers’). According to the National Crime Records Bureau, heat strokes caused 16,000 deaths between 2000 and 2014. Just in 2015, an abnormally long heat wave caused over 2,241 deaths in the country. With El Niño expected to be on the wane this year, the heat during summers in India (and in large parts of Asia, Australia and southern Africa) is likely to be severe.

With researchers predicting that heat waves will become increasingly severe and frequent, government agencies at Central, state and local levels have begun to take note of the problem. “We now have the capacity to issue city-specific forecasts, alerts and warnings and plan to roll out an expansion to several cities in the near future. While the advisories can help improve vital services in agriculture, processed foods, water and energy, the biggest benefit would be the support they will provide to healthcare professionals and the public health system during heat waves,” says Sivananda Pai, head of the Long Range Forecasting division at IMD.

Since heat waves are often caused by a combination of local and large-scale climatic factors and are captured more accurately with localised forecasts, city-specific advisories are likely to be a great help for the agencies involved.

States Take The Lead

Initiatives to deal with heat waves have mostly come from state governments. For instance, following the devastating heat wave of 1998, which claimed over 2,000 lives in Odisha, the state put in place district-level disaster management centres. Similarly, after the 2010 heat wave that caused 1,344 deaths in Ahmedabad, a City Heat Action Plan was launched in 2013 to improve public awareness and promote inter-agency coordination. In mid-March this year, Nagpur and Bhubaneshwar also launched their own city-level plans.

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“The experience with Ahmedabad has been very positive. Local authorities are increasingly realising the requirement of a plan. City-specific data from IMD will immensely help in generating warnings and predicting heat waves because it allows better use of vital local factors such as humidity. In coming years, there are several new cities that we will assist in making such a plan,” says Anjali Jaiswal, director of the India Initiative at New York-based non-profit Natural Resources Defense Council. The non-profit has been a consulting partner in all the three action plans (Ahmedabad, Nagpur, Bhubaneshwar) that have been devised so far in the country.

A Difficult Link To Prove

The difficulty in linking mortality to heat wave makes the task of formulating and implementing relief measures difficult. For instance, Andhra Pradesh announced a compensation of Rs. one lakh to the kin of those who had died in the heat wave last year. But a majority of the families were denied the compensation on the ground that the heat wave could not be established as the cause of death.

“Medical practitioners determine the cause of death on the basis of most evident symptoms, which may be of some underlying condition. They often fail to recognise the role of heat. For example, a person with cardiac problem would be adjudged to have died of a cardiac arrest even if the cardiac arrest was caused by exposure to heat,” explains Dileep Mavalankar, director of the Indian Institute of Public Health, Ahmedabad. “The best way to ascertain the link is to check the body temperature soon after death and analyse for any correlation between heat and mortality,” he adds.

The difficulty in linking cause of death and with heat waves has led to a huge underestimation of heat wave-related deaths in the country. This could also be the reason for the huge discrepancy in the number of deaths associated with the disastrous 2003 heat wave that struck Europe and killed over 70,000 and the 2015 Indian heat wave in which 2,241 people died. Both the events were of comparable duration and intensity.

In government records only deaths due to ‘heat strokes’ and ‘heat exhaustion’ are counted as heat wave deaths. Heat, however, can cause death in several ways—from organ failures to strokes.

“Heat strokes can be either exertional or non-exertional. Exertional strokes happen due to physical exertion in intense heat and the effect is immediate. But non-exertional strokes are caused by stress on internal organs due to constant exposure to heat. They exacerbate existing medical conditions and the effects are not immediate. Due to a time lag between the death and the heat wave, the link is less apparent and more difficult to establish,” explains Mavalankar.

Experts also say that the most common victims of heat waves are also the ones that are least likely to benefit from government initiatives. “We have found that slum dwellers and labourers in big cities are the most susceptible group. They are also least likely to enjoy the benefits of action plans and technological innovations,” says Vimal Mishra, associate professor at the Indian Institute of Technology, Gandhinagar. Mishra has extensively studied trends and health impacts of heat waves. “Unless relief measures target them, we cannot hope to curb deaths due to heat waves,” he sums up.

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

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Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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