Lack of Proper Data, Harsh Impact on Poor: What Heatwave Death Tolls Indicate

It was around 7:30 pm on Tuesday, 18 June — Delhi’s hottest day in at least 55 years — when 53-year-old Vipin Tiwari, a security guard at a godown in West Delhi's Mayapuri Industrial area phase 1, suddenly collapsed.

Tiwari, who hailed from Uttar Pradesh's Azamgarh, was rushed to the Deen Dayal Upadhyay (DDU) hospital by labourers in the area, but he did not survive.

The 53-year-old is likely to have been a victim of a heatstroke, a police official from Mayapuri confirmed to The Quint.

(The Quint could not reach out to DDU officials on the matter.)

But Tiwari is not the only victim of India's brutal heatwave. Between March and June, there have been 110 confirmed heatstroke deaths and over 40,000 suspected cases, as per Health Ministry data.

The highest number of such deaths was reported from Uttar Pradesh (36), followed by Bihar (17), and Rajasthan (16), Associated Press reported.

“In my 13 years of experience as a doctor, I have not seen something like this. This is an unprecedented heatwave. I have signed several death certificates due to heat-related illness...” Dr Ajay Chauhan, head of the heat stroke unit at Dr Ram Manohar Lohia Hospital (RMLH) told The Quint.

How many Indians have succumbed to the high temperatures over the last decade? Why is obtaining reliable data such a persistent challenge? What are the policy changes needed to mitigate the impact of heat waves?

Rise In Heatwave Deaths, But No Reliable Data

According to the Indian Meteorological Department (IMD), a heatwave occurs if the maximum temperature reaches at least 40 degrees Celsius in the plains and at least 30 degrees Celsius in hilly areas.

In India, heat waves typically occur between the months of March to June, and in some cases, even extend till July.

The total average number of heatwave days annually has been steadily increasing each decade; from 90 in 1990-99 to 94 in 2000-09, and to 139 in 2010-2019, a EnviStats-IMD analysis showed.

The annual average heatwave days increased from 42 in 2020 to 190 in 2022, and took a dip in 2023 at 111 days. (Note: Average heat wave is calculated by totalling the average number of heatwave days in states.)

In 2024, however, in many states, heatwaves are lasting for as long as 10 to 20 days at a stretch, instead of the usual 4 to 8 days, IMD data showed.

The National Heat-Related Illness (HRI) and Death Surveillance under the NPCC-HH defines heat-related deaths as a death which exposure to high ambient temperature either caused the death or significantly contributed to it.

The diagnosis can be based on either the history of exposure to "high ambient temperature" or from the circumstances surrounding the death, investigative reports concerning environmental temperature, and/or measured antemortem body temperature at the time of collapse.

So, how many deaths from extreme heat stress have taken place in India?

To answer this, one must understand that there are wide divergences among numbers reported by various agencies such as the IMD (Ministry of Earth Sciences), the National Disaster Management Authority (NDMA), and the National Crime Records Bureau (NCRB).

While MoES reported only 6,270 deaths due to heat-related illnesses between 2012 and 2022, NCRB, which counts heat-related mortality among accidental deaths caused by forces of nature, reported close to double the figure at 11,882. The NDMA, meanwhile reported 7,952 during the same time period.

Though the data collected by IMD and NDMA show a sharp decline in the number of heat-related deaths since the implementation of Heat Action Plans (HAP), it has been showing a reversal of trends in the last five years.

In a reply to a Parliament question in 2023, the Health Ministry said it had information about just 33 heat-related deaths in 2022. However, the NCRB reported 730 deaths for 2022. In that same reply, the Health Ministry reported 264 heat-related deaths in the first six months of 2023.

The actual number, however, is likely to be much higher as heat-related deaths are often under-reported, experts believe.

Dileep Malvankar, Director of the Indian Institute of Public Health (IIPH) in Gandhinagar said:

"That there are two types of heatwave deaths – exertional, and non-exertional. Exertional deaths are caused by exertion in direct sunlight for long hours and inability to cool down by sweating. Non-exertional deaths occur among the most vulnerable section – mainly the elderly with co-morbidities. After dehydration, their kidneys, heart or brain start failing. There are chances that these people can die anywhere, even at home, or outside at work. Sadly, these deaths are not categorised as heat strokes and are hence, possibly not counted as heat deaths at all."

Dileep Malvankar to The Quint

Aravind Unni, an urban researcher working with informal workers told The Quint, "Unfortunately, just like during COVID-19, we are unable to count the deaths, because the State does not want it to come out. Because once it does, you will have to take very strong measures to curb the deaths... not counting deaths properly stops us from responding better to the crisis."

Informal Workers Most Susceptible To Heatwaves: Experts

With daily temperatures crossing 40-degree celsius in parts of North India including Delhi, it is the vast majority of the poor, who generally work outdoors, who face the brunt of it.

In Delhi, over 45 heatwave deaths were recorded— most of whom are believed to be construction/factory labourers, security guards, and street vendors, reports suggested.

"This year, most of the heatstroke cases we have received belong to the exertional category, which includes large number of labourers, gig workers, street vendors, rickshaw pullers, Dhaba workers, all of whom who belong to lower socio-economic background.

Dr Ajay Chauhan

While the Delhi Police has said that, in the last 48 hours, they have picked up as many as 50 bodies of homeless people, a total of 192 homeless people died due to heatwave in national capital of Delhi between June 11 to June 19, a report by the NGO Centre for Holistic Development stated.

Shalini Sinha, Asia Strategic Lead, Women in Informal Employment: Globalizing and Organising (WEIGO) told The Quint:

"Labourers start from an a disadvantaged position as they are informal workers, with minimal or zero job security, have irregular incomes, and work in unsafe worksites... Domestic workers are exposed to hot stoves, construction workers to the blazing sun. They are the ones who point to frequent heat-related illnesses like fatigue, dehydration, etc. This, along with pre-existing socio-economic and health vulnerabilities, makes the majority of workers more susceptible to heat waves."

Shalini Sinha

Agreeing with Sinha, Aravind Unni said that since workers do not have health insurances, "they will have to spend out of their pocket for medical treatment, and for protective gears, which is an additional expense."

Soon after Delhi reported its first heatwave death in May, Lieutenant Governor VK Saxena issued an advisory on paid breaks for labourers from noon to 3 pm, water and coconut water at construction sites.

"Even if the advisories reach the public, we need to ask what proportion of our population have the ability to heed those guidelines or access protection during extreme heat? Advisories not backed by strong implementation framework just remains on paper."

Shalini Sinha to The Quint

So, What Policy Changes Does India Need To Tackle Heatwave?

Focusing on crisis management, rather than on better preparedness, is at the root of the country’s failings, experts believed. “Sadly the approach is to wait and watch until the hazard turns into a disaster. When a crisis is recurring, you cannot call it 'unprecedented," Unni said.

Experts said that the heatwave deaths and illnesses reflect to inadequate warnings from authorities and a lack of infrastructure to protect people from extreme heat.

"The government failed to disseminated early warnings to the public about impending heatwaves using IMD forecasts. Protection begins with awareness and certain measures. Plus, hospitals need to be ready to receive and take care of such emergencies."

Dileep Malvankar to The Quint

Heat Action Plans (HAP) in India suggest a combination of measures to alert the public about heatwaves, and educating the public through campaigns, building heat shelters and cooling centres, and providing clean drinking water to avoid dehydration.

However, both Unni and Shalini Sinha believed that it was important to move away from an "ad hoc, instruction-based response" to a more focussed long-term measures of urban planning and climate action plans (CAPs).

"Our urban imagination needs to be reconfigured, especially in cities, so as to not only ensure water, shade, better infrastructure, transport to mitigate heatwave impacts, but also to find more ways of advancing workers’ rights in cities. Today, we wait for heatwaves to start killing people before we put a plan in place. This should change,"

Shalini Sinha to The Quint

Unni said that there was a need for system-wide protections for workers including compensation for loss of income, which requires state-intervention.

"Unless advisories have long-term plans with money and implementation mechanism and follow-ups, this is not going to work out. Again next year, people will die, but we will still not have responses or answers. That needs to change," he concluded.