Imagine losing your home and livelihood each year to devastating floods, being forced to live in makeshift refugee camps, eating meals of broken rice porridge, and enduring countless waterborne and infectious diseases without proper care. These are the realities of climate change in Northeast India.
What's most infuriating is that Northeast India, with per-capita emissions significantly lower than the national average, bears a disproportionate share of the repercussions of climate change. Every year, millions are displaced, and thousands lose their lives to the floods in Assam alone.
While we have been experiencing floods and cyclones for decades now, one additional suffering this year has been the heat waves. This summer, temperatures in Northeast India soared to 40°C—an extreme for the region. Unlike metro cities, most people here lack access to air coolers, making them vulnerable.
In all of these, the women of Northeast India face the harshest consequences of climate change. Whether while enduring the annual floods, the recent heatwaves, or the frequent hurricanes, women bear the double burden of gender inequality and the region’s vulnerability itself.
This summer, I was talking to one of my friends from home who was pregnant with her second child. Our conversation revolved around how her first pregnancy was different from the second one, and one of the most significant differences for her was the change in weather and the heat wave.
“I live in a house with a roof made of asbestos, and we never had an air cooler and neither it is possible for us to install one because of how our house has been made. It is already 40°C here. I feel like I am always palpitating and I am always irritated,” she said.
A study conducted in China indicates a strong association between heat exposure and a range of health complications, including kidney disease, mental health disorders, and gestational hypertension. The impact is especially intensified for pregnant and new mothers, who may face lifelong health challenges from heat-related stress.
One study conducted in a resource-limited environment in Kenya found that pregnant and lactating mothers residing in informal settlements or slums experience heightened health risks due to heat exposure. Living in these conditions perpetuates a cycle of vulnerability for populations already at an elevated risk, further magnifying the adverse health effects of extreme heat on this demographic. This increased burden often manifests in severe outcomes, such as preterm birth, reduced birthweight, congenital anomalies, and, in some cases, stillbirth.
These risks are particularly prevalent in regions where access to cooling systems like air conditioning is limited and where healthcare systems may lack the resources to address these growing challenges effectively. The healthcare infrastructure in many of these regions is already strained under the weight of infectious diseases and insufficient facilities, leaving vulnerable populations with minimal support against additional threats posed by rising temperatures.
A study suggests that rising heatwaves are intensifying the anaemia crisis among Indian women. Another study conducted in Northeast India showed around 40 percent of women in the region had anaemia (mild, moderate, or severe). The high prevalence of anaemia in women coupled with heatwaves only intensifies the vulnerability of women. Their social positioning often limits their access to adaptive resources, such as healthcare, sanitation, and proper shelter.
Additionally, these gendered burdens intersect with structural inequalities such as caste-based discrimination, intensifying the challenges for women from marginalised backgrounds. Lower-caste women, who are often confined to blue-collar or outdoor labour-intensive jobs, endure prolonged exposure to extreme temperatures.
The compounded impact of gender and caste-based inequalities highlights the urgent need for targeted interventions to address the vulnerabilities experienced by women in low-resource and socially marginalised communities. Initiatives and regulations that can help tackle heatwaves, ensure timely access to healthcare, improve living conditions, and provide cooling systems can significantly mitigate heat-related health risks for these groups.
Addressing these disparities requires a multi-faceted approach that not only tackles the immediate health effects of heat but also the broader social and economic factors contributing to these vulnerabilities.
A study from Bangladesh shows that the mortality rate associated with cyclone events is higher for women compared to the same for men. It also revealed a number of health challenges in women including post-natal health issues, urinary tract infections, trauma, anxiety, PTSD, and panic attacks. Hence, women bear a disproportionate burden even during cyclones, a recurrent natural disaster in Northeast India.
Frequent cyclones often lead to prolonged power outages in rural areas, disrupting access to essential services, such as potable water. In many households, women shoulder primary responsibility for daily tasks, including securing water for their families. This added demand, both during and following cyclones, exacerbates the already considerable challenges women face.
The scarcity of clean water disrupts everyday routines and impacts women’s menstrual health and hygiene practices. In rural Northeast India, women often rely on cloths during menstruation, yet limited access to water often forces them to reuse or use inadequately cleaned ones, heightening the risk of infections, with potentially long-lasting repercussions for their well-being.
Among the environmental challenges affecting Northeast Indian women, perhaps the most severe and persistent is annual flooding.
For decades, these floods have brought displacement and significant disruption, leaving enduring intergenerational traumas. The most horrifying of the stories I have encountered are the ones where women force themselves to starvation to avoid exposure to sexual violence when forced to relieve themselves in undesignated spaces. Some pregnant women give birth on boats, and flooding is also associated with increases in child marriage and trafficking.
One study shows that during flooding, the increased incidence of urinary tract infections (UTIs) presents serious health challenges for women. The stress associated with such disasters is worsened when women seek shelter in relief camps, where access to adequate sanitation is often limited.
In these environments, women frequently resort to using shared or inadequate toilet facilities, which can exacerbate their risk of developing UTIs. Additionally, many women lack access to menstrual hygiene supplies, forcing them to use unclean cloths.
Many of these relief camps are located in temples or other culturally restrictive spaces for menstruating women, resulting in social ostracism and consequently a reliance on unsanitary alternatives, which further compromises their health and dignity.
A report from the Eastern and Southern African region suggests that the impact of climate change on the frequency and severity of flooding events exacerbates gender inequalities.
Incidents of sexual violence against women during floods are strikingly high. During floods, people resort to open defecation because most of the infrastructure is either underwater or destroyed by floods.
One of the surveys conducted in flood-affected regions indicates that 67 percent of people resort to open defecation due to damaged or unavailable sanitation facilities. Research consistently links open defecation to increased risks of violence, particularly in the Indian context, where women are disproportionately vulnerable in these situations.
Though the data on school dropout rates due to flooding is limited, the compounded impacts of this burden likely exacerbate vulnerabilities, especially among young girls. Reports from Sub-Saharan Africa reveal that during these crises, families facing emotional, financial, and physical strain often prioritise survival over girls' education which in turn increases their risk of child marriage, labour, and trafficking. Human trafficking is alarmingly high in Northeast India and a leading newspaper has even described the region as a hub for human trafficking.
Additionally, one of Nature's studies has projected that NE India is “exceptionally susceptible to climate change, with notable projections of shifts in temperature, precipitation, and extreme weather events. These changes are likely to have significant impacts on water resources, agriculture, health, and infrastructure.”
This region requires focused attention, particularly in the realm of research and development. It's crucial to recognise the region's unique context and allocate resources accordingly.
Having been born and raised in Northeast India, I remain optimistic that we will return to enjoying the abundant greenery that sets this region apart, as well as a future where natural calamities are merely chapters in our history books.
(Shuma Banik is a global health professional and an MSc in International Health and Tropical Medicine from the University of Oxford.)
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