Heatwave Preparedness: Reducing Heat-Related Injuries in Kerala

In the heart of God’s Own Country, where the gentle monsoon rains are celebrated with joy, the rising temperatures and ensuing heatwaves present a stark and grave challenge. Kerala, with its verdant landscapes and tranquil backwaters, is now facing an environmental adversary that threatens the health and harmony of its people.

Heatwaves are not just a meteorological statistic; they are a public health emergency that can cripple the daily life of millions. The elderly, the young, the infirm, and even the healthy are at risk when the temperatures soar beyond the body’s capacity to cool itself. In recent years, Kerala has witnessed a worrying trend of increasing temperatures, and with it, the spectre of heat-related illnesses has loomed large. It is a silent crisis that unfolds in the shadows of our homes and streets, often unnoticed until it claims its victims.

As we stand on the cusp of another sweltering summer, it is imperative that we understand the magnitude of the threat and arm ourselves with knowledge and tools to combat it. Here are a few strategies that can be employed at various levels—from the individual to the government—to ensure that Kerala remains a safe haven for all its residents.

Understanding Heatwaves in Kerala

Heat waves in India mainly occur during March to June and sometimes in July, with May being the peak month. Heat waves generally occur over the plains of northwest India, Central, East, and north Peninsular India. States like Punjab, Haryana, Delhi, Uttar Pradesh, Bihar, Jharkhand, West Bengal, Odisha, Madhya Pradesh, Rajasthan, Gujarat, parts of Maharashtra & Karnataka, Andhra Pradesh, and Telangana are prone to heat waves.

Kerala, known for its tropical climate, is increasingly experiencing intense heatwaves. These periods of extreme heat can lead to significant health risks, particularly for vulnerable populations such as the elderly, children, and those with chronic health conditions. The Kerala State Disaster Management Authority (KSDMA) has been proactive in issuing heatwave warnings and advocating for community preparedness. In recent times, Kerala has seen a rise in temperatures, with certain districts like Ernakulam, Thrissur, and Kozhikode experiencing temperatures up to 37 degrees Celsius.

Heatwaves are defined as periods of abnormally high temperatures that persist for two or more days. They are silent killers, often underestimated in their potential to cause widespread health emergencies. The India Meteorological Department (IMD) classifies a heatwave based on temperature thresholds that are region-specific. For instance, in the plains, a heatwave is declared when temperatures exceed 40°C, while in hilly regions, the threshold is 30°C. The severity of a heatwave is determined by how much the temperature exceeds the average seasonal temperature, with severe heatwaves occurring when temperatures are 6.4°C above normal or reach a scorching 47°C. Furthermore the high humidity levels typical of our coastal state further exacerbate the situation, leading to a higher incidence of heat-related illnesses.

Heat related injuries

The human body is resilient, yet not invincible against the relentless heat. Vulnerable populations, including the elderly, infants, outdoor workers, and those with pre-existing health conditions, are at a higher risk. Heat-related illnesses range from mild conditions like heat cramps to life-threatening heatstrokes.

Heat Cramps: The mildest form of heat injury, heat cramps, are muscle spasms that typically occur in the legs or abdomen. They are often the result of heavy sweating during intense exercise, leading to a loss of fluids and electrolytes.

Heat Exhaustion:A more serious condition, heat exhaustion, arises from a significant loss of water and salts from the body. Symptoms include heavy sweating, dizziness, fatigue, weak and rapid pulse, muscle cramps, and headaches. If you or someone you know is experiencing these symptoms, it is crucial to move to a cooler place, drink water and rest. If symptoms worsen or do not improve, medical attention should be sought.

Heatstroke: The most severe form of heat injury, heatstroke, occurs when the body’s temperature rises above 104°F (40°C) and the body’s heat-regulating system fails. Symptoms include hot, dry skin or profuse sweating, hallucinations, chills, throbbing headache, high body temperature, confusion/dizziness, and slurred speech. Heatstroke is a life-threatening emergency; call for immediate medical assistance if these symptoms are present.

Strategies to Reduce Heat Related Injuries

As Kerala grapples with the increasing frequency and intensity of heatwaves, it is crucial to adopt a multi-faceted approach to reduce heat-related injuries. Here outlined are a few strategies that individuals, communities, and the government can explore to mitigate the impact of these heatwaves.

Individual-Level Strategies

Hydration: The cornerstone of heatwave preparedness is staying hydrated. Individuals should aim to drink at least 2-3 litres of water daily, even if they do not feel thirsty. Those who are exposed to the heat should hydrate before, during and after work. Being hydrated when you start to work makes it easier to stay hydrated through the day. Drink before feeling thirsty. By the time you feel thirsty, you are already behind in fluid replenishment. Dehydration is a primary contributor to heat exhaustion. When working in the heat, try to drink at least a cup of water every 15-20 mins which approximates to about a litre of water in an hour. Drinking water at shorter intervals is more effective than drinking large amounts infrequently. Traditional hydrating drinks like ‘sambharam’ (spiced buttermilk), lime juice (with added salt) and coconut water, which are rich in electrolytes, can be particularly beneficial.

Avoid consuming energy drinks often. Some energy drinks contain much more caffeine than standard servings of coffee, tea or soft drinks. Drinking several energy drinks per day can raise your caffeine levels to affect your heart. High caffeine levels can be risky when added to the strain placed on your body by heat. Needless to say, consuming alcohol within 24 hrs of working in the heat can cause dehydration and increase the risk of heat illness.

Appropriate Clothing: Wearing light-colored, loose-fitting clothing made of natural fibers like cotton facilitates the evaporation of sweat, aiding the body’s natural cooling process.

Sun Protection:Using wide-brimmed hats, umbrellas, and applying sunscreen can protect the skin from harmful UV rays and prevent sunburn, which can exacerbate heat stress.

Cooling Techniques:Simple measures like using damp cloths on the skin, taking frequent cool showers, and using fans can help lower body temperature. Avoiding strenuous activities during the hottest parts of the day (12 pm to 3 pm) is also advised.

Household-Level Strategies

Ventilation: Proper ventilation is key to maintaining a cooler home environment. Opening windows during cooler hours and using fans can help circulate air and dissipate heat.

Shading: Utilizing curtains, blinds, or external shades to block direct sunlight can significantly reduce indoor temperatures. Planting trees or shrubs near windows can provide natural shade.

Cool Roofs: Applying reflective paint or installing green roofs reduces the amount of heat absorbed by the building thereby keeping indoor spaces cooler.

Insulation: Proper insulation of walls and roofs can prevent heat from entering living spaces, maintaining a more comfortable indoor temperature.

Community-Level Strategies

Greening: Planting trees and creating green spaces not only provide shade and cooling but also improve air quality. Community gardens and parks can serve as oases during heatwaves.

Awareness Campaigns:Educating the public about the risks of heatwaves and how to stay safe is vital. Campaigns should focus on recognizing the signs of heat-related illnesses and the importance of staying hydrated and cool.

Cooling Centers:Establishing cooling centers in places like community halls, schools, and public places can provide relief for those without access to air conditioning.

Governmental Initiatives

Heat Action Plans:Developing comprehensive heat action plans that include early warning systems, public awareness campaigns, and emergency medical services is essential for preparedness and response.

Building Codes:Implementing building codes that require heat-reducing features can ensure that new constructions are better equipped to handle high temperatures.

Public Health Services:Strengthening public health services to respond effectively to heat-related emergencies can save lives. This includes training healthcare workers and ensuring that medical facilities are prepared for an influx of heat-related cases.

In conclusion, as the sun sets on another day in Kerala, let us reflect on the lessons learned and the tasks ahead. In the face of rising temperatures and the increasing occurrence of heatwaves, Kerala stands at a critical juncture. The strategies and measures we adopt today will define our resilience and capacity to protect the health and well-being of our communities tomorrow. While heatwaves are a natural phenomenon, their impact is exacerbated by human activity and urban development. Therefore, it is within our power to mitigate these effects through strategic planning and proactive measures. We must focus on enhancing public awareness, improving our infrastructure to cope with high temperatures, and ensuring that our emergency response systems are robust and efficient. The strategies outlined in this article are not just recommendations; they are necessary actions that require the commitment of individuals, communities, and government agencies alike. By working together, we can ensure that Kerala remains a place where life thrives, even in the face of challenging climatic conditions.

Dr. Binoy Xavier

Consultant & HOD

Department of Emergency & Trauma Care

Apollo Adlux Hospital, Angamaly.