In the aftermath of a devastating heat wave in Karachi, Pakistan, CKDN held consultations with key stakeholders to assist the city in heat wave management.  Zofeen T. Ebrahim, a freelance journalist based in Karachi with an interest in environmental issues, reports on the event and next steps.

In the heatwave that hit Karachi, Pakistan in June 2015, a majority of those who perished were the poor, the elderly, outdoor labourers and the homeless. Half of them were women. 

Temperatures rose to 44.8 degrees Celsius, dropped slightly and then shot back up to 45 degrees putting millions in this mega-city at risk of heat stroke.

The extreme heat resulted in the death of over 1,200 people. This extreme weather phenomenon which scientists have termed an "urban heat island" (making 45-degree temperatures feel like 50-degree heat) and which are predicted to become more frequent and more intense due to climate change has raised questions around factors that contributed to the high death toll, the vulnerable populations and if any lessons were learned on how to reduce the health impacts in the face of future heat waves.

At the same time it also raised questions about resilience and urbanisation. By 2011, nearly 3.6 billion (50 % of human population) people were living in cities and by 2050 it is projected to rise to 6.3 billion.

Karachi, with a population of an estimated 24 million is already in the throes of rapid urbanisation and is witnessing an unprecedented concentration of people living in slums. Once a sleepy little town by the sea, today, 55 per cent of its population lives in informal and unplanned settlements exacerbating the cities socio-economic disparities and health risks.

A stakeholders consultation was organised by the Climate and Development Knowledge Network (CDKN) in November 2015, at Karachi, as part of the project titled ‘Facilitating Karachi City in Heat Wave Management’. The issue was discussed - until it was threadbare - with experts who offered ways to draw attention to leveraging climate and socioeconomic information to make Karachi's population more resilient to such tragedies and in fact pre-empt another such catastrophe in the future through a heat wave management plan. This could be quite like the one in place in Ahmedabad, India designed and implemented by the local municipal administration back in 2013, also with CDKN support.

The Heat Health Action Plan (HHAP) was developed in the wake of 2010 heatwave in Ahmedabad that killed 1,300 people. An early warning system and health adaptation plan was designed with recommendations and suggestions from national and international experts. In the 2015 heatwave that engulfed parts of India, of the 2400 deaths in India, only seven were reported from Ahmedabad.

In the Karachi consultation, most agreed that the responsibility lay with the local government and that a close and well-oiled coordination with other departments was crucial. This meant setting up a central repository where all information pertaining to the heatwave and its level of intensity is gathered and then shared simultaneously with all relevant departments as well as the media. In turn, those departments would be ready to roll out their plan.

However, without a primary data collection mechanism to assess the vulnerabilities (complemented by a centre of excellence to analyse the data) it would be difficult to come up with a sound plan. In addition, the district disaster management authority needed to be empowered, to improve the paramedic and public transport system.

Further, since most deaths occurred in densely populated localities, building codes needed to be revisited to ensure houses are adequately ventilated.

To minimise hospital admissions which brought the healthcare system to a collapse, shelters can be earmarked in the locality and quickly equipped with the necessary items to manage those suffering from heat stroke. People suggested that marriage halls and schools in the communities can be equipped with generators so that the place has electricity, and ask community members to cool themselves off and also seek treatment for those suffering from heat stroke.

Further, by making all the 42 or so public healthcare units in the city functional, people would not have to throng to the five main ones.

Valuable lessons can be learned from how the dengue virus outbreak was managed in the city of Lahore. Among them was the importance of someone to champion and take ownership for such initiatives. At the same time, said journalists, both mainstream media as well as social media could be an important and effective ally in the campaign and can be used to mobilise the citizens way before disaster strikes. But for this, media need to be trained, specially the electronic media to air effective and simple messages.

A very important conclusion of the consultation was that if people reached hospitals it meant the plan has failed as the idea behind a heat wave management plan is that the situation should not reach that juncture in the first place. Despite the high death toll in Karachi, gaps exist in policies and institutions which will be a barrier towards effective management of extreme heat events in future.

All participants agreed that a Heat Wave Management Plan must be developed for Karachi on a "war footing" to prevent a repeat of last year’s tragedy. Interventions in Ahmadabad and other cities have proven that such deaths are avoidable.