How the record-breaking heatwave revealed Delhi’s climate vulnerabilities

As temperatures soared, shortcomings in infrastructure and policy left millions vulnerable.

A man drinks water from a pipe during a hot summer day in New Delhi on June 18. Temperatures in the national capital soared to record highs amid concerns of water shortages in the sprawling metropolis. | Photo Credit: PRIYANSHU SINGH/REUTERS

After a gruelling 40 days, Delhi residents finally got some respite from the relentless heatwave that began on May 13, as light showers on June 23 brought the maximum temperature below 40°C for the first time in one and a half months. India faced record-breaking temperatures in 2024, with over 37 cities recording temperatures above 45°C. According to the India Meteorological Department (IMD), the national capital of Delhi and surrounding regions saw temperatures crossing 49°C.

The nights remained equally unforgiving, with some areas reporting minimum temperatures of 36°C, preventing people from cooling down effectively and exacerbating health risks. The heatwave coincided with the country’s six-week-long general election, potentially contributing to lower voter turnout due to the extreme weather. Media reports indicated at least 10 people involved in the electoral process died from suspected heat stroke in Bihar, with another 33 election workers losing their lives in Uttar Pradesh.

This year’s heatwave was the longest ever recorded in India, with Delhi recording 12 heatwave days—five in May and seven in June. According to official data released by the Ministry of Health and Family Welfare, nearly 41,000 cases of heat-stroke were reported across the nation, resulting in about 116 fatalities.

Rise in heat-related illnesses

Dr Ajay Chauhan, the nodal officer of the Heat Stroke Unit at the Ram Manohar Lohia Hospital (RML) in central Delhi, described this year’s heatwave as “totally unprecedented”. He noted that, previously, heat-related illnesses were rare and exceptional. However, this year saw an increase, likely due to climate change, as evidenced by the 3,775 deaths due to heat-stroke recorded across India from 2015-19, according to the National Programme on Climate Change and Human Health (NPCCHH).

In response to the crisis, RML Hospital established a first-of-its-kind Heat Stroke Unit. Chauhan explained: “The basic principle of heat stroke management is cooling.” The unit utilised dynamic components, including inflatable tubs and ice boxes, kept in an air-conditioned office, along with multiple multi-parameter monitors that can also monitor the temperature. The heat-stroke room is fully equipped with two ceramic tubs, each with a 200-litre capacity, an ice maker, and a refrigerator machine capable of producing 200 kg of ice a day.

Chauhan elaborated on two types of heat-strokes: classical and exertional. Classical heat-stroke affects individuals with comorbidities, such as the elderly, children, and those with chronic conditions. Exertional heat-stroke occurs when individuals continue to work in harsh conditions without rest. “From my experience, the majority of patients we treated had exertional heat-stroke,” Chauhan noted. He observed zero cases among children this year, with a maximum of 10 per cent of cases being heat-related illnesses among the elderly.

Daily wage workers and those from poorer socio-economic backgrounds were particularly affected by the heatwave. Krishna Arya, a 23-year-old rickshaw puller from Uttar Pradesh, expressed frustration at the lack of government support: “The government hasn’t provided us with any facility, even drinking water is scarce and difficult to find. We do not have houses of our own, these rickshaws are our home. We don’t know how we will get help, but the government should do something.”

Ruby, a construction worker in Lajpat Nagar, said that despite the Lieutenant Governor of Delhi’s order for paid leave for all construction workers from 12 noon to 3 pm, they continued to work without breaks. “We start our work at 8 in the morning till 1 pm after which we have food. Then again we work from 2 pm till 8 pm. We do not know anything about this order and we weren’t given any leave.” She also mentioned the lack of potable drinking water at construction sites.

A patient admitted due to heat stroke and exhaustion undergoes treatment at New Delhi’s Lok Nayak Hospital, on June 19. Due to prevailing heatwave conditions, hospitals in Delhi and surrounding areas are seeing an influx of patients with complaints of heat-stroke and exhaustion. | Photo Credit: PTI

Dr Amlendu Yadav, head of the Department of the Heat Stroke Unit at RML, explained the treatment process for heat-stroke patients: “Most patients arrive unconscious. The temperature of these patients is usually around 105-110°F which is very high. Such patients are placed in a bathtub with cold water ranging from 0-5°C for 30 to 40 minutes. About 50 kg of ice is required per patient to bring their body temperature down.” He added that “the earlier you start the treatment, the more chances you have of saving them”.

Chauhan noted that an overwhelming number of patients were very sick, with almost 80 per cent at the lowest scale of the Glasgow Coma Scale. He stressed the importance of early treatment and the potential role of bystanders in providing immediate assistance to those suffering from heat-related illnesses.

Struggles of hospital patients

The heatwave also took a significant toll on patients receiving long-term treatment at major hospitals like AIIMS and Safdarjung. Many of these patients, often from distant parts of the country, were forced to live on the streets near the hospital premises due to lack of affordable accommodation.

Anwari Khatoon, an elderly lady who had been living in the subway connecting AIIMS and Safdarjung hospitals for four months, shared her experience: “I came from Katihar district of Bihar with my daughter. They found a tumour in my womb and now we are waiting for the reports. It gets extremely hot in here, and we have to either buy water or fill it up from the hospital. There is no ventilation in here and sometimes it gets very suffocating”.

Mohammad Ali from Amroha in Uttar Pradesh, accompanying his wife for treatment, described their struggles: “We live on the road here. We face a lot of difficulty during this harsh summer. We often don’t even get water to drink.”

Street vendors also faced significant challenges due to the heatwave. Khushbu and Tanu, who have been managing a fruit stall outside Safdarjung Hospital for 10 years, noted the progressively hotter summers. Tanu shared her personal experience: “Yesterday only, my situation was really bad due to the heat. I got dizzy and fainted. Today, see, I am drinking an energy drink [electrolytes].”

Khushbu and Tanu have been managing a fruit stall outside Safdarjung Hospital for 10 years. Street vendors also faced significant challenges due to the heatwave. | Photo Credit: Vitasta Kaul

Mukesh Kumar, a lemonade seller outside AIIMS for the past 20 years, said: “This is the worst summer I have witnessed. Our income has also taken a severe hit. We lose our revenue if it gets very hot. People think that in summer we earn more but if the customers don’t even step out of their homes due to the heat, how are we going to earn?”

Arbind Singh, national coordinator of the National Association of Street Vendors of India, highlighted the challenges faced by street vendors: “They try to avoid the heat by getting their goods early in the morning and opening their shops after the heat intensity has dropped. The food vendors who cater to offices only find customers in the afternoon, so they are left with no choice but to work in the blazing heat.” He noted a 30 to 40 per cent drop in vendors’ income due to extreme heat conditions and highlighted the need for comprehensive measures to support street vendors during such weather events.

Significant shortcomings

The Heat Action Plan, developed jointly by the IMD and the National Disaster Management Authority (NDMA), aims to address heatwave challenges through a three-phase implementation strategy. However, a 2023 assessment by the Centre for Policy Research revealed significant shortcomings in the plan, including lack of consideration of local context, inadequate funding, and poor targeting of vulnerable groups.

Experts Frontline spoke to acknowledged the limitations of medical services alone in addressing heat-related illnesses, pointing out how managing such illnesses also involves broader prevention strategies that require coordination with other departments. Yadav added: “This heatwave is not a phenomenon of one day. Climate change has started manifesting since this decade. In coming years it is only going to get worse. We understood the gravity of the situation and prepared accordingly.”

Mridusmita Choudhary, the communications officer of NDMA, explained their role in issuing guidelines for heatwave management: “Our responsibility primarily involves issuing guidelines for the heatwave, which then state disaster management authorities are expected to interpret and implement wherever applicable.”

As India continues to face increasingly severe heatwaves, there may be a need to reconsider including them as a notified disaster under the Disaster Management Act. This would make affected regions eligible for financial aid under the National Disaster Response Fund and the State Disaster Response Fund, potentially improving the response to and management of these extreme weather events in the future.