HealthTamil Nadu heatwave policy is only a start

Tamil Nadu heatwave policy is only a start

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There are no sanctions in the Tamil Nadu heatwave policy should the State fail to act appropriately or in the event that these measures are deemed insufficient. File
| Photo Credit: The Hindu

In October, the Tamil Nadu government notified extreme heat as a State-specific disaster. As things stand, the decision is good because it allows those at risk of heat-related morbidity or mortality to avail institutional mechanisms and recompense in the event of a deadly heatwave. This expands the State’s responsibility to guarantee public welfare to the new and unique threats posed by climate change. But there are also reasons to wait and watch.

First, the gazette notification says the government will provide “medical care including supply of oral rehydration solution packets” and “drinking water in water kiosks”. These are incentives in the policy, but there are no sanctions should the State fail to act appropriately or in the event that these measures are deemed insufficient.

The next paragraph in the notification is more illuminating: that a heat-related death is diagnosed “based on a history of exposure to high ambient temperature and the reasonable exclusion of other causes of hyperthermia”. Further, “diagnosis shall be established from the circumstance surrounding the death, investigative reports concerning environmental temperature, and/or measured ante-mortem body temperature at the time of collapse”.

Estimates of a heatwave’s deadliness are typically based on the extent to which the ambient temperature deviates from the historical average at a specific location and the number of lives lost during and because of the heatwave. This is a tricky, even devious, combination as illustrated by the accompanying rider: “to the reasonable exclusion of other causes of hyperthermia”.


Editorial | Sun signs: On extreme heat and Tamil Nadu’s policy decision

A heatwave injures and/or kills by first pushing more vulnerable people over the edge; the less vulnerable are further down the line. The new policy is presumably designed to help the State catch those whose risk exposure the State has not been able to mitigate in time. However, the goal should be to altogether reduce the number of people requiring such catching. The policy lacks the instruments to guide the State toward this outcome.

This detail serves as a crucial reminder: this is well begun, and well begun is half done. But bearing in mind governments’ penchant for taking isolationist views of how climate change affects the people, there is value in keeping what remains pending in sight.

As a second example, the policy skirts the State’s responsibility by limiting itself to the consequences of a heatwave or a heatwave declaration and does not mitigate the deadliness of high heat in advance and in contexts beyond climate change. Such inaction could potentially facilitate a disaster, risking people’s lives even before the ambient temperature has crossed legally recognised thresholds. For example, if a doctor concludes a person died of a heat-related injury because they could not ventilate themselves, yet the weather department has not declared a heatwave, the person’s family will not qualify to receive the ex-gratia solatium in the new policy. That is, the policy will not help catch in advance the same people who are likelier than others to be injured or killed during a heatwave.

On a related note, if a person dies during a (declared) heatwave, the ambient heat itself will be less responsible for stressing an individual than the heat interacting with pre-existing vulnerabilities and comorbidities. At the least, the Tamil Nadu health department should clarify the interaction between high heat and comorbidities and which of the latter might disqualify families from receiving the solatium.

Finally, the Tamil Nadu government has adopted a climate change mission that could address some of the anthropogenic components responsible for aggravating heatwaves. But actions to mitigate climate change and to adapt to a future with it are long-term, whereas keeping a heatwave from being deadlier has many short-term solutions such as better urban planning, improving access to green spaces, better enforcement of working conditions in the informal sector, etc.

For now, the gratuitous relief is effectively a self-imposed penalty on the State’s failure to lower its people’s vulnerability to heat injury during a declared heatwave, at the expense of the State Disaster Response Fund. Tamil Nadu will miss the forest for the trees if it does not expand the policy in the future to include its implicit long-term responsibilities.



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