aDr. Amrendu Yadav flipped the switch, and water spurted out of a large pipe while he shoveled ice into the bathtub. Two minutes later, the bath was full and ready for its next patient, at the new emergency heat stroke unit at Ram Manohar Lohia Hospital in India’s capital.
Speed is key, he explains: To survive, heatstroke patients need to be bathed as soon as they arrive at the hospital.
“Time is life and time is organization,” said Yadav, head of emergency medicine. “It is imperative to reduce the temperature of patients quickly and this is the quickest way to do it. That is why the water pipes are large so that 250-litre bathtubs can be filled quickly and the ice maker can make 50 kilograms of ice.”
Hospitals have seen more than 50 heatstroke patients in the past week. New Delhi and many parts of north India have been hit by relentless heat waves of over 40 degrees Celsius every day since mid-May. March was the hottest month on record. Delhi recorded its hottest ever temperature in early June, with two weather stations in the capital recording temperatures of 49 degrees Celsius (120.2 F) and 49.1 degrees Celsius (120.38 F).
Delhi hospitals have reported 275 heatwave-related deaths since mid-May, according to a newspaper that compiled the figures, though the actual number is likely much higher. Many of these deaths were among poor workers, disproportionately those who worked outdoors, but their deaths went unrecorded because relatives and doctors did not recognise them as a result of heatstroke.
Though many Indians are accustomed to the hot weather, they are unaware that being outdoors in extremely high temperatures can damage the kidneys and liver, cause loss of consciousness and lead to organ failure.
“Patients do not realise the symptoms and continue working till they become confused and in their confused state they do not seek help and eventually collapse. Usually, when patients come to us, we have to put them on ventilators immediately,” said Dr Seema Wasnik, who works with Dr Yadav.
The corridors outside the new ward are packed with people suffering from heatstroke-related symptoms. “My husband had been working all day breaking stones and then he started vomiting. We thought he had a virus or something he had eaten,” said Sharmila Devi, standing near her husband’s gurney.
Before the hospital’s new heat stroke unit, doctors used cold sponges, ice packs and cold intravenous fluids to lower patients’ temperatures, a time-consuming and slow process: a 40°C body temperature (Yadav has experienced one as low as 43°C) takes time to come down, and in the meantime organs can be damaged.
In the bathtub, this time is reduced to 25-30 minutes as the cold water acts on the body surface area. While in the bathtub, the patient’s vital signs are constantly monitored. Once the temperature has been reduced, the patient is transferred to the ICU.
When more than one patient is admitted, the unit has an inflatable bathtub (essentially a wading pool) that has the added benefit of being portable and easy to move to wherever the patient is.
Dileep Mavalankar, a public health expert who helped develop India’s first heat plan for Ahmedabad, Gujarat state, said it was unfair that 10 years on, few other cities have followed suit.
The Delhi government came up with a plan this year that includes an “early warning system”, but there are no signs of progress amid the current heatwave.
Mavalankar told the Times of India that although the heatwave had been predicted on the India Meteorological Department’s website, the government had done little to prepare the public.
“Heat records are set to be broken one after another from 2022 onwards. If we don’t act now, it’s only going to get worse,” he said.
There was some relief over the weekend with rain and temperatures dropping to 37C, but the Met Office expects temperatures to rise again.
Human-caused climate disruption is making heat waves all over the world more intense and likely to occur. Extreme heatwaves in Western Canada and the United States in 2021Without global warming, this would be nearly impossible.
