Published in the Open magazine in June 2015
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| Labourers hard at work on an afternoon in coastal Andhra Pradesh |
On the evening of 23 May, as she downed the shutters of her
tiffin shop in Kothapatnam village in Andhra Pradesh, Padmavati Sanagapalli
decided to board a bus to town early the next day. It was 14 days since her
brother had passed away and his family was holding a religious ceremony at
their house in Ongole, around 20 km away from her village in Prakasam district.
The temperature of the coastal town had soared in the past few days and
delaying her departure would mean facing the blaze both ways.
When she returned, she found her 56-year-old husband
Sanagapalli Srinivas Rao fast asleep inside the shop. Without a second glance,
she started manning the counter. The siesta didn’t hurt business; the crowd had
been thin in the afternoons with most people staying indoors. “An hour later, I
checked on him again but he still lay there, unmoving. I panicked and called
for the doctor,” she says a week later, sitting in a local community hall along
with her daughter and a few relatives. It is an austere setting: the duo sit on
two mats on a granite floor as their relatives mill about a few feet away from
the deceased’s framed photograph propped on a plastic chair.
Word of heat wave casualties has become increasingly shrill
among locals. In the absence of a plausible explanation of why a ‘perfectly
healthy man’ would suddenly die, the family decides to believe that the
calamity has struck their household as well. Informed of it, the local tehsildar has sent his daily count
of heat-wave deaths to the district collector: two in a population of 50,000.
The heat wave, which started off as a ‘news brief’ shoved to
the margins of newspapers, now has top billing in the Indian and international
media. Headlines flash that the southern states of Andhra Pradesh and Telengana
are bitten by a heat wave. The all-India death toll has reportedly crossed
2,000, making it the fifth most lethal heat wave in the world.
On 26 May, as the number of reported deaths continued to
mount, the Andhra Pradesh government declared ex-gratia compensation under the
Chief Minister Relief Fund (CMRF) amounting to Rs 1 lakh for each victim. To
weed out false claims, each of these deaths was to be investigated by a
three-member committee consisting of a medical officer, tehsildar and police officer. “In
order to accelerate the process and keeping in mind the sentiments of the
people, the government ruled out post-mortems,” says Sujatha Sharma, the
collector of Prakasam.
When Dr D Rosaiah, in charge of the local primary health
unit, visited the late Sanagapalli Srinivas’ family, they told him exactly what
they had said to me. “But we made a few additional inquiries with the
neighbours and found out that the deceased was suffering from tuberculosis,”
says the doctor, “The nurses at my centre confirmed that he used to visit the
[primary health unit] to procure medicines. But over the last few months, he
had stopped taking them.” It wasn’t the heat wave that killed Sanagapalli, Dr
Rosaiah had concluded, but multi- drug resistant tuberculosis.
Among the 13 cases that the doctor later examined from the
village, he found that only four deaths were caused by the heat wave. The rest
died of heart diseases, HIV, and, in a few cases, natural causes. “Since there
is no post-mortem conducted on the victims and the findings are based only on
inquiries, one can never be hundred per cent certain about the cause of death,”
he says, “But what I have generally observed is that people are aware of the
compensation they are entitled to. Often, they end up reporting a natural death
as one caused by the heat wave.”
I ask a senior IAS officer about this alleged tendency of
people to capitalise on the compensation being offered. While I get a
confirmation on the trend in general, the officer refuses to make such a
comment on-record, fearing he would be labelled as an ‘insensitive’
administrator. Till last week, by the time the mercury had slowly started to
recede in the state; Kothapatnam had reported 14 cases of heat-wave related
fatalities. After investigations, the number of families eligible for
compensation stood at just five.
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| Padmavati Sanagapalli was reported to have lost her husband to the extreme temperatures. An official probe revealed that it was actually a drug resistant tuberculosis. |
A heat wave, as defined by India’s National Disaster
Management Authority, is a condition declared when the maximum temperature at a
weather station crosses 40° Celsius for plains and 30° for hill stations. Worst
affected by a heat wave are usually the poor. Symptoms of heat-induced illness
range from fatigue and nausea to headaches and dizziness. But it only becomes
fatal when those in a ‘red zone’ (as marked on an isotherm map) are hit by a
sunstroke, mainly caused by prolonged exposure to the sun and inadequate intake
of fluids.
For someone tracking the numbers, however, the emerging data
is difficult to grapple with. The number of dead varies depending on which news
source one refers to. For example, on 28 May, the Telugu daily Eenadu reported that nearly 2,600
people had lost their lives in the past one week in the two states. On the same
day, the news channel NDTV pegged the figure at 1,700, whereas The Times of India claimed that 900
had died in the region. By broad consensus, the cities of Prakasam, Guntur and
Visakhapatnam are said to be the worst hit. These three coastal cities have
reported an aggregate toll of 751 deaths, and the entire state, a total of
1,709.
One of the main agencies supplying figures to the media is
the disaster management unit of the respective states. However, given the
conflicting numbers, journalists and authorities say that it is probably a
result of ‘an initiative taken by the regional media’. A correspondent of Eenadu in Telangana admits as much.
“Unlike the mainstream media, regional dailies have a presence at the
grassroots and report deaths as they emerge. We get our data from the mandal level (an administrative
block which several villages under it). Many of those in the mainstream media
also take this data from us and report it,” he says. There is, however, one
flaw in this grassroots reportage: instead of delving into the cause of deaths,
all fatalities are clumped as ‘heat wave related’.
In the last week of May, in order to generate awareness of
the deaths, the authorities started holding special programmes. Srinivas Rao,
the revenue divisional officer (RDO) of Prakasam, recounts an incident when he
was holding a gram sabha in
Inkollu mandal. “Around 6
am, an hour before the programme was to begin, a villager who was drawing water
from a tub collapsed and died on the spot,” says Rao, “When I reached the
venue, [the villager’s] relatives approached me and asked me to register it as
a sunstroke death.” The doctors eventually ruled cardiac arrest as the cause of
death. “But that is what generally happens... people are reporting the heat
wave as a cause of death just to receive ex
gratia [compensation].”
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| A man taking a bath in the open on a May afternoon in Ongole |
On the day of my visit to Rao at his office, the district’s
official death toll is 202. Rao explains that each death in the region is
reported by the tehsildar to an
RDO who, in turn, forwards it to the district collector. The information is
then passed on to the state disaster management cell, which forms the primary
source of information for the media. “But the figures we submit to the cell are
of deaths suspected to have been caused by sunstrokes,” he says. “They are not
confirmed ‘heat wave deaths’ as they are reported. The number includes the sum
of all deaths that have occurred during this period likely to be caused by
sunstroke. For example, it will not include a road or traffic accident, but if
the deceased was within four walls when it happened, it then qualifies as a
‘suspected death’.”
In the absence of an autopsy, the committee members conduct
inquiries about the medical history and work routine of the deceased, and
examine the circumstantial evidence. The medical officer conducts a preliminary
check of the body—if it has not already been cremated or buried—and the police
file a panchnama for the
case to rule out other possibilities. Based on the findings, a certificate is
issued to the kin of the deceased stating whether or not the death was caused
by sunstroke. These victims can then apply for compensation under the CMRF.
“So far, in our district, nearly 200 deaths are reported in
all the 56 mandals,” says
Rao. “After getting an inquiry from the team of officers in their respective
jurisdictions, we found that only 30 cases come under the category [of
sunstroke]. Most were suffering from diseases like cancer and AIDS in addition
to those who died of natural causes. Some of them were [in their nineties] who
had been bedridden for the last few months.”
By 31 May, the reported death toll for the district had
swelled to 337, but the number confirmed was only 56. Officials explain that
the number is indicative only of those considered eligible for compensation.
The person has to be between 18 and 69 years of age, which qualifies only 185
people. This is a practice that is still followed even though there is no such
eligibility criteria set by the government. In the neighbouring Guntur district
where 233 cases were reported, only 35 deaths have been confirmed out of 130
cases taken up for investigation. The results of more inquiries are expected
soon.
“The information that initially reaches us passes through three to four
levels, so there is always a possibility of the numbers not holding up. Compared
to the initial numbers, we are expecting 20 to 25 per cent reduction in the
actual number of casualties,” says Dhananjay Reddy, director of the Andhra
Pradesh Disaster Management Department. He adds that the department had
received reports that only 500 deaths in the state could be confirmed as caused
by the heat wave.
For the dissonance between the reported numbers and the
actual figures, Rao points at the logistical constraints that prevent them from
submitting accurate data at the very onset, instead of ‘suspected sunstroke
deaths’. “One tehsildar covers
10 to 15 villages, sometimes up to 20 villages. Say, four or five deaths are
reported in one day. How can one be expected to conduct an inquiry the same
day?” In spite of that, he adds, the rules mandate that the fatality has to be
reported to the government within 24 hours. The information is thus supplied in
two stages and the ‘suspected sunstroke deaths’ end up masquerading as ‘heat
wave fatalities’.
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| Elore Thimmaiah, a patient admitted at RIMS hospital in May, along with his son |
In spite of the confusion, all quarters agree on one
integral aspect: temperatures have reached alarming heights. According to data
available at the India Meteorological Department, over the past 10 years, the
maximum temperature in Ongole, the administrative area of Prakasam, has hovered
around 45° Celsius for the month of May. While parts of the state touched 47°
Celsius, this year was no different for Prakasam. But compare it to the
mean-maximum temperature between the years 1971 to 2000 for the month of May in
the same district, and one realises the marked rise: from 39.1° to 47° Celsius.
The number of casualties has also increased over the last
few years. According to data accessed from the National Crime Records Bureau,
in an undivided Andhra Pradesh, the graph has showed a steady rise from 2011 to
2013 with 91, 221 and 418 deaths in the state in those three years
respectively. After the formation of Telangana as a separate state, the death
toll for Andhra Pradesh fell to 371 in 2014 before it shot up dramatically
again this year. “For Andhra Pradesh and the rest of the country, heat waves
are not an unusual occurrence. So there is no direct one-to- one relation with
global warming that we can establish,” says YK Reddy, director in-charge,
Indian Meteorological Department in Hyderabad. “In coastal Andhra Pradesh,
where the death toll is supposed to be the highest, the temperatures didn’t
break any records. But this year, the heat wave lasted for 10 days as opposed
to its usual four to five days.”
It need not be that only those with direct exposure to the
sun are the ones falling ill. Among the 30 patients that were treated at the
Rajiv Gandhi Institute of Medical Sciences (RIMS) in Ongole, several patients
were admitted simply because they couldn’t bear the heat in their own houses.
Elore Thimmaiah, a soda- seller, who had been admitted for four days, says that
even though he avoided going out before 4 pm, the heat in his tin-roofed
dwelling was too oppressive.
In order to deal with the critical temperatures, the
government has pressed its machinery to generate awareness about the dangers of
the heat wave and made arrangements for water-distribution centres. In
Prakasam, packets of oral rehydration salts are being distributed at local
train and bus stations. The district administration has also collaborated with
a local milk dairy to print about 120,000 pamphlets with Do’s and Don’ts to be
followed in the summer months.
TVS Anil Kumar, who has been running a free buttermilk kiosk
at TB Road in Ongole for the last two months, tells me what he has gathered
from his interactions with visiting labourers. “In the absence of development,
people have no choice but to take up jobs as manual labour even in these hot
months,” he says. “Sometimes I feel that instead of distributing free TVs
during the election season, politicians should distribute free ACs.”
So far, the counter-measures have worked for only those who
can afford to be salvaged. Those who are dependent on their daily-work to earn
a livelihood, continue to do so, and, as a result, fall prey to the extreme
weather. Before the government announced a clampdown on the timings of work
assignments under the National Rural Employment Guarantee Act (NREGA), around
20 to 25 per cent of those killed by the heat were workers employed under the
scheme.
Around 10 am on 22 May, when Subbaratnam, a resident of
Kunkupadu village, was out shopping for vegetables, she received a call
informing her that her husband Chandra Subbaiah had collapsed while at work.
“Under the NREGA, my husband was part of a group that was contracted to dig an
artificial pond ahead of the rains. Since our house is under construction and
our daughter is unmarried, he went to work every single day,” she says. While
Subbaratnam is certified as eligible for compensation, what her husband actually
lost his life to was a pitiful fixed salary of Rs 120-150 per shift.
It’s the same story for many others. “Usually, we discharge
patients after four to five days of treatment. But many patients leave within
one to two days. They couldn’t afford to not work any longer,” says a nurse at
the RIMS hospital.
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| Multiple water and buttermilk distribution centres were set up by the government and citizens across Andhra Pradesh and Telengana to help people deal with the heat |
Coupled with poverty, the other major impediment in dealing
with a heat wave crisis is the sheer scale of the calamity. In case of any
natural disaster like floods, earthquakes or cold-waves, the Centre doles out
monetary relief to those affected. It was only in the last week of May,
following an uproar over its exclusion, that heat waves were included in the
Government’s list of ‘natural disasters’. But the authorities add that apart
from spreading awareness and compensation, there is little else to be done in
the face of nature’s fury.
“You are seeing an ecological imbalance. Yes, the
green cover is drastically reducing and the ozone layer is also being affected,
but this does not mean that you can stop people from earning a livelihood,”
says Reddy. “You can’t just create a situation akin to the Emergency.”
