The temperature was 48°C, and the sun bore down on Apekshita Varshney. Reporting from the city of Akola in western India’s Maharashtra state, the journalist remembers how ill she felt that day eight years ago.
What stayed with her was how, despite the searing heat, everything around her was business as usual – farm labourers worked in the fields, vendors sold food on the streets and others went about their daily work routines.
Prolonged physical activity in such conditions, she would later understand, makes heatstroke almost inevitable. A 2024 study across major Indian cities found that a single day of extreme heat was associated with a 12 per cent increase in the daily mortality rate, increasing to 33 per cent for heatwaves lasting five days.
In India, the economic losses caused by heat are well-documented. According to the Lancet Countdown, the country lost an estimated 247 billion labour hours in 2024 due to extreme heat, resulting in US$194 billion of lost potential income. But heat-related deaths and the impacts of prolonged heat stress aren’t documented as extensively, Varshney found.
Realising that India might be undercounting heat-related deaths, Varshney began compiling numbers based on media reports. In 2022, she founded HeatWatch, an initiative focused on heat awareness, research and policy advocacy.
By conducting studies on vulnerable populations such as waste and garment workers, and collecting data on heatstroke cases, the non-profit helps expand awareness, capacity and accountability to facilitate better decision-making and on-the-ground action.
Her work also brings up data points that show the broader, compounding impact heat has on people across the country. “We cannot just be focusing on mortality. We also need to think of morbidity,” Varshney says. “What’s the impact on our people’s cardiovascular health? What’s the impact on our people’s kidney health?”
Dialogue Earth spoke to Varshney about some of the key questions surrounding heat in India, including how the most vulnerable suffer, as well as the long-term impacts of heat stress and what more can be done to mitigate these issues. The interview has been edited for length and clarity.
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There are no easy solutions as this is a complex problem. But one important step would be to notify heatwaves as a national instead of state-specific disaster. That can help unlock financing at a national level.
Apekshita Varshney, founder, HeatWatch
Dialogue Earth: India’s official records cannot agree on the number of deaths caused by heat. Why?
Apekshita Varshney: Heat is a slow-onset hazard. It’s not visibly dramatic like storms. We don’t immediately recognise that heat is causing so much damage – not just to people’s health, but also to productivity, to businesses and to the economy.
Because of that, even the idea that heat can kill is still quite contentious. Our healthcare systems are only now getting more equipped to deal with the impacts of extreme heat on the human body, and it’s still an evolving area of research.
There is a lot of confusion among medical practitioners, policymakers and bureaucrats about what counts as a heatstroke death. Was it a person with pre-existing conditions whose health was worsened by heat, or was it someone otherwise healthy who was exposed to extreme conditions? That distinction becomes difficult to make.
On the ground, doctors often say they don’t have the resources or time to carry out the detailed examinations or postmortems needed to be certain. In states where heatwaves have been notified – meaning officially recognised – as a disaster, there is also the question of compensation for families, which adds another layer of complexity. All of this has made heatstroke into a political challenge.
At the same time, what is undeniably true is that people are dying because of heat.
There is increasing evidence of this and more questions being raised. Researchers and public health experts have also pointed out that the actual number of heatstroke deaths is likely far higher than what is officially reported. So what we really need is a much more honest and transparent approach to understanding heat-related deaths.
Different government agencies are collecting data in different ways, with no standardised system. There are guidelines, but they are not consistently implemented. There are also platforms like the Integrated Health Information Platform, where data is supposed to be uploaded. But these are not publicly accessible, so people outside the system cannot verify or understand what is being reported.
There is also a tendency to downplay the crisis, with people often saying India has always been a hot country. This makes it harder to recognise the scale and severity of what is changing.
Since you established HeatWatch, have you come across a story of a person or community that shocked you about heat in India?
There are many examples that show how gigantic the problem is. One that has really stayed with me is a Mongabay story about 54-year-old security guard Devi Prasad Ahirwar.
He belongs to a marginal caste and suffered a serious heatstroke at work just outside Delhi. After spending six days on a ventilator, unconscious, he survived but was left bedridden. With no income or employer support, Ahirwar and his family were pushed into financial distress.
That story highlights simple but important truths: we want people to survive, and we want our healthcare systems equipped to be able to immediately provide lifesaving relief to heatstroke victims. But we are not really thinking about what kind of recovery is possible afterward. The impact of severe heat on the body is tremendous.
Would you say caste, class and labour conditions are still underplayed in coverage?
There has definitely been an increase in coverage in the last couple of years, especially on the impact of heat on vulnerable communities, and that is important to acknowledge. But we still have a long way to go.
There is not enough research or reporting on how caste and occupation are linked to heat exposure. We are also not making the argument strongly enough that these communities, which contribute very little to carbon emissions, are the ones facing the most severe impacts of climate change.
Similarly, when it comes to gender, we tend to generalise women as a single group – but there are further vulnerabilities within that category. For example, Dalit women are far more impacted than dominant-caste women.
On labour, the conversation has largely moved towards heat action plans, but these plans do not address working conditions in a meaningful way. They do not talk about enforceable protections for outdoor workers or compensation for lost wages. We are still at the stage of fighting for basic amenities like water, sanitation and shade. The conversation needs to move further to include healthcare, compensation and broader protections.
One extremely important study from IIM Bangalore and others finds that marginalised caste groups experience higher heat exposure because caste and occupation are so closely linked in India.
However, we still do not have enough research, or even enough media reporting, on how deeply interconnected these issues are: the impact of heat on manual scavengers, waste workers, sanitation workers, and others who work on the streets; why they are forced into these jobs; and the impact of climate change and extreme heat on communities that have contributed virtually nothing to carbon emissions.
A HeatWatch study found that indoor heat is an everyday reality for garment factory workers. Many reported stagnant air and lack of ventilation at workstations. Can you talk more about the dangers of this type of heat?
Indoor heat is a major issue especially in informal settlements and smaller factories. Many of these spaces are built using materials like tin and asbestos, which trap heat. There is poor ventilation, overcrowding, and multiple people living or working in small spaces, which adds to the heat.
Studies that have measured temperature and humidity in these environments show they can be significantly higher than outside.
In factories, there may be limited cooling – sometimes just an exhaust fan or distant fans – and in some areas, cooling cannot be used because of the nature of the work. All of this means that people indoors can experience conditions as severe as those working directly under the sun.
People cope in small ways: by sitting near doorways to get some airflow, sending children to neighbours who have access to coolers or air conditioning, or continuing to work despite extreme discomfort.
The solutions are complex. They involve using better building materials, improved design, access to credit, and addressing issues like land rights and eviction fears. Without addressing these structural issues, it is difficult to provide meaningful thermal comfort.
Heat stress seems to only increase with every passing year. This year, since March, Maharashtra alone has reportedly recorded 163 heatstroke cases and three suspected deaths, along with more than 400,000 hospital visits linked to heat-related symptoms. If nothing changes, what will Indian summers look like in the next decade?
We are already seeing changes in places that did not experience heatwaves before. Bangalore, for example, has had very intense summers recently.
We are likely to see more heatwave days and more extreme temperatures. Unless we make significant changes to how our cities are designed and managed, they will become increasingly unliveable. Only those who can afford cooling will be able to maintain some level of normalcy.
This also raises larger questions about who has access to cooling and who does not, and whether cooling should be treated as a necessity rather than a privilege available only to those who can afford it.
If you could implement one fix before the next heatwave season in India, what would it be?
There are no easy solutions as this is a complex problem. But one important step would be to notify heatwaves as a national instead of state-specific disaster. That can help unlock financing at a national level, not just for reactive measures when a heatwave strikes, but for actual mitigation efforts. Right now, we tend to respond after the fact, but what is needed is planning and investment before conditions become extreme.
Alongside that, we need large-scale capacity building. This is not just about communities, who are often framed by the nonprofit sector as beneficiaries. What we really need is for bureaucrats and policymakers to be trained and equipped to understand the scale of the problem. They need to be armed with data on what extreme heat and climate change are doing to the country, and knowledge on what solutions are available.
And there are solutions. But unless the people in positions of power understand them and are able to act on them within their own constituencies, it becomes very difficult to implement meaningful change. These are things that should have already been in place, but they need to happen as soon as possible.
This article was originally published on Dialogue Earth under a Creative Commons licence.
