In June 2015, Karachi witnessed one of the worst heat waves in recorded history — temperatures rose to 43.7oC killing more than 1,500 people in just five days. However, experts fear that this year’s heat wave may be even worse than the last. Met officials predict that the metropolis will witness two to three heat waves in May, June, and July — where temperatures may reach 44 to 45oC (and shall feel like 50oC).

It won’t just be the port city that shall be at risk, but also the plains in north Sindh and south Punjab (Sukkur, Ghotki, Jacobabad and Multan, etc). According to a March 2016 report issued by the National Weather Forecasting Centre, a subsidiary of Pakistan Meteorological Department, the “second half of May and the first half of June is likely to remain drier and hotter than normal [and will] increase the probability of occurrence of heat waves over the plains and the coastal belt of the country”.

Pakistan has faced severe flooding, droughts, and heat waves over the past five years, and experts point out that this trend, due to climate change, is set to continue. The think-tank, Germanwatch, ranks Pakistan as one of the 10 countries most-affected by climate change, on the basis of vulnerability to global warming from 1994 to 2013, on its 2015 Global Climate Risk Index.

A combination of climate change, and the El Nino effect means that Karachiites shall be at the receiving end of multiple heat waves. Are contingency plans drawn up by the non-profits and the government enough to mitigate this crisis?

However, other factors, such as weather patterns and the layout of the city, could make the heat wave more intense. Dr Pervaiz Amir, a well-known environmentalist, points out that the El Nino effect (a natural weather phenomenon that influences the monsoons and sea temperatures), the ‘island effect’, and the tendency of Karachiites to burn trash outdoors and in the streets, could be the contributing factors.

A recent study at the Aga Khan University (AKU) highlights how the ‘island effect’ can make the city’s residents more vulnerable to the impact of a heat wave: high population density, small living spaces, and buildings constructed close together, tend to trap the heat generated by sunlight, vehicles and factories, etc.

“All types of burning [and heat generating activities] … including industries, vehicles, power plants, power houses and generators by more than 20 million people in a small place have created a space called ‘heat island’ due to which the city is witnessing severe heat with every passing year,” said Dr Zafar Fatmi, an associate professor who conducted the study and heads the research group, Environmental and Occupational Health and Non-communicable Diseases, at AKU.

The study suggests “increasing vegetation, [conducting] more tree plantation in and around the city as swiftly as possible [to] reduce the effects of increasing heat in urban centres”.

During the 2015 heat wave crisis, Jinnah Postgraduate Medical Centre (JPMC), Karachi’s biggest hospital treated 10,000 heatstroke patients in three days when JPMC only had 1,400 beds. So for this year the hospital management has come up with a novel solution: the use of wedding halls.

After receiving forecasts about a series of intensive heat waves, non-profits have started chalking out plans to cope with the situation. Most of the focus is on awareness campaigns, and programmes aimed at handling the high body count.

The Edhi Foundation (EF), for instance, has asked the city government to dig at least 500 graves in different graveyards around the metropolis, so that people may not face difficulties in finding burial places, as happened last year. In addition, shipping containers have been converted into mobile mortuaries.

“During last year’s heat wave, people were carrying bodies of their relatives in ambulances and were searching for burial places, but all the graveyards were full and there was no place even in the cold rooms of the city,” pointed out Faisal Edhi, the spokesperson for the Edhi Foundation.

Another non-profit, Chhipa, has been introducing similar measures: “We have introduced this new mortuary where 100 plus bodies can be kept,” said Haris Abbas, who is in charge of the welfare organisation’s mortuary department.

The think-tank, Germanwatch, ranks Pakistan as one of the 10 most-affected countries by climate change on the basis of their vulnerability to global warming from 1994 to 2013 on its 2015 Global Climate Risk Index.

Both charities have also increased their fleet of ambulances and are looking to improve the transportation of patients. According to Abbas, Chhipa now has more than 600 ambulances at their disposal, while Edhi said EF has added “300-plus new ambulances, and made the operating system central, so that transporting heatstroke patients from their areas to hospitals can be done on an immediate basis”.

The EF has launched awareness campaigns in the city since April 1, to explain to people what to do if someone at their home or area suffers from heatstroke. Edhi pointed out that they wanted people to know that they don’t need to rush victims to “hospitals; people can start initial treatments of heatstroke patients in their own home”.

The Pakistan Medical Association (PMA), in collaboration with the EF and Farozaan Forum, will also be holding a series of awareness sessions and medical camps. “We will also be holding camps across the city during the heat wave crisis,” said Dr Tipu Sultan, senior member and former president of PMA.

The city’s hospitals have also been working on their own contingency plans, in anticipation of the upcoming heat wave crisis. For them the priority is efficiently handling the patient overflow, and security.

During the 2015 heat wave crisis, Jinnah Postgraduate Medical Centre (JPMC), Karachi’s biggest hospital treated 10,000 heatstroke patients in three days, when the JPMC only had 1,400 beds. So this year, the hospital management has come up with a novel solution: the use of wedding halls.

“Heatstroke patients need to be kept in air-conditioned areas where their hydration level is maintained; last year everyone was rushing to hospitals and we were unable to treat every patient, so it [has been] decided to use marriage halls to treat patients who are not in critical condition,” said Dr Seemin Jamali, JPMC’s joint executive director.

Protecting hospital staff, nurses and doctors is also at the top of the agenda. Dr Jamali pointed out that they faced some cases last year where “family members became violent and attacked doctors” after losing their loved ones. Thus, wireless connections will be provided to the heads of all major hospitals in Karachi, which will be directly connected to concerned deputy commissioners, and will function as a hotline.

The Sindh Education Department has announced that summer vacations will be timed to ensure that schools are closed when the heat waves hit the city, and that school buildings will be made available to the health department to be used as temporary wards if needed.

In addition, Sindh Chief Minister Syed Qaim Ali Shah recently announced that a Rs200 million grant had been approved for the purchase of new and standby machinery at the Pipri water pumping station, and for repairs of old machinery at the Dhabeji water pumping station — the government pointed out that this should ensure better water supply during the heat wave crisis.

Last year saw the authorities struggling to cope with the crisis; they didn’t launch public awareness campaigns, or put in preventative measures, until it was too late. Whether enough has been done this time remains to be seen.

The writer is a freelance environmental journalist based in Karachi. He tweets @AmarGuriro

Published in Dawn, Sunday Magazine, April 17th, 2016