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Inside India’s first heat stroke emergency room

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In one of the largest hospitals in India’s capital, Delhi, a physician says he has never seen anything like this before.

“This is an unprecedented heatwave. In my 13 years of working here, I don’t remember signing a death certificate for heat stroke. This year, I’ve signed several,” says Ajay Chauhan of the Ram Manohar Lohia Hospital (RMLH).

Delhi has been reeling under a prolonged heatwave, with daily temperatures crossing 40C (104F) since May, peaking at nearly 50C. Humidity and hot winds exacerbate the heat, compounded by water shortages and power outages due to soaring demand. And people are dying from the heat, with media reports suggesting at least 20 fatalities due to heat-related illnesses.

A heat stroke, the most severe heat illness, is identified by three key signs: exposure to high heat and humidity, a core body temperature of 40.5C (105F) or higher, and mental changes like mild confusion or impaired consciousness. Heat stroke is also a silent killer, and victims can begin to fall ill hours after exposure to sun. India’s National Centre for Disease Control calls heat strokes a “life-threatening” condition with a mortality rate of 40-64%.

Since Dr Chauhan’s hospital in Delhi opened a heat stroke clinic in late May, seven people have died of heat stroke and more than 40 have been treated for heat-related ailments.The majority were men working outdoors and in small, unregulated factories with poor conditions, enduring extreme heat exposure. To be sure, the heatwave is not restricted to Delhi: dozens have died from heat-related illnesses since March, with more than 50 deaths in just three days in early June in the states of Uttar Pradesh and Odisha.

At the RMLH clinic, possibly the first of its kind in India, the effort to save heat stroke patients underscores the challenge posed by rapid climate and health emergencies.

A few days ago, a man was wheeled in with body temperatures soaring to 42C (107.7F). A body’s normal core temperature is 37-38C. He was suffering from a heat stroke.

At this temperature, a human body begins to shut down, cells deteriorate, and there’s a risk of organ failure. Sweating ceases as blood flow to the skin stops, leaving it cold and clammy.

At the clinic, doctors dunked the patient into the icy waters of a 250-litre ceramic tub where the temperature ranges from 0 to 5C. (The clinic is equipped with two ceramic tubs, a 200kg ice-making machine, rectal thermometers, ice boxes and inflatable tubs.) The patient took about 25 minutes to cool down and begin recovering before he was moved to the ward for further treatment. (BBC News)

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