Lessons from Nepal: Coping with hotter and longer heatwaves

Last month, Kami Rita, a Nepalese sherpa, reached the summit of Everest for the thirtieth time. Rita’s achievement, in some of the least hospitable conditions on Earth, is staggering.

For Nepal – where I’m from – the mountains, and the cold, are the cliché. But in fact, it’s extreme heat that’s the growing problem.

Everest’s cold and height claims a dozen or more lives most years. But in Nepal the heat takes far more.

Most of Nepal is in the grip of a punishing heatwave. This month, schools across Chitwan have been closed because, at 38°C, it’s simply too hot to learn. In the city of Nepalgunj, it’s worse. Daytime temperatures are 44°C.

In fact, much of Asia has been gripped by a heatwave for weeks. Swathes of Africa suffered unprecedented heat in March and into April. As North America and Europe move into summer, the heatwaves are spreading to both. An ‘epic’ heatwave is hitting the east of the US right now. Athens’ Acropolis has been closed because of Greece’s earliest annual extreme heat on record. Worldwide, 2023 was the hottest in human history. And 2024 is on track to be worse.

The problem is laid stark in a recent report. It defines an extreme heat day as one when a place experiences a temperature that falls within, or above, the top 10% of all temperatures there between 1991 and 2020. Between 15 May 2023 and 15 May 2024, almost everywhere in the world endured a record number of extreme heat days — some had hundreds. Of them, the report finds, climate change was responsible for adding, on average, 26 days to a place’s extreme heat day tally. Almost everyone on Earth was affected.

This will almost certainly get worse in our lifetimes. We face a scorching future. Fundamental will be how we cope.

Heat isn’t as sudden or visible as a cyclone, flood or landslide. Deaths aren’t as obvious in the moment and, even afterwards, are ascribed to health conditions rather than the heat that caused or exacerbated them. Europe is, officially, the continent with the highest number of heat-related deaths — 60,000 in 2022. But the reality is that European countries are simply the best at accurately recording them. Those most at risk are the already vulnerable: the old, the very young, the poor and those working outside.

Heat, then, is too often a silent assassin, an invisible killer. But there are ways to beat the heat. The organization I lead, supporting and representing Red Cross and Red Crescent Societies worldwide, has made sharing best practice across our network a top priority. Lessons from Nepal are proving vital.

The Red Cross Red Crescent Climate Centre will soon publish a summary of three years of work in Nepalgunj. Its headline will be that, in heatwaves, locally-led coordinated efforts — often very simple efforts — can save lives.

The first step in Nepalgunj was for researchers from the Climate Centre and the Nepal Red Cross Society, in collaboration with multiple partners, to identify areas of the city at greatest risk and the people within them. They also needed to define heat thresholds. When does a hot day slip into the start of a dangerous heatwave? Answering this questions meant a top-down data approach — think satellites, remote sensing data and the application of science of various acronyms — and a bottom-up approach. The latter meant interviews with those living in informal settlements or working outside, as well as data collection at individual spots on specific streets. In humanitarian sector lingo that work is called ‘ground-truthing’. A conversation with a food hawker can be as valuable as the data from the smartest of satellites.

They found that the more urban the area the hotter it got. Areas around the airport, busy highways and industrial zones were worst. Those people outdoors, living in tin houses or working as rickshaw pullers or street hawkers, suffered most. As for both? Well, Nepalgunj Airport is not an easy place to be a baggage handler.

Next was to find out whether heat really was a threat. Death certificates don’t record when someone dies “from heat”. But studies in Nepalgunj showed hospitalization cases attributed to water-borne diseases like cholera and diarrhoea rose by 2.1% for every 1°C rise in average temperature. Hospitalizations due to insect bites — malaria and dengue — rose 7.3% for every 1°C increase. There was much less data on exhaustion, dehydration or heart conditions exacerbated by heat, but the ground truthing heard of lots.

Armed with when and where to act, the researchers went to those with the power to make things change. Here, buy in-from the local city officials was crucial. Together they developed a Heat Action Plan, launched in 2023. It focuses on reducing seasonal heat risk — actions required to protect before, during and immediately after heatwaves — and on long-term urban planning. That means anything that might stop temperatures getting quite so high in future, like greenery, cool rooftops.

Nepalgunj’s Heat Action Plan is in place now. Raising awareness of extreme heat and its dangers is a big part. Early warning systems alerted people before the latest heatwave hit. LED display boards now show real time heat and humidity data across the city, with suggestions on what people should do about it. So-called Water ATMs are in place too, so people can access subsidized cold drinking water when and where they need it. Home visits by Red Cross volunteers target those most at risk.

None of this is revolutionary. But so fast has been the rise of extreme heat, heat action plans are new and still rare. Officials in hundreds of other cities are looking at what Nepalgunj and a handful of other places have achieved to see what they can learn.

In Nepalese culture, mountains are life. Like many growing up there, I used to look up in awe with the desire to reach their peaks. Now, I look at the spread of heat in fear. But I also allow myself some hope. Nepal is famous for Everest, cold and ice. It might yet get a reputation as a case study in how to beat the heat.