What India can learn from France

A large part of India reeled under the season's first major heatwave in the last week of May 2020. Ambient temperature in Delhi on May 27 hit 47.5 degree Celsius — the hottest day recorded in May in 18 years. Series of thunderstorms in the last few days brought relief, but heatwave conditions are likely to return.

Almost half the Indian states record instances of extremely high temperatures or heat waves during April-June every year. Heatwaves are responsible for the second highest number of deaths after floods in India from natural events. They caused 22,223 deaths from 1992 to 2015 across the country.

Some cities and states have even formulated heat wave action plans, but India has not notified it as a disaster event so far. That is why it doesn't have a national action plan to address it. Heatwaves are projected to increase in frequency, intensity and duration all over the world — especially in India. Many countries have already put in place national and local polices to help their people and infrastructure survive with minimal human and economic damage.

Here is a brief insight into France's heatwave action plan. France, among other countries in Europe experiencing frequent heatwave events, has developed national action plans to tackle the problem. After 15,000 people died in the 2003 heat wave event, France put in place its first national heatwave action plan. It is updated every year and has helped the country to reduce mortality and health consequences.

Preventive measures to raise awareness and tackle the health consequences of heatwaves start by June 1 and last until September 15 every year. The National Public Health Agency (ANSP) of France informs people through a press release about the vigilance and action plan. It provides all the information material such as form leaflets and information brochure etc to regional health services, local administration and the associative network, which is then distributed to the general public.

The information materials are also specifically developed and implemented based on the needs of the department (equivalent of a municipal body in India), keeping in mind the identified vulnerable population.

Communicating the danger

For a successful implementation of the plan, communication (preventive and during heat wave events) forms an important part of the action plan. Local bodies, regional health services, central health services and central administration coordinate among each other to maintain consistency of communication.

Media, such as television and radio, are effectively used to disseminate information on a regular basis during the emergency phase — when heatwaves are declared. It is then that television, radio and other platforms are used to disseminate information.

Heatwave levels

Heatwave warning levels and the vigilance required are assigned colours — Yellow (level 2), Orange (level 3) and Red (level 4).

These heatwave warning levels are forecast based on weather forecasts, complemented to a frequency analysis of 30 years of data on mortality rate with weather indicators. The information provided by health services are also a part of the forecasts.

Level 2 warning (Yellow), where heat wave is forecast for one-two days, asks for implementation of graduated measures, but mostly a beefed-up communication and activation of heat wave telephone information service.

Level 3 warning (Orange) is activated by the department concerned and represents a dangerous situation, during which the public is advised to keep abreast with latest developments and follow advice issue by public authorities. In addition to national heat wave hotline, a local heatwave hotline is opened for the public for health advice. When one or more departments show orange heatwave event, the communication is managed at the level of national health ministry. The department, depending on the local needs, mostly relies on the ORSEC system.

Information regarding the host of measures implemented by the prefecture and local authorities is put in place, particularly through the ORSEC portal. Every department has an ORSEC plan, which is basically a description of who will do what during a disaster event.

During this heatwave alert phase, daily monitoring of health indicators is carried out through a Health Information System of Alerts and Crises, which are monitored by the National Public Health Agency.These include number of emergency service request and trips, SOS doctor visits and number of deaths accounted by the National Institute of Statistic and Economic Studies.

When it gets red hot

A level 4 warning (Red) is triggered for a possibly intense and long-lasting heatwave event, which is declared by the health ministry. During red alert, communication, implementation and coordination of special measures are put in force, both at national and local level. These warnings are found on France's Meteorological departments' website that updates the warning levels twice a day for each department.

At this time, the prime minister can entrust the operational conduct to a minister of his choice. Besides ramping up the communication system, it is made sure that the identified vulnerable people — isolated elderly people, people in elderly care, school children, people in nursing homes, homeless — are provided extra care and the administration of these institutions take special measures to mitigate the effect of heatwaves.

The measures as stipulated in level 3 heatwave are maximised to a full extent with regular update on the healthcare facilities, which is regularly updated and strengthened under the leadership of the PM.

For instance, in Paris elderly homes were provided 'cool' rooms equipped with air conditioners or shaded or faced north direction. Further, school outings and sports events were cancelled, and public and private firms allowed more and more people to work from home.

Every townhall is required to keep a register of all its senior citizens. Identification of the vulnerable population is critical in the success of the action plan. The National Heat waveaction plan is revised each year. A monitoring and evaluation committee meets twice a year — once before the summer season and then at the end of the season to incorporate feedback gathered. Result: France has been able to cut heatwave induced death toll by 90 per cent since 2003.

Courtesy: Down To Earth