Unseen casualties: As heatwaves intensify, India still doesn’t know who’s dying

Many heat-related deaths go unrecorded or are misclassified as heart attacks or other causes.

Last year, on a scorching May afternoon, a ragpicker in Delhi's Ghazipur area collapsed from heat exhaustion.

"The family hurried him to the hospital," recalls Majida Begum, a sanitation worker who witnessed the incident. "But he was declared dead on arrival. Since they had no proof linking his death to the heat, they weren't given any compensation." His death went unrecorded, just one among the countless lives claimed by India’s intensifying heatwaves that slip through the cracks of the system.

An investigation by PTI has uncovered that outdated and fragmented reporting systems are obscuring the true toll, undermining both public awareness and vital policy action.

Accurate data on heat-related deaths is crucial for identifying those most at risk. Without it, the government struggles to plan effectively, craft targeted policies, or take prompt actions to save lives.

Yet, behind these missing numbers are real people, often poor and undocumented, whose deaths routinely go unrecognized in India’s chaotic reporting framework.

At present, there are at least three datasets attempting to track heatstroke or heat-related fatalities. The two most frequently cited in the media come from the National Centre for Disease Control (NCDC), a health ministry agency, and the National Crime Records Bureau (NCRB) under the home ministry.

Additionally, the India Meteorological Department (IMD) releases figures on deaths attributed to "heatwaves" in its annual reports, primarily relying on media coverage for its data.

However, these three sources often produce conflicting numbers.

For example, data obtained through an RTI query from the health ministry shows that 3,812 heat-related deaths were recorded between 2015 and 2022 under the Integrated Disease Surveillance Programme (IDSP), which is managed by the NCDC. In stark contrast, the NCRB reports a figure of 8,171 deaths from "heat/sunstroke" during the same period, a number frequently cited in Parliament by Union Earth Sciences Minister Jitendra Singh. Meanwhile, the IMD's annual reports list 3,436 deaths due to "heatwave" within the same timeframe.

While the NCDC and IMD have already published figures for 2023 and 2024, the NCRB has yet to release its data for these years.

Since 2015, the health ministry has been gathering data on heat illnesses and deaths from April to July, which was later expanded to include March through July, encompassing 23 states.

The NCRB has maintained records of heatstroke deaths since 1995, classifying them as "accidental deaths from forces of nature" since around 2010.

A senior official from the Delhi Police quoted in the PTI report explained that NCRB data generally reflects the number of unattended individuals found dead in public spaces or homes. Such bodies are then taken to hospitals where doctors perform autopsies to determine the cause of death.

According to the NCRB, there were 730 deaths from "heat/sunstroke" in 2022, 374 in 2021, and 530 in 2020. In stark contrast, NCDC data shows just 33 heat-related deaths in 2022, none in 2021, and only four in 2020, largely due to numerous states not reporting their figures.

States that failed to report included Delhi, Uttar Pradesh, Rajasthan, Punjab, Haryana, Madhya Pradesh, Chhattisgarh, Bihar, Jharkhand, Karnataka, Kerala, Andhra Pradesh, Telangana, West Bengal, and Tamil Nadu.

An official from the health ministry, speaking on the condition of anonymity, noted that the NCRB and NCDC data "aren’t directly comparable" because they come from different sources.

"The NCDC tracks deaths of patients who visit hospital OPDs or are admitted. But if someone dies and is taken for an autopsy, that information goes to the forensic medicine department, which may not always share it with the NCDC," the official elaborated.

He acknowledged the presence of multiple datasets on heat-related deaths in India, stating, "None of these alone provides a complete picture."

While understanding the actual number of heat-related deaths is crucial for effective policymaking, confirming such incidents is challenging, even with guidelines from the health ministry.

This official remarked that surveillance systems typically capture only a fraction of actual cases for other communicable and non-communicable diseases, saying, "We have some numbers, but never the full picture."

One major hurdle in data collection is the absence of an electronic record system.

"Healthcare facilities still rely on manual data entry, making it even harder to get accurate reports on heat-related deaths," said another official.

Although the Integrated Health Information Platform (IHIP) does allow for digital submission of data like heat-related deaths, hospital staff still manually enter the information online, with no automated transfer from hospital records.

Officials also indicated that although states are required to report data, compliance is often lacking. For instance, hospital staff might neglect to report during cloudy weather when temperatures drop.

A senior doctor from a central government hospital in Delhi, speaking anonymously, pointed out that most hospitals operate with insufficient staffing, which further complicates data reporting.

(With PTI inputs)