It has been Karachi’s hottest summer since 1979 with temperatures rising above 40°C. Attributed to an unprecedented weather event; the high temperatures took the residents of Karachi by surprise. As the temperatures soared, the number of patients coming to the emergency department at the Aga Khan University Hospital suffering from heat stroke rose considerably. The emergency department went into action; successfully treating – approximately 150 extra visits per day – double its average num
ber of daily visitors.
It all started on June 20 but the night of June 21 was when the emergency department started to receive an overwhelming number of visitors. By 8 pm, the triage waiting had exceeded 30 patients and eventually went up to 80, with all available staff called on. The emergency department management team, the physicians in charge all remained through the night to manage the heavy influx of patients.
The next day, ER visits went up to 284 and on June 23 to 287. Total hospital admissions on June 22 were recorded to be 90, the highest ever. On June 22 and 23, the hospital midday occupancy reached nearly 93 per cent.
“From June 20 till July 1, we received 551 heat stroke patients, of which we managed to successfully treat 493, unfortunately 27 were patients were dead on arrival while 31 expired here at the hospital,” said Fazal Hameed Khan, chair, emergency medicine. “We added 30 more beds to our normal 62, staff generously worked longer hours and off-duty members volunteered to assist.”
The medical and nursing staffs were at the forefront as the emergency room accommodated the patients; many more worked behind the scenes. Facilities management kept essential utilities flowing; the clinical laboratories worked extra hours to get the lab results out on a fast track to the ER, while the pharmacy and medical teams replenished supplies.
“This 10 day situation simply proved one thing, that together, the AKU community has all what it takes to rise up to any challenge that is thrown in their way,” said Dr Munawar Khursheed, consultant emergency medicine.
A rapid increase in population paired with a change in lifestyle is releasing huge amount of greenhouse gases in a small area. A concentration of gas and fuel burning by industries, vehicles, power plants, power houses, and generators, with more than 20 million people living in a small place has created a ‘heat island’. Since the heat trapped in urban areas prevents temperatures from decreasing at night, the constant rise of temperature during a heat wave causes crises like the one experienced in Karachi.
“The phenomenon of death due to extreme air pollution or heat wave is commonly called ‘harvesting effect’,” says Dr Zafar Fatmi, Head, Research Group Environmental and Occupational Health and Non-communicable diseases, Department of Community Health Sciences of AKU. “Those individuals who are frail (elderly and diseased) and whose body system is already compromised succumb to extreme weather and we witness increasing death, as it happened in Karachi.”