Kolhapur, Maharashtra, India—Rukmini Kamble, 69, has a unique way of identifying how severe a heat wave is. “I look at the number of painkillers and paracetamol tablets I take in the months of extreme heat,” she told me. She now takes two painkillers every day. During the heat waves last year, she took at least one pill a day to bring down or prevent fever while she worked.
I spoke to her as she weeded a field on the outskirts of Arjunwad village in western India’s Maharashtra state. Surrounded by 13-foot-tall sugarcane, she repeated the same movements: bend over, cock her arm holding a sickle, and then smoothly scythe down an overgrown area. “Every weed brings down the sugarcane production, and so I have to cut it,” she explained.
This has been her routine for over four decades, but the hotter weather has made her work more grueling. After just 20 minutes in the sun, her iron blade was almost too hot to touch.
Recently the temperature has soared over 104 degrees Fahrenheit, nearly 10 degrees above her village’s average. A few days before I met her, she collapsed in a sugarcane field after working 10 consecutive hours. “I experienced something was wrong, and within a moment, everything blurred,” she said. Immediately, around eight farm workers rushed to give her some water. “I ate sugar, and returned to work within 10 minutes,” she recalled.
This too has become part of her job. “I collapse almost every 10 days now in this scorching heat. I’ve worked in the fields throughout my life, but such incidents never happened before.”
Kamble said she sweats excessively while working in the fields. As we talked, she switched to spreading chemical fertilizers with her hands and then moved to a nearby field to cut sugarcane. “The work doesn’t end here. We even carry this sugarcane on our head and load it into a tractor,” she said. At this point, we were both soaked.
Sweating helps regulate body temperature, but once the wet-bulb temperature, which measures a combination of heat and humidity, hits 95 degrees Fahrenheit, a human body cannot cool itself by sweating. At that temperature, even a person sitting in the shade risks multiple organ failure after only a few hours—and Kamble’s only protection from the sun is a white cotton coat over a sari.
In April, heat waves hit much of India and Bangladesh. Six cities in India hit 111 degrees Fahrenheit. These temperatures are becoming the norm across the region. A report by international climate scientists as part of the World Weather Attribution group found that human-induced climate change made these heat waves 30 times more likely than the historical norm. A study published in PLOS Climate showed that more than 90 percent of India’s population is now vulnerable to heat waves. And by 2060, according to the projections by the UN’s Intergovernmental Panel on Climate Change (IPCC), heat-wave duration will increase by average of 12 to 18 days. The IPCC further warns that the heat waves could spread to Southern India, where they are currently rare.
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When Kamble feels nauseous and dizzy, she takes a two-minute break and sips some water. “We can’t even waste a second on the field,” she said. If she starts to feel even worse, she asks a doctor to inject her with a steroid injection. This happens about once or twice a week.
Kamble has been applying henna on her palms and legs to help cool her body down, but in extreme heat, it doesn’t help much. Sometimes she says she’s so weak from working in the heat that she’s unable to eat food. “Look how frail I’ve become,” Kamble said, but she told me she no choice; she’s her family’s sole earner.
The heat waves are pushing farmworkers like Kamble to the edge of survival. Last year Mangal Khandekar, 60, from Arjunwad village of Maharashtra’s Kolhapur district, would carry a bundle of sugarcane tops weighing more than 64 pounds to feed cattle five times a day. “Every day, I walked at least three kilometers like this,” she said. When she got home, Khandekar’s joints hurt, and she would vomit.
Since then, she has found it difficult to return to farming. “I tried a lot to resume farm work, but I collapsed when I stepped out in the heat this March.”
Khandekar told me she spends 2,500 Indian Rupees ($30) on medicines a month, an equivalent of what she’d earn in the fields for 125 hours of work. “I’ve spent my entire life farming,” she said, “but now when I step out in the sun, I feel dizzy.”
After it became too hot for Khandekar to work in the fields, she was forced to sell her buffalo. She now has no dependable source of income.
The extreme heat will keep getting worse. Between 200–04 and 2017–21, the number of extreme heat deaths rose by 55 percent in India, according to a 2022 study in The Lancet. In 2021, India lost an estimated 167 billion labor hours to heat exposure, a nearly 40 percent increase from the 1990s. The NGO Climate Transparency estimates that this has led to $159 billion in losses, or some 5.4 percent of GDP.
Community health care worker Shubhangi Kamble, no relation to Rukmini, says the impact of rising temperatures has hit women especially hard. She said, “Women farm workers can’t step out before 9 am. They wake up as early as 5 am, tend to the family, milk the cattle, prepare lunch, and only then go out.” By this time, the temperature is already hot.
Pramila Waghmare, 31, from Maharashtra’s Bhadole village, told me she has been working for over a decade in the fields but has never experienced such heat. She said the biggest problem is that there is often no potable drinking water available to workers on farms. “We have to walk at least three kilometers to find water. Instead of walking so much and collapsing, we prefer not drinking water.” Dr. Angelina Baker, the village of Arjunwad’s community health officer, says farm laborers should drink at least four liters of water a day during such heat waves. Instead, many go without.
For the last few weeks, Waghmare has been experiencing severe knee pain and she is finding it difficult to walk.
And for most people, taking a break from farmwork during the hottest months just isn’t possible. Maya Patil, a community health care worker with 15 years of experience from Kolhapur’s Kutwad village, said, “People work all day in extreme heat, because they fear it will flood again in a few months, taking away all the work. So they cover up for four months of work in summer.” This has not just devastated their physical health, but the constant state of fear also affects their mental health, Patil said.
This has led to rising irritability and a widespread feeling of hopelessness in her village, Patil observed. Studies have found a relationship between higher temperatures and increased violence, aggression, and suicide.
While several Indian states have a heat action plan—public documents that list the measures that various government departments are supposed to take to mitigate heat-related dangers—adequate health care facilities remain rare in rural villages. There are only 767 functioning public district hospitals to serve India’s 833 million rural residents.
The Centre for Policy Research, an Indian think tank, assessed 37 heat action plans across 18 Indian states and wrote in a report, “Most heat action plans are not built for local context and have an oversimplified view of the hazard.” It also concluded that most plans were poor at identifying vulnerable groups.
During such times, community health care workers are coming up with their own solutions. Hundreds of health care workers like Patil and Shubhangi Kamble post on WhatsApp with heat wave precautions that workers and families can take. “Many people since then have started calling us to ask about heat waves,” Patil said.
Baker has set up an emergency facility in Arjunwad for patients with heat-related illnesses.
“Almost every day from April, a farmworker or laborer would come with a complaint of either dizziness, severe body ache, or rashes,” she said, adding that the incidence of heat-related illnesses will only increase. “Despite the severe heat waves,” she said, “farmers and laborers can’t abandon their work. So, we need to come up with concrete measures quickly.”
Farm workers like Kamble, Khandekar, and Waghmare say they can’t afford to take even a day’s break. “What option do I have?” Kamble asked. “No matter how much it kills me daily, I have to work in the heat waves to survive.”
After saying this, Kamble counted aloud the sugarcane bundles that she’d have to carry to the tractor today: 10 bundles, collectively weighing 440 pounds.