Growing up in South India, we had an annual routine to prepare for the summer heat. Living in a single-story house meant we felt the heat directly, so adaptation was essential. As summer approached, my brother (primarily) and I would whitewash the terrace to reflect the sun’s heat. Then came the ritual of fixing the coolers with my grandfather: my brother would paint the coolers with red oxide, and I helped change the mats. Inside the house, we would wash and prepare the terracotta water pot to keep drinking water cool throughout the season.
Now, as I work more deeply on the intersection of climate and health, especially on heat-related challenges, I find myself reflecting on these early adaptations we practiced as a family. Communities have long identified local solutions to adapt to extreme heat. Recently, I came across a simple but effective technique used by households with metal roofs: they place palm leaves and wet rice or jute bags on top to keep their homes cool. However, with climate change intensifying, these approaches need to be strengthened and scaled.
The Growing Heat Crisis and Vulnerable Communities
Extreme heat is one of the most pressing challenges of the 21st century, and its full impact is yet to be realized. South Asia is experiencing an average of 40 additional very hot days annually, threatening over 2.3 billion people. Heat-related deaths are significant, with Asia accounting for 45% of the annual fatalities globally between 2000 and 2019. Productivity losses from urban heat islands could reduce GDP by up to 11% in the worst-hit cities by 2100. Additionally, marine heatwaves in the Indo-Pacific are projected to increase from 20 to 250 days annually by the end of the century, severely impacting threatening food systems and livelihoods.
Strengthening Heat Awareness and Response in Primary Healthcare
The spectrum of heat-related illnesses is often underreported in health systems. With over 40,000 suspected cases of heat stroke across India in 2024 alone, early identification and household-level adaptation have never been more critical. Strengthening primary healthcare response to extreme heat is crucial to reducing mortality and morbidity, including:
- Training frontline workers to easily identify and manage heat stress
- Integrating heat-health advisories as job-aids and into outreach programs
- Establishing emergency cooling stations, especially in urban slums and labor-heavy areas
- Enhancing surveillance of heat-related illnesses in public health monitoring systems
Ahmedabad was one of the first cities in South Asia to implement a Heat Action Plan, a model now recognized globally. The plan includes an early warning system, public awareness campaigns, and targeted interventions such as cool roofs and water distribution in high-risk areas. It also establishes coordination between key stakeholders at the local level to respond proactively to extreme heat. Scaling such approaches across other heat-affected regions is critical to ensuring communities receive timely, life-saving care.
Practical Solutions from South Asia to Stay Cool and Safe
While systemic interventions are critical, household-level strategies remain an essential line of defense against heat stress. Some effective practices from South Asia that could be applicable globally include:
- Hydration - In addition to water, some effective hydration methods include:
- Homemade ORS (6 teaspoons of sugar and ½ teaspoon of salt in 1 liter of water)
- Sabja (basil) seeds soaked in water
- Coconut water and palm fruit/ice apple
- Buttermilk and other yogurt-based drinks to maintain hydration and body cooling
- Body Cooling
- Wearing loose, cotton clothing
- Applying coconut or sesame oil to the head, feet, and navel area
- Using damp cloths or wet towels on pulse points (wrists, neck, ankles) and head for rapid cooling
- Soaking feet in cool water
- Household Cooling
- Keeping indoor plants to regulate temperature and improve indoor air quality
- Using thermocol sheets as a false ceiling to reduce heat absorption
- Placing small cups of water around the house for evaporation-based cooling
- Hanging wet empty jute bags on windows to allow cooler air circulation
- Using vetiver (straw) mats for evaporative cooling
These tested practices play a vital role in reducing heat stress at the household level. As temperatures rise globally, integrating traditional wisdom with modern adaptation strategies will be key to protecting vulnerable communities from extreme heat.
Check out our advisory note to be prepared for extreme heat!
Author - Nymisha Herrera Nimmagadda
