Webinar recording: too hot to work, too poor to rest

Good, good afternoon, good evening and welcome everybody. Uh on behalf of the international institute for environment and development and all our partners, thank you for joining us today. >> So a warm welcome to all of you and I'm Rubaraj. I'm the director climate resilience finance and loss and damage at IAD and I also lead a work program called all act. So alliance for locally led action and loss and damage. It has uh representation from more than 50 governments and uh 70 plus grassroots organization where all the organizations or different types of stakeholders they have an equal platform. Um so this is a research that we have done too hot to work too poor to stop. Uh this is something that we have done in partnership with our grassroots organizations uh and and several of our um so I I see Tom Mitchell has just joined. So Tom, we just started off, but maybe I'll hand it over to you uh to give some brief introductory remarks. >> Yeah, welcome everybody. Um delighted to see you on this call and thanks for making the time. Um I just wanted to um thank Ritu and the team for the kind of the work that they've been doing to kind of prepare this report and also for the the coverage it's received. I think you will um appreciate uh that there's some very kind of serious and sobering findings that we're going to be sharing today um that have also I think started to raise some big questions about how kind of whole economies are being impacted by extreme heat but also how that boils down to individual experiences um and some really challenging individual experiences that can often have multi-layered and and and you know quite um difficult and intersecting impacts within families, within individual people's health, within the uh you know, areas of um physiological impact that you don't necessarily immediately pick up when you think about um extreme heat. Um and also the really tough choices that people having to make dayto-day about, you know, where their workplace is, is it open, have you got access to water, are you got access to sanitary facilities, what are the um adaptations that are possible? and equally what are the um the rules around uh dealing with extreme heat in the workplace. Now of course this is research that's focused on India but I'm sure that in many places um and and people on this call are of course you know working on these topics in very many different places around the world these will be um topics that are all too familiar to you. So um I'm very much hoping that during the conversation today we can hear from a range of experts and people giving kind of commentary and insights where we can um gather some of the experiences of what are the practical approaches that we can take to support and deal with um some of the very localized and individual experiences of extreme heat. but also how can we raise this up to be um policy topics that can gain very significant attention and action now um where um where pooling that experience is so vital. So just wanting to um confirm that ID is an organization you know we are a a research body but we want to make sure that our research turns into practical policydriven solutions but also makes a difference to people um at the front line of these challenges. We do work on extreme heat and particularly in the context of cities um all around the world. Um but it's something that we're going to continue be continue to be committed to do particularly looking at the intersection with with health and with work and so on. So um this is a body of work that we're very much committed to and look forward to working with many of you on the call as we as we take this agenda forward given certainly given its seriousness and and presence in it in everyday lives. Thank you. Thank you Tom for that introduc those those introductory remarks and I'm not going to take too much time and I'm going to straight away dive into the findings uh that on the basis of which we are going to have some some some good uh discussions today. Uh we are also very thankful to all our uh panelists who have joined today. So you know I I'll and we are very very thankful to them because this is an issue and as Tom was mentioning it's it's about psychological impact it's about the health impact that they that these workers are facing. So it was not very easy for these workers to come and share their experiences and we are very thankful to our partners like change alliance OKOP uh and and couple of other organizations that you see there. They're absolute grassroots organizations working with the workers and that enabled them to open up and share their experiences with us. uh we are also very thankful to five of the doctors who worked very closely with us not only in the design of these uh this research but also in the way in which uh the the data was analyzed and how we came out with some of the findings uh that we did. Uh so I'm going to straight away dive into uh what this research is. We covered this research in four cities, three in India and one in in Bangladesh. Uh today we are launch only launching the paper related to India. Yeah, the Bangladesh paper would be launched later in this month. uh we surveyed close to 700 plus uh households and some of the areas that we tried to cover through this we we really we didn't want to repeat what many of the other organizations have already done because you know these days research funding is very limited and we don't want to overress research the same thing which has been we which we already know and therefore we wanted to focus this research more into trying to understand uh some of the underresarched area. Now, we typically when we talk about talk about extreme heat, we only think about outdoor workers. We don't care. We don't really think that the indoor workers might probably be exposed as much as the outdoor workers. Um, and um I see I think is somehow my Can you still see my screen there? Yep. Okay. And the second thing we wanted to highlight was to understand the extent to which it's not just the the health impact on on the bodies but also the non-economic loss and damage that these workers are facing. And the third was around how much is like we also typically think that the workers are only exposed to heat at their work site when they come back into their into their living spaces. Probably the impact of heat is not that experienced. We also wanted to understand that plus combined with all of this research we wanted to come out with very practical solutions something that Tom mentioned that you know we are a research organization but at the same time we don't just want our research to sit in some paper or some journal somewhere but we really want to some of these research outputs to be actioned upon and that's something that we'll be discussing later on uh with some of our esteemed panelists. Now this is the way in which we have designed our research. We are not just looking at the precipitating factor. We not just looking at the heat impact but we are also very much looking into the predisposing factor. what are the conditions around the heat that really makes the workers more vulnerable uh to being exposed and then broad broadly we covered the housing condition, the social drivers, the occupational drivers, the economic demographic drivers but also to what extent are workers themselves trying to cope with this heat and to what extent there's a lack of social protection around them uh which really makes them more and more vulnerable to the range of uh impacts that they typically ally phase. Now let's just first very quickly go through the precipitating factor. Now this is the average mean average annual mean temperature and you can see we started analyzing the data right from 191. So more than 125 years 125 years of data and you can see the average annual mean temperatures increased by more than 1°. But more more important to see is this temperature anom anomaly. Now temperature anomaly as you will see has increased more in the last two decades. And similarly the maximum temperature has increased. Why maximum temperature analysis was important? Because for you know for us to understand the extent to which a worker through the day experiences the height of temperature in the in their uh in in through the throughout that day and also again here you will see the maximum temperature normally. You know we typically think about 2024 uh is the year that we remember as being the hottest in India but I think if you look at this data 2016 was another year which was extremely high peak. Now for the predisposing factors we we try to analyze who are these informal workers who typically work in cities and in what it worked out was you know this was a random sampling. So what it worked out was outdoor workers close to 90% were uh migrant workers and indoor close to 77% and and many of them they migrated with their families. So you'll see a lot of children u migrating with them as well. But most interesting thing is to see here is that majority of these migrants started migration only in the last 5 years. And you know things something that I've not presented in the slide here is if you go and ask them the reason as to why they migrated behind that is a failed crop uh because of so to a large extent it is the climate risk that has pushed them from many of these rural areas into these urban informal settlements and because they are migrant workers it is it becomes even more important to understand their predisposing factor because many of them they stay in informal settlement they don't have a permanent households and that is why we we looked into this housing heat exposure index and this is made up of a number of factors for example roof roof roof type roof height per capita housing area and so on and I'm not going to take you through too much in in detail with this but basically what you will see is in many context the roof type is mostly tin topppoline which barely protects them any provides them any protection then again the heat the roof height is very low because heat typically rises on the top and if it has no space to escape or no it basically stays within the living space of the people. Again uh we looked at the wall type per capita housing area again in one single room there are like five or 10 people staying together. uh availability of fans. You'll see close to onethird don't have a fan and even those who have fan there's just one fan. There's no refrigerator. But what it does is you will see that the food security issue really increases around the summer months. Why? Because a lot of food gets spoiled but more than that it's also because of lack of wages. Uh the um people don't find work a lot uh during the heat uh summer peak summer months. And that is why you will see the food insecurity issues goes up. Again, water availability typically in summer is an issue and also toilet facilities at home. In terms of protective factor which could have brought down some of the impact that the the workers are suffering, you will see on a scale of 1 to 10 typically the social protection index is less than three or three or around three. And this is this is when if you look at the food aid program in India, it's probably the best in the world. Like when I say best the amount of money that the government provide spends on this plus India is probably the only country where you have the one nation one ration card uh program where workers can avail their ration or or ration from anywhere it does not ma matter whether they're migrants or non-migrants but still you will see a lot of a third or in some cases around 40% of the households don't even have um uh coverage or they don't have access to those cards even those who have cards are not able to avail it. Similarly is in the case of health facility. India again I would say is I do a lot of work on social protection programs and I've reviewed a lot of programs globally as well. India's health program especially the Aayushman and Bharat cashless program allows people to go and seek benefit or seek uh treatment cashless treatment even from private hospitals. But you will see a lot of people are not aware of them. they don't have those cards and even if if they have those cards they're not able to go and avail those facilities. Similarly, there's a labor welfare scheme enrollment is enrollment. You will see a lot of the uh workers do not either are not aware of them or they don't have access to them. Now this is again the workplace heat exposure index. Uh so to what extent workplace facilities help workers cope with the uh with the heat conditions on a scale of 0 to 10 it is less than three. Um it the indoor workers are slightly better off than outdoor workers but they're actually not that great. And some of the ways in which we have tried to understand this is the daily working hours. You will see both for outdoor and indoor workers. For indoor workers is slightly longer. The work day is more than 9 hours and again availability of shaded workspace, cool water, electrolyte is almost negligible. There's no medical pro uh provision but also there are ways in which the exposure to extreme heat can be regulated. For example, ban on midday work, job rotation, work schedule changes but none of that is happening right now. Again, quality of toilet facility at work becomes important because a lot of workers which who we interviewed said they didn't they didn't drink water because there was no toilet facility especially for women and that you can understand has a even more damaging impact. Now workers try out different hacks or try out different ways in which they can deal with the with the impact of heat and but again you will see on a scale of 0 to 10 it stays less than halfway mark. There are different ways in which they try to adjust like rest in shade, cover the head with cloth, avoid uh carry water to work places and so on. But all of that I'm I'm not spending too much time because it's quite given a lot. Anyone who stays in India or Bangladesh or any of has seen many of these areas, they would know that this is kind of a given. Uh but what we don't really know is the health impact. And to understand the health impact we looked into three category of impacts. One was heat. So there and this is not us like we are not the experts in the health area. So that panel of doctors who really helped us analyze this data they explained to us that there are three types of health impact that can come in. Now for it starts with a lower like heat cramp is the most common but if it becomes more pronounced like then it can lead to heat exhaustion and from there it can lead to heat stroke and heat stroke probably is the worst kind of impact that they can suffer and that leads to acute kidney injury in case of many workers and repeated exposure to dehydration can then lead to chronic kidney disease. Now we try to understand the level to which the workers are exposed to this heat cramp, heat exhaustion, heat stroke and how many of them are suffering from AKI and uh chronic kidney disease. Now heat cramp again you know these are some of the symptoms of them. Uh these are the share of workers you will see that you know less than 14 15% are actually seeking um medical care for for these symptoms and this is the heat heat stress prevalence index. So on a scale to 0 to 10 8.99 like close to 90% of the workers indoor and outdoor are suffering from uh from uh heat cramps. Now the second stage of this impact could be is heat exhaustion. Now these are the symptoms of heat exhaustion and we then looked into how much of the workers are actually suffering from heat exhaustion in summer and then the non-summer months. Now and this is the scale at which or or you know estimate of the workers who are actually um seeking any kind of medical attention for the impact that they are suffering. You will see close to a a third of the workers even if they are suffering they are not seeking any medical help for that. Now the worst form of heat uh related damage is heat stroke and this is the scale at which it is happening which is 54% of outdoor and 51% of indoor workers are suffering from heat stroke related uh symptoms and of that those who are actually seeking help in terms of outdoor is close to 20%, again in case of indoors it it is close to 19%. Now heat score prevalence index this is something that we de developed just to understand the scale of damage. So you can see in the summer month out of on a scale of 10 it is around five again in case of outdoor risk 5.42 in the rest of the year it goes down which is quite understandable but that's the scale at which workers are suffering from heat cramps, heat exhaustion and heat stroke. heat stroke is almost a medical emergency and that is what we were told. Uh now we also tried to understand what are the factors that really contribute to that. So is it just the heat exposure or is it a range of other factors and for that we developed a regression model and I have my colleague joining later in the panel discussion who will explain what this regression model output really means. We also try to understand that beyond the physical health damage uh what are the psychological impact that the workers are suffering. Now some of the ways in which we tried to develop this psychological stress uh uh index was to understand the increase and this is how the workers themselves explained irritability an being angry mentally tired feeling sad hopeless having not being able to sleep properly and these are some of the factors that really stood out very strongly and we also compared it with non-summer months and that is it was very clear that it bent down in non-summer months compared to the summer or or during the period of extreme heat. We we have we did all of this analysis on a toolkit called seik. So comprehensive. >> Sorry. Me too. Apologies. Um people are asking you to slow down in the chat. >> Okay. Okay. So we used uh thanks Marcela. So we use something called CIC. So CEC is a comprehensive climate impact quantification toolkit where we try to understand the tangible intangible intrinsic and functional damage that uh that climate impacts create and we use the same framework to identify the heat impact on on the workers. Of course you know you will see a lot of this uh explained in greater detail in the paper that my colleague must have shared in the chat. uh but uh we'll have like we can we'll have more discussion around this in the panel. So I'm sorry for being a bit fast because we have one of the panelists who has to leave early. So I'm I'm making sure that we get a chance to hear from him as well. But this is where I would really want you to to focus. So what are the longerterm wage and heat related kidney disease uh that workers are suffering from? And here I' I've presented both India and Bangladesh data. So this is you know if you remember I had mentioned about heat heat cramps, heat exhaustion and heat stroke. And in India the workers who are suffering from AKI turns out to be around 18.67% of the total workers which is quite high if you ask me. Bangladesh is around 23%. Now in terms of in terms of the estimated percentage of the workers who who I would say graduate or who go from AKI acute kidney injury to uh chronic kidney disease in India it is around 4.82. Now you might feel that 4.82 is a very small percentage but this is a medical emergency. This is where their kidney gets damaged and they might need diialysis. Now you can understand a a worker going to that stage means that they will not be able to earn a a decent or or a regular living anymore. Now number of workers that it translates into and this is something that we projected uh based on our data is around 26.35 million workers might be suffering from CKD purely because of heat related uh exposure. Now the wages lost because of exposure to CKD in terms of million is around 4 45 4507 million in India and of course 607 in Bangladesh and in terms of uh the wage earning lost in billions in purely in amount in India is close to 22.73 billion that is a huge amount we then translated that amount into what does it really mean in terms of GDP loss so in India here that GDP loss purely from CKD chronic kidney disease comes to around 58% of GDP. India's a big economy. You can imagine how much that really means. Now beyond the heat, beyond the health related damage, we also try to work out the work days and wages lost during extreme heat events. So we try to calculate it on the basis of three parameters. One is work days missed because of heat related illnesses. work days lost because of inefficient working because they can't work with the same uh efficiency. Uh and the third is around a lot of workers complain that because of extreme heat and they are daily wage earners a lot of construction sites are closed because of regulations and therefore they can't even find work. So combining all three the the average amount of uh work days which are lost but due to extreme heat for outdoor workers it comes to around 24.3 days and for indoor workers around 14.8 days and in terms of uh the wages lost per year is around $151 uh uh and for indoor around $89. Now those of us who stay in Europe or UK this amount might seem very small but for a daily wage earner this is a huge amount of money and this is the level as it is many of these workers are living below the living wage uh but this heat related uh damages leads to even more decrease in that living wage that they suffer. Now if you like earlier I showed to you that close to.58% of GDP is lost because of health related issues but if you combine all of this India's loss of GDP purely because of extreme heat is around 1.99% which is close to 2%. In case of Bangladesh although the report would be published later on uh in this month it comes to around 1.38%. Now we just didn't want to highlight the issue. We also wanted to share the solutions with you and the solutions are actually within reach of India and that is because India already has some extremely good um as I say the systems already in place. India has Aadhaar card there's an eshum registration almost most of the households have a bank account which is linked to Aadhaar card. So we already have that systems in place. What we are saying is that if you look at the and and majority of these losses are concentrated in 13 states in India uh and which you know if you only look at the amount of workers which are exposed to extreme heat it is around 350 million and if you like currently in those 13 states 350 million workers are losing close to 36.36 billion uh dollar per But if we were to provide them coverage through a cash transfer program uh and for this we have worked out three models. We have taken the average wage based on the MGNR regsbased social protection program. So if you look if and there the average the floor ba wage floor is around $3.15. So if you take that into account and in a normal year based on the IMD projection the heat days extreme heat days comes to around 4 to 7 days. So we have taken 6 days there for a normal year. In in a in a very hot year it can go up to 11 to 12 days. So we have the second model is around 12 days and in a record year it could go up to 18 days. So what we are saying is that in a normal and hot year that 6 to 12 6 or 12 days of wage should be paid to the workers so that they can stop working in those extreme heat days and stop causing themselves permanent loss and damage that they suffer on their body and their mental health. But in case of record year when it goes up to like 17 18 days of extreme heat then that extra days can come from insurance and this is based on some of the experiences that we have learned from uh India's sava model and we have cla coming in later in the panel discussion and she can explain more about it. What we are saying is that do not use insurance as the only way in which workers can be compensated because if you only look at the insurance payout then it hardly covers $7 to $8 which is like a very small percentage of what workers actually lose. But if you combine it with cash transfer then you can provide a much better coverage so that workers can actually stop working. And what we are saying is that you know there should be on a living wage modeling approach. There should be a heat triggered cash transfer. Uh workers should be provided support to get better access to Aayush manat uh PDI scheme. So that the total you know if all of these measures are combined then in a hot year then the total expenditure that comes to is around 1.45 45 on cash transfer alone 1.33 billion but that is nothing compared to what workers actually lose and you know we have our own analysis which also shows that for every $1 that is spent in early action you can actually reap a benefit of about $5. So why not do that and rather than letting these workers face that loss and damage on their body, we India also very recently they came up with um uh a revision in their uh labor laws where 13 different um obsolete laws were combined together into one law. But what we really urged the government is to also introduce a heat related thresholds in the code so that workers can be allowed to stop work when it goes beyond a certain threshold. Uh then also like right now those regulations are only applicable to um to workplaces above a certain threshold of workers crowd but heat impacts each and every worker and there so it should not be based on the worker count rather based on hazard based approach. So the moment heat goes above a certain threshold you know they this regulation should come into action and then again we are urging that heat stroke and other heat related illnesses should be considered as an occupational disease because right now the state insurance program does not recognize uh heat stroke or heat related illnesses as an occupational disease. So I know I went a little bit fast uh and apologies for that if you have not been able to follow all the findings but we my my colleague has shared link to the paper and we'll be hearing more from the panelist as well so they'll um so you'll get a chance to understand some of these uh issues in greater detail but with that I will really request if we still have u Dr. Kit Dr. Krishna what's and we are very uh thankful for him to be joining us today. He's a member and the head of department uh for the National Disaster Management Authority in India and if uh we still have him um uh we I would really request him to come and give his opening remarks. I know he had to leave and that's why I was going a little bit fast. Um Chandra, can you just confirm if Dr. Watsa is still there? No, I I can't see him in the meeting room yet. >> Okay. Um I'm really sorry colleagues. I tried my best. I you know he had sent me a me message that he had to leave uh earlier. Um so um we are very sorry to have him go but maybe if he is able to join in later on then we can have uh some of his comments. But uh I'll start off with the first panel and we are really um thankful uh for uh for four of esteemed panelists to be joining us today and all of them are experts in their own field. Uh we have Mandakini uh Balohi who's the director insurance ministry of finance in India. Uh we have Medeline Thommpson uh who's the head of climate impacts and adaptation at welcome trust. Uh we have Bart uh Vanderh who scientific director and the co-chair of IPCC working group 2 and we have Claire Harborn who is the chief executive uh officer of the Hen Foundation. Almost all of them have extensive work in the heat space. Um and uh I am I'm very pleased that we have them with us. So probably I'll start off with you Mlin if you're okay. uh is because I know I've been very closely um associated with the climate health impact awards uh pro initiative that you have and we know that and and in most of my own work I keep saying that we do need to put numbers on these impact because without putting numbers it really loses the attention of the policy makers. So from your experience Merlin, how do you really see that the importance of some of these findings coming on the table and how do you really see these evidence influencing real action in the policy space and and and especially the kind of social protection programs that we've been demanding for for the workers who are exposed to these extreme heat and suffering with their bodies. >> So uh thank you so much and it's just a pleasure to be here. I think uh uh what struck me most about the report is really how you lay out the breadth and depth if you like of the heat experience for individuals. Um quite often you see quite simple statistics uh on heat stress or heat stroke or uh loss of uh uh labor time etc. but quite a comprehensive um and broad look if you like about the impact of heat on on people and their lives. I do want to actually um say something else uh which um uh struck me in your opening slides. In your opening slides, you presented uh the rising temperatures in India and you also showed how they vary from year to year and you showed the big peak years uh and you described 2016 and then 2024 as the last big peaks. Those were both El Nino associated years. The 2015 2016 El Nino, the 2023 2024 El Nino. What happens during an El Nino is you get a lot of heat released into the atmosphere and we have this global rise in temperature which we are experiencing at the moment. So one of the things that um uh we didn't you didn't discuss in the report in the options for uh support the safety nets uh the use of insurance etc. We also do have the potential certainly for these really um bad years uh to get some sense of early warning because uh El Nino allows us a bit of prediction about what's going to happen in the climate system. Uh so um uh the other thing I just I thought your presentation was so helpful is the numbers of people you know like when we talk about things at a country level and we talk about one country we say oh you know this is what's happening in the Gambia this is what's happening in uh Nigeria this is what's happening in uh Fiji you don't get a sense of the difference in population and obviously the Indian population is a huge population a very significant part of the world's population and so any percentage uh experienced in India has huge ramifications uh for the numbers of peoples involved so I think presenting it both at a country level and a people a number of people involved is really really important uh another area I thought that we could elaborate on a bit more and you do mention it in one of your slides is the experience that people can't sleep. We know from a physiological perspective that sleep is actually where people recover from the stress and strains of the day. And if people can't sleep, they can't recover. And so even if you set up protection systems in the workplace, ensuring that they have a cooler environment to work in, ensuring like you said um uh water breaks, uh not working in the in the full heat, etc., etc. you still need to think about workers at night so that they can actually rest at home and you need to have innovations. There's the white roofs um uh that that are being developed to um cool people's living accommodation down. We need to think about about people not just the way that heat impacts all of their lives, but how it impacts it across the whole uh 24-hour cycle, not just when they're actually in the fields or um uh in the factories. So um so I think if you if you think there are three things that are needed um you're asking about how the evidence should be taken up and first of all is as I mentioned you've broadened the evidence base about what counts really giving that comprehensive overview including both mental and physical health I think incredibly important as well as the other characteristics. Um we also need to uh make visible as we do through our climate impact awards the harms uh that are being experienced and making that visible tangible to decision makers and the numbers really count there but not just the numbers I think it's also the lived experience the voices of communities getting uh and enabling those voices to be heard I think is a really important part of the process and um so listening to communities uh intently and understanding their experiences is where the evidence uh really needs uh to come from. It's not just an external look see and say oh this is what we think is happening to you but really directing the research from the perspective um of the uh of those who are actually living through the experience. And so to me the challenge is not that there is insufficient evidence that climate change is harming health. The challenge is really uh that our institutions, our funding systems, our decision-making processes really under estimate the full scale of those harms and we need to measure them differently, value them differently and fund them differently in order to respond to that. Uh so yeah, so welcome. this is really core uh to what we think about what we try and do and um I'm very appreciative of the work that you've done because it also helps us understand uh the processes better. >> Thank you so much Meline. you know what you have highlighted is is is is I think it's very important and that's the reason why we also wanted to show like policy makers in India especially that a country which is growing and growing at the back of many of these serviceled organi serviceled industry and if the workers within them start falling sick you know it's their economic growth which is going to get impacted so it is important for them to take that like you know for because the entry point was to get the attention of policy makers by showing the scale of damage that this was doing to their GDP. Even if whether they care about the workers or not, at least they would care about the GDP and therefore then invest in in their in the in the care and that is needed for them. Especially like they what we have gone and talked to the policy makers and what they always tell us is giving them 6 days 12 days without them working but what they don't understand that by giving them 6 or 12 days of pay without work will have a far greater impact on protecting their own economy and protecting the the productivity of these workers who really contribute to making the economy. So I'll probably come back to you Meline again. Um but I'll now move on to Bart whose work has really inspired me influenced me. Uh he is the co-chair of IPCC working group 2. But the way in which he is reformed uh or allowed for different diverse knowledge systems and evidence to come through is very important. But more so what I really like about your approach is you keep pushing all of us even in IPCC that it's you know we have to do something not just to look into the impact highlighting the impact of climate change but also the value of acting on it. What are the responses emerging? what are the best practices emerging? How can others um uh you know how how can government can really act on on them? So I wanted to understand from you as to you know and we tried our best to put hard numbers on both the physical and mental health impact. So how do you really see some of these analysis being useful and do you think that we should be changing or or modifying the way in which we present this evidence and analysis to make it more actionable? Yeah, thank you very much, Ritu. And I must confess that um reading through the Guardian uh coverage this morning on the work you do and now seeing again the presentation, it really gets to me if uh it it it's also it's not only a factual story, it's also an emotional story because it I indeed I scale up an immense number of people. I I scale up the immense difficulty to for them to cope and to find alternatives. uh and that well that is that is that is yeah uh that is touching touching me as as IPCC I I definitely indeed call for uh you know the time of diagnosis uh I I wouldn't say is over but whenever we do an an additional diagnosis or an assessment or the current risks and the impacts or whatever the the your your work to to zoom in on individuals although it is a large group of of it is numbers it is it's immense but that that gives a much uh more clearer picture of what actually how climate change actually looks, feels, smells that kind of things by by the diversification and I guess that is also where we really want to make an upgrade relative to previous assessments that we don't want only to to have these gross numbers and numbers of people but also zoom in on regions on professions on on on that kind of thing. So this is definitely uh adding to that with with with all that substance and yeah I I I would indeed call this you know enriching the evidence base for IPCC. you rely on uh a lot of evidence that you collect in the field so to say. It's it's not only a modeling study. It's not only you know a download of of federal statistics. It's really going on into the grounds. And I I I think that's a very important contribution to also yeah the science itself but ICC can pick it up readily indeed. What I also like a lot is the uh the suggestion that you make and you have some some some experience as IED with that with you know what is what is the coping uh schematic for a government or for that blended finance insurance versus the social protection system. I think that is also uh very well in line with with the ambition not to do the diagnosis only but also to find where the remedy is. What I find really challenging on this and and intriguing I must say because I uh there is in this solution thinking and and definitely if you think about uh social protection changes or blending um insurance with with with federal governments. I know or at least I from your report I acknowledge the microeconomic benefits of it. Uh but I do not readily take the conclusion that that microeconomics is thus the incentive to to to act because there is so many other interests that that that actually yeah know uh will there will be different ways to spend that money. There will be different accountability records to actually make sure who is eligible for it and there may be other policies that like that need to for instance uh intensify the the industry of insurance for instance and and and so that is always my uh I think the struggle that we have also within IPCC is that uh there is there is in in a lot of particularly governmental but also I guess more businesses or whatever in the solution space a lot of normative uh arguments need to be uh settled as well and so it's not even enough to to give the solution. It's it's also important to to actually make a map of what that actually solution what how that actually competes or is enabled or is is blocked by surrounding conditions that also need to be in place and also there the the evidence base is is the IPCC bread and butter. I would say if you can really show that this blended finance or this blended uh support system where you indeed zoom in on okay in the excessive years that is where you rely on insurance but in the more mild years this is more you know a more sort of generic social protection scheme. If you have numbers that can show applications that this indeed worked, that indeed you saw a reduction of uh of uh exposures and an an increase in the profitability of the of the go of the companies that employed these workers. That of course is our story to tell. Um there is always I guess there is nothing wrong with bringing in a normative justification for this. We also embrace uh the notion we we we want to work on the principles of equitability on on just transitions. We have uh in intense discussions within the auto team what it actually is, how you actually mainstream equity and justice in our assessment. And very often it comes down for our for us as scientists that work with hard numbers. It's about that diversification that that uh explicit subcategorization of these mean numbers. Zoom in on on specific groups. not only look at their uh immediate impacts but also look at the number of years they need to recover to actually uh come back from from the economic fallback that they experience. that kind of reasonings is is very prominently there and that of course in itself has some normative element because as soon as you start zooming in on specific groups you have to justify why this group that but but and but there's nothing wrong with that but I think it would be good to to to have this evidence base that it is shown from practice that if you invest in this direction with this this lens with this um you know scope to to have a a huge pool of potential labor hours being saved for the sake of the greater good. And if you can show that in this case, that would give another evidence base under a very normative discussion that that society needs to go through and that that is I guess what your report definitely uh contributes to. But I will I will keep on encouraging every author in the team to chase uh the literature that that don't takes necessarily an an uh an emotional point of view or a normative point of view but collects the evidence that allows a good discussion about the emotions that we all feel when we see your numbers. >> Thank you so much B. uh in fact the the the purpose was to you know I was at the heat stress international heat stress workshop that government of India NDMA in fact we missed out on um having uh Krishna Watsu he was supposed to come and give an opening remark but he said he only he had to leave hopefully he joins later but the whole point was there were lot of insurance company in that workshop and I was quite amazed as to how many like how how come it's only an insurance discussion and even there I said insurance is part of the solution but not the only solution and I'll come to clear about this um and and probably it's because some very good experimentation has already been done in India and there are some learnings emerging from that as well um and and that's why I'll bring in Claire Harborn uh who is the chief executive officer of Harden Foundation and Claire I think Harden support no I don't think I H howen did support a scheme in India uh where women workers receive received a cash payout when the temperature became unsafe to work. Uh and you have learned quite a lot from that experience and it'll be useful to understand from you as to what those experiences are and especially when we're talking about scaling up similar experiences uh at a panindia level and probably in other countries as well. Uh what is it that you would really uh tell us from your from your learnings? >> Thank you so much. It's a pleasure to be here. I enjoyed reading the report this morning morning morning and and hearing you present it as well. I echo all the comments of my previous panelists on you know the combination of facts, reality and kind of emotional engagement in this topic is is really powerful. So yes, you're absolutely right. Um Hen Foundation, we had the absolute privilege of supporting SA's excellent work in India as part of our partnership with an organization called HIA previously known as climate resilience for all. and I think colleagues from both those organizations are on this call as well today. So I'm going to talk a little bit about that experience in terms of what we learned and obviously we learned via those organizations um and the work the great work that they've done and I think the first thing to say is to echo previous comments. You know insurance is a really important solution. It's a powerful tool, but it is not and can never be the whole solution for different reasons and in in different ways. So, I'll I'll say a bit more about what I mean by that. But I think the first thing just to hone in on, make sure we're all really clear when we're talking about insurance for informal workers and when you know we're referencing the work that SA and Her did in India, we're very specifically talking about parametric insurance products. So, we're talking about products that pay out based on a pre-arranged trigger. We're not talking about indemnity insurance where the worker needs to go and prove their loss and fill in lots of paperwork afterwards. And I think if we're talking about the positives of insurance for these workers, that is one of the real positives. So parametric insurance products offer I think a couple of things that do stand alone as really powerful and those are simplicity from the perspective of the consumer, certainty. You know that when a trigger gets reached something will happen and that certainty is powerful and meaningful and what that then gives you is agency. And Tom mentioned in his opening remarks the reality that these impacts are impacting individuals in different intersecting ways. And so whether it be through insurance or some other form of cash payout, being able to access small amounts of money that then you yourself decide what you need in that moment is a powerful moment of agency in a very volatile world. So I want to celebrate the the positives of insurance solution but I think we also need to be cognizant of its limits and your report calls that out and and rightly so. It calls it out from a financial perspective in terms of the financial gap that is covered but the reality being the financial gap that is not covered by insurance and it doesn't cover the whole the whole piece. It does not cover the whole risk. It does not reduce the risk. So I want to talk about two things in terms of its limits. I want to talk about the fact that it doesn't reduce the risk and the impact on you and why it must be bundled with other solutions. And then secondly touch on this point about how powerful it can be when it is combined with other forms of cash payout. And I want to reference um a a great piece of work that was done by Hera actually on the basis of this work with SA and it's a report that they released in 2025. It's it's brilliant in its simplicity in calling out very practically what they learned needs to be bundled with insurance for it to work well. And so this first point is that for it to work well, it also needs to come with risk reduction measures. So, early warning systems, you talked about those as well. Simple education about how to protect yourself. I mean, no one is lying in a hot house at 45° thinking, "Oh, well, it's fine because I'm going to get an insurance payout." You know, that's just nonsense. You've got to be bundled with sensible passive cooling options, whether that's white roofs, they were mentioned as well, um cooling stations at work. All of these things also need to be in place. And as a foundation who cares deeply about the role of insurance, we also recognize that. And if you look at our portfolio in India, we're also investing in these other types of bundled solutions as well. So it needs to be bundled with with all of those pieces. But I think crucially, and this is the sort of exciting bit that I know you've pulled out, this idea of it also being combined with a cash layer. I think it's something that was trial in in this work. And now both Sabre and Hera are taking this idea beyond including to new geographies and we're excited to be supporting that as well. So the way that it worked in in in India is you know once the temperature reached 38° there was an option for a small cash payout not insurance just a a cash transfer. Once it reached that really extreme temperature of 41, that's where insurance kicks in and the insurance payout comes. And Rita, you you kind of showcase that idea in your opening slides, right? So insurance should really only be kicking in for the really extreme, you know, extreme is a relative term, but really really extreme heat events. Other than that, it should be social protection and other where where appropriate kind of just risk reduction and risk management measures. And we saw it work. You know, if you look at the stats, you have some of these in your report. In 2024, 50,000 women were signed up to this program. By 2025, that was 225,000 women. That's insane scale in such a short space of time for such a new initiative. women literally voting with their feet as they see that this works. They see that combination of simplicity, certainty, and agency play out. And in that first year, 100% of women received a cash payment at some point, and 92% of women received the higher insurance payout. And there are powerful powerful stories of what this means to these women and I won't try to do them justice but stories of women who you know suffered really significant health impacts as a result of extreme heat who then would have been plunged into debt around medical bills and inability to feed their families who were then able to have some funds to continue to feed themselves their families to pay off some of those medical bills. These are real life examples and hundreds of thousands of women are those examples as this scales. If you want to hear more because I think the stories are real and they are a powerful way of bringing it to life. Um we have a lovely very short blog on our website which brings to life the story of an incredible woman called Gizben and Kathy Boffman Mloud who's a CEO of her tells that story really powerfully and Gizen herself tells the story as well. So I'll put the link uh in the chat. Do go and watch it and bring to life at least one example of how this works. But I would agree Ru I think it's powerful but it's not and can never be the sole solution. >> Thank you so much Claire. Uh and and please do share that link because you know that's that is what an NGO a small initiative is trying to do. So that's already a proof of concept what we are asking government and and and small organizations like SA and HA and others. Now you are trying your best to prove a concept but then it's for the government to take it to scale and what we are trying to prove through our numbers is you know it's viable and it should be done because if it is not done there's a huge cost of inaction and it's quietly being suffered by the workers themselves. Um, now if and I'll I'll I I'll request uh all three of you to please be be there because we might come back and I'll I'll seek your comment on some of the inputs uh from other of the panelists and I'm going to slightly modify the program a little bit. We also have a documentary but I don't want to waste the time for everyone to go through the documentary uh right now. I'll probably ask my colleague to paste the link to that uh in the chat so we can spend more time in discussing with all of you. I'll now bring in uh the second panelist uh uh Dr. Archa Shukla Mukharji. Uh she's the CEO of change alliance and they were one of the anchor partners that we had. So I'll bring both the anchor partners now both from India and from Bangladesh. Uh so Archa is part of the our anchor organization in India. And Archa you've been working in this space for very long time. In fact I know you for more than two decades. I'm pretty sure like it's it's a it's a long uh working association with you but what the aspect I would really want you to highlight is because we covered both outdoor and indoor workers. So especially to understand from you like what do you really think is needed to be done especially in in terms of bringing in private sector in this space of supporting the government action. Um so Archa if you're still you were on the screen but somehow I don't see you now. >> Yeah. Hi. >> Yeah. Yeah. Archa. Yeah. Go ahead. Yeah, thank you so much Ritu. Um I I'm very glad first of all I think we were involved as part of you know uh collecting so much of data and then uh reaching out to the communities but I have never thought of in my imagination that the data will speak so much and the kind of triangulation which has been done by uh ID team is like commendable. So congratulations for that. Um to start with in terms of um because we we have worked also on ground and we we are continuously working in various supply chains. So I think one very important aspect which has come out through the case studies as well that even if people are uh falling sick uh they're not uh the uh the u employer is not responsible even to uh make them to reach to the hospital if they are having heat stroke and all that. one uh they're not realizing two they do not have the mechanism and three they do not have the intent to you know provide those kind of services because it will have its own cost so I think one of the very important aspect and as you already mentioned in in your presentation that how it can be included in ESI uh the uh employees state insurance uh as heat stroke can be included as occupational disease uh that can provide some kind of uh respite to these uh workers but at the same time I think accountability has to be fixed on the uh private sector as well and there should be a and we're continuously talking and working very closely with the supply chains also how to track and trace these supply chains and not limited to tier one and tier two and how we can look into the informal sectors who are working for your factories to be part of your uh entire system. They are not invisible workers and they are not invisible citizens of the country. So I think that's very important in terms of how how are we putting accountability but having said that I think um you have already talked about um a lot of uh suggestions from the policy framework. What amazed me in fact uh the the declaring uh outcome related to um uh the kind of uh you talked I mean the the report is talking about the uh very limited access of u and link access of voter ID card Aadhaar card uh bank accounts uh access and linkage to the Aish man cards even PDS for the migrant workers um and and and cities like Delhi NCR and Agura and Ajmir where we have worked on. I think uh these were very um uh typical kind of outcome which has come out. So I think what what was very glaring that uh there has to be a lot of work to be done on ground in coordinating in engaging meaningfully with the multistakeholders and also having lot of social dialogue and support system for these migrant workers um to be part of the system. I mean at one level we are talking about that we have lot of policies lot of um you know instruments and mechanisms. I completely agree on that but uh if it is not reaching to the most vulnerable and marginalized then I think we are not doing something right. So I I feel that it has to be looked into from the uh policy framework from the private sector looking into the entire supply chain and also looking into uh the human stories within it and how they can be supported and and as the the the report clearly talks about how migration is you know impacting and it is not at the urban space but also it is coming from the rural setting and from the source to destination. So how to look into that and making not only the government and private sector players accountable but everybody all the multistakeholders can come together and work on it and there is a huge scope to work on this kind of uh things and I feel that everybody including unions including the women collectives have lot of role and civil society organizations specifically have lot of role to play to connect the dots which is completely missing uh as per this study and it's the the findings are very glaring. Ru let me admit that. Thank you so much. It just because uh as part of our research and uh we also collaborated with labor unions and they highlighted a lot of issues and one of the recommendations that we have made there is you know government of India had a very long elaborate discussion on how how labor laws should be strengthened and in fact they they brought together 13 different earlier labor laws and created this one law which is occupational safety, health and working conditions code and it's it's it's really sad to see that while there are heat stress related discussions happening at the government level there is no heat heat does not even get a mention there's no heat related thresholds by which the workers should be allowed to stop working uh stop work and in fact some of the earlier laws that were there in Tamil Nadu in Gujarat in Maharashtra where there was a wet bulb uh norm which allowed workers to get some protection in terms of once the those triggers were alerted even those are no longer there. So we really need to push and bring in some of those uh changes but you know something that you highlighted Arjuna we do need to bring in a supply chain we do need to enforce some of this through the private sector through the construction company through these garment manufacturing companies and so on. So that brings me to our next panelist uh who also uh uh who who are who were our anchor partner in uh in in Bangladesh and uh Shakirro Islam who's the chairperson of obiwashi karmi unayan uh uh program in Bangladesh and in fact we have collaborated with them um over several years they work very closely with the migrant workers and some of the findings that we got from Bangladesh of course we'll be coming out with a report by the end of this month but I wanted to bring in uh Shakiri role into this discussion because especially you know we have seen that this extreme heat is really reshaping the way in which people live they work and the kind of income that they receive. So from your context and we have heard about some of the social protection programs, some of the labor laws in India, but from your context like how do you think some of these reforms should look like in Bangladesh? >> Uh thank you Ru. I think it's uh it's it's our pleasure actually to be part of this uh research and um it was really interesting to uh to see your presentation with all data and all the things and uh yes we all are talking about solutions how how we can actually uh uh uh make sure that the people who are affected by this kind of heat waves particularly in the informal sectors or formal sectors like uh the government sectors how it look died and in my opinion I'll say that yes the Bangladesh has some sort of social protection schemes but it does cover the extremely poor people. it is not uh uh yet uh uh responding uh to the people who are affected by climate change for example heat stress right so so there is no special protection system for the workers including migrant workers uh uh who face uh heat stress and other climate shocks so it's completely missing in our country and uh when we are talking about insurance uh how it can cover So we have a lot of doubts uh because uh the mass people have no trust on the insurance company in Bangladesh particularly because that uh uh uh they have uh they actually do not comply with the conditions most of the cases people are frustrated to run after uh uh the companies to get uh uh the insurance claims right so so that's why it's again it's a huge issue even if it it it is in place what I want You say uh uh uh it's it's it's really important actually to talk with the affected people how they look like the solutions whether it is insurance whether it is social protection whether it is something else we don't know as an organization as a grassroot migrant organization we are trying our best to understand uh the the sustainable solution what what can be the sustainable solution when we are talking about yes uh you know uh a compensation for uh uh uh for for for a uh for several days in a year during the heat stress can help them. But it is really helpful for the families for the affected communities because uh the heat stress is not creating the physical health stress or the mental health issues at the moment. Because of these kind of health stress, people are going through different kind of longer term uh you know diseases and that is actually really really uh concerning that they don't have enough uh you know protection system uh uh to uh uh to get them treated right so so so uh uh I mean we really need to think of that it is not the instant issue there are implications that come after a long period of time and how the people will respond to uh to this situation and uh you know uh in in in in our context I mean uh uh what I already said the social protection the insurance uh it doesn't actually make sense for the people who are affected uh and if I give an uh talk about the workers in in the government factories uh they are indoor worker and you know in government sector uh after the Rana Plaza incident in Banglad Bangladesh uh the compliance issue has been improved and then uh the government has adopted policies uh and all are there in the written form but you know the implementation of these kind of policies are really really rare only the first category of uh factories particularly the government factories uh it's very uh small number they actually comply with the uh uh with the compliance uh you know said by the uh buyers and also according to the laws and policy but most of the cases the works uh I mean the subcontracting work uh I mean uh uh the government works uh factories who actually work under subcontracting did do not follow uh the compliances. So that's why the most of the workers particularly the female workers in the government sectors they face a huge problem and they don't have any facility to to get treatment and uh the the facility for example the health workers workers welfare center are there but you know uh it doesn't make any sense to the workers because the health welfare center is open from 10 to 7:00 in the evening h but [laughter] this is the time for the workers to work in the factory right so they do not have uh any uh I mean this is conflicting the opening time and the you know working time in at the head uh you know welfare center and and the uh working time of the workers uh conflict so that that's why they do not take any uh service uh out of this kind of system in the factories uh there are uh some sort of uh you know instant uh first aid services uh for example they have saline water but you know the saline water is not good for every worker who have particularly who have high high high blood pressure like something. So it actually if they take saline water during the heat stress uh it it create some other health issues for them and how they will deal with that right. So I I mean my point is like yes it's really interesting to know and I also want to convince the uh government officials from the economic or macroeconomic perspective that how the country is being affected but it's really important uh to bring uh uh uh uh uh the the individual experiences because you know this time uh the uh the countries like in the EU have faced a huge heat wave right so if we go through this kind of uh heat stress we can realize what kind of uh difficulties we are facing. So this kind of thing also need to uh uh need to consider and uh I don't know how we can bring the policy makers and the government officials into this kind of discussion so that they feel that yes the workers are human being so uh uh they they they need to uh they need attention from the from the authorities to to get uh support protection and all these things. So uh uh uh so I I will finish with that that we should not uh ensure uh only the preventive uh only the I mean reactive measures that yes people will get excess instantly but it's really important uh uh to look at the preventive measures as well so people go through good health. Yeah thank you. >> Thank you. Thank you Shakir. In fact one of the recommendation or one of the things that we try to understand was whether medical camps are organized. Now you would say like why is it needed? Because but what we found was if medical camps are organized then many of these workers who continue to work with high temperature with all of those symptoms they at least would get identified. Some of those issues would be identified and some preventative measures could be taken and one of the ways through which it could be done is by pushing some of these private sector at least if it starts happening in government sector. if it starts happening in construction sites uh you know it can gradually then start getting mainstreamed uh all you and that's why I sometimes feel that the work that Hen foundation did with insurance I understand insurance is not the panacea but at least it provided a model along with the the her model where cash transfer plus insurance it provided a a a proof of concept and it's ultimately it's up to the government to take it to scale you know no individual or private entity or philanthropy can take uh you know ever act at the scale of the government but it's all about putting the evidence there on the table. I would now want to turn to Rajini Mukharji and she's a very important speaker here in this in this uh panel because he represents something called coalition for disaster resilient infrastructure. This is again an intergovernmental organization but a lot has been discussed today about not just the the work site related exposure to heat but also the kind of heat people experience in their homes low height tin or tooline uh sheds and so on. So Rajini coming back to you or coming to you is to understand like what role do you really see in in heat resistant or infrastructure? What can be done at a low cost and what can these poor workers really do at their end? Um um or what we could push the some of these the private sector which employs a lot of these workers uh to do. So over to you Rajni. >> Um thank you. Thank you Ru. First of all at the outset I would like to thank IED for inviting CDRI into this important discussion and uh and also kind of the opportunity to go through this very interesting presentation that you made. Um now coming to I have I I was looking at some of the key recommendations and findings from your paper and uh of course the heat the impact of heat does not stop at the work site only and heat is kind of a 24 into 7 risk and not a 8 hours occupational or workplace hazard and for million millions of people who are exposed to heat it continues even after they return to their home. So they are exposed to kind of uh you know because of the heat trapped within the housing the built environment they continue to remain exposed to the heat there is lack of power supply there is lack of water supply and all this emanates from heat. So basically [clears throat] when we talk about reducing the impact of it building resilience of the infrastructure is extremely important and then when I say that uh we have to build it at the household level at the workplace level and at the city level or at the environment level or the neighborhood level where the people are residing. Now at CDRI which is coalition for disaster resilient infrastructure uh we have been working with uh different governments on extreme heat management but before getting into what we have been doing or what needs to be done I would just like to share some data points because I saw in your paper you're talking about economic losses. Now we [clears throat] what we try to do through our giri uh model which is a probabilistic model which tries to look at the impact of you know various disasters and climate change on different infrastructure uh sectors and we have tried to look at the impact of heat on different infrastructure sectors and of course only the direct impact because I'm just looking at we just looking at the impact of uh you know heat due to the resulting to damage to c some of the infrastructure assets are not at all the indirect losses and that figure globally is approximately $23.9 billion. So that's the impact and that's what I'm saying average annual loss that will be incurred due to impact of beat on various infrastructure sectors. And when we look at the distribution across sectors the highest is seen at the build the building which is like more than 11 billion dollars. The next is the power where the impact ranges between 8 to 8.7 followed by roads and railways again some 4 to six billion. Now coming to your point of uh what could be done like you know at the household level if I start from the household level um resilient infrastructure can definitely help in improving the thermal comfort by introducing climate responsive building designs cool roofs reflective materials better insulation and of course natural wiration and reliable electricity. We have been working with the ministry of power in India uh and many other stakeholders to look at how you know we can ensure supply reliable supply of power during extreme heat situation because for us when we say resilient infrastructure what we meant is the system that has the capability to absorb the shock to respond to a shock and the recover from a shock. So it is extremely important that when there is an extreme heat situation there will there might be power outage but at the same time the power facilities the utilities the power ministry should have the ability to respond to that crisis and therefore we are helping the government to come up with standard operating procedures and many other such measures and not get into detail because then it becomes very sectoral. Coming to the workplace as you said now for workplace again we need to prioritize the heat resilient buildings shaded work areas cooling facilities safe drinking water and here probably I would like to highlight about the two guidelines that we have developed uh one is actually a guideline for managing extreme heat management in public transport system we have also come up with a guideline on how to manage extreme heat in schools and third we worked very closely with national disaster management authority in India to come up with a guideline on cooling shelter where people can actually go and take refuge when the temperatures are very high. So these are some of the lowcost measures which can be introduced at various levels by the government in order to kind of you know manage the impact of extreme heat. Coming to your uh the other point that I would like to mention here is also about the city level because when we talk about uh you know building uh resilience to extreme heat uh and when we have and because we work on infrastructure uh I think when it is important to look at at the city planning level. So we can do uh there can be certain measures introduced at the design level like as simple as expanding tree cover, blue green infrastructure you know maintaining the water bodies so that there is a cooling impact sensitive street design covered uh walk you know cycle paths and walkaways and as simple as cooling centers located uh in different location. Now that's about the existing uh when you actually plan new infrastructure what is extremely important to do a risk assessment to identify the hotspots and to ensure that we do not get into developing our assets and our you know settlements in areas which are highly prone to heat. So that's something could be introduced when we were talking of developing new infrastructure. Um so maybe if I have to sum up I would say we need an integrated approach. We cannot just you know it requires a com integrated approach where we combine infrastructure design and upgrades urban planning governance community preparedness and bring all of this together to reduce the impact of uh you know heat both at work and at home and as I said to start with it is extremely important to do a heat risk assessment and integrate that into infrastructure planning and sighting because unless and until the data is not available we are not aware about the risk how much risk is embedded then it's very difficult to design our systems um design for natural again for the natural ventilation I talked about that's a very again a simple particularly when you're designing something new uh there are ways there are methods there are guidelines there are codes even available through which you can introduce such designs u and finally I would talk about the governance and I'll end there uh because there is a there is a need for a strong governance across various level you need to have a heat action planning which brings all these elements together and uh along with capacities of the government at various levels to implement them so maybe I'll stop here Ru and thank you very much >> thank you thank you Rajni and if you could post links to some of those guidance and guidelines that you mentioned it might be useful for for all our uh participants I move to uh John Pgram uh who I came to know very closely very recently at London climate action week and um I'd like to bring you in uh especially to talk about how what should be really done because there's one segment we haven't yet talked about and that's children and as I showed in one of my slides that many of these migrant workers they move with children now in IAD we have a very strict protocol not to click pictures of children not but in most of the documentaries that you know we had to take out some of those videos because in most of the sites children were alongside parents and they were exposed to that extreme heat. So you know from your units of experience what do you think really needs to be added on what we have done or what we are recommending or how could we modify or or what could be really done for those children because children ultimately are part of the household unit. So over to you uh Journey. >> Yeah thanks so much Ru and thanks and congratulations also to to IED and partners for for this for this excellent study. I think it's really important to shine a light on this issue. You know, I think the report makes clear that, you know, extreme heat isn't just an issue for the workplace, right? It's also this health emergency. It's also a household crisis. So, um, you know, children are really at the center of this. So, when those informal workers, many of them are caregivers, they're coming home and there's no respite. There's no respite from the heat. There might be lack of access to to water, sanitation, adequate food, and so on at home as well. And if we're zooming in on children and what this means for children, then there are sort of two key pathways through which this this affects children. You know, direct impacts of heat um for their health, for their education, for their wellbeing. And I I'll come back to that in a second. But also through these cascading effects, these indirect effects um of of their caregivers occupational sort of heat exposure, right? And I think it's really key to understand when we're talking about children as a segment of the population and as you said Ritu they they do generally actually tend to be a little bit invisible in these discussions right that that is a a key challenge that that that faces children as a large segment of the population but also it's really important to understand that they don't experience climate impact in the same way as adults. they, you know, because they're at this unique stage of physiological development, cognitive development, you know, they have a unique sort of behavioral um characteristics, unique developmental needs and and as a result of all of that, they do experience climate impacts, including heat in in unique and disproportionate ways. So, they are hit harder and those effects do begin before birth. So I think it's really important to outline, you know, just just briefly that sort of heat stress during pregnancy, for example, we're seeing um is linked to key adverse outcomes. Um we see evidence linking a one degree C um increase [clears throat] in heat exposure during pregnancy to a five degree a 5% heat um increase rather in still births. Um and up to 16% increase during a heat wave. So these are significant figures. We're also seeing significant increases in preterm birth. So 4% increases per one degree C uh increase in temperature and up to a 26% rise in pre-term births during a heat wave. So these are quite significant impacts that we're seeing. Um during childhood, children also um experience, you know, disproportionate impacts. They can't regulate their their body temperature in the same way that adults can. So if a newborn, for example, can't sweat. So you know, during extreme heat, um we're really seeing that that effect. They can't cool down their bodies. um and that can lead to organ failure and and death. So these are sort of um you know I would say the unseen effects um or and and sort of not not uh significantly sort of taken into account in in the research and literature right and the scale is is large. So in India you know we have as many as 392 million children or 92% of the child population exposed to heat waves and in Bangladesh 83% of children are exposed to extreme heat. So these are a large impacts and when homes are hot at night you know children can't sleep either they can't recover I think Meline you were talking to that sort of loss of sleep is really important right for for all all humans but especially for children it affects their concentration their mental health their cognitive and physical development and it has that uh impact on their ability to learn dayto-day but also there's that sort of impact on infrastructure that they require to learn. So um you know heatwave disruption to education. Um in 2024 we had a study UNICEF conducted a study that showed that schooling for 118 million children or at least 118 million across uh children at Bangladesh, Cambodia, India, the Philippines and Thailand had disrupted schooling in April 2024 alone uh because of extreme heat. So those are some of the the direct effects that children are incurring on their health, on their education, on their well-being. But there are also these cascading and indirect effects, right? That we're talking about the sort of loss of workers health, um reduction on income. What does that translate to in the household for children? It means effectively reducing meals, lack of nutrition, delaying health treatment, uh withdrawing children from school, uh perhaps sending adolescence, even children, to to work or or to migrate to make up for household, you know, loss of income. Um and there are also I would say that these impacts on children are large but um also not felt equally right so there will be gendered impacts for example for girls or for children with disabilities that will experience these these impacts in in different more heightened ways. Um we're also seeing studies linking extreme heat to child marriage and and very significant increases in child marriage in in certain in certain areas as well. So you can really trace the lines from these heat related illness, loss of productivity, uh reduced household income through to nutrition, health care, education outcomes for children. And of course, children are the workforce for tomorrow. So there are also those larger societal human development impacts. If a child is not healthy and they're not learning, then what's the long-term implications of that? And I think the key point I want to convey is is really that these consequences do remain unaccounted for currently. Right? So we can calculate lost wages, we can calculate medical costs, but what we're not necessarily taking into account are the impacts of a child's loss of sleep, loss of learning, loss of nutrition, loss of play, loss of uh parental care, emotional security, and future opportunities. So these are real non-economic losses and damages that are very real, cumulative and shaping a child's entire life um sort of opportunities and outlooks. So that that's the key kind of message I want to convey. And then in terms of the measures that we can take to protect families and children, I think many of the sort of measures have been discussed today. But zooming in from a child rights perspective would say, you know, assessments need to measure the full household burden, right, of of heat exposure. So using age, gender, disability, disagregated data, we need to capture those impacts on children's health, on children's nutrition, education, protection, psychosocial well-being as well. Secondly, protection needs to extend from the workplaces to the settings where children live um or or yeah experiencing um you know these impacts. So homes, schools, childare centers, health facilities um and and what that looks like is really ensuring that the housing and uh housing is is climate resilient um and that they can access essential services that are climate resilient as well, the the sort of essential services that they rely on to to survive and thrive. And finally, shock responsive social protection. So heat triggered cash, health coverage, food assistance, income support and making sure the pregnant women are are covered as well. So these are just a few recommendations. Back to you. Thank you. >> Thank you. Thank you Johnny. They're they're all all very very relevant points and uh well taken probably we will cover some of those aspects in our next research. But I want to quickly bring in uh Karthik Nagar Rajan uh because he's the one who developed that regression model to understand because it's it's okay to understand uh how heat is leading to those health related damages but then what are the factors that really influence those like why are workers suffering heat stroke why are workers suffering heat cramps or heat exhaustion what is really driving them so Karthi do you want to come in and explain a little bit about that because I really rushed through a lot of graphs and slides. So I want you to explain it more like easily for people to understand what that uh regression model really conveyed and I know we are up for time so I'm sorry about that. >> Okay. Thank you so much. In fact there is a question from Aaron uh did you consider disability uh factor in the study? So the question is related to that. So uh we have employed uh a regression technique called binomial logistic regression model uh to understand who are prone to uh the heat has 70% at the three levels of heat form heat exhaustion and a moderate form of illness and heat stroke which requires medical emergency uh this new in fact also has presented like almost all 89 85 90% of the workers experienced heat crap symptoms while 65 to 70% of the workers experience heat exhaustive symptoms and around 50% of the uh workers from India experience stroke symptoms and through this uh uh lost regression modeling we want to we try to understand who are prone to uh this these uh three levels of symptoms. So we uh uh introduced or we considered seven variables like uh heat exposure whether the people who are workers who outdoor workers or indoor workers or the workers from high hotter regions are the wild hot regions and workers with high physical level intensity and workers with less physical home and uh whether the safety measures available at workplace uh affect the heat illnesses and housing conditions very importantly most of the studies do not consider this but in our research we have specifically found out some important insights uh whether uh uh the housing conditions contribute to uh the the fut conditions and the pract practice of coping actions. The study findings, variation model findings were quite interesting. Uh so in terms of heat cramps almost all of them, all the workers whether it is outdoor workerity, housing almost 80 90% of the workers were experienced symptoms. But there are two significant variables. Workers doing physically demanding jobs or high intensity labor jobs uh were more prone to heat cramp symptoms. Uh and very interestingly people who followed or adapted uh using adapted coping measures informal coping measures uh were less prone to uh the heat symptoms. But the contributing factors for heat exhaustion, heat stress were almost similar. Uh people workers living in hotter climate zones. Uh workers doing high intensity labor works. Workers living in poor housing conditions which are prone to heat and aging people at least particularly people workers above 45 years age. And uh very importantly for specifically for heat stress conditions uh the availability of uh uh better poor workplace conditions contributed to heat store conditions. So these conditions contributed to heat exhaustion and heat stress. So to sum up uh there's no difference between outdoor workers and indoor workers. Most of the research works so far have considered the outdoor workers but in our research we have specifically found that irrespective of the the the heat exposure whether it is indoor or outdoor during summer months the workers who are involved in physical labor are prone to the heat related illnesses and as the as as the level of heat related illnesses from heat to heat stroke structural factors like housing and availability of safer conditions contribute more uh towards this heat exhaustion and heat stress. So these are the uh findings. Thank you. >> Thank you. Thank thank you so much Karthi. Basically you see the reason why we did this regression is like we do need to understand that the factors driving different type of illness only then we can address them. uh so do read our report and I'm really really thankful uh to all our partners uh especially the grassroot partners who who work like who like because data collection a lot of time meant that they had to do it beyond the office hours and we are really thankful for them to have shown that commitment and worked with us um I'm also very thankful to all our panelists and especially you know people like uh Meline who I know personally because they are doing a lot in this space and I really appreciate that. I put that at very high level because we keep talking a lot but a few organizations are really going out and doing something and I really put that um u at a very high level. Um uh and again people like Claire uh who who went out who had the courage to go and experiment something and do and uh and all the partners along with you who have tried to do something and proven the concept. It's up to government now to scale it up. Uh we are also thankful to Bart because I know at IPCC level he's trying to do something different uh to Archa to Shakiol um but also to um uh Rajini and I hope Rajni we can work with you at CDRI to scale this whole initiative or or disaster resilient infrastructure um both at the government level but you know not just in India but in other country context where CDR is working and to Joan definitely uh we we will make sure that we our next research really focuses on trying to quantify some of those intergenerational the cognitive damages uh that heat or other uh climatic impacts are creating. So thank you so much and I hope we can continue to work together because as I said this is not an issue that you know IAD alone can handle all hands on deck is needed. So I would really appreciate that if we can work together in future and and try to come up with some innovative solutions to so to these pressing challenges. So thank you all um and and see you soon. Bye-bye.