The ever-growing population of India, along with the increasing competition for water for productive uses in different sectors – especially irrigated agriculture and related local water systems and drainage – poses a challenge in an effort to improve water quality and sanitation.

Studies on urban metabolism have provided important insights in the material and socio political issues associated with the flow. However, there is dearth of studies that reveal how infrastructure as a hybrid of social and material construct facilitates disease emergence.

This report, one of CDKN’s Inside stories on climate compatible development, looks at how the city of Ahmedabad in Western India is preparing for the increasingly extreme heat of the city, through an early warning system and heat preparedness plan.

The researchers conducted an analysis of all-cause mortality associated with a May 2010 heat wave in Ahmedabad, Gujarat, India, to determine whether extreme heat leads to excess mortality. Counts of all-cause deaths from May 1–31, 2010 were compared with the mean of counts from temporally matched periods in May 2009 and 2011 to calculate excess mortality. Other analyses included a 7-day moving average, mortality rate ratio analysis, and relationship between daily maximum temperature and daily all-cause death counts over the entire year of 2010, using month-wise correlations.

In the recent past, spells of extreme heat associated with appreciable mortality have been documented in developed countries, including North America and Europe. However, far fewer research reports are available from developing countries or specific cities in South Asia. In May 2010, Ahmedabad, India, faced a heat wave where the
temperatures reached a high of 46.8uC with an apparent increase in mortality. The purpose of this study is to characterize the heat wave impact and assess the associated excess mortality.

Health is currently a privilege in India. Not a right. Maternal and child health remains neglected even after countless plans, programmes and political proclamations. Every year, nearly 60,000 women die in pregnancy and childbirth, while approximately 1.7 million children less than five years of age also die. In absolute numbers, India outranks all other countries in both regards.