Naruvi Hospitals, Vellore, in collaboration with The Hindu, will present a webinar on “Stress: The Silent Killer of One’s Heart”, from 11.30 a.m. on Sunday.

This is the 10th webinar in the 15-part series organised as part of the “Healthy India, Happy India” initiative.

The session will focus on the often-overlooked link between chronic stress and heart health, offering insights and practical takeaways for individuals of all age groups.

Vinayak Shukla, senior consultant, cardiothoracic surgery, Naruvi Hospitals, Vellore, will speak on “Managing stress for a healthier heart”, while Ray George, consultant, cardio- thoracic and vascular surgery, Naruvi Hospitals, Vellore, will speak on “Signs, symptoms, and hidden dangers”. Mohammed Jaffer Sherif, consultant, cardiothoracic and vascular anaesthesia, Naruvi Hospitals, Vellore, will share his views on “Stress: The science behind it”. Hiba Mariam will moderate the session.

E-certificates will be issued to those who register. To register, visit https://newsth.live/HIHIUIE or scan the QR code.

In the first week of April 2025, Delhi crossed a dangerous threshold: the temperature soared above 41°C, and nights offered little relief. These extreme conditions are no longer outliers but part of a new, deadly normal. With climate change intensifying year after year, Indian cities have become the epicentre of a growing crisis.

And while heatwaves affect everyone, it is India’s millions of urban informal workers who are bearing the brunt of this slow-moving disaster. The Reserve Bank of India has pointed out, in 2024, that extreme heat threatens the health and livelihoods of occupationally exposed people, potentially causing a projected 4.5% loss to India’s GDP. Despite their considerable contribution, essential roles and sheer numbers, they are consistently excluded from the planning and implementation of urban heat response strategies. This exclusion has deadly consequences.

Key challenges in current Heat Action Plans

Many Indian cities now have Heat Action Plans (HAPs), inspired by pioneering efforts as in Ahmedabad. These plans, guided by the National Disaster Management Authority (NDMA), are meant to prepare cities for increasingly frequent and intense heatwaves. Yet, more than a decade later, most HAPs remain perfunctory, underfunded and poorly coordinated.

A review of HAPs across India reveals a consistent worrying pattern: informal workers are largely invisible. Worse, most treat heatwaves as temporary — short-term disasters instead of the symptoms of a deeper climate crisis that demands long-term, structural responses. The NDMA’s 2019 heat wave guidelines do not mention informal workers explicitly, but generally, under the category of outdoor workers and vulnerable groups. At the State level, most HAPs lack protocols for occupational safety, hydration, cooling spaces, shade provision or even a mention of compensation for lost work. City-level plans take a generalised public health and awareness approach, neglecting livelihood impacts. HAPs in India also suffer from fragmented governance and institutional silos. The Ministries of Labour, Environment, Urban Affairs and Health operate independently in the absence of guidelines at the central level, resulting in disjointed and inconsistent protections for workers. Moreover, city HAPs often remain short term, immediate for summer months, crisis-oriented documents. City heat actions rarely integrate long-term strategies such as urban cooling, heat-resilient infrastructure, working conditions, flexible work norms, or worker-focused social protection

Globally, cities are adopting worker protections against rising heat. In the U.S., California and Oregon mandate employers to provide water, shade, rest breaks, and heat safety training. France’s “Plan Canicule” requires work adjustments, hydration during heat alerts, and opened public buildings and spaces to the public for cooling off. In Qatar and Australia, outdoor work is restricted during peak heat, and employers are obligated to assess and mitigate heat risks. India, too, offers examples. Ahmedabad’s HAP introduced adjusted working hours and shaded rest areas. Odisha mandates a halt to outdoor work during peak hours. These good practices and innovations do offer replicable, worker-centric models for adapting urban livelihoods to extreme heat.

Towards a worker-centric response

We urgently need a new kind of urban heat response: one that is worker-centred, just, and grounded in lived realities.

First, the NDMA’s 2019 Heat Guidelines must be updated to explicitly include informal workers. A revised framework must map occupational vulnerabilities distinctly for varied workers —whether it is for construction workers, street vendors, waste pickers, gig workers or rickshaw pullers — and provide actionable protocols for city and State governments that may use them contextually. This includes defining safe working hours, mandatory rest breaks, access to water, and emergency response mechanisms.

Second, is the mandate for worker participation in the creation of city and State HAPs. These cannot remain top-down exercises. Every municipal body must engage worker collectives, unions, and worker welfare boards in co-creating occupation-specific plans. Constituting civil society and community coordination groups at the city level is key. Local wisdom and the involvement of workers’ associations in co-producing solutions makes policies more realistic, responsive, and respected.

Third, informal workers deserve the right to shade, rest, and cooling. We need to establish shaded rest zones, hydration points and community cooling centres in key locations — markets, transport hubs, public spaces, labour chowks, construction sites. Open public buildings, malls and open spaces as cooling centres. These must be accessible, gender-sensitive, and co-maintained by workers and the local community. It is time to develop norms, guidelines, institutionalise protections and allocate dedicated budgets for this.

Fourth, innovative financing — through corporate social responsibility, or dedicated city development budgets —must support local solutions as adaptations. Health insurance must be expanded to cover heat-related illnesses, especially for those in informal occupations who are typically excluded from mainstream schemes. And yes, community-neighbourhood contribution and involvement are a must and should be woven in action plans. Cool roofs, shaded walkways and passive ventilation must become standard practices, not just pilots.

As a part of city design and governance

Fifth, this leads to a bigger shift: embedding heat resilience and worker safety into how we design and govern our cities. Heat adaptation and worker inclusion must be legally written into master plans, building bye-laws, and infrastructure codes. Cities must promote natural shade through urban forests and tree corridors, while also planning blue networks such as water bodies and public resting spaces. Informal workspaces such as vendor markets, waste depots and labour chowks must be retrofitted with materials and design strategies that ensure thermal comfort.

Sixth, at the national level, we need an inter-ministerial task force on climate and work, bringing together the Ministries of Labour and Employment, Housing and Urban Affairs, Environment, Forest and Climate Change and Health, with of course NDMA, and State Disaster Management Authorities. This task force must develop an integrated road map linking climate resilience with worker protection and labour codes. It must guide cities, coordinate efforts, and ensure accountability. Every city and district must appoint a dedicated heat officer — someone empowered to manage and monitor heat response measures and work across departments.

For informal workers, the climate crisis is not a distant threat. It is a present and daily struggle. The cost of inaction is no longer measured only in degrees — it is measured in lives, in lost livelihood and poor health, and, in burdened futures.

Aravind Unni is an urban practitioner and researcher working on building resilience for informal workers and urban communities. Shalini Sinha is Asia Strategic Lead, Urban Policies Program, Women in Informal Employment: Globalizing and Organizing (WIEGO)

Experts at the Indian Institute of Public Health during the convocation ceremony of Masters of Public Health batch on Friday.
| Photo Credit: Special Arrangement

India’s life expectancy stands at approximately 73.4 years, the healthy life expectancy is almost a decade shorter, said K. Srinath Reddy, honorary distinguished professor at the Public Health Foundation of India (PHFI).

Speaking at the convocation ceremony of the Master of Public Health (MPH) programme at the Indian Institute of Public Health (IIPH) in Hyderabad on Friday, Dr. Reddy highlighted the need for a sustained approach to public health. A total of 38 students from the 2022-24 MPH batch graduated on Friday.

“The loss of healthy years is not confined to the final decade of life, it is the cumulative result of health burdens across the entire life course. This calls for corrective measures through public health interventions, which must engage not only the health sector but also education, housing, environment, and transportation,” he said.

Echoing this sentiment, Zelalem Tafesse, Chief of UNICEF’s Field Office for Telangana, Andhra Pradesh, and Karnataka, reminded graduates that public health is deeply intertwined with economics, governance, gender equity, climate change, and infrastructure.

“Even the national budget and market trends influence health outcomes,” Tafesse said, warning that misinformation in the digital age has become a serious public health threat.

Highlighting the growing role of digital technologies and Artificial Intelligence in shaping the future, Tafesse encouraged graduates to harness their digital fluency to drive solutions. “You are better equipped than my generation to thrive in this digital era. Let your public health knowledge grow with the tools of tomorrow,” he said.

Addressing the graduates, IIPH-H Director Anil Kaul underscored the increasing significance of their chosen field. “You are stepping into a world grappling with global health crises and complex challenges. Your work has never been more important. This field demands innovation, resilience, and a commitment to equity and justice,” he said.