Extreme heat is dangerous for people with hypertension
In Ahmedabad, temperatures climbed above 43C (109F) every day between May 19 and May 25, creating deadly hot working conditions for many of the labourers who keep the local economy humming.
For 40-year-old Lataben Arvindbhai Makwana, it was too unbearable to run her sewing machine inside her tin-roofed house, which has little ventilation and only a small ceiling fan. As a daily wage labourer, that meant she was not earning the money she needed to feed her kids and buy blood pressure medication for herself.
"It's getting worse every summer," Ms Makwana said. The extreme heat is especially dangerous for people like her who suffer from hypertension.
With climate change raising temperatures during heat waves, millions of Indians face a difficult choice: work in dangerous conditions or go hungry. But some women like Ms Makwana are now getting help from a program to make a third choice: stop working for at least a few hours.
As soon as temperatures breached 43.6C in Ahmedabad, Ms Makwana and thousands of other women were told that ICICI Lombard, an insurance company, would pay them a portion of their daily wages. The program uses parametric insurance, which pays out when a particular metric is hit, such as a daily high temperature.
More than 46,000 women across 22 districts in India were paid $340,000 in total over last month's heat waves. About 50,000 women are enrolled in the program. Ms Makwana's insurance payout was Rs. 750 ($9), enough to cover food and medication for a few days. (That sum came on top of a separate charity payout of Rs. 400 when the temperature breached 40C the first time.)
The Self-Employed Women's Association labour union runs the insurance program. Its premium is paid for partly by the women enrolled in the program, with a charity covering the remaining portion. The pilot program launched last year and is set to run until April 2025.
Kathy Baughman McLeod, chief executive officer of Climate Resilience for All, the non-profit supporting the program through development, technical expertise and funding, says that it has been "successful." The charity, which focuses on protecting women and vulnerable communities from extreme heat, plans to expand the insurance program to other parts of the world.
Baughman Mcleod hopes that the funders supporting the Indian program can continue to do so for a few more years. Ultimately, the plan is to get SEWA's 2.9 million members signed up, which would allow the plan to be funded entirely by women paying the premiums.
"Our experience is that poor women don't want charity always," said Reema Nanavaty, general secretary of SEWA. "Once they see that this program is addressing their dire needs, I'm sure the women would start contributing toward the program." The eventual plan would see the premium for each woman be about a day's wage every month, she added.
Typical insurance programs work because a fraction of the population that pays a premium asks for a payout in any given year. If most of them ask for a payout every year, which can be the case with heat waves, then next year's premiums have to rise to match the outgoings and that could easily become unaffordable.
Baughman McLeod readily admits that she doesn't know if such an insurance program can become financially viable. "It's a solution for the urgent needs of right now, when women are developing blisters, or worse, suffering miscarriages, as a result of working in extreme heat," she said. "This is a humanitarian crisis affecting those who are completely blameless for the climate impacts"
In any case, she said, the insurance program cannot solve all the problems. So Climate Resilience for All and SEWA are working on a host of other interventions, including education programs that teach women how extreme heat affects health and what steps they can reasonably take to avoid suffering. SEWA's members work in more than 100 professions, from construction workers to outdoor food vendors. As a result, interventions vary, ranging from something as simple as carrying an umbrella for shade to working with a construction company to ensure access to cool drinking water.
Still, cash in hand when it's needed can be crucial. Losing wages often forces the poorest women in India to go to informal money lenders that charge extortionary interest or personal favors.
"The biggest value the insurance payment gives them is dignity and self-respect," said Ms Nanavaty.