‘Trauma and insecurity’ on rise as heat ailments disrupt work in Bangladesh
By Mosabber Hossain and Tanvir Ahmed
As an intense heatwave swept across Bangladesh’s capital Dhaka in August, Najma Begum - a cook and cleaner in a richer family’s household - developed skin rashes across her body. Soon she had a fever as well, and developed dysentery, which left her too weak to work.
When she returned to her job, after spending 10 days recovering, she discovered she was being dismissed. “You do not need to come. We are recruiting someone else,” the house manager told her.
“It was a huge blow for me,” said the 35-year-old, who lives in Dhaka’s crowded Pallabi neighborhood.
Begum - who migrated to Dhaka three years ago after repeated flooding destroyed her home and farmland in northern Bangladesh - eventually found a new job, but at only two-thirds the pay of her old one.
Now, she said, she struggles to make enough money to support herself, her young son and her elderly parents living in northern Bangladesh.
“I had worked at this place for the last two years and hardly ever missed my responsibilities, yet they decided to cut me off from the job. I could not sleep for many days when I remembered that. I still cry about the injustice they did to me,” she said.
Health problems are spreading as a result of worsening extreme heat in Bangladesh, and are leading to growing income and productivity losses, a World Bank survey of 16,000 people in the country found.
In a country ranked second globally for exposure to elevated temperatures - behind only Burkina Faso - 25 million workdays were lost in 2024 due to “heat-induced physical and mental health conditions,” researchers found, an estimated economic loss of between $1.3 billion and $1.8 billion.
One out of five people surveyed in Bangladesh reported they struggled with depression during summer heat, and problems such as heat exhaustion, diarrhea and chronic cough are rising significantly during hot periods, the 2024 survey found.
Temperatures over 35 degrees Celsius are also boosting problems from diarrhea and heat exhaustion to low birthweight and premature birth, said Wameq Raza, a senior high specialist at the World Bank.
With global temperatures currently projected to rise by 2.6 to 3 degrees Celsius by the turn of the century, as efforts to cut use of gas, coal and oil falter, “the implications for health and well-being will be severe” in Bangladesh, researchers said, with extreme heat expected to cut GDP by 4.9 percent by 2030.
insecurity for women
Women are particularly suffering in the summer heat, said Iffat Mahmud, a World Bank senior operations officer and a co-author of the report.
The incidence of diarrhea in Bangladesh, for instance, is now double in summer what it is in winter, she said, The likelihood of suffering from diarrhea nearly doubled on days with temperatures over 35 degrees Celsius (95 degrees Fahrenheit) compared to days under 30 degrees, researchers found.
Women “frequently fall sick in summer with illnesses like diarrhea, pneumonia, fever and other complications,” Mahmud said, creating added costs for them as they try to buy medicine for heat-related ailments.
As well, “they are more affected because they are day labourers. If they do not go to work, they cannot earn, which impacts both their physical and mental health. They suffer trauma and insecurity about life, and they are anxious about their family and survival.”
Anjuman Ara, a 45-year-old day-labour construction worker, is one of those struggling with more extreme heat at work.
In April, as temperatures soared in Dhaka, she fell seriously ill with a fever, forcing her to miss two weeks of work carrying bricks up a ladder for a construction crew.
“I was completely weak and had no taste for food due to the high fever. I was too weak for construction work,” she remembered.
Without income and unable to pay her rent, she faced eviction by her landlord, she said, forcing her to turn to high-priced money lenders to hold onto her home and pay her bills.
“I took a loan at 20 percent interest, and I am still paying the installments,” she said in October.
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urban heat risk
Heat is particularly threatening urban women who live in districts that act as “urban heat islands”, with concrete and paved surfaces absorbing heat during the day and then releasing it at night, raising night-time temperatures compared to surrounding greener areas.
In Dhaka - a magnet for migrants from other parts of the country who have been displaced by climate impacts such as flooding - “rapid urbanisation, population growth and unplanned development resulting in loss of green space and vegetation are some of the factors contributing to the urban heat island effect,” the World Bank report noted.
Since 1980, Dhaka’s maximum temperature has risen by 1.4 degrees Celsius - but the city’s humidity and the heat island effect mean temperatures feel 4.5 degrees Celsius (8 degrees Fahrenheit) hotter at the warmest times of the year, it noted.
Women - who besides working in hot conditions are often responsible for cooking family meals, fetching water and caring for children - have particularly long periods of exposure to heat.
Women in Bangladesh had a 77 percent higher likelihood of suffering heat exhaustion than men, a figure closely linked to the time they spend indoors where “females are more likely to be engaged in cooking in poorly ventilated areas,” the report said.
Women’s greater percentages of body fat, hormonal cycles and reduced sweating compared to men also make them more vulnerable to heat-related illness, doctors say.
Poverty is also a significant indicator of risk for heat-related ailments, the World Bank study found, with richer people likely to have more resources to pay for cooling or avoid the worst heat exposure.
ADDING HEALTH SERVICES?
As extreme heat worsens, public hospitals are facing more demand for care, a problem that needs to be addressed, said Md. Saidur Rahman, secretary of health services for Bangladesh’s Ministry of Health and Family Welfare.
“Heat is a big issue for us, and we are considering an emergency response program during summer,” he said.
With places in public hospitals in short supply, “we are planning to increase capacity in summer so (poor people) can access low-cost health services during heatwaves.” That will happen by next summer, he said.
The ministry is also planning heat-awareness campaigns in the poorest areas of Bangladesh’s major cities, to try to raise awareness about how to best manage heat threats, he said.
Raza, of the World Bank, said Bangladesh also “urgently” needs a national heat-health action plan that would combine meteorological and health data to create heat early warning systems. It also should work on expanding cooling tree cover and shady spaces, improving healthcare responses to heat, and educating the public about how to better protect themselves from increasingly scorching conditions.
For now, those working in Dhaka’s worsening summer heat say they are managing as well as they can - but with many suffering much more anxiety and stress.
Riziya Akter, a garment worker who lives in Duaripara, a Dhaka informal settlement, said increasingly overwhelming heat meant she had not been able to manage working every day, angering her employer and risking her income.
“I feel breathing problems, and sometimes I sweat so much it hammers my head,” the 48-year-old said. “My line manager blames me for not working as much as they expect - but honestly, I am not doing it intentionally.”
She said she felt very alone.
“Nobody will understand my problem,” she said. “I have a family and if I lose my job, I cannot stay in the slum - but where would I go?”