Ahmed Rizq watched the mercury on his thermometer rise: 48, 53…55 degrees Celsius. It rose higher than he had ever seen it rise before. And then it stayed there—for over three weeks. Rizq had lived in Aswan in the very south of Egypt his whole life; he could take a little heat. But August 2015 was a new kind of hot. It was the sort of hot that could kill you.
The Ministry of Health began distributing flyers to hospitals all around the country, encouraging citizens to stay at home if possible and avoid prolonged exposure to direct sunlight. But those flyers never reached the desert village of Ladid, and even if they had, they wouldn’t have made a difference, said Rizq, who researches public health access for the Egyptian Center for Economic and Social Rights. “The village is close to a mountain in the desert,” Rizq described. “There isn’t a water source inside, you’re outside the agricultural area by some kilometers.”
Ladid, like most small Egyptian villages, is served by a modest medical center. In general, these centers are well equipped but lack the staff to run them, Rizq said, because anyone who can get enough medical experience to get out of his village usually does. The closest hospital is in Edfu, about an hour and a half away by public transport. By mid-August, Ladid residents were shuttling their sick and dying to and from Edfu, Luxor and Aswan general hospitals. “They were taking people one after the other to the hospital,” Rizq said. “There was a very high number and the hospital had far more people than it was equipped to handle.”
Ladid was hardly the only village to be overwhelmed by the crushing heat. As August crept along and the heatwave persisted, the city hospitals became overrun as patients poured in from surrounding rural villages. Heat stroke, dehydration, high blood pressure, heart attacks: the cases kept on coming and the hospitals soon ran out of beds. The Luxor International Hospital, widely considered to be the best hospital south of Assiut, was overflowing.
“The emergency wing can treat up to 300 patients at a time, 50 at a time in the ICU,” said an emergency room doctor who asked not to be named, as he had been instructed not to speak to the press about the heatwave. “We were always full. People had to wait.”
The death toll began to rise. By the second week of August, 13 Ladid residents had died, according to local journalist Doaa Ibrahim. “They would take them to the local medical center and then to the hospital in Edfu and they would die there or on the way,” Ibrahim said. “But the government didn’t count these as heat-related deaths. They said they died of high blood pressure or liver problems or heart problems.”
And so when the Ministry of Health announced the official tally of heatwave casualties later that week, Ladid’s dead were not counted among them. As it stands, the official death toll for entire country stopped at 110 this summer, with a mere 11 casualties from Aswan, but dozens, if not hundreds more have gone unaccounted for, Rizq said. “They say [the Ladid villagers] died of natural causes, but how can you tell me 13 people from the same place died in one week from natural causes?” Rizq said.
The emergency room doctor at the Luxor International Hospital confirmed that plenty of heatstroke cases went undocumented. “Officially, we maybe had 5 diagnosed cases a day of heatstroke, but we certainly saw a noticeable rise in heat deaths this summer, even if not all were documented,” he said. “Each doctor has to make his own diagnosis. One could write ‘heat stroke’ and the other could write ‘acute renal failure’ and he wouldn’t necessarily be wrong.”
When Al Monitor asked the hospital deputy director Nahed Ahmed Mohammed for the official number of heatstroke patients and casualties from this summer, he declined to comment.
“All I know is what we observe, and that’s that when the temperature goes up, the number of deaths goes up,” said Aswan resident Khaled Sadek, “We don’t have conclusive proof that the heat was what caused the death. And so that’s what you see in the government studies. Hospitals, when they get cases like these, have a lot of causes they can pick from. But that’s not actually helpful for researching the problem and understanding what’s going on here.”
What’s going on here, in a nutshell, is that Aswan, along with the rest of Egypt is getting hotter with every passing year. As of 2010, data from the Egyptian Meteorological Authority showed that Egypt’s five hottest years in recorded history have occurred from the year 2002 onward. The data also showed that heatwaves are becoming more common and prolonged. From 2001 to 2010, Aswan recorded over 100 days with temperatures in the 90th percentile or higher—whereas in the 70s, that number was closer to 40, the study showed.
And as this past summer revealed, the heat is starting to take its toll. Rizq estimated that there were no fewer than 50 deaths in the Aswan governorate alone—but these casualties are just the tip of the iceberg. Bahaa George, an obstetrician at the more modest Luxor General Hospital, said the heat is proving damaging to unborn children and their mothers.
“When you are pregnant, you are particularly at risk of dehydration,” George said. “It can severely affect the amniotic fluid. If the mother is dehydrated, she will draw her amniotic fluid from her urine. There will also be comparatively less blood flow to the fetus and the baby’s immunity will be lower.”
While George said it was too soon for him to have noticed any trends in maternal or infant mortality as a result, he did say the heat was negatively affecting his patients and could cause further problems down the road.
For several years after they’re born, children remain particularly at risk of heat stroke and dehydration and parents are encouraged to keep them at home if temperatures climb to over 40 degrees. This will have a profound effect on elementary education rates, Sadek said. “A child can’t go out and play in the streets, he can’t go to school. And when he does go to school, he doesn’t learn anything. Most schools here don’t even have a fan,” Sadek said.
Additionally, rising temperatures risk leading to an increase in parasitical diseases, according to Wael Lotfy, a professor of parasitology at the faculty of Medical Research in Alexandria University. What worries him most is the possibility that in the next three or four decades, malaria could be reintroduced to Egypt if malaria-carrying mosquitoes begin to migrate north from Sudan.
“With global warming it is possible that Anapholese gambiae [a malaria carrying mosquito] expands its range of distribution to Egypt, and hence introduces the parasite to the country,” Lotfy said. The mosquito has already been reported in Aswan and Toshka, though it was not carrying malaria.
In addition to malaria, Egypt could see a resurgence of schistosomiasis, a disease caused by tiny worms burrowing their way through the human vascular system, harming the liver, bladder and blood vessels. The worms are carried by a particular variety of snail that thrives in warm, stagnant water. As the flow of water through the Nile and its canals lessens, Lotfy expects to see an increase in these snails, accompanied by an increase in schistosomiasis cases. Now more than ever, the Ministry of Health needs to ensure the accurate reporting of parasitical diseases and monitor their spread, Lotfy said. Other than that though, there isn’t much anyone can do but wait and see.
That’s what’s hardest for Sedky: to know the future of his homeland is out of his hands.
“Most of these poor people aren’t part of the problem: they use simple tools that don’t hurt the environment. But then the end result is a lot of problems that fall on them,” Sedky said. “I don’t want to live in a skyscraper. I just want to live on an island with water around me and clean environment beneath me. You can live in a skyscraper if you want but don’t you choose something that’s going to hurt me in the end. Live the way you want to live but don’t live in such a way that will hurt me here.”