As Europe has been struggling with an intense heat wave over the last week, Turkey is also among countries to experience more frequent heat waves, said an expert. Despite the World Health Organization’s (WHO) advice in 2006, Turkey still does not have a heat wave action plan to prepare against the harmful consequences to public health said Ümit Şahin, climatechange coordinator of Istanbul Policy Center of Sabancı University.
Since the notorious heat wave of 2003, we started to see heat waves at least two or three times each year. There is not a well specified monitoring system. In fact, there is not a set definition in Turkey on what a heat wave is. In fact, this definition should not be valid for the whole of the country but differ according to different regions.
According to a publication in 2016 of the Meteorology directorate, the frequency and the number of heat waves in Turkey between 1971 and 2016 have increased. And according to the same publication, if carbon emissions continue at current levels Turkey will experience 78 days annually of heat waves by the end of the century. That is nearly the whole summer.
To what degree are officials taking this issue seriously?
That’s the fundamental problem: the Turkish state does not have a heat health action plan. It does not even have a warning system.
The general directorate of meteorology is issuing some warnings based on its projections about weather conditions along the lines of “Turkey will brace for extremely hot weather or it will experience temperatures above seasonal levels.” The expression “extreme hot weather” is used, but the expression “heat wave” is not used. Or if it is used from time-to-time, it is not systematic.
What is the global approach to the problem?
World Health Organization conducted a very serious work following the heat wave in Europe in 2003 and advised European countries to prepare and put into implementation heat health action plans. According to these plans, you need to define and determine different levels of warnings according to different regions.
Countries are advised to define different alarm levels, like yellow, orange and red. These have to be defined considering the health and meteorology statistics; what is the rise in the death toll depending on the rise in the heat, etc.
After you set up the warning mechanism, then you have to be prepared about the measures to be taken.
What are these measures?
Following the warning about the upcoming heat wave, the Health Ministry needs to warn local administrations, municipalities and governors to take the relevant measures. First, the public should be informed about the timing of the heat wave and told the measures to be taken. They should be advised, for instance, not to go out, etc.
In Canada, for instance, they have identified the risk groups: the elderly, those who live alone, those with chronic illnesses, the hotspots in the city etc. In heat waves, they call these people and tell them not to go out.
If we don’t have a heat health plan, we could experience a tragedy similar to the one that took place in France in 2003. Just like France, we will see temperatures above 40 degrees. France took its lessons after the high death toll. In 2006, fewer people died during the heatwave. Do we have to see many dying before we take measures?
Turkey should not waste time to endorse a heat health action plan and put it into implementation. But to do so, Turkey needs to acknowledge there is a problem called climate change and that Turkey will suffer from the consequences of this heat wave.
What are the main institutions that have to take primary responsibility for the heat waves?
First, the health ministry, and then the meteorology directorate, which is supposed to make the weather projections. The latter has the responsibility of warning but not protection, whereas the Health Ministry has the responsibility of protecting the health of the public. The ministry should warn the health directorates in the relevant cities so they take the measures. You cannot expect people to take their own measures once there is a public warning about a heat wave. There are patients with Alzheimer; there are elderly people. Some need to be warned individually.
The state needs to prepare the public but also have the health system prepared.
Despite measures, illness due to heat will increase, so doctors, especially those working in the emergency, need to be trained about it.
Another responsibility of the state is to make research and gather data. But in Turkey, currently the state is not sufficiently transparent on mortality and health issues.
I guess local municipalities could also take some measures.
Obviously, I get all sorts of unnecessary SMS [messages] from the municipality where I live. Never once have I gotten a warning on a heat wave. Municipalities can set up special units to handle heat waves.
One of the advices of WHO is to keep public buildings open so that those whose houses are not cool enough can go stay. Municipalities can offer their buildings in such situations.
Another point: We should not add fuel to the fire. The cities need to be designed according to thermal comfort; in other words, it has to be designed in a way to protect from the harmful consequences of hot and cold weather. The trees in the streets, the small parks, the green plants in the walls or the roofs; they are not ornaments; they help in lowering the heat. We need to spread out the small green islets all over the city.
İstanbul, for instance, is a touristic city. Foreign tourists should be warned as well.
Indeed. We should also not forget the air pollution. We attribute air pollution in general to winter time. But there is also air pollution in summer time, especially due to car traffic. This can lead to heart and respiratory diseases.
Car traffic should be decreased in places where there is intense circulation. I don’t think Turkey is sufficiently aware of this issue.
Unfortunately, health in Turkey has become too much treatment oriented. The primary responsibility of the health ministry is to prevent illnesses. The best example of preventive medicine in Turkey has been the campaign against smoking, for instance. Just as they have endorsed a campaign against smoking the ministry should fight against the consequences of climate change. This sentence is key: The 21st century’s biggest global health challenge is climate change. The health ministry needs to take into account the climate change and develop a preventive medicine strategy.