Heat stroke is the most dangerous and serious health problem in summer, especially in children.
It occurs when the temperature of the child’s body rises above 40 °C (104 °F), and the body is unable to cool down naturally. Hence, it’s a life-threatening situation and needs urgent medical attention.
More than 700 people lost their lives last year due to heat stroke in one of the provinces of Pakistan. Death was secondary to heat stroke and severe dehydration. These deaths occurred during three days when the temperature of the atmosphere was almost 45 °C.
Why are children more susceptible to rapid heat loss compared to adults?
Children are more susceptible to heat loss and exhaustion compared to adults due to the following reasons:
- They sweat less compared to adults, and they heat up faster.
- They may face difficulty while recognising the signs and symptoms of overheating.
- Children are playful, and they mostly cannot avoid playing outside, especially during peak heat hours, further increasing their risk.
Why Heat Stroke Is a Critical Concern in Pakistan
There has been a significant rise in the heatwaves in Pakistan over the past decades, which have caused several alarming situations and trends:
- Increasing frequency and intensity
The number and duration of heat waves have increased over the past decades. - The 2024 Sindh heatwave
Last year, from 21st May to July 2024, Sindh Province was hit hard by the heat wave with temperatures reaching up to 49 °C (120 °F). This has caused significant morbidity and mortality, with over 5,358 hospitalisations and causing the death of almost 568+ people. - Disruption of education
Heat waves have caused the early closure of schools . 26 million children missed school during May 2024 alone, due to extremely hot weather. Worldwide, over 118 million students missed school and were affected due to the heat crisis. This not only affects their education but also badly affects their health - Power outages compound risk
Due to increased Power outages and frequent blackouts leaves families and smaller children are left without power and electric fans or other cooling devices, which further increases the risk of heat-related morbidity and complications - Climate change makes it worse
Pakistan was ranked as the 5th most vulnerable country to climate change according to the Global Climate Risk Index 2023 report . Experts have predicted that this heat wave intensity will increase over the years, which will greatly affect Public health and children well-being
Early Warning Signs of Heat-Related Illness
Each parent should know the early warning signs of heat exhaustion and heat stroke before it’s too late.
What are the symptoms of heat exhaustion?
Symptoms: heavy sweating, weakness, dizziness, headache, nausea, fainting, cool and moist skin
Temperature: 37–40 °C (98–104 °F)
Treatment: rest in shade, drink fluids, cool environment
What are the signs of heat stroke in a child?
Core temperature > 40 °C (104 °F)
Hot, dry skin (may switch to moist)
Confusion, irritability, seizures, or unconsciousness
Rapid heartbeat, fast breathing
Vomiting or an intense headache
If untreated, heat stroke can lead to organ failure, permanent damage, or death.
What is the first aid for heat stroke?
Immediate action can save a life:
Move the child to a cool or shaded place.
Remove excess clothing to help the body cool.
Cool the body with wet towels, misting, or a lukewarm bath.
Increase airflow using a fan or natural breeze.
Provide fluids (water or ORS) only if the child is conscious and able to swallow.
Call emergency services or go to the hospital at once.
What to do for a child with heat stroke?
Time outdoor activities before 11 AM or after 4 PM.
Hydration: Encourage water or ORS every 20–30 minutes.
Dress smart: Light-coloured, loose cotton clothes; wide-brimmed hats.
Shade and cooling: Sunglasses, umbrellas, shaded play areas.
Avoid enclosed cars and rooms without proper ventilation; such spaces can exceed 49 °C in minutes
Indoor cooling: Use fans and AC where possible; insulate homes to block sunlight.
Rest breaks: Ensure children have rest periods during play or sports.
Watch children closely during heatwaves; they may not express discomfort.
For infants and toddlers:
Dress them minimally.
Keep them cool and well-hydrated.
Never leave them in hot environments, vehicles, or under direct sun.
Tips endorsed by experts
According to UNICEF, parents should check if a child is thirsty, sweaty, vomiting, has a dry mouth, or has a headache, and act quickly.
Schools, Climate, and Community Response
Schools Must Adapt
Many schools in Pakistan lack cooling or ventilation, making classrooms dangerously hot. In Punjab in 2025, authorities shifted school hours to start earlier and close by 11:30 AM.
Consider these strategies:
Heat monitoring: Keep class thermometers and inform parents/school management.
Revised hours: Shift school start times or introduce morning-only sessions.
Outdoor shade: Plant trees or install shade structures for playtime areas.
Cooling infrastructure: Equip classrooms with fans, coolers, or AC.
Community and Government Actions
Early warning systems: NDMA developed a Heatwave Action Plan 2024 including forecasting and community alerts
Energy resilience: UNICEF highlights that improving energy supply can avert heat-related deaths and ensure schools and health facilities remain operational during heatwaves.
Awareness campaigns: Health education on heat stroke, first-aid, and hydration should be widely shared through schools and community centres.
Long-Term Strategies for Child Safety
Build resilience into public health and education systems.
Ban children in hot cars—enforce strict public awareness.
Grow green zones in urban schools and public spaces.
Promote renewable energy for uninterrupted power during peak demand.
Community watches: Neighbours checking on elderly and children during heatwaves.
Heat Stroke and Climate Change: A Real Risk
Heatwaves, made more frequent and intense by climate change, are now a public health emergency. Pakistan is among the world’s top five most affected countries. Experts estimate heat-related deaths could increase by tens of thousands annually by 2030.
Children who cannot regulate temperature as efficiently and are exposed in schools or outdoors face a severe risk. The ripple effects—missed education, health emergencies, economic strain—impact entire families and communities.
Final Thoughts from a Doctor
Heat stroke in children is preventable with early detection, proactive steps, and community support. Remain vigilant, act fast, and prioritise hydration and cooling. As a Paediatric trained doctor, I urge every parent, teacher, and community leader to treat heatwaves with urgency and care.
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