‘Kui, kui, kui’ is a familiar sound in Andhra Pradesh and Telangana. Every time political leaders in the two states talk of their much-vaunted 108 ambulance service, they repeat this, impersonating a siren.
When the heat wave swept through the two states last fortnight though, the villages where several died found themselves outside the scope of any medical help. Many have never seen an ambulance in their midst; in others, these couldn’t reach on time due to unmotorable roads. Yet other victims were at least a 30-minute walk away from any means of transport to the nearest hospital.
There was another factor common to the victims. As temperatures around 47°Celsius kept others indoors, they had no option but to be out working. A majority of the victims were from scheduled tribes or castes, employed as labourers or daily wagers in villages, and unaware of alerts such as heat wave advisories or the treatment in case of a heat stroke.
Bukhia Bujjibai, Farm labourer, 25
Bhatrupalem settlement, Guntur (Andhra Pradesh)
Temperature on May 28: 46° C
Bujjibai was mute and partially physically disabled. Yet, one look around their house shows why mother Saidibai, 50, couldn’t shield her daughter from the rigours of work as farm labourer. The Rs 100 each they both made per day was the family’s only income. Saidibai also supports an elder son, who is totally disabled, with the money she earns.
Saidibai’s husband died long ago of an illness.
Bhatrupalem is a settlement of members of the nomadic Lambadi tribe, all of whom work as farm labourers in Dachepally, or as daily wagers in the lime-stone kilns at Piduguralla. The nearest primary health centre or hospital is 30 km away.
“On May 28, around noon, while we were out in the fields, Bujji indicated she was not feeling well and we returned home. She was running high fever and lay down in bed. We debated how to take her to hospital as autorickshaws do not come frequently and there is no other means of transport here. But within a few minutes, she was no more,” Saidibai says.
Bujjibai had no other ailments apart from her disability.
Saidibai stares blankly when asked if she or any of the neighbours thought of calling an ambulance. Kondala Naik, the sarpanch, says he tried calling 108 from his cellphone but could not get through.
The last rites were performed without informing the village revenue officer, also based 30 km away in Dachepally.
“The plight of this family is such that even though there is no post-mortem report or FIR, we have cleared release of ex-gratia,” says Dattatreya Sarma, the Mandal Revenue Officer.
Bojja Venkataravanamma, Farm labourer, 55
Srinivasapuram village, Dachepally, Guntur
Temperature on May 26: 45° C
18-year-old Bojja Gopi remembers it was very hot on May 26. “My mother who was working in the field beside me suddenly collapsed. It was 11 am, we had been working for four hours. I should have taken her to hospital but the thought of the expense of hiring an autorickshaw and the doctor’s fees stopped me,” says Gopi.
Venkataravanamma came home and flopped into bed. She only woke up the next morning, and told Gopi she felt uneasy. “I rushed to my uncle’s house to borrow money for an autorickshaw to take her to hospital. When I returned, she tried to say something to me but no words came out. She just passed away,” sobs Gopi.
Venkataravanamma didn’t suffer from any illness.
Gopi, an only child, shrugs when asked why he didn’t call an ambulance. “Ambulances don’t come here. I have never seen one.”
The village is about 5 km off State Highway 2, but the way till there is a bumpy ride. An ambulance has to come from Dachepally, 15 km away, where there is a primary health centre.
“After my father passed away, we leased our one-acre land for Rs 15,000 per annum. My mother also worked in the fields for Rs 100 a day to support us and pay for my college fees (Rs 3,000 a semester),” says Gopi, a polytechnic student.
Dachepally Deputy Tehsildar S Sudhakar has confirmed it to be a case of sun stroke, and recommended Rs 1 lakh relief for Gopi. “We didn’t go into the details of why there was no medical care,” he adds. “These things happen in villages.”
Prathi Anjaiah, Palmist, 35
Pathaganesunipadu village, Konaki, Guntur
Temperature on May 23 : 47° C
Like most days for the past 10 years, Prathi Anjaiah had set out from home at 7 am on May 23 looking for customers. He was headed for the Bramanapalli village market. It was a 10-km walk in the blistering heat but markets were a good place to find people who wanted their palms read.
With his meagre earnings that seldom amounted to even Rs 100 a day, Anjaiah supported his aged parents, a widowed sister and her two children, and his wife and two children. They live crowded under two tents, covered with plastic, in Pathaganesunipadu village.
That evening, Anjaiah returned from work complaining of nausea and headache. His family members hailed an autorickshaw to take Anjaiah to hospital, but the driver sought more than Rs 100 for the 11-km ride to Piduguralla.
The family decided that was too much money. “We are illiterate, poor… What would we know about calling an ambulance?” says Anjaiah’s father Prathi Mastan.
Anjaiah died one hour later. He had no previous illnesses.
It is almost 4 pm, 11 days later, and the family members are gathered around two aluminium bowls containing rice mixed with a dry curry. They take turns eating the balls of rice.
Village Revenue Development Officer S Venkateshwar has certified Anjaiah’s case as a heat stroke death. “We have recommended ex-gratia payment,” he says.
“Anjaiah was the sole earning member,” his 70-year-old father cries. “I had stopped working due to bad health. I may have to start again.”
Ringu Ravi Kumar, Sweeper, 39
Temperature on May 26: 42° C
As a gram panchayat sweeper, Kumar was a part-time employee in a “government office”. But while his work required long hours outdoors, he didn’t get any advice from officials regarding the heat wave. Kumar took no precautions on his own either.
“He would normally come home at 2 pm, but on May 26, he did not,” recalls wife Lakshmi. “We didn’t think much about it presuming he was at work. He came home at 8 pm finally and said he had taken rest under a tree as he was not feeling well. He had some food and went to sleep. At about 4 am, he called out for water. He couldn’t speak coherently. He took a few sips and immediately collapsed.”
She also remembers Kumar had high fever at the time and his face had gone completely dark, as if he had spent a lot of time in the sun. “It was over within a minute or two, before we could call anyone,” adds eldest daughter Renuka.
The family says Kumar suffered from no previous ailments.
While Telangana has not announced any ex-gratia for victims — and hence is not trying to confirm the deaths, but just recording them — the Apathbandhu Accidental Insurance Scheme for workers of unorganised sectors may fetch Kumar some relief.
Kumar used to earn Rs 2,000 a month. While Renuka is married to an autorickshaw driver, his younger children Mamata, 12, and Madhu, 9, are both studying.
Lakshmi is now thinking of finding work. “We asked him to stay at home but he said he would lose his job,” the 35-year-old says. “He was just 39.”
Mudavath Somla Naik, Farm labourer, 50
Sivulathanda, Narmetta mandal, Warangal
Temperature on May 28: 45° C
There was no question of taking Mudavath Somla Naik anywhere when he came home to Sivulathanda hamlet in Narmetta on the afternoon of May 28 and told his wife Suguni the heat was killing him. The nearest location where one could get an autorickshaw or bus is Tarigoppulla, a 5-km walk away.
Naik just sat on a bench outside his home and asked Suguni for water saying his head was spinning. Suguni was alone at home, with Naik’s son and daughter-in-law away.
“He took a few sips and lay down on the bench for about half an hour, clutching his stomach. I called for help and someone went to get the RMP (rural medical practitioner), but before he arrived, my husband had died,” Suguni says.
While the family has an acre of land and sowed cotton and maize this year, the earnings were never enough and so, for the past over 30 years, Naik also worked as a farm labourer.
On the morning of May 28, he had gone to work in a neighbouring field after watering his own.
Naik had no previous illnesses.
The nearest primary health centre and hospital are 30 km away, in Janagaon, and an ambulance takes 40 minutes to reach Tarigoppula, from where a dirt track leads to Sivulathanda. There is no public transport.
“We could not have taken him on a motorcycle and autos do not come here. The RMP suggested calling an ambulance but everything was over by that time,” says neighbour Kavitha Venkat.
Karingula Ramulamma, Anganwadi attendant, 62
Dospahad village, Penpahad Mandal, Nalgonda
Temperature on May 24: 41° C
On May 24, Karingula Ramulamma started vomiting and fainted at the anganwadi where she worked.
Ramulamma’s husband K Bishan used to work as a farm labourer, but past 70 years of age and ailing, he is now bedridden. Their eldest son Somaiah died a few years ago in an accident. The younger one, Nagaiah, and his wife both work as farm labourers but earn barely enough to sustain themselves and their two children.
Ramulamma therefore had to continue working past the age of 60 as an attendant at the village anganwadi to support her husband. As a contract worker for the past 12 years, she got Rs 300 per month while the teachers contributed and gave her another Rs 200.
The week she died, sarpanch M Srinivas says, had been unusually hot. “When she fainted, we put her in an autorickshaw and took her to Suryapet, 16 km away, but she died on the way. We didn’t even get to the hospital and brought the body back to her house,” Srinivas says. The nearest primary health centre is at Penpahad, 12 km away.
They could have called an ambulance but it would have taken more than 30 minutes to reach, says Srinivas. “The rural medical practitioner was of not much help, so we decided to take her in an autorickshaw.”
Nagaiah lives in a separate one-room house built through a government scheme, while his parents stayed in a hut nearby. Since Ramulamma died, Bishan is dependent on food brought by his daughter-in-law.