Pradeep Kumar can earn nearly eight dollars a day selling the traditional Indian drink with cumin and lemon that he makes at his cart in a popular market in New Delhi — supposed to cool the body, the beverage has been much in demand in recent months as north India reeled under a brutal heat wave.

But on some days, he says he could not summon up the energy to set up his cart as the punishing temperatures took a heavy toll on those working outdoors.

“I am exhausted every night after standing under the sun. Sometimes I fall sick due to the heat and then I need to rest for a few days,” said Kumar. “Once I could not come for a week.”

It is not surprising — while temperatures are normally high in May and June, the heat spell began unusually early this year. Temperatures in March shattered a 122-year record, April was the hottest month on record in north and central India and this month the mercury has topped 45 degrees Celsius on several days.

In a city where tens of thousands work as construction labor, rickshaw pullers, hawkers or at pavement stalls, many like Kumar have lost income due to the weekslong searing heat. Although temperatures eased Monday, the respite is likely to be brief.

India suffers the highest loss of productivity in the world due to extreme heat — it lost more than 100 billion hours of labor every year between 2001 and 2020, costing the country billions of dollars, according to a study published in Nature Communications by Duke University.

The heat waves are a huge health hazard — most of those working outdoors cannot heed a government advisory to avoid being out between noon and 3 pm on hot days.

“Heat strokes are the second biggest natural force which is killing people in India after lightning,” said Avikal Somvanshi, senior program manager of Urban Lab at the Center for Science and Environment citing government data. “In fact, more than 20,000 people have died in last 20 years because of heat stroke and over half of them are men aged between 30 to 60 who are working outdoors. This is not just exhaustion or discomfort. It is actually killing people.”

The impact is worsened by what is called the “heat-island effect” — the concentration of concrete buildings and roads that leads to much higher temperatures in city centers compared to suburban or rural areas.

Divyanshu Pratap, who has come to New Delhi from his village to work at a pavement stall for the first time, has experienced it firsthand.

“When I am standing and the sun blazes on my head, I get dizzy spells. Then I feel weak and fall down,” he said. “It was also hot in my village, but nothing compares to this.”

Homes in densely packed urban slums provide little respite at night — not only are they unbearably hot, but the situation is worsened by the long power outages that India has experienced this year as the intense heat triggered higher demand.

The situation for these workers could worsen in the coming years as studies warn that climate change will make such heat waves even more frequent.

A recent analysis by Britain’s Met Office said that record-breaking temperatures in northwestern India and Pakistan have become 100 times more likely due to climate change. Scientists said that heat waves could happen every three years whereas such extreme events would be expected only every 300 years in the absence of climate change.

“Extreme climate events will become increasingly normal if we continue to see inaction in bringing down global temperatures,” said Abinash Mohanty at the Council on Energy, Environment and Water in New Delhi. “Cities will face the brunt of climate extremities — Delhi might have more severe heat waves, while others like Mumbai may face flooding if we do not put in more aggressive climate action.”

The Health Ministry last month issued an advisory to employers asking them to install temporary shelters and limit hours for new workers. Several cities in India have put in place a Heat Action Plan that focuses on raising public awareness and reserving beds in hospitals for victims of heat stroke.

“This does not stop the exposure. It is like an emergency response to a tragedy that has already happened,” pointed out Urban Lab’s Somvanshi. “As far as adaptation, mitigation, or building resilience to this heat, no concrete plan has been made in India. Even globally, governments are just coming to recognize that rising temperatures pose a big challenge.”

Those involved in manual labor face the grimmest situation. Virendra, a rickshaw puller ferries customers over short distances of about two kilometers but keeps a look out for a tree to sit under after the ride is over.

“It is unbearably hot. My throat keeps getting parched and I worry that I will fall sick,” he said. “It takes much more energy to ride the rickshaw in summer.”

Although the work is hard, Virendra said he has no choice — he makes more money as a rickshaw puller than he would doing unskilled labor.

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