Sunday, 16th April 2023 was a deadly day for 14 people who had come to attend a social rally to be addressed by A-list politicians in Kharghar, a suburb in Navi Mumbai, India.

As they came to attend a socio-political rally, the 14 were dead and many were in hospital being treated for sunstroke, a medical condition that occurs after getting dehydrated in the intense sun for long hours.

The occasion at Kharghar was an award ceremony that was expecting around 1 million (ten lakh) people to attend. The timing was beginning of the Indian summer. The arrangements seemed to be ill-planned even though the budget of the event was approx. 1.7 million US dollars (Rs. 14 crores). As per a newspaper report, 14 people lost their life, mostly women.

Plans remain on paper if there is no awareness or an informed, enthusiastic executioner.

Rallies will continue to happen, not only in India but all over the globe. Should the people attending have to die? What can be done to prevent such incidents from happening again?

Wherever the word prevent is uttered, a much less known medical specialty by the name Occupational Health (OH) is the most useful but seldom considered by authorities or rally organizers. That is simply because of lack of awareness.

Most countries have a National Disaster Plan. If followed many of these kinds of tragedies can be averted. After all, deaths during a socio-political or a political rally is not the aim of the organisers as it can defame the A-list politicians who were present or anyone for that matter.

Attending a rally is not an occupation, yet principles of OH can be applied to any situation where health can be proactively protected and an illness prevented. This is what makes OH all pervasive.

Plans remain on paper if there is no awareness or an informed, enthusiastic executioner.

For example, medical specialist who deals with worker health (the Occupational Health physicians) take care of the workers working out in the sun by making sure at least the following is done:

  • Sensitize the senior management about effect of heat on health, safety and performance
  • Ensure senior management sensitizes the site managers
  • Conduct separate sessions on effects of heat for site managers and workers expected to be supervising or working out in the sun
  • Have shade areas for workers to rest for 10 minutes after 45 to 60 minutes of working in the sun or hot areas
  • Provide clean and cool potable water and encourage workers to drink during the 10-minute break
  • Provide ablution facilities as otherwise workers avoid drinking enough water which in turn leads to dehydration 
  • Maintain high level of preparedness to deal with any heat-related health effects (keep ambulance(s) close by)

    In a rally, the organizers must be sensitized about the health effects on people due to being out in the sun. They should be aware of the national/regional advisory on heatwave. And they should seek OH advice as the OH physicians have hands-on experience of handling workers working out in the sun.

    In the absence of access to OH physician, the organisers should meticulously plan the event accounting for all details, including minor ones, as it can turn into a major incident. Considerations such as – is the place (area) enough for the number of people expected, is ventilation proper, is there enough potable water, are make-shift hygienic ablution facilities available for both men and women, is a well-equipped ambulance close by etc. All these prevent as well as prepares for any mishap that may still happen despite arrangements, thereby reducing the intensity of human misery and damage.

    Attending a rally is not an occupation, yet principles of OH can be applied to any situation where health can be proactively protected and an illness prevented. This is what makes OH all pervasive. It has immense usefulness wherever harm to health or life can be prevented, Kharghar rally was one of them. 

    It is time the governments should consider seeking OH inputs to avert such tragedies.

    The awareness to proactive or preventive care is so low that it is time that the local media responsibly sensitize the rally-organizers.  

    Ideally, arrangements to have overhead shade, clean and cool potable water, washrooms etc. must be a part of the rally, whatever the numbers. The audience were out in the sun for around 6 hours without water; while some were camping overnight.

    Of the many lessons to be learnt after the Kharghar tragedy, one is to seek Occupational Health advice for at least one reason – that it prevents proactively.

    If socio-political or political rallies must be successful it is important that the lessons learnt be implemented with immediate effect else avertable hardships and tragedies will continue leading to a questionable future of such rallies.

    Of the many lessons to be learnt after the Kharghar tragedy is to seek Occupational Health advice and/or do meticulous and logical planning for at least one reason – that it prevents illnesses proactively. The Kharghar tragedy was preventable.

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    Dr Ajay Sati is an Occupational Health physician who prefers to describe himself as an Occupationist, to denote, ‘an expert in diseases and other concerns of occupations’. Dr Sati has managed health and wellness programs in industries he worked, like the atomic energy, and energy (oil & gas) in India and overseas. An experienced virtual consultation expert he was involved in many greenfield and brownfield projects providing inputs from health point of view. He supported many corporations during the Covid pandemic.