Are Madhya Pradesh’s Government Hospitals Ready for the Extreme Heat?

On 18th April, Kamini Jain and Puneet Jain, along with their three-year-old son, Veer, traveled five hours from their home in Parvaliya village of Bhopal district to attend a wedding in Ashta of Sehore district. They indulged in wedding festivities near a makeshift pandal from ten in the morning till four in the evening. The heat was unbearable, with a recorded temperature as high as 42°C. It wasn’t long before Veer’s health required attention. He had a high fever, and the parents remember that he ‘almost fainted.’

They rushed him to Sehore’s district government hospital, almost an hour away from Ashta. At the hospital, Veer had a 104 ° fever, and the doctor confirmed that his condition was due to a heat stroke. He was admitted to an intensive care unit and placed on IV fluids. He was later shifted to a 14-bed children’s ward with one cooler and six fans. His father, Puneet Jain, remembers that the ward was uncomfortably humid. He thought the humidity in the room might worsen Veer’s condition. He said, “Humidity was increasing because of the cooler.” 

The night of 18th April didn’t bring any respite either, as the recorded temperature was close to 30 °C (86 °F). Puneet considered an early discharge for Veer. He had three options to get some respite from the mix of heat and humidity: take him home, a five-hour journey, or to a relative’s place nearby, or eventually shift him to a hotel with better conditions. Though Kamini was against the early discharge, and insisted on completing the treatment, which included fluids through drips and two days under the doctor's observation.

In two days, Veer’s fever subsided. He was discharged two days later.

Sehore’s government hospital is the centre for all major healthcare facilities in the district. Almost every day, hundreds of patients and their family members line up outside the different departments in the hospital compound. Most of them wait for their turn in the tin shed waiting area. The area is both hot and dirty. While Veer’s mother was at his bedside, his father spent nights outside under the tin shed. 

By the 2030s, Madhya Pradesh’s average highs are expected to increase by another 1.8–2.0 °C and its average lows by 2.0–2.4 °C, making extreme heat more frequent and intense. With improper facilities inside the wards for the vulnerable patients and a lack of proper waiting areas, in the era of rising temperatures, how prepared are concrete hospital buildings? 

Madhya Pradesh’s Health Department has made a 2022 plan called the “State Action Plan on Climate Change and Human Health.” It explains how the state will prepare, work together, and share information so people’s health is better protected from the effects of climate change. Its goal is to strengthen health services, especially for children, women, the elderly, and marginalised groups, against climate-sensitive diseases.

Under the National Programme on Climate Change and Human Health (NPCCCH), Madhya Pradesh prepared a 2022-2027 action plan to climate-proof existing facilities and ensure all new district-level health-centre buildings become climate-resilient by 2027. The idea was simple and obvious. The new buildings should have a few clear things:

• Heat- and cold-resistant designs based on local climate-risk assessments.

• High-performance double-glazed windows and doors to block heat, light glare, and noise.

• Adequate insulation in colder zones and proper ventilation and daylighting.

• Energy and water conservation through energy audits, LED lighting, rooftop solar panels, and rainwater-harvesting systems.

• Retrofitting of existing structures to meet the same standards.

• Appointment of a district nodal officer and formation of a monitoring committee in every district.

To understand and see the progress, Ground Report visited government hospitals in Rajgarh and Chhatarpur districts.

Ground reality: Situation in Rajgarh

Mod Singh’s wife delivered their first child in the maternity ward inside the trauma centre of Rajgarh District Hospital’s old building. Moments after birth, the baby’s condition worsened, and doctors shifted the newborn to the Special Newborn Care Unit (SNCU) on the first floor of the same building. For Singh, the heat’s intensity outside the SNCU made it difficult to stand and wait. Though waiting outside isn’t ideal either, as the hospital lacks a proper waiting area for the patient’s family members. The treatment has exceeded fifteen days, and “we keep sitting outside even at night,” he said. 

In March this year, Rajgarh’s new three-storey district hospital finally opened its doors. A few yards from the old building, where Singh waits, is a 200-bed multispecialty block, built for ₹40 crore. To make space for the new block, several trees inside the hospital compound were felled—an immediate hardship for the relatives who wait outside with no shelters to escape the sun. 

The patient load is heavy: hospital administrators count an average of 16,000 cases a month, and in May the figure topped 18,000. 

For now, the ground floor of the old building still houses the pathology lab, the children’s ward, and the SNCU, but outpatient clinics, general wards for men and women, and an ICU already operate on the first floor of the new structure. Work is underway to retrofit the paediatric services and move them to the new building once the remaining rooms are ready.

Inside, however, the architects tried to tackle the heat. Local contractor Mohsin Khan, who installed the aluminium frames and glazing, explains that every window is fitted with double-glazed glass: two panes separated by a thin insulating gap that slows the flow of heat in either direction. Ventilation shafts and wide openings funnel hot air upward, keeping the wards comparatively cooler even as summer temperatures soar. 

Until the old wings are upgraded and the grounds regain some greenery, that extra bit of indoor comfort offers one small relief to the thousands.

Rajgarh district's nodal officer for human health and climate change, Dr. Mahendra Pal Singh, said, "Work has begun this year… The committee was formed last year.” He added that about 60 per cent of the work related to health services has been completed. 

He explained that the things are happening as per the guidelines: temperature-friendly buildings are constructed, and rainwater harvesting systems are installed. And 50% of the hospitals have solar panels. But the district hospital’s civil surgeon, Dr. Nitin Patel, refutes the claim. While there are solar panels installed on the hospital’s trauma centre, they don’t supply electricity to the building. A rainwater harvesting system is to be installed in the district hospital’s new building. 

We checked what Dr Nitin Patel said and found problems. Solar panels are on the roof, but no wires connect them to the hospital’s power system. The rainwater harvesting setup is also unfinished; only a trench and a few pipes are in place. The action plan states the need for green buildings. Essentially, to reduce heat inside the building and cut hospital power costs. But in Rajgarh, the solar panels ‘soak up’ the heat and don’t generate electricity. 

The hospital already spends nine lakh rupees a month on electricity, administrators say, and they expect that bill to climb this summer as water cooler usage increases in the season. On the other hand, the installed tubewell is insufficient for the hospital’s water needs. To manage the water needs, the municipality supplies water, for which the hospital pays around one lakh twenty-five thousand every month. 

Chhatarpur’s district hospital is no better. Reporter Manvendra Yadav found the district has not even formed the team meant to run the plan. 

Chhatarpur: Story of incomplete preparations 

Dr. Anil Jain, Chhatarpur district’s nodal officer, admits plainly,

“The committee meant to handle the action plan has not been set up, but the work is going on.”

Chhatarpur’s district hospital—a five-story, 300-bed block finished in 2018 for ₹32 crore—rises from an 18,000-square-foot plot like a slab of white concrete against the dust-brown skyline. 

A rooftop plant on the fifth floor drives the building’s centralised air-conditioning, but only select zones feel the cool air: the SNCU, ICU, neonatal and post-natal wards, and five modular operating theatres. Everywhere else, ceiling fans whirl above rows of beds, and a fleet of a dozen water coolers labours in the corridors. Patients and staff move between floors on five elevators, cutting the distance in a structure designed to serve as the district’s main artery of care. 

 According to Dr. Anil Jain, "The average number of patients is around 1000 daily, but this past Monday, this number was more than 1400." 

He explained that the solar panels were installed in the 5-storey building. But they were soon damaged. The renewable energy department has been notified, but the panels “have not been removed yet." Out of eight water coolers, against the official claims, we found only seven. Out of seven, two didn’t supply cold water, while another one had a ‘water-supply issue”.

Relatives have no shelter inside the hospital. In the daytime, they wait under sheds near the old building to escape the sun. And, at night, they head to the second floor, where a few fans offer the only respite.

Sehore’s Hospital

Veer was admitted to Sehore’s old hospital buildings. Its windows are single-pane, not double-glazed. The families walk around and settle near a window for ventilation and air. The hospital plans to move the children’s ward and newborn unit there once repairs are finished.

Conclusion

While these family members are in distress, the heat slowly dehydrates them. They bundle their clothes and rest, using them as a pillow. The already vulnerable patients— from low-income communities, children, the elderly, and women— face the brunt of poor health infrastructure. 

This report aimed to find discrepancies in the state’s action plan and its on-ground implementation. But these hospitals lacked basic facilities like fans, coolers, and even a sitting area for the patient’s family members. With increasing heat and climate change-induced consequences, our government hospitals are important to provide a necessary resilience to the vulnerable communities. 

We face the impact of climate change and extreme heat. Though our fight is for basic health infrastructure. At this pace, these hospital buildings will not match the ambitious language of the plan by 2027. 

The question isn’t of the buildings and equipment; it is of the lives and health of millions of people. 

Edited by Rajeev Tyagi | Report: Pallav Jain (Sehore), Abdul Wasim Ansari (Rajgarh), Manvendra Yadav (Chatarpur).

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