A deadly combination of factors, including poor urban planning, a crippled energy infrastructure, climate change, Ramadan, and freak weather conditions, has led to the unprecedented deaths of more than a thousand people in a Pakistani heat wave.
More than 65,000 people suffered heatstroke during the two-week heat wave, which started on June 19 and has just subsided — the majority of which were in Karachi, the country's largest city. The total number of dead is around 1,300, according to the provincial government of Sindh, where Karachi is located.
The number of bodies was so high and the heat so intense that morgues ran out of space and bodies had to be buried without being identified.
The temperature in Karachi hit the second highest ever recorded — 109 degrees Fahrenheit. Compounding that was the mysterious cessation of a breeze that usually flows in from the Arabian Sea coast, thanks to low pressure out at sea, which has been blamed on climate change.
Dr. Muhammad Hanif, the director of the national weather office Pakistan Meteorological Department (PMD), told VICE News that recent weather in Karachi had been "extraordinarily hot," like nothing ever seen before.
"Along the coastline the sea wind normally blows for 10 months, which keeps Karachi weather more moderate, but this year in June, a hot month, suddenly the sea wind stopped," he said. "This was really dangerous and alarming, and we have no idea why this happened."
It could be because of global warming, said Hanif, which has had a major impact in Pakistan over the last 10 years. "In the past 10 years the winter season was reduced from 115 days to 80 and the hot weather season was extended from 150 days to 180," he said. "It is a major change in the ecosystem which means in future the nation may face more heat waves like Karachi or the storm in Peshawar in April which left 44 dead."
The heat wave disproportionately affected Pakistan's poorest residents, many of whom work outside and are unable to take days off regardless of weather conditions or sickness. The homeless face even greater risks.
Anwar Kazmi, spokesman for the major Pakistani charity Edhi Foundation, said the organization had buried 150 unidentified bodies. Officials believe many of them were homeless.
"An unidentified body is generally kept at the morgue for at least 20 days, but because of the overwhelming inflow at the facility and the condition of the bodies, the deceased are being buried sooner," said Kazmi. "We [had] a space crunch in the Edhi morgue [and] a shortage of rescue workers who [could] prepare dead bodies for a funeral."
Karachi cemetery worker Gul Pasha outlined burial issues while speaking to VICE News.
"Due to the sudden and high number of dead in Karachi, people are facing problems [organizing] funeral prayers and also in finding space for the graves," he said.
The Edhi Foundation's Karachi director Mohammed Bilal told the BBC he had never seen so many people suffering heatstroke in 25 years working as a charity worker transporting casualties. "The bodies just kept coming from all over the city," he said. "Over… eight days, we received 900 bodies. We had to turn away so many families," he said.
Most of those who died or were treated for heatstroke were people who were fasting for Ramadan, said Jawaid Shaikh, a doctor at Karachi's Civil Hospital. The heat wave started two days after the start of Islam's holy month, during which Muslims do not consume food or water from dawn to dusk.
Various religious leaders appeared on media urging people to break the fast if they felt unwell. "We [religious scholars] have highlighted on various television channels that those who are at risk, especially in Karachi where there is a very serious situation, should abstain from fasting," prominent Islamic cleric Tahir Ashrafi told Australian news network ABC.
Environment expert and activist Major Abid Hussain said that the number of deaths was avoidable, even with the extreme weather occurring during Ramadan. He blamed the government and Pakistan's failing energy network.
"Karachi is a bad example of unplanned construction which lacks basic facilities," he said. "So then when people suffer from heat stroke it causes so many deaths. It is alarming and the Pakistani government and people need to learn from this disaster and take sufficient steps to meet the challenge of climate change."
Environment expect Moazam Khan from the World Wide Fund for Nature said the government and energy companies were to blame. "This disaster is due to the lack of ability to respond [adequately]," he claimed. His mother, aged 61, died from heat stroke "despite of all facilities available in my home. My air conditioning wasn't working due to the lack of electricity," he said.
Pakistan has suffered massive electricity shortages for years, with blackouts and load shedding — where the electricity supply is deliberately cut off in certain areas to avoid a total system shutdown during periods of high demand — have become common. But turning off electricity during a heat wave can be fatal, because it cuts off fans, AC, and medical facilities.
Even before power outages, many hospitals in Pakistan are desperately overstretched and lacking in basic facilities. Khan added that the huge influx in extra patients during the heat wave had left Karachi's hospitals unable to cope.
Abdual Salam's brother Adbudal Kram, 50, died of heat stroke. Salam said his brother was fasting "and suddenly he became unconscious. We took him to the nearby hospital, where I saw a terrible situation. The hospital didn't have enough facilities to treat the patients."
Another man, Imran Khan, told VICE News that everyone was suffering in his Karachi neighborhood. His whole family had become ill when the electricity was cut off, he said.
"The fan was not available for many hours in our home. My sister died and my brother Naseer Khan is being treated and still suffering," he said.
Sindh's provincial government was criticized for responding very slowly to the unfolding crisis, reported the BBC. But it in turn blamed the federal government and Karachi's private electricity company, K-Electric, for cutting off power during the crisis.
A K-Electric spokesman told VICE News that "due to the increase in consumption there was a failure of electricity in Karachi." Electricity had now been restored, he said.
The PMD has warned that a fresh heat wave is likely to hit Karachi next week. Temperatures are expected to again reach 107 to 109 degrees.
Touseef Alam, former chief meteorologist of the PMD in Karachi, told VICE News "the intensity of the fresh heat wave could be similar to the prevailing one. Relief efforts should continue with the same pace even if the city receives rain."
Follow Mohammad Zubair Khan on Twitter: @HazaraZubair