KARACHI, Pakistan — Heat waves have become common this time of year in Karachi, Pakistan’s sprawling seaside port city. Still, the latest one caught its 20 million residents off guard.
It was all anyone here could talk about last week as people moved lethargically about their days, helpless to avoid temperatures that sometimes soared to above 110 degrees Fahrenheit, leaving people in a fever-like haze, even in the shade.
The heat, radiating from roads and cement buildings well into the night, was made worse by the city’s notorious lack of green space. Shops and households that can afford air-conditioners cranked them up, but most people were left with few options: wet washcloths and electric fans, and those only for the few hours when the power was on.
The streets, normally congested with traffic, became eerily empty around noon. The traffic police listlessly motioned at cars from under umbrellas as people made their way indoors or hid for a few moments in the shadow of one of the city’s many concrete towers — anywhere that could provide some respite.
The heat spiked on May 18, just days after the beginning of the Muslim holy month of Ramadan — during which all able-bodied Muslims are required to abstain from food and water from sunrise to sunset. The timing exacerbated the effects of the brutal temperatures.
The death toll has reached 65, according to Faisal Edhi, the head of the Edhi Foundation, a charity that operates Karachi’s biggest fleet of ambulances and its central morgue. Government officials dispute that figure.
After four days, the extreme heat subsided — to a relatively cooling average of 91 degrees Fahrenheit. But on Wednesday it’s expected to be over 110 again.
One of those who lost their lives was 30-year-old Tayyiba Feroz.
When she went to cook food for her family on the evening of May 20, she was struggling with the heat but still felt fine, said her husband, Sheikh Mohammad Shiraz. She wasn’t fasting because she was pregnant, and pregnant women are exempt from the religious obligation.
The power goes out about six hours a day in their neighborhood, in one of the city’s more crowded northern slums, so residents plan their days around the times it comes on. Her husband said she had insisted on cooking dinner that night, worried that she wouldn’t be able to feed the family when the power would inevitably fail again.
He said she had been laughing with their 3-year-old son before heading to the stove to prepare dinner. Minutes later, she collapsed and died.
Mr. Shiraz, arranging traditional Quranic recitations a week later, seemed unable to process her sudden demise.
He suspects that the heat from the stove compounded her dehydration.
And he is racked with guilt because, he said, he knows well the signs of heat stroke from his job as an ambulance driver for the Edhi Foundation.
Mr. Shiraz, holding his son in his lap, said that in the past three years he had seen at least two dozen people die of heat stroke, most of them in June 2015, when Karachi suffered through one of the deadliest heat waves in history. More than 1,000 people died in two weeks then, overwhelming hospitals and emergency responders.
“I saw men fall dead in the street,” he said. “We’d have people die in the back of our ambulances. It was nonstop.”
Mr. Edhi, whose family began the Edhi Foundation, said he believed the true number of casualties was underreported in 2015 and continues to be underreported.
The 65 deaths his group reported this year, he said, are “just deaths that we know about in Karachi.”
“Outside of the city, dozens more could have died,” Mr. Edhi said. “But we just don’t have records.”
Mr. Edhi said that during the heat wave, bodies began arriving at the morgue at over twice the usual rate, and that the local government should do more to help people handle the heat.
The city has not released official numbers on fatalities, and its top official says no one died from heat stroke, but rather from heat-related injuries, like dehydration.
Dr. Seemin Jamali, the executive director of the Jinnah Postgraduate Medical Center, one of the biggest hospitals in Karachi, said the city had learned from the experiences of 2015. “We’re absolutely more in control of the situation,” she said.
Heat waves have been more frequent in Karachi since that time, but the recent one is the worst since then.
Mufti Muhammad Naeem, the head of Karachi’s biggest religious seminary, said Islamic jurisprudence was clear about fasting during hot summer months.
“It’s only acceptable to break your fast if you’re near death,” he said. “But doctors are quick to encourage us to drink water at the slightest sign of hot weather these days.”
“This is against Shariah,” he added.
His beliefs are held widely among the city, leaving a gray area for strict believers who balance the risks of fatigue and heat stroke with religious requirements when the city’s temperatures climb.
Residents of Karachi’s slums — by some estimates 61 percent of the population lives in the haphazard concrete sprawl along the city’s perimeter — face other challenges in dealing with the heat.
The city’s own water utility says 42 percent of its supply, which is meant to reach nearly 20 million people, is stolen or lost. The result is extreme water scarcity in an already arid climate, with steep prices and instability for the city’s poorest residents.
Mr. Shiraz said he was forced to buy water from a criminal syndicate even though his home was connected to a water line. “We never get water from our taps,” he said. The water is cut “at the source,” he added, “so we buy it from them.”
The police and city officials have tried to close down the criminal groups. And the city has made progress in limiting power failures in recent years. Still, widespread blackouts returned to Karachi in April as a deadlock continues in a battle between the city’s electricity supplier and gas company.
The result is that the city’s poorest are left to cope with punishing heat without stable water or electricity supplies. Mr. Edhi, leafing through his records of the deceased, said almost all of last week’s dead had come from slums where most of the city’s labor force resides.
Mr. Shiraz is preparing to return to work as an ambulance driver after the customary 10-day grieving period. “I’m keeping fast, of course,” he said. “I’ll pay my respects at my wife’s grave in the morning and get back to the dispatch center.”
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