As Pakistan grapples with increasingly frequent and intense heatwaves driven by climate change, millions of outdoor workers, particularly in Khyber Pakhtunkhwa, continue to toil under the blazing sun with minimal protection. Construction labourers in Dir and rickshaw drivers in Malakand are among those bearing the brunt, facing daily risks of heat exhaustion, dehydration, and long-term health damage.
Sajjad, a 38-year-old construction worker from Chakdara, Lower Dir, wipes sweat from his brow while describing his routine. “We start work at 7 in the morning when it’s still bearable. But by 2 o’clock, the sun turns the iron rods and cement slabs into burning metal. Our hands blister, heads spin, and bodies feel completely drained. Last June, two of my colleagues collapsed from heatstroke and had to be rushed home. We drink water constantly, wrap wet cloths around our heads, and wear loose shalwar kameez, but there is no proper shade or breaks. If we stop, we lose the day’s wage of Rs. 1,000. This is our majboori (compulsion),” he said.
Akbar, 45, a rickshaw driver plying routes in Batkhela, Malakand, shares a similar plight. “Sitting inside this black metal box all day feels like an oven. Sweat soaks my clothes from morning till evening. Passengers complain about the heat, but I have no fan or air conditioning. Sometimes dizziness hits so hard that I have to pull over on the roadside. I rely on Nasaf for temporary energy and drink whatever water I can find, yet my body is exhausted by night. I must keep driving for my children’s food. This extreme heat is slowly killing us drivers and daily earners,” Akbar explained.
Dr Noor Rehman, a medical expert, warns that prolonged exposure to extreme heat, often exceeding 40–45°C with high solar radiation, overwhelms the body’s cooling mechanisms. The human body maintains a core temperature near 37°C through sweating and increased blood flow to the skin. In high heat and humidity, especially in Khyber Pakhtunkhwa’s southern and central districts, evaporation slows, leading to rapid dehydration, elevated heart rate, and strain on vital organs.
Common symptoms among labourers include heat cramps, heat exhaustion (dizziness, nausea, weakness), and in severe cases, heatstroke when core temperature surpasses 40°C, causing confusion, seizures, or organ failure. Long-term risks involve chronic kidney disease from repeated dehydration and muscle breakdown (rhabdomyolysis), cardiovascular complications, and reduced productivity.
Dr Muhammad Nafees, Head of Department of Environmental Sciences at the University of Peshawar, warns that “The numbers are alarming. Pakistan loses millions of working hours every year because of extreme heat, and by 2050, this crisis will affect over 200 million workers. I have seen construction labourers in Khyber Pakhtunkhwa work through heatstroke symptoms simply because stopping means no food for their children.
Many attempt to start work earlier or avoid the harshest afternoon hours (12–4 pm), though daily-wage structures often make this impossible
This is not just a health emergency; it is an economic catastrophe unfolding in slow motion. Governments must immediately revise labour laws to mandate rest breaks, shaded workspaces, and hydration facilities at all outdoor worksites. The solutions exist. What is missing is political will.”
National Disaster Management Authority data show that Pakistan’s vulnerability to extreme heat has grown alarmingly over the past fifteen years. The country has experienced increasingly severe and frequent heatwaves, with temperatures regularly exceeding 45–50°C across southern and central regions. The deadliest remains the 2015 Karachi and Sindh heatwave, which killed between 1,200 and 2,000 people, the majority being outdoor workers, the elderly, and vulnerable urban populations succumbing to heatstroke and dehydration within days.
This was not an isolated tragedy. In 2010, temperatures surged past 50°C across parts of the country, claiming dozens of lives. The early spring heatwave of 2022, which struck before communities had any chance to acclimatise, was linked to at least 90 deaths across Pakistan and India combined, while also inflicting severe agricultural losses on farming communities already stretched thin. By 2024, the scale of devastation had grown further. In just a matter of days in June, the Edhi Foundation reported over 568 bodies in Karachi alone, while thousands more were admitted to hospitals nationwide with heat-related conditions.
These figures, stark as they are, almost certainly undercount the true toll. Across Pakistan, heat-related deaths are routinely recorded as cardiac failure or dehydration without any link being made to extreme temperature, a pattern that masks the real human cost of each passing summer. Cumulative heatwave mortality between 2010 and 2025 likely exceeds several thousand, with daily-wage outdoor labourers in construction, agriculture, and transport disproportionately represented among the dead.
What these events collectively reveal is a country facing a recurring and escalating threat. Heatwaves are no longer rare emergencies in Pakistan; they are a predictable feature of every summer, made more lethal by rapid urbanisation, rising humidity, and chronic power outages that deny relief even indoors.
Studies and reports, including those from Amnesty International and local health surveys, highlight that outdoor workers such as construction labourers, brick kiln workers, farmers, and rickshaw drivers are disproportionately affected. During the 2024 heatwaves, ambulance services like Edhi reported sharp spikes in urban centres, with many cases linked to outdoor work. Productivity losses on construction sites can reach 29–41 per cent during peak heat, according to global analyses applicable to Pakistan’s context.
Faced with economic realities, workers rely on simple, low-cost strategies. Common practices include frequent hydration with water or oral rehydration solutions, wearing light-coloured loose cotton clothing, using caps, umbrellas, or wet towels on the head, and seeking whatever shade is available, including trees, makeshift cardboard shelters, or building shadows.
Many attempt to start work earlier or avoid the harshest afternoon hours (12–4 pm), though daily-wage structures often make this impossible. While these behavioural adaptations help, they are insufficient against rising temperatures amplified by climate change.
We are not asking for luxury. Just a little shade, some rest without losing wages, and respect for the limits of the human body under this burning sun
Evidence-based guidelines stress the need for structured interventions. These include shifting heavy physical tasks to cooler morning or evening hours, implementing mandatory rest breaks using work-to-rest ratios based on temperature and workload, and providing shaded rest areas, hydration stations with cool water, and temporary cooling shelters at construction sites and markets.
Other measures include gradual acclimatisation for new workers over 7–14 days and training supervisors to identify early signs of heat stress and ensure rapid cooling protocols. The National Disaster Management Authority Pakistan Heatwave Guidelines 2024 explicitly call for protecting vulnerable groups, including outdoor labourers, through such measures, alongside early warning systems via text messages, media, and community alerts.
Pakistan has developed a layered policy architecture to tackle extreme heat. The National Climate Change Policy 2021 recognises heatwaves as a major risk and advocates for early warning systems, heat-resilient infrastructure, public awareness, and integration into health, agriculture, and labour sectors.
In Khyber Pakhtunkhwa, the Provincial Disaster Management Authority Heat Wave Action Plan 2022 identifies high-risk groups including construction labourers, outdoor workers, farmers, rickshaw and auto drivers, and street vendors. Key actions include early warnings, mobile health units, shaded facilities in markets, uninterrupted power supply, and awareness campaigns.
Both national and Khyber Pakhtunkhwa frameworks are well-aligned, yet implementation gaps persist, especially in the informal sector (comprising approximately 71 per cent of the non-agricultural workforce), where enforcement of occupational safety standards remains weak.
Economic pressure is the biggest barrier. Daily-wage workers cannot afford lost income, leading many to ignore recommended breaks or work through symptoms. Limited access to affordable cooling at home or worksites, insufficient public cooling centres, and poor urban planning exacerbate risks.
Underreporting of heat-related deaths, often recorded as cardiac issues or dehydration without linking to heat, masks the true scale of the crisis. Community-based education has shown promise: one randomised controlled trial in Pakistan demonstrated that training via community health workers improved knowledge and reduced heat-related hospital visits by 38 per cent. However, scaling such interventions requires sustained funding and coordination.
Experts and labour advocate Tariq Afghan say that climate change is significantly affecting daily-wage workers in Khyber Pakhtunkhwa, especially construction workers, rickshaw drivers, and street vendors whose incomes depend on outdoor work. Heatwaves, unpredictable rainfall, and extreme weather have turned climate change from an environmental issue into an economic and human rights crisis for vulnerable labourers.
He notes that although policies such as National Disaster Management Authority frameworks, climate policies, and Provincial Disaster Management Authority plans exist, their implementation remains weak. According to him, most laws remain on paper, with poor coordination among institutions, limited worker-focused measures, and weak monitoring systems.
Tariq Afghan emphasises that heat protection should be recognised as a fundamental labour right. Employers should be responsible for providing safe working conditions, while labour departments must ensure monitoring, fines, and legal action for violations.
He recommends effective heat action plans, including limiting outdoor work during peak heat hours, especially in districts like Dera Ismail Khan, Malakand, and Dir, along with the provision of water, shade, first aid, and emergency response systems. He adds that protecting informal workers from worsening heatwaves is essential for Pakistan’s economic stability, human rights protection, and climate resilience.
“We are not asking for luxury. Just a little shade, some rest without losing wages, and respect for the limits of the human body under this burning sun.” — Sajjad, Construction Worker, Lower Dir