India health systems are becoming a pressing concern as extreme weather patterns intensify. From diarrhoea outbreaks in October to heat stress in April and year-round cases of malaria and dengue, health activists in districts like Palghar, Maharashtra, are witnessing a new pattern of illnesses that demand urgent preparedness.
Local voices from Palghar
Suvarna Kamble, a 46-year-old ASHA worker in Palghar, has seen firsthand how heavy rains, followed by floods, disrupt essential services. Rations and medicines often cannot be distributed, and pregnant women face complications when cut off from care. Her senior ANM (auxiliary nurse midwife) explains that once waterlogging recedes, people begin drinking contaminated water, leading to diarrhoea and gastrointestinal diseases. Soon after, vector-borne diseases like malaria and dengue emerge.
In April 2025, Maharashtra reported higher-than-average malaria cases, showing that seasonal boundaries for such diseases are fading. Palghar recorded 97 malaria cases in 2023, compared to Mumbai’s 7,319, but even this smaller number highlights the growing vulnerability of semi-urban and tribal populations.
ASHAs and multipurpose health workers go door to door, eliminating mosquito breeding grounds under refrigerators or in water-filled pots. But while they fight these visible battles, mental health impacts of floods and disasters remain unaddressed due to lack of training.
Climate data and the health link
Scientific research supports these field observations. A 2020 Canadian study highlighted how floods trigger immediate gastrointestinal and vector-borne diseases, while also leaving survivors with long-term mental health issues. Yet, mental health rarely features in frontline healthcare planning.
Data further confirms the scale of India’s challenge. Between 1995 and 2020, India faced 1,058 climate-related disaster events, with floods accounting for 33%, heatwaves 24%, and droughts 22%. In 2024 alone, India experienced extreme weather on 322 of 366 days — nearly 88% of the year.
Rural populations, particularly the elderly, are disproportionately affected. Analysis from the Longitudinal Aging Survey of India found that droughts and floods severely impact older rural residents, worsening pre-existing vulnerabilities.
Systemic gaps in preparedness
Despite repeated climate disasters, logistical delays hinder healthcare delivery. ORS sachets needed during early summer heatwaves often arrive late. Malaria and dengue preventive supplies reach subcentres after peak demand. ASHAs in remote areas face treacherous terrain, including snake-infested paths, to reach affected populations.
India health systems are therefore not just about infrastructure but also about timely response and supply chain efficiency. The mismatch between need and delivery exacerbates disease burdens during extreme events.
Odisha: A case study in resilience
While Maharashtra ranks relatively higher on the NITI Aayog health index, Odisha provides an important lesson in disaster preparedness. Historically flood-prone, Odisha has transformed its disaster management approach over two decades.
The state’s evacuation of over one million people during Cyclone Phailin (2013) was hailed by the United Nations as a model for disaster risk reduction. Even during Cyclone Hudhud (2014) and the devastating cyclone of 2019, Odisha significantly reduced casualties compared to earlier decades.
One critical shift was integrating malnutrition and health care into flood relief operations. Data from flood-affected communities in 2006 and 2008 showed alarmingly high levels of child wasting. Odisha responded by weather-proofing health facilities, ensuring they remained operational during floods and cyclones.
However, experts caution that infrastructure alone is insufficient. Shyamal Santara of Transforming Rural India stresses that weather-proof solar-powered primary health centres must be supported by community outreach and adaptive planning to handle emergencies like prolonged marooning of villages.
The bigger climate-health picture
Globally, extreme weather linked to climate change caused nearly half a million deaths between 1999 and 2018, with economic losses of $3.54 trillion. For India, these numbers underscore the urgency of strengthening its healthcare system.
India ranked fifth in global climate vulnerability according to the 2018 Climate Risk Index. Rising sea levels, frequent cyclones, floods, and heatwaves are expected to increase the prevalence of diarrhoeal diseases, dengue, and malaria in tropical and sub-tropical regions like South Asia.
What India must do
To prepare, India Health Systems need a multi-pronged approach:
Early-warning systems – Weather alerts integrated with local health advisories can help frontline workers respond before disasters strike.
Efficient logistics – Ensuring ORS sachets, electrolyte solutions, and vector-control supplies reach vulnerable areas on time.
Mental health support – Expanding ASHA and ANM training to include counselling for trauma and anxiety disorders following disasters.
Infrastructure resilience – Flood-proofing and disaster-resilient design of healthcare facilities, particularly in coastal and flood-prone states.
Community participation – Empowering local workers like ASHAs to adapt strategies based on on-the-ground realities.
Conclusion
The stories from Palghar and the example of Odisha show that while India faces daunting challenges, solutions exist. India health systems must be addressed together through data-driven planning, grassroots empowerment, and proactive policy.
As extreme rainfall, floods, and heatwaves become the norm rather than the exception, the resilience of India Health Systems will determine how well the country safeguards its most vulnerable citizens. Preparing today is not just an option — it is a necessity for survival and dignity in a changing climate.