Turkey and Syria earthquake: evidence-based innovations and guidance for acute crisis response.

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Principal Investigator: Junaid A. Razzak, Johns Hopkins


Get an overview of this research study and its findings in this research snapshot.



The purpose of this study was to develop and test a set of interventions to reduce the impact of extreme heat on urban low-income populations. There were three main objectives:

  1. To develop evidence based care strategies for management of people with exposure to extreme heat (EH) in both households and emergency departments in low income settings such as Pakistan;
  2. To implement Heat Emergency Education and Training (HEAT) bundle in Karachi and measure its impact on a composite outcome comprising of emergency department admissions, hospital admissions and all-cause mortality
  3. To determine the impact of HEAT implementation on the knowledge and care practices in households and emergency departments.


The study developed and tested a set of interventions called Heat Emergency Education and Treatment (HEAT), which were designed using current evidence, international best practices, and with relevance to low resource settings. The study filled several critical gaps in research by carrying out the first randomised controlled trial comprised of a set of customised community- and hospital-based interventions in a low-income urban population, with inclusion of a control group of similar socio-economic status in the same city.

The study also include standardised assessment for categorising causes of heat related morbidity and mortality, and attempted to control for some of the important external confounders by collecting data before the intervention was carried out. In order to align the research intervention with what could be done in real life, the study team relied on indigenous community health mobilisers and the infrastructure present in local healthcare facilities.

Related Resources

Article, Peer Reviewed Disaster Risk Reduction

Impact of community education on heat-related health outcomes and heat literacy among low-income communities in Karachi, Pakistan

Article, Peer Reviewed Disaster Risk Reduction

Effective Community-Based Interventions for the Prevention and Management of Heat-Related Illnesses

Article, Peer Reviewed Disaster Risk Reduction

Heat Emergencies: Perceptions and Practices of Community Members and Emergency Department Healthcare Providers in Karachi, Pakistan

Manual Disaster Risk Reduction

HEAT: A provider manual for healthcare professionals on assessment and management of patients with heat exhaustion and heat stroke

Latest Updates

HEAT Provider Manual produced

Mar 2020

The HEAT Provider Manual was produced and utilised by the investigators to train healthcare personnel in the hospitals that participated in the trial.


Treatment algorithm produced

Mar 2020

A Treatment algorhithm accompanied the HEAT Provider Manual.


Tackling extreme heat – changing behaviours, changing policy

Jul 2018

Blog by Simon Pickard, R2HC Portfolio Manager: When a recent period of high temperatures hit Canada, it made the global headlines. Tragically up to 70 people are reported to have…


Invisible Victims

May 2018

Our project, “Heat Emergency Awareness and Treatment (HEAT)”, is focused on developing training and educational materials that will be implemented in hospitals and communities to increase awareness about heat-related illness…

Community Health worker in Karachi. Credit: Aman Foundation.

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