By the time Pakistani schoolboy Saeed Ali was hospitalized in one of the hottest cities in the world, his body had been shut off from heat stroke.

A 12-year-old teenager fell after walking home from school under the scorching sun, spending his day in the shower in a classroom without fans.

“My son had to be transported here by rickshaw. He couldn’t even walk, “the boy’s mother Shahila Jamali told AFP from his bed.

Jacobabad in Pakistan’s arid province of Sindh is in the grip of the latest heatwave that hit South Asia – a maximum temperature of 51 degrees Celsius (124 degrees Fahrenheit) over the weekend.

Canals in the city – a vital source of irrigation for nearby farms – have dried up, and around the scattered debris are almost invisible points of stagnant water.

Experts in Pakistan say the scorching weather is in line with global warming forecasts.

The city is on the “climate change front,” said Deputy Commissioner Abdul Hafiz Sial. “Overall the quality of life here suffers.”

Most of the million people in Jacobabad and surrounding villages live in acute poverty, and water shortages and power outages threaten their ability to cope with the heat.

This puts residents in front of desperate dilemmas.

Doctors said Saeed was in critical condition, but his mother – driven by a desire to avoid poverty – said he would return to school next week.

“We don’t want them to grow up workers,” Jamali told AFP, her son is lethargic and tearful next door.

Heat stroke – when the body overheats so much that it can no longer cool down – can cause symptoms ranging from dizziness and nausea to organ swelling, loss of consciousness and even death.

Nurse Bashir Ahmed, who treated Said at a new heat stroke clinic run by the local NGO Community Development Foundation, said the number of patients arriving in critical condition is growing.

“The heat used to be at its peak in June and July, but now it comes in May,” Ahmed said.

Workers forced to work in the sun are among the most vulnerable.

Working bricks work near kilns, the temperature of which can reach 1000 degrees Celsius.

“Because of the heat, I sometimes want to vomit, but if I can’t work, I can’t make money,” said Rashid Rind, who started the site as a child.

– “Water Mafia” –

Attempts to cope with the heat predominate in life in Jacobabad.

“It simply came to our notice then. We need electricity and water the most, ”blacksmith Shafi Mohammad said.

Electricity shortages mean only six hours of electricity a day in rural areas and 12 in the city.

Access to drinking water is unreliable and inaccessible due to a shortage in Pakistan and serious infrastructure problems.

Hayrun Nisa gave birth during the heat, her last days of pregnancy spent under one ceiling fan shared by her family of 13.

Her place under a light wind is taken by her two-day-old son.

“Sure, I’m worried about him in this heat, but I know God will provide for us,” Nisa said.

A government-installed faucet is drying near their three-room brick house, where the stench of rotten garbage and stagnant water hangs in the air.

But local “water mafias” are filling the supply gap.

They used state reserves to direct water to their own distribution points, where cans are filled and transported on donkey carts for sale at 20 rupees (25 cents) per 20 liters.

“If it weren’t for our water supply, there would be great difficulties for the people of Jacobabad,” said Zafar Ula Lashari, who runs an unlicensed unregulated water supply.

“There’s nothing we can do.”

In a farming village on the outskirts of the city, women wake up at 3 am to pump drinking water from a well all day – but that is never enough.

“We prefer our cattle to have clean drinking water in the first place, because our existence depends on them,” said Abdul Satar, who raises buffalo for milk and sells it on the market.

There is no compromise in this, even if children suffer from skin diseases and diarrhea.

“It’s a difficult choice, but if the cattle die, how will the children eat?” he said.

Pakistan is the eighth most vulnerable country to extreme weather caused by climate change, according to the Global Climate Risk Index compiled by the environmental NGO Germanwatch.

Floods, droughts and cyclones in recent years have killed and relocated thousands of people, destroyed livelihoods and damaged infrastructure.

Many people decided to leave Jacobabad in the hottest months, leaving some villages half-empty.

Sharaf Khatun lives in a makeshift camp in the city, where up to 100 people survive on a few meager rupees, which male family members earn on undeclared work.

They usually relocate the camp in the hottest months, 300 kilometers to Quetta, where temperatures reach 20 degrees Celsius.

But this year they are late trying to save money for the road.

“We have a headache, an unusual heartbeat, skin problems, but there is nothing we can do about it,” Hatun said.

Professor Naushin H. Anwar, who studies urban planning in hot cities, says authorities need not only to respond to emergencies but also to think long-term.

“Taking heat seriously is very important, but sustained chronic exposure to heat is especially important,” she said.

“This is exacerbated in places like Jacobabad, due to degraded infrastructure and access to water and electricity, which threatens people’s ability to cope.”

– “Battlefield” –

Along a dried-up canal filled with garbage, hundreds of boys and a handful of girls in Jacobabad merge into a school for exams at the end of the year.

They gather around a hand pump to drink water depleted before the start of the day.

“The biggest problem we face is the lack of basic facilities – so we are experiencing more difficulties,” said director Rashid Ahmed Khalhora.

“We try to maintain the morale of children at a high level, but the heat affects their mental and physical health.”

Due to the extreme temperatures that arrived earlier in the year, he appealed to the government to postpone the summer holidays, which usually begin in June.

Some classes have fans, but most do not. When the electricity goes out in just an hour of the school day, everyone is in the dark.

Some rooms become so unbearable that children are moved down the hallway, children often lose consciousness.

“We are suffocating in the heat. We are sweating a lot and our clothes are getting wet, ”15-year-old Ali Raza said.

The boys told AFP that they suffered from headaches and frequent diarrhea, but refused to miss lessons.

Khalhora said his students are determined to break out of poverty and find work where they can escape the heat.

“They are prepared, as on the battlefield, with the motivation that they must achieve something.”

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