How extreme heat and poor sanitation endanger the health of women in outdoor jobs

When summer temperatures can soar to 42°C, poor environmental conditions make heat exposure a serious occupational hazard, especially for those doing outdoor work. Photograph used for representational purposes only
| Photo Credit: Giri KVS

It’s a humid Friday afternoon at the M.G.R. Nagar market in Chennai. Piles of vegetables line the street, and fish are kept in ice boxes, under shade, to prevent spoilage in the stifling heat of May. 

R. Ponni, a 60-year-old vendor, is busy vying for customers. In a few hours, the market will reach its busiest time of the day. Ponni starts her day by shopping for vegetables early in the morning, heads home to cook before returning to the market at noon. 

“Earlier, when I was younger, I could manage better. I used to be a hawker. Now, I can’t imagine carrying a basket on my head and walking around. Even sitting in one place tires me out in this heat. It’s becoming increasingly difficult,” she said.

Rationing water

The relentless heat demands constant hydration. Ponni carries a 2-liter water bottle, carefully monitoring how much she drinks at a time. She does this for two reasons: to ration her water and to avoid the need to urinate, since there’s no proper toilet at the market. Her home is three kilometres away, and walking is the only way to get there — so she can’t go to the bathroom whenever she needs to.

Studies show that the combination of excessive heat exposure and limited fluid intake significantly raises the risk of health problems for women. In Tamil Nadu, where summer temperatures can soar to 42°C, poor environmental conditions make heat exposure a serious occupational hazard, especially for those doing physical labour.

A 29-year-old traffic police constable in Chennai, who wished to remain anonymous, acknowledged the difficulty of taking bathroom breaks when needed. “We can’t always take bathroom breaks at the exact time we need to. If it’s peak traffic, we might have to wait 10 or 15 minutes while coordinating with a colleague who can take over,” she explained.

As for bathroom access, she said they often use nearby buildings. For example, at Ashok Pillar, where she’s been posted for several months, she has access to a post office, a bank, or a hotel. “In this regard, police personnel are privileged because no one objects to us using these facilities,” she added.

Another constable, stationed at Teynampet and with four years of service, mentioned that the difficulty arises when they’re posted for ‘bandobast’ — security during VIP movement. In such cases, there are long waits with no guarantee of a clean bathroom nearby. Regardless of the hygiene conditions, they have no choice but to use whatever is available. However, in the summer, both constables noted that because they sweat so much, they don’t feel the need to use the bathroom as often.

These women are only a few examples of the many women in outdoor labour who endure the harsh effects of heat.

Lack of toilets

A study titled ‘Heat Stress and Inadequate Sanitary Facilities at Workplaces – An Occupational Health Concern for Women?’, led by Vidhya Venugopal and published in Global Health Action, surveyed 312 women working in informal sectors like agriculture and brick and steel manufacturing in southern India between 2014 and 2016. The study found that nearly 64% of these women lacked access to toilet facilities at their workplaces. There was a clear link between heat-related health issues and the absence of toilets.

The study also revealed that 87% of working women reported experiencing urinary and genital infections periodically. Women without access to toilets were six times more likely to suffer from these infections compared to those with toilet access. Furthermore, women who didn’t drink enough water were four times more likely to develop genito-urinary problems compared to those who stayed properly hydrated.

Thirty-two-year-old S. Marutham, a mother of two, said she has stopped setting up her fruit cart on Mount Road for two days each month during her menstruation due to the lack of a proper toilet. She used to develop rashes, so she decided to take two days off work each month to avoid further discomfort.

What does it do to women’s health?

Akila Mani, consultant – diabetologists & endocrinologist, Apollo Specialty Hospitals, Vanagaram said that while women are not inherently more vulnerable to heat, factors such as inadequate access to sanitation facilities and poor hydration place them at greater risk of heat-related illnesses. “When you sweat, you lose not just fluid but also salt. So it’s important to stay hydrated by drinking fluids — like buttermilk with salt,” she said, adding that women are also more prone to skin infections, especially in areas like the groin or under the underwear.

Dr. Mani said that dehydration in extreme heat can lead to serious health issues. She emphasised that women with diabetes who work outdoors should be particularly cautious. “Even if the sun doesn’t feel harsh, UV radiation can still cause itching and rashes,” she said, adding that these conditions are worsened when women lack access to safe drinking water.