Kenyan women pay harsh price for rising heat: lost pregnancies
By Dominic Kirui
Susan Ng’etich has long picked tea to earn a living in Kenya’s green western highlands, the country’s premier tea-growing region. But rising heat, linked to climate change, is making that job more perilous, especially for pregnant women.
In April, as she worked on hot days picking and transporting tea and carrying out other jobs at home and on her farm, Ng’etich, a 31-year-old mother of two, suffered her first miscarriage.
“We were happy that we would soon welcome our third child to the family. It wasn’t to be like that,” she said, looking away as tears welled in her eyes.
Around the world, worsening extreme heat is leading to a surge in miscarriages, stillbirths and early births among women with little choice but to labour in hot conditions, health experts say.
A May 2024 study in the Journal of Global Health noted that pre-term births spike during heatwaves, and that pregnant women are among those most impacted by rising heat extremes, alongside newborns and older people.
Kericho County, where Ng’etich lives, has a reputation as a cool and wet place. But in recent years heat extremes have worsened, especially in the first three months of the year, and also at year’s end, with temperatures now nearing 30 degrees Celsius.
Such unaccustomed heat is taking a toll on women not used to working in it, medical officials say.
Caroline Chelang’at, the reproductive health services coordinator at the Kericho County Referral Hospital, said no specific county study has been carried out tracking worsening heatwaves as a cause of pregnancy-related problems.
Across much of Africa, data related to rising heat risk is lacking, with impacts often under-reported, complicating efforts to quantify and address the growing problems, African and global health officials say.
But “at our facility and also across the county, the number of these cases has been constantly rising. We cannot directly correlate extreme heat to each case, but it surely has been a factor compared to the previous, cooler years,” Chelang’at said.
The hospital has seen miscarriages, pre-term labor and fetal deaths, where babies die before they are born, she said.
Worsening heat is also an added burden on pregnant women already suffering from other health problems, from high blood pressure to malnutrition or COVID infection, she said.
Ng’etich can’t be sure what caused her miscarriage in April. But it came in a month busy with a heavy workload outside, in conditions much hotter than she remembers from her youth, when temperatures in Kericho County were about 1.5 degrees Celsius cooler on average.
“Sometimes I carry about 30 or 35 kilograms of fresh tea leaves, under a scorching sun. While I was growing up at my home, before I got married, we used to do this every day when schools closed to help our parents. But it was not that hot. Now it’s like the sun has fallen a few metres - it’s scorching,” said Ng’etich, who lives in the village of Ainamoi.
“In our area, it’s sweltering from January to around April. I think this is what contributed to my miscarriage,” she said, noting that the tea she picked each day also had to be carried two kilometres to market.
She used to volunteer as a community health promoter, going from house to house to check on patients and refer them for care but had to quit that job in the face of rising heat, her pregnancy and a lack of pay, she said.
“I couldn’t do it anymore as it was too hot, making me very weak during my pregnancy,” she said.
A few kilometres away, in the village of Chemorir, Janet Ng’eno lost a full-term pregnancy in May as she worked picking tea as a day labourer in hot conditions.
“When I was due, I went to the hospital, eager to hold my baby. But after giving birth, the nurse told me that the baby didn’t cry,” 32-year-old Ng’eno said.
“The nurse told me that the baby might have died due to too much work that I had done while pregnant, especially having to carry heavy loads of tea leaves and water from the distant river where we fetch it,” said Ng’eno, who is her family’s main breadwinner.
She said she had drunk a lot of water to try to stay healthy in the heat but the strategy had not been enough to save her pregnancy.
“Now the temperatures are better but from towards October and into January until March it is so hot you won’t believe you are in Kericho,” she said.
“June has been known (here) to be so cold but now I don’t know what has changed. It gets really hot,” she said.
'A major problem'
Dr. Martin Muchangi, the director for population health and environment at Amref Health Africa, an African health non-profit, said increasingly extreme heat often comes alongside worsening drought, which can increase the burden on women on a continent where they are usually responsible for providing household water.
“When there is heat, most of the water sources dry up and women, who are largely charged with fetching water, have to walk longer distances to get that resource. That experience itself exposes them to heat syncope,” or episodes of dizziness and fainting, particularly as they sweat and become dehydrated, he said.
With heatwaves worsening around the world, such problems are expected to impact many more pregnant women, he said.
“Women who are pregnant are actually much more predisposed to heat stress as compared to other cohorts within the population. We have seen this happening. There are mortalities that have been reported,” said Muchangi, a public health specialist.
Rising heat “is becoming a major problem moving forward”, he added, particularly as even hotter conditions are expected in coming years.
The U.N. Secretary-General in late July issued a global call to action on extreme heat risks, noting that “crippling heat is everywhere” and already affecting billions of people.
“More than 70 percent of the global workforce - 2.4 billion people - are now at risk of extreme heat,” he noted.
Efforts to reduce threats from growing heat - the last 12 months have been the hottest on record globally, meteorologists say - will require putting a special focus on women, according to a June 2024 report by the U.N. Development Programme on how heatwaves expose societal inequalities.
"Due to structural barriers, women and girls are affected by extreme heat more than men in terms of work, pay, and health. During heatwaves, women are more likely to experience job losses and increased caregiving responsibilities. This affects their education, economic opportunities, and overall well-being while further exacerbating gender inequalities," the authors noted.
cooler jobs
With the Kenya Meteorological Department predicting that every season in 2024 will be the warmest on record, Kericho County’s women say help is needed soon. They talk of fatigue and dehydration, weakness and nausea as they work amid worsening heat.
Sharon Cherono, who lives about five kilometres from Ng’etich, in the village of Kapkweny, also had a miscarriage last year - but is delighted to have now welcomed her third child in June, even if he was born more than four weeks early.
“Last year the doctor told me that the biggest contributor to my miscarriage was carrying heavy loads, standing in the sun for so long as I pluck tea, and also doing too many household chores,” said Cherono, who must fetch water for her family from a nearby river, carrying a 20-liter jerrycan of it up a steep hill each day.
On the advice of her doctor, the single mother stepped up the amount of water she was drinking during her most recent pregnancy, which she and her doctor credit with saving her son.
But she and many other women in Kericho County said they wish they could find work that doesn’t expose them as much to fast-worsening heat extremes.
“If I could only get a job in an office or a supermarket, somewhere with a roof to protect me from the sun, I think that will be better”, Ng’eno said as she picked up a jerrycan and headed to the river for yet another load of water to cook her family’s dinner.