Amid continuously rising temperatures caused by extreme heat and global heatwaves, a critical health risk that should not be overlooked is heatstroke. This condition is becoming increasingly common during hot weather, especially among high-risk groups such as the elderly, young children, outdoor workers, and individuals with underlying conditions like heart disease, diabetes, and hypertension.

Heatstroke is not just general heat exhaustion—it is a medical emergency. It occurs when the body is unable to dissipate heat effectively, causing a rapid rise in body temperature that disrupts the function of vital organs, particularly the brain and heart. Without timely treatment, it can lead to severe complications or even death.

Dr. Suresh Kumar Narula, a specialist in cardiology, critical care medicine, coronary artery disease, and diagnostic angiography at Praram 9 Hospital, explains:

“Heatstroke occurs when the body temperature rises above 40–40.5°C, reaching a critical level. The brain’s temperature regulation system fails, and the body can no longer release heat through sweating. As a result, the patient’s skin becomes extremely hot but dry, with no sweat. Internal organs begin to suffer damage immediately.”

A key warning sign of heatstroke is a body temperature above 40.5°C without sweating, despite intense heat. This indicates failure of the brain’s temperature control system. The brain is the most heat-sensitive organ—once the temperature exceeds this threshold, brain cells begin to shut down. Patients may experience confusion, seizures, or loss of consciousness. This triggers a domino effect, where damage rapidly spreads to the heart, liver, and kidneys, causing acute inflammation.

In severe cases, this may lead to Disseminated Intravascular Coagulation (DIC)—a dangerous condition involving abnormal blood clotting throughout the body, which can be life-threatening.

Dr. Suresh emphasizes that the key to treating heatstroke is time:

“Every minute counts. The faster we can lower the body temperature, the higher the chance of survival. This principle is similar to ‘Time is Brain’ or ‘Time is Muscle’ in stroke and heart attack patients.”

Heatstroke affects the entire body. The heart may develop serious arrhythmias due to electrical disturbances. While it may not stop immediately like in cardiac arrest, delayed treatment can lead to heart failure. At the same time, patients may suffer acute kidney failure, severe liver damage, and abnormal blood clotting, accelerating multi-organ failure.

High-risk groups for heatstroke include:

1. Individuals with weakened physical conditions, such as children, the elderly, and patients with chronic diseases (especially heart disease, diabetes, and hypertension)
2. Healthy individuals engaging in intense outdoor activities, during the afternoon hours when heat is intense such as athletes or laborers

Patients with heart disease and diabetes are particularly vulnerable because their bodies already have underlying weaknesses. When exposed to extreme heat, these organs are affected first, leading to faster and more severe complications. If hospital treatment is delayed, survival rates may drop below 50%.

First Aid for Suspected Heatstroke:

If someone is suspected of having heatstroke, the most important action is to seek immediate medical attention.

• Move the patient to a shaded or air-conditioned area
• If conscious, allow them to drink cool water
• Generally, the heart is still beating, so CPR is not the primary first aid unless the patient has stopped breathing

The priority is to get the patient to the nearest hospital as quickly as possible. Every minute is critical. With prompt treatment, recovery to normal life is possible.

Dr. Suresh also clarifies a common misconception:

Many people confuse heatstroke with stroke due to similar symptoms. However, the causes are entirely different.

• Stroke is caused by blocked or ruptured blood vessels in the brain, leading to lack of blood and oxygen
• Heatstroke is caused by excessive heat overwhelming the body’s temperature regulation system

Stroke symptoms include facial drooping, arm weakness, slurred speech, and vision problems—commonly remembered with the FAST (Face, Arm, Speech, Time) principle.

In contrast, heatstroke is characterized by extreme body heat without sweating, along with neurological symptoms such as confusion, delirium, seizures, or unconsciousness.

Prevention Tips:

• Stay well-hydrated throughout the day
• Avoid outdoor exposure between 11:00 AM – 3:00 PM, when temperatures are highest
• Maintain good health through proper nutrition and regular exercise (at least 5 days per week, 30–40 minutes per session)

For more information about heatstroke, please contact the Cardiovascular Institute at Praram 9 Hospital or call +66 (0) 2202-9999, or reach us via Facebook: @Praram9Hospital.International

Led by Thailand’s Royal Irrigation Department, a climate-financed initiative is showing how strong national ownership can deliver lasting adaptation at scale.

As climate impacts intensify across Southeast Asia, Thailand is offering a compelling example of how climate finance can translate into effective climate action when driven by national institutions. Under the leadership of the Royal Irrigation Department (RID), and with technical and financial support from the Green Climate Fund (GCF) and UNDP, Thailand is implementing an integrated adaptation approach that strengthens climate information for water management, ecosystems, and rural livelihoods in flood- and drought-prone areas of the Yom–Nan River Basin.

From the outset, RID has played a central role in steering project design, coordinating across sectors, and aligning climate investments with national water management priorities. This strong government leadership has enabled the project to move beyond pilots toward solutions that are scalable, institutionalized, and embedded within Thailand’s development systems.

These climate-financed initiatives are currently under development by the Royal Irrigation Department and will be fully operational in the future.”

Turning Climate Data into Action

A cornerstone of the project is the expansion of Thailand’s climate and hydrological monitoring capacity under RID’s operational framework. By 2025, RID—working with national technical partners—oversaw the installation of a comprehensive hydro-meteorological network, including weather stations, water-level sensors, soil-moisture monitoring, and flow radar systems.

These systems directly support RID’s mandate to manage water resources under increasing climate uncertainty. Clear operational procedures and inter-agency coordination mechanisms have been developed to support the use of climate information in irrigation planning, flood management, and agricultural decision-making. These arrangements are currently being adapted and refined during early implementation, as agencies and local users integrate climate information into routine operational practices. Farmers and local officials have been engaged throughout this process, helping to build trust in climate information and encourage practical uptake at the local level.

Infrastructure and Nature Working Together

RID’s leadership has also been central to demonstrating how traditional water infrastructure can be strengthened through nature-based solutions. Drawing on its long-standing experience in irrigation and flood management, RID led the planning and implementation of climate-resilient infrastructure upgrades, including canal head regulators and drainage systems, improving water management for more than 20,000 hectares.

At the same time, the project has benefited from complementary international expertise. The Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) provided specialized technical support on Ecosystem-based Adaptation (EbA), contributing international best practices, ecological assessment methodologies, and design expertise. This collaboration enabled the integration of wetland restoration, river reach rehabilitation, and natural water storage solutions alongside conventional infrastructure. All EbA investments were developed based on rigorous climate risk and ecological assessments and approved under GCF environmental and social safeguards.

Together, this blended approach positions ecosystems not as add-ons, but as essential components of climate-resilient water management.

Strengthening Livelihoods and Access to Finance

Under RID’s coordination, the project has extended climate resilience beyond infrastructure to rural livelihoods. Farmer Field Schools, climate-informed extension services, and digital innovations—such as smart farming applications and drone-based crop monitoring—are enabling farmers to respond more effectively to climate variability.

Access to finance and financial capability have been strengthened through partnerships with national financial institutions. In 2025, the Bank for Agriculture and Agricultural Cooperatives (BAAC) committed approximately USD 16 million in credit for farmers participating in project-supported training, supporting investment in climate-resilient agricultural practices.

In parallel, Krungsri Ayudhya Bank has contributed to farmer resilience by providing financial literacy training, helping farmers strengthen household financial management, savings, and investment planning under increasing climate uncertainty. Emphasizing financial literacy enhances access to credit, ensuring that climate finance translates into sustainable and inclusive livelihood outcomes.

The project has also supported farmers in diversifying income sources as part of climate adaptation strategies. Farmers received assistance to develop online marketing channels, strengthen product branding, and improve retail outlets and storefronts, enabling them to reach wider markets. These efforts promote secondary occupations and value-added activities, reducing livelihood vulnerability to climate shocks and enhancing long-term adaptive capacity.

Challenges and Lessons from Implementation

While progress has been substantial, RID’s leadership has also involved navigating several key challenges. Integrating new climate information systems into long-established operational procedures has required adjustments in institutional workflows, staff capacity, and coordination across multiple agencies. Building confidence among local users—particularly farmers—in the reliability and practical value of climate data has taken time and sustained engagement.

Introducing ecosystem-based adaptation alongside conventional infrastructure has likewise required careful balancing of engineering, ecological, and social considerations, together with strict adherence to international environmental and social safeguards. In addition, aligning project timelines has necessitated adaptive management in response to site-specific constraints, climatic conditions, and differences between national and international technical requirements and design standards.

Addressing these challenges has strengthened institutional learning within RID and its partner agencies, reinforcing the importance of adaptive governance, capacity development, and continuous stakeholder engagement in climate-financed programmes.

Lessons for COP and Climate Finance

Together, these measures demonstrate how climate adaptation can strengthen not only production systems, but also financial resilience and market access for rural communities.

Thailand’s experience offers several relevant insights for Conference of the Parties (COP) discussions and climate finance practitioners:

National ownership matters: Climate finance is more likely to translate into tangible outcomes when led by capable government institutions with clear mandates and decision-making authority.

Institutions enable scale: Embedding climate information systems and adaptation approaches within agencies such as the Royal Irrigation Department (RID) supports continuity, learning, and the potential for scaling beyond the project lifecycle.

Nature-based solutions can be piloted alongside infrastructure: With robust technical analysis and environmental and social safeguards, ecosystem-based adaptation can complement core water infrastructure. This project serves as a pilot area to test integration approaches before wider replication.

Finance follows capacity: Strong public leadership and institutional readiness help crowd in domestic and sectoral finance, linking climate finance with longer-term investment in adaptation.

With major preparatory, safeguard, and design milestones now completed, RID is well positioned to accelerate implementation and scale climate-resilient water management across Thailand. As countries look to COP for models that convert climate finance into tangible outcomes, Thailand’s RID-led approach delivers a clear message: when national institutions lead, climate finance delivers results.