A powerful El Niño event is gripping South Africa, threatening to strain the country's water and food supplies, and compromise public health. The super El Niño, which is expected to last until at least February, is characterized by record-high sea surface temperatures in the Pacific Ocean, releasing heat into the atmosphere and raising global temperatures. According to Professor Sibusiso Mkwananzi, a senior researcher at the Wits Reproductive Health and HIV Institute, the nation is at a threshold where rising temperatures are no longer just a weather story but a threat to public health, human equity, and medical resilience.
The effects of extreme heat on health are multifaceted, with heat exhaustion and heat stroke being two of the most significant risks. Mkwananzi explained that the body attempts to thermoregulate through sweating, but when temperatures become too high, thermoregulation becomes difficult, leading to heat stroke, a medical emergency. The most vulnerable populations, including children, pregnant women, and the elderly, are disproportionately affected by extreme heat due to immature thermoregulatory systems, chronic illnesses, or an inability to prioritize self-protection.
Structural inequalities also exacerbate the effects of extreme heat on health, particularly in informal settlements and rural townships, which can become thermal traps. Research conducted in informal settlements has found that temperatures inside homes made of corrugated iron can be 3-5°C higher than outside. For community members managing chronic conditions, prolonged exposure to these temperatures can trigger severe cardiovascular stress, electrolyte imbalance, and acute kidney impairment.
A study from the Climate Impact Lab warned that the super El Niño could cause approximately 1,200 additional heat-related deaths in South Africa from September 2026 to February 2027. Globally, it is projected to claim more than 450,000 lives. However, Mkwananzi believes that the focus should be on empowering the public with strategies to protect themselves, rather than sensational reporting on projected deaths.
To cope with the extreme heat, low-cost community-level interventions offer practical protection. These include reflective roof coatings, community greenery and shade canopies, hydration depots, and early warnings. Mkwananzi's organization, Wits RHI, has successfully conducted several projects providing vulnerable communities with low-cost cooling strategies, such as umbrella hats, water bottles, and battery-operated handheld fans.
The preparedness of the healthcare system is also a concern, as traditional medical curricula have rarely incorporated climate change epidemiology. Mkwananzi stated that healthcare workers need training on climate change and its effects on health to provide adequate care during climate-driven health crises. Wits RHI has piloted rapid training programs to address this gap.
As the super El Niño continues to affect South Africa, it is essential to prioritize public health and take proactive measures to mitigate the effects of extreme heat. By empowering communities with knowledge and strategies to protect themselves, and strengthening the healthcare system, the country can reduce the risks associated with this climate phenomenon.
Key points
- Super El Niño brings record temperatures and health risks to South Africa
- Low-cost community-level interventions can offer practical protection against extreme heat
- Healthcare system needs training on climate change epidemiology to address health crises
