As extreme heat becomes more common, fears are growing that Greater Western Sydney’s health system is becoming exhausted.

By the time Frankie Scott took her daughter to the emergency room in March, the routine had become familiar. The symptoms of nausea and delirium, the wait times that stretched into hours, the thoughts about the whole situation.

In November 2023, at the age of five, Ms. Scott’s daughter was diagnosed with stage 3b kidney disease.

Medications and specialists helped slow the decline, but as summer arrived, bringing temperatures above 30 degrees Celsius, problems followed closely.

Between January and March, Ms Scott’s daughter was admitted six times to nearby Campbelltown Hospital in Sydney’s southwest, ranging from acute kidney injury to suspected infections and exhaustion from the heat.

The probable cause, according to doctors, was the heat.

“I don’t know exactly how it all works yet, but looking back at its history, when it gets hot enough, it deteriorates pretty quickly,” the 35-year-old said.

Exposure to heat can have life-threatening consequences, increasing the risk of dehydration, heart attack and kidney failure.

For existing illnesses, such as kidney disease, the danger is a worsening of the situation.

“My big worry is that she’s going to continue to progress at the rate that she is,” Ms. Scott said.

Extreme heat predicts serious damage for Greater Western Sydney

As Australian summers intensify, bringing sweltering temperatures and frequent heatwaves, one result is a health system under increased pressure.

Extreme heat is responsible for more deaths and injuries than any other natural disaster in Australia, with deaths likely underestimated, some research suggests.

The repercussions of global warming are already being observed. In the three years to 2022, heat-related hospitalizations more than doubled in NSW.

“Heat is really this kind of risk multiplier,” said Thomas Longden, a health economist and senior researcher at Western Sydney University’s Center for Urban Transformations Research.

Rampant heat has national implications, but some areas are more vulnerable than others.

In Greater Western Sydney, the region’s distance from the coast and rapid urban development can result in temperatures 10°C higher than in the city’s east.

Climate modeling has long suggested that these temperatures will increase, reaching 16 days above 35°C by 2030 and 46 days by 2090.

Such heat can harm everyone, but it poses acute risks to certain groups, including those who live in a “heat island” or who cannot escape high temperatures.

Diabetes and heart disease are more common in Western Sydney. These are also diseases that are more likely to become fatal during heat waves.

“Any increase would tip us over”

Such forecasts have begun to raise alarms about whether Greater Western Sydney’s health system, long plagued by underfunding and capacity issues, is equipped to cope with a surge in demand.

“Greater Western Sydney has been underfunded, underfunded, and it’s the most vulnerable to extreme heat events,” said Lai Heng Foong, chair of ACEM’s public health and disasters committee and Senior emergency physician working in Greater Western Sydney.

“I don’t usually make doomsday predictions, but this is pretty dire because we’re already struggling to keep up with demand. Any increase would tip us over the edge.”

This prediction is partly explained by how socioeconomic disparities and chronic illnesses may increase heat wave risks, alongside other known exposure risks, including increased suicidality.

But it is also how these factors, Dr Foong said, would combine with others, such as health illiteracy and a growing population, to increase the potential for harm.

“It’s a domino effect on the healthcare system, and community members will suffer.”

“We need to do more”

Steps have been taken by state and local governments across the region to prepare for cascading heat, including establishing thermal shelters and dedicated task forces.

The state government has also pledged to increase Sydney’s forest cover by 40 per cent by 2036, with green spaces long touted as a tool to mitigate the west’s increased temperatures. The worry, defenders say, is that this will only be topical.

“We have enough data and studies to show that we need to do more.”

The solution, Dr Loo said, lies in meaningful adaptation, including climate-focused building developments and regulations, as well as reducing fossil fuel emissions. A short-term response is to improve primary and preventive health care resources.

“The cheapest way to solve this problem is to keep people in the community safe, so they don’t end up sick enough to go to the hospital.”

Even though the outlook is dire, there is reason for optimism, Dr Loo said, because “anything is possible”.

“We have no choice because if we do nothing, people will die,” she added.

“If we do something, fewer people will die.”

A NSW Health spokesperson said hospitals are “well equipped to respond to periods of increased demand for services”.

“As demonstrated during the annual winter respiratory period, which is traditionally the busiest time of the year.

“During a typical heat wave, the number of additional presentations directly related to heat, such as heatstroke, exhaustion, cramps and sunburn, represent only a small proportion of the total presentations and emergency admissions.”