Myanmar’s El Niño threat shows why extreme heat is also a question of inequality

A historically strong El Niño is underway. US forecasters expect a strong to very strong event to continue into early 2027. In Myanmar, meteorologists warn that its effects could extend into the hot season from March to May. Forecasts can estimate how high temperatures will rise. But they cannot predict who will become ill or die. That depends not only on the weather, but also on people’s ability to protect themselves. In Myanmar, though, widespread hardship does not mean equal risk. After years of conflict, displacement and unreliable electricity, extreme heat will deepen existing inequalities. The International Federation of Red Cross and Red Crescent Societies (IFRC) warns that heat can disrupt electricity, water and healthcare, especially where conflict has damaged infrastructure. The UNHCR highlights displaced people’s greater climate risks due to inadequate housing and essential services. Myanmar is not alone. Three in four people displaced by conflict live in countries highly exposed to climate hazards. Why extreme heat is especially dangerous in Myanmar The human body cools itself mainly through sweating. When temperatures and humidity remain high, this process becomes less effective, putting extra pressure on the heart and kidneys. The World Health Organization (WHO) warns that extreme heat can worsen cardiovascular disease, diabetes, asthma and kidney disease. High nighttime temperatures are particularly dangerous because the body needs cooler conditions to recover. Without relief after sunset, the risk of heat-related illness increases. Myanmar’s electricity supply has deteriorated since the military takeover in February 2021. Power cuts have become more frequent during the dry season, when falling hydropower reservoir levels reduce electricity generation while demand for cooling rises. The pressure emerged early this season. Starting Oct. 5, the Ministry of Electric Power and Energy introduced rotating power cuts, citing El Niño-related heat that had pushed electricity demand beyond available supply. The consequences go beyond losing access to fans and air conditioning (AC). Electricity is also needed to pump clean water, refrigerate medicines and operate medical equipment. A 2023 US modelling study found that a multi-day blackout during a heatwave could more than double heat-related deaths. Although the exact impact may differ in Myanmar, this highlights an important point: electricity is a public health resource during extreme heat. Who bears the greatest health risks? Social epidemiologists identify three ways social disadvantage affects health: exposure, vulnerability and consequences. All three are evident in Myanmar. First, exposure is unequal. Farmers, construction workers and day labourers often continue working during the hottest hours because losing a day’s income is not an option. Wealthier households, meanwhile, can invest in solar-powered cooling such as fans or AC to stay safe during grid blackouts. One industry estimate suggests that household solar installations increased from a few hundred in 2019 to around 300,000 in 2025. With the global fuel shock pushing inflation to 24.6% in April 2026, that protection is slipping further out of reach for poorer households. Rising heat stress also threatens workers’ livelihoods and productivity. Second, vulnerability differs. Older people, young children, pregnant women and people with chronic illnesses face greater health risks during extreme heat. WHO estimates that heat-related deaths among people aged over 65 increased by about 85% between 2000–04 and 2017–21. Third, the consequences depend on access to treatment. Heatstroke requires rapid cooling and medical attention. Survival may depend on access to transport, functioning clinics, medical equipment and electricity. These are precisely the resources that poor and displaced communities are least likely to have. How conflict widens the protection gaps Conflict does not flatten these inequalities; it sharpens them. As of July 2026, nearly 3.8 million people were internally displaced in Myanmar. Many live in temporary shelters with limited access to clean water and healthcare. Plastic roofs, overcrowding and poor ventilation leave them particularly exposed to extreme heat. Healthcare access is also increasingly difficult. The humanitarian organisation Insecurity Insight recorded at least 1,939 attacks on healthcare between Feb. 2021 and May 2026. Ongoing fighting and movement restrictions further limit humanitarian organisations’ ability to deliver medical assistance. For an older woman with heart disease living in a displacement camp, the risks are compounded. She has no fan, limited drinking water and no nearby functioning clinic. Her age, illness, gender and displacement each add to her risk. These disadvantages can reinforce one another, an example of intersectionality, a concept used by health equity researchers to explain how overlapping social disadvantages drive poorer health. No study has yet measured these combined effects in Myanmar, where weak death registration also makes heat-related deaths difficult to identify and count. Epidemiologist Geoffrey Rose argued that the causes of illness in an individual are not necessarily the same as the factors driving disease across a population. In Myanmar, temperature may explain why someone becomes ill on a particular day. But poverty, displacement and electricity shortages explain why entire communities face greater risks. Why heat preparedness may fail The military-backed government has begun opening heat shelters in Yangon. But a shelter only protects people who trust it and feel safe enough to reach it. Young people have been seized at checkpoints and in public places under the military’s conscription law. Displaced communities have also faced military attacks, including reported airstrikes on displacement camps in Rakhine State. For people living in areas affected by military operations, travelling to an officially designated shelter may itself involve risks. There is also a political and administrative challenge: no single authority controls all of Myanmar. Ethnic armed organisations and resistance groups administer large parts of the country. Yet most heat plans assume a single government that issues warnings and runs clinics. A plan delivered through the military-backed government alone is unlikely to reach many communities. As the climate warms, Myanmar is a preview for other conflict-affected countries such as Sudan and Yemen, where stronger heat is arriving just as protections are falling apart. Even in a crisis, suffering is not shared equally, and treating crisis-hit populations as one group hides those most at risk. The heat is shared; the harm is not.