The heatwave arrives. The flood warning sounds. Evacuation orders are broadcast across television channels, loudspeakers, and mobile alerts. For most people, the response is instinctive grab what you need, follow the instructions, get to safety.

For a person with deafblindness, none of that chain works.

The alert is inaudible. The evacuation signage is invisible. The emergency responder at the door does not know how to communicate in tactile language. And the one person in the household who has spent years building a trusted communication relationship with their deafblind family member mother, a sister, a community worker is quite possibly overwhelmed, exhausted, or displaced herself.

"Behaviour is communication," says Akhil Paul, Chief Mentor at Sense International India, one of the country's foremost organisations working with people who have deafblindness. "When a person with deafblindness cannot express fear, confusion, or pain through words, they express it through behaviour. In emergencies, this is almost universally misread leading to responses that compound distress rather than relieve it."

The consequences, Paul makes clear, are not minor. They are not temporary. And in a world where climate-related disasters are arriving with greater frequency and intensity, they are becoming an urgent human rights issue that India's disaster preparedness architecture is almost entirely unprepared for.

The Compound Crisis Nobody Is Measuring

Rutu Trivedi, Principal Technical Lead for Mental Health and Research at Sense International India, has spent years studying the intersection of disability, mental health, and environmental stress. What she and her colleagues have documented across 25 states is uncomfortable reading.

"During climate-related disruptions, the indicators we screen for — irritability, withdrawal, sleep disturbances, reduced task engagement — spike noticeably," she says. "Heatwaves disrupt sleep, increase physical discomfort, and create a generalised state of physiological stress that is difficult for deafblind individuals to communicate or process without support."

The mechanism is not difficult to understand, though it is rarely discussed. People with deafblindness already experience the world through an extremely narrow set of sensory and relational channels. They navigate daily life through routine, through familiar physical environments, and above all through trusted human connection. When an environmental crisis strips those anchors away — when the home-based programme is suspended, when the caregiver is emotionally overwhelmed, when the community is displaced — the psychological deterioration can be severe, sustained, and largely silent.

"Individuals with deafblindness already experience heightened isolation due to the dual loss of sight and hearing," says Paul. "When climate-related disasters further disrupt their daily rhythms, the psychological toll is compounded for both individuals and their caregivers in ways that are rarely visible to those around them."

Rarely visible. That phrase carries a particular weight. Because the mental health crisis building inside India's deafblind community during floods, heatwaves, and air pollution emergencies does not present in forms that emergency systems are designed to recognise or respond to.

The COVID Mirror

The pandemic offered, briefly and painfully, a window into what social isolation and communication breakdown do to a person's psychological state. For people with deafblindness, says Paul, that was not a revelation. It was a glimpse of what their lives already look like.

"The COVID-19 pandemic gave the wider world a glimpse of what social isolation, communication breakdown, and loss of routine can do to a person's mental health. For people with deafblindness, that experience is not an exception — it is closer to the baseline of their daily lives, and disasters deepen it catastrophically."

During the pandemic, Sense International India saw a sharp rise in behavioural challenges and psychological deterioration among the children and young adults they work with. Families reported that their deafblind members were struggling in ways that specialist services, now shut down, could no longer address. It was this crisis within a crisis that pushed the organisation to develop the SII-SAMWED tool — India's first structured mental health screening instrument designed specifically for people with deafblindness.

The parallel to climate disasters is exact, notes Trivedi. "Climate disasters create the same perfect storm of isolation, service disruption, and communication breakdown."

Measuring What Was Previously Invisible

The SII-SAMWED tool is, in many respects, a direct answer to one of the most persistent failures in disability-inclusive mental health care: the assumption that because emotional distress does not present verbally, it is either not there or not measurable.

Developed through field research, literature review, expert consultation, and statistical validation with more than 300 children and young adults, the tool assesses mental wellbeing across five domains — emotional regulation, behavioural regulation, social functioning, cognitive and physiological regulation, and substance use. It takes between thirty and forty minutes to administer, and it is designed to be used not just in clinical settings but in homes, schools, rehabilitation centres, and community environments by special educators and community-based rehabilitation workers.

"It goes beyond being a screening tool," says Trivedi. "It functions as a full monitoring and intervention planning system — supporting baseline and endline assessments, progress tracking across all five domains, and integration into Individualized Education Plans and counselling programs."

What it makes possible, in practical terms, is the identification of gradual mental health deterioration that would otherwise be invisible. A deafblind person who becomes increasingly withdrawn over weeks of sustained heat, or whose sleep patterns collapse during a prolonged air quality crisis, would previously have had those changes attributed to their disability — not to a treatable, preventable environmental stressor.

"The behavioural indicators of worsening mental health in deafblind individuals are often attributed to the disability itself rather than to environmental causes," Trivedi explains. "This misattribution means that the underlying distress goes unaddressed, and conditions deteriorate further."

The Infrastructure That Doesn't Exist

Ask Paul or Trivedi about the accessibility of Indian cities and emergency systems for people with sensory disabilities, and the answer is unambiguous.

"Indian cities and public spaces remain significantly inaccessible for people with sensory disabilities, and the gap is even wider for people with deafblindness," says Paul. "Public infrastructure, emergency systems, transportation, healthcare facilities, and civic spaces are still overwhelmingly designed around the needs of people without disabilities."

There are no tactile cues for evacuation paths. There is no trained staff at emergency shelters. Communication in cases of disasters is entirely dependent upon audio and visual cues – cues that cannot be accessed by deafblind individuals, who cannot see or hear at all. While the Rights of Persons with Disabilities Act of 2016, which was lobbied for by Sense International India to legally acknowledge deafblindness as a disability, remains in place in name only.

"Climate-resilient infrastructure must be designed with the understanding that deafblind individuals experience the world primarily through touch and through trusted human relationships," says Paul. "This means evacuation routes with tactile guidance systems, emergency shelters staffed with disability-trained personnel, and communication protocols that go beyond visual or auditory alerts."

The same is true of his description of that which is left out of these dialogues – the importance of the people infrastructure. The special education teachers, community-based rehabilitation specialists, and caretakers constitute the front lines of psychosocial support in crises, but they are seldom included in disaster planning efforts.

"When disaster preparedness plans are developed, these professionals must be part of them," Paul says. "Not as an afterthought. From the beginning."

The Livelihoods Dimension

The author mentions one issue that is seldom considered in connection with climate and disability: how to deal with adult deafblind people who had attained some economic independence but lost it due to environmental changes.

The organization Sense International India provides vocational training for over 600 adult clients and helped develop the business of 269 micro-entrepreneurs by giving out seed capital grants. For these people, employment is more than an income; it is dignity and self-respect.

"When that is lost, the mental health consequences are severe," says Trivedi. "Environmental damage to communities also affects the informal support networks that families and caregivers rely on. When communities are destabilised, the capacity of families to support deafblind members diminishes, isolation deepens, and access to specialised services is often cut off entirely."

Recovery, she argues, cannot be sequenced. Mental health support, livelihood restoration, and community rebuilding have to happen together — not in the neat, compartmentalised way that most disaster relief systems are designed to operate.

What Inclusion Actually Demands

The organisation works with two networks that shape its advocacy: Udaan, a network of 281 adults with deafblindness, and Prayaas, a network of 2,120 families across India. These are not passive beneficiary groups. They are, in Sense International India's framing, the communities whose voices must be central to the design of any climate resilience system that claims to serve them.

"Inclusion in climate resilience cannot be designed from the outside," says Paul. "It must be built in partnership with the communities most affected."

That principle extends to the digital world. In July 2025, Sense International India launched what it describes as a first-of-its-kind multilingual digital platform — the Global Resource Hub — bringing together learning resources, training materials, and accessible information for people with deafblindness, caregivers, educators, and policymakers. The broader digital ecosystem, Paul and Trivedi are clear, remains deeply inaccessible. Government portals, healthcare systems, and emergency information services are built for people without disabilities, and retrofitting accessibility afterwards is both expensive and inadequate.

"When accessibility is treated as an afterthought, it becomes expensive to retrofit, limited in scope, and fundamentally inadequate for people with the most complex needs," says Trivedi. "For people with deafblindness, retrofitted accessibility is rarely sufficient."

The Measure of a Community

Paul ends with a framing that has the weight of nearly three decades of field experience behind it.

"The measure of a community's mental health is found precisely in how it treats its most vulnerable members. A community that excludes people with disabilities from participation, from services, from public spaces, and from decision-making is not truly healthy — regardless of how green or well-designed it may be in other respects."

Green, in other words, cannot simply mean environmentally sustainable. It must also mean socially inclusive. Sustainable cities that are inaccessible to people with deafblindness are not, in any meaningful sense, sustainable at all.

As India and the world mark World Environment Day, the deafblind community offers an uncomfortable but necessary lens on what climate resilience actually demands. Not just renewable energy and mangrove restoration and cleaner rivers — though all of that matters. But the harder, quieter, less celebrated work of designing emergency systems that leave no one invisible. Of embedding disability-trained personnel in every disaster management authority. Of building the human infrastructure of care alongside the physical infrastructure of cities.

Because when the next heatwave arrives, when the next flood warning sounds, the test of a society's preparedness will not be how quickly it evacuates the majority. It will be whether anyone thought to knock on the door where someone cannot hear them coming.