French disquiet at heat's toll

Living alone in the Parisian suburb of Mont Fermeil, nonagenarian Georgette Valéri grew increasingly desperate as temperatures soared to 100 degrees F.

Her husband died 10 years ago, her children have moved away, and after an injury from a fall, she rarely leaves the house now. The nurse who normally visits twice a week only came once in August, and the friend who sometimes does her shopping was on vacation.

Ms. Valéri did what she could to stay cool - keeping the blinds closed, drinking huge quantities of water, and applying compresses of wet towels. "It was terrible," she says. "I found it difficult to breathe. I felt very tired. My children phoned to give advice, but what could they do?"

She survived, but thousands of other seniors in France did not. The hottest summer in more than 50 years, the solitary lifestyle of many elders, and France's annual August holiday exodus proved a fatal combination.

As deaths continue to be counted in what some here call the heat "massacre" of earlier this month, both fingerpointing and soul-searching are intensifying.

"Everybody is responsible for this disaster: families, friends, children, the associations for the aged, the state," says Alain Parant, a demographer and analyst for the group Futuribles International, which focuses on the elderly. "It is a wake-up call for us all."

The number of fatalities is a matter of highly politicized debate. According to preliminary government estimates, up to 5,000 died, but undertaker estimates put the figure at more than 10,000. Most of the victims were over 80. With many families vacationing, there was no relative to check on them.

"The typical case was an old woman living alone with no immediate family whose only contact with the outside world was a friendly neighbor who did her shopping and the concierge who normally delivers her mail to her door," says Pierre-Jean Guillausseau, a doctor at Lariboisière Hospital in Paris. "In August when the heat wave struck, she had nobody to turn to. By the time the authorities found her she was already dead or dying,"

Many of the deaths occurred in homes for the elderly. Pascal Champ- vert, president of the French umbrella organization for such homes, lamented government budget cuts which he said had led to chronic staff shortages.

"There is a serious lack of care at these establishments because of staff shortages, which was aggravated by the 35-hour [work] week and the August holidays," agrees Dr. Guillausseau. He said he saw as many as five victims a day from the same senior citizens' home during the heat wave, most of them already dying by the time they arrived.

The catastrophe has prompted calls for French society to look at the way it treats its elders.

"We have left our senior citizens to fend for themselves under the cruelest circumstances," wrote Chantal de Singly, director of Saint-Antoine Hospital in Paris, in the daily Le Monde. "For many, too many of them, it proved fatal. Nobody deserves to die like that ... abandoned.... We need to restore the social contact in a society that has become too individualistic."

"It's not a political or medical problem, but a social one," Guillausseau agrees. "Society has become too materialistic," he says, adding that "religion doesn't play such a big role anymore. The fabric of society has changed. We don't have respect or time for our elders anymore."

Still, many blame the government. President Jacques Chirac is under pressure from the opposition and the media to explain how three weeks of intense heat could have taken such a toll.

Fifty-one percent of the French believe the government was "incompetent" in dealing with the situation, according to a poll in the newspaper Le Parisien last week. Some doctors and health workers have accused the government of ignoring early warning signs that hospital morgues were filling up fast and staff were overstretched.

Mr. Chirac, who was relaxing with his wife, Bernadette, in Canada while deaths mounted at home, has been severely criticized in the media, even by the traditionally sympathetic Le Figaro, for his three-week absence and initial "deafening" silence about the fatal heat wave.

Other government officials were also on holiday, an absence the opposition has called a "vacation of power."

Late last week, Chirac promised an inquiry into the handling of the disaster, as well as the creation of new state measures for taking better care of France's growing number of elderly. But these announcements were dismissed by critics as "too little too late."

Medical unions, the opposition, and left-wing media have called for health minister Jean-François Mattei to be sacked, but a government spokesman said after a cabinet meeting Thursday that the possibility had not been raised.

So far, the only political victim of the crisis has been Dr Lucien Abenhaïm, the former French surgeon general, who resigned, saying he was a "scapegoat."

Prime Minister Jean-Pierre Raffarin has urged the nation to be "cautious" regarding death estimates. A government report on the heat crisis is expected within a month.

If the 10,000 figure were proven to be accurate, it would top the number of people who died in car accidents in France last year, which was 8,000.

France, where temperatures are now cooler, has derived its official death estimates by comparing mortality rates this summer with last summer and attributing the difference to the heat, which reached 104 F. degrees at one point - particularly searing in a country with little air conditioning.

In other parts of Europe also scorched by the heat wave, the death toll has reached about 2,000, with the highest official estimates coming from Portugal, with 1,300 fatalities.

French Red Cross president Marc Gentilini voiced skepticism that all the deaths in France were directly related to the heat. He said he expected the ongoing investigation would enable France to "perhaps lower the figure."

• Material from the Associated Press was used in this report.