Heatstroke explained: What really happened to referee Janny Sikazwe on the pitch?

Africa Cup of Nations - Group F - Tunisia v Mali - Limbe Omnisport Stadium, Limbe, Cameroon - January 12, 2022 Tunisia players appeal to referee Janny Sikazwe for a penalty as they wait for a review from VAR [Reuters, Mohamed Abd El Ghany]

On January 12, 2022, one of the most bizarre incidences in sports took place at the Limbe Omnisport Stadium in Cameroon.

In an Africa Cup Of Nations Group F match pitting North Africans Tunisia and Mali, centre referee Janny Sikazwe was guilty of ending the match prematurely twice, much to the anger of the Tunisian bench.

The Zambian official’s actions received a wave of criticism after he made a number of controversial decisions, capping it off with blowing for full-time in the 85th minute of the tie.

However, Sikazwe repeated his mistake by ending the tie in the 89th minute, sparking more outrage from the North African nation, who were trailing 1-0 at the time.

Sikazwe blamed the high humid weather in Limbe for his erratic performance in the second half and said his body temperature wasn’t responding to medication.

"The weather was so hot, and the humidity was about 85%. After the warm-up, I felt the conditions were something else. We were trying to drink water but you could not feel the water quenching you – nothing,” said Sikazwe.

Sikazwe added he was not able to communicate with the rest of his officiating team hence ending the game and noted that he escaped death by a whisker.

Head of referees at the AFCON Essam Abdel-Fatah defended Sikazwe’s errors, insisting he suffered from the effects of the heat (34 degrees then) and high humidity (65 per cent) in Limbe.

'The referee suffered from heatstroke and very severe dehydration, which led to him losing focus and was taken to the hospital. It caused him to lose time in the 80th minute, and he ended the match in the 85th minute. He returned after directions from the assistant staff and then returned to finish the match in the 89th minute, “said Abdel-Fatah.

What did Sikazwe really suffer from? 

Tunisia coach Mondher Kebaier remonstrates with the referee Janny Sikazwe after the match [Reuters, Mohamed Abd El Ghany]

A heatstroke has many definitions, but can generally be defined as a condition caused by overheating of the body, usually due to exposure to high temperatures. Heatstrokes also occur in the event of dehydration, which leads to failure of the body's temperature regulation system. It is the most serious form of heat injury and can arise if the body temperature rises to 40 degrees Celcius (104 F) or higher.

Heatstroke signs and Symptoms

• High temperature of the body: The main sign of heatstroke is a body temperature of 40 degrees Celcius (104 F).
• Headache: A throbbing headache all the time
• No/Lack of sweating: The skin feels hot and dry even upon contact. Nausea and Vomiting 
• Increased heart rate: Your pulse may increase due to the efforts of the heart to try to cool your overheating body 
• Flushed skin: The heat may turn your skin red or hot and dry 
• Behavioural changes: One might experience confusion, irritability, seizures and unclear speech 
• Shallow, rapid breathing
• Dizziness
• Weak muscles
• Unconsciousness
• Seizures

What causes heatstrokes? 

• Exposure to excess heat: Staying in a hot environment leads to rising body temperature. Heatstroke happens when there is prolonged exposure to humid and hot weather.
• Vigorous physical activity: Known as ‘exertional heatstroke’ can occur if a person is working out in hot weather.
• Wearing extra clothing: This prevents the evaporation of sweat, which is responsible for cooling your body
• Alcohol: Drinking alcoholic substances may reduce your body’s inability to regulate its own temperature.
• Dehydration: Liquids lost through sweating are sometimes not replaced in the body.  

Treatment of heatstrokes

All kinds of heatstroke treatments are aimed at reducing the temperature of the body to normal as well as preventing damage to the brain and other vital organs.

Cold water bath: Ice or cold water helps reduce the temperature of the body significantly and prevent death or organ damage. Upon the occurrence of a heatstroke, one is advised to immerse themselves in ice/cold water.

Evaporation cooling: Mayo Clinic recommends the use of the evaporation method, where cool water is applied (misted) on the body as warm air is blown over. This causes water to evaporate and cool the skin.

Cooling blankets: Wrapping the body with a blanket with ice packs applied on the back, groin, neck and armpits lower body temperature. 

Medication: A doctor may recommend specific medication, such as a muscle relaxant to help lower the temperature of your body  

Home therapies

Air conditioning: Strive to move to a public/private place with proper air conditioning.

Damp sheets: Covering someone who has experienced heatstroke with damp sheets helps bring the body temperature down.

Take a shower; Cool or cold.

Rehydration: Drinking plenty of liquids (fluids) helps replenish water lost through strenuous activity.

Avoid sugary beverages when rehydrating since they limit your body’s ability to control temperature.