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Gaza City, Gaza Strip – In the stifling heat of Gaza City, Dr Rizq Sufyan Abo Halima sits in a small tent pitched in an alleyway, waiting for his next patient.

The tent was a last resort for the doctor, given that the high demand and low supply of properties in the Gaza Strip as a result of Israel’s genocidal war have made finding an affordable surgery impossible.

“The stifling rise in temperatures was my first challenge,” he told Al Jazeera. “I had to adjust the corners of the tent and lift it at the ends to allow air to pass through.”

His old clinic, Smile One, in Sheikh Zayed City in northern Gaza, was bombed during the early days of the war in 2023.

The 31-year-old built a new clinic in May last year, next to where his current tent is pitched, in Gaza City’s al-Nasr neighbourhood. But three months later, it too was destroyed when Israeli forces assaulted the area, just weeks before the ceasefire last October.

He is now forced to conduct operations and other emergency dental procedures in the tent close to the ruins of his former surgery. When the electricity supply stops, which is frequent, there is little he can do but sit in his tent and wait for the power to come back on.

Finding another office would be the obvious solution, but residential and commercial units are hard to find in Gaza and those few that remain are unaffordable.

More than four in five buildings in Gaza City and northern Gaza have been completely destroyed or severely damaged in Israel’s war, according to the United Nations Satellite Centre (UNOSAT).

Fewer than one in five buildings in Gaza can still be used and Israel’s ban on building materials has made repairs impossible. That has created a skewed supply situation, which has made prices of office spaces or homes unaffordable.

“Before the war, I used to rent an entire apartment for my clinic for 500 shekels ($166) a month, but today I cannot afford the prices of remaining apartments at all,” he said. Now, the cost is closer to $1,000.

Heat is better than high costs

Using a tent is the cheapest alternative Dr Abo Halima could find, and he does not want to pass on what he calls the excessive price of building rent to his customers, who are already suffering immense personal and financial hardships.

“If I had rented an apartment for my clinic instead of a tent, the cost of one filling to teeth would have doubled for the patient,” Dr Abo Halima said.

“I am here, enduring the harsh summer heat, so that I can protect people from the high prices that I will inevitably have to charge if I rent an apartment, in addition to the fact that I have no other options at all.”

Dr Abo Halima treats his instruments with care. He sterilises them regularly to protect them from dust and germs and hires a security guard. After all, the thin canvas walls offer little protection from thieves.

Despite his best efforts, the collapsed, resource-starved economy in Gaza means that dental care is a luxury for many patients.

One of them, 25-year-old Yousef Abo Halima, sums up the situation in a few simple words: “I can handle the harsh heat inside the tent, but I certainly cannot afford the high costs of fillings at clinics that operate inside apartments”.

Difficult choices

After Heba Rihan, 23, graduated from Al-Aqsa University with a major in general nursing, she struggled to find work in her field.

So she made an arduous daily journey from the south of the Gaza Strip to the west on foot, looking for work. She eventually found Dr Abo Halima’s clinic in May and began working there.

Now, one of the most regular parts of her job is explaining to patients that the high cost of treatment is due to the scarcity of materials and other issues related to the war and Israel’s siege on Gaza.

“One day [a patient] came in deep pain… When he asked how much the filling cost and was told it was 350 shekels ($116), he didn’t have the money. He asked directly about the tooth extraction, which is only 50 shekels ($17),” she said.

“He decided to extract his original tooth because he could not bear the pain or the cost. That was the most painful moment I’ve ever had here.”

DES MOINES, Iowa — Paul Grinvalds has completed 114 marathons in all 50 states, but he still wilts when he races in temperatures beyond 60 degrees.

It’s the same for most runners, as the body can’t cool down during exertion, and heat makes that even harder.

“One thing about marathoners is typically we’re kind of stubborn,” said Grinvalds, 68, from West Des Moines, Iowa, who finds even temperatures in the 50s a bit warm. “So if we have a goal and it’s hot, a lot of times we’re still going to try to do that goal, which is just stupid because you’re almost guaranteed to have a very painful experience.”

Such an experience can also be dangerous, a reality that marathon organizers are having to confront as climate change, caused mostly by the burning of fuels like coal and gasoline, pushes temperatures up. To improve the chances of having the 26.2-mile race in cooler weather, organizers are shifting race dates, starting earlier and even giving options for participants to cut their runs short.

Starting in 2027, the Twin Cities Marathon in Minneapolis-St. Paul will shift its more than 40-year tradition of holding the race on the first Sunday in October to later in the month. That decision comes after cancellation of the marathon in 2023 because of record heat and humidity, and starting temperatures near 70 for the 2025 race.

Organizers of the Sioux Falls, South Dakota, marathon last year similarly moved their annual race from August to September after canceling the 2024 race due to hot conditions. And other races, including the Air Force Marathon in Dayton, Ohio, the Little Rock Marathon in Arkansas, and the Long Beach Marathon in Southern California, all moved their start times to earlier in the morning in search of cooler temperatures.

In Los Angeles in March, warm conditions prompted race organizers to give runners the option of stopping after 18 miles and still receiving a finishers medal. Less than 5% of participants opted for the shorter finish and only 14 of roughly 27,000 runners were treated at a hospital, with all released the same day. Still, the move led to some online derision.

“We welcome the feedback and it’s certainly something that caused a lot of discussion, but when we’re grading ourselves on it, it has to do with how safe our runners were on the day of the event and we’re very happy with the outcome,” said Meg Treat, a spokesperson for the marathon.

At the Twin Cities Marathon, race director Ed Whetham called the decision to cancel the 2023 marathon “devastating” for runners and the organization. Whetham said it prompted an extensive analysis of weather patterns that resulted in the decision to permanently delay the race by a couple weeks.

That analysis showed that by holding the race later in October, runners would have a far greater chance of optimal conditions. Given that snow sometimes falls in the Twin Cities in late October, there is a greater chance of chilly conditions, but Whetham said, “We’ll take a 39-degree start over a 70-degree start.”

Temperatures are expected to keep rising

The contiguous U.S. just had its warmest July ever recorded, and the Earth had its hottest year on record in 2024. The World Meteorological Organization forecasts that between 2025 and 2030 the Earth’s average global temperature will likely rise by more than 2.7 compared to the 1800s.

The warming is already making conditions worse for most marathons, according to a study of 221 races by the climate research group Climate Central. By 2045, optimal conditions for recreational runners — in the low 40s — would be less likely at 46 of the 51 U.S. marathons analyzed.

“The ability to go outside, to exercise, to take advantage of your human body and being healthy, that’s something that’s getting challenged by climate change,” said Andy Pershing, who led the Climate Central research.

Jessica Murfree leads a University of North Carolina-Chapel Hill lab studying climate change’s effect on sports. She said organizers of marathons, bicycle races and other competitions — from tennis to college football — increasingly must consider changing event dates and times and adopting other safety measures, as climate change makes the weather hotter and more volatile.

Murfree said the concern extends beyond organized sports to whether people can even get outside on increasingly warm days, pushing people to exercise indoors or opt for activities like swimming.

“If we can’t walk, if we can’t exercise or go for runs, it’s too hot, can we still stay physically active while remaining cool?” she asked.

Marathons are especially hard in warm weather

Any kind of exercising in the heat can be challenging, but running a marathon in warm, humid conditions is especially difficult because it’s hard to prevent overheating when a person keeps pushing themselves for hours. And the faster a person goes, the more heat their body produces.

Chris Minson, a University of Oregon professor who researches how people can adapt to extreme heat and other environmental conditions, said the optimum temperature to run a marathon is about 50 degrees. As the temperature creeps into the upper 50s and 60s, the body has a tougher time supplying blood to muscles while also keeping the body cool.

“As you get to warmer temperatures you end up having a bigger competition between blood supplying your muscles to keep running, to keep nutrition going, and blood flow to your skin for thermal regulation,” Minson said.

Minson said it takes a tremendous amount of energy to run quickly. But of that energy, only about 25% is used to move the body forward. The rest goes to deal with the heat that is created by rapid movement.

Even worse than high temperatures is high humidity, which prevents sweat from evaporating and cooling the body.

Minson adds, though, that by regularly exercising in warm weather, people can acclimate to high temperatures and perform better in the heat, though likely not as well as they would in cooler conditions. Athletes who acclimate to high heat also can perform better in lower temperatures than if they hadn’t exercised in warm weather, he said.

Some athletes like John Seals even run in the midday heat and endure a sauna after a workout to acclimate their bodies. That all forms part of Seals’ training for an annual 135-mile ultramarathon held in July in Death Valley, California.

“We had a heat wave this week and for me, that’s a great thing,” said Seals, of West Des Moines.

Still, running in the heat can be dangerous without taking precautions.

Douglas Casa, a kinesiology professor who leads the Korey Stringer Institute, which studies sudden deaths in sports, said the Twin Cities Marathon’s change was prudent, especially considering the way in which many runners approach races.

“If someone was smart enough to say, ‘OK, it’s a little hotter today than usual, I’m going to run a 7 minute mile instead of a 6:30 mile,’ then they won’t get any hotter than normal,” Casa said. “It’s just that runners are sometimes very locked into what they normally do and what their goals are.”

McFetridge writes for the Associated Press. The Associated Press’ climate and environmental coverage receives financial support from multiple private foundations. AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.

A TODDLER’S antics got a flight canceled as air crews aborted takeoff due to unsafe cabin conditions.

The shocking incident grounded Porter Airlines flight PD444 that was departing Victoria International Airport in British Columbia on Thursday.

Furious passengers were forced to get off the aircraft and wait overnight for a new flight.

The airline revealed that as the plane was leaving the terminal and was heading for the runway when cabin crew noticed the child “standing in their seat” refusing to “secure their seat belt,” Porter Airlines told PEOPLE.

“The aircraft could not takeoff in this unsafe condition, so the crew elected to return to the terminal and have the passengers disembark.”

Numerous attempts had been made by the crew and the child’s parents to get them to co-operate but these all failed.

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The toddler’s unruly antics triggered major schedule delays to the point where the airport runway had closed by the time they looked at rescheduling the departure.

After the plane returned to the terminal, passengers got off with their baggage, and flight planes were refiled, it was gone 12:30am and all passengers and crew had to wait overnight for a new flight.

Porter Airlines issued a grovelling apology to everyone affected by the child’s behavior.

The flight eventually took off for Toronto on Friday at 10:49 pm and arrived at its destination at 6:16 am Saturday morning, delaying passengers by a whole day.

Under the airline’s policy, child safety seats or a restraint device is mandatory for any child under two years old occupying a seat.

The family involved have not publicly been identified.