Developing countries have long lists of problems—illiteracy, disease, hunger, corruption. There's one more problem that has gotten less attention, until recently: lightning strikes, which cause a disproportionately high number of deaths in developing countries.

Thanks to years of public education campaigns, most Americans know that "when thunder roars, go indoors." But that basic guideline isn't as well known in many developing countries, which consistently see hundreds or even thousands of deaths and injuries per year from lightning strikes. Experts point to lack of education, but a number of doctors and meteorologists from around the world are trying to change that.

A largely agricultural and labor-intensive economy, poor infrastructure, and a tropical climate all play a role in higher rates of lightning-related deaths and injuries in countries such as South Africa, Malaysia, India, and Bangladesh, said research meteorologist Ron Holle with Vaisala, a Finnish company that makes lightning detection and other scientific equipment.

"Factories aren't safe; homes aren't safe," said Holle about many structures in developing countries. Open-air designs and thatched and flimsy metal roofs leave people more vulnerable, he explained. And open-air taxis and carts don't provide the protection from lightning that is typically afforded by solid vehicles.

"There are just some areas of the world with no safe place or vehicle to go to when it storms," said Holle.

In India, lightning killed 32 people during one storm alone in October. According to Holle, there are no solid statistics on the number of people killed by lightning in India overall because incidents often aren't reported, but scientists estimate the number is more than 3,000 per year.

In Nepal, more than 130 were reported killed by lightning in 2012, and the average for South Africa is about 260 deaths reported per year.

"And those are just the ones that make the news reports," Holle said, explaining that because of underreporting, the actual numbers are likely higher.

Even in the U.S., tracking lightning incidents is tricky because they aren't required to be reported to any agency, so there is no universal database. As in other countries, experts are often left with little more than news reports to go on. Still, the numbers tend to be lower in the U.S. than in developing countries, experts say. In 2013 so far, 23 people have died in the U.S. from lightning strikes, according to reports collected by the National Oceanic and Atmospheric Administration.

When it comes to injuries, which are even less likely to be reported than deaths, a general rule of thumb, experts say, is that for every death by lightning, there are about ten injuries. (See "Fishing and Camping Top Activity List for Lightning Strikes.")

"In underdeveloped countries, it is not unheard of to have 18 deaths from the same storm. Imagine how many injuries that also resulted in," said Mary Ann Cooper, a retired physician with the Lightning Research Center at the University of Illinois, Chicago.

Lack of solid infrastructure and lightning rods (which transfer the energy in a bolt into the ground) also lead to property and economic losses from the fires that can result from a strike. In Malaysia, losses are around $100 million per year, according to Chandima Gomes, head of the Center for Electromagnetic and Lightning Protection Research at the University of Putra Malaysia.

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Misconceptions About Lightning

In countries with little or no education on the science of lightning, misconceptions often run rampant.

"We've seen revenge killings in the developing world," Cooper said. "Two villages are feuding, and someone's brother dies from a lightning strike. So the fingers point to the family in the next village, and [the victim's family will] go murder someone in that rival family," she said.

"We've seen lots of tires on the roofs of homes because they believe it'll ward off lightning," Cooper added. "But it doesn't do a thing."

Added Gomes: "There is a common idea in the developing world that lightning only hits sinful people. I've seen this result in isolation from the family of a victim in rural Malaysia."

In both rural and urban areas of South Africa, "many people believe that witches can control lightning and send it to kill a person or to destroy that person's property or livestock," said Estelle Trengove, a lecturer at the School of Electrical and Information Engineering at the University of Witwatersrand in Johannesburg, South Africa.

The belief that only sinful or otherwise specially targeted people get struck can instill a false confidence, and results in people not seeking shelter during storms, according to Trengove and Cooper.

Looking Ahead

In an effort to cope with the high rate of lightning deaths and injuries, the Center for Science and Technology of the Non-Aligned and Other Developing Countries, an intergovernmental group with a membership of 45 countries across Asia, Africa, and Latin America, brings together doctors, meteorologists, and engineers and gives them tools and plans to dispel myths and raise awareness of the dangers of lightning.

And in February, the African Center for Lightning Information and Research was established to raise awareness and emphasize the need for proper engineering to reduce the number of lightning-related deaths and injuries per year.

While it will likely take a few years to see a significant decline in injuries from lightning, "we are going to get results from these conferences," Cooper said.

She added that those who gather at these events come up with game plans on how to bust myths and train laborers on the dangers of working outside during storms. Recommendations are then made to governments. Proposals include adding lightning safety to school curricula and displaying safety instructions in vulnerable areas, such as beaches and playgrounds, urging people to take cover when lightning is in the area.

In South America, the Colombian military recently hired a lightning specialist to train farmers to avoid strikes by seeking shelter during storms.

In Malaysia, media blitzes that dispel myths and safety curricula in schools are being rolled out, according to Gomes. "We also conduct periodic training programs for engineers on lightning protection technologies."

According to Holle, such training is much needed. Out of the almost 200 UN member countries, "about 150 don't have lightning experts."

Lightning Rods

Lightning rods must be installed properly, said Holle. "This is a situation in which doing something wrong to save money is worse than doing nothing at all," he explained. "You have to make sure the rods are on top of the buildings and that they are attached to thick conducting cables that go directly into the ground. In some developing countries we'll see rods going directly into the buildings, and that causes fires."

The cost of lightning protection technologies varies, with differences seen between the French and Spanish standards, known as Early Streamer Emission (ESE), and the rest of the world's, known as International Electrotechnical Commission (IEC).

"The ESE systems are expensive and not scientifically proven," Gomes argued. "These systems are about $3,000 to $4,000, no matter how big or small the building. For IEC standards, the cost of protecting for a smaller building would be far less."

However, when getting lightning rods to developing countries, "the biggest issue isn't the cost, but the inability of manufacturers to provide scientific evidence to back up the product," Gomes said.