The same old story

The fire-ravaged ICU at the Ahmednagar civil hospital on November 6. Pic/PTI

It's the same old story that emerges from an unfortunate incident in an ICU in a district civil hospital at Ahmednagar that killed 11 patients on Saturday, mostly seniors being treated for COVID-19. Preliminary observations point out utter disregard for the recommendations made by fire auditors, employees inadequately trained or untrained in emergency response, ill-maintained electrical and life support equipment, human error (negligence), and inordinate delay in releasing the funds for state-run hospitals that were asked to get fire safety audits conducted and implement the recommendations made early this year. The trigger for the state-wide plan was an incident in January this year in which 10 newborn infants died in a fire in the Sick Newborn Care Unit of the district hospital at Bhandara.

Both public and private hospitals had been affected by a series of incidents this year. In April, 15 COVID ICU patients died in a fire at the Vijay Vallabh Hospital in Virar. A month before it, a fire claimed the lives of 11 patients in a private COVID-designated hospital in a mall at Mumbai's Bhandup. In another tragedy in April, 24 COVID patients died when a leaking oxygen tank stopped their life support at a municipal hospital in Nashik. There have been incidents of hospitals catching fire in the past decade across the country. Last year, Rajkot, Ahmedabad and Vijayawada reported over 20 deaths in hospital fires. Kolkata's 95-death fire of 2011 remains one of the scariest incidents. Three years ago, 11 patients died in a fire at ESIC Hospital in Marol, Mumbai. A spate of deadly fires in Maharashtra hospitals doesn't reflect any better on the state's stand-out image.

The Ahmednagar ICU was set up barely 18 months ago, perhaps in great haste to cater to a growing number of COVID cases without a fire safety approval because a fire audit that was conducted as part of a statewide mission early this year, recommended installing all necessary fire safety equipment like sprinklers system and hydrants. However, the installation could not be done because the financial proposal is reportedly pending with the state health office. In Bhandara, the authorities rushed into clearing a financial proposal only after the infants' death rocked the public, politicians and babus. After inquiry, some local hospital officials and staff members were transferred, some suspended and terminated from the service. The harshest punishment was handed to the employees at the bottom of the ladder. Will the Ahmednagar incident be any different when it comes to fixing the responsibility?

The Ahmednagar hospital's only fire safety tool was fire extinguishers. In Bhandara, a delay in realising funds was cited as one of the causes, other than the negligence on part of the staff and discrepancies created because of ill-maintained equipment. In Ahmednagar too, the causes aren't expected to vary much from earlier blazes. Prima facie, the fire has been blamed on a short circuit, the origin of which will be found in the inquiry CM Uddhav Thackeray ordered immediately after the incident. Local fire authorities took a lid off when they talked about the audit that was conducted across the state following the CM's orders that came in the wake of the Bhandara fire. Now, the opposition wants responsibility fixed in the delay in financial approvals.

Writing on the Bhandara incident, we had said that our hospitals, especially state-run ones, could be made safer with a sustainable and uniform effort. It will require a statewide plan to be implemented within a deadline. Of course, it would need substantial funds that should be released without delay. However, spending money on buying equipment and creating facilities alone will not help to make the public health infrastructure robust. Once the building is constructed, furnished and the equipment installed, not much attention is given to the upkeep of the structure and maintenance of life-saving machines, incubators, oxygen plants, diagnostics and clinical equipment. We don't count profit-making corporate/private hospitals in this because they have an ecosystem that is different from the public hospitals. The government will have to weed out flaws in its ecosystem and make it work uninterrupted between top and bottom. For the state of Maharashtra, which is considered many notches above the rest, it is time, again, for learning a hard lesson, introspect and fixing the problem of hospitals turning into deathtraps.

Dharmendra Jore is political editor, mid-day. He tweets @dharmendrajore

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