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Falling short on basic safety

In a significant development on Thursday, the chairman of SUM Hospital in Bhubaneshwar, Manoj Nayak, surrendered before the local police, two days after 21 people were killed and over a 100 injured in a major fire that broke out in the dialysis ward at the medical facility. The state police have already arrested four hospital officials for the incident on Monday. The point of outrage here should be what Dr Sanjay Nagral addressed in an editorial for the Indian Journal of Medical Ethics in 2012. “It should be a given that since the core function of hospitals is to look after the sick and, in a sense, vulnerable population, those who run them need to have a heightened sensitivity to safety. Whether it is the food served, the ventilation, or the hygiene, hospitals need to ensure that these don't aggravate already existing illness and disease amongst its occupants. So, though it is important for all modern buildings and public places to have mechanisms for fire safety, for a hospital to ignore and flout them is particularly disturbing and deplorable,” he wrote. In a shocking claim, the National Human Rights Commission said only three of Odisha’s 568 hospitals had fire safety clearance. 

It is appalling that a significant number of hospitals in the state are allowed to function without proper fire safety clearances. As the NHRC rightly states, such lapses do amount to a violation of the right to life of the patients. Even Union Health Minister JP Nadda, who had visited the site of the fire earlier this week, raised similar questions. “I don’t understand how a hospital is running without having fire safety clearance," Nadda said. "Secondly this is an empanelled hospital that the government is recommending for the medical treatment. How can it be empanelled after violating the safety rules?” In the wake of the Bhubaneswar hospital fire, the Centre will soon issue new guidelines and examine how more stringent provisions can be introduced to the Clinical Establishment Acts by the respective state governments. 

Will stricter rules prevent such incidents in the future? According to the guidelines prescribed by the Odisha administration, hospitals that have an intensive care unit require certification for fire safety. Even the National Building Code of India has laid out the minimum standards of fire safety and guidelines. Unfortunately, most hospitals in India, especially those in the private sector, do not take these guidelines seriously enough. This is not the first time that fire in a major hospital has resulted in severe casualties. Back in 2011, a fire at the private AMRI hospital in Kolkata killed 89 people. Reports indicate that the fire began in the basement where highly inflammable materials were stored. Senior authorities at the hospital were booked for culpable homicide not amounting to murder. After the AMRI tragedy, the Brihanmumbai Municipal Corporation, also known as the Municipal Corporation of Greater Mumbai, conducted a survey of public and private hospitals to check on their fire safety capabilities. Suffice it to say, 56 hospitals in the city, were issued notices stating that they did not maintain basic fire prevention standards. Similar to the first information report filed in the aftermath of the SUM Hospital incident, the notice claimed that in many hospitals staircases to be used for fire rescue were blocked. Even hospitals in the national capital have been accused of violating such basic safety measures. In other words, what happened at SUM Hospital could have happened anywhere.   

Going by media reports on the incident, SUM hospital authorities were notified of the glaring lapses in their fire safety system long before Monday’s incident. According to the first information report filed after the devastating fire, the hospital failed on various counts. Among the most glaring lapses was that its fire detection system did not work, as a result of which no alarm went off when the fire broke out. Another glaring failure was that the building did not have a functional external fire escape stairs. Evidently, the lack of fire escape stairs posed a serious hindrance to evacuation efforts, and patients had to be evacuated through windows after breaking the glass panels. Despite these glaring shortcomings, the hospital remains operational, with only three wards affected by the fire closed off for investigation.
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