The tragic death of at least 22 people and injuries caused to dozens of others in the > SUM Hospital fire in Bhubaneswar on Monday throws up the question: what lessons were learnt from the > AMRI Hospital fire in Kolkata that claimed over 90 victims five years ago? Was the hospital fire fighting system activated immediately and were emergency measures taken to evacuate patients? These and other aspects of the incident must be addressed by an impartial investigation. If each deadly fire in a medical facility provided lessons in hindsight, India’s hospitals should be witnessing fewer events annually, with a sharp decline in casualties. That would follow the global trend, as causes of hospital fires are understood better, and regulations tightened for safety of patients, their families, visitors and staff. There is also insight within the country on why fires in hospitals could be particularly fierce. One study by IIT Kharagpur engineers points to enrichment of the local environment by oxygen leaks, which sets off fires in thin plastics. The National Building Code is specific, requiring hospitals to have horizontal evacuation exits for bedridden patients and sprinkler systems for structures of specified height, which would cover most medical institutions.
Prevention of fires and emergency response are not high priorities in India, viewed by the Centre as a municipal function under State governments. With a steady decline in the enforcement of urban regulations and building plans, fire risks have multiplied in public buildings. It will take enormous political will and active judicial oversight to enforce best practices and rein in violators. Meanwhile, patients and visitors could get a modicum of risk protection and suitable compensation if all institutions offering any form of medical care are compulsorily required to be insured against disasters. Such a regulation would make a hospital insurable only if it installs good quality fire warning and control systems. There are reports that not enough could be done in the SUM Hospital fire to move patients away quickly, as the blaze spread and affected vulnerable people receiving intensive care. It is also believed there were not enough ambulances available to shift the patients out. Such evacuation is not the responsibility of the hospital alone, it is also the local administration’s. Looking ahead, the Centre and State governments should address fire risk in medical institutions as a top order priority. This can be achieved by understanding the hazard, adopting the right infrastructure, enforcing the building code, and holding frequent fire drills to do things correctly in an emergency.