Felled by fire: On newborn deaths in Maharashtra hospital

To avert another Bhandara-like hospital inferno, govts must address underlying causes

Published - January 11, 2021 12:02 am IST

The deadly fire that snuffed out the lives of 10 infants in the Bhandara District General Hospital in Maharashtra is a shocking reminder that safety norms in several medical facilities in India do not pass muster. The parents of the babies who perished in the sick new-born unit have been plunged into a lifetime of trauma. Some of the victims, a few just days old, had been brought to the hospital for better care from smaller health facilities; seven had a providential escape. There are reports of poorly trained staff failing to respond adequately. The terrible blaze joins the long list of such accidents recorded in government and private hospitals, underscoring a painful reality: safety protocols are yet to be institutionalised even in places where people legitimately expect a high degree of professionalism. Last year, there were devastating fires in COVID-19 facilities in Vijayawada and Ahmedabad , with several casualties, blamed on poor oversight by fire authorities or faulty electrical repairs. The Maharashtra government has ordered a probe into the Bhandara fire to be concluded in three days, and a fire audit of hospitals , but a perfunctory inquiry cannot effectively address the underlying causes. Hospital fires are a distinct entity, and research indicates that there are specific factors that trigger them off and aggravate their impact.

Intensive Care Units, neonatal ICUs and operating rooms are often the site of fires, implicating the presence of a high concentration of oxygen in a confined space. A review of Indian hospital fires published in the Journal of Clinical Anesthesia identified higher oxygen availability in intensive care facilities as the likely primary cause, with motors and electrical units in the room providing the ignition, and plastics fuelling it. It is worth considering, therefore, whether hospitals have been audited with such factors in mind, and to evaluate national building safety codes against international practice. Oxygen monitors for hospital rooms, to ensure that the ambient level is within safe norms — set at a maximum of 23.5% by the U.S. National Fire Protection Association — could help avert an accident. Locating electrical equipment for air-conditioners with sparking potential away from oxygen saturated areas may also reduce the risk. As the health sector expands, it is essential that all new infrastructure conforms to rigorous safety standards, a small premium to stop disasters such as the Bhandara carnage. If the government sets the bar high enough, ensuring full adherence to safety in its buildings, regulatory authorities can compel commercial structures to fall in line. The Centre should also create a public platform for insights gained from inquiries into hospital fires to be shared. Hospitals should mandatorily hold regular safety and evacuation drills which are key to saving lives when disaster strikes.

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