Fire tragedy at Bhopal hospital shows India's medical centres are becoming tinder boxes

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At least four infants have died when a fire broke out in the neonatal ward of a hospital in Bhopal; on Saturday, 10 COVID-19 patients died when a blaze ripped through the ICU ward of a civil hospital in Maharashtra's Ahmednagar district.

While fire-fighters continue to battle the blazes, we try to understand why fires have become such a phenomenon in our hospitals.

Fire, fire everywhere

According to a report published in the Indian Express in May of this year, 93 people — most of them COVID-19 patients — have died in 24 incidents of fire in hospitals in India since last August.

Another Times of India report, published on 8 November, reported that 51 people have died in Maharashtra alone owing to hospital fires in the past 14-15 months, highlighting the fact that these medical facilities have failed to prevent such incidents.

Let’s just recap the recent tragedies: Just last night, four infants died in a fire that broke out in the special newborn care unit (SNCU) of Kamla Nehru Children's Hospital in Bhopal. According to an official, the blaze started on the third floor of the hospital, which houses the ICU. Medical Education Minister Vishwas Sarang said a short circuit may have caused the fire and described the situation inside the ward as "very scary".

This was preceded by 10 patients dying in a civil hospital in Maharashtra’s Ahmednagar after a after a fire broke out in the ICU on 7 November. The incident prompted Prime Minister Narendra Modi to tweet, saying he was "anguished by the loss of lives".

Before this, on 18 October, a fire broke out in a seminar room on the ground floor of the Lok Nayak Jai Prakash Narayan Hospital in Delhi. Fortunately, no casualties were reported in this incident.

Causes of fire

So, what is causing this so-called fire pandemic?

Experts state that 'overstressed' hospital systems are the main cause for these tragedies.

Hospitals increase beds and equipment to cope with the growing patient load, but don't immediately expand the electrical systems and wiring. This causes equipment or wires carrying current beyond their capacity to overheat.

An article reiterates this point. ‘Fire Safety hazards: How safe are our hospitals’ published in the Indian Journal of Community Medicine (Jan-March 2020) said that no hospital at the time of designing and execution takes into account the electricity load. So much so, that when the hospital is commissioned, the power requirement is doubled and it keeps increasing annually.

As Santosh Warick, Director, Maharashtra Fire Services, explained in an Indian Express report, "Hospital ICUs did not function up to 100 percent capacity before the pandemic. The ventilator, equipment, air conditioners are working 24 x 7 now. It puts a pressure on the entire system."

Moreover, ICUs and other hospital wards are turning into tinder boxes owing to the increase in inflammable equipment such as sanitisers, which contain high levels of alcohol, and PPE kits, which are made of synthetic material.

Rich oxygen supply for patients also is a perfect fuel, should there be even a minor leak in the pipeline or cylinders.

Another issue that could be contributing to higher incidences of fires is the lack of cross-ventilation. Hospitals are focused on keeping rooms sterilised, but the lack of windows is a problem.

More importantly, if there is one thing that these fires have shown is that hospitals lack firefighting tools, along with the lack of audits, becoming a lethal combination for patients. For instance, the investigation into the fire at the Bhandara District Hospital in January this year, in which 10 babies died, showed that fire-fighting equipment was inadequate. If that wasn't bad enough, the hospital was functioning without a no-objection certificate from the fire department.

Fire fighting equipment and training

Hospitals must install sprinklers and ensure that they are working. As former Mumbai fire officer said: "If temperature rise to 78°C, sprinkler automatically starts dispensing 35 litres per minute. They can become first form of response."

Additionally, hospital administration should carry out stringent audits and ensure that no corners are cut when it comes to replacing electrical equipment and wiring is of high quality.

Another key aspect in trying to prevent these fires is proper training to the hospital staff. In many cases, staff members run helter-skelter in case of a fire, which shows that they haven’t been properly trained.

Experts believe that the working personnel in a hospital should be provided with in-depth training into firefighting — which includes how to maintain one’s temperament and using a fire extinguisher.

It has been reported that in many cases, the fires became even worse as personnel didn’t know how to use the extinguishers present at the site.

Another key aspect is that states should disburse adequate funds to set up fire-fighting systems.

If only these issues are looked into and officials get serious about it, could we prevent such tragedies from taking place and make hospitals a safe place where we get treated and not burnt.

Things to remember while fighting a fire
• The first thing to do when you spot fire is pull the fire alarm
• The fire has to be small enough for you to fight it and it hasn't spread
• Evacuate people before you begin fire fighting
• There has to be an exit door for you to run to, in case you are unable to douse the fire
• Inform a fire safety officer just in case you are unable to fight and have to evacuate the premises
Also please remember,
• You MUST exit the building when told to by the management
• If you have been told to exit, you must exit even if there are fire extinguishers accessible to you
• The exception is when you have been specially trained and are expected to use a fire extinguisher

With inputs from agencies

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Fire tragedy at Bhopal hospital shows India's medical centres are becoming tinder boxes
Fire tragedy at Bhopal hospital shows India's medical centres are becoming tinder boxes
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