Hospitals afire: on lack of safety in health-care centres

 

Health-care centres lack fire safety because governments pay lip service to regulation

he shocking deaths of at least 19 people in special facilities for COVID-19 management in Vijayawada and Ahmedabad have exposed the deep rot in regulatory processes for institutional and commercial building safety. While 11 died in the Andhra Pradesh incident, where a hotel had been taken over by a private hospital to run a COVID-19 care centre, nine patients perished in the blaze in a Gujarat hospital intensive care unit (ICU). These ghastly incidents which claimed the lives of those who were getting treatment or recovering from an infection in supposedly secure conditions lay bare the lack of preparedness among States to manage the expanding pandemic, and hasty contracting procedures. In a familiar pattern, civic and fire authorities who were expected to monitor the safety of such buildings have sought to pin responsibility for the carnage on the owners of the properties. They are being held responsible for failure to obtain a no objection certificate or, in the case of the hotel-turned-COVID-19 care centre, carrying out electrical upgrades for safety. This is clearly untenable, as the Supreme Court of India observed about a decade ago in the Uphaar cinema fire tragedy case in Delhi, pulling up authorities including the Union Home Ministry for abdicating responsibility and passing the buck on to the management of the institution. In the Ahmedabad ICU blaze, patients expected the institution to offer the highest levels of safety, but suffered as it was ill-equipped to fight a fire.

Safety regulation of buildings used for health-care delivery is a subset of the overall need to regulate hospitals, and States should use the recent deadly fires as the occasion to launch much-delayed reform. In the absence of safety systems, many died of fire and smoke inhalation, while those who survived had nothing but luck to count on. This situation cannot be allowed to continue. The National Building Code of India, with additional fire safety provisions for hospitals, is the basis for hospital accreditation systems, but these should be made mandatory and enforced in all States. If smoke alarms and sprinkler systems, along with local fire-fighting aids are available, loss of life can be eliminated. All patients should also be covered by substantial life insurance. Evacuation systems for ICU patients need to be part of the building design. Often, hospital buildings are regularised for unapproved constructions by State governments acting thoughtlessly. Schemes introduced to regularise building violations are clearly anti-social in character. The many fires in institutional buildings and their terrible toll should lead to a full inspection of all such facilities for safety, with civil society keeping up the pressure on governments to act.