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Introduction

Recent ICU fire tragedies, including at SCB Medical College and Hospital, expose deep governance failures in hospital safety. Despite regulations, recurring incidents reveal gaps in compliance, infrastructure, and accountability, endangering patient lives.

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Causes of Recurring Fire Incidents in Hospitals

• Weak Enforcement of Safety Norms: Mandatory fire clearances and audits exist but are poorly implemented.
  Eg: 2016 Bhubaneswar ICU fire occurred without fire safety clearance despite norms.
• Electrical Infrastructure Deficiencies: Faulty wiring, overloading, and mismatch with equipment load increase fire risk.
  Eg: Jhansi audit revealed exposed wiring and circuits not matching power load.
• Inadequate Staff Training and Preparedness: Hospital staff often lack skills to handle fire emergencies or equipment.
  Eg: Delay in alerting fire units at Cuttack ICU led to late response (30+ minutes).
• Technological Risks in ICUs: Oxygen-rich environment and advanced equipment create high fire vulnerability.
  Eg: Ventilator-linked short circuit suspected in Cuttack fire wherein harmonic currents cause overheating.
• Compliance as Formality, Not Accountability: Safety treated as paperwork rather than responsibility with consequences.
  Eg: Despite ₹320 crore allocation by Odisha government, incidents continued due to poor execution.

Measures to Ensure Patient Safety

• Strict Enforcement with Criminal Accountability: Fix responsibility on hospital authorities for negligence in safety compliance.
  Eg: Treating fire safety lapses as criminal offences, not procedural lapses.
• Upgrading Electrical Infrastructure: Regular audits, load assessment, and modern circuit protection systems required.
  Eg: Mandatory re-evaluation of wiring with every new ICU equipment installation.
• Capacity Building and Training of Staff: Regular drills and training in fire response and evacuation protocols.
  Eg: Use of CO₂ extinguishers for electrical fires requires trained personnel.
• Strengthening Emergency Response Systems: Ensure quick alert mechanisms, functional firefighting systems, and coordination.
  Eg: Functional hydrants and real-time alerts could have reduced response delay in Cuttack.
• Institutionalising Continuous Safety Audits: Move from one-time compliance to periodic, technology-enabled safety monitoring.
  Eg: Post-2016 audits made mandatory, but need stricter periodic enforcement and independent verification.

Conclusion

Ensuring hospital fire safety demands a shift from procedural compliance to accountability-driven governance. Strengthening infrastructure, training, and enforcement can safeguard vulnerable patients and uphold the right to health with dignity and safety.

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