The lapse in safety procedures at the AMRI private hospital in Kolkata, India, which led to the death of 94 patients and staff in a major fire in early December has raised concerns about India's reputation for medical tourism.
Reports in local and national Indian newspapers and television stations have highlighted the shortcomings in safety standards and monitoring of both public and private hospitals in India.
The toll in the fire is the worst in a hospital in India. Relatives of many of the victims blamed the private hospital for the absence of safety measures, including emergency exits or functional fire alarms. Medical staff wanting to smoke, habitually turned off fire detectors so they could smoke inside, say the forensic investigators.
Most of the victims died in their beds, unable to escape the fire. Residents living in the neighbourhood accused the security-men of not taking any measures to control the fire and of even preventing others from rushing to the rescue of the hapless patients. According to the police, the hospital did not have adequate fire-fighting equipment, and medical staff abandoned the patients, leaving them to their fate.
A local court in Kolkata has remanded six of the hospital directors; they are charged with culpable homicide.
Local authorities had warned the hospital about the lack of safety features. West Bengal chief minister Mamata Banerjee described the lapse as a criminal offence.
The fire was detected between 2:15 and 2:30 am, but the first call to the fire brigade came at 4:10 am, from a neighbour, not from the hospital. The fire alarm did not sound. The sprinklers were not functioning.
The fire began in a basement that had been inspected by the fire department and that they had asked the hospital to clear. The hospital had agreed. The deadline for clearing was 4 December. The hospital says the basement is a car park but that is strange as it includes a pharmacy, the medical records section, the maintenance department and a library. Firemen found jerry cans filled with liquid and heaps of cartons, thermocol sheets, electric cables and diesel. The blaze was fed by diesel fuel and motor oil stored in the hospital’s basement, according to West Bengal State’s minister of urban development, Firhad Hakim.
The National Accreditation Board for Hospitals and Healthcare Providers had kept the hospital’s application for re-accreditation from 10 November in abeyance because of non-conformities, the details of which they are not revealing. The hospital’s licence has been cancelled.
Dr. Shakti Gupta, of the All India Institute of Medical Sciences (AIIMS), stated "The government should mandate regular fire audits, and it should plan on the opening of more institutes which can train paramedics and medics in fire safety drills."
According to Dr. Muzzafer Ahmed, of the country's National Disaster Management Authority, "What we need to look into when issuing the licenses for running the hospitals is that building construction has complied to safety building codes and a safety plan is in place in case of fire."
According to national paper, The Times of India, "Most Indian city hospitals may not be fully prepared to handle a disaster of the magnitude of Friday's Kolkata hospital blaze. While the fire brigade admitted it did not carry out regular checks, officials said most hospitals are ill-equipped and do not follow safety norms, According to the District Fire and Rescue Service department of the 100 Kolkata hospitals, only 33 hospitals have been issued the mandatory fire license."
The Kolkata hospital fire has raised concerns across India about the safety standards, monitoring and accreditation of Indian hospitals. Outside India, the tragedy has received widespread press and media coverage and will no doubt affect patient confidence in the Indian medical tourism industry.
Ian Youngman is a writer and researcher specialising
in insurance and health. He writes regularly for a variety of
magazines, newsletters, and on-line services. He also publishes a range
of insurance reports and undertakes research for companies. An ACII,
with an honours degree in Economics from the University of Liverpool,
Ian was a co-founder of The General Insurance Market Research
Association. He also has widespread experience within the insurance
industry at management level, working for brokers, a bank and an
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