Fatal fires: the need for strict safety norms.

Fatal fires: the need for strict safety norms.

News:

Fire at the Andheri hospital of the Employees State Insurance Corporation in Mumbai killed eight people.

Important Facts:

• Fire department of Maharashtra has claimed that hospital was functioning without adhering to fire safety standards and demanded thorough probe and examination.
• The Andheri horror evokes memories of the AMRI hospital blaze in Kolkata seven years ago, in which 92 people died. It led to an assessment of hospital safety in all States.

Hospital safety and its importance

• Most fire-related hazards are caused due to carelessness and improper handling of good.
• Evacuating people from hospitals during a fire hazard is challenging because it involves moving patients who are immobile and are unable to help themselves.
• Therefore, it is important that hospitals and other health care centers have adequate fire prevention and safety measures in place
• Prevention is the key in the case of fire-related accidents especially when places like hospitals are concerned
• A hospital has many combustible substances, chemicals, and gases, heat dissipating equipment, and electrical wiring, which can lead to a serious fire accident if appropriate safety measures are not observed.

Underlying Vulnerabilities to hospitals

• Inadequate or non- compliance of structural elements of hospitals to building codes and other safety norms which result in the failure of hospital structures and their component non-structural elements;
• Absence of an operational Hospital Disaster Management Plan;
• Lack of planning and preparedness to respond to disasters;
• Inadequate or complete lack of internal and external communication; and
• Lack of networking amongst hospitals.

Institutional Mechanisms to deal with Disaster

• Both Health and Disaster Management being state subjects, it implies that the respective state

health departments and state disaster management authorities, along with the state public

works department, will play a crucial role in implementing these guidelines on the ground.

• However, the Ministry of Health and Family Welfare, the Central Public Works Department

and other licensing agencies at the Central or State levels will also undertake the necessary

actions to implement guidelines for effective compliance.

• Wherever necessary, the National Disaster Management Authority, the Bureau of Indian

Standards, technical institutions like IITs and other relevant agencies shall extend their support

to further the agenda of Hospital Safety in our country.

Major Guidelines for Hospital Safety:

• The National Accreditation Board for Hospitals and Healthcare Providers (NABH) goes by the National Building Code and its specific norms for hospitals, which include minimum requirements for multistoried structures, such as alarms, sprinkler systems, specified-width staircases, smoke barrier enclosures and checks against storage of combustible materials in areas where patients are kept.
  • The National Accreditation Board for Hospitals (NABH) made mandatory for all hospitals to obtain no objection Certificate from the concerned Fire Department before the building can be occupied.
• Regulations as per National Building Code 2005: ‘National Building Code of India – 2005’ on ‘Fire & Life Safety’ covers the requirements for fire prevention & life safety in relation to fire and fire protection of buildings.
  • The Code specifies construction, occupancy and protection features that are necessary to minimize danger to life and property from fire.
• In the wake of the recent fire accident at AMRI Hospital at Kolkata, National Disaster Management Authority (NDMA) were given the responsibility to prepare guidelines for Hospital Safety and Preparedness to deal with on-site emergencies

Objective of the NDMA Guidelines

• To address hospital safety through a multi-hazard and inter-disciplinary approach.
• To ensure structural safety of hospitals (especially of critical facilities).
• To ensure that all professionals involved in the day to day operation of hospitals

are prepared to respond to disasters; and

• To ensure that every hospital in the country has a fully functional and regularly tested Hospital Disaster Management Plan.

Preventive measures to reduce fire risks in hospitals

• Architecture and layout – The design and architecture can prove as a turning point in case of a fire breakout. A hospital’s architecture planner must make sure that there is ample of open space in the building to minimize the possibilities of spreading fire in the entire building. Pressurized exclusion of smoke must be a priority while planning the architecture of a hospital.
• Fire safety plan – Every member of the hospital must be aware of a well-charted and detailed action plan which everyone needs to follow in case of a fire breakout. Fire drills must be carried out on a regular basis to make sure that hospital staff including doctors must know how to respond during emergency situations.
• Fire detection equipment – Fire detection is the first step towards preventing fire hazards. Hospitals must have fire detection equipment such as heat detector, smoke detector, fire gas detector, flame detector, etc. installed at important locations. Not only the installation of fire detection equipment is essential, it must also be ensured that these devices are working properly by checking them on a timely basis.
• Fire audit survey – Hospitals can seek help from professional bodies for conducting fire safety audits to make sure that the adequate fire prevention measures are observed in the hospital. If the authority recommends any changes, it should be implemented diligently.
• Maintenance of electrical wiring and equipment – Faulty wiring systems can be a cause of fire outbreak. To prevent fires from electrical equipment, maintenance must be carried out at least once in a month and other electrical equipment that can lead to fire hazard must also be properly maintained.
• Prohibiting smoking to reduce chances of fire – Hospital authorities must ban smoking inside the premises of the hospital, especially near oxygen cylinders. This will significantly reduce the chances of fire outbreak.

Way Forward:

• The prime objective of disaster preparedness and response for hospitals/healthcare institutions should ensure that they are remain functional and continue providing the necessary health care services during and immediately after an emergency.
• A strong building code with features for reduction of fire hazards for all structures, and specially for hospitals since they host people who are incapacitated and cannot be evacuated quickly
• State governments should require mandatory compliance with such safety features for any institution handling patients or giving care.
• Certification of facilities through third-party audit should be made compulsory to eliminate conflicts of interest involving official agencies
• The institutions should also be insured for the highest levels of public liability.