At least 92 patients and staff members have now died as a result of a fire that broke out in the early hours of December 9 at the Advance Medicare & Research Institute (AMRI) hospital in Kolkata, the capital of the Indian state of West Bengal. The high death toll among the 160 patients in the private five-storey facility points to the violation of elementary fire and safety standards permitted by successive state and national governments in India.
The fire started in the basement of the hospital, and heavy smoke quickly spread to the upper floors. Deadly carbon monoxide fumes wafted into patients’ wards through the lift area and ducts in the centralised air conditioning system. The patients who suffocated to death came from several Indian states, including Bihar, Jharkhand and Tripura, and one was from neighbouring Bangladesh.
People living nearby noticed the fire’s smoke around 2.30–2.40 a.m. Many immediately rushed to the hospital to help, only to be turned back by security guards at the entrance. Fire fighters did not reach the hospital until just after 4 a.m.
More patients would have died except for the efforts of nurses and local residents. Remya and Vineetha, nurses from Kerala in southern India, both in their early 20s, saved eight patients but died when they tried to pull out a ninth from the smoke-filled female ward.
Young residents of south Kolkata’s Panchanantala slum, whose homes hem the AMRI facilities, had to defy guards and police to cut through barbed wire around the hospital, climb walls and smash windows to rescue patients, many of whom were sedated, elderly or infirm.
Surojit Basak, 25, told the Indian Express: “We weren’t allowed inside for a long time. We tried to reason with the private security guards at first, then tried to barge in.” Basak had a painful shoulder and a deep gash in his left foot. The first wound came from a police lathi (baton), as he tried to climb the hospital wall, while the second resulted from trying to climb in through a smashed window.
Pradip Purkait, another resident, told the Times of India: “Many more lives could have been saved. At the first light of dawn, we saw people frantically waving from the third and fourth-floors. We ran straight to the hospital gates. It was locked.” When nobody opened the gates, Purkait and local youth used bamboo sticks to scale the hospital wall.
On Saturday, police again threatened to lathi-charge protesting residents outside the hospital, who accused the management of locking the gates to cover up the extent and causes of the disaster.
The hospital basement, supposed to be for parking, had been filled with inflammable materials, including chemicals, paints, gas cylinders, diesel fuel, broken wooden furniture, cartons, thermo-cool sheets and electric cables. Highly combustible items that should have been kept in different locations were kept in the basement to “save” space and reduce costs.
The state government’s fire department said that on August 29 it gave the hospital formal notice to clear the basement within 90 days. The hospital management gave a written assurance that it would obey the order but did nothing. Fire department failed to inspect the hospital after its own deadline passed on November 29, just ten days before the tragedy.
On Friday morning, hospital staff took one and a half hours to call the fire brigade. The reason for the delay was most likely an earlier incident, involving a minor fire, on October 8. Hospital authorities reportedly reprimanded and suspended for two weeks a security guard, Haradhan Chakraborty, for calling the fire station on that occasion without his superior’s approval. Hospital authorities had evidently wanted to cover up the facility’s unsafe conditions.
AMRI’s ability to violate basic safety standards with impunity is above all the responsibility of West Bengal’s previous Communist Party of India Marxist (CPM)-led Left Front government, which governed the state for 34 years until May this year, as well as the present Trinamool Congress state government.
To divert attention away from its political culpability, the current state government has cancelled the hospital’s licence and announced a judicial inquiry. Seven AMRI directors, including R.S. Agarwal, chairman of Emami Group, the hospital’s majority shareholder, have been charged with culpable homicide and violation of safety rules.
Standing in front of the burnt-out AMRI hospital, West Bengal Chief Minister Mamata Banerjee put on a display of public anger, saying people “sell each and everything they have” to “come to this hospital to get treatment.” Yet her government has already proved little different from the Left Front, which presided over a systemic running down of public hospitals, pushing many people into seeking private care.
After taking office in May, Banerjee declared that henceforth state-run hospitals could not refuse patients. When patients filled government hospitals, however, they soon found that the conditions had not improved.
The former Left Front government promoted AMRI Hospitals as a joint government venture with private investors. The government’s initial shareholding of 26 percent declined to 2 percent as private promoters poured more capital into the highly profitable project. Currently, the Emami Group holds 66 percent, with Shrachi Group, a real-estate company, owning 32 percent.
AMRI Hospitals is one of the most lucrative medical ventures in Kolkata. Its operating income increased from 1.5 billion rupees ($US28.68 million) in 2008-09 to 1.9 billion rupees in 2009-10. In the same year, its profit rose fivefold, from 20.9 million rupees to 111 million rupees.
Opposition leader and former Left Front health minister Surjya Kanta Mishra told the media: “This is not the time to do a post-mortem of the incident, the government is taking steps, the inquiry will take place, and action will be taken according to law.” Asked by a reporter about the regulatory clearances given to AMRI during his tenure, he said: “The licence was granted after applications came, and an inspection was done.” Clearly, the Left Front fears that any “post-mortem” will point to its complicity in compromising safety standards.
The Left Front government was routed in elections in May after ruthlessly enforcing the Indian business elite’s program of transforming the entire country into a cheap labour producer for world capitalism. As well as facilitating private hospitals, the Stalinist-led administration expropriated peasant lands for big business projects, shut down public sector enterprises, handed tax concessions to investors and outlawed strikes in IT and IT-enabled industries.
Nationally, India’s public health system has been severely under-funded for decades, forcing people to seek treatment from private hospitals. India’s public expenditure on the health sector is among lowest in the world—just 1.2 percent of gross domestic product. West Bengal’s Left Front government was in the forefront of this deterioration.
For its part, the national government sought to cover its tracks by issuing a hospital safety alert. Health secretary P.K. Pradhan asked directors and medical superintendents of premier government hospitals to immediately conduct fire audits and practice drills, and submit reports within a week. This is an implicit admission that government hospitals also lack proper safety and emergency measures.
It is an indictment of the Indian ruling elite that it has failed to maintain essential safety standards in the government hospitals that cater for millions of patients a day. It has been reported that even prominent New Delhi institutions, such as the All India Institute of Medical Sciences (AIIMS), have no anti-fire certifications.
Under such conditions, private hospitals and medical institutions subject to minimal regulation have become a thriving profit-making industry. The AMRI tragedy demonstrates the human price being paid for this process.
The author also recommends:
India: Stalinist-led Left Front suffers debacle in state elections
[14 May 2011]