The absence of elementary safety standards has led to the death of 22 patients and the injury of 105 after a major fire erupted at the Institute of Medical Sciences & SUM Hospital in Odisha state on October 17. The privately-owned health facility is located in the Khandagiri area of Bhubaneswar, the state capital. Most of the victims were in the hospital’s Intensive Care Unit.

The tragedy is a damning indictment of the Biju Janata Dal (BJD) state government, the national government and the entire Indian ruling elite for failing to provide or maintain basic safety standards at hospitals catering for millions of patients throughout India.

The fire, which began on the first floor of the four-storey hospital building, is believed to have been caused by electric short circuit in the dialysis ward. Several patients noticed smoke at about 6.30 p.m. and informed hospital authorities. Their warnings were ignored and the fire worsened over the next hour with carbon monoxide fumes and smoke spreading through air conditioning ducts. The blaze eventually engulfed the first floor and began to spread to upper floors, trapping over 500 people inside the hospital.

Many patients were rescued through broken windows while attendants were forced to jump from the first floor. Over 100 patients were move out by ambulances and have been admitted to other hospitals in Bhubaneswar and Cuttack.

In an attempt to cover up their own responsibility, SUM hospital management declared that the fire was “an accident” and insisted that “prompt action [was taken] to douse the fire and evacuate patients.” Eye-witness accounts reported in the Times of India directly contradict these claims.

Jaspal Singh, who managed to shift his 78-year-old father, Tirath Singh, by wheel-chair from the third floor told the newspaper: “Patients and attendants were kept in dark [about the fire] till very late.” He praised nursing staff for their exemplary courage, putting their own lives at risk in helping to evacuate as many patients as possible.

Anil Patra, whose mother, Rajani Patra, 46, died in the Intensive Care Unit, said: “There was commotion among hospital security staff after smoke was noticed on the first floor around 6.30 p.m. The hospital staff and security personnel, who were supposed to ensure a smooth evacuation, had no coordination leading to a chaotic situation. This delayed the process. As a result, people died.”

Arpit Senapti used a wheel-chair to shift his mother, Sarojini, 86, from the fourth floor to the ground. He said hospital staff kept re-assuring patients and visitors that nothing would happen. “Finally they asked us to take her away on a wheel-chair. We exited using the fire exit ramp. After that it was agonising wait of more than an hour outside the hospital before an ambulance shifted her, [even] though my mother was on ventilator.”

In the face of growing anger over the lack of elementary safety at the facility, four hospital officials—Medical Superintendent Pusparaj Samantsinhar, Electrical Maintenance Engineer Amulya Sahoo, Fire Safety Officer Santosh Das and Junior Engineer (Electrical) Malay Sahoo—were suspended and arrested.

Odisha Director General of Police (Fire Service) Binay Behera told the media that the SUM hospital had failed to implement basic safety standards, including 10 basic requirements made after a 2013 fire audit of the facility. He said: “Upon an inspection of the mishap site, it was found that the majority of the suggestions had not been complied with.”

Hospital authorities did not obtain a valid fire safety certificate. The facility did not have a 25,000-litre water tank, a functional sprinkler system or operating alarms. There was no external fire escape staircase and the fire hydrant system did not operate.

While the Odisha state government has feigned concern over the tragedy it is directly complicit. Director of Medical Education and Training Prakash Chandra Mohapatra admitted this week that out of the 568 fully-operational private hospitals and nursing homes in Odisha, only three hospitals—in Bhubaneswar, Cuttack and Puri—had fire safety certificates.

The National Accreditation Board for Hospitals & Healthcare Providers (NABH) certificate for the SUM facility lapsed last August. The NABH inspection report pointed to “serious deficiencies in almost every chapter pertaining to patient safety” and “overall intent of the [SUM] hospital.”

The NABH accreditation committee concluded by deciding that the hospital would no longer carry the NABH tag. Despite its blatant violations, state government authorities failed to shut down the hospital thus allowing Monday’s disaster to occur.

In an attempt to contain public anger and divert attention over his government’s role in the disaster, Odisha Chief Minister Naveen Patnaik declared that the fire was “very tragic.” He announced an “official” investigation and directed all government and private hospitals to treat the SUM hospital patients.

Others shedding crocodile tears for the victims, included Indian Prime Minister Narendra Modi, who tweeted that he was “deeply anguished by the loss of lives in the hospital fire in Odisha …”

SUM hospital management have provided meagre compensation payments of 500,000 rupees ($US7,500) to the next of kin of those killed and said it would pay for all those injured.

The disaster in Odisha is the direct political responsibility of successive central and state governments—whether led by the Bharatiya Janata Party (BJP) or Congress—that are callously indifferent to fire and other basic safety requirements and have drastically cut funds for the health sector, forcing people into private, profit-making hospitals.

Under the Modi-led BJP government, healthcare funds have been slashed almost 20 percent. Health ministry officials told Reuters on Tuesday that more than 60 billion rupees ($US948 million) had been cut from their budget allocation of around $5 billion for the financial year ending on March 31.

Indian governments spend only one percent of the GDP on healthcare. This is less that many other countries in South Asia, including Afghanistan and Maldives. Even the tiny, impoverished state of Nepal spends 5.5 percent of the GDP on healthcare.

Almost 80 percent of government hospitals in Delhi, the national capital, lack basic fire safety measures. According to A.K. Sharma, former director of Delhi Fire Services, the hospitals have not taken adequate measures “to prevent spread of smoke and fire from one section to another” and had “unreliable fire management systems.”

The absence of these basic safety measures in government and private health sectors has led to series of fire tragedies in recent years.

In late May a fire erupted in the cardiology department at the state-run SCB medical college and hospital in Cuttack, Odisha.

Over the past five years, there have also been serious fires at the Advanced Medicare & Research Institute (AMRI) hospital and Murshidabad Medical College in Kolkata and at Mumbai’s Gokul Hospital. The AMRI blaze, which erupted in late December 2011, killed over 90 patients and staff members.