Fourteen infants did not have to die in the nursery of the Pakistan Institute of Medical Sciences on Wednesday morning. They died because a public institution, twice warned by its own recent history, did nothing to fix what everyone already knew was broken.
Barely two years ago, in June 2024, a fire tore through the paediatric ward of Sahiwal Teaching Hospital in Punjab and killed eleven babies. The trigger, investigators found, traced back to a fault in the hospital’s air-conditioning infrastructure, the same category of failure now under scrutiny at PIMS. Punjab’s government responded at the time with visible urgency: the Chief Minister ordered the arrest of the hospital’s medical superintendent and three senior doctors after inquiries revealed the facility’s fire extinguishers had expired. It looked, briefly, like accountability. It was, in retrospect, theatre without follow-through.
Because two years later, in the federal capital’s largest and best-resourced public hospital, the same failures resurfaced in a different building. Preliminary findings on the PIMS fire have shifted from an AC compressor explosion, to an electrical short circuit, to an exploding nebulizer attached to an incubator, a narrative unstable enough on its own to raise questions. But whatever ultimately lit the spark, the response to it is what should alarm the country most. A Capital Development Authority fire brigade report found that emergency exits in the ward were locked from the outside and blocked by barriers. Parents described an unstaffed nursery, no visible evacuation route, and firefighting equipment that did not work. This is not the profile of a freak accident. It is the profile of a building that was never made safe to begin with, run by an administration that assumed, as Sahiwal’s administration once did, that nothing would go wrong until something did.
This is where the conversation about blame needs to be far more precise than it currently is. In the aftermath of these fires, public anger, understandably, gets directed first at the hospital and, by extension, at its doctors. But the deeper problem is structural, and it sits in how Pakistan’s public hospitals are run in the first place. When a doctor becomes senior enough, the system’s default move is to hand them administrative authority over the hospital itself, medical superintendent, hospital director, and similar posts are routinely filled by clinicians promoted up the ranks. Yet nothing in a medical career trains a doctor to run a hospital as a building: to manage fire codes, electrical load, facilities maintenance contracts, or emergency-evacuation planning. These are technical and managerial disciplines in their own right, and treating clinical seniority as a proxy qualification for administrative competence is precisely how gaps like locked exits and unserviced extinguishers go unnoticed until a fire finds them. Sacking a federal health secretary after the fact, as has now happened, is a start, but it should not be mistaken for the fix. It treats the position, not the process, as the point of failure.
What both Sahiwal and PIMS reveal is an inspection and maintenance culture that treats fire safety as paperwork rather than infrastructure, something to certify once and forget, rather than audit continuously. Until Pakistan’s public hospital system separates clinical accountability from administrative accountability, and until facilities oversight becomes a matter of independent, recurring inspection rather than a scramble that follows each tragedy, this will happen again. The next fire will not be a surprise. It will be a repeat.Fourteen families in Islamabad, like eleven families in Sahiwal before them, deserved a system that learned from its own past.
Read more:https://digdebate.com/pims-hospital-fire-14-infants-killed-islamabad/
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