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Thursday 15 December 2011

AMRI HOSPITAL :A battle lost before it began

A battle lost before it began

Primitive firefighting and ignorance about the basics of rescue were as much to blame for the AMRI tragedy as the callousness of those who ran the hospital, according to an evacuation expert who lost a family member in the fire.
Jayanta Das (in picture, left), 46, had reached AMRI Dhakuria around 5am last Friday to try and save his immobile sister-in-law Munmun Chakraborty, who was nursing a fractured hip. But for all his experience as a merchant navy officer trained in emergency evacuation, Das discovered that the odds were heavily stacked against those trapped inside.
In the three hours that he was there, he saw the firefighting and rescue operation go wrong at almost every step. And as the minutes ticked by, each fumble reduced the chances of finding survivors in the wards and cabins filled with toxic smoke.
Das will live with the regret that he couldn’t save 36-year-old Munmun, but he hopes his observations on what the fire brigade, the rescue personnel and the hospital authorities could have done would help manage future emergencies better.
Metro revisits Black Friday through the eyes of the merchant navy officer.
He saw: The fire brigade trying hard to put out the fire in the basement, but failing to stop smoke rising to the upper floors through the open air-conditioning ducts. The inside of the building was dark even at dawn with a few torchlights the only source of illumination.
He recommends: Zero tolerance for faulty fire-safety equipment. “Many lives would have been saved had the fire and smoke alarms been working. Any central air-conditioning system is meant to be connected to the fire and smoke alarms so that power is automatically cut off and all ducts and flaps are sealed the moment smoke is detected,” says Das.
Battery-operated emergency lights should come on when power is switched off. Had the corridors and staircases at AMRI not plunged into darkness, rescuers would have reached the trapped patients faster.
He saw: The first gas mask being brought at 6.15am, more than four hours after the fire was detected. Three more arrived at 6.35am, but could not be used. “When leaks were detected in the first three oxygen cylinders they had tried out, a disaster management team didn’t use the fourth, fearing public outrage,” recounts Das.
None of the firemen were wearing safety goggles and gloves. The lack of drills was evident. The men were trying to strap the masks and open the valves of the cylinders while wearing the breathing apparatus. The cylinders should be worn on the back first and the valves opened before putting on the mask. The masks are supposed to be strapped tight last.
The fire brigade also erred in not breaking the windowpanes before doing anything else so that there was an outlet for the smoke.
He recommends: Basic equipment for firefighters, first and foremost. “The firemen were not carrying even basic tools like pickaxes and hammers. If they had these, they would not have had to waste time searching for pipes and stones to break the glasspanes on the sealed windows,” says the merchant navy officer.
He saw: Victims being lowered from different floors using ropes. The knots were around the chest and feet with a loop in the middle. “This primitive technique can be fatal,” says Das.
He recommends: Neil Robertson stretchers, made of semi-rigid canvas, that enable patients to be lowered vertically without any injury. “Every hospital and fire brigade unit should have these. They should also have scoop (orthopaedic) stretchers for those with spinal injuries,” suggests Das.
He saw: Lack of co-ordination among everyone involved in the rescue even after the fire in the basement had been raging for almost three hours. “When I reached at 5am, young volunteers, the fire brigade and the police were all present. But there was only one fire engine that had a hydraulic ladder. Worse, the ladder wasn’t reaching anywhere near people craning their necks out of the broken windows and screaming for help,” says Das.
The firemen told him that the delay was because they were unable to locate the operator of the ladder. “Things started moving at 5.40am and the second skylift began operating only after 7.30am,” recalls Das.
He recommends: At least one emergency drill every month in hospitals and frequent mock drills to check the alarms.
He saw: Noxious smoke swirling up the floors of Annexe I, making it difficult to see beyond a foot without flashlights and breathe without gas masks. Most of the bodies brought out of the building had mouths open and faces blackened with soot, suggesting death caused by air poisoning and oxygen deficiency.
He recommends: An oxygen mask next to every hospital bed. “I remember seeing an oxygen tube above Munmun’s bed (No. 2,224 in the female ward), but there was no oxygen mask. Nobody died of burns or excessive heat. They all choked on smoke,” he says.
Medical view: Doctors say oxygen inhalation would have saved many lives, provided enough of it was being supplied. “Paramedics would have taken five seconds to lift a patient’s head and put the masks on, given that the system starts working automatically,” says a surgical oncologist attached to several private hospitals.
“The oxygen plant in Annexe I was equipped to support 160 patients for at least two hours,” adds an official formerly employed with AMRI Dhakuria.
Text by Rith Basu
Pictures by Pabitra Das, Sanjoy
Chattopadhyaya and Bishwarup Dutta

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