KARACHI: Expressing concern over the Liaquatabad government hospital tragedy that has so far claimed lives of five victims, experts have called upon the government to focus on fire prevention and safety measures, considering the high mortality risk and cost involved in treatment of burns.

They also regretted the fact that only two public sector hospitals in the whole province offered complete specialised care for burns, forcing families to move their loved ones in critical condition from the interior parts of Sindh either to Hyderabad or Karachi.

“Most victims with serious burn injuries either die on the way (while being shifted to Hyderabad or Karachi) or succumbed to their injuries during treatment,” a doctor at the Dr Ruth Pfau Civil Hospital Karachi (CHK) told Dawn, wishing not to be named.

Currently, he pointed out, the CHK burns unit was attending to patients not only from the hugely populated city of Karachi but also from the interior parts of Sindh as well as Balochistan.

Sindh has only two public sector hospitals specialising in care for burns victims

“Burn victims are referred to us from Hyderabad as well, which has one dedicated facility at a major tertiary care hospital. Patients are also referred to Karachi from the Gambat Institute of Medical Sciences (in Khairpur district) as it doesn’t have equipment for skin grafting,” he explained, claiming that the CHK unit being run with the support of a non-profit organisation was well equipped and adequately staffed.

About the shifting of victims of Sindh Government Hospital Liaquatabad’s fire from CHK to a private hospital, doctors at the unit said that it had more to do with families’ discretion than lack of trust in a public sector facility.

The CHK burns unit with 65-70 bed capacity, they said, carried a big patient load at all times, making the working conditions stressful.

“It’s not humanly possible to perform 100 per cent in each and every case. Besides, it’s highly unfair (to the people) not to have a burns unit at tertiary care hospitals in other cities of the province,” another doctor shared, adding that Punjab and Khyber Pakhtunkhwa fared better in this field than Sindh.

The head of the CHK burns unit declined to comment when asked to explain why families of Liaquatabad hospital fire’s victims refused to have their loved ones treated at the facility.

About the treatment cost, Dr Nizam said it’s expensive across the world, at times costlier than cancer treatment with high mortality risk.

“Patients often end up seeking financial assistance from hospitals. This explains why private hospitals avoid offering treatment for burn injuries as they find it non-viable,” he observed.

It might be recalled that a fire was reported at the Sindh Government Hospital Liaquatabad on Feb 11. Blamed on a short circuit, the fire had caused serious injuries to seven people, six of them hospital employees. All victims were shifted from CHK burns unit to Patel Hospital on families’ insistence a day later.

‘Most fire injuries are preventable’

Sources said the latest victim, 44-year-old Kashif, was a dialysis technician at the government hospital. He was a father of two girls. He had received 29pc burns in the incident.

Earlier, two paramedics, one cook and a sweeper had lost their lives during treatment at the private hospital.

“It’s sad that we have lost Kashif as he was recovering well. Unfortunately, he suddenly developed an infection that led to fatal health complications,” Dr Mazhar Nizam, representing Patel Hospital told Dawn, adding that one victim was still under treatment at the hospital.

Explaining the complications involved in the victims’ treatment, Dr Nizam said two of them were brought with 80 to 90pc burns and that survival rate was too low in cases with over 50pc burns.

“Treatment of burns is expensive across the world, at times costlier than cancer treatment with high mortality risk. Patients often end up seeking financial assistance from hospitals. This explains why private hospitals avoid offering treatment for burn injuries as they find it non-viable,” he observed.

Experts also explained that multiple factors contributed to high mortality risk in burn injuries which included the total body surface area affected, inhalation injury, age, patient’s health status and depth of the wound. In several cases, they said, death was caused not by damage to the skin but rather by lung injuries caused by toxic fumes inhaled by the victim.

“A major risk factor is infection/s. Death may also occur due to kidney failure resulting from extensive loss of fluid,” senior plastic surgeon Dr Mohammad Ashraf Ganatra said, while underscoring the need for fire prevention measures and training in fire safety given the high mortality risk and cost involved in treatment of burns.

According to him, most fire injuries reported in society could easily be prevented.

“Fire prevention at home and workplace is a subject that we must explore and create awareness about. Also, we must upgrade the existing government facilities for treatment and equip every big city in the province with a dedicated burns unit in the public sector,” he said.

Published in Dawn, February 29th, 2024