Twin negligence : On the Jhansi hospital fire

Jhansi tragedy is a result of neglecting fire safety and health care

The fire in the neonatal intensive care unit of the Maharani Laxmi Bai Medical College in Jhansi district, Uttar Pradesh, where 10 newborns died on November 15 night, underscores the fatal intersection of severely neglected sectors in government budgeting and planning — health care and fire safety. There was an eerily similar incident in May this year, in a hospital in east Delhi. The neonatal care unit in Jhansi was operating at almost three times its capacity — there were 49 babies for incubators meant only for 18. Hospital staff have said that this number sometimes goes up to 60. This must not surprise given that in 2021, the doctor-patient ratio in U.P. was 1: 2,158. A point to be noted is that India’s doctor-patient ratio for 2024 is 1:836, which is well within the World Health Organization recommendation of 1:1,000.

Established in 1968, the Jhansi hospital is the main health-care facility serving Bundelkhand, an impoverished region of about 10 districts straddling U.P. and Madhya Pradesh. Despite a patient flow of over 5,000 a day, several wings of the hospital have remained in a dilapidated state. While multi-level investigations have been announced by U.P. Chief Minister Yogi Adityanath’s government, initial reports suggest an electric short-circuit could be the cause, exacerbated by oxygen cylinders in the care unit. According to National Crime Records Bureau data, 101 people died in 106 incidents of electrical short circuit-induced fires in U.P. in 2022, ranking it the fourth highest in fatalities after Odisha, Maharashtra and Bihar. In an editorial this year, “ Insidious, incendiary ”, this daily highlighted the chronic disregard for India’s fire safety norms: “Fire services are not well organized in India”, it said, adding that “In recent years the requirements for fire safety cover have increased manifold whereas the development of fire service has not made much headway”. In the Union Budgets of FY2022 and FY2023, there was an allocation of a mere 2.2% to health care, which declined to 1.75% this year. This is severely inadequate even when compared with spend by India’s peers among developing countries such as Brazil and South Africa. India’s public health expenditure was 3.3% of GDP in 2021. This is lower than the global average for developing countries, where public health spending often ranges between 2% to 5% of GDP. Brazil and South Africa typically allocate approximately 10% and 8% of their GDP to public health. It may, therefore, be safe to wager that even while investigations are underway, a broader indifferent approach to both public health and fire safety together led to the tragedy in Jhansi.