City Hospitals have few Crisis Management Mechanisms in Place

Times of India
By Prasad Kulkarni & Umesh Isalkar
Pune, India

Judging by the state of our hospitals and their disaster fighting mechanisms or lack thereof, it appears our health care structures are rather vulnerable to natural and man–made disaster.
This year’s theme for World Health Day is ‘Save Life. Make hospitals safe in emergencies’ and TOI interacted with the authorities of both government and private hospitals, to see what kind of measures they had in place to deal with disasters, including floods, bomb blasts or earthquakes, and how capable they are of serving those in immediate need of attention.

Most of the main hospitals in Pune are in old structures, which means they are vulnerable to natural disasters. The list of such hospitals includes Sassoon general hospital, Pune Cantonment Board hospital and the Pune Municipal Corporation–run hospitals, dispensaries and maternity homes. Some of these buildings were built during British rule, and some of them are more than a hundred years old.

“We are working on a plan to strengthen the Sassoon hospital building by introducing a few relevant modifications. The public works department (PWD) will soon be asked to do modification work,” P S Pawar, superintendent of Sassoon hospital told TOI.

Pawar was of the view that the older parts of the hospital are robust and well–fortified, it was the newly–constructed parts that might require modification.

As far as tackling man–made disasters, including bomb blasts, Pawar pointed out that steps are being taken to put things in place. “The manpower to keep a check on suspicious activities in Sassoon hospital has been increased. Even private security guards have been appointed to add security,” he said.

As for the other hospitals, modification does not feature on their agenda at all. S M Mahajan, resident medical officer (RMO) of Sardar Vallabhbhai Patel Cantonment general hospital said, “At present, we don’t have any plans to strengthen the structure as per WHO norms of disaster management.” He said the hospital comprised both new and old buildings. Some of the buildings have been built in 1928.

“We will take measures to make the new buildings earthquake–proof but right now the hospital has no plans to strengthen the building,” said Mahajan.

The Pune Municipal Corporation (PMC) also doesn’t seems to have given any thought to modifying the buildings of civic hospitals. “At present, we have no plans as there are other medical requirements that need urgent attention,” said V M Satarkar, assistant health officer of the PMC. He said that the buildings of newly–constructed civic hospitals including the Kamala Nehru hospital had been built as per the disaster regulatory norms.

When contacted, D S Dakhore, director of state health services told TOI, “A draft enabling health systems to keep functioning through a disaster, with immediate and future public health consequences is being discussed with the chief minister of the state. With this, we have already started taking steps to brace the clinical establishments to survive a disaster and function through it.”

While many old structures are not disaster–resistant, newly–designed structures have supposedly been built in order to sustain natural disasters. Senior orthopaedic surgeon K H Sancheti told TOI, “We have built our hospital as per international disaster management norms meant for health care facilities. We have used anti–vibration pads at the base while constructing the building, which prevents the vibrations caused by earthquakes from entering the columns of the hospital building.”

Throwing light on regulatory rules meant for building hospitals in India, Sancheti said, “There are rules for ensuring safety for internal fires etc, but there are no regulatory rules fortifying the hospital building for natural calamities like an earthquake or a cyclone.”

On whether older structures could be modified to suit requirements, architect Anagha Mujumdar said, “All types of old structures can be modified to sustain disasters. It is possible to increase the strength of the building foundation to make them disaster resistant.”