On
Page 6 we
publish a report on a disturbing fire in the Philippines capital Twentynine
people were killed when fire broke out in the intensive care unit
of Manila's Lung Centre
and spread through the
three storey building .
At
the very least,
the establishment seems to have been ill prepared - hundreds of patients,
many of them still connected to medical equipment, were evacuated into
the car park ;
staff have claimed that
due to power failures,
evacuations had to be
conducted using cigarette lighters
and that there were not
enough wheelchairs to evacuate all the patients.
The
hospital had no sprinkler system, fire hydrants, few fire extinguishers
and
not
many fire exits.
Subsequent
inspections in
Manila found severe deficiencies in 29 other hospitals
common failures included
lack of sprinkler systems, smoke detectors, emergency lighting and hydrants.
In
July, we
reported on the flaws in legislation, enforcement and funding of fire safety
in Italy's hospitals that have come to light after 11 people died in a
hyperbaric chamber at a private institute in Milan.
An Italian association
for promoting safety at work said:
"Managers of hospitals
are generally doctors, rather than engineers, and as a consequence,
they pay more attention
to health issues than to safety issues."
This
view seems
to have been reinforced by hospital fire safety experts as they gathered
to discuss this issue
at Health Fire International
98 (see page 43). One survey on fire evacuation in Britain's hospitals
found that
reasons cited for not
carrying out evacuation training included objections from clinicians,
administration managers
and ward staff. Interestingly,
five percent said that
the reason for not carrying out such training was
concern about litigation.
Others
say that some
managers of health care institutions consider emergency management structures,
staff emergency training,
emergency action plans and fire drills both difficult to carry out when
running a busy
hospital, and not necessarily
cost effective.
But
what about the loss of life
and of expensive medical equipment?
The risks in hospitals
are high any where in the world. Often these establishments are housed
in converted older buildings not necessarily designed for that purpose.
The presence of hazardous materials and other chemicals. Oxygen, nitrous
oxide, combustible (and expensive) medical equipment and sup0plies, large
quantities of bedding , laundry and cooking facilities,
a mass of electrical power
supplies and wiring all in an environment that must be precisely controlled
in many fixed areas - compound the fire protection problem.
And
added to this are the
patients themselves. Patients are already stressed, disabled or incapacitated
by
their ailments, and are
often worried, disorientated, distracted.
They will have a poor
knowledge of the hospital's layout and
tend to suspend their
usual instincts of self preservation,
They have, quite literally,
put their lives in the hands of others.
And patients can cause
fires…
This is claimed to be
even more true when mentally disturbed or geriatric
patients are involved.
In
many countries the
statistical incidence of fatal fi4res tends to belie the sometimes
appalling
lack of precautions. It is , nevertheless, true that sooner or later, circumstances
will combine to create another tragedy like that in Manila, which could
be avoided or,
at
least, mitigated,
It
is the duty of all those concerned in health care
establishments
to focus not only on the health matters of those in their care,
but
of the right of patients to be safe from fire.
Emily
Hough
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