PIMS tragedy: Making hospitals fire-safe before disaster strikes again
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Sultan Kiani
Hospital fire safety is essential to protecting patients, especially those who depend on staff for evacuation and care. Preventing tragedy requires reliable safety systems, trained personnel and consistent enforcement of precautions.
August 3, 2026, was a tragic day as a fire engulfed the NICU at PIMS, the capital’s central government hospital. The fire quickly intensified due to the medical oxygen supply, making evacuation nearly impossible. Hospital staff could rescue only one of the 15 infants admitted to the NICU, bringing the total death toll to 14. The fire, which received global media attention, was neither the first nor the only incident of its kind. Several fires have been reported in Neonatal Intensive Care Units (NICUs) in Pakistan and other parts of the world. In June 2024, a similar devastating fire killed 11 infants admitted to Sahiwal Teaching Hospital. In June 2012, another fire incident gutted the children’s ward at Services Hospital in Lahore, resulting in 4 fatalities and leaving 24 others with smoke inhalation and burn injuries. Other notable recent fatal fire incidents outside Pakistan include Bhandara District Hospital, Maharashtra, India (2021); Vivek Vihar, New Delhi, India (2024); and Tivaouane, Senegal (2022).
Although the government has responded with seemingly extensive hospital fire safety reforms across the country, they appear to be more symbolic and short-term than genuinely effective. The PIMS tragedy occurred 14 years after the 2012 Services Hospital incident, which was also investigated and led to similar safety reforms being recommended. Nevertheless, administrators failed to consistently enforce fire safety regulations over the past one and a half decades, contributing to multiple hospital fires in the meantime, some of which proved fatal. Therefore, it is extremely important to examine the root causes of the problem to find a sustainable solution.
The initial inquiry report into the recent PIMS NICU tragedy revealed that the disaster could have been prevented if basic safety protocols had been followed. A faulty air conditioner started a small fire, which went undetected due to the absence of smoke detectors. This delay wasted precious seconds that could have been used to suppress the blaze or, at the very least, evacuate the patients.
Fire is a universal hazard, yet hospitals require special attention to fire safety for several important reasons. Medical facilities store potentially flammable and combustible materials, such as bandages, surgical cotton, and alcohol-based disinfectants. While medical oxygen does not burn itself, it can greatly accelerate combustion, turning a small fire into a massive inferno. With such fire hazards present, even a minor source of ignition can trigger a deadly blaze! Electrical short circuits, overheating equipment, and sometimes even static sparks can become effective sources of ignition. Poorly managed hospitals are at high risk of fire because they not only store flammable materials in a haphazard manner but also have faulty electrical systems and equipment that can malfunction and become sources of ignition. Furthermore, many hospitals in developing countries lack adequate fire detection and firefighting systems and sufficient, functional emergency exits. The majority of hospital staff are also unprepared to respond to emergencies that may require immediate evacuation. The PIMS incident inquiry report also pointed out fatal flaws in emergency preparedness. The NICU staff panicked, the emergency call for help was delayed, and when firefighters eventually arrived, security staff refused to open the door, forcing the CDA Fire & Rescue team to wait at the gate for several minutes before being allowed to enter. All these unsafe practices turn a hospital into a death trap in the event of a fire. Unfortunately, such incidents are very likely to recur unless the underlying causes are effectively addressed in the long term.
Having identified the causes of this serious public safety issue, it is equally important to suggest practical measures to prevent hospital fires in the future. Here, we recommend some key fire safety reforms to reduce the risk of such fatal incidents in hospitals:
Launch a comprehensive hospital safety audit to identify major fire hazards, beginning with main healthcare facilities in Islamabad, Lahore, and Karachi before expanding it to other cities across Pakistan. This could greatly help identify the types of hazards and the required mitigation measures to address them.
All electrical equipment used in hospitals, particularly ICUs, must meet fire safety standards and be installed only by qualified technicians. Any electrical repair or maintenance work may be performed only by a certified and experienced technician under the supervision of hospital officials.
Hospitals must meet the minimum fire safety requirements as specified by regulations. This may include the installation of smoke detectors, fire extinguishers, automatic sprinklers, and fire hydrants.
There must be sufficient and clearly marked emergency exits to facilitate quick and safe evacuation in the event of a fire. Emergency exit doors should be equipped with security alarms and monitored by surveillance cameras to prevent unauthorized entry while ensuring that they remain unobstructed for their intended use.
Hospitals house vulnerable persons, such as critically ill patients, persons with disabilities, older adults, and young children, who cannot escape on their own during an emergency. Therefore, emergency exits should be designed to accommodate wheelchairs and stretchers, facilitating the safe and efficient evacuation of vulnerable individuals.
It is very important to train hospital staff in the safe use of fire prevention equipment and in emergency response procedures. Everyone should be aware of their roles and responsibilities in emergency situations, including alerting others to a potential fire, extinguishing a fire when it is safe to do so, notifying emergency services, and initiating the evacuation process. These actions can make the difference between life and death. Government departments such as provincial emergency services (Rescue 1122) and CDA’s Emergency & Disaster Management Directorate can help train hospital staff to prevent fires and minimize loss of life.
Periodic and surprise fire safety inspections should be mandatory at all hospitals. This is to ensure that the recommended safety measures are not only followed occasionally or shortly after a tragic incident, but are consistently implemented and maintained over time.
In addition to safety inspections, hospital administrations must also conduct periodic fire drills to evaluate staff competence during actual fire emergencies. These drills can help identify shortcomings in fire detection and suppression systems, as well as potential obstacles to the safe and timely evacuation of the hospital building.
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