Hospitals pose bigger risk than other buildings

The recent fire in AMRI hospital, Kolkatta, brings to light the lack of proper safety standards in our hospitals. As per GHMC sources and the director general of fire services, many hospitals in Hyderabad and Ranga Reddy districts do not have the required fire safety norms. If this is the situation in the capital, we can only imagine the condition of hospitals in other parts of the state.Hospitals pose a major fire risk compared to other commercial buildings. They deal with medical gases which can be ignited and laboratories which use inflammable materials and also house immobile patients, hearing impaired, visually impaired, speech impaired and other differently-abled persons. As per the National Building Code (NBC) of India, people should be shifted to a safe place within three minutes of a fire occurrence. It is impossible to evacuate all the patients from the entire building in a short time. Only shifting them from the affected area to a safe location within the hospital can be contemplated.Fire safety consists of five elements--fire prevention, detection and alarm, compartmentalisation, fighting, and evacuation. All these are absolutely necessary to ensure safety of people and property. Internationally, it is recognised that 1/3rd of fire accidents are due to electricity-related problems, 1/3rd due to negligence and the rest due to arson. But in India, 56 percent of fire accidents are due to electrical problems, which are caused by old and poor quality wires and poor cable insulation, overloading and temporary installations.As per IE Rule 61A, residual current circuit breakers (RCCBs) are mandatory for three-phase installations of above 3 kw and single-phase installations above 5 kw.  However, at many places, they are either not provided or bypassed due to nuisance tripping. If RCCBs are provided, they trip the power supply on electrical leakages and ensure life and fire safety. Fire detection systems are mandatory for all hospitals and nursing homes of ground plus two floors. Smoke and heat detectors can give an alarm in case of fire and alert people for evacuation.Many of deaths in case of fire happen not due to burns but due to asphyxiation.  As high as 57 percent of deaths occur at places where the fire has not spread but smoke has.  Hence, compartmentalisation of space is a major requirement for hospitals so that fire in one compartment is contained and the fire or smoke does not spread to other compartments. Each compartment shall be separated by two-hour fire-rated walls and automatically closed fire-rated doors.As per NBC, the size of each compartment shall not exceed 750 sq m and if fully sprinkled 1,125 sq m. Each compartment shall have means of smoke venting either naturally or mechanically.Fire fighting systems with hydrants and hose reels are mandatory for hospitals of ground plus two floors or more. A fire water reserve sump of 50,000 litres to 1,50,000 litres capacity, which is always filled with water, is required for hospitals. The capacity depends on the number of beds and the height of the hospital.Fire extinguishers are essential for all hospitals and be located at all important places, within a distance of not more than 30 metres. Automatically operated fire sprinklers shall be provided in the entire hospital if the height is more than 15 metres. Now, in USA and UK, it has become a practice to install sprinklers for even residential buildings of more than two floors.Having fire fighting systems alone will not suffice to ensure safety of people. Minimum two fire exit staircases, each two metre wide, are mandatory for evacuation. Also six metres of fire vehicle access around the building is a must. Besides all the systems and means of exit, a proper emergency action plan, training of individuals on fire safety and evacuation practices and conducting regular fire drills are necessary. Unfortunately in India, trained manpower for fire safety and also the awareness levels are very low.NBC has restricted the height of hospital buildings to 30 metres, but the state government has increased it to 60 metres with additional safety precautions. It remains to be seen how these high-rise hospitals ensure fire and life safety.(The author is a member of the national executive committee, Fire and Security Association of India.)