Low smoke zero halogen wires should be made mandatory in medical infrastructure

Shreegopal Kabra, Managing Director & Group President, RR Global shares his views on the need for strengthening of hospital infrastructure

India’s Budget allocation for Health care is a whopping 64000 Crores under the Aatmanirbar Swastha Bharat Yojana in 2021. Seen in isolation it may seem as an imposing number but in reality it is only 1.28% of our GDP while WHO recommended spend is between 4-5% for universal health coverage of any nation. Not surprisingly, India is a laggard on the Health Care Index at 44^th rank globally, behind even countries like Bhutan & Bangladesh.

If we look at the budget allocation in detail, it covers setting up of infrastructure for additional Primary, Secondary & Tertiary level facilities in areas not covered till now. There are allocations for new medical equipment, beds, health care manpower, training etc. but never addressing upgradation of standards for the upkeep and maintenance of the infrastructure already created / to be created along with the equipment.

In todays interconnected world, hospitals are closely connected with critical life saving devices which need to be continuously powered. Sadly, none of these are electrically   safe and are not designed to withstand prolonged periods of continuous operation. While the equipment / device is state of the art of today, the Electrical connectivity is powered by wires which are a few decades old in their standards. Fires accidents are bound to occur due to electrical short circuits.

International Journal of Community Medicine and Public Health (September 2020) conducted a review of 33 major fires reported in hospitals across the country between January 2010 to December 2019. The study found that the electrical short circuit with air conditioners was the most common cause of fires in hospitals. In fact in certain cases, fires originated at or near intensive care units.

There are hardly any periodic inspections that are carried out to assess critical aspects like;

• Condition of the insulation of the existing wiring
• Load on the system (how much is the deviation from its original design)
• RCCB protection and every floor or wing
• Independent isolated power supply for critical areas like Operation Theatres / MICU / ICU’s
• Where central air conditioning is not available, inspect the standalone units for its wiring (these units are not meant for continuous operation and hence are more prone to fire accidents due to heat and poor insulation.

Fire accidents in hospitals result in more fatalities since the victims are patients whose movements are limited or non-existent. Smoke is the major killer here and studies have shown that patients have died on their beds without even knowing what has affected them in the absence of timely help. Even in cases where help has arrived, the increasing toxic smoke levels and poor visibility makes it impossible to find a safe exit.

The use of Low Smoke Zero Halogen Insulated Wires & Cables should be made mandatory in every hospital as the nation moves forward in creating better medical infrastructure facilities. This is the first step in creating a circle of safety and then the requisite health care.

Government should immediately make it mandatory to change the standards for the insulation of wires from PVC to Low Smoke Zero Halogen if it desires to provide Electrically Safe health care to every citizen of India. Recent cases of Fire accidents have shown the vulnerability of our health care infrastructure and there is an urgent need to review the functioning of various bodies involved in prescribing standards.

In India, we are aware that even the strictest of measures are diluted by end-user-client-contractor nexus in Government & Private space. Unless tough steps are taken for the implementation of upgraded standards with penal action for violation, we will continue to witness fire accidents in Hospitals.