Jhansi hospital fire: A chronicle of criminal neglect

Overcrowded NICU, expired fire extinguishers, and absent staff led to 15 infant deaths in Uttar Pradesh’s premier medical facility.

Parents and family members of children who were rescued from the fire resting outside another ward of the hospital where their children have been shifted. | Photo Credit: A.M.FARUQUI/The Hindu

The fire at the neonatal intensive care unit (NICU) of State-government-run Maharani Laxmi Bai Medical College in Jhansi, Uttar Pradesh, on November 15, which tragically claimed the lives of 10 newborns, is a glaring example of systematic neglect in both healthcare and fire safety. It reflects the institutional indifference to the most vulnerable: premature infants from impoverished families.

The fire broke out at around 10.10 pm in the NICU, a facility designed to accommodate 18 beds but was overcrowded with 49 newborns. Amid the chaos and suffocating smoke, 10 babies died either from burns or suffocation. By November 18, two more infants succumbed and between the night of November 19 and the evening of November 20, three additional deaths were reported, bringing the total death toll to 15. According to hospital staff, the babies did not suffer burn injuries or suffocation but died from the illnesses for which they were initially admitted. 

Currently, 22 to 23 newborns have been shifted to a newly inaugurated Pediatric Intensive Care Unit (PICU), which has been converted to a temporary NICU, while a few have been discharged. 

For Pradeep and Nancy, the relief of taking their baby home was overshadowed by the harrowing trauma of the past few days. On the night of the fire, they were sitting outside the NICU when panic and chaos erupted. In the confusion, their baby went missing. 

“I couldn’t find my baby the entire day; we were in mourning,” Pradeep said. “In the end, we found out he was in Lalitpur, almost 100 km from Jhansi. There was so much chaos that whoever found him just took him with them. It was only when the doctors checked the babies that we realised that our baby wasn’t here because the Lalitpur baby had passed away in the fire. The parents there were then asked if they had taken a baby, and only then, 24 hours after the accident, we got him back.” 

The couple attributes their child’s survival to sheer luck. “My baby was admitted for pneumonia and had been taken off oxygen the day of the accident. That’s why he was closer to the exit and was saved,” Pradeep explained.

For Vishal, however, it will be a while before he can heave a sigh of relief, as his niece continues to fight for her life in the NICU. “She is just 20 days old, born prematurely at seven months. Originally, she was admitted to a private hospital, but she was referred here,” he told Frontline. He believes the smoke has severely impacted the babies’ lungs and they have remained on oxygen ever since the accident.

Both Vishal and Pradeep were present at the time of the fire and, along with others there, turned into rescuers, risking their own safety. “There wasn’t much staff present at the time of the incident, and even the guards were absent,” Vishal recalled. “Due to almost three to four babies being put on a single ventilator, the machines appeared to have overheated. With the ample oxygen in the room, it didn’t take much time for the fire to spread everywhere.”

Approximately 24 newborns were in the rear end of the ward, and only a few could be rescued. Parents, doctors, and nurses had to break the windows to pull out the babies, most of whom had already suffered burns by then. The parents waiting outside the ward sprang into action as soon as they realised the building was on fire. “All those present immediately started the rescue. We didn’t see whose baby it was we were saving,” Pradeep recounted.

Charred remains inside the Neonatal Intensive Care Unit are seen after a fire on November 16, 2024. | Photo Credit: PTI

Crawling through the ward with two handkerchiefs tied around his face, Vishal entered the blazing unit in a desperate attempt to rescue the infants. “Newborn babies look similar, and I just tried to rescue every baby that I saw. I wasn’t fixated on saving my kin alone,” he added. 

The absence of functional safety equipment only added to the disaster. “The fire extinguishers in the neo-natal ward were empty, so we had to fetch the ones from the women’s ward. However, those cylinders had also expired and were ineffective,” Vishal said. “The fire extinguishers were empty and there was no water in the fire hose. If there was proper maintenance, this incident would not have happened,” Pradeep said. 

The lack of safety measures was not limited to the NICU. Frontline found several fire extinguishers in the hospital that were long past their expiry dates.

Technical failure

President of the Junior Doctors’ Association and PG Department In-Charge, Neeraj Sharma, stated that the fire accident was caused by a short circuit, not human error. This explanation was supported by the Chief Medical Superintendent, Sachin Mahor, who said, “It is proven that the fire occurred due to a spark in the extension board, and due to the oxygen-rich environment, it spread rapidly. These ICU rooms cannot be open and well-ventilated as we have to maintain the temperature of these rooms.”

The Uttar Pradesh government has formed a four-member panel to investigate the incident. The panel, led by Kinjal Singh, Director General of Medical Education, includes the Director General of Health, a fire officer, and an electrical officer. “The panel conducted inspections at the site of the incident, assisted by fire and electrical experts. They visited the location and questioned hospital employees, doctors, and officers deemed potentially responsible for the incident,” Dr. Mahor told Frontline. The panel, he added, was formed on November 16 and was given seven days to submit a report.

Regarding concerns about the fire extinguishers, Dr. Mahor rejected the allegations that they were empty. “The NICU, where the fire occurred, had the capacity for six extinguishers, all of which were refilled earlier this year, between March and April,” he claimed.

The hospital’s overall condition is dire, with any improvements to the NICU described by Vishal as “superficial and merely to appease the inquiry panel”. The rest of the facility remains dilapidated, reflecting systemic neglect. | Photo Credit: Vedaant Lakhera

Dr. Sharma, who was posted in the new NICU, explained the vulnerability of these units. “A NICU is a very sensitive department. The body temperature of newborns is lower, so we have to maintain that temperature. It is not possible to do that in a place that is open and ventilated. The babies are always kept in a closed space. The presence of concentrated oxygen further elevates the risk of a fire.”

This susceptibility is not unique to Jhansi. A similar incident occurred earlier this year in May when a fire broke out in a private neonatal clinic in East Delhi, claiming the lives of eight newborns. In both cases, the combination of confined spaces, high oxygen concentration, and electrical equipment amplified the risk of fire.

At the Jhansi hospital, however, the centralised oxygen supply system in the NICU helped avert a greater disaster. “In the ICUs here, the oxygen supply comes directly through pipes, so no cylinders are used in the NICU. This setup improves efficiency in providing oxygen to babies and also eliminates the risk of cylinder blasts,” Dr. Sharma said. 

The NICU shares a wall with the labour room, where large oxygen cylinders are stored. A gynaecologist on duty, speaking on condition of anonymity, told Frontline, “It was us doctors who moved the oxygen cylinders outside with the help of attendants. We had to act on time otherwise the labour room would have also caught fire and the cylinders could have burst.” The doctor added that at the time of the incident, there were 40 patients in the labour ward who had to be evacuated. “The neonatal ward had no fire exit. There was only one entry-exit point. People had to break the windows to rescue the babies.” The congested location of the NICU also posed challenges. “The ward is built in such a tight space that even the fire brigade couldn’t enter the premises.”

The temporary NICU, where the rescued babies are now being treated, looks no better. Situated on the second floor, the narrow corridors are overcrowded, with families of the babies staying there round the clock. Dr. Sharma admitted to the shortcomings of the temporary setup: “We have done our best to manage [the situation] right now but there are obvious lapses. This setup was created within four hours of the accident. Conditions are dire: people are sleeping on the floor, and there is barely space to walk.”

The neonatal ward where a tragic fire killed ten newborns on November 15 is now under investigation. | Photo Credit: Vedaant Lakhera

Vishal criticised the recent interventions, calling them superficial measures designed to appease the inquiry panel. “The committee visited the ward today, and just before they arrived, beds were brought in for the mothers and family members. Before that, even women who had recently delivered babies slept on the floor. The tube lights in this ward were installed only yesterday. The ward was dirty, the lighting was poor, and the washrooms were in a dreadful condition. But today, everything has been cleaned,” he said. These actions were merely for show, he said, adding, “If you conduct a surprise check in any other department, you will find them in a terrible condition.”

Ironically, the walls of the medical college are pasted with fresh posters about fire safety and emergency helplines, which seem to be new. Anurag Sharma, a Member of Parliament (MP) Lok Sabha from the Jhansi-Lalitpur constituency, from BJP, said, “We must be able to anticipate and prepare for such incidents. Whether in government medical colleges or in private institutions, such lapses are unacceptable,” he told Frontline. “In this country, we are always reactive, only waking up once such incidents occur. There should be strict minimum standards in place that must be aggressively followed.”

Dr Sharma, however, spoke of the strain on public health infrastructure. “We know that there are norms, but it is difficult to enforce them when you see the background and the number of patients. We cannot turn anyone away. Unlike private setups, we have to admit every patient. There is immense pressure on government hospitals.”

Overburdened resources

“Jhansi Medical College is a mini-AIIMS,” he said. “Being one of the only major hospitals in the entire Bundelkhand region, it caters to 10 to 12 districts of Uttar Pradesh and five to six districts of Madhya Pradesh. The burden on this hospital is unimaginable.”

Uttar Pradesh Deputy Chief Minister Brajesh Pathak talks to the bereaved family members during an inspection after the fire broke out inside the NICU. The incident exposed the institutional indifference to the most vulnerable: premature infants from impoverished families. | Photo Credit: PTI

Dilip Jha, the Deputy Project Director at the Public Health Foundation of India, underscores a significant gap in the nation’s approach to fire safety in healthcare settings. “We still don’t have a system where certification is mandatory and where those responsible for certification do proper assessments. Certifications should only be granted if it is certain that every precaution has been taken. When major electrical overhauls are made, are they certified by the fire and electrical departments from a fire safety point of view? I think those systems are really lacking,” Jha said. He also pointed out that government hospitals, in particular, had become frequent offenders in the wake of several recent fire-related incidents.

Jha emphasised the critical need for comprehensive drills and training for healthcare professionals, arguing that proper fire safety training can make the difference between life and death, especially in an ICU where the patients are immobile. Apart from that, according to him, given that most medical equipment uses electricity, there is an urgent need for medical staff to understand how much load each piece can take.

Jha suggested that while overcrowding may be an unavoidable reality, proper planning and basic safety measures can exponentially prevent fire accidents. “Even if there’s overcrowding, we need to take care of basic things. Even in your house, it does not matter how many people live there, if the electrical system is secured as per the load you won’t have an electrical fire. The government agencies or fire safety department should ensure that such lapses do not occur.”

In the wake of this tragedy, the Uttar Pradesh government has announced financial assistance of Rs. 5 lakh to the parents of the infants who lost their lives, and Rs. 50,000 to the family members of the injured from the Chief Minister’s Relief Fund. Prime Minister Narendra Modi also announced an ex-gratia of Rs. 2 lakh from the Prime Minister’s National Relief Fund for the kin of the deceased. While this financial assistance offers some immediate relief, it pales in comparison to the immense loss suffered.