Calcutta Corner

Absence, Presence

I am standing outside the AMRI hospital in Calcutta. It was here, today, at the break of dawn— or was it the darkest hour before it?— that men, women and children who had come here to be cured or just to be to be cared for before succumbing to some terminal illness— suffocated in their beds from the fumes of a fire that started in the basement of the building. And spread slowly and steadily before engulfing all six floors.

There were people from every sphere of life. But there was a curious omission. Before I tell you who was missing let me tell you who were there.

I spoke to ordinary citizens who thronged to the hospital premises not just as spectators but as saviours. It was they— slum dwellers who lived in the congested area behind the hospital— who first saw smoke coming out of the hospital building at 2 in the morning. They tried too enter the premises but were stopped by security guards saying things were under control.

Two hours later when they saw thick fumes gushing out of the windows they informed the police and fire department.

There were private investigators who were probing all sorts of possibilities— accident, negligence, sabotage, terrorism.

There were police, press and politicians.

Missing in action were hospital staff.

In fact, when the fire broke out…they fled leaving the patients to die. No, wait, by evening one hospital staff made a grand entrance. She had left her purse behind and had returned to collect it. Security guards weren’t allowing any one to enter the building. “It’s too dangerous, Madam,” said a security guard. “So many patients died,” she replied putting a mask on her nose to keep the carbon monoxide out, “It’s ok if I die.”

“Really? Then what stopped you from trying to save the patients who were under your care? Why did you flee without even calling the fire department?” I asked her.

She sculled away after collecting her purse but didn’t answer my questions.

What cost so many lives was not just that the fire evacuation plans were sadly lacking—the National Accreditation Board for Hospitals and Healthcare Providers (NABH) had kept the re-accreditation of the hospital in abeyance since November this year and the hospital also lacked safety certification from the Atomic Energy Regulatory Board for two new machines it had acquired —but also how ill-prepared the staff apparently was with respect to standard codes for fire safety and emergency response.

Skeletons in the Cupboard

A persistent question has been why there was so much delay on the part of the hospital to inform the fire-department. The fire was first spotted between 2.15 and 2.30am, on the third and fourth floors but the fire brigade records show that it was informed not by the hospital but by a call from a neighbour on their 100 emergency line at 4.08am as a result the first fire engines arrived only at 4:30. Not only were the minimum fire-safety standards missing, even the fire alarm had been kept switched off on the grounds that it disturbed the patients. A private investigator at the spot told me the following: “The authorities tried to hush up the matter because they didn’t want their brand image to be tarnished. I suspect, hospital staff present were told not to ‘blow this out of proportion’. That’s why the security staff didn’t allow the local people to enter.”

In our country those such as the six influential industrialists— including owners and board members of the hospital— who were arrested after the incident in accordance with Chief Minister Mamata Banerjee’s order— use their power and money to get away with murder literally. If this happens in this case as well, it would only add to the despair of the common people.. At least prima facie, not only are the hospital authorities guilty of gross negligence which caused the fire, but to try and hush it up— at the cost of lives— so that brand image would not be tarnished, is a criminality that cannot be condoned under any circumstances.

Despite the lack of safety measures, even if the local people were allowed to enter the premises and rescue the patients trapped inside at 2 am when they first saw smoke bellowing from windows, the tragedy would not have taken on this enormous proportion.

And while the AMRI fire exposes the negligence that patients admitted to Superspeciality hospitals in the country are subjected to, the abysmal state of affairs in the majority of other hospitals in Calcutta is another story altogether.

Calcutta's 9/11

On the streets of Calcutta I have never before heard any one topic discussed as much or by so many different people at so many different places as the fire at AMRI. People walking down the street talking on their cells. People on the bus and in the bank. People in restaurants and restrooms. Someone called it “Calcutta’s Nine-Eleven” and “Corporate Terrorism”.

A Fire That Burns Within

And like the smoke bellowing out of the glass panes smashed open by fire-fighters, in the haze of the lingering carbon monoxide that is permeating the air, memories rush back.

Memories of when my father was admitted to AMRI. He had cardio pulmonary obstructive disorder and was unconscious when he was put on a life support ventilator. Nothing perhaps is more traumatic than to witness a loved one in pain. It is the one time that you are so emotionally vulnerable that the slightest act of insensitivity can leave indelible psychological scars. That is from the point of view of family— and friends.

I don’t know what is like from the point of view of someone who is lying in a cold and clinical ICU room. But it was at AMRI that I first experienced the notorious insensitivity of Calcutta hospitals. It was clear that making money from each patient was the prime interest and doctors, nurses and other staff were all seeing each hospital admission as another source of income. That too could be tolerated if they made some effort to be gentle with patients and families at a time when they are at their most vulnerable physically and emotionally.

To give you an example, I asked AMRI doctors, nurses and other hospital staff to let one of us be there so that when my father came through— in a dark, unfamiliar room full of unknown people in varying stages of illness on ventilators and oxygen cylinders and other menacing-looking machines— so that he wouldn’t be traumatized. But that was not done. And not just my father, I saw other fathers and mothers, husbands and wives, siblings and children stunned and shocked because of the callousness that prevailed. In the ICU, in the cabins and wards.

I found doctors and nurses talk callously in front of patients discussing how hopeless their conditions were as though they were already dead. One doctor scolded a woman who was dying of septicemia because she was howling and wanted to see her husband who was waiting outside and crying. I found nurses laughing about the number of tubes attached to a dying patient right in front of him. I used to break down after each visit not because of the sickness all around and the suffering that was perhaps beyond our control but because of the suffering inflicted on humanity by people who are in control and are supposed to care.

No, I don’t know what is like from the point of view of someone who is lying in a cold and clinical ICU room.

As dawn broke on Friday December 9 and a fire spread silently choking 90 such helpless people to death I just hope that no one ever has to know what it is like.

Ghare, Baire

I had once been hospitalised when I lived in the US. In terms of the money spent I don’t think AMRI charged any less in comparison than the bill incurred then. But the difference was in the way the doctors and nurses treated me and my family at George Washington Hospital. I felt like I was at home. The doctors and nurses always smiled and spoke kindly. Some will argue that the staff in my own country are over-worked and under-paid. First of all, that is not an excuse for inhumanity. And second, Superspeciality hospitals like AMRI which charge exorbitant rates, should not keep their staff under-paid and over-worked.

I hate to think it— far less say it— but it will take a long time for us to call ourselves a Superpower. You can’t be a Superpower— or a Super-special anything— only in name.