HYDERABAD: Unavailability of intensive care unit (ICU) in the burns ward of Liaquat University Hospital (LUH) has become a mystery.

Record of the ICU-related paraphernalia is not present in the hospital’s record. The management finds it hard to solve the riddle as to how ICU equipment were not procured despite being part of the approved Project Cost-I (PCI) of the annual development scheme of the LUH.

Even in the aftermath of the May 30 Paretabad tragedy, when LUH administration could not undertake treatment of the patients arriving in the ward, no inquiry has been initiated either by the health department or the LUH management itself as to why this vital ICU is nonexistent in the ward. LUH administration got the flak from patients’ relatives for failing to treat their dear ones.

Neither Health Secretary Rehan Iqbal Baloch nor Additional Health Secretary Badar Sheikh appeared ready to explain the shortcoming.

However, LUH Medical Superintendent Dr Aijaz Abbasi, speaking to Dawn argued that he was posted only recently whereas the scheme was executed years ago. “The matter was dealt by an administration of the past, but after the May 30 tragedy, I have somehow arranged a few monitors and ventilators for the burns ward to make the ICU functional,” he said.

Factsheet

The scheme papers seen by Dawn show that the ‘burns dedicated ICU’ has remained a curious case. An LUH official confirmed on the basis of these papers that under the scheme, the ward was supposed to be a ground-plus-three storey building as provided under the 2016-17 scheme. Its layout papers bear the signature of Dr S.M. Tahir, an associate professor at the Liaquat University of Medical and Health Sciences (LUMHS) who had headed LUH burns ward over the last two decades.

Administration finds procurement documents missing from record

According to the scheme’s design, the third floor has provision for the ICU. But when scores of fire victims started arriving at the LUH on May 30, the fact came to light that the ICU never existed there. It was only then that an ad hoc arrangement was made to create an ICU facility only for the less affected patients following a hue and cry by their relatives.

The media also questioned referral of most of the 63 burn victims to Karachi’s Civil Hospital and private Patel Hospital due to the absence of a properly equipped burns ward and ICU at the LUH to handle critical cases. Delay in the treatment caused in the travel to Karachi appears to be one factor in the death of many of the 27 people, most of them children, in the tragedy.

‘Urgent’ but belated measures

“We have now arranged three ventilators from paediatrics ICU and also procured four monitors from a vendor [soon after the tragedy],” said Prof Dr Faheem Memon, who is LUH’s director administration. He revealed that “correspondence and papers between PC-I and PC-IV are missing from the record; we are unable to find them to know why the ICU component is missing even after handing over of burns ward’s building to the hospital”.

Hospital sources said that only a covering letter for the modified PC-I document was available. “It is not understandable that the government may have exclude the ICU component, along with its machinery, from the entire scheme. ICU is the most sensitive component and has always been a top priority of government,” said a source.

Heads had rolled after previous incident

Medical Superintendent Dr Aijaz Abbasi told Dawn that, in fact. requirements of the ICU were not mentioned in the tendering process undertaken over the past years when then LUH administration officials were solely looking after the scheme, which stood completed in the financial year 2020-21.

The administration had started admitting fire victims in the new burns ward building in early 2023, i.e. several months after seven family members of Ravi Tanoli — a leader of the hospital’s paramedics — lost their lives in a fire that had broken out in his house in August 2022. The victims, with critical burn injuries, were rushed to the LUH but had to be sent to Karachi because the hospital’s burns ward was devoid of relevant facilities.

“The existing ward had actually started functioning after this particular incident,” Tanoli had told Dawn during Governor Kamran Tessori’s recent visit to the LUH to inquire after the health of Paretabad tragedy survivors.

Published in Dawn, June 12th, 2024