HYDERABAD: The Intensive Care Unit (ICU) at Liaquat University Hospital’s burns ward has not yet been made fully functional. The administration has placed only two ventilators in the ICU so far.

The administration seems to be trying to run the unit on an ad hoc basis by making temporary arrangements till the required number of ventilators, monitors and staff are made available to the hospital.

Though the two ventilators, along with a couple of technicians have been arranged by the administration, the ICU has remained dysfunctional in practical terms.

The doctors who have experience of working in ICUs are needed but such staff, trained technicians and essential equipment are not available.

Ad hoc arrangements made but unit remains dysfunctional

Sindh health department, however, has also not yet ordered a formal inquiry as to how the vital components of the ward, such as ICU, was excluded from the entire scheme of this burns ward that stood completed two years ago.

Following the May 30 LPG gas cylinder blast that unfolded a tragedy in Paretabad, the capacity of LUH to handle such a situation fully exposed, one again, as no fewer than 27 people, 19 of them children, had lost their lives after having been referred to Karachi’s Dr Ruth Pfau Civil Hospital and Patel Hospital.

All victims of the tragedy were admitted to the LUH but most critical among them had to be shifted to Karachi. Only stable patients with 20pc or 25pc burns were admitted in LUH’s burns ward and those needing ICU care were shifted to the hospital’s surgical ward.

It was perhaps only after the Paretabad tragedy that the LUH came to know that the ICU, provided in the scheme’s documents, was nonexistent in this ground-plus-three storey building, although burns ward had started functioning a couple of years back. It is located opposite LUH’s outpatient department (OPD).

As reports appearing in the media highlighted the miseries and difficulties faced by burn victims in LUH, its administration started scrutinising papers of scheme. It dawned upon administration that ICU’s machinery and equipment were not procured because they were not part of the SNE (schedule of new establishment.

“We had already included requirement of these equipment in an overall indent through SNE and submitted the same to government,” said an official. But, he said, this was yet to be made available as the new budget has just been passed.

Two health officers from Karachi visited LUH a fortnight back and met Medical Superintendent Dr Aijaz Abbasi to gather information. “Sindh health department has not yet ordered any formal inquiry to determine as to where the burns-dedicated ICU has gone. It was part of the actual PC-I of the building,” said a health official. “This is how the health department is treating such an important issue,” he regretted.

LUH Medical Superintendent Dr Aijaz Abbasi is on record having told Dawn that some papers of this scheme are not available that could have guided the administration on how the ICU was excluded from the SNE. LUH director administration Dr Faheem Memon had earlier stated that as per the scheme’s design, ICU was to be set up on the third floor of the building.

Now the administration has placed five beds, five monitors and “two ventilators” in the ICU which has been opened on the building’s first floor. It is yet to start functioning. “It is a technician who intubates patient in ICU. On ad hoc basis, two technicians have been arranged from other ICUs,” said one official.

According to LUH director administration, ICU needed fully-fledged human resource. “On a temporary basis staff is being arranged for the ICU,” he said, and added that the health department had been informed about status of the ICU.

Prof Memon, himself an orthopaedic surgeon, explained that 1:1 ratio was recommended for an ICU for patients. “It means one technician per bed is needed in an eight-hour shift and three for 24 hours. In HDU (high dependency unit), this ratio could be 1:2. ICU is not an easy area as it requires round-the-clock observation of patient on vent,” he said.

The third floor where ICU was originally to be established has been handed over to dental department’s maxillofacial section. Shifting of this section was allowed by the past administration and nobody objected to its shifting. “Three shower trolleys were made available to burns ward but they have not been used yet and are lying idle,” said a doctor.

MS Dr Abbasi told Dawn that he had suggested to visiting health officers that high dependency unit (HDU) should also be converted to ICU of burns ward considering the experiences of the May 30 tragedy. He said that he had informed the health secretariat officers that list of SNE was already submitted so that equipment for the ICU could be procured. “LUH even otherwise deals with patients from other district, Matiari, from where burn victims of a similar blast ended up in our burns ward,” he said. He added that only four beds could be kept in the ICU as more could cause congestion.

Sindh Health Secretary Rehan Baloch was not willing to explain his position. Several calls to him were made and a message was dropped but he did not respond. Additional Health Secretary Badar Shaikh was also not responding to Dawn’s queries, saying that he would not talk over phone.

Published in Dawn, July 3rd, 2024