“There needs to be much greater coordination between both the hospitals and with the ambulance services,” says Dr Saeed Quraishy, the Medical Superintendent at the CHK.

At present, JPMC accident and emergency department chief Dr Seemin Jamali says, the links and information dissemination between institutions is good, but is also informal. “We get most of our information [about emergencies] from the media, or from the Edhi foundation,” she says. The CDGK has an emergency response plan, but sources at the hospital, speaking on condition of anonymity, say it has not been made available to the JPMC, one of the largest public hospitals in Karachi. Sources at the CHK also confirm that while they are told there is an emergency response plan as formulated by the Sindh government, it has never been implemented at the CHK.

Other senior officials at the CHK complain of a lack of initiative on the part of the provincial government to take control of the disaster management set-up. They say that while there are district level disaster level management committees there is nothing at the provincial level. The official noted that without any provincial level committee, the point of forming the district level committees is almost entirely lost.

Officials at the JPMC say that they have never been contacted by the CDGK, the Sindh government or even the National Disaster Management Authority regarding any disaster management committees or plans. They say that while they are currently coordinating with other agencies informally, they would welcome the implementation of a formal emergency response system.

Overall, then, it appears that a large-scale, unified emergency response plan is required, one that includes all major hospitals, ambulance providers, the city government and the Sindh authorities. The Executive District Officer of the city’s government’s health department, Dr A.D. Sajnani, says that the city government is currently formulating a Karachi-wide plan, which will be made available to all stakeholders.

Dr Sajnani also says that the ‘1122’ hotline will go from being just an ambulance service to being a full-scale rescue service, with links to the fire department and police as well.

Emergency control room required

“There is no sufficient coordination between different departments when it comes to emergency response,” says a security analyst. “The police are not even under the mayor’s office, which is the way it is in almost every other major metropolitan city. The mayor’s office is the only one which can provide sufficient coordination in these matters.”

At present, the closest the CDGK has to an emergency response control room, such as the one used in Mumbai on Nov 26, is the ‘Command and Control Centre’, where authorities can watch large parts of the city through video surveillance cameras. The system was initially implemented to keep track of traffic patterns, but law-enforcement agencies have periodically been invited to use the facilities as well. At present, that coordination does not seem to exist, with the police reluctant to use the service. It has also been criticised for not having cameras at effective locations – a prime example being the ethnic violence seen in Karachi in early December, when the video surveillance system failed to aid law-enforcement authorities because no crimes were witnessed by it.

Emergency control rooms in major metropolises generally tend to be focal points of information and action. All major stakeholders of the city, including the police, the city government, the fire department, security forces and medical personnel are present and have hotlines to the control rooms of their respective agencies. Some cities, such as New York in the United States, even have a separate Office of Emergency Management.

“We have invested Rs1 billion in a surveillance camera network and emergency control room,” says Capital City Police Officer Wasim Ahmed. Mr Ahmed says the new control room will likely be established by June 30, 2009, and will provide coordination between security forces (including the police and rangers), medical authorities and the fire department. Interested parties have already made presentations to police officers in order to get the contract to handle the project, according to the CCPO.

“This technology is necessary,” says Mr Ahmed, “as all advanced countries have it. The time of conventional policing is over.”

For their part, officials with the Rangers say coordination between the Police and their agency is excellent, with high ranking officers of both agencies often formulating joint plans to deal with contingencies in Karachi. He said that the police and Rangers forces will often work together to secure the city against any mishaps.

As for the fire department, greater coordination is still required between the 13 major stakeholders in Karachi in order to provide full fire protection to the entire city, according to CDGK’s Executive District Officer (municipal services) Masood Alam. At present, several key sites at risk of fires, specifically the industrial estates, do not have their own fire fighting set ups, and depend on the CDGK’s force, which is inadequately equipped to deal with more than the 35 per cent of Karachi it is technically responsible for.