26/08/2026
Prevention Is Better Than Repentance
The tragic fire incident at PIMS today, reportedly resulting in the loss of 14 newborn lives, is deeply heartbreaking. Our prayers are with the grieving families who have suffered an unimaginable loss.
At the same time, such tragedies compel us to pause, reflect, and ask an uncomfortable but important question: what could have been prevented?
This incident took me back to 23 August 2015—almost 11 years ago—when I faced a similar fire emergency while working as a second-year resident and the senior-most duty doctor in a large NICU of a tertiary-care teaching hospital.
The NICU was a large hall with intermittent pillars. Electrical sockets and oxygen outlets were installed within the same pillars, with their main supplies running through them.
At approximately 10:25 PM, the switch of a warmer attached to one of the pillars near the main examination couch began sparking. I immediately disconnected the plug and moved the examination couch, which had three newborns on it, away from the pillar.
Within seconds, flames erupted from the pillar, where the electrical switchboard assembly and oxygen supply were located.
There were approximately 45 critically ill neonates in the NICU, and it was a night shift—when staffing is usually minimal.
We immediately organized the available doctors and nurses. Relatively stable babies were evacuated to the mother-based care area across the NICU. Security staff were alerted and instructed to secure the exits of the Gynecology Complex to prevent any newborn from being inadvertently taken out or mishandled.
The NICU in-charge and hospital administration were informed.
Meanwhile, the situation was rapidly deteriorating.
The plastic switches attached to the pillar were melting, and burning pieces of plastic were bursting out and falling onto the floor around incubators containing critically ill newborns.
Nobody wanted to approach the pillar because there was a genuine fear that the oxygen supply might cause an explosion.
I picked up a fire extinguisher and, together with my junior resident, started extinguishing the burning plastic pieces scattered around the incubators to prevent the fire from spreading further.
We then tried to extinguish the fire at its source, but the extinguisher was initially ineffective because oxygen was continuously feeding the fire.
There was only one option left: shut down the main oxygen supply.
All neonates receiving mechanical ventilation were immediately switched to manual AMBU-bag ventilation, while one of our nurses shut off the main oxygen supply.
Once the oxygen supply was disconnected, the fire extinguisher became effective, and the fire was brought under control.
By then, smoke had engulfed the entire NICU.
Doors and windows were opened to clear the smoke, and critically ill neonates were transferred to the mother-based care area along with the equipment required for their ongoing care, including incubators and ventilators.
We systematically ensured the evacuation and safety of all neonates, staff, essential equipment, and important medical records.
The second challenge began after the fire was controlled.
Our attention immediately shifted to the critically ill neonates who had previously been dependent on mechanical ventilation and were now being manually ventilated.
During the primary survey, we found a premature, low-birth-weight baby who was gasping, with a critically slow heart rate.
We performed resuscitation for approximately 30 minutes, and fortunately, the baby stabilized.
By this time, consultants and administrators had arrived and played an important role in reassessing the situation, guiding management, and coordinating the eventual return of the neonates to the NICU.
Approximately 90 minutes after the fire began, all the neonates were back in the nursery.
We were extraordinarily fortunate.
There was no loss of life, no loss of important records, and no major loss of equipment.
The following day, the entire team was invited for tea with the hospital head, who presented appreciation certificates to those involved.
I suggested that the electrical and oxygen supplies should be separated and should not be routed together through the same pillar. Combining these systems creates a potentially catastrophic risk.
Sadly, nothing changed.
Eleven years later, the lesson remains the same.
A fire does not announce itself.
An electrical fault does not wait for the day shift.
A disaster does not care whether the ward is adequately staffed.
And when something goes wrong, there may be no time left to develop a plan.
Therefore, some lessons are worth repeating:
1. Never leave critically ill patients unattended.
2. Do not leave your place of duty until the next responsible team has arrived and taken over.
3. Every hospital, ward, office and even home should have a clear emergency plan.
And importantly, the plan should not remain on paper. Practice it.
4. Patient safety must never depend solely on individual heroism.
5. Clinicians can directly influence the lives of the patients under their care. Administrators and the healthcare hierarchy can influence the safety of an entire hospital and, ultimately, a community.
6. Never compromise safety to save a few pennies.
The purpose of sharing this experience is not to compare two incidents or assign blame. It is to remind ourselves that every tragedy should become a lesson—and every lesson should lead to action.
Prevention is better than repentance.
May Allah protect our patients, healthcare workers and hospitals from such tragedies, and may He grant strength and patience to all families who have lost their precious children.
Ameen.
- The Diary of a Pediatric Nephrologist (Wednesday; 26 August 2026; 10:26 PM)
