The PIMS neonatal ward fire has once again exposed weaknesses in electrical safety, emergency evacuation, fire preparedness and institutional accountability. But Pakistan’s larger problem may be what happens after the inquiry.
On August 26, 2026, a fire at the Pakistan Institute of Medical Sciences (PIMS) turned one of the country’s lar-gest public hospitals into the scene of an unimaginable tragedy. Newborn children patients who could neither walk nor call for help were among those who lost their lives.
For Pakistan’s healthcare system, however, the incident raises a question that extends far beyond one hospital, why does the country repeatedly identify safety failures only after lives have been lost?
The federal government responded by constituting a high-level inquiry committee to determine the cause of the fire, establish responsibility and examine whether any conduct amounted to criminal negligence.
Several senior PIMS officials were subsequently removed from their positions, including the Executive Director, the Head of Neonatology at the Children’s Hospital and an Assistant Director for Security.
Such measures may be necessary for accountability. But administrative action alone cannot resolve a systemic safety problem. The more troubling question is why the same deficiencies continue to appear in hospital fire incidents across Pakistan.
The answer may lie in a familiar cycle: a tragedy occurs, an inquiry follows, deficiencies are identified, responsibility is assigned and then institutional memory fades until the next emergency.
A Pattern, Not an Isolated Incident
The PIMS fire did not occur in a vacuum. Pakistan has witnessed a series of hospital fires over the past several years, ranging from incidents causing equipment and infrastructure damage to fires in which patients, newborns and hospital employees lost their lives.
The following selected incidents, reported by publicly available sources, illustrate the recurring nature of the problem:
In the pattern becomes more concerning when PIMS itself is considered. The hospital experienced another fire in its Female Nursing Hostel on July 6, 2026, only weeks before the August tragedy.
According to the Prime Minister’s inquiry findings, an earlier inquiry had already identified deficiencies relating to fire detection, alarm systems, evacuation preparedness, electrical inspection, security response and record keeping. That should force a more uncomfortable question than simply asking who was responsible for the latest fire: What happened to the recommendations of the earlier inquiry?
If deficiencies had already been identified, why had they not been completely rectified? This is where Pakistan’s hospital-safety problem becomes larger than any individual incident.
The Inquiry Cycle
In the aftermath of a major accident, accountability is under-standably demanded. Families seek answers, authorities launch investigations and officials are asked to explain what went wrong. But an inquiry should not be the end of the process. Its real value lies in preventing recurrence.
A functioning safety system should operate through a continuous cycle:
Incident → investigation → corrective action → independent verification → monitoring → prevention.
The danger is when the cycle stops at investigation. Pakistan does not appear to suffer from a complete abse-nce of committees, rules or standard operating proce-dures. The greater challenge is ensuring that recommen-dations are translated into physical improvements, tested through drills and independently verified.
A hospital may possess a fire-safety manual, but that manual has little value if staff do not know who activates the alarm, who contacts emergency services, who assu-mes command, who unlocks emergency exits and who is responsible for evacuating patients who cannot move independently.
The PIMS inquiry itself reportedly highlighted precisely these kinds of gaps. The lesson is therefore not simply that hospitals need more SOPs.They need functioning safety systems.
Electrical Infrastructure: The First Line of Defence
Hospitals are among the most electrically intensive public buildings. Modern healthcare depends on equipment that must operate continuously from ventilators and monitors to incubators, diagnostic equipment, pumps and air-con-ditioning systems. In critical-care environments, electrical failures can have consequences far beyond loss of power.
NICUs are particularly vulnerable because they combine large amounts of electrical equipment with oxygen-enriched environments and patients who cannot indepen-dently evacuate.
Electrical faults, damaged wiring, overloaded circuits, inadequate maintenance and improperly managed conn-ections can therefore create serious fire risks. The answer should not simply be to install more equipment. Hospitals need properly designed and maintained electrical infra-structure.
Critical-care areas should have appropriately rated and dedicated electrical circuits, reliable grounding and earthing, suitable circuit protection and emergency power arrangements. Electrical installations should be inspected periodically, while damaged equipment and wiring should be removed from service rather than repaired temporarily and returned to operation.
Automated protective devices should be installed where appropriate, and electrical systems should undergo documented preventive maintenance and independent periodic inspection. Most importantly, the inspection process should not be reduced to paperwork.
A hospital should be able to demonstrate when an electrical system was inspected, what deficiencies were found, who was responsible for correcting them and whether those corrections were subsequently verified.
Oxygen: Essential for Treatment, Dangerous When Mismanaged
The presence of oxygen creates another dimension of risk in critical-care environments.
Oxygen itself does not ignite a fire, but an oxygen-enriched environment can dramatically accelerate combustion. In a neonatal or intensive-care ward, where oxygen is routinely used, medical-gas infrastructure must therefore be treated as an essential component of fire safety.
Hospitals should maintain properly designed medical-gas systems, regularly inspect pipelines and connections and ensure that staff understand emergency shut-off procedures.
Area Valve Service Units (AVSUs) can allow oxygen supply to be isolated to a particular area without necessarily shutting down the entire hospital’s supply. Their location should be known to relevant staff and emergency responders, and procedures for using them should be incorporated into emergency training.
Where appropriate, oxygen monitoring and leak-detection measures should also be considered. But infrastructure alone is insufficient. Staff must know what to do when an oxygen leak is suspected, which supply can be isolated and how patients dependent on oxygen are to be supported during an emergency.
