How safe are our healthcare facilities?

The National Building Codes and Hospitals

How safe are our healthcare facilities?
Photo by Robert Linder / Unsplash

In the recent past, several fire incidents a hospitals have been reported all over the country. To name a  few hospitals were AIIMS – New Delhi, SAL Hospital – Ahmedabad, SMS Hospital – Jaipur, LNJP Hospital – Delhi. Some of the incidents have led to a severe loss of human life. About 90% of the fire incidents have occurred in government hospitals. Some of the reasons for such accidents are electric short circuits, Liquefied petroleum gas cylinders, torn mattresses, and wooden boxes.

Apart from that, split air conditioners in ICUs, neonatal ICUs, and operating rooms are some of the other causes. However, several other hospital equipment's have similar vulnerabilities. Not just fire accidents, another big problem of Indoor Air pollution is severely affecting people who spend 90 percent of their time indoors. Indoor Air Pollution (IAP) has ranked among the top 10 factors for health issues in developing countries. The indoor air pollution problem has become visible with more airtight buildings or a small amount of fresh air circulating inside the building. With less or no natural ventilation, people are exposed to contaminants.

Buildings are responsible for a large portion of emissions that causes mild to lethal health outcomes depending on the concentration and duration of exposure to the pollutants. The source of such contaminants can be either the exterior or the interior of the building. Even the building site, physical factors such as temperature, humidity, lighting, vibrations, etc., exacerbate Indoor Air Quality problems. Providing an indoor environment where people can work comfortably requires an integrated building, design, and construction approach.

National Building Code - plays a crucial role in the community's welfare. Building codes are made to protect the life and health of the person with an investment made by an individual. They also serve the purpose of economic development by preserving the built environment (Levin, 1999, p.1). Bureau of Indian Standards, in 2016, made the salient features of the National building code for healthcare facilities, which are:

1.     The requirement of Heating, ventilation, and air conditioningfor data centres and healthcare facilities,

2.     Refrigeration for old stores to keep vaccines,

3.     Efficient strategies for winter heating using reverse cycle operation,

4.     Solar heating system,

5.     Ground sources heat pump, an electric heat pump, and

6.     The modern system of mechanical ventilation of industries,

7.     Commercial kitchen and underground care parking and

8.     The piped gas facility in hospitals for medical purposes.

The National Building Code of India (NBC), a comprehensive building Code, is a national instrument providing guidelines for regulating building construction activities across the country. The National Medical Commission Act, 2019, makes the regulations in Clause 2(2) under the heading "QUALIFYING CRITERIA", under section (2A) for Medical Colleges being established from Academic Session 2021-22. The qualifying criteria for college buildings and other built-up infrastructure must conform to building codes and local bye-laws. They must also comply with the requirements for providing access and facilities to those who are disabled. The built-up area of the teaching hospital must conform to national norms and local building bye-laws. Moreover, hospitals should have fire-safety measures, including patient evacuation plans as per local bye-laws and regulations.

However, no information on the current status of Indian medical education institutions is available regarding the building condition, indoor environment, etc.