JPMC struggles to survive without power for 13 hours

Patients who died were already in critical condition, says neurosurgery chief.

KARACHI:

After 13 hours without power, four deaths of patients on ventilators and not a drop of diesel in their back-up generators, the administration of the city’s largest hospital, Jinnah Postgraduate Medical Centre (JPMC), said that their critical functions are at stake.

The 1,200-bed hospital went without electricity from around 1am on Tuesday morning till about 2pm that afternoon. The power was restored when a substation that broke down at midnight was fixed by the Pakistan Public Works Department with the help of some private contractors.

During this time, four critical patients on ventilators in the neurosurgery intensive care unit (ICU) died. However, it is unclear whether their deaths were actually linked to the power outage. Neurosurgery chief Prof. Sattar Hashim said, “The patients [who died] were very critical when they were brought in. They include one child and three men, all who suffered severe head injuries.” Staff administered manual resuscitation via the ambu bag but, according to Sattar it cannot substitute a machine like a ventilator which is calibrated.

The question is how much of a difference uninterrupted access to the ventilator would have made. “There is always a chance [of recovery] but these patients were critical,” Sattar said. “I would say they had a 50-50 chance at recovery though. Of course, being without electricity did play a role but we cannot say anything with certainty.”

The neurosurgery ICU has space for 12 beds however it was packed with 16 patients on Monday night. All four ventilators were in use till the power outage.

JPMC has three 1,000 kVA generators to run life-saving functions but all of them were bone dry because the hospital is already in debt for a diesel bill.

A member of the hospital’s administration who did not want to be named, said, “We have about one million rupees in dues from the previous financial year which the federal government has to pay. However, since the hospital has been devolved, it has rung up another Rs1.3 million in diesel bills. This needs to be paid by the provincial health department.” According to this official, the provincial health secretary has been informed several times about the situation. The latest written communication took place on September 9.

It has been a struggle to keep afloat. “Last week we had a power outage which lasted about an hour and a half,” JPMC executive director Prof. Tasnim Ahsan told The Express Tribune. “Since it took place during the tail-end of OT hours, it caught some surgeons in the middle of their operation. We had a huge situation on our hands with surgeons refusing to operate unless we could guarantee backup power.”

If one generator runs for one hour, it needs a little over 1,000 litres of diesel which cost about Rs40,000. After the power outage, the health secretary supplied the hospital about 2,000 litres of petrol, good to last for about two hours if the hospital faces a similar outage.

Other problems were reported in the gynaecology ward where the JPMC blood bank could not be accessed due to the power outage. “The blood is stored in a freezer at a particular temperature,” one doctor explained. “Any rise in the temperature beyond a certain degree and all the blood in storage would no longer be usable.” Out of the fear of a few hundred bags going to waste, the blood bank was kept shut to maintain the temperature.

Aggravating the situation was the rainwater seeping its way into some of the wards on the first and second floors. The doctors mess and residential quarters went without power for about 20 hours.

Published in The Express Tribune, September 14^th,  2011.