HOSPITALS are sanctuaries of healing—at least, they are meant to be.
In Pakistan, however, they are fast devolving into breeding grounds for perilous infections. At the very heart of this creeping catastrophe lie our operating theatres (OTs), the core of surgical intervention and patient care. Recent studies have illuminated a distressing reality: widespread negligence and systemic decay have compromised even the most basic standards of hygiene in these critical spaces.
A cross-sectional study conducted in Karachi found that compliance with hand hygiene protocols among healthcare professionals during surgeries stood at a dismal 16.1%. In other words, more than eight out of ten opportunities for sterilization were disregarded. This flagrant dereliction of duty exponentially increases the risk of infection and directly fuels the prevalence of hospital-acquired infections (HAIs). The failure to follow such a fundamental practice speaks volumes about the lack of oversight and accountability within hospital systems.
In most operation theatres across Pakistan, HVAC systems (Heating, Ventilation and Air Conditioning) are commonly installed to regulate temperature and humidity—but without the integration of specialized HEPA filters essential for microbial control. This compromises patient safety, as the primary function of HVAC in surgical environments is not just comfort, but infection prevention through air purification. Unfortunately, due to high maintenance costs and the technical expertise required to operate these systems, many hospitals opt for basic air conditioning setups that lack the capability to filter airborne pathogens.
Moreover, the absence of regulatory checks and enforceable standards allows this critical oversight to persist unchecked, putting countless patients at risk of post-operative infections and complications that could otherwise be prevented through proper air quality control. The consequences are both immediate and grave. A comprehensive study spanning 13 hospitals across Punjab revealed that 8.4% of inpatients suffered from HAIs, with surgical site infections, bloodstream infections and pneumonia emerging as the most common culprits.
The prevalence of such infections was alarmingly higher in private hospitals (25%), intensive care units (33.3%) and among newborns (23.8%). Even more troubling are the findings concerning pediatric patients. A nationwide survey encompassing 19 public hospitals found that 13.3% of children admitted to pediatric wards contracted infections during their stay. Neonates and those in intensive care bore the brunt of this neglect. The pathogens most frequently isolated—Staphylococcus aureus, Klebsiella pneumoniae and Escherichia coli—are infamous for their resistance to multiple drugs, compounding the threat.
At the Aga Khan University Hospital in Karachi, research into pediatric oncology revealed that 3.1 out of every 100 admissions resulted in hospital-acquired bloodstream infections, with an alarming mortality rate of 12.5% among those infected. These numbers should serve as a clarion call to healthcare administrators and policymakers alike. Tragically, such findings are not outliers but emblematic of a broader institutional malaise, especially within public-sector hospitals.
These institutions are plagued by a lack of fundamental infection prevention and control (IPC) infrastructure. From critical shortages of sterile instruments to the dangerous reuse of syringes, from haphazard waste disposal to insufficient training of medical staff—the cumulative effect is catastrophic. The 2019 HIV outbreak in Ratodero, Sindh, where hundreds of children were infected due to the reuse of syringes, stands as a haunting testament to this systemic collapse. While such tragedies momentarily capture media attention, they are merely the surface tremors of a much deeper, more pervasive crisis silently unfolding in hospitals.
—The writer is President, Islamabad Chamber of Commerce and Industry.
