A couple of days ago, newborn babies burned to death in the nursery of PIMS. Let that sentence sink in. These were not patients who died after a long illness. They were newborns. They had barely entered this world. Fourteen have been reported dead, with only one baby rescued from the nursery. The fire reportedly started around 7am, apparently after an electrical or air-conditioning fault and, as always, there will be an inquiry. There will be statements. There will be suspensions. There will be arrests perhaps. Someone will be declared responsible. We will express outrage for a few days and then move on.
This is not an isolated accident. In Sahiwal, a hospital fire in 2024 killed infants in a pediatric ward. The fire was again linked to an air-conditioning electrical fault. There were reports of inadequate firefighting arrangements and desperate attempts to evacuate children through windows. How many fires do we need before we understand that this is not bad luck? We were recently told that the system has collapsed. I disagree; the system never existed for ordinary Pakistanis.
For decades, people have walked into public hospitals and negotiated with shortages, broken equipment, overcrowding, unsafe buildings, absent medicines and exhausted healthcare workers. They have learned to survive a system that was never designed around their safety. Perhaps what has changed is that the collapse has finally started reaching places where it can no longer be ignored. PIMS is not some forgotten rural dispensary. It is in the capital, and that is perhaps what makes today’s tragedy particularly frightening. Our response to every disaster is reactionary and punitive. Find someone to blame. Form a committee. Demand an inquiry. Announce action. Then nothing fundamentally changes.
This is structural violence at its most brutal. Not because someone necessarily intended to kill these children, but because years of neglect, poor maintenance, weak safety systems, inadequate investment and institutional failure create conditions in which predictable disasters become inevitable.
Underneath all of this is politics; our politicians spend enormous energy doing politics to get into government. Once they get there, they are supposed to stop campaigning and start governing but they don’t, they continue doing politics. They fight for positions, institutions, influence and control. They consume resources while governance becomes an afterthought. Pakistan does not have unlimited money. Debt servicing and defense consume an enormous share of federal resources, leaving very little fiscal space for human development. But scarce resources make reform more, not less, important.
We don’t need a revolution. Our people are not ready for one, and revolutions rarely fix broken institutions anyway. We need something much less dramatic and much harder; reform. Professional governance. Independent regulation. Hospital safety audits that actually matter. Preventive maintenance. Fire preparedness. Accountability that does not disappear after the headlines, but perhaps that requires something we have consistently failed to produce: people in power willing to make intelligent decisions in the public interest. And that is where the real tragedy lies. We keep changing governments. We keep changing faces. We keep changing slogans, but we don’t change the system. Today, fourteen newborns paid the price. Tomorrow, we will hold another press conference.
—The writer is Professor of Public Health, Shifa Tameer-e-Millat University, Islamabad.([email protected])
