Syed Wajid
WHEN unprecedented, measurable outcomes of any system can be attributed to several external and internal complexities, a never-ending debate can be triggered, veiling reality to justify the status quo. Nature, however, has its own ways of manifesting reality through omens. Not to mention the collapsing transport networks and mining deaths, coupled with natural disasters killing thousands of poor citizens over the last five years, here is a brief chronicle of the fire incidents that have not only damaged our infrastructure but have also damaged public trust and hope.
PIMS Hospital Nursery Fire, Islamabad (August 2026): 14 newborns killed. RJ Shopping Mall Fire, Karachi (January 2026): over 65 people burned alive. Sahiwal Teaching Hospital Fire, Punjab (June 2024): suffocating and killing 11 infants. Children’s Hospital Fire, Lahore (June 2022): completely gutting millions of rupees worth of specialized medicine stocks. Larkana Children’s Hospital Fire (August 2021): a sudden ward fire forced a total blackout, cutting off life-saving oxygen and electricity supply lines to critical patients for six hours. Sialkot Covid-19 Centre Fire (May 2021): a rapid electrical short circuit erupted at the Government Sardar Begum Memorial Teaching Hospital directly threatening the lives of 15 vulnerable children.
A governance system—based on people, processes, subsystems and technology—is built around the objective of supporting the populace who feed the complete ecosystem: the citizens. When structures built to protect citizens become the cause of their deaths, these become omens for a potential collapse of the system, not just a failure. The collapse of any system has more devastating effects than failure. What is the most important factor in governance? I would say “people,” as processes, subsystems and technology are developed and executed by people.
When clinicians, leaving their core duties without qualifications to administer and manage a hospital, are placed based on political favours and out of merit, what else can be expected? When building authorities fail to develop processes, standards and compliance, what else can be expected? When regulators are neither empowered, independent, nor competent, what else can be expected? When such incidents are handled with bureaucratic detachment and defensive posturing, what else can be expected? When cosmetic adjustments are prioritized and administrative leaders escape long-term institutional accountability, what else can be expected? When those who place unverified individuals to gain loyalty and political favors face no systemic repercussions, what else can be expected?
These are the very forces that resist change and go to any extent to deter a system that could impact on their hegemony and interests. No matter what structural changes are proposed and implemented, only the right people can bring about real change. The number of incidents and the rising death tolls of innocent children and citizens warrant a change and reforms in the selection and placement of the right people before any structural changes are implemented—and that goes for all sectors, not just hospitals.
We all know that changes are not brought about in a day but take time, especially when we face a complex, dynamic and structurally compromised system. We can start with at least one model and evaluate the results. Highly competent professional resources are available who are ready to step forward and prioritize national duty to help and support. What it requires is a “Will to Serve” and leadership that can place and sustain the right people in the system, as an entrenched ecosystem easily rejects those who dare to bring about change.
—The writer is a management professional with a focus on enterprise technology, operational change management and institutional reforms.
