By: Alina Janat
ISLAMABAD: The tragic deaths of 14 newborn babies at the Mother and Child Health (MCH)/Gynae Ward of Pakistan Institute of Medical Sciences (PIMS) have triggered serious questions over the hospital’s administrative structure, delegation of powers, multiple additional charges, appointment of officials to unrelated administrative and technical positions, and the composition of the inquiry committee constituted to investigate the incident.
The tragedy has raised questions about whether the incident should be treated merely as an isolated technical or operational failure, or whether the entire administrative and technical chain of command at PIMS needs to be examined to determine responsibility for supervision, maintenance, safety and decision-making.
PIMS, one of Pakistan’s major national teaching hospitals, has reportedly been facing concerns over the concentration of important administrative powers at the level of the Executive Director, while the authority of other administrative officers is allegedly limited. Officials and sources have questioned whether, in such a system, accountability for a major incident can legitimately be restricted to a subordinate employee without examining the officials exercising supervisory and administrative authority.
Sources said several officials at PIMS are holding additional charges apart from their substantive positions. Those reportedly holding such responsibilities include Dr Sharjeel, Dr Saadia, Dr Nousheela, Dr Zorul Ain, Dr Rana Fatima, Dr Zulfiqaan, Atif, Tasham-ul-Haq, Qamar Javed Gujjar, Rana Naeem, Liaqat and Dr Aneza Jaleel.
According to sources, Dr Sharjeel, whose substantive position is Medical Officer, has been assigned responsibilities including Coordinator Emergency and several other important administrative functions. Questions have been raised over whether assigning multiple administrative responsibilities to a Medical Officer alongside emergency-related duties affects his primary medical responsibilities and administrative accountability.
Dr Saadia, a Deputy Medical Officer, is reportedly holding the additional charge of Deputy Director MCH/Gynae. Sources say she is the wife of Dr Sharjeel. Their simultaneous presence in important administrative positions has raised questions regarding merit, transparency and the possibility of a conflict of interest, requiring clarification from the competent authorities.
Dr Nousheela, whose substantive department is Gynaecology, is reportedly performing duties as Director/Administrator. Questions have also been raised regarding complaints associated with Gynae Unit-I, with demands that previous complaints, incidents and inquiry records relating to the department be reviewed in the context of the current situation.
Dr Zorul Ain, whose substantive field is Medicine, is reportedly holding additional charges as Director Procurement and Director Kitchen. Questions have been raised over the appointment of a doctor to sensitive procurement and kitchen functions involving administrative, financial, supply and operational responsibilities instead of assigning them to relevant specialists.
Dr Rana Fatima, from the Medical Department, is reportedly holding the additional charge of Deputy Director Housekeeping. Since housekeeping is directly linked with cleanliness, infection control and patient safety, questions have emerged regarding whether such responsibilities are being assigned according to relevant professional expertise and administrative experience.
Dr Zulfiqaan, whose substantive field is reportedly Medicine, is holding the charge of Director Outdoor. Questions have also been raised regarding responsibilities connected with PIMS buildings, construction projects and civil works, particularly whether such technical matters are being supervised by qualified civil engineers and technical experts or officials from unrelated professional backgrounds.
Atif is reportedly serving as In-charge of the Electrical Department. Following the deaths of the newborns, questions have emerged regarding responsibility for the hospital’s electrical systems, AC units, compressors and other sensitive installations, including their maintenance, inspection and safety.
Tasham-ul-Haq, reportedly possessing a three-year DAE qualification in Civil, is serving as In-charge of the Civil Department in Grade 17. Questions have been raised regarding the professional qualifications and applicable service rules for heading an entire Civil Department. Sources have also alleged that directions issued by a senior officer were previously ignored, calling for the matter to be formally investigated.
Qamar Javed Gujjar, whose substantive area is reportedly Medical Operation Theatre, has been assigned additional responsibilities relating to Mechanical, Laundry and other technical departments. Questions have been raised over the basis for assigning several sensitive technical functions to a Medical Technician. Alleged actions against employees who questioned his appointment or authority should also be independently reviewed, sources said.
Rana Naeem, whose substantive department is Nursing, is reportedly performing additional duties as Law Officer, PIMS. Since legal affairs require specialised qualifications and professional experience, questions have been raised regarding the eligibility and service rules governing such an appointment.
Liaqat, whose substantive department is Nursing, is reportedly holding the additional charge of Deputy Director O&SP. Questions have been raised as to why an officer from the nursing profession has been assigned responsibility for another administrative department instead of being utilised according to his professional background.
Dr Aneza Jaleel, whose substantive field is Medicine, is reportedly performing multiple important administrative functions. The assignment of several administrative responsibilities to a doctor alongside clinical duties has raised questions regarding both clinical availability and effective administrative supervision.
Officials and employees have called for a comprehensive review of the management of sensitive departments at PIMS, including Civil, Electrical, Mechanical, Laundry, Housekeeping, Procurement, Kitchen, Building Maintenance and Fire Safety, to establish whether the persons responsible possess the relevant qualifications, professional experience and technical expertise.
They have argued that excessive reliance on additional-charge arrangements can affect both the officials’ substantive departments and the professional supervision of sensitive technical areas.
Chain of Command Under Question After 14 Newborn Deaths
Following the deaths of 14 newborn babies, key questions have emerged regarding responsibility for the maintenance and safety systems associated with the ward.
The inquiry should establish who was responsible for the maintenance of the AC and compressor systems, who was responsible for electrical and mechanical safety, who inspected the fire-safety and emergency systems, who was officially in charge of the relevant technical departments, who supervised the ward and its technical systems, and who held the final authority for decision-making and supervision.
It should also establish whether any previous complaints, maintenance concerns or safety warnings had been reported and, if so, what action was taken.
Sources and employees have maintained that if negligence, inadequate supervision, poor maintenance or administrative failure is established, responsibility should not be confined to a subordinate employee. The entire Chain of Command and decision-making process should be examined.
Inquiry Committee’s Composition Also Raises Questions
Meanwhile, the composition of the inquiry committee constituted following the tragedy has also come under scrutiny.
According to sources, the committee comprises Dr Umar Farooq, Dr Sharjeel, Dr Nousheela and Dr Saadia.
Questions have been raised over the administrative relationships and responsibilities of committee members within PIMS, particularly their reported additional charges and their administrative relationship with the Executive Director. The possibility of any conflict of interest should be examined before the inquiry proceeds, sources said.
The inclusion of Dr Sharjeel and Dr Saadia, who are husband and wife, on the same inquiry committee has also raised questions about the perceived independence and impartiality of the investigation, particularly in view of their reported administrative responsibilities at PIMS.
Sources have stressed that no individual should be declared guilty before completion of an impartial investigation. However, the composition of the committee should be such that there is no reasonable doubt regarding its independence or potential conflict of interest.
Dr Umar Farooq’s Appointment as Inquiry Chairman Questioned
Dr Umar Farooq has reportedly been appointed Chairman of the inquiry committee. According to sources, he is a Professor associated with the Department of Medicine and is also involved in administrative matters relating to house officers’ rotations, postings and other related affairs.
Questions have therefore been raised over whether an officer associated with the same administrative system should chair an inquiry into matters involving that system.
Sources have called for a review of the administrative links, responsibilities, additional charges and potential conflicts of interest involving all members of the committee and the Executive Director.
PIMS’ National Role Under Spotlight
The controversy comes against the backdrop of PIMS’ long-standing role as one of the country’s major medical institutions. PIMS doctors, nurses, paramedics and other staff have served the country during major national emergencies, including the Ojri Camp tragedy, the 2005 earthquake and the Margalla Hills plane crash.
The current situation has consequently raised concern among employees and observers over why an institution with such a significant national record is facing recurring questions concerning administrative weaknesses, unclear delegation of authority, additional charges and professional competence.
They have called for PIMS to be governed through merit, professional qualifications, relevant experience, clearly defined powers and institutional accountability, rather than excessive dependence on individuals or additional-charge arrangements.
Demands for Independent Investigation
Employees and concerned quarters have demanded an independent and transparent investigation into the deaths of the 14 newborn babies; determination of responsibility across the entire Chain of Command; a comprehensive review of all additional charges and appointments outside relevant professional domains; and placement of civil, electrical, mechanical, fire-safety and other technical departments under appropriately qualified specialists.
They have also demanded that the inquiry committee be made fully independent and impartial, that the administrative relationships and potential conflicts of interest involving its members be examined, and that the MCH/Gynae Department and other departments where complaints have previously been reported undergo an independent review.
A comprehensive technical audit of the hospital’s electrical, mechanical, AC, compressor, fire-safety and maintenance systems has also been demanded.
The tragedy involving 14 newborn babies has therefore placed not only the immediate circumstances of the incident but the wider administrative, technical, supervisory and accountability system of PIMS under intense scrutiny.
