“Families of patients with 60% burns are told not to bring them to the City as the chances of survival are slim.”
TUESDAY’s fire mishap is a shocking reminder that the City has just two burns wards with 56 beds between them. And, at least 43 beds are occupied at any given point in time in these two hospitals. Although, in the Carlton Towers incident no one died of burns, were there to be burn injuries, would the hospitals have been able to handle the situation?
The burns ward in government-run Victoria Hospital – Mahabodhi Burns Centre – is probably the oldest in the state and perhaps the biggest in the whole of South India. The 50-bedded Centre under Department of Plastic Surgery and Burns, occupies the first floor of the Casualty building. It handles patients with different degrees of burns from not only the City and state but from neighbouring states as well.
Apart from having male and female wards, the Centre also has a paediatric ward and two beds in Intensive Care Unit (ICU). Being a government hospital, it usually gets patients from poor economic strata and around 50 beds, including the post operative ward, are occupied at any given time.
“We have only two ICU beds, which is really not sufficient, and no ventilators. Many a times we have had to put extra beds in the corridor to accommodate the patients,” said Dr Tilak, Medical Superintendent of the hospital. Although the bed strength will still remain the same after renovation, some new features will be ventilators for the ICU and a post operative ward dedicated for burns patients.
Most of the private hospitals are unwilling to admit burns patients because they either are not equipped or don’t want to take risks as the mortality rate is very high. A doctor confided that they told families of patients with 60 per cent burn injuries not to bring the patients to Bangalore, as the chances of survival were slim. “Most patients coming from other parts of the state first go to a local hospital. By the time they come to us, they lose a lot of fluids resulting in renal failure and other complications,” said Dr Tilak.
The only other burns ward is in St John’s Hospital with a mere six beds. The hospital saw 130 cases in 2009 with about three patients at any given time. “We don’t have huge number of patients as we feel we won’t do justice if we took more,” said Dr Vijay Joseph, head of the Plastic Surgery department.
In Victoria Hospital, the burns ward is managed by one professor, two assistant professors, one lecturer, one senior resident and six super speciality Post Graduate students from Plastic Surgery department. However, there are only seven nurses (in three shifts) handling the 50-bed ward. Also there are only two male and two female Group D workers, each putting in 12 hours.
“I have asked the Department of Medical Education to allow me to recruit nine more doctors,” said Dr Tilak.
“We need an autonomous institute for burns and plastic surgery. There are hospitals dedicated to treating cardiac diseases, nephrology, chest diseases, etc, but we don’t have a single one for burns,” Dr Tilak pointed out. He recalled that he sent a proposal to the Medical Education department almost four years ago but didn’t get any response. “With the help of NGOs and others who support this cause, we should be able to get something going by next year,” he said, gearing up to renew his proposal.
Another crucial need was skin bank and skin culture.
Dr Joseph believed strengthening the burns care centres in the peripheral areas was the way ahead. They are in talks with the government to train government doctors in handling burns cases. “We are willing to train government doctors who can then go back and improve the facilities in their hospitals. There is a huge need for special care in the moderate burns – 25 per cent to 60 per cent – segment at district level,” he said.
The Department of Health and Family Welfare has no plans to augment burns care in the City for a purely technical reason. “Burns care come under super speciality treatment. All our hospitals in Bangalore look after primary and secondary health issues, while the tertiary care is handled by Medical Education department,” said Dr Ramesh, deputy director, Medical, Health and Family Welfare. Although, KC General Hospital and Jayanagar General Hospital have beds for burns patients, they are soon referred to Victoria Hospital as these hospitals don’t have plastic surgery units. However, the health department is setting up six 10-bedded burns wards at district level. At present there are nine such wards.
The Carlton Towers fire has set Health commissioner D N Nayak thinking. “It’s undisputed that we require to increase the capacity of the burns wards in a growing city like ours, but even private hospitals can chip in and admit burns patients with government bearing the cost. We will need to look into it in the next financial year.”
(Published in Deccan Herald)