Friday: Continued investigations at Giulesti

Day 4 since a fire swept through the Giulesti Maternity Hospital in Bucharest killing five new-borns (three left on a table unsupervised and two in burnt-out incubators) and leaving six in critical condition with 70-80% burns on their little bodies. Their futures look bleak, their recoveries very uncertain. And as they fight for their lives, new facts keep cropping up, highlighting the incompetence, negligence and indifference that lead to the tragedy starting with the minister of health, Attila Cseke, Bogdan Marinescu (the ward director) and his management, right down to maintenance and medical staff on the ITU - the scene of the blaze.

We now know that new electronic doors had been installed that could only be opened by a card swipe. The assistant chief of ITU on duty that night, Florentina Cârstea, was the only one with a card to the door behind which lay the premature babies, helpless and alone - but she had gone AWOL when the fire broke out and was nowhere to be found.

First, let's look at the issue of the doors. The Bucharest Herald reports that they amplified the tragedy. Indeed. Instead of spending money on installing a decent air conditioning system, or how about smoke detectors? Fire extinguishers perhaps? Even water sprinklers which would kick in at the first sign of smoke or a rise in temperature? Nope. Doors. Doors that noone could get through without the swipe card, snug in the pocket of the absent assistant chief. Doors that clearly had no evident emergency opening device and hampered the rescue of the babies.

The ITU had apparently been recently modernised - by which I guess they mean the doors, because nothing else seems too modern in the service. Mirela Ranga, the hospital's (rather obtuse, it seems) medical director told reporters that there was two million euros worth of equipment in the ward but no smoke detectors. On being asked why, she replied glibly, "I heard it and know there are no smoke and fire detectors, but I also heard it's not mandatory to have them." On an ITU ward where there are oxygen tanks everywhere, innocent babies and a couple of million euros worth of equipment...where nurses smoke in the corridors and in the entrance hall right next to them. Not mandatory... Saving money. Can't be bothered. Don't care enough. Period.

As for the incubators, the alarms of ten went off...but noone heard them or could intervene if they had. In the absence of Florentina Carstea with the swipe key, the babies were at the mercy of the fire. When parents/visitors standing round the door noticed the smoke, they panicked. What to do? How to open it? Save the babies? It took those outside the walls of the hospital (firemen?) and the father of one of the babies to break the door down. Utter chaos. No evacuation plan. Noone there to take charge.

(Photo Agerpres)

The gossip rag, Cancan, have published photographs of the babies room - burnt incubators, a wooden cupboard that should never have been there, a melted plastic table and also shows how the investigators got the outdoor air-con unit down with the help of a cherry picker.

Several heroes have come to the frontline in moving accounts of how the afore-mentioned father eventually broke down the door and how a fireman took off his gloves to try to ease one of the babies out of a melted incubator and rip the wires away with his teeth...in every dreadful tragedy, there are brave, sensitive, kind people. Disaster breeds humanity. Shame it doesn't go as far as the minister of health.

Cancan also reports that Bogdan Marinescu wasn't in Bucharest at the time of the fire - but he interrupted his holidays to return. He told the journalists for Adevarul: "the ITU was the pride of the hospital. A great deal was invested in this service." Where? What? Tell us more, do. Two million euros worth of equipment that couldn't detect a fire or even put one out. Two millions euros of equipment with alarms that rang unheard. Cretinous. Simply cretinous coming from a ward director in the job for twenty seven years...

The SETimes quotes Vasile Barbu, the head of the National Association for Patients' Protection (APP) in a very clear, well documented article: "there were no smoke alarms in the area and some of the medical devices had not received fireproofing treatment. Furthermore, we found a wooden cupboard there which was not supposed to be kept in an intensive care ward because it is first of all a germ-nest and secondly a fire enhancer."

The leading investigator confirmed that nearly an hour passed after fire broke out before anyone in the hospital reacted. In the absence of any sign of medical staff, it was a father who alerted them.

Since there is a new "stand-in" temporary director, Victoria Nicolau, it was she who refused to give the name of the firm who had installed the a/c system in the ITU. I am guessing it probably wasn't a firm, but someone's husband/brother/in-laws for a backhander and there's no paper trace. Vasile Barbu accused Nicolau of lacking in transparency.

The Bucharest Herald and Mediafax along with several other tabloids report today that one now knows where the medical staff had all vanished to that night - they were celebrating the feast of St Mary (which fell last Sunday) in a different room. So, when Florentina Carstea says that she went to the bathroom for a few minutes and then, when the video cameras prove this to be a lie she changes her story to having been called to help a collegue on another floor, well....can she be believed? Or was she, too, enjoying the celebrations for St Mary? She told the investigator that when the fire broke out, she was on the ward and sounded the alarm. More porkies. She was nowhere to be found and, as we now know, it was the father of one of the babies who alerted staff.

This, incidentally, is NOT the first incident on the ward, says SETimes. In 2008, several babies suffered severe burns after a nurse confused a bottle of disinfectant for a bottle of medical alcohol, washing the babies in it. Three nurses were "penalised" for failing to report the incident.

A separate incident in November 2009: also from SETimes at the Bucur Maternity Facility in Bucharest, a nurse forgot a baby in an incubator. It suffered burns on 20% of its body and needed corrective plastic surgery. The nurse was sacked but declared that she had been a victim of the system - she had had too many sections to cover, due to lack of personnel.

Attila Cseke, the minister of health, turns a blind eye on the health care problems, says the Bucharest Herald, and instead, he congratulates doctors who did their duty with great professionalism. Still no sign of cseke's resignation.

And finally, I would like to draw your attention to an excellent article in Gândul by Rodica Ciobanu called "A Normal Tragedy." The very title makes you stop for a moment. I thank my sufletzel for the translation. The first paragraph gives a summary of what happened on Monday night and ends with the question, "what do we know?"

"We know that they (the babies who didn't survive) were victims of gross negligence - the electrician who did a shoddy job; the assistant chief who wasn't there; the hospital management who tolerated staff's unprofessionalism and insubordination; the public health system almost in a state of financial collapse, emptied of professionals with frozen jobs and miserable salaries. The abhorrant conclusion: considering the working conditions, it was normal that this tragedy occurred.

Except that it isn't normal at all.

Poor wages (excluding "spaga") does not justify the lack of consideration for patients' lives. As long as things remain this way, there will be other "normal" tragedies.

No official directly responsible for this deathly system has resigned, neither the hospital management nor the minister of health, nor anyone from higher levels. To resign as a sign of decency since the death of these five innocents occurred during their watch does not seem like a normal gesture to them. The only decision taken to prevent another serious accident is to check the electrical equipment and networks in all units throughout the country - as if this is the only danger patients face in a hospital. Minister Cseke doesn"'t intend to clean up and ventilate the system to ensure efficiency in the future. No, he just thinks up a law that forbids physicians to work for both state and private institutions. He will completely destroy the health care system. Under the present crisis, when even surgical gloves are lacking in hospitals, salaries have been cut and "spaga" is less, a good doctor would be either out of his mind or an idealist to work in the public sector.

Prime Minister Boc offered 5,000 lei in compensation to the families who lost their babies and two billion lei to the ministry of health. Then he allocated 5 million EUROS by sms to the 125 PDL deputees (here follows uncouth expression in the Roumanian text...!)

Traian Basescu is convinced that resources are being wasted in the system, therefore, he has informed us that he will help the Republic of Moldova with 125 million euros from "the income of Romanian citizens". He was clear on that. We believe in an interest (the territorial integrity of the republic of Moldova), he declared. No comment.

For each one of them, the tragedy is normal. They simply cannot be bothered - not even a demand for a minute's silence...."

The more we hear, the worse it gets. The more outlandish, the sublime to the ridiculous and just plain offensive. When the result of a cascade of gaffs and brainlessness ends with babies being burnt alive, then it's really time to admit that those at the top are well and truly incompetent, impotent and incapable. And heads must roll.