The PIMS Tragedy Demands Accountability from Those Who Failed Their Duty

The death of 14 new born babies in the tragic fire at the Pakistan Institute of Medical Sciences (PIMS), Islamabad, is not an incident that can be described merely as unfortunate and then forgotten. It is heart-breaking, unacceptable and demands the highest level of accountability. Fourteen families handed their new born children over to one of the country’s premier public hospitals with the expectation that they would be protected, treated and cared for. Instead, they received the most devastating news any parent could ever hear. No explanation, compensation or expression of sympathy can bring those innocent lives back.

Yet, while grief must be accompanied by accountability, accountability must also be based on facts.

Federal Minister for National Health Services Syed Mustafa Kamal has naturally come under intense public scrutiny because PIMS falls within the federal health system. This scrutiny is legitimate. A minister must answer questions when a tragedy of such magnitude occurs under his ministry. However, political accountability should not become a substitute for identifying those who were directly responsible for maintaining the hospital, enforcing safety procedures, supervising staff and ensuring that emergency systems were functional.

It has been widely observed and witnessed that, since assuming responsibility for the federal health portfolio, Syed Mustafa Kamal has demonstrated remarkable energy, commitment and dedication to his responsibilities. His hands-on approach, consistent engagement and efforts to improve the health sector reflect a strong sense of responsibility and public service. At the same time, appreciation of his performance does not place him beyond scrutiny. Rather, genuine leadership is demonstrated by the willingness to face difficult questions, accept accountability and stand responsible when circumstances demand it.

In this regard, Mustafa Kamal’s response following the PIMS tragedy deserves particular attention. Federal Minister for Health Syed Mustafa Kamal reportedly offered his resignation to the Prime Minister while presenting himself for accountability. However, the Prime Minister did not accept the resignation and decided to retain him in the federal cabinet, reflecting continued confidence in his leadership and services. The development has been viewed as a demonstration of Mustafa Kamal’s willingness to take responsibility during an exceptionally difficult situation. His decision to offer himself for accountability also reflects qualities of political commitment, loyalty and responsible leadership.

Such willingness to accept responsibility is significant in a political culture where resignation and voluntary accountability are often rare. Instead of distancing himself from the tragedy or shifting the entire burden onto subordinate officials, Mustafa Kamal placed himself before the country’s leadership for accountability. Whether one agrees with his performance or not, this approach establishes an important principle: leadership is not only about receiving credit for achievements; it is also about standing at the front when an institution under one’s authority faces a serious crisis.

The Prime Minister’s decision not to accept his reported resignation is equally significant. It indicates that the country’s chief executive continues to repose confidence in Mustafa Kamal and expects him to oversee the accountability and reform process rather than leave the ministry at a moment of crisis. Retaining a minister, however, should not bring the matter to an end. Rather, it places an even greater responsibility on him to ensure that the inquiry is transparent, those found negligent are held accountable and weaknesses within PIMS are corrected without delay.

The most important question, therefore, is not simply, “Who is the minister?” The more important questions are: Who was responsible for the nursery at the time of the fire? Were the required doctors, nurses and supporting staff present at their assigned locations? Were fire-safety systems functional? Had safety inspections been conducted regularly? Were emergency exits accessible? Were electrical and oxygen systems properly maintained? Had the hospital management previously identified safety risks, and if so, what action was taken? Who signed the relevant inspection and maintenance reports?

These are the questions that go to the heart of institutional accountability.

The PIMS tragedy cannot and must not be forgiven through routine administrative explanations. A neonatal nursery is among the most sensitive areas of any hospital. The children inside cannot save themselves. They cannot run towards an emergency exit, call for assistance or understand the danger around them. Their survival depends entirely upon the competence, vigilance and responsibility of the doctors, nurses, administrators, technicians and other officials entrusted with their care. That makes any negligence in such a facility particularly serious.

This incident also forces us to confront an uncomfortable reality about our broader institutional culture. As a nation, we frequently talk about corruption only in financial terms, but moral and professional corruption can be equally destructive. Reporting for duty but failing to perform it, signing an inspection report without conducting a proper inspection, ignoring safety requirements, delaying essential maintenance, treating public property carelessly and refusing to accept responsibility after failure are also forms of institutional corruption.

Too often in our public institutions, responsibilities are treated as formalities rather than moral obligations. Files are signed, routine reports are prepared and official meetings are conducted, but basic questions of implementation receive inadequate attention. Safety procedures become paperwork exercises, maintenance is postponed, rules are overlooked and officials assume that somehow nothing serious will happen. When tragedy eventually strikes, responsibility begins to travel from one office to another until nobody appears responsible.

The public has every right to ask where the concerned hospital staff were when the emergency occurred. It has every right to ask what the hospital administration had done to prepare for such an emergency. It has every right to question whether fire drills had been conducted, whether firefighting equipment was functional, whether staff members had been properly trained and whether senior management had personally ensured compliance with safety standards.

These questions should not be considered an attack on doctors, nurses or public servants as a whole. Thousands of healthcare professionals work under difficult circumstances and save lives every day. But respect for the profession cannot become a shield against accountability wherever negligence is established.

Pakistan unfortunately has a tendency to look for one prominent individual after every tragedy while overlooking the institutional chain through which negligence actually develops. A minister exercises political and administrative oversight, but a large hospital operates every hour through a hierarchy of executives, departmental heads, administrators, engineers, technicians, safety personnel, doctors, nurses and supporting staff. Each person has a defined responsibility. An honest investigation must therefore determine precisely where the chain of responsibility broke down.

This does not absolve political leadership. If an investigation establishes that the ministry ignored repeated warnings, failed to provide necessary resources, overlooked documented safety deficiencies or refused to act despite knowing about serious risks, responsibility must reach the highest relevant level. No political office should provide immunity. But neither should accountability become political theatre in which the most visible person is blamed while those directly responsible for years of administrative negligence quietly escape scrutiny.

If a technician failed to maintain critical equipment, that failure must be investigated. If a safety officer neglected inspections, he or she must answer. If hospital administrators ignored warnings, they must be held responsible. If senior officials failed to supervise the institution, their role must be examined. And if failures are ultimately traced to policy or ministerial oversight, those findings too must be accepted without hesitation.

The families who lost their children deserve much more than condolences. They deserve to know exactly what happened, why it happened, who failed in his or her duty and what concrete steps will ensure that another family never experiences the same horror. Their grief must not disappear from the national conversation once media attention moves to another issue.

The inquiry into the PIMS incident must therefore be independent, transparent and comprehensive. Its findings should not disappear into government files. Every identified failure should translate into reform: regular fire-safety audits, functional emergency exits, upgraded electrical systems, careful management of oxygen and other hazardous systems, mandatory emergency drills, staff training and clearly defined individual responsibility.

Responsible leadership is ultimately judged not only by what a leader says during a crisis, but by what changes after the crisis.

The PIMS tragedy should therefore not become an argument about protecting Mustafa Kamal or politically targeting him. Nor should it become another temporary controversy that disappears after a few days of headlines. It must become a national test of whether Pakistan is prepared to identify institutional failures honestly and hold the right people accountable.

Fourteen innocent newborns lost their lives. We cannot reverse that tragedy. But we can honour those children by refusing to allow negligence to hide behind bureaucracy, political point-scoring or institutional silence.

The real question after PIMS is not merely who should resign. The real question is who failed to perform the duty that could have saved those 14 innocent lives and whether our system has the courage to identify them, hold them accountable and make certain that such a tragedy is never repeated.