7/11 Verdict: Lessons learnt from 2006 blasts

‘Hospitals need to coordinate better, ensure severely injured get attention’.

UNTIL 11.30 pm, five hours after seven bombs rocked Mumbai local trains, the civic-run Sion hospital, which was nearest to the spot had 43 dead bodies, more than double its morgue capacity.

Like the 1993 blasts, over 100 deaths were reported in less than an hour in city hospitals. The bodies were badly mutilated. Sion hospital morgue had a capacity of 22 bodies (now upgraded to 78). It took hours to vacate an OPD ward to place the increasing number of mutilated bodies. “We realized then, that resource management needs to be improved,” assistant professor at forensic department Dr Rajesh Dere said.

There were talks of a system to grade the injured to ensure treatment is first given to the severely injured during disasters, but it has not been implemented.

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While National Disaster Management Authority (NDMA) recommends identification of warehouses for storing bodies in case of mass casualties, doctors at tertiary-care hospitals admit no such back-up options are present, either under the state government or the civic body guidelines.

The 2006 blasts had something forensic experts were not used to, bodies mutilated beyond recognition. In the days that followed the blasts, relatives had to run from one hospital to another looking for bodies. The difficult part was showing mutilated limbs or body parts for identification, forensic experts admit.

“The disaster made us realize that a centralized system needs to be generated where, whenever there is a disaster, pictures could be clicked of dead bodies and their belongings and numbered. Relatives could view the picture for identification. This would save them the trouble of running around,” Dr Harish Pathak, KEM Hospital’s forensic department head said.

No such system is in place. In case a disaster strikes, each civic and state hospital documents dead bodies without co-coordinating with the other hospitals.
The disaster plan sets guidelines for a nodal officer in each public hospital to be the point of contact.

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For the 24 civic hospitals, just one nodal officer has been assigned, apart from another nodal officer at JJ hospital.

Additionally, the triage system continues to remain in books. According to Dere, in case of mass casualties, social workers and police officers first identify critical patients and send them to the nearest hospital. “Currently, it is like first come, first admit. In such cases, those in need of urgent medical attention may be left behind. By the time they are transported to a hospital, they lose the golden hour period,” Dere said.

According to experts, in a triage, patients requiring immediate attention are marked ‘red’ while those with less serious injuries are marked ‘yellow’. The dead are marked ‘black’ and can be attended to last. “Police need to be sensitized on the triage method. This will help in saving lives,” Pathak said.

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