Mumbai: At Sion hospital, patients can’t afford to soil bedsheets, gowns remain unchanged for dayshttps://indianexpress.com/article/cities/mumbai/sion-general-municipal-hospital-mumbai-5391044/

Mumbai: At Sion hospital, patients can’t afford to soil bedsheets, gowns remain unchanged for days

With acute shortage of washed clothes, 40 minor, major surgeries were cancelled on September 24.

Inside a ward at Sion Hospital. (Express photo)

In Sion hospital’s ward 12 that houses pregnant women, eight-month pregnant Rekha Gaud’s bedsheet was last changed a week ago, her gown unchanged since four days. She has been in hospital for last 16 days due to bleeding complications. “We change clothes when the nurse gives fresh ones. There is no point complaining,” the 25-year-old said.

Next to her is Nasreen Ansari’s cot, where the 28-year-old sits and eats carefully so as to not dirty her clothes. “Fresh gown will come only after four days. We are careful to not soil bedsheet,” she says.

In a public hospital where patients’ clothes and bed linen must be changed every day for infection control, Sion hospital is battling with an acute shortage of washed clothes. So much, that on September 24, over 40 major and minor surgeries were cancelled in general surgery, urology, and orthopaedic department after doctors in operation theatre did not have fresh pair of pajamas, apron and bed sheet to conduct any procedure.

The issue runs deeper into the Municipal Power Laundry in Parel, which is struggling to meet hospital’s daily demand of over 3,000 clothes.

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Even as the Brihanmumbai Municipal Corporation (BMC) has called for private laundry tender for Sion hospital, which remains pending since a year, the hospital is forced to desperately rely on municipal laundry that is itself battling with massive vacancies.

Administrative delay

In November 2016, Sion hospital appointed tender of two years to private laundry to wash a total of 9 lakh clothes — 10 per cent of hospital’s requirement. The remaining 90 per cent would go to municipal laundry that washes clothes of 60 BMC-run hospitals.

In January 2017, the crunch began. Due to labour shortage, the municipal laundry could not deliver washed clothes within standard 48 hours. Eventually, Sion hospital shifted its laundry load to private tender. “By June 2017, private contract of 9 lakh clothes had exhausted,” said Deputy Dean Dr Vidya Mahale. The contract ended much before the tender ends in October 2018.

According to Sion hospital officials, since last year, the hospital’s entire laundry is depended on Municipal Power Laundry as the civic body’s accounts department is yet to process the tender that was recently cleared by the standing committee last month. The hospital now plans to appoint private laundry for three years to wash 50 per cent of its clothes. “This should reduce our dependence on BMC laundry and solve the problem,” Dean in-charge Dr Jayshree Monkar said.

But even as fresh contract is awaited, the hospital struggles with infection control, delay in surgeries and witnesses a backlog of six days before it gets its fresh laundry from the municipal facility.

Municipal power laundry’s burden

Municipal power Laundry in Parel. (Express photo)

In the 1965-established municpal laundry, half a dozen men clad in white slip and shorts sit amidst mountain of washed clothes and fold them. In the adjacent heated anti-chamber, another dozen work around tumbler and washing machines.

The Parel laundry has a capacity to wash 16,000 clothes every day. But since few years, the capacity has dipped to barely 11,000 clothes. “Currently, we manage to wash 8,000 clothes or so each day,” a worker said.

Of 176 sanctioned posts in laundry, 53 remain vacant. The maximum shortage lies in labour force, where of 83 posts, 44 (53 per cent) remains vacant. In the last two months, four labourers retired.

“Last permanent appointments were made in 1992,” an administrative official said.

The municipal laundry is manually operated. As many as 12 labourers are needed in washing section, 14 in drying section, one for delivery, four for folding clothes. The laundry currently has only 39 labourers to handle both shifts.

“Earlier, we had three shifts… slowly we came down to two shifts. Currently, the second shift hardly has three-four labourers. In one shift, we need at least 42 labourers,” an official says.

The dip in laundry’s performance has affected major hospitals with Sion hospital being the worst victim. On Friday, laundry records showed that 4,102 clothes of KEM and 3,408 clothes of Sion hospital were pending. Maximum clothes were of doctors, including their apron, pajamas, and shirt, forcing a delay in surgical procedures. For instance, 843 doctor slips and 676 pajamas in Sion hospital were yet to be washed.

“We wrote multiple letters to the Labour department. But there have been no appointments,” an official said.

The work in laundry starts by 9 am every day, once a delivery van leaves with fresh clothes to deliver at hospital and pick soiled ones in return. It gets 2,000 clothes from KEM Hospital, 2,500 from Nair and 3,000 from Sion hospital daily. The clothes — bed linen, apron, doctors’ clothes, patients’ clothes — are then separated manually into lots.

On Friday, the laundry had 20,000 pending clothes to wash.

Once separated, the clothes are fed in eight large washing machines. Each machine, with 57 kg capacity, washes 150 clothes in one cycle.

The clothes are pre-washed in cold water, then washed in steam at 85 degrees to kill bacteria. Sodium hypochloride is then added as disinfectant, followed by ultra-marine blue to whiten clothes. The clothes are then manually fed in dryer with 11,000 rotations per minute. Once excess water is removed, the clothes are fed in calender machine to dry and iron them completely.

The two calender machines in laundry, requiring 13 labourers each, were crafted by the Britishers. In 1965, they were transferred to the municipal laundry.

The clothes are then hung and passed through heating chamber for 10 minutes. In the end, another section is dedicated to pneumatic pressing machine where 20 machines iron clothes of doctors and patients. Six of them were manufactured by Britishers.

The washed clothes are then manually folded by labourers before being packed for delivery.

Every week, over 50 maternity and peripheral hospitals send clothes for wash. “We manage to handle load of peripheral hospitals and maternity homes since quantity of clothes is less. But the issue comes in handling daily load of KEM, Sion and Nair hospital,” an official from laundry said.

“With labour shortage, the output of the laundry has greatly suffered. I have complained to the additional municipal commissioner who has assured 44 labourers will be appointed on contract basis,” said local corporator Ashraf Azmi.

Infection risk

“Any infection spreading from hospital is termed as nosocomial infection,” said Dr Bhupendra Awasthi, medical director at Surya Mother and Childcare Hospital.

Experts claim unwashed bedsheets used for prolonged period in a hospital may pose greater infection risk in new-borns who already have low immunity. In cases where one bed sheet or pillow is infected, it may get transferred to other patients if nursing staff and doctors do not follow standard hand-sanitising hygiene.

“In hospitals, infection rate is high. Overcrowding can also led to increased risk,” Awasthi added.

In Sion hospital’s ward 15, for instance, where women post delivery are housed, in about 40 cots, over 70 women patients are adjusted with their new-borns, with some accommodated on mattresses on floor.

A senior doctor from gynaecology department said not just unwashed linen but poor hygiene too leads to infection risk. “Our hospital caters to lower income strata. Mothers are already under-nourished and their babies have poor immunity. In that case, this becomes a highly contagious environment,” he said.

“In cases where body fluids from one patient are coming in contact with bed linen, there is always a fear of infection. It could be gram negative, gram positive or fungal infection,” said Dr Om Srivastava, infectious disease expert.

According to Dr Avinash Supe, Dean of KEM hospital, the hospital shifted its 50 per cent laundry load to in-house laundry to ensure linen is never short in supply.

“We understand the risk. Because 50 per cent of our clothes are washed in hospital, we are able to continue surgeries,” he said.

In Nair hospital, 30 per cent of hospital linen is washed through private laundry. Doctors claim in intensive care units, specifically, linen must be changed every day for patients.

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“That is why I use clothes from home,” said Gazala Parveen Ansari, who delivered her second baby on September 24 in Sion hospital. “My one-day-old son is at risk of infection in hospital… I keep him covered,” she said. Under her bed, a stray cat had defecated. “Complaints to nurses yield no response,” she said.

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