Idris Khan and his wife had waited four years after their marriage for a child. When their prayers were answered on Wednesday, at the hour of Fajr, a son was born. In that quiet, sacred window before dawn, Idris did what a father is meant to do: he recited the azan into his newborn’s ear and gave him a name.
The child was meant to be carried home for celebrations, but Idris instead carried his body home. His son was among the 14 newborns killed in the nursery fire at PIMS hospital in Islamabad on August 26, 2026. The fire tore through the nursery of the Maternal and Child Health Centre around 6:45am. The interim inquiry has not conclusively identified the source of ignition, but said an internal electrical or equipment-related failure remained plausible.
Fifteen infants were inside. Only one was rescued after a nurse alerted a female security guard posted outside the nursery. Parents outside said staff were not immediately available when the fire broke out and that the ward’s doors, kept locked, they were told, to prevent baby theft, left no clear way out.
This was not Islamabad’s first warning. The capital’s H-9 Sunday Bazaar has been hit by fires at least five times since 2017, most recently in June this year, damaging hundreds of stalls each time. In 2022, flames swept through the Centaurus Mall, the capital’s largest shopping centre. A citywide survey completed just months ago found that most of the roughly 6,500 buildings inspected, including some 300 government facilities, lacked valid fire-safety certificates.
A similar pattern was seen in the Karachi shopping-complex fire in January 2026 that killed 65 people, again exposing enforcement gaps. The findings were documented. Little appears to have changed.
Hospitals have fared no better nationally. A Dawn timeline of incidents since 2010 lists fires at Lahore’s Services Hospital, Rawalpindi’s DHQ and cardiology institute, Karachi’s Sindh Government Hospital and Ziauddin Hospital and, most chillingly, Sahiwal Teaching Hospital in June 2024, where a short circuit in an air-conditioning unit killed 11 babies in a children’s ward. Two years and one inquiry later, another nursery fire has killed more newborns in the capital.
The interim inquiry into the PIMS tragedy identified serious deficiencies in firefighting arrangements, emergency exits, evacuation planning and emergency response. It noted hoses without couplings, no water at a fire point, alarms that did not provide timely warning, and exits that were locked or blocked by barriers.
The city’s Fire and Disaster Management Department had been issuing PIMS non-compliance notices since 2018, according to official communications. The warnings said fire-prevention equipment was missing. The most recent notice, issued in 2024, gave the hospital three months to comply. That deadline passed without the deficiencies being addressed.
The question now is whether the burden on the hospital has become too great to manage. Available health-sector data show that a large majority of patients seek treatment in the private sector. For those dependent on public care, Islamabad has roughly 90 Basic Health Units and Rural Health Centres meant to absorb routine treatment so that patients do not flood PIMS and Polyclinic, the capital’s two major public hospitals.
Most of these BHUs and RHCs function in name only. For years, many sanctioned posts have remained vacant, while some facilities lack even electricity or clean water, forcing rural populations towards the two overstretched city hospitals. That overload leaves wards such as PIMS’s nursery understaffed and infrastructure stretched beyond what ageing wiring and equipment can bear.
Money for compliance was never the only constraint. Enforcement was equally important. The Islamabad Healthcare Regulatory Authority, created under a 2018 law, sets minimum standards for healthcare establishments and regulates licensing. Yet no public record has emerged of effective regulatory action to ensure that PIMS addressed years of fire-department warnings.
The law creates a separate arrangement for federal government hospitals, which are deemed registered while the federal government is required to certify their compliance with minimum standards prescribed by IHRA. That arrangement has blurred accountability: the hospital, health ministry, regulator and civic authorities can all point elsewhere when basic safety failures go unaddressed.
Recruitment bans, contract-based hiring and appointments made through influence rather than merit have hollowed out technical and administrative posts across health institutions. They have left critical-care wards without dedicated safety officers or accountable engineers. The right person for the right job simply was not there when it mattered.
Fixing PIMS’s wiring will not fix Pakistan’s hospitals. What is needed is mandatory, independently audited fire-safety certification for every government facility, with enforceable deadlines and consequences; continuously staffed, unlocked and monitored ICUs and nurseries; functioning primary-care facilities that reduce pressure on tertiary hospitals; and an independent mechanism empowered to enforce safety standards rather than merely recommend them.
Idris is still waiting for someone to explain why his son was trapped in a room that was supposed to be the safest place in the hospital. Until the system that allowed this to happen is rebuilt, not merely investigated, he will not be the last father asking that question.
(Writer: Dr Quaid Saeed Akhunzada, former Chief Executive Officer, Islamabad Healthcare Regulatory Authority. The views expressed are the author’s.)