Investigation of Hospital Fire Continues

A week and a half after a fire ragedthrough two floors of San José’s HospitalCalderón Guardia, claiming 19 lives andcausing an estimated $15-20 million indamages, questions still cloud the air as tothe cause of the pre-dawn blaze, andwhether the same fate could befall otherpublic institutions.While the fire department’s investigationinto the cause of the fire concluded itwas accidental, and the police investigationcontinues undecided, directors of thehospital, who have come under criticismfor not heeding warnings and improvingfire safety at the facility, have accused anurse of starting the blaze.The Firefighters Corps, a division ofthe National Insurance Institute (INS),announced July 15 it had finished its investigation,and concluded the fire was startedby a fluorescent light in a storeroom on thefourth floor filled with paper and plasticcups.The Judicial Investigation Police (OIJ),though, has yet to conclude its investigation.“WE are 50-50, in the sense that itcould be accidental or it could be intentional,and there is not an inclination toeither side,” Jorge Rojas, director of theOIJ, told the Tico Times. He said policehave not questioned the nurse charged bythe hospital because they have yet to determineif there is a crime to investigate.“We cannot detain anyone if it is notclear whether this was intentional,” Rojassaid.Meanwhile, little doubt remains thatmany of the deaths could have been prevented,as reports surfaced immediatelyfollowing the fire from as far back as 10years warning the hospital about its lack ofsafety measures and detailing specific risksas well as precautions it should take (TT,July 15).Calls for the resignation of the directorof the hospital, Luis Paulino Hernández,came quickly from various sectors of society,but most notably from the SocialSecurity System (Caja), which overseesthe nation’s hospitals.Hernández, however, refused toresign. He told the press he had asked theCaja to give his hospital the resources tomake the necessary improvements, but itnever did.The Caja responded that it gave thehospital a budget large enough to cover thechanges, and it was Hernández’s responsibilityto make sure they were made. In aspecial session the day after the blaze, Cajadirectors were ready to suspend Hernández,according to the daily La Nación.Instead, they opted to give the director oneweek to submit a report showing he did allhe could to improve safety at the hospital.Hernández submitted the report Wednesday,according to Caja spokeswomanLiliana Insera.AS a result of the fire, the nation turnedits attention to the safety of other publicinstitutions.The Constitutional Chamber of theSupreme Court (Sala IV) ruled yesterdayin favor of U.S. building codes adoptedby the INS in January. Constructionindustry members had filed requests withthe court to overturn the codes, claimingthey are too costly and difficult to accessin Costa Rica.The Sala IV ruling upholds thecodes but requires that they be translatedinto Spanish and made more easily available.Meanwhile, President Abel Pachecohas requested that a group of specialistsfrom various departments of the government,headed by Public Health MinisterRocío Sáenz, investigate and issue areport on the safety of the buildings thathouse Costa Rica’s public institutions, LaNación reported. The group will evaluatethe buildings’ preparedness, or lackthereof, in case of fire, earthquake, orother threats.The President also signed a decree July14 declaring the fire a national emergency.This step frees money within the governmentto assist in the rebuilding of CalderónGuardia.The decree makes available theresources of the National EmergencyCommission, including funds that have notbeen tapped by other national emergenciesand money from other institutions that arerunning surpluses, according to a statementfrom Casa Presidencial.It also allows public institutions as wellas private companies to support the reconstructionthrough donations and other contributions.The declaration is effective untilthe hospital reestablishes its services “in acontinual and adequate manner,” the statementsaid.In addition, two experts from the Pan-American Health Organization came toCosta Rica to check up on the safety ofvarious hospitals in what was the first ofvarious visits the organization plans tomake, the daily reported. The officials saidone of the objectives of the visit was tohelp create programs that reduce potentialrisks in hospital areas.WITH the assistance of other publichospitals and clinics, as well as some privateuniversities, Calderón Guardia isreturning little by little to its normal routines,though according to some estimatesit could be months before the hospitalwill be functioning at its pre-firelevel.According to La Nación, about 5,000appointments and 300 surgeries were suspendedbecause of the fire. One week afterthe fire, medical specialists at CalderónGuardia had resumed their normal practice,and five area hospitals had taken onmany of the surgeries that CalderónGuardia is unable to perform.The private universities Latina,Interamericana and Internaciónal de lasAmericas have all offered assistance to theCaja, Calderón Guardia and other hospitals,such as sending student nurses to helpease overload at Hospital San Juan deDios, where many patients from CalderónGuardia were taken after the fire, andoffering clinic space for appointments thathad to be moved, according to the daily LaRepública.