On the morning of 26 August, fifteen newborn babies were in the nursery of the Mother and Child Health ward at the Pakistan Institute of Medical Sciences in Islamabad. Fourteen of them did not leave it alive. The federal health minister said the fire began with a blast in the ward’s air conditioner. One infant was carried out by a doctor. The rest of the cots were emptied by the time the fire brigade had finished.
The federal health secretary was suspended within hours and a fact-finding committee was constituted. That is the sequence Pakistanis have learned to expect: a catastrophe, a suspension, a committee, and then the slow return of silence. What is rarely asked is the prior question. Why does a nursery in the country’s largest public hospital reach the morning of a fire with nobody having checked whether it could survive one?
The answer is not primarily about wiring. It is about who the people in charge believe they owe an answer to.
When those who hold power know and understand that the public played no part in bringing them to it, the public becomes irrelevant to them. It is a simple proposition, and everything else follows from it. If the voter did not confer the office, the voter cannot withdraw it. And if the voter cannot withdraw it, then the voter’s problems, hardships, griefs and needs become someone else’s department.
The most dangerous consequence is not indifference. Indifference can be shamed. The dangerous consequence is that those in power stop regarding themselves as answerable at all — not reluctantly answerable, not slowly answerable, but answerable in principle. Once that idea goes, governance does not decline gradually. It loses the mechanism that was supposed to correct it.
Accountability is not a ceremony conducted after a disaster. It is the thing that was supposed to prevent one.
This is why the inquiry committee arrives too late by design. An official who expects to be questioned in advance maintains the fire alarm. An official who expects to be questioned only afterwards prepares an explanation instead. Both are rational responses. They simply produce different nurseries.
Nothing about the PIMS fire was unforeseeable. Islamabad’s own authorities had already established the risk: a survey by the Capital Development Authority covering some 6,500 public and private buildings, including 300 government facilities, found that most had neither obtained approval for fire-safety plans nor been issued fire-safety certificates. The finding was on the record before the fire, not after it.
Nor was it the first warning at that hospital. Three years earlier, four patients died in the PIMS emergency ward over two days, the deaths attributed to heat from a non-functional air-conditioning system. In June 2024, a fire in the paediatric ward of Sahiwal Teaching Hospital killed eleven babies. The information existed. What did not exist was any person who would lose their position for ignoring it.
The same absence shows itself differently in public works. Gujranwala is being rebuilt around a mass transit corridor announced at a cost of Rs 62.7 billion, running 31.2 kilometres and promised, at its groundbreaking in December 2025, within twelve months. The design has since been revised to add underground sections, and completion is now targeted for March 2027. Meanwhile hundreds of thousands of citizens live inside a construction site.
I regard this as a poor use of public money, and I say so as a matter of judgement rather than accounting. Others will disagree, and the corridor may yet serve the city well. But the question worth pressing is not whether the project is good. It is who was in a position to ask, before the first excavator arrived, whether this was what Gujranwala most needed — and whether that person had any reason to care what Gujranwala’s residents thought of the answer.
Here the responsibility turns, and it turns towards us. A public that votes on the politics of the street drain and the discretionary fund will be governed by people who deal in street drains and discretionary funds. That transaction is small, immediate and comprehensible, and it is precisely why it is offered. It purchases the vote at the lowest possible price and settles nothing.
We must raise the price. When choosing those who will lead, three tests should be applied and no others allowed to substitute for them. Is the candidate’s record clean — as clean, in the old phrase, as dew? Does the candidate possess genuine capability and competence, as opposed to connections? And does the candidate have courage, the willingness to say an unwelcome thing to a powerful person on behalf of people who cannot say it themselves?
These are demanding standards, and they will disqualify many familiar faces. That is their purpose.
None of this is a call for despair, and none of it is a case against the state. It is the opposite. A system in which power flows from the people is not merely more legitimate; it is more competent, because it is the only arrangement that makes those in office pay attention to a fire alarm before it is needed. Accountability is not the enemy of strong governance. It is its precondition.
If we choose our representatives on the basis of integrity, ability and courage, the change that follows will not belong to a party or a personality. It will be a change whose fruit the people themselves will eat. Fourteen families in Islamabad are owed at least the attempt.
The views expressed in this article are those of the author and not necessarily those of The Lahore Times.
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