India and Pakistan: When Human Lives Become 'Small Change' in National Budgets

Within a single week, three newborns died in a fire at the neonatal intensive care unit (NICU) of a public hospital in Amravati, Maharashtra, western India. Two days later, 14 other infants perished in a blaze at the maternity ward of one of Pakistan's largest public hospitals in Islamabad. The reported causes differed – a faulty ventilator in Amravati and an exploding air conditioner in Islamabad – but the grief of parents on both sides of the border is identical.

In both places, parents stood outside public hospitals, trying to comprehend the cruelty inflicted by their own authorities. In Amravati, a father was still distributing sweets to celebrate his child's birth, never having seen the baby's face. In Islamabad, a family was celebrating their firstborn son after years of waiting. Circumstances differed, but institutional failure and official response followed a familiar pattern: rescue teams arrived late, and emergency evacuation was hampered by basic fire safety lapses. Politicians quickly expressed condolences. High-level inquiries were announced, along with financial compensation and fire safety audits. When the dust settled, both tragedies exposed the same undeniable truth: the lives of poor, vulnerable families are expendable in both nations.

The two countries are rivals in cricket, military displays, and diplomatic rhetoric, but they are united in treating their citizens' lives as 'small change' in national spending. In 26 years as a health journalist, I have witnessed hospital fires in India and Pakistan causing significant loss of life repeatedly, with no change in how these facilities are managed. The 2011 AMRI hospital fire in India killed 89 people; the 2016 SUM hospital fire in Bhubaneswar killed 24 – no one was convicted. In Pakistan, the 2012 Services hospital fire in Lahore killed 10 newborns, and 11 more died in a 2024 fire at Sahiwal Teaching Hospital.

The latest fires – in Amravati and Islamabad – cannot be dismissed as equipment malfunction or personal negligence. They occurred not in remote areas but in India's wealthiest state and Pakistan's capital. They speak to government priorities. Official data paints an even grimmer picture. Neither country is poor or war-torn, lacking the knowledge or wealth to do what is necessary. The refusal to improve is a political choice – and an unforgivable one.

India and Pakistan have spent decades persuading their citizens that the highest form of security is defending against each other. The truth is that the greatest threat their people face is our own careless governments. Fires in large buildings – factories, malls, and hospitals – occur frequently, often due to poor compliance with safety regulations and lax enforcement of building codes. These recurring incidents raise questions about the political system, judiciary, newsrooms, and civil society. They expose the core of these two democracies – what they prioritize and whom they value. And the answer comes in the same voice – not the vulnerable, the sick, or the poor.

Earlier this month, both nations celebrated 79 years of independence. Both have spent 79 years reminding each other of pride in their complex history, culture, languages, and cuisine. But on both sides of the border, we are governed with brutal carelessness. We now have states that have the form of procedural democracy but no concern for changing the lives of the poorest. We are taught to sacrifice – wealth, loved ones, dignity – all in service of the nation, and to fend for our own safety without expecting anything from the government.

Watching defenseless newborns die in fires on both sides of the border, I wonder if the leaders of these two countries feel shame. Shame for the women who had just given birth and had to run down multiple flights of stairs, climb out of windows, and down ladders to escape. Or when horrified families discovered that the hospital's sprinkler system did not work when the fire broke out. Or when they will spend the rest of their lives recovering from the horror of seeing charred infant bodies.

I wonder what military strength and nuclear arsenals mean to Indian Prime Minister Narendra Modi and Pakistani Prime Minister Shehbaz Sharif when they stand before a weeping mother outside a neonatal ward. This is not rhetoric, but a sober assessment of incompetent leadership that lacks love for its own people. Because countries that can spend billions preparing for war cannot justify that installing fire sprinklers or enforcing fire safety regulations in hospitals is an unreasonable demand.

Fire safety is not a luxury. It is not a Western or colonial aspiration. It is not even the infrastructure of wealth – like high-speed trains – that a nation acquires when it is rich enough, modern enough, or powerful enough. It is the minimum standard. It is the bottom line below which a government cannot let its people fall repeatedly and remain blithely indifferent each time.

Seventy-nine years is long enough for a nation to become itself. Long enough to build armies, launch satellites into space, develop nuclear arsenals, and show off to neighbors. But what good is national security if a newborn cannot survive in the very building where it is born? Or does security only mean the state's ability to protect itself from other nations – while their citizens die like insects, unpredictably and needlessly? Parents in Amravati and Islamabad do not need nuclear arsenals to protect their children. They need functioning fire alarms and unobstructed escape routes. Nations that cannot guarantee such a basic amenity have no right to national pride.