Language feels almost laughable. Fourteen infants died in a fire at PIMS in our mighty capital. Fourteen infants dead - and we are left asking what, exactly, was protecting them. There are condolences, grief, demands for an inquiry, promises of action and, inevitably, a wave of anger. Can somebody hear me without rushing to speculation about facts that an investigation must establish? Can we instead ask what this catastrophe reveals about the systems in which we place our most vulnerable lives? An anxious autopsy, if you will not of the infants, but of the institutional body around them. Is there anyone in government, in the bureaucracies, willing to step outside their comfort zone and move past the signature shamelessness - besharmi - of institutional denial, and examine causes? The questions may even qualify as forbidden text.

Who designed and maintained the infrastructure? Who allocated the money? Who could raise an alarm without fear of consequence? Whose safety was imagined when the system was designed? And who is held accountable when the system fails?

These are not merely questions about one hospital. They are questions about inequality and power.

In Pakistan, healthcare is often discussed as though hospitals are collections of buildings, machines, doctors and beds. But a health system is also a hierarchy of people. There are those who command, those who implement and those who quietly carry the consequences of decisions made above them.

An ordinary doctor in a public hospital may have professional responsibility........

© The Express Tribune