KARACHI, Pakistan — When temperatures reached 44.8°C (112.6°F) on 17 September, Khayal General Hospital listed 72 cooling beds as ready for patients. But a visit that afternoon found only 29 beds in air-conditioned rooms, while people with dizziness, faintness and dehydration waited in a corridor, according to staff and patients interviewed by The Plausible Post.
The discrepancy widened in the public figures. A comparison of anonymised triage entries from 13 to 17 September with the Karachi Heat Desk’s daily totals found 61 cases recorded at the hospital as heat exhaustion or heat-related fainting but absent from the city tally. The hospital reported 112 heat cases for the period; its triage register contained 173 entries in those categories.
The beds behind the numbers
The records were reviewed with permission from patients and staff, then checked against interviews and two visits to the ward. Emergency physician Aisha Kshlerin said staff were instructed to mark a case as heatstroke only when a core temperature had been measured. The triage room had no working thermometer for part of the heat emergency, she said.
“People were fainting in the corridor, but without a temperature reading the form sent them somewhere else,” Kshlerin said. The city desk’s count, she added, did not capture people treated for heat exhaustion or fainting unless a doctor entered the narrower heatstroke code.
The ward was listed as ready, but most of its beds were not cool enough to use.
Aisha Kshlerin, emergency physician
Hospital spokesman Tevin Ruecker disputed that the difference showed patients had been hidden. He said the city total counted confirmed heatstroke, not every case of heat exhaustion, and that the 72-bed figure referred to approved capacity rather than beds guaranteed to have air conditioning at every hour. He denied that staff had been told to alter diagnoses.
A payment tied to capacity
The bed count also carries a financial consequence. A public schedule for the provincial Heat Relief Fund sets a daily payment of ₨8,500 (about €27) for each certified staffed cooling bed. At 72 beds over five days, the hospital’s allocation would be ₨3.06 million (about €9,900), though the schedule does not establish how much it received.
Mía Toledo, who brought her 67-year-old father to the emergency department on 16 September, said they waited more than four hours in a room where two ceiling fans were turning and the cooling unit was off. “We could hear the air conditioner in the next room, but nobody could tell us when ours would work,” she said. Her father was treated and discharged that evening.
The hospital said a mechanical fault and unusually high demand had reduced the number of usable beds, and that repairs were completed on 19 September. Ruecker said its funding was based on certified capacity, not a daily count of patients, and would not confirm the amount paid for the period.
Nathalie Marchal, a deputy at the Karachi Heat Desk, said the office would inspect the ward on 4 October and compare its bed count with the hospital’s submissions. The public tally has not been revised. With another hot spell forecast later this month, doctors said the reporting rules should count heat exhaustion as well as confirmed heatstroke.
