Outside the elevator of Hyderabad’s Osmania General Hospital’s (OGH) outpatient block, Bugappa, a 50-year-old man, his abdomen swollen, was laid out on a stretcher.  A few feet away from him sat Padma, a 55-year-old woman, waiting patiently with her son Mahendar. They were at the hospital for her 28-year-old son’s monthly epilepsy check up. Bugappa’s son Anji and Padma said they came to the hospital travelling significant distances to seek medical care. 

Bugappa works as a stone cutter in Medchal district, 27 km away from the OGH. “My father’s knees are in bad shape as is his abdomen,” said Anji, who thinks his occupation may have contributed to his health condition. An illness in the family can easily upset the lives of people down the socio-economic strata because the livelihoods of others too would be affected. Padma stopped working as a house-help to take care of her son. “He can start getting seizures at any point,” she said. It’s expensive for them to come all the way every month from her home in Jagadgirigutta but there is no other option available, she said. 

OGH, a government hospital in Hyderabad’s Afzalgunj has housed patients, free-of-cost since its inception nearly a 100 years ago. Last week, the Telangana government submitted an affidavit to the High Court clarifying its intent to demolish the heritage building and construct a new one in its place. The decision has raised alarm bells for heritage activists even as hospital staff and government officials make a case for prioritising medical care over heritage conservation. 

“It isn’t that heritage isn’t a priority. It is. But as a doctor my concern rests with the needs of patients,” said OGH Medical Superintendent Dr Nagender. Nagender said patients, mainly from working class Muslim households, seek medical care at OGH from districts like Nalgonda, Mahbubnagar and even from bordering states of Karnataka and Maharashtra. 

“We need modern infrastructure,” he said. The old building of OGH isn’t fit enough to address the modern health care and no expansion is possible. “Medical research is improving and with it, the need to expand and accommodate spaces for facilities like geriatric care, transfusion medicine, and a trauma centre,” he said. 

In 2020, during the COVID-19 pandemic, the old building was flooded with rain water after heavy showers and patients had to be evacuated. Patients were accommodated in other blocks of OGH, which were constructed over a decade ago. While many blamed the old structure for the flooding, it was later found that a clogged drain in the premises was the culprit. Since then, even during continuous heavy rainfall, the old building has not been flooded. 

Dr Nagender told TNM that the hospital is congested currently but nobody is denied care. “A new, better building will mean better medical care for a host of patients,” he added. The OGH Superintendent said the old building has not been in use since 2020.

An OGH official said patients would be accommodated by the state government elsewhere once the construction of new building commences. Where exactly they would be accommodated is however not clear.

Dr Nagender said OGH accommodates 1800 to 2500 patients every week. The old building has 1385 beds of which 1000 were relocated to the new building inside the OGH premises. The Petlaburj and King Koti hospitals are nearby but do not have the patient capacity that OGH does. Dr Nagender said when the construction commences, the patients will continue to be treated in the new building without any concern. 

Osmania General Hospital (OGH) was commissioned around 1919 by Osman Ali Khan, the last Nizam of Hyderabad. It was designed by British architect Vincent Jerome Esch and was completed around 1926. It is part of the Old City’s skyline, which has the Telangana High Court, also designed by Esch, across it. The building’s dome, pavilions and stairwells are regarded as a lucid example of the Indo-Saracenic style. 

The hospital buildings old and new are housed in a 26.5 acre compound but there is no space for new buildings.

In the affidavit submitted by the state government, Telangana health secretary S A M Rizvi said that OGH needs 1812 beds to handle the patient load and as per Indian Public Health Standards (IPHS), there is a stipulation for 100 to 110 square metres per bed for teaching hospitals. Additionally, he said that a 21.75 lakh square feet of built up area along with a 4.84 square feet is needed for residential quarters for postgraduate students including a 5.85 lakh square feet for multilevel parking and 2.66 lakh square feet for oxygen tank, mortuary, electric substation services are essential. 

A two-member expert committee appointed under the direction of the High Court which had the Director of IIT Hyderabad and the head of Archaeological survey of India (ASI), concluded that the current building is unsafe and cannot be used in its present state.

“In view of the above deliberations, it was opined that the old building is unfit for any kind of patient care and that the said building is to be removed along with other satellite buildings for development of an alternate hospital building,” Rizvi stated in the affidavit.  

Historian and conservation activist Sajjad Shahid however does not buy the government argument. “Surely, even the government has to admit that not all parts of a hospital need to be modernised. But even if there is a pressing need, there is a possibility of remodelling OGH while preserving its historical past,” he said. 

Shahid was referring to a 2012 report prepared by conservation architect GSV Suryanarayana Murthy. Murthy’s report lays out a master plan to explain how “the new built forms shall not (have to) compete or dwarf the OGH in terms of form or scale.”

A 2019 report by Indian National Trust for Art and Cultural Heritage (INTACH) concluded that the OGH building is structurally safe and can be made safe for another century if properly maintained and restored.

While discussing the state government’s move, Murthy told this reporter that the government’s current decision is “abrupt and illogical” and each time he presented a solution, the issue of extra beds or extra floor space was brought up to dilute his argument. Both Shahid and Murthy concluded that additional needs could be accommodated elsewhere if the need arises. 

“The Osmania General Hospital is a symbol of Hyderabad’s identity and stands for it. This has happened previously when the state government tried to do away with the historic Irrum Manzil. An attack on history is an assault on identity,” concludes Shahid.