Ten coronavirus patients died in a fire at a Romanian hospital on Saturday, sparking wider safety warnings in a country marked by crumbling infrastructure and a culture of makeshift repairs.

"Any intensive care unit in Romania could find itself in the same situation tomorrow," says anaesthetist Carmen Marginean of the hospital fire in the town of Piatra Neamt.

"How many Romanian hospitals have secure fire doors? Who knows where the nearest emergency exit is," she asks.

According to Marginean, fire safety training for medical personnel "only happens on paper".

Liviu Ungureanu, the head of the intensive care unit where the tragedy unfolded on Saturday, said it had been caused by a syringe pump that caught fire.

The flames rapidly spread through the unit, where eight patients were on ventilators after catching coronavirus.

Those patients, along with another eight in a neighbouring room, had just been transferred there after a reorganisation of the unit.

That reorganisation was meant to ease the workload of the hospital staff, struggling like all other health workers in Romania with a vicious second wave of the pandemic.

But it hadn't been authorised by local health officials and was done in a rush, with a partition put up to divide one large room into two.

Cramming so many extra patients into the same room was clearly too much for the unit's electrical system in a building constructed in the communist era in 1973.

Extra safety checks have been announced for intensive care units across the country.

And not a moment too soon: electricians who have worked in hospitals have taken to social media to publish disturbing images of loose wiring dangling from walls which could cause a short circuit at any moment.

Romanian hospitals "often buy high-performing medical equipment but the electrical systems don't conform to any sort of safety standard", electrician Sorin Popa told local media.

Flames spread rapidly through a hospital unit that had recently been reorganised to cope with extra coronavirus patients
Flames spread rapidly through a hospital unit that had recently been reorganised to cope with extra coronavirus patients AFP / Robert IOSUB

Hospital bosses "are meant to conduct checks on their own initiative but it seems that they need a police officer to be checking up on them", Marius Filip, director of Romania's National Authority of Quality Management in Health (ANMCS), told AFP.

But Beatrice Mahler, who's in charge of the Marius Nasta hospital in Bucharest, says it can be difficult to make sure technicians conduct the necessary regular checks on the electrical systems.

Filip is exasperated by the widespread mentality of "making do and mending", which leads to a reliance on makeshift solutions while hoping things turn out for the best.

"If sometimes a member of staff stands up against this, the bosses will just get angry with them and say: 'Leave it, it works just fine as it is,'" he says.

For many Romanians the disaster in Piatra Neamt brought back memories of a fire five years ago in Bucharest's Colectiv nightclub, in which 64 people died.

That fire brought into sharp focus the flouting of rules and regulations which pervades so much of Romanian public life.

It transpired after the blaze that local authorities had allowed the nightclub to continue operating despite not having the necessary permission from the fire department.

Since then, local fire departments are meant to conduct a review before hospitals are allowed to operate.

But according to Filip, while there has been some progress, less than one third of Romania's 670 hospitals have the necessary authorisation.

Carmen Uscatu and Oana Gheorghiu, who run an NGO that built a children's hospital using private donations, are similarly worried about the risk of a repeat of Saturday's fire.

A prefabricated hospital built for coronavirus patients not far from Piatra Neamt "seems to be a makeshift structure even more dangerous than the one that burnt down", they said in a Facebook post.

As well as a heating system that could well stop working in the first cold snap, there is also a gas storage system they say has been constructed in violation of safety rules.

Their appeal to doctors working there is to voice their concerns about such issues: "Speak now, or nothing will change in Romania."