Osmania Hospital was constructed on the site of Afzal Gunj Hospital, which was home to the Hyderabad Chloroform Commissions. After the Great Musi Floods of 1908, the City Improvement Board strived to provide Hyderabad with public healthcare matching universal standards. The current heritage block of the Osmania General Hospital was designed by Architect Vincent Jerome Etsch and the construction was finished in 1919. The building is the icon of Osmanianarchitecture, resembling the Indo-Saracenic trend of the time. Since the design was completed in the aftermath of a devastating deluge, the new construction was designed to handle future floodings of the Musi. Though the Musi was tamed by dams, Vincent Etsch would not have dreamt in his wildest dreams that subsequent governments would add layers of cement over the drains of his lovely hospital. 

The reason Osmania is dying a slow and painful death is that governments have consistently overlooked it and it fell into disrepair. The wards were plastered over with vitrified tiles and many unplanned developments took place in and around the building. Basic maintenance like clearing vegetation, filling cracks, waterproofing roof, clearing of drains and chimneys, fixing leakages etc would not have cost the authorities a fortune and yet keep the structure at its original strength. But the root cause of the problem is not in the hospital itself but in its surrounds.

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