The biggest market for FM-200 looks like Saudi Arabia, we were looking at a tender from there two months ago, they had 22 rooms with FM-200 in a 30,000 SF facility (every electrical closet had FM-200). Relying on an operating room to be air tight is ridiculous, at discharge, some nurses will just run out the door and call for help, leaving the door wide open. How many SCBA's you would have in the room? can your patient use a SCBA?
When an operation takes place, you have a dozen people in that room that can turn out a fire with FE's. If the room is not occupied, sprinklers are just fine.
The middle east is subject to all sorts of life safety philosophies, British, Australian, US, etc.
They still design fire hose cabinets with 1 1/2" hoses expdecting the user to turn out the fire. They also have smoke exhaust for operating rooms and fire rated ducts (but the medical gases and power not in fire rated enclosures) with 2-hour rated walls in operating rooms.
The truth is, the average engineer in the middle east is about 32 years old (you can check HAAD statistics for expats in the UAE)with about 4 years of experience (two of those being Autocad), and does not have a clue, and he is scared as hell. He is also a mechanical engineer (not a fire protection engineer). And you get some of the weirdest life safety designs around.
They deisgn with FEAR in mind.
Matter of fact, most companies don't even have code books or masterspecs. Most companies have one MEP guy, a Mr. know-it-all of sort who bakes his own bread (does his own CAD). Their drawings don't even have equipment capacities, they don't size a fan, a pump or anything.
And man, do they play like they are big shots.
Mr. mabed, tell me if I am wrong - suggestion, if you use NFPA, fllow th advice of US pratitioners such as the advice you just got here. Most of the guys on this forum are actually fire protection engineers.