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  • A relative sits next to a child patient who is suffering from acute encephalitis syndrome at a hospital in Muzaffarpur, in the eastern state of Bihar, India.

    A relative sits next to a child patient who is suffering from acute encephalitis syndrome at a hospital in Muzaffarpur, in the eastern state of Bihar, India. | Photo: Reuters

Published 26 June 2019

In June, more than 150 poor rural children of the eastern state of Bihar died of “brain fever,” most of them suffered from malnourishment.

More than 150 children in India, mostly from poor rural families, have died this month from encephalitis, a type of brain disease that has afflicted the eastern state of Bihar for more than two decades.

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Acute Encephalitis Syndrome (AES) known as ‘brain fever’ is caused by any one of a number of viruses. Symptoms include high fever, vomiting and, in severe cases, seizures, paralysis, and coma. Infants and elderly people are particularly vulnerable.

The precise causes of AES are not known, though a majority of medical professionals say it is linked to a ferocious heat-wave.

India’s top court Monday ordered an investigation into the death of the children after hearing a petition in which the state and central governments were accused of negligence.

The disease has reached endemic proportions in Muzaffarpur, a poor district of Bihar, which has some of the worst child health statistics anywhere in the world. Over 131 children died from Muzzafarpur alone. 

A similar outbreak killed 350 children in Muzaffarpur in 2014, leading to questions about why the state and central governments had not done more to combat the disease.

Amid an acute shortage of beds, medical supplies, and failing infrastructure, doctors from other parts of the country have been dispatched to Muzaffarpur to help staff at the Sri Krishna Medical College Hospital which had to evict a group of sick inmates from a ward to accommodate the surge in AES patients. Most of the children who died were being treated at the hospital.

"There were no beds available. Only a few doctors were attending to a huge rush of patients," said Nirmala Devi who lost her son on June 9. 

"Multiple children were kept on the same bed in wards," she told Al Jazeera. "If there were enough doctors to attend to patients, my son would have been alive."

Some studies have blamed toxins in lychees, a fruit grown in abundance in orchards around Muzaffarpur. 

Kaushal Kishor, additional secretary in Bihar’s health department said, "It's all guesswork. There is no conclusive evidence that lychees cause this disease."

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As the death toll mounts, both the Bihar and the federal governments have come under criticism for their inability to save children, and doctors and government officials have faced angry protests.

“We issued a notice to the Bihar government seeking a detailed response,” said Supreme Court Justice Sanjiv Khanna Monday in response to a petition filed by activist lawyer Manohar Pratap.

The petitions, known as public interest litigations, are a common way for citizens to pressure state and national governments into action.

The petition stated that AES “is completely curable and lives of young children are being lost due to the inaction of the state machinery… Most of the deaths are occurring due to lack of medical facilities in the area of the outbreak.”

Protests have also taken place, joined by parents who lost their children to the disease. However, a complaint was filed to the police against the protesters, according to local media that said a First Information Report was filed against at least 39 protesters.

As the news broke of the complaint, a nationwide outrage ensued. "None of the identified people have been arrested so far and investigations are on to identify the unnamed accused," a police officer said. 

Locals remain fearful of more deaths amid what they perceive as slow reaction from the authorities. "So many children have died due to this brain fever," said Kusheela Devi.  "I am worried about my two grandchildren who are currently admitted here."

"As a parent, I know the pain of losing a child. My appeal to [Bihar Chief Minister] Nitish Kumar's government is to please focus on the state's healthcare sector and improve the facilities in the hospitals so that no parent loses his child to such diseases in future," said Hussain Mian who lost his three-year-old daughter on June 15.

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