GORAKHPUR: Malti collapses on the filthy hospital floor and wails: “Oh my son, you have just left us! Oh my child, why have you left us?” She shrieks through her sobs at the foot of her dead son’s bed, but no one pays much attention.

Death has become a common sight here.

Four days earlier, Malti’s 16-year-old son, Lakshman, fell ill with a high fever. His condition worsened until the family drove him 75 miles to the government hospital in Gorakhpur, near the border with Nepal. Lakshman joined hundreds of other children struggling to survive the same disease, many lying two to a bed. Over the past six months, Japanese encephalitis has ravaged both sides of the border, killing more than 1,000 people, mostly poor Indian children.

The mosquito-borne virus is easily prevented with vaccines, but there is no money for the shots in this poverty-stricken corner of northern India. Most parents wait until the situation becomes dire before scrounging enough rupees to travel to the government-run B.R.D. Medical College in Gorakhpur, hoping for a miracle.

But miracles are hard to produce without supplies, equipment and staff — all in short supply at the overcrowded and long-neglected hospital, where dirty water pools at the bottom of a stairwell and floors are covered with grime, medical wrappers and an occasional syringe. The humid air is thick with the smell of death.

Dr. K.P. Kushwaha remains committed. He races from patient to patient, checking oxygen being pumped into heaving chests and placing a comforting hand on the shuddering shoulders of mothers like Malti. As the pediatrician in charge of the Japanese encephalitis wards, he has seen many outbreaks over the past 25 years. In 1986, 960 patients were hospitalized with the disease. But nothing compares to this year: About 560 of the more than 2,000 patients admitted have died. “This is the worst,” Kushwaha says, shaking his head. “This is the severest epidemic we have ever seen.”

Uttar Pradesh is ripe for the disease because it has plenty of rice paddies and a bowl-shaped landscape that allows water to collect in pools. Heavy rains have saturated the ground this year, leaving the perfect breeding grounds for mosquitoes that carry the disease from pigs to humans. Residents are often illiterate, making it harder to raise awareness about the disease, Kushwaha says. Given the state government’s lack of money and political will to vaccinate seven million children in the affected areas, Kushwaha said the easiest solution would be to eliminate all swine. Although many Indians are strict vegetarians, the Hindu religion does not restrict eating pork.

“People are dying because of pigs,” he said. “It’s really very frustrating to us.” Medical experts have argued that India should acquire a cheap, one-shot vaccine for the disease produced in China. India produces a more expensive kind that requires three shots. Regardless, it’s too late to prevent this year’s outbreak.

Japanese encephalitis patients take up two floors at the Gorakhpur hospital. Children dominate the caseload because most adults in the area have immunity to the virus. Only about 1 in 250 people infected develop symptoms, and survivors become immune. The unlucky who fall ill face raging fevers up to 40 degrees C (104 degrees F), followed by convulsions and coma. The World Health Organization estimates 75 per cent of survivors live with some type of physical, mental or emotional disability. Japanese encephalitis strikes only in Asia, where the WHO says an average of 50,000 cases are reported per year, with 15,000 deaths. Many cases go unreported. But the illness is pushed down on the priority list by other diseases, including Aids and malaria, that compete for money and attention. “Frankly speaking, it is not very high because those cases are relatively small,” WHO Director General Dr. Lee Jong-wook said on the sidelines of a WHO meeting in New Caledonia.

At the Gorakhpur hospital, relatives sleep in shifts for weeks in crowded hallways, and in one ward, 80 patients are stacked in 54 beds. In a small intensive care unit, unconscious children sleep with hoses taped to their faces and their eyes rolled back. There are only seven ventilators for the most severe cases, but not enough doctors to ensure they’re working properly. Parents act as nurses in a vast open-air area with rows of beds. They hold plastic tubing from oxygen cylinders and pound their children’s chests to try to help them breathe. They bathe their children to ease burning fevers. Mostly, they sit and hope.

Occasionally, a wail is heard and a mother falls to her knees as death visits another bed that soon will be filled by a new sick child.—Dawn/LAT News Service