Behind the Byline

Muzaffarpur diary: Chronicles of deaths

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The story of pain, suffering and death from Acute Encephalitis Syndrome that kills hundreds of poor children in Bihar's Muzaffarpur district every year.

I try to find drama. For the sake of the story. Because in journalism school, they told me to locate the conflict, and to show and not tell.

But there's too much conflict. So much that I have to walk out on and off to feel better. I step on the chlorine powder sprinkled on the ramps of this hospital, and try to look away when I cross the corridors for it is full of the sick and the dying. There are those that may be categorized as 'mentally challenged' that lurk everywhere. I am here to report on the Acute Encephalitis Syndrome that kills hundreds of poor children in Bihar's Muzaffarpur district every year.

I have never covered an epidemic. To me, this is one. They won’t declare it. But children are dying in the temporary ICUs and are then loaded on to the mortuary vans and taken home.

On Sunday morning, I walked into an PICU on the second floor of the Sri Krishna Memorial College Hospital in Muzaffarpur, and they didn’t stop me. They let me sit there.

For three days, I recorded the deaths of a three-year-old, and a seven-year-old, and others. I sit determinedly. I don't let the facts get blurry.

I just sit, and I write.

"They are temporary people. This is suffering that comes from indifference to it. Dejection is a permanent feature of this place. This is a temporary place."

I write exactly like how an objective reporter is not supposed to write. My mother had accompanied me. She is afraid to let me travel in my own state on my own. She is outside. She tells me to leave. She is worried that I won’t be able to handle this.

They say the epidemic will go when the rains come. But the sky looks and feels like a blasted furnace. White and blue, shimmering, and merciless. Relentless, too.

But I am not going to be ‘soft’. I sit, and watch the nine cardiac monitors that show the pulse rate and the arterial pressure. I don’t know what these digits mean. The doctors tell me everything is dismal.

What can a poor man do? Ram Bharose knows his curse. His wife isn't here. His three-year-old daughter is dying.

You walk up on floor, and then another, and outside this PICU 1, you meet these people waiting for news of death or life. It doesn't take too long in either case. It is an epidemic. The poor seldom blame anyone. They are just grateful the doctors are trying their best.

Bihar is a timeless place. Everything changes everywhere. But here, nothing ever changes. There’s deprivation, and death, and sadness, and resignation.

In the PICU, they tell me not all will survive. A doctor tells me to take his photograph. He poses with a dying child.

I am not crying.

I walk out. It's evening. The skies have turned orange. It is still very, very hot. I am told I should take injections to guard against infections. I refuse.

The next morning I try to call the father. I call the doctor instead.

"Which one?"

"Mani. The one who was gasping," I offer.

"Gone. A few others also gone. Shobha also is no more," Prof. Arvind says over the phone.

Ram Bharose must be back in his village, which he had said was about 40 kilometres away. What do you do to a child's body gone limp with death? The driver says they give it to the river. If they are more than five years old, they are to be cremated, he adds.

There's the name of Motipur and Sendhwari scribbled on the hospital admit card for Shobha. On Mani's, it says Motihari in Madhubani. It's far, the driver says.

We drive to find the mourners. Journalism is often scoffed at for its lack of expertise, or domain knowledge. But there’s curiosity. I don’t even know what I am looking for.

That I am a reporter has no meaning here. A notebook and pen, and a camera slung over my shoulder are all so misplaced here.

In the cluster of hutments, we try to find Meena Devi. Children with golden hair, and bloated stomachs run around. An illusion. They are suffering with malnourishment. Nine-year-olds look shrunken, and shrivelled. I mistake them for three-year-olds. But they correct me. They don't grow. They have nothing to grow on.

Shobha passed away at 5:30 am on Monday morning.

Sonam, the 10-year-old sister, refuses to talk. Perhaps, more than anyone else where, she doesn't want to make the death of her sibling a spectacle. She walks away.

On Monday evening, I find myself in PICU 3 looking for Shobha's brother Nitesh. He isn't here. He was transferred to the emergency ward, a nurse says after looking into the registers with the information of patients.

Nurses are waiting for shift change. A frail woman in her twenties sits and presses her six-month-old daughter's feet. Rinku Devi is careful not to touch the needles that are pierced here and there. Nandini is gasping. On the bed next to her, a man has fallen asleep at the feet of his daughter. The cardio monitor is still dismal.

Prabha, a nurse, says it is difficult. They are mothers, and they understand the loss. They can imagine its magnitude, and its threat.

I am not a mother. Do I understand?

On Tuesday morning, a woman mourns her loss with a song. That's how they grieve, another woman tells me.

The guard outside the PICU 3 wields the stick, nudges the woman who is wailing, and pushes her.

"I have to sit," he says.

The husband, who sits motionlessly, looks up, and shifts.

"Why are you doing this? They just lost their child," I say.

I call the superintendent of the hospital. Previously, I was in his air-conditioned room to ask about the epidemic.

I want to tell him the poor can't be treated like this. I feel angry. Or is it disbelief at my own stoicism. How can I, a feeble reporter, sit in the ICUs for hours chronicling the deaths of those that didn't have much chance to live? I was trying to fight for human dignity of others. But failed.

"You media and politicians come and lecture us. There are children dying. You don't know the kind of people that come here. What can I do? I am working round the clock. I am 63. I am working round the clock."

"I am not lecturing you. I am only trying to point something …"

The line went dead.

He had shouted something like 'get out of there'

A father takes me to the ward. A man is cleaning the remains of what is left of a life that was messed up. On a lone bed, the child is lying. Dead. No fuss over this one. The father's brother lifts her up. She looks at nobody in particular. She is/was pretty. Big eyes, and hair that frames her tiny face. Here, most children don't grow too big. They are all tiny, amorphous beings with golden hair. He walks ahead. The father totters behind.

I don't know how I can offer money. I do it anyways. And there is that awkwardness of being grateful. At both ends. I follow them to the van that is called Mortuary. They turn back several times, and I have nothing to say.

The child is placed inside the car. The uncles, and the grandfather get seated. The driver turns on the ignition, and the van lurches ahead. They are gone. Just like that.

The doctor turns to me. It seems that his favorite line is 'children are dying.' But the media is celebrating FIFA and Schumacher's return from the coma. The deaths are only numbers being reported in the local papers, and a few national dailies. A reporter tells me he has not done his annual report.

"What is there to write? It is the same," he says.

I say I know what he means. Back in Delhi, and elsewhere, friends and others ask me what is this story. They have no idea what AES is, and if children of the poor are dying. They are busy celebrating football.

In Ward No. 2, you would have to skip and hop to reach where Nandini lies. In PICU 3, they tell me they shifted her to the emergency ward.

By now, I am desperate to find those that have survived the night, for my own sanity.

On a blue tarpaulin sheet, she is gasping for breath. The doctor visited once in the morning. There's a doctor on the list but she is nowhere to be found. Nandini, the six-month-old, is about to die. Not because of AES alone but because the doctors shifted her to a ward with no care. She is sprawled on the bed with yet another child. The fans don't work.

A father comes and complains. When important people visit, and lately they have been coming to either announce compensations, or to accuse the government of inaction, they shut the doors of such wards and hide the sick and the poor. They are not allowed to go outside. The bathrooms here have no bulbs, and no soaps. But they have announced they have waged a war against a mysterious fever that strikes in places that are unhygienic. They blame the poor and the illiterate. But here, he says, even the patients have to use the toilets outside.

I ask the nurses. A ward attendant Vijay Kumar takes me to a doctor, who offers to check. He says Nandini is serious, and scribbles a few things on paper, and they take Nandini upstairs to PICU 1. The grandmother holds her in her arms, and a kind young doctor manages to make space for her. After the oxygen mask is n, the doctor says they may not even have medicines to administer to the child who seems to be suffering with pneumonia. But they will do something, Dr. Mohd. Shamim says. He gets the reports, and looks at the X-Ray and reads through the jottings of the other doctor. He looks despondent. But manages to say they will try. It is an ICU, a nurse says. Each one of them is critical.

The poor don't protest the lack of care, or the loss of dignity. Loss is personal.

Over the phone, doctors tell me how can I be so myopic and talk about hygiene. I am told to understand the demographics of those who come to government hospitals. They are used to living in filth, I am told. I retort but they don’t care. Why are poor so different? Why must they not get dignity even in death?

It's evening. I wish Nandini’s mother hope. I have the numbers. I don't have the courage to call. The death toll has crossed 111.

In the car, I open Fernando Pessoa's The Book of Disquiet. On most journeys, I carry a book for company, and open random pages to get over things. It is a trick. A thing from childhood. I hope it will lead me to some calm, or resignation.

"I begin because I don't have the courage to think; I finish because I don't have the courage to quit."

I am back on the Gandhi Setu that will take me home at some point. I will write the story and hope for a release. But does it come at all?