A team of doctors who independently investigated the deaths of children due to suspected encephalitis in Muzaffarpur district of Bihar, blamed “administrative failure” and the “state’s apathy towards people” for the tragedy, PTI reported on Friday. The team also alleged that the parents of most children had no access to the public distribution system due to the lack of ration cards.

At least 154 people, mostly children, have been killed in Bihar this year due to encephalitis. In Muzaffarpur, 132 children have died so far. Chief Minister Nitish Kumar has announced compensation of Rs 4 lakh for the families of the deceased.

The team of doctors, under the banner of the Progressive Medicos and Scientists’ Forum, said most of the children were malnourished and had no treatment for it. They also did not possess growth-monitoring cards, the team added. The team included doctors from the All India Institute of Medical Sciences in New Delhi.

“There is a severe shortage of drinking water and no functional sewerage system in the entire Muzaffarpur district,” Former AIIMS Resident Doctors’ Association and president of the group Dr Harjit Singh Bhatti said. “Sanitation is very poor, even at the health facilities.” He added that these deaths have been taking place for the last 10 years.

“ASHA workers, sub-centres and anganwadi services are deficient in their numbers and functions and people do not have faith in the local health system,” the group said in its report. “Immunisation services are poor.”

The team added that at the Sri Krishna Medical College and Hospital, where most of the deaths took place, one emergency room holding 500 patients a day was monitored by only four doctors and three nurses, and there was a chronic shortage of medications and equipment. The team said the Intensive Care Units were also not well equipped.

“The doctors are working hard overtime, despite the poor conditions and lack of resources, although proper protocols are not in place for a standardised treatment and the period of stay in the hospital,” the group said. “It has been noted in some cases that after treating for hypoglycemia, the children were discharged in a few hours and they died at home due to developing hypoglycemia.”

“Looking at these points, this kind of disasters are always waiting to happen in this area,” the team said. “The government is trying to hide its apathy towards people behind the jargons of etiological research of a ‘mysterious’ disease. While scientists are working on the etiological research, the focus of the state should be on strengthening the healthcare infrastructure so that such disasters can be prevented.”

Earlier in the day, Union Minister Of State for Health and Family Welfare Ashwini Kumar Choubey had said that the government has been working on a long-term plan to tackle acute encephalitis syndrome. The minister said that three high-level teams from the central government had been sent to Bihar in order to deal with the outbreak of the disease.

The state health department’s data showed that 23 out of 40 districts were affected due to the outbreak, and the total number of acute encephalitis syndrome cases registered since June 1 was 729.