Little Kajal convulsed twice and fell silent. With an aching stomach, she made the long journey from the local primary health care centre to the government hospital in Chapra, Saran district. Her brother Rajesh Sah who rushed her for treatment saw his sister die before his eyes. He then informed the doctor about it.

“At the Chapra Sadar hospital, the doctor said there was no needle and not enough oxygen for everyone. I saw my sister convulse twice. She did not move later. I thought she was dead and called the doctor. He asked me for my mobile phone and using its light, he checked her eyes and declared her dead. In Chapra, the facilities were even worse than the PHC,” Mr. Rajesh told The Hindu.

By Thursday, the death toll in the Bihar mid-day meal tragedy mounted to 23. A criminal delay in receiving treatment for poison caused the maximum number of deaths, said every devastated family in the Gandaman village, where the victims belonged.

Commotion ensued on Tuesday as the news of the children falling sick spread in the village. Harried parents and guardians first rushed the children to the PHC. “There,” said Ramanand Rai, who lost his five-year-old daughter, also named Kajal, “we were told there are no doctors. They said there is no water here so make your own arrangements. So I took my daughter to a private clinic like the rest. At the clinic, the doctor said this case was beyond him.”

People made a maddening dash for a solitary ambulance that was carrying one patient. “The ambulance was not ready to take so many at one go, but we took the driver by the scruff of his neck and forced him to take the children. The ambulance took us to the Chapra hospital. All the way I kept checking my daughter’s pulse. I was hopeful she would survive this, but when I put her on the bed in the hospital, she had died,” Mr. Rai told The Hindu.

“Please take us in or else my daughter will die,” Ajay Kumar, father of five-year-old Deepu had pleaded to the ambulance staff. Deepu had started to froth at the mouth and nose. “She just kept saying, ‘Papa take me home. I don’t want an injection’. In Chapra too no treatment was given,” said Mr. Kumar, who has gone numb from the loss.

“Why has the government opened these hospitals if they cannot provide treatment? Shut them!” cried Vinod Mahato, uncle of Arti (8), Shanti (6) and Bikas (5). The family lost all the three children, throwing the parents – father Vinod Mahato (same name) and mother Buchi Devi – in a state of shock.

“The treatment itself started three to four hours later. Till then we were just moving from one place to another. The government is only playing politics on the dead body of the poor,” Mr. Mahato said. He said the children mentioned at home that the food tasted bitter like ‘neem’, but the headmistress Meena Kumari insisted they should eat it. “She herself did not eat the meal, nor did her nieces. This is a clear conspiracy,” he said.

Mala Kumari kept putting her fingers in her sister Mamta’s (8) mouth. “Mamta had gone cold. There was no sound. Many lives would have been saved with timely treatment,” she said.

Shankar Thakur lost his only daughter baby Kumari (7) died in the incident. “What can I possibly want now. Who can bring my daughter back? I can only hope that hospitals provide good facilities from hereon. Many lives were lost only because of the delay,” he said.

Many parents said the doctor at the PHC initially refused to treat the children as he was on a religious fast. However, AR Ansari, medical officer in-charge, denied the charge saying he was conducting a vitamin A training programme at the time and had mobilised resources immediately. The two MBBS doctors at the PHCs had to be summoned immediately. A married couple has been employed on a contract basis at the PHC. The duo runs their own nursing home, coming to the PHC only to mark their attendance.

Over 50 children were brought to the PHC. “I was a team leader. There was no death in my PHC. All the deaths were later, either en route to Chapra or at the government hospital there. There was no shortage whatsoever. Much of it is false news,” Mr. Ansari told The Hindu.

One hundred ampoules of Amikacin injection, 50 ampoules of Dexona and Metoclopramide (to stop vomitting) and salines were used at the PHC to treat the children.

Asked if atropine – used as an antidote to phosphorous poisoning was given, Satish Chandra Jha, the PHC’s store incharge said the doctors had not ask for atropine. Mr. Ansari, however, said atropine was administered to the victims.