Balaghat, Madhya Pradesh: The children dying in India’s remote tribal heartland

Once the outbreak was recognised, health workers began door-to-door screening in affected villages. Mobile medical units carrying oxygen, nebulisers, suction equipment, malaria tests and medicines visited more than 20 affected villages.

One mobile doctor, Neeraj Sharma, says teams routinely saw more than 50 patients a day, about half of them children. They conducted 10 or more malaria tests daily, sometimes finding two positive cases a day.

More than 6,200 patients – mostly children – were eventually treated at home, according to Gautam. More than 630 were referred to district hospitals. About 600 returned home, while around 30 remain admitted.

Vaccination became an emergency response. Although official records suggested 90-95% coverage in some areas, health workers found children without records and families reluctant to vaccinate.

Authorities therefore offered the measles-rubella (MR) vaccine to all children under 15, regardless of recorded status. Of about 40,000 children identified in Birsa, roughly 27,000 had been vaccinated, Gautam said. Of the area’s 180 villages, some 67 are predominantly Baiga and among the most vulnerable.

But vaccination is only one part of the protection children need. There are wider questions about whether basic nutrition and other health services are reaching those most at risk.

A 2024 audit by India’s Comptroller and Auditor General found “serious irregularities”, external in Madhya Pradesh’s distribution of take-home rations meant to supplement the diets of children aged six months to three years, pregnant women and lactating mothers, including problems with beneficiary identification, production, transport and distribution.

The outbreak has now subsided. Officials say the last child death was more than two weeks before their late-September assessment, while teams continue visiting villages. In Kundekasa, a medical camp that once saw about 120 children a day was seeing fewer than 10.

Back in Matla, Bamita’s mother speaks about the child who would ask for money for snacks, play with her sister and run inside whenever cars approached because vehicles frightened her.

“I had hope she’d study and make something of herself. I never regretted I didn’t have a boy,” Koushila says.

Then she looks at Ankita, the surviving sister.

“I want more kids,” she says. “I feel alone. Ankita is alone. She keeps crying for her sister.”