Each year as monsoon-bearing clouds arrive over eastern Uttar Pradesh, so does a pestilence.
Hundreds, mostly children, fall ill with fever, convulsions, and disorientation. So familiar are people with these symptoms that at the first signs they rush their children to Baba Raghav Das Medical College Hospital, Gorakhpur.
Few other hospitals in the eastern Uttar Pradesh region either have the doctors or the equipment to handle this affliction. And so, the journey of children from nearly 15 districts around Gorakhpur ends at the biggest hospital in these parts.
For the hospital, it is an annual, inevitable, slow descent into chaos.
By September, around 50 patients arrive every day, and the medical colleges infrastructure stretches to breaking point. There arent enough beds: unconscious children, sometimes two or three, lie on a single bed. There arent enough doctors, so diploma students in child health from around Gorakhpur are drafted in. There arent enough mechanical ventilators, even though patients with severe encephalitis often need them.