32 children dead in Indian tribal villages as measles, malaria collide with poverty

In the early hours of a May morning, three-year-old Bamita Markam began to convulse. For days she had burned with fever, her body covered in angry red sores. Her mother, Koushila, had taken her to a doctor first, who gave her an ointment. The child seemed to improve, then worsened again. A faith healer came to their home in Matla village and left syrups and tablets. Nothing stopped what was happening. By dawn, Bamita was dead. Koushila remembers the crying, the convulsions through the night, the moment her daughter vomited blood. They buried her in the jungle after midday.

Bamita was one of at least 32 children who died between May and September in a cluster of remote villages in Balaghat district, in Madhya Pradesh state. Most of the dead were Baiga, one of India's 75 particularly vulnerable tribal groups. Officials traced the deaths primarily to measles and malaria, though malnutrition and delayed treatment played decisive roles. Eight to ten deaths were linked to measles, roughly another ten to malaria, with several children suffering both infections simultaneously. The victims ranged from infants just three or four months old to an eighteen-year-old.

But disease alone does not explain what happened in these villages. Balaghat's remote, forested terrain—where Maoist insurgency once took root—makes reaching a health centre a test of will and resources. During monsoon season, narrow dirt tracks between paddy fields and mud homes become slippery and impassable. The nearest state hospital, a hundred-bed facility in Birsa, sits seventy kilometres away. For families without vehicles, the journey means muddy tracks, a makeshift bamboo stretcher, or a motorcycle ride, and a full day's lost wages. When Bamita fell seriously ill, it was raining heavily. The tracks were treacherous. The family had no way to transport her. Koushila later said: if she had reached the hospital, her daughter might have lived.

Cultural beliefs about illness shaped how families responded in those early weeks. Some Baiga communities understand certain diseases—chicken pox among them—as the arrival of a disease goddess who must be appeased rather than treated. Families perform seven to nine-day rituals of bathing and offering cool water and neem leaves to the local goddess. Many believe that seeking medical treatment before the ritual is complete could cause death. For weeks, as children fell ill with fever and rash, families performed these rituals instead of seeking doctors. By late July, when village council chief Parshuram Dhurwey heard of two children dying in the same household in Bondari village, the scale of the crisis became impossible to ignore. The next morning brought news of another death. When officials arrived, they found homes where nearly every child was sick—fevered, rashed, visibly undernourished.

Government medical officer Nimish Gautam encountered severely dehydrated children and families refusing examination. In one case, police had to be brought in to persuade a family to take a teenage girl with dangerously low blood sugar to a health centre. The family insisted that treatment would kill her. Officials eventually forcibly entered homes in one village and took five seriously ill children to hospital. All five recovered. By September, Dhurwey's council area—covering four villages—had recorded ten child deaths. Sagnibai of Bondari lost two children within twenty-four hours: her twelve-year-old daughter Lamnin on June 26, and her one-year-old son Sahil the next day. A local healer had told the family it was the goddess. They had no money and no vehicle. Her husband, Samaroo Dhurwey, remembers nights when the children's bodies seemed to be on fire, when they could not digest food. They died at home. Mahasingh Parte of Matla village lost two children—a six-year-old girl and a four-year-old boy—within two days. A faith healer had instructed him not to take them to hospital. Parte is a landless farm labourer earning about two dollars on a good day. Work is scarce in monsoon. A primary health centre sits just five kilometres away, but he had never been there.

When investigators from the National Institute for Tribal Health Research tested samples from the affected villages on August 7, six of ten tested positive for measles; four were negative. Measles is highly contagious, causing high fever, cough, runny nose, and red watery eyes before a rash appears. Most children recover, but malnutrition transforms measles into something far more dangerous, increasing the risk of pneumonia, severe diarrhoea, dehydration, and brain inflammation. The infection weakens the immune system, leaving children vulnerable to other infections. Malaria compounds that vulnerability. A five-year-old who died recently of measles weighed around five kilograms. Gautam believes malnutrition is driven partly by early marriage and motherhood, with some girls becoming mothers at sixteen or seventeen, when their own bodies are still developing. Closely spaced pregnancies, premature births, and low birth weight follow. Young mothers struggle to breastfeed and care for their children. Diet is another problem: many families rely heavily on rice and lentil soup, with too little protein and dietary variety.

Once the outbreak became unmistakable, the response was swift but came weeks after deaths began. Health workers conducted door-to-door screening. Mobile medical units carrying oxygen, nebulisers, suction equipment, malaria tests, and medicines visited more than twenty affected villages. One mobile doctor, Neeraj Sharma, says teams routinely saw more than fifty patients a day, about half of them children, conducting ten or more malaria tests daily. More than six thousand two hundred patients—mostly children—were treated at home. More than six hundred and thirty were referred to district hospitals. About six hundred returned home; around thirty remained admitted. Vaccination became an emergency response. Although official records suggested ninety to ninety-five percent coverage in some areas, health workers found children without records and families reluctant to vaccinate. Authorities offered the measles-rubella vaccine to all children under fifteen, regardless of recorded status. Of about forty thousand children identified in Birsa, roughly twenty-seven thousand had been vaccinated. Of the area's one hundred and eighty villages, some sixty-seven are predominantly Baiga and among the most vulnerable.

By late September, the outbreak had subsided. Officials reported the last child death was more than two weeks before their assessment, though teams continued visiting villages. In Kundekasa, a medical camp that once saw about one hundred and twenty children a day was seeing fewer than ten. Back in Matla, Koushila 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. She had hoped Bamita would study and make something of herself. She never regretted not having a boy. Now she looks at Ankita, her surviving daughter, who keeps crying for her sister. Koushila says she wants more children. She feels alone. Ankita is alone.