No one thought of Jharkhand last month when the deaths of scores of children in a government hospital in Gorakhpur, Uttar Pradesh, caused widespread outrage in the country. But as disturbing numbers of paediatric deaths in the state emerge, it seems the 'premier' hospitals run by the Raghubar Das government have fared worse than those in UP. In July and August alone, 213 children were reported dead at the Rajendra Institute of Medical Sciences (RIMS) in the capital Ranchi whereas MGM Medical College and Hospital in Jamshedpur accounted for 104 deaths.

A majority of the deaths took place due to pneumonia, asphyxia, malaria and premature birth. The children mostly belonged to poor and lower middle-class families. RIMS and MGM are the biggest state-run hospitals in Jharkhand. The scale of the deaths has exposed their inability to handle emergencies. Between January and August, RIMS has witnessed the death of 660 children.

Jamshedpur principal district and sessions judge Manoj Prasad, who conducted an independent inquiry at the MGM Hospital on August 28, is believed to have mentioned in his report that only four beds in the hospital's neonatal ward were fully equipped and that the hospital was incapable of handling even a slight spurt in emergency pregnancy cases.

On August 30, Dr A.K. Choudhary, head of paediatrics and neonatology at RIMS, had claimed to the media that his department was doing a good job. Dr Choudhary said 543 out of 646 children admitted to the hospital in August had been saved while in July, 588 out of 698 children were treated and sent home healthy-"a success rate of 84 per cent", in his words. Recently, the hospital's director, B.L. Sherwal, maintained that the deaths were "nothing unusual" in a tertiary hospital like RIMS.

Perhaps the courts think otherwise. Based on judge Prasad's report, the Jharkhand High Court on September 1 initiated a suo motu public interest litigation and issued notices to the state's health and finance secretaries, director-in-chief of health services and the directors of MGM Hospital and RIMS. The court sought to know what measures the officials had taken to check the high mortality among newborns and children. While the judicial rap is expected to push the state government into action, officials accuse both chief minister Das and health minister Ramchandra Chandravanshi of not being proactive in addressing the inadequacies of the healthcare system. So far, the state government has only removed RIMS superintendent S.K. Choudhary.

On inspection, however, a committee of legislators found several doctors and professors of the hospital missing from duty. The task of equipping the state's primary, secondary and tertiary health centres to handle emergencies also remains. Jharkhand, formed in 2000, has an under-five mortality rate of 44, marginally better than the national average of 45. But clearly, that's only half the story. The other half still has children wrapped in shrouds.