Bengaluru, India — Two children younger than 5 die every minute in India. Even by India’s easy acceptance of child mortality, the death of 70 children within five days at a hospital in the northern city of Gorakhpur was hard to accept.

A majority of the children who died had been struck by Japanese encephalitis, a mosquito-borne, potentially fatal viral brain infection that periodically ravages the Indian state of Uttar Pradesh. But the immediate reason for at least half the deaths appeared to be the cessation of piped oxygen into the intensive care ward. Japanese encephalitis has no known cure, and as it progresses, patients require oxygen to survive.

Despite 11 reminders over six months, the Uttar Pradesh government did not pay the company that supplied oxygen to the Baba Raghav Das Medical College hospital. The company acknowledged it had threatened to stop supplies but denied it had actually done so. The state administration, with its own role in question, vaguely promised “stringent action against the guilty.”

In a country chronically short of medical facilities, the Baba Raghav Das hospital is the largest and most important referral hospital in a poor, populous region, serving a population of more than 50 million in hundreds of nearby towns and villages. Stunned parents — carpenters, construction workers, security guards, homemakers and others from poor families — streamed out of the hospital with the bodies of their dead children.