Autopsy reports show the children had gone without food for up to nine days prior to their deaths.

India’s public was in shock on Thursday as authorities confirmed three children starved to death in the national capital of the fastest-growing economy in the world.

Mansi, 8, Shikha, 4, and two-year-old Parul were declared dead in a New Delhi hospital on Tuesday, bringing malnourishment and hunger within India into sharp focus.

The disbelief was so great that authorities opted for a second postmortem to confirm the children had indeed died of starvation.

Police accounts said the children were left to fend for themselves because their father, Mangal Singh, was missing and their mother, Beena, struggled with “mental health issues”.

Reports confirmed the minors died of “gross malnutrition”.

“The forensic test that was done at our hospital clearly suggests the children who were looking marasmic died of hunger. The pictures depicted gross malnutrition, there was no hint of fat anywhere on their bodies,” Dr Amita Saxena, medical superintendent at the Lal Bahadur Shastri Hospital in New Delhi, told Al Jazeera.

“When we opened their bodies up, the stomach was empty, the bladder and the rectum were empty, as well. There were no signs to show that the kids had eaten anything in the past eight to nine days,” she added.

The children’s mother Beena, 29, is struggling to answer police queries, Constable Sateesh at Mandawali police station, where a case has been registered, told Al Jazeera.

Nikhil Dey from Mazdoor Kisan Shakti Sangathan, a peasant and workers’ organisation in the western Indian state of Rajasthan, described the case as a “tragedy beyond words”.

“Starvation deaths are happening under the radar in many villages across India. But these Delhi deaths are glaring because they took place in the national capital, where people have so much in terms of wealth, money and availability of resources,” Dey told Al Jazeera.

“The parents of the kids – a rickshaw puller and a mentally unstable person – these are double, triple-vulnerable Indians with young children in a big city.”

According to 2011 government data, 65 million Indians live in slums that lack basic facilities. Multiple starvation deaths were reported this year in Jharkhand, one of India‘s poorest states.

Dey said the crisis is caused by rising inequality and a failure of the implementation of public distribution systems.

“Wealth is increasing in the hands of the one percent and is flowing less and less to those at the bottom. Our public distribution systems need to worry about the terrible tragedies that result out of these exclusions,” he said.

Up to 670 million Indians, who comprise the poorest half of the population, saw just one percent increase in their wealth while the richest one percent cornered 73 percent of the national income generated in the country last year, according to a 2018 report by anti-poverty charity Oxfam.