TEHRAN, Young Journalists Club (YJC)-In the early afternoon of August 22, Pawan Tiwari and his wife Rinki sobbed inconsolably in front of the Baba Raghav Das (BRD) Medical College in the northern Indian city of Gorakhpur.
Oh, my boy, oh, my boy," wailed Tiwari's wife Rinki while sitting on the floor.
Parents of other children at the hospital tried to comfort the couple sitting outside in the shade of a tree.
Doctors had informed Pawan, 35, that his six-year-old child, Naitik Tiwari, was dead. But shortly afterward, Pawan's brother, Anjan Tiwari, emerged from the hospital to tell him that his son was still breathing and doctors were struggling to save him.
The couple rushed inside the ward. They peeked through the glass window of the paediatric intensive care unit to look at their son, their eyes swollen from crying.
As Pawan and his wife left the ward, his brother broke down. He told me that he had given them false hope; a doctor had told him that the child was unlikely to survive.
In August, the deaths of more than 60 children over five days at the hospital in northern Uttar Pradesh (UP) state, allegedly due to oxygen failure, caused public uproar. Children have died from infections and conditions such as Japanese encephalitis. Naitik was among the 415 children who died in the month of August, according to the official data provided by the largest government hospital in the region.
In the first 23 days of this month at least 534 children, including 231 newborns, have died, taking the death toll to more than 1,000 since August.
Most of the children who arrive at the hospital are malnourished newborns, Dr PK Singh, the college principal, had told Al Jazeera in August. Flooding in the region - in eastern UP and western Bihar states - has caused widespread infections, he added.
"Children are already infected; they die in the first hour of admission. The patient load is too much, nearly 4,000 patients are coming daily. We can't refuse to admit them," he said, adding that staff place multiple children onto a single bed. There is one doctor for every 17 patients, he said, when a normal ratio should be one for every ten.
"In our country, the neonatal mortality rate per 1,000 live births is 27 but in UP it's 43. Most of the deaths at neonatal stage are due to breathing problems. The next big cause is infection," said Professor KP Kushwaha, a former principal of BRD Medical College.
"By the time the infants arrive at the hospital their condition is already in critical stage. It becomes difficult to save infants at this stage," said Kushwaha, a renowned pediatrician, adding that the institutional approach toward neonatal care must be overhauled, to include specialised care in primary and community health centres across the region.
The deaths at BRD, the only major state-run hospital in a 200km radius has put a focus - in a country that spends only 1.2 percent of its GDP on public health - on a facility that cannot adequately care for its patients and the wider, impoverished region that desperately needs the government to provide healthcare infrastructure.