An unnamed one-month-old boy lay in his mother's lap fighting for his life. His tiny chest bounced up and down sporadically as he let out tortured gasps. This little boy probably weighed no more than one kilogram. He and his mother sat in an un-airconditioned van on a hot, humid day in Kolkata.
They were sitting outside the city's biggest government-run children's hospital. The irony of a critically ill child taking what may be his last breaths 100 metres from where he could be treated was heartbreaking.
My eyes kept flickering from the wrinkly, yellowish baby, whose skin looked too big for his body, to his oddly calm mother. She too looked underweight and weak her orange and red sari hung loosely, inelegantly covering her small frame.
She didn't have that "first time mother" glow or the "my child is dying in my arms" look. She just stared out beyond the window of the rickety van she had arrived in. Uncertain and perhaps unaware that life could or should be any different.
This mother and her critically ill baby are like tens of thousands of desperate people who come to Kolkata's B.C. Roy Hospital in search of help every year. Often, doctors say they come to late, just as the child's organs are failing or his or her pulse is slowing.
As this young mother tried to comfort her baby I asked her why she was still waiting outside in the stifling heat instead of barging into the hospital's reception area and demanding immediate help. She said the hospital was busy, that she and her family had been told to wait. She said that if they couldn't get help soon they would either seek help at a private clinic or come back to this hospital and wait their turn again tomorrow.
As this scene of fading hope and desperation played out a few questions came to my mind. Why didn't this family come here earlier? Why did they wait until now? What's going on inside that hospital? How can a baby this sick not be a priority?
But when I let my emotions ebb and I stripped away the horrendous pictures and sounds, I saw this as a basic problem of supply and demand: A concept that seems so understandable when talking about economics and numbers but so utterly incomprehensible when talking about the lives of very sick children.
There simply aren't enough well equipped, adequately staffed local and district hospitals in this state. When, and if, patients make it through that layer of state funded treatment, they often end up in this hospital in Kolkata.
Here, where patients from all over the state are sent, the lines are even longer and the conditions more desperate. Most patients who seek treatment at the hospital's neo-natal intensive care unit are at death's door.
The overwhelming demand for acute medical treatment here means that any good progress or development on part of the hospital and the government's health department – be it new technology or more trained staff – are lost amid the sea of small patients and the cacophony of families jostling for help.
In India so much is said and written about maternal and child health and millennium development goals and government programs but the truth is there are just too many people to help.
And in most cases, the hospitals and medical facilities they are sent to as their bodies fail are too overburdened, too underequipped, and too economically and politically paralysed to offer effective neo-natal care at the eleventh hour. As I've seen today, it's the last minute dash that only the lucky survive.
All day my thoughts have been drifting back to the tiny, fragile body that I saw at the start of the day. His mother's vacant eyes are a stark reminder for me of the helplessness that accompanies poverty in life and death in India.
I wonder if that little boy and his family found help in time today and if not, whether he made it home alive, 80 kilometres away? And if he did make it home, will he be alive to do it all over again tomorrow morning?