By Annie Banerji
PATNA, India, July 18 (Reuters) - Within minutes of eating a meal of rice and potato curry at school, the children began to fall sick, a cook at the centre of one of India's deadliest outbreaks of mass food poisoning in years, told Reuters from her hospital bed.
At least 23 children, aged four to 12, died after vomiting and convulsing from agonising stomach cramps after eating the meal on Tuesday, officials and relatives said. Death came so quickly for some that they died in their parents' arms while being taken to hospital.
Dozens of other children are being treated for food poisoning. A local official said 25 children had died, but the toll could not be confirmed.
Police were searching on Thursday for the headmistress of the school in Gandaman village in eastern Bihar, one of India's most impoverished states, who has disappeared. The school provided free meals under the Mid-Day Meal Scheme, the world's largest school feeding programme involving 120 million children.
Federal education minister M.M. Pallam Raju vowed that "action will be taken" against those responsible but did not single out anyone by name.
The focus of the investigation is on the oil used in the preparation of the meal. Doctors treating the children said they suspected the food had been contaminated with insecticide. Media reports said the oil may have been stored in an old pesticide container.
"The minute the children were brought in, we smelled this foul odour of organophosphorous," said Dr. Vinod Mishra, a doctor in the medical team treating 25 children at Patna Medical College Hospital in Bihar's capital, Patna.
"It seemed as though it was coming out of their pores. That's when we prepared the diagnosis for organophosphorous poisoning and it worked. The diagnosis has shown results," he said.
Organophosphorus compounds are used as pesticides.
COOK SICK TOO
With her mother sitting beside her, school cook Manju Devi lay in bed in a dimly lit ward of the hospital, almost too weak to talk.
Speaking in a local Bihari dialect, she told Reuters that she had almost immediately fallen ill, along with the children, after eating the lunch.
When asked if she had prepared it, her mother quickly intervened, saying, "No! She had nothing to do with the meal that day, another cook had made the deal that day. She wasn't a part of it."
Also in the ward were 17 of the children being treated for food poisoning. They lay listlessly on their beds, each with a saline drip.
Nurses were administering injections while parents fanned their children with wooden handheld fans. Hospital workers distributed fruits, a loaf of bread and milk to each child.
A 2008 study in the Lancet medical journal said suicide by consuming pesticide was a major problem across much of rural Asia. Many studies estimated that such poisonings accounted for 200,000 deaths a year, it said.
"Deaths from unintentional organophosphorus poisoning are less common," it said.
The symptoms of organophosphorus poisoning vary but in acute form include convulsions, excessive phlegm and drooling, respiratory arrest, coma and eventually death, according to patient.co.uk, a leading independent health website in Britain. Intermediate stages can also include vomiting and diarrhoea.
Indian police said they were many different versions of what happened at the school on Tuesday.
"We have made no arrests so far as we are waiting for forensic reports which will help us piece together the entire investigation," said Sujit Kumar, superintendent of police in Chapra district, where Gandaman village is located.
"We have circumstantial evidence but the key to the investigation is the headmistress who is absconding," he said, adding that police were trying to find her.
P.K. Shahi, Bihar's education minister, said on Wednesday that the headmistress had been dismissed over the incident, although she has not yet given any account of what happened.
"In spite of the cook's complaint (over the smell of cooking oil used for the food), the headmistress insisted on its use and the cook made the food. The children had also complained about the food to the cook," Shahi said.
On Wednesday, demonstrators angered by the deaths pelted a police station with stones, set ablaze buses and other vehicles, chanted slogans denouncing the state government and burned effigies of Chief Minister Nitish Kumar, the seniormost elected official in Bihar. There were no reports of further rioting on Thursday. (Writing by Ross Colvin, additional reporting by Mayank Bhardwaj, Manoj Kumar, Jo Winterbottom, Sruthi Gottipati, Malini Menon and Anurag Kotoky in New Delhil; Editing by Raju Gopalakrishnan)