As another dangerously underweight toddler balances precariously on his set of scales, Dr Om Prakash knows he has to move fast to avert tragedy. “The children who are severely malnourished can die between a few hours to a few days,” says the doctor during a shift at an intensive care unit exclusively for children in India’s poorest state. The 30-bed hospital at Darbhanga in the eastern state of Bihar teems with children with protruding bellies and sunken eyes — telltale signs of wasting and stunting, owing to severe malnutrition.