As a senior paediatrician at the Baba Raghav Das Medical College, Dr Kushwaha has been on the frontline of a decades-old battle against encephalitis, which has claimed some 6,000 lives at his hospital alone since 1978. Horror stories are nothing new to Gorakhpur. In one case in 2007, local police picked up a dairy farmer and owner of a blood farm - "a ruthless modern-day vampire", according to one account - who locked up men and extracted blood to sell it in the black market. But it is encephalitis that has been the leitmotif of Gorakhpur's unending misery.