An extraordinary human tide has overwhelming Barasat, a muddy Bengali provincial town between Calcutta and the East Pakistan border whose medical and health services are barely adequate, even by Asian standards, for its normal population of 21,000. In the past week between 150,000 and 200,000 people have flooded into Barasat and the already crowded farmlands around the town. They are camped in schools, religious buildings and at least one cinema, or in patches of swampy wasteland. Some of them are simply lying hopelessly by the roadside when they can walk no farther. Barasat district hospital stands just off the main road between the border crossing point from East Pakistan at Hasanabad and Calcutta. The hospital is a group of grabby single-storey buildings. Some are having a second storey added, but unluckily the work is not far enough advanced to receive the present influx. They are scattered over a walled enclosure with a ragged lawn, now under inch-deep pools of water in many places after the heavy rains of the past two days.

Down the road there passes, determined as a file of ants, a never-ending stream of refugees. They are barefoot, thin, and dressed in minimum clothing - a strip of cloth wound as a sari for the women, and a loincloth for the men, with the children up to about five naked. In this they are not much different from the local inhabitants and of course all have the slender build, dark skin, and flashing teeth of Bengalis. But the refuges can easily be distinguished. While the local people stroll in knots and laugh and joke as they walk, the refugees march in determined, unsmiling lines. On their heads they all carry much the same burdens, the men rolled-up mats and a few belonging on top, the women cooking pots and folded pieces of cotton, such spare clothing as the family may possess. Incongruously many of these country gents carry a tattered black umbrella.

As they file past the hospital gate many of them glance hopefully into the grounds. At first it looks like a reasonably inviting camp-site. Then they see the bloodstained bandages scattered about, the broken pieces of plaster- cast and the other uncollected medical garbage which identifies the place as a hospital. They whip a corner of their single garments over their mouths, turn their head away, grasp the hand of the nearest child trotting at their heels and hurry on. People who go into such places, they know, often do not come out.

Some of them have business in the hospital. Every few minutes a sick person is carried in on a crude stretcher made out of bits of wood tied together, or a woman carries a child. Occasionally a patient arrives in style in a pedal rickshaw and a battered ambulance shuttles in and out. I follow along the squelchy path to the main entrance of the hospital. Outside are two bundles of cloth. As I step over one of them, I see it is trembling violently and has the outline of a human being . There is a crush of people going in and out - patients, nurses, relatives and friends - but no one takes any notice of these bundles, apparently dumped there by Good Samaritans who found these people lying by the roadside on the long walk from East Pakistan.

I walk in and find the hospital jammed with patients lying on both sides of the corridors. A rusty sign says: Give Your Blood - It may Save a Precious Life. The doctor in charge, Dr. A. K. Ghose, tells me that the hospital was intended for about 300 patients. He has in fact more than 2,000 - “We are behind with the count today.” He says 757 people have been admitted with the symptoms of cholera since May 22 of whom 103 have so far died. Would I like to see the cholera wards? He warns that they are “a bit grim.”

Cholera is a horrible and humiliating way to die. The only mercy is that it is comparatively quick. The cholera wards are two buildings behind the main hospital block. There are no beds. The patients lie on metal sheets covering a concrete floor. The disease produces uncontrollable, continuous diarrhea and vomiting, the results of which are everywhere. One victim strains at a bedpan - there appears to be only one available - while the rest do without. Those who still can, fan themselves weakly; those who are too far gone to do so are black with flies. There are men, women and children of all ages. All are getting the same treatment - a bottle of saline solution, dripped through a tube and needle into a forearm, a foot or a thigh. Some small babies have their mothers, also afflicted with the disease, lying beside them. One woman has two small babies beside her, all three connected by thin Plastic tubes to saline bottles slung from a rope overhead. One child, a girl about 10, is dead. Two women wail loudly over her body as it is wrapped in a cotton cloth for burial.

Four men are busy carrying the bodies of the dead away. One has a handkerchief tied over his mouth. They carry the body of a dead man wrapped in cloth away from the isolation ward on a crude stretcher, like a home made ladder, to the hospital’s emergency cemetery. This is a walled garden, 100 yards down the main road, where they heave their grim bundle over the wall. Then they go back for another. The stench from this makeshift mortuary is overpowering. Back at the isolation ward, another body has been prepared. It is wrapped in cotton with a slip of paper pinned over the chest. This turns out to be a death certificate, done with a rubber stamp and the briefest conceivable epitaph: “name-age-Hindu/Muslim- male/female”. There is a pile of these slips ready stamped and fastened with a paper clip on a table. The Bengali nurses in white saris seem to take the whole thing stoically. One nurse I did indeed see in tears, trying to comfort a woman weeping over a dead baby. But a moment later she was laughing with another nurse at some, I suppose grim, joke.

I was appalled that these nurses, members of the West Bengal Nursing Service, were so indifferent to the flies and the filth of their wards. But then it must be said that the patients already had cholera and could not be further infected. I was full of unqualified admiration for their courage in working in such a charnel-house. I returned to the main hospital, past a mound of coconut shells. Relatives had brought coconuts to the cholera wards, hoping that the milk would ease the razing thirst which the disease produces. I found Dr. Ghose had some encouraging figures. Admissions for cholera and gastroenteritis, which has exactly the same symptoms, are falling: from 150 a day this week to 73 yesterday. They suggest that, in Barasat at least, the epidemic has passed its maximum virulence.

Two reasons were given by Dr. Ghose and other experts I spoke to. The vaccination campaign, while far from complete, slows the spread of the disease, as clearings slow a forest fire. Secondly, the sinking of new wells by the West Bengal authorities is giving more people access to uncontaminated water, though these are still a fortunate minority. I got few clues at the hospital about what had caused this human tidal wave. One woman arrived while I was there needing treatment for a bullet wound, which she said she had received from the Pakistan army.

Other refugees told me that they left when their houses were burnt down, some said by soldiers, others said by Muslims who were not Bengalis. Others simply said they left because they were afraid. I had the impression that I was seeing waves from a distant storm of unimaginable violence which had driven these people down the peaceable roads of West Bengal. As I left the Barasat hospital I saw that one of the bundles at the gate had gone and that the other had stopped trembling. I lifted a corner of the cloth. It was an old man, in the last stages of emaciation. I think dead. He wore, I noticed, the scared threat, which showed he was a Brahmin who had met this supremely unprivileged end.

The massive influx into Barasat took the civil servants of the West Bengal local government administration completely by surprise. Barasat was considered too crowded already to take a refugee camp. It seems that the main reason for the influx is that Barasat lies at the junction of a number of roads leading from the East Pakistan border to Calcutta. The West Bengal authorities have begun issuing ration cards to refugees from a temporary post in the local secondary school and handing out rations - 400 grams of rice a day, 200 grams of dried peas, and cooking oil, enough to keep people alive for the time being - and roadside stalls have sprung up selling chilies, curry powder and Bengali cigarettes mad out of uncured tobacco leaves. The refugees are paying for these necessities for an Indian diet either with Pakistan money brought out with them and changed at the Indian banks or by selling the women’s bangles and trinkets. The tidal wave is moving steadily on from Barasat, which seems to be only a temporary and accidental nesting place. The road seems to lead west, farther and farther away from East Pakistan - and towards Calcutta.

One of the biggest camps occupies the swampy ground at the end of the Calcutta Airport, Dum Dum. The refugees seem to have stopped here because they believed that relief supplies from abroad would be handed out directly at the airport. This has certainly not happened. So far no supplies from abroad have been distributed at the Dum Dum camp, although they are held in the customs warehouse about a mile away. There are various reasons - a Norwegian gift of nine tons of dried fish is rotting because the West Bengal authorities wisely do not want people soaking the fish in contaminated water. Baby food in powder form is similarly being held while a system is worked out for mixing it with clean water. And the Calcutta customs are holding vast quantities of supplies which have been consigned “to the refugees” or “to the Government of India,” on the bureaucratic quibble that some identifiable person of substance must step forward and sign for these supplies - tents, plastic sheeting and food - in case it is decided that there is duty to pay.

There is still an optimistic feeling among many non-refugee Bengalis I spoke to, from villagers to officials, that this is a temporary thing, and that the refugees will go home soon, or at least go away somewhere else. The civil aviation authorities are pressing hard to have the Dum Dum camp shifted immediately: they point out that the habitations there, grass huts, though most of them are, will attract vultures, which will be right in the final approach path of aircraft landing at Dum Dum. But none of the refugees I spoke to - all of them Hindus - thought there was any chance that they would ever go back to a now almost wholly Muslim East Pakistan. I noticed today that road signs have appeared outside the Dum Dum camp: “Refugee Camp - Go Slow.” They looked very permanent to me.