critics denounced as unlawful and inhumane. Moreover, members of the current administration contend that Mr. Trump’s decision to freeze a portion of the aid to the region in 2019 ended up blunting the impact of the work being done to improve conditions there.

But experts say the reasons that years of aid have not curbed migration run far deeper than that. In particular, they note that much of the money is handed over to American companies, which swallow a lot of it for salaries, expenses and profits, often before any services are delivered.

Record numbers of Central American children and families were crossing, fleeing gang violence and widespread hunger.

independent studies have found.

“All activities funded with U.S.A.I.D.’s foreign assistance benefit countries and people overseas, even if managed through agreements with U.S.-based organizations,” said Mileydi Guilarte, a deputy assistant administrator at U.S.A.I.D. working on Latin America funding.

But the government’s own assessments don’t always agree. After evaluating five years of aid spending in Central America, the Government Accountability Office rendered a blunt assessment in 2019: “Limited information is available about how U.S. assistance improved prosperity, governance, and security.”

One U.S.A.I.D. evaluation of programs intended to help Guatemalan farmers found that from 2006 to 2011, incomes rose less in the places that benefited from U.S. aid than in similar areas where there was no intervention.

Mexico has pushed for a more radical approach, urging the United States to give cash directly to Central Americans affected by two brutal hurricanes last year. But there’s also a clear possibility — that some may simply use the money to pay a smuggler for the trip across the border.

The farmers of San Antonio Huista say they know quite well what will keep their children from migrating. Right now, the vast majority of people here make their money by selling green, unprocessed coffee beans to a few giant Guatemalan companies. This is a fine way to put food on the table — assuming the weather cooperates — but it doesn’t offer much more than subsistence living.

Farmers here have long dreamed of escaping that cycle by roasting their own coffee and selling brown beans in bags to American businesses and consumers, which brings in more money.

“Instead of sending my brother, my father, my son to the United States, why not send my coffee there, and get paid in dollars?” said Esteban Lara, the leader of a local coffee cooperative.

But when they begged a U.S. government program for funding to help develop such a business, Ms. Monzón said, they were told “the money is not designed to be invested in projects like that.”

These days, groups of her neighbors are leaving for the United States every month or two. So many workers have abandoned this town that farmers are scrambling to find laborers to harvest their coffee.

One of Ms. Monzón’s oldest employees, Javier López Pérez, left with his 14-year-old son in 2019, during the last big wave of Central American migration to the United States. Mr. López said he was scaling the border wall with his son when he fell and broke his ankle.

“My son screamed, ‘Papi, no!’ and I said to him, ‘Keep going, my son,’” Mr. López said. He said his son made it to the United States, while he returned to San Antonio Huista alone.

His family was then kicked out of their home, which Mr. López had given as collateral to the person who smuggled him to the border. The house they moved into was destroyed by the two hurricanes that hit Guatemala late last year.

Ms. Monzón put Mr. López in one of her relatives’ houses, then got the community to cobble together money to pay for enough cinder blocks to build the family a place to live.

While mixing cement to bind the blocks together, one of Mr. López’s sons, Vidal, 19, confessed that he had been talking to a smuggler about making the same journey that felled his father, who was realistic at the prospect.

“I told him, ‘Son, we suffered hunger and thirst along the way, and then look at what happened to me, look at what I lost,’” Mr. López said, touching his still-mangled ankle. “But I can’t tell him what to do with his life — he’s a man now.”

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How India’s Kerala Has Battled Coronavirus

When India’s second coronavirus wave slammed the country last month, leaving many cities without enough doctors, nurses, hospital beds or lifesaving oxygen to cope, Sajeev V.B. got the help he needed.

Local health workers quarantined Mr. Sajeev, a 52-year-old mechanic, at home and connected him with a doctor over the phone. When he grew sicker, they mustered an ambulance that took him to a public hospital with an available bed. Oxygen was plentiful. He left 12 days later and was not billed for his treatment.

“I have no clue how the system works,” Mr. Sajeev said. “All that I did was to inform my local health worker when I tested positive. They took over everything from that point.”

has failed, in many ways, to provide relief for victims of the world’s worst coronavirus outbreak.

online networks, charities and volunteers has emerged in India to fill the gaps left by the stumbling response of the central government and many states. Patients around India have died for lack of oxygen in hospitals where beds filled up quickly.

Deaths are rising. Workers face long hours and tough conditions. The situation could still worsen as the outbreak spreads.

On paper, Kerala’s death rate, at less than 0.4 percent, is one of India’s lowest. But even local officials acknowledge that the government’s data is lacking. Dr. Arun N.M., a physician who monitors the numbers, estimates that Kerala is catching only one in five deaths.

A relatively prosperous state of 35 million, Kerala presents particular challenges. Over 6 percent of its population works abroad, mostly in the Middle East. Extensive travel forces local officials to carefully track people’s whereabouts when a disease breaks out.

tackling a 2018 outbreak of the Nipah virus, a rare and dangerous disease.

As borders closed last year and migrant workers came home, the state’s disaster management team swung into action. Returning passengers were sent into home quarantine. If a person tested positive, local officials traced their contacts. Kerala’s testing rate has been consistently above India’s average, according to health data.

Experts say much of the credit for the system lies with K.K. Shailaja, a 64-year-old former schoolteacher who until this week was Kerala’s health minister. Her role in fighting the Nipah virus inspired a character in a 2019 movie.

drove India into recession. This year, Mr. Modi has resisted a nationwide lockdown, leaving local governments to take their own steps.

India’s states are also competing against each other for oxygen, medicine and vaccines.

“There has been a tendency to centralize decisions when things seemed under control and to deflect responsibility towards the states when things were not,” said Gilles Verniers, a professor of political science at Ashoka University.

has worsened the country’s outbreak, though they have been hindered by a lack of data. Kerala has used gene sequencing since November to track variants, helping to drive policy decisions, said Dr. Vinod Scaria, a scientist at the CSIR Institute of Genomics and Integrative Biology in New Delhi.

“It’s the only state that has not given up at any point in time,” Dr. Scaria said, adding that “they’re eager to use evidence to drive policies.”

A political shuffle has led some experts to wonder whether Kerala can keep its gains. This past week the Communist Party of India, which controls the state government, excluded Ms. Shailaja from its cabinet. The party said it wanted to give young leaders a chance, but observers wondered whether Ms. Shailaja had grown too popular. She didn’t respond to requests for comment.

“Even the best-performing governments,” Professor Verniers of Ashoka University said, “are not immune from shooting themselves in the foot due to misguided political calculations.”

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How India’s Kerala Has Battled Covid-19

When India’s second coronavirus wave slammed the country last month, leaving many cities without enough doctors, nurses, hospital beds or lifesaving oxygen to cope, Sajeev V.B. got the help he needed.

Local health workers quarantined Mr. Sajeev, a 52-year-old mechanic, at home and connected him with a doctor over the phone. When he grew sicker, they mustered an ambulance that took him to a public hospital with an available bed. Oxygen was plentiful. He left 12 days later and was not billed for his treatment.

“I have no clue how the system works,” Mr. Sajeev said. “All that I did was to inform my local health worker when I tested positive. They took over everything from that point.”

has failed, in many ways, to provide relief for victims of the world’s worst coronavirus outbreak.

online networks, charities and volunteers has emerged in India to fill the gaps left by the stumbling response of the central government and many states. Patients around India have died for lack of oxygen in hospitals where beds filled up quickly.

Deaths are rising. Workers face long hours and tough conditions. The situation could still worsen as the outbreak spreads.

On paper, Kerala’s death rate, at less than 0.4 percent, is one of India’s lowest. But even local officials acknowledge that the government’s data is lacking. Dr. Arun N.M., a physician who monitors the numbers, estimates that Kerala is catching only one in five deaths.

A relatively prosperous state of 35 million, Kerala presents particular challenges. Over 6 percent of its population works abroad, mostly in the Middle East. Extensive travel forces local officials to carefully track people’s whereabouts when a disease breaks out.

tackling a 2018 outbreak of the Nipah virus, a rare and dangerous disease.

As borders closed last year and migrant workers came home, the state’s disaster management team swung into action. Returning passengers were sent into home quarantine. If a person tested positive, local officials traced their contacts. Kerala’s testing rate has been consistently above India’s average, according to health data.

Experts say much of the credit for the system lies with K.K. Shailaja, a 64-year-old former schoolteacher who until this week was Kerala’s health minister. Her role in fighting the Nipah virus inspired a character in a 2019 movie.

drove India into recession. This year, Mr. Modi has resisted a nationwide lockdown, leaving local governments to take their own steps.

India’s states are also competing against each other for oxygen, medicine and vaccines.

“There has been a tendency to centralize decisions when things seemed under control and to deflect responsibility towards the states when things were not,” said Gilles Vernier, a professor of political science at Ashoka University.

has worsened the country’s outbreak, though they have been hindered by a lack of data. Kerala has used gene sequencing since November to track variants, helping to drive policy decisions, said Dr. Vinod Scaria, a scientist at the CSIR Institute of Genomics and Integrative Biology in New Delhi.

“It’s the only state that has not given up at any point in time,” Dr. Scaria said, adding that “they’re eager to use evidence to drive policies.”

A political shuffle has led some experts to wonder whether Kerala can keep its gains. Earlier this week, the Communist Party of India, which controls the state government, excluded Ms. Shailaja from its cabinet. The party said it wanted to give young leaders a chance, but observers wondered whether Ms. Shailaja had grown too popular. She didn’t respond to requests for comment.

“Even the best-performing governments,” Professor Vernier of Ashoka University said, “are not immune from shooting themselves in the foot due to misguided political calculations.”

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The Pandemic is Ebbing, But What About Governors’ Emergency Powers?

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As the threat from the coronavirus pandemic grew in early 2020, so did many governors’ executive powers. Without a federal plan, it fell to the states to issue lockdown and stay-at-home orders, mandate masks, and close schools and businesses.

Nearly 14 months later, with states moving to reopen amid a drastic drop in new cases, legislators have been asking about the current need for restrictions. And just how much sweeping authority do governors need to have during a public health emergency.

Voters in Pennsylvania this week became the first in the United States to help check an executive’s authority during an emergency period. The state’s Democratic governor, Tom Wolf, and its Republican-controlled legislature sparred over Mr. Wolf’s emergency actions, which included closing schools and many businesses, during the pandemic.

Two measures passed on Tuesday in Pennsylvania, both with about 54 percent approval. The state’s Constitution will be amended to end a governor’s emergency disaster declaration after 21 days. And lawmakers, with a simple majority, will be given the only authority to extend or end the emergency disaster declaration. The ballot questions had been pushed forward by Republican legislators.

Mr. Wolf said this week. “So I’m looking forward to working with the legislature to figure out how to make this work.”

In New Jersey, a Democrat-led legislature took the initial step this week to roll back dozens of Covid-related orders issued by Gov. Phil Murphy, also a Democrat. But the bill that was introduced also leaves the governor with expansive powers to apply new measures in an emergency. Mr. Murphy is one of two governors to keep an indoor mask mandate, even for vaccinated people; the other is Hawaii’s.

New executive orders related to the pandemic are still being announced. Gov. Greg Abbott of Texas, a Republican, said on Tuesday that counties, cities, public health authorities and local government officials in his state would be prohibited from requiring people to wear masks. His order came days after federal health officials announced new guidance that encouraged people who were fully vaccinated to forgo masks in most situations.

Democratic lawmakers in Connecticut, though, supported an extension this week of Gov. Ned Lamont’s expanded pandemic powers through mid-July. They were set to expire this week. Lawmakers argued that executive orders were still needed to manage the vaccine rollout and federal relief funds.

curtailed Mr. Cuomo’s emergency powers, and in late April, it suspended some of his pandemic directives, including a rule that required New Yorkers to order food with their alcohol orders at bars and restaurants.

Mr. Cuomo also faces federal and state investigations, including one looking into his reporting of deaths at nursing home during the pandemic.

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Fungal Infections in Covid Patients in India Push Government to Get Grip on Spread

India’s federal health ministry raised an alarm on Thursday, asking state governments to immediately report all cases of a potentially deadly fungal infection that appears to be spreading quickly among Covid-19 patients.

The rare condition, mucormycosis, commonly known as black fungus, was present in India before the pandemic, but it is affecting those with Covid or those who have recently recovered.

Many health experts blame the spread on a central coronavirus treatment, steroids. These drugs can limit inflammation of the lungs, but they also dull the response of the immune system, which can allow infections like the black fungus to take hold.

More broadly, Covid patients with weakened immune systems and underlying conditions, particularly diabetes, are especially vulnerable to black fungus, which has a high mortality rate.

Video of a woman saying she would jump off the roof of a hospital if it failed to arrange injections of the medication for her husband spread widely on social media early this week.

The woman, in the central Indian state of Madhya Pradesh, said, “If I don’t get the injection today, then I will jump off the roof of the hospital and commit suicide. I have no other option left.” She added that the hospital had none of the medication and said of her husband, “Where should I take him in this condition?”

amid a virulent second wave.

Of the medication for the disease she said: “It is not one of the common over-the-counter medications. This is a toxic medication by itself. It can’t be given by all and sundry. It is not something which you can take at home. It needs strict monitoring of body parameters because it is a toxic drug.”

The federal government directive requiring state governments to immediately disclose cases follows those of many Indian states that had already required hospitals to report cases of mucormycosis.

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Texas Governor Will Prohibit Local Mask Mandates

Most government entities in Texas will soon be prohibited from requiring people to wear masks, Gov. Greg Abbott announced on Tuesday, days after federal health officials announced new guidance that encourages people who have been completely vaccinated to forego masks in most situations.

The executive order Mr. Abbott announced on Tuesday would prevent counties, cities, public health authorities and local government officials from requiring people to wear masks beginning on Friday. Violators could be fined $1,000.

Hospitals owned or operated by the government, state-supported living centers and jails and other criminal justice facilities are exempt from the order. Schools can continue their current mask policies until June 4, the end of the school year in some Texas districts, after which they will not be allowed to compel anyone to wear a mask. The C.D.C. also recommended that masks remain universally in use in K-12 schools until the end of the current school year.

Only a third of Texans are fully vaccinated, below the U.S. average of 37 percent, according to a New York Times database. No Covid-19 vaccines have been authorized yet for children under 12.

rescinded a statewide mask mandate and capacity restrictions on March 10, the new recommendations from the Centers for Disease Control and Prevention were less of a shock than they were in other states, where officials and business leaders scrambled to figure out how to safely accommodate residents and customers. Many states, and chains like Target, CVS and Best Buy, have since relaxed their mask mandates for vaccinated people.

Mr. Abbott’s mask rollback in March invigorated some individuals and business owners and alarmed others. But some local leaders chose to initially keep mask requirements in place, including the mayors of Texas’s biggest cities — Houston, Austin, San Antonio and Dallas — all of which are in counties won by President Biden.

Mayor Sylvester Turner of Houston, a Democrat, called the governor’s new order “a clear overreach,” and added, “His power is not absolute.”

Going forward, Mr. Turner said in a statement, “If you are a city employee or entering a city facility and you have not been fully vaccinated, you should wear your mask. We are not mandating it, but I strongly encourage everyone to get vaccinated to protect yourself, your family and your co-workers.”

Mayor Steve Adler of Austin and Travis County Judge Andy Brown, both Democrats, said in a statement that in the coming days, “we will be speaking with parts of our community most impacted by the governor’s order, including schools and nursing homes. Our community’s safety will continue to be our highest priority.”

New York Times database.

“Texans, not government, should decide their best health practices, which is why masks will not be mandated by public school districts or government entities,” Mr. Abbott said in a statement announcing the order. “We can continue to mitigate Covid-19 while defending Texans’ liberty to choose whether or not they mask up.”

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Was That a Giant Cat? Leopards Escape, and a Zoo Keeps Silent (at First).

For a zoo to let a leopard escape is worrisome. To lose three of them and fail to warn residents for days seems something else altogether.

A safari park near the city of Hangzhou in eastern China is facing an onslaught of questions after it achieved that dubious feat, belatedly admitting late last week that three of its leopards had somehow absconded into the nearby hills.

By Monday, searchers had found two of the big cats, and teams with dogs, drones and dart guns were looking for the third.

A search for answers was also underway. The government put a senior manager of the zoo under criminal investigation, and officials promised an inquiry. Many Chinese people wondered how the Hangzhou Safari Park could lose several wildcats and hold back the news for up to a week, maybe longer.

on Saturday after the local government confirmed the escape and warned residents to be on guard.

The Chinese internet has been agog with updates and discussion about the missing leopards. Many were not impressed by the park’s explanation and had questions about the government’s actions, the frantic search and the well-being of the leopards that were hunted down. Leopards are an endangered species, and are found in the wild across remnant patches of western China.

“The ‘leopard hiding’ affair has exposed gaps in management that warrant more scrutiny and reflection,” Chinese Central Television News opined in an online article.

Chen Fang, the owner of a rural leisure lodge in the area of the search, said in a telephone interview, “The zoo should have notified us earlier, but at the start they didn’t own up, and so nobody knew about it.”

“If you say you worried about triggering public panic, wouldn’t someone panic if they ran into a leopard on the city outskirts?” one person wrote on Weibo, the popular Chinese social media platform.

stepping out of their cars in drive-through animal parks.

told The Shanghai Observer. “This was much bigger than a cat.”

Mr. Zhu was alarmed but kept his cool. He used his phone to snap a picture of the creature gazing at him quizzically among the tea plants. But he was too busy with farm work to overthink encountering an exotic wildcat. After it walked off, he said, he kept working in his fields.

Mr. Zhu later made another sighting of a leopard, but friends in the village advised him not to report it to the authorities in case that brought “unnecessary hassles and interfered with work,” he said.

announced on Saturday that it was closing temporarily to deal with unspecified “safety issues.”

Later that day, the government of Fuyang District, the site of the park, disclosed that the three leopards had gone missing and one was still at large, and the park issued its apologetic admission. Since then, search teams have swarmed the lush hills on the edge of Hangzhou.

So far, there have been no reports of injuries from the leopards, and the safari park and some experts said the shy, youngish cats were unlikely to attack people.

one article said. “Whatever you do, don’t panic,” said another. If attacked, it added, consider as a last resort ramming your fist down the leopard’s throat. “That’s the only chance of saving your life.”

Liu Yi contributed research.

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Deaths Mount at an Indian Hospital After Oxygen Runs Out

When the pipes carrying oxygen to critically ill Covid-19 patients stopped working at a hospital in the southern Indian state of Karnataka on Sunday evening, relatives of sick patients used towels to fan their loved ones in an attempt to save them.

Some anguished family members sent desperate pleas for oxygen on social media. Others grabbed their phones and frantically dialed local politicians. A few even sprinted down the hospital’s hallways, desperately searching for a doctor, a nurse, anyone, to help.

But nothing worked. There was no oxygen left.

“Everyone was helpless,” said Rani, who goes by one name, and whose husband Sureendra, 29, was among several Covid-19 patients who died because the lifesaving oxygen had suddenly run out. “I want to kill myself. What will I do without my husband now?”

Local officials provided different accounts of the death toll at the hospital. Some said that at least 10 died from oxygen deprivation. Others said that 14 more died after the accident but that they died of comorbidities related to Covid, not directly from the oxygen shortage.

battles a tremendous second wave of infections and demands for medical oxygen far outstrip supply.

after family members said that there, too, the oxygen had run out though officials denied that.

Doctors at dozens of hospitals in Delhi have been warning that they have come dangerously close to running out as well and that it was untenable to keep waiting for last-minute supplies to arrive. As the latest incident shows, at a hospital more than a thousand miles from the capital, oxygen shortages have now spread nationwide.

Nigeria, have faced oxygen shortages as well, and the World Health Organization estimated earlier this year that 500,000 people were in need of medical oxygen every day.

But no country has seen as many sick people desperate for oxygen as there are in India right now, and the deadly accidents, like what just happened in Karnataka, keep repeating themselves.

“It is a failure of governance,” said Ritu Priya, a professor, at Center of Social Medicine and Community health in Jawaharlal University, in New Delhi. “We were not able to channelize oxygen distribution over the past year, when that is what we should have been doing.”

“We are living from oxygen cylinder to oxygen cylinder,” she said.

Medical oxygen has suddenly become one of the most precious resources in India, and the need for it will continue as the surge of coronavirus infections is hardly abating.

On Monday, the Indian federal Health Ministry reported 368,147 new cases and 3,417 deaths from the virus, a figure that remains low on the first day of the week. The Indian government says that it has enough liquid oxygen to meet medical needs and that it is rapidly expanding its supply. It blames logistical issues for shortages of oxygen, but many doctors and sick people question that.

While people continue to die from a lack of oxygen, Prime Minister Narendra Modi’s government and the local government in Delhi, the epicenter of the oxygen crisis, are fighting in court.

sent supplies late on Sunday evening, but Chamarajanagar district officials said none arrived at the hospital.

Rani, 28, a staff nurse and the wife of Sureendra, who was in the I.C.U., said she spoke to her husband around 8:30 p.m. on Sunday when he was eating dinner and sounded fine, she said.

But around 11:30 p.m., he called his wife, gasping for breath, she said.

“Please come here, I don’t want to die without seeing your face,” he said.

Rani, said she was shocked and called hospital authorities, who said they would arrange the oxygen soon. She called her husband again and told him to do breathing exercises and try to lay face down.

She asked neighbors to accompany her to the hospital, a journey of 45 minutes from their village home, but they refused, saying it was risky to travel at night.

When she arrived at the hospital her, father-in-law told her she was now a widow. Her husband had died early on Monday, during that 10-hour period when the hospital was out of oxygen.

“God has been very unkind and cruel to me.” she said. “The happiness he gave me briefly has been snatched from me.”

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As Covid-19 Cases Rise in India, Oxygen Becomes Scarce

When 54-year-old Niranjan Saha started complaining of breathlessness at home last week in New Delhi, his wife, Usha Devi, immediately suspected the coronavirus. With India’s outbreak worsening and hospitals turning away patients, she rushed into their sons’ room.

“Do whatever you want but find me an oxygen cylinder,” Ms. Devi told Anikat, 21, and Mukul, 19. “Sell my gold, but get a cylinder.”

In India, amid probably the world’s gravest current outbreak, families beg for aid, and flames from funeral pyres burn day and night. Oxygen has become one of the scarcest commodities. On Wednesday, the Indian Health Ministry reported 3,293 deaths from the virus, taking the country’s toll to more than 200,000 since the pandemic began, and 357,000 new infections, breaking the global one-day record it set just days ago.

The Indian government says that it has enough liquid oxygen to meet medical needs and that it is rapidly expanding its supply. But production facilities are concentrated in eastern India, far from the worst outbreaks in Delhi and in the western state of Maharashtra, requiring several days’ travel time by road.

gasping for breath in ambulances, he told his wife that he would prefer to “die at home” rather than begging strangers for help.

Their sons began looking anyway.

They set off across Delhi on a motorbike, stopping at hospital after hospital to ask if any had a bed and oxygen supply. They called friends and sent mass texts on WhatsApp. They approached a politician from the Aam Aadmi Party, which runs the Delhi government. No one could help.

Mr. Saha’s condition worsened and his fever soared. Lying in bed, he pleaded with Mrs. Devi to find a doctor.

“I don’t want to die,” he said, grasping her hand.

On Sunday evening, four days after he had tested positive, his sons stopped outside an oxygen refill shop in southern Delhi. A man stepped forward and offered to help. Relieved, Anikat and Mukul prepared to hand over the money their mother had given them: 10,000 rupees, about $135, the standard rate for a cylinder.

looted from hospitals. A Delhi court on Tuesday said that the local government had failed to curb a mushrooming black market and described those hoarding supplies as “vultures.”

“When hundreds of people die over something as basic as medical oxygen, it is a massive governance failure,” said Asim Ali, a research scholar at the Center for Policy Research, a think tank in New Delhi.

The brothers spoke to their mother, who made desperate calls to neighbors and relatives in Assam, their father’s home state. In the end, they did not have to pawn her gold jewelry: They scraped together the money and carried the cylinder away on their motorbike.

At home, they couldn’t immediately figure out how to connect their father to the oxygen supply. By the time they got it to work, the oximeter on his finger showed his blood oxygen level dropping below 50 — dangerously low. For several hours, he drew shallow breaths through the tube.

But then his eyes closed and his body lay still.

They called an ambulance and Mrs. Devi rode with her husband to a hospital where they were told they might find a bed. They arrived to find a line of ambulances waiting outside with patients. Mr. Saha died before he could be admitted.

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