the effectiveness of the healthcare delivery system in Andhra Pradesh is coming under intense scrutiny after 400 tribals reportedly died in Adilabad district due to gastroenteritis. The deaths occurred despite the fact that primary health centres ( phc s) and hospitals have been strengthened in tribal areas and priority investment has been made under the World Bank-assisted Andhra Pradesh Economic Restructuring Programme ( aperp ). According to official reports, 15,000 cases of gastroenteritis were reported during 1998, and over 400 people succumbed in Adilabad alone. State officials who visited the affected areas believe that the cause of the high death rate is a deep rooted superstition prevalent among the tribals. The tribals, majority of whom belong to the Gond tribe, view these disease as a visitation caused by divine curse. However, V N Sastry, joint director, tribal welfare, who has worked among the Gonds for several years, says it is not fair to blame the tribals for their beliefs.