The word "microcephaly" comes from the Greek, "small head". But in Pakistan, such children are known as chuas or "rat people". The name is uncharitable but apt, for their sloping foreheads and narrow faces do, indeed, have a rodent quality. When I visited the shrine earlier this year, I found only one chua, a 30-year-old woman called Nazia. Mentally disabled - I would judge her intelligence to be about that of a one- or two-year-old child - her nominal function is to guard the shoes that worshipers leave at its entrance, but that work seems to be mostly done by her companion, a charming hypopituitary dwarf called Nazir...
These days, most chuas are itinerant beggars. Traveling up and down the Grand Trunk Road, following a seasonal calender of religious festivals. Each chua is owned, or perhaps leased, by a minder, often a raffish, gypsy-like figure. The Chua-master looks after, and profits from, his chua rather as a peasant might a donkey; together, they may earn as much as 400 rupees per day, about £4...
There are several reasons for believing that microcephaly in the Punjab is not caused by clamping. The first is simply that no one, or at least no one I spoke to, seems to have actually seen it. The source of the allegation always seems to be an untraceable relation in an unreachable village. The second is that it is probably biologically impossible...
By the late 1990s, the disorder had been mapped to deficiencies in at least six different genes.
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