THE DEATH of any child is a tragedy. The death of two children who fell ill while at school is unspeakable. And while the cause of death for a first-grader at Andrew Jackson School has not been determined, both cases demand that we take a hard look at the impact the district's budget realities may be having on children.

When the Jackson student died Wednesday, there was no school nurse on duty. Nor was there a school nurse on duty in October when a sixth-grader had an asthma attack and subsequently died.

We don't know whether a nurse would have made a difference in either case, but we do know nurses play a critical role in the health, safety and ability to learn for thousands of children who go to school each day.

In 2012, 300 nurses were on the School District of Philadelphia payroll. This year, 179 nurses cover 179,000 students. That includes about 139,000 in district schools, and 31,000 in parochial and private schools.

That's how important nurses are: Important enough that taxpayers pay for them in parochial and private schools.

State law mandates that schools maintain a ratio of one nurse per 1,500 students. That ratio was established in 1965. It's time to rethink that number.

Federal law requires that schools accommodate special-education and disabled students with nursing services. Those disabilities include chronic conditions such as asthma, hyperactivity and diabetes, often requiring medication and treatment.

Last year, the Education Law Center set out to find out what impact the school nurse cuts are is having on children. The resulting report raised alarms about the 14 percent of district children with special ed needs and the number of children with qualified disabilities such as asthma and diabetes that the district is obliged to accommodate with nursing services.

According to the school district, nearly 37,000 Philadelphia students (including private and public, but not charter) have asthma, nearly 12,000 have attention-deficit disorder, 637 have diabetes. Other chronic conditions include epilepsy, anemia, cerebral palsy and a host of others.

In addition, nurses perform vision and hearing screenings for all students. They cope with illness and injuries. Last year, there were 154,000 visits to school nurses for illness, and 103,000 visits for injuries.

Too few nurses mean that teachers or aides administer medications and/or treatments, and, in some cases, according to the report, make errors in administering those meds. Many children are not getting urgent medical care. For school populations with high rates of poverty such as Philadelphia's, nurses provide a key access to medical attention.

The Education Law Center report urges a cost-benefit analysis to measure the risks to safety, reduced health and the impact on a student's ability to learn with fewer nurses.

Yet both the state and City Council are still leaving the district's budget crisis unresolved.

The death of a child in school, whatever the cause, feels like a grievous sign of failure -on all our parts.