Chugging Away for Good Health

It all began with a quest to reduce physical disabilities across the globe. Owing to the increasing number of people with physical disabilities, the year 1981 was declared as the International Year of Disabled Persons. UN experts and health administrators from around the world met at Leeds Castle, England to deliberate on preventing these disabilities. The participants at the meeting concurred that adopting a cost-effective approach to combat disabilities was the need of the hour and the recommendations at the meeting were later adopted by the UN General Assembly in 1982. The assembly pointed out the need for private and government partnerships in order to develop health projects of national importance using existing delivery systems and infrastructure. With the view to implement these policies, the Impact Foundation was formed in pursuant to the New Delhi Declaration launched by the Government of India.

The major thrust of Impact was to be at the level of primary healthcare (PHC) and this included prevention of diseases. The focus of Impact was to reach out to the 70 million disabled people in India. Today, the organisation has 19 foundations across the world. As Impact's journey continued, the member of the foundation came across many remote villages in India that had no healthcare access at all. While on a project, Zelma Lazarus, CEO, Impact India along with few other members came up with an idea to use the rail route to provide basic healthcare facilities to the remote villagers of India. This thought was then presented to the government and the Ministry of Railways donated five coaches customised for a fully equipped hospital. That is how the world's first hospital on a train, The Lifeline Express was initiated.

The Magic Train as it has now come to be known has completed around 125 projects and treated 7,00,000 patients in thousands of villages. The train visits different parts of the country, usually remote rural areas with insufficient medical facilities, or areas hit by natural disasters and stays in each place for at least one month while medical care (routine as well as major surgery) is provided to the local people. It is sponsored by local business houses and foundations. So far, 150,000 doctors and medical personnel from India and abroad have voluntarily participated in this free camp. Zelma Lazarus, CEO, Impact India shares the illustrious journey of the Lifeline Express with Raelene Kambli

Tell us about the progress of Lifeline Express all through these years.

It was started in a small way with three wooden coaches, one operation theatre (OT) and three OT tables. Soon the benefits of this train soon became evident. This unique train was started to provide on-the-spot diagnostic, medical and advanced surgical treatment for disabled adults and children in far-flung areas where medical services were not available. People started flocking in hordes to this train for treatment. Villagers, who were unable to afford these basic treatment procedures, could now have access to the best facilities free of cost.

In addition to providing access to these much needed services, the Lifeline Express also gave a boost to the existing voluntary health infrastructure and services. It also provided initiative and encouragement for local bodies to get involved in all aspects of the programme and provide follow-up services after the train left a particular village. The Lifeline Express is listed as a national resource in times of disaster by the government's National Disaster Management Authority. Moreover, Impact has expanded this Lifeline Express to other countries like China (three trains), Central Africa (one train), Bangladesh and Cambodia (one riverboat hospital each).

Our work has been appreciated by many. The Lifeline Express has been the subject of several films in India and abroad. BBC's recent one-hour film titled 'The Magic Train of India' gives an inspirational coverage about this hospital.

How did you manage to raise the funds for the Lifeline Express?

The Ministry of Railways supported us by donating the wooden coaches and the rest of the funds were raised by way of international and national financial contributors. We also have doctors and other healthcare workers who donate their services for this cause.

How does the project function?

Project work starts much before the train arrives at the village. Patients register in advance at primary health centres for an initial check up and are taken on board as soon as the train arrives. Surgeries that are carried out include orthopaedic surgeries, ophthalmic surgeries, ENT and plastic surgeries. The train also offers dental and oral health hygiene services and treatment of epilepsy and neurological disorders. Facilities such as immunisation, counselling and promotion of health awareness are also made available.

Tell us about the infrastructure on the train?

We have all the state-of-the-art facilities available on the train. There are seven to eight people working constantly on the train. Other facilities include an Ophthalmologic testing room, a laboratory, an X-ray unit and an auditorium with a large LCD display unit. The train also has a public address system and closed-circuit TV.

Today, the train has five coaches with two OTs and five OT tables. It also has a facility for dental and ophthalmic procedures. The main OT has its state-of-the-art equipment required for a surgery. The theatres are also equipped with a closed circuit television camera which is used to train local doctors on live surgical procedures. An attached six bed recovery room is situated beside the main theatre. In addition, the train has a sterilising room, several patient wards, on-board power generators, a pantry car, storage for medical supplies, and accommodation for medical staff. The first coach houses the office and medical store, as well as two autoclave units. It also houses a drawing room. The staff compartment is situated at the rear with a 12-berth staff-quarter, kitchen unit, water purifier, a gas stove and electric oven and refrigerator.

Tell us about your other initiatives.

In addition to the train, mobile clinics equipped with LCD screens regarding health are being screened to create awareness among the population. Since 2006, the first Lifeline Express (LLE) mobile clinic has screened 11494 patients, mainly children, for vision and hearing problems. Apart from this, we have the Community Health Initiative (CHI) and Aashramshalas.

What are your future plans for Lifeline Express?

Impact is always looking for better alternatives to be included in Lifeline Express”, eg: population control, new methods for club feet and gynaecological procedures. The aim of this train in the coming years is to make sure that each Indian in every corner of the country is given access to the best medical treatment.

raelene.kambli@expressindia.com