The World's First Hospital on Rails

The Lifeline Express, one of the projects of Impact India Foundation, is the world’s first hospital on rails. Launched on 16th July 1991, it reaches those who cannot reach hospitals. Its main function is to provide medical and surgical treatment to the disabled in rural and tribal areas and the beneficiaries are mostly from the most underprivileged sections of society.

This unique project is the dream of Sir John Wilson, a prominent British advocate for the disabled, who founded Impact Worldwide, a non profit health service provider and a British NGO. Leaders of Impact India took up the challenge of turning Sir Wilson’s idea into reality and created the Lifeline Express (Jeevan Rekha), which brings the benefits of modern medicine free of cost to millions of poor villagers in rural India. Disability being a global phenomenon, Impact UK wanted to spread out globally and chose India for setting up their counterpart in view of the magnitude of the problem as well as the potential to tackle it effectively.

The Tata Group of Companies offered handsome support to the project and Impact India Foundation (IIF) was born in 1983. A registered public trust, promoted by the United Nations Development Programme, UNICEF and WHO, IIF was inspired by the vision of Pandit Jawaharlal Nehru who dreamt of taking essential services to the disabled by using the Indian railways, the largest network in the world.

The Lifeline Express was flagged off from Victoria Terminus station at Bombay on 16th July 1991 for Khalari, Bihar, as a heartening implementation of that dream. With full co-operation from the Indian Railways, this unique train began its journey to perk up the lives of those stunted by disabilities. Since its inception in 1991, the world’s first hospital train has been rolling to reach the magic of medical intervention to far flung areas of the country’s vast interiors.

The Lifeline Express offers on the spot diagnostic, medical and advanced surgical treatment for preventive and curative interventions for the handicapped using the Indian Railway network which is the largest in the world, having over 63,500 kilometers of tracks.

Over 4 lakh Indians have so far benefited from the remarkable train, and other countries have come forward to start their own Lifeline Express on which major surgeries have been performed to restore movement, hearing, sight and correction of clefts.

This Project has been developed in collaboration with the Indian Railways and the Home Ministry. It has been funded by Impact UK, international charitable sources, Indian corporate houses and individuals. The Tata Group of Companies, Rajiv Gandhi Foundation and Indian Oil Corporation are among the major corporate donors in India. More than 80 projects have been conducted all over India and over 105,000 people have received life-transforming treatment from this unique train.

Four old railway carriages released by the Indian railways were completely re-designed and restored by engineering and medical consultants and refurbished into a fully air conditioned hospital equipped with all modern medical and surgical facilities including training facilities for up to five medical persons.

This mobile hospital has 2 surgical operation theatres with three fully equipped operation tables each (so that 3 operations can be held simultaneously), a sterilization room, two powerful generators (to ensure 24 hour power supply), recovery room for patients, a meeting room, residential area for medical staff, a kitchen, changing room, store for medical supplies, ophthalmic room, X-Ray room, Auditorium and training facilities, toilets etc. Lt Col Randhir Singh Vishwan is the Chief Executive Officer and oversees each project.

Actually there are two such identical trains in India and they visit different parts of the country, usually rural areas with insufficient medical facilities, or areas hit by natural disasters etc and stays in each place for several days or weeks while medical care (routine plus major surgery) is provided to the local people. Lifeline Express projects are held in smaller towns/villages which are connected with broad gauge railway lines. The active involvement of the local Govt and Non Governmental Organizations (NGOs) as well as business houses, volunteers and local businessmen is necessary for the success of each project. The time period at each place varies is approximately 6 weeks, but may vary depending upon the response and the number of people treated. The current location of the Express can be seen on the internet.

Before the Lifeline Express arrives at the designated place, the District Health Officer conducts a Publicity campaign in the neighboring villages and suburbs to make the people aware of the facilities. Personnel from the Primary Health Centers talk to the local people personally to make them understand the benefits they can get through this project. A light motor vehicle fitted with loudspeakers is also often used to make announcements and pamphlets are also distributed in the surrounding areas.

The District administration and Railway authorities usually provide a room/shed/enclosed place on the railway platform or near it for the doctors to screen the patients and advise them about the surgery. For post operative care, a hall or rooms are taken close to the railway station so that the patients’ condition can be monitored by the medical staff. The doctors and specialists are usually housed in Circuit Houses, Guest Houses or hotels close to the station while the nursing staff and attendants stay on board the train. Local contacts are crucial to the success of the mission because they can speak the local language and instill confidence in the rural people, many of whom have never seen a doctor, leave alone a hospital or an operation theatre.

In February 2005 the Lifeline Express visited Orissa and set up a facility of a 300 bed hospital for pre and post operative as well as in-patient care. Needy patients were given corrective surgery and appropriate aids and appliances. When Gujarat was torn apart by a massive earthquake on 26th Jan 2001, the Lifeline Express was rushed there to provide aid and relief to hundreds of victims.

The Lifeline Express was at Rourkela railway station for three weeks from 11th July 2006 to 5th Aug 2006 on its 84th project. Medical personnel on board conducted a large number of operations including those for lip cleft, polio and clump foot, ear and cataract. A large number of people from the nearby villages and tribal areas benefited from the advanced medical care offered on the train. The local District administration provided all possible help and Doctors, Nurses and para-medical staff from hospitals and Nursing Homes in Rourkela offered their voluntary services. Specialists and Plastic Surgeons were also brought from Bhubaneswar, Kolkata, Lucknow and Jamshedpur.

The author visited the Lifeline Express and also interacted with three foreign medical personnel on board. They were Mr Marcus Schettle of Germany (a final year medical student), Ms Laila Benoit of The Netherlands ( a nurse) and Mr Guillame Aurias of France ( a nursing attendant specializing in surgical cases) who were giving their voluntary service in the train. In their conversations with the author, they were full of praise for the Indian people whom they found very simple and friendly and said that they loved this beautiful country. They also said that they learnt a lot about surgery on the Lifeline Express and worked hand in hand with the Indian surgeons and specialists.

The author had also invited the trio to two Rotary Club meetings at Rourkela and also to the Max Mueller Bhavan and Indo German Club. Mr Schettle was pleasantly surprised to know that German classes are very popular at the Max Mueller Bhavan in Rourkela and was taken around the German section in the library as well.

Raju, a ten year old child afflicted by polio, living in a tribal village near Rourkela, was totally awe struck by the ‘magic train’. After being provided the calipers he was overjoyed and said, “I could never imagine that I could walk properly like my friends”. His parents were in tears after seeing his improved condition. Sixty year old Yudhisthir, a slum dweller in Rourkela, who had lost most of his eye sight due to cataract couldn’t believe that his vision now is almost normal. “I was used to living in a dim world, it is a re-birth for me”, he said. Most of the patients and their relatives the author talked to were full of praise for the unique service offered in the Lifeline express and blessed the doctors and staff for their great services.

The following services are offered by the Lifeline Express:

• Restoration of movement to polio and orthopedically affected people by surgery and providing calipers.
• Restoration of sight through cataract operation and providing intra ocular lenses.
• Restoration of hearing through surgery and supplying of hearing aids.
• Correction of clefts through surgery.
• Counseling and referral services.
• Follow up of patient’s progress through arrangement with the local authorities.
• Preventive services including immunization and provision of nutrients.
• Opportunity to medical and voluntary personnel to work in a unique field situation.
• Teaching surgeons working in smaller towns the finer skills of micro surgery.
• Training health workers, doctors and NGOs on various health issues.
• It also involves itself speedily and deeply in disaster management of natural calamities/emergencies.
• It provides food and lodging for the patient as well as an attendant as well as medical accessories like calipers, spectacles, intra ocular lenses, hearing aids etc free of cost.
• To address the grass roots problem of low health awareness it also conducts health awareness camps among the deprived sections in neglected rural areas.

The Lifeline Express has become a model of transfer of Indian appropriate technology to setting up similar projects in China (which has 3 similar trains), Zimbabwe, and a hospital river boat, “Jibon Tori’ in Bangladesh.

As per available data, from Jan 2005 to June 2006 the Lifeline Express has visited Rae Bareli (U.P), Jajpur (Orissa), Guna (M.P), Palghar (Maharashtra), Jharsaguda (Orissa), Itarsi (M.P), Kariar Road (Orissa), Nihalgarh (U.P), Sini (Jharkhand), Babrala (U.P), Ashok Nagar (M.P), Rewa (M.P), Bishrampur (Chhatisgarh) etc. During this period it has registered a total of 73894 patients out of which 555 are for orthopedic cases, 210 for cataract, 4197 for intra ocular lenses, 1465 ENT cases, 1101 for clefts and 50 for other ailments.

In Nov 2004 the Lifeline Express was on display at the National Rail Museum in New Delhi. The 3 day exhibition saw 50,000 students, parents and teachers catch a glimpse of the magic train and scores of doctors and para-medical staff pledged to donate their voluntary services on board as and when required.

Many renowned persons have lauded the unique efforts of the Lifeline Express (LE) and the dedication of its staff who offer voluntary services in far flung interiors of the country. The LE has received the UN Award for Excellence in Public Service Worldwide in 1994 and other awards have been pouring in.

Taking advantage of the vast railway network, the train transforms any empty railway siding into a temporary hospital and brings all sophisticated medical care to the people who have virtually no access to the same. It is estimated that there are 90 million disabled people in rural India, crippled with polio, blindness, deafness and other disabilities. The ‘magic train’ provides yeoman service to ensure that these people are not robbed of health, productivity and joy. The unique train tirelessly criss- crosses the interiors of India in a silent crusade against disability and has been rightly christened the ‘harbinger of hope’.