On July 16, 1991, the world’s first hospital on a train chugged out of Mumbai’s Chhatrapati Shivaji Terminus on its maiden journey. Twenty-six years later, the Lifeline Express (also called Jeevan Rekha Express) continues to take a multitude of medical services, from major surgeries to dedicated cancer treatment, to the people of India.
It started with a simple idea: take hospital services and medical aid to the people, especially those living in far-flung areas of rural India, who remain untouched or poorly serviced by healthcare facilities.
With this concept in mind, the Impact India Foundation (IIF) — a Mumbai-based NGO — proposed the idea to the Ministry of Railways. Shortly afterwards, the Indian Railways (IR) and IIF signed a Memorandum of Understanding (MoU) under which the Railways agreed to provide a three-coach train, supply water and electricity and maintain it, while the NGO would operate the medical services.
In the years that followed, the Lifeline Express regularly camped in different parts of India regularly to conduct medical projects that offered free consultation, treatment and surgeries in various specialities.
Before the train arrived at a location, a medical team visited the area to assess the health requirements — disability data, vital health indicators and available facilities — of the locals.
Following this preliminary screening, the team would collaborate with the local primary health centre or community health centre to prepare a list of those who require surgeries.
While the hospital train started off providing treatment primarily for cataract, cleft lips and Polio, over time, it began providing plastic surgeries, dental surgeries, epilepsy services, burn contractures, cancer treatment and curative services to people suffering from various kinds of disabilities (mainly disorders of the eye, ear, nose, throat and limbs).
Currently, each project (between three to five weeks long) of the Lifeline Express serves nearly 5,000 people and relies on community participation. At every stop, local villages and non-governmental organizations offer various assistance, from food and laundry services to crowd control (polite patients waiting in line and disorderly mobs are equally common) to finding accommodations for post-operative patients and family who accompany them.
The medical camps also include training and awareness programmes among the rural poor, local doctors and school students. Apart from places in remote rural areas, the train also travels the length and breadth of the country to areas affected by natural or man-made disasters.
Till date, the Lifeline Express’s projects (sponsored by both private and public organisations) have treated around one million poor people in rural parts of the country free of charge since its inception in 1991.
Furthermore, nearly 2 lakh medical professionals from across the world have donated their services to fill the crucial gap in rural health services.
Even today, when the Lifeline Express arrives for a camp, hundreds of hopeful patients turn up, often clutching flowers or bearing small bags of fruit and vegetables for the doctors.
As for the train itself, its A/C coaches house state-of-the-art operation theatres, a pathology lab, a mammography unit, a gynaecology examination room, a dental unit, an x-ray unit, pharmacy, consultation cubicles, numerous patient wards, onboard power generators, a well-equipped pantry and lodging for medical staff.
Moreover, the Lifeline Express is WiFi enabled, which helps doctors and experts sitting in metropolitan cities examine patient’s diagnostic reports and other images.
In 2016, the vibrantly painted train also got two new coaches, donated by the Railways, for additional services in cancer detection and family planning.
In December 2016, Hiralal Lodhi (from Pipari Kala village in Madhya Pradesh) became the first patient to be operated in India for a cancer surgery on the Lifeline Express. His story beautifully illustrates the tangible transformation wrought by the hospital train in the lives of millions of rural poor.
A 52-year-old tea vendor, Lodhi earns about Rs 700 every month from his roadside tea stall. After a cancerous growth in his mouth grew from a tiny boil to a lump that bloated his jaws and cheeks, he began facing difficulty in swallowing and talking.
By the time he heard about the train full of doctors that offered free medical aid, he had already spent Rs 20,000 on treatment in Jabalpur and had started borrowed money from his villagers to pay the doctors who were asking him for more.
So when Lodhi visited the Lifeline Express at Satna and was able to not just consult expert oncosurgeons but to also undergo a five-hour long tumour removal surgery for free, he considered it nothing short of a miracle.
Here’s another story that highlights the life-changing impact of the Lifeline Express. Dr Taral Nagda, a Mumbai-based paediatric orthopaedic surgeon who has volunteered his services on the train for the last 16 years, recalls receiving a wedding invitation from the father of a girl he had once treated on the train.
“When she came to me as a child, she had bilateral club foot deformity. I told her father that after the treatment, she would be able to go to school, but he was more worried about her marriage. I operated on her and her feet were straightened. Now she has gone to college and chosen her own partner. Her father sent me a wedding invitation. The reach of this train is not just limited to treatment, it is changing lives”, Dr Nagda told The Hindu.
In fact, such has been the impact of the train that other countries have replicated the idea — China now has four such trains and South Africa has two while Bangladesh and Cambodia each have a riverboat hospital.
Closer home, the Maharashtra government, is planning a separate Lifeline Express just for its state.
Lifeline has inspired other rail projects in India, too. In 2007, the government launched the Red Ribbon Express (to increase awareness of HIV and AIDS) and the Science Express to promote scientific temper among students.
A train that has truly lived up to its name, the Lifeline Express continues to “reach the doorstep” of thousands of poor patients. It is now planning to get a blood bank of its own and ramp up its post-operative care facilities. In collaboration with the Tata Memorial Hospital, it will also focus on providing breast, oral and cervical cancer treatment to marginalised Indians residing in villages.