The concept of Lifeline Express was originally suggested by Jawaharlal Nehru to late Sir John Wilson, a blind visionary and founder of Impact International. Both Nehru and Wilson were concerned with the problems of blind. Nehru suggested that the way to reach Indian rural population was through Indian Railways.His idea realised only in 1991. The hospital train came at a time when the government infrastructure was fast crumbling in rural India. We were offered three old wooden coaches that were to be sent to junkyard. UNAID, an international organisation funded to custom build it. We started our first project in 1999. I still cannot believe the national and international attention it received.
Q. You are entering into the 100th project on Thursday. How was the journey so far?
You should ask this question to the 70,000 people who can now walk, see, hear and talk normally. When the train first chugged off for its project in 1991, London Times sent their reporter and photographer to cover it. BBC made a full length documentary. Subsequently, films were also made on it in French, Japanese and German. Even today, people eagerly wait for the train. It feels good that the efforts are not just appreciated in India, but the idea is replicated elsewhere in the world too. Bangladesh has a boat that conducts free corrective surgeries.Today, we have international organisations funding our projects.
Q. How important is it to penetrate into the rural healthcare?
With the crumbling public health infrastructure, especially in rural areas, it is very important to penetrate into the rural healthcare. Under Impact India Foundation, we have another initiative called community helath initiative. We believe in working with the government. When I last met UPA chairperson Sonia Gandhi, I conveyed that the ambitious National Rural Health Mission was not really working and she replied, “I am aware of it”. Last year out of the money allotted to Maharashtra under the NRHM, Rs 650 crore was not used. After the intervention, both by the NGOs and the media, the state appointed a liaison officer. We are just beginning to get support from the Maharashtra government for health interventions as well as for water harvesting project at Surya river. The public health centres should be made to work, and communities and other NGO’s need to be involved.
Q. With reduction in number of polio cases and still alarming numbers of malnutrition cases in India, will the focus of the hospital train be shifted to malnutrition and anaemia?
At a time when polio was rampant in India, we started off the campaign Poliofree Madras’ in 1985. But even before that the focus of the hospital train has always been on correcting deformities related to polio and other deformities like vision, hearing and cleft lip. It’s true that the number of deformity cases related to polio is lesser as the number of polio cases are reducing in the country, but we will continue correction surgery till it’s required. Another disease that is crying for attention is malnutrition and anaemia. Now, we also plan to venture into malnutrition. We are targeting school children.
Q. Using trains as a medium for imparting health education in the rural areas, how far has it been successful?
Red Ribbon Express is doing a fabulous work imparting awareness on HIV and AIDS. Also to some extent, Science Express is also successful in disseminating health education. It is very important to look out for newer ways to educate people on various health issues. Even though the Lifeline Express is strictly for performing operations, it has become symbolic for corrective surgery in rural areas.But, we have an audiovisual compartment at the rear end of the train to train doctors. We do run films made by our organisation on infant mortality, maternal mortality and many more pressing issues. The mobile medical clinic also has a television screen inside the bus so that the people waiting in the queue to be checked can also be shown films on community health.
Q. What are your future plans?
We have done very little, though we are happy about what the Lifeline Express has done so far. We have reached only seven per cent of the population who need corrective surgery. Not just correction, we need to focus more on the prevention also. We have adopted eight talukas comprising a tribal population of 1.4 lakh in Thane district and are working extensively in the area for three years. We will soon launch another mobile medical clinic apart from the existing two.
Known best as Lifeline Express or “Jeevan Rekha”, the five-coach train – a venture which started in response to urgent needs of the handicapped in remote areas where it has changed the lives of five lakh people through corrective surgeries – has now entered its 100th project. Akhtarali Tobaccowala, chairman of the Impact India Foundation and one of the founder members of the Lifeline Express, spoke to Newsline about the first ever hospital train in the world and the need to work with the government for better healthcare in rural India. Excerpts from an interview: