India's Jeevan Rekha Express, otherwise known as the Lifeline Express and dubbed by India's millions of poor as the Train of Hope, performs in excess of half a million operations around the country, a year.
It's half past five in the morning, and the sun is just peeping over the horizon in the town of Mandsaur in India's central state of Madhya Pradesh.
At Mandsaur railway station a train pulls up to the platform.
There are lights ablaze in all the carriages and people can be seen milling around inside, but the doors of the carriages do not fly open, nor does anyone disembark from within.
This is because this train is not just any ordinary passenger train, but India's Jeevan Rekha Express ( The Lifeline Express ), a mobile medical train dubbed the Train of Hope, that travels to the four corners of India bringing hope to the country's sick and poor.
The vast sub - continent of India has seen a rapid economic growth during the last decade, but despite this fact, the country still hosts great swathes of deprived areas, with large numbers of it's population living in abject poverty.
We are all familiar with the large slum areas of the country's vast cities, but these slum dwellers are considered priviledged in comparison to their country cousins, who live without the most basic services of fresh water, public transport and medical facilities.
India's rural hinterlands consists of vast provinces of inaccessible villages and small towns lacking a modern infrastructure, leaving the rural population with little or no paved roads, with which they can access the larger towns and cities in order to visit medical personnnel.
But the problem can not be allieviated by just good access, there is also a question of money too.
These rural communities are some of the poorest in the world, with whole families existing on less than $2 a day.
So even if they were to live on the doorstep of a large modern hospital, most would not be able to afford medical costs.
These facts led to many headaches for the country's medical authorities, as the country does not exactly lack for money, modern facilities or highly trained personnel in the field of medicine, but what it did lack, was access, access to the most worthy and needy cases in the country, whom for the lack of transportation and money are denied the benefits of the governments expansive modern and highly equipped medical services.
This unobtainable healthcare has led to high instances of polio cases, due to lack of child immunisation programmes, premature blindness due to cataracts in the elderly, babies born with cleft palette going untreated and cases of ear, nose and throat infections developing into deafness and even death.
India's vast rail network.
However, one thing India does have in abundance, is a railway network, the largest railway network in the world actually with 63,500 km of track, and one that is able to access every corner of this vast country.
This got Indian Health Ministers to thinking, what if we could access all these people by train by way of a mobile hospital, we could deliver medical expertise, drugs and even perform operations to all these needy people.
Ministers contacted Indian Rail, who were more than happy to donate trains complete with carriages,engines and rail personnel.
Ministers then contacted the Impact India Foundation, a non profit making charity who by way of corporate and private donations, pays for the poor of India to undergo medical programmes that they would not ordinarily be able to afford.
Impact India were thrilled by the idea and straight away began to organise and supply medical equipment,doctors and nurses for the trains.
The trains would conduct on the spot diagnostic, medical and surgical treatments to the most inaccessable areas and poorest communities in the country.
In July 1991, the Jeevan Rekha Express went from a dream to a reality when two fully equipped locomotives began the service known as the Lifeline Express.
Twenty years on the service now runs four trains, all of which perform different medical duties, that travel around the country stopping at different towns and villages with rail stations, for two weeks at a time, in order to deliver vital medical operations,medical education and medicines.
The trains are equipped with state of the art medical facilities, that are worked by some of India's finest doctors,specialist nurses and various medical technicians.
Each train's facilities include fully equipped operating theatres, X - Ray machines,autoclave units, anaesthetic equipment, microscopes, defibrillators, ventilators, recovery room, laboratory,CCTV and a public address system.
The fully air conditioned trains are also fitted out with living quarters for the staff, such as bedrooms,bathrooms, a kitchen and staff rest room, as well as seating and waiting areas for patients and their relatives and friends.
Each train is designated to a different medical service that is most needed, one for orthodontics and cleft palette operations, one for orthopeadic operations for polio victims, one for ear, nose and throat complaints, and one for eye problems and cataract operations.
The trains also run vaccination programme for babies and children and health education and counselling services for patients and their families.
Follow up care and operating theatre after care is also organised by the train's doctors, by way of arranging beds and out patient facilities at the nearest hospitals to the patient's homes.
Each train is capable of performing around 25 operations a day, resulting in over half a million operations and services a year by each train.
The Lifeline Express parked in a railway siding for it's two week duration of administering medical services.
Since the success of the Train of Hope in India, the system has now been replicated in Bangladesh, China and Zimbabwe, with plans to adopt similar services within other third world nations with vast numbers of poor who cannot afford or access their normal governments medical services and healthcare programmes, all funded by the Indian Impact Foundation and Impact U.K.
The Impact charity was founded in the 1980's by Sir John Wilson in order to supply disaster relief around the world.For more information about both the Impact India Foundation and impact U.K, visit their websites.
© D.B.Bellamy. April 2010.
All images courtesy of wikimedia commons.