THE MAGIC TRAIN
OF INDIA
In the face of overwhelming need, the Lifeline Express and its staff are beating the odds to bring hope and medical care to the forgotten corners of India.
He'd been hovering around the corners of our shoot for a few days before we noticed him.
Wearing the same smudged button-down shirt each day and an almost perpetual line of sweat across his forehead, he had a habit of blending into the faded 90's decor of the train. Which, it turned out, wasn't exactly an exaggeration.
"See that bed?" he says, pointing to a maroon drop-down bunk attached to the ceiling in the next room, "I've slept on that for 26 years."
This was my first meeting with 56 year-old Raj Dev Mahto.
A proud stocky man from Bihar, he has a bald head, shiny like an idol or a Buddha. His voice is deep and gravelly; he has thick hands and a habit of banging kitchen utensils louder than they ought to be.
"I work as the cook and I am the canteen supervisor," he tells me. The entire time he wears a frown.
We're standing inside his kitchen aboard the Lifeline Express - an old train painted the colour of the sky and made of mismatched carriages. Two of them happen to be fully-equipped, state-of-the-art operating theatres.
Chef Raj Mahto, 56, and local kitchen hand Chaya Bai Vasantrao Suryavanshi, 55.
Chef Raj Mahto, 56, and local kitchen hand Chaya Bai Vasantrao Suryavanshi, 55.
Chef Raj Mahto, 56, and local kitchen hand Chaya Bai Vasantrao Suryavanshi, 55.
Chef Raj Mahto, 56, and local kitchen hand Chaya Bai Vasantrao Suryavanshi, 55.
Chef Raj Mahto, 56, and local kitchen hand Chaya Bai Vasantrao Suryavanshi, 55.
Chef Raj Mahto, 56, and local kitchen hand Chaya Bai Vasantrao Suryavanshi, 55.
Run by Impact India, the train delivers medical care into the most remote corners of India, helping those who might otherwise spend their lives without ever crossing paths with a doctor. While stationed for one month, its volunteer surgeons and staff work in a race against time to treat as many people as they can before its scheduled to depart. From orthopaedic deformities to cleft lips, dental, gynaecological or cardiac problems, deafness or blindness, it’s all treated on board the train.
“In the train, each member of the staff has their own role to play,” explains chef Raj, stirring onions. “Everyone has a responsibility and if they don't perform their responsibility, the train will not be able to function.”
He’s standing over a giant steel wok atop a gas cylinder on the floor, holding an equally oversized ladle that functions like an extra limb. He wants me to understand: this train is special.
It’s true. At every stage, the odds seem stacked against it.
Today, India is home to 1.3 billion people and 70% of them live in rural areas where medical care is either extremely limited or doesn’t exist at all. Cut off by poverty or distance or both, even the most basic health checks are for many unimaginable. The Lifeline Express, then, is trying to help the millions who fall through the cracks.
What makes this mission more impossible is the fact that for a single operation to take place on the train, strangers from multiple disciplines, institutions and backgrounds must all align for 30 days. The government must clear the railways; volunteer doctors and surgeons flown in; the cleaners, cooks and technicians all sourced from nearby towns, a spare generator loaned to provide the power. In a country ruled by slow bureaucracy, the fact any of this comes together at all seems nothing short of a miracle.
“When I joined the train, people used to think that the project would finish within 5 or 6 years,” Raj tells me. “Originally it was not very well equipped. The first two compartments were British-era wooden coaches. But now it has 7 coaches and has been running for almost 27 years.”
As the Lifeline Express drags itself from one tiny village to the next, chef Raj has been on board, watching the flat plains of Mahasrashtra merge into the mountains of Orissa. He’s the only constant on a train where life and quiet miracles sift through like sand.
Usha Bhagwant Das, 28, assistant cook from Latur, employed for 25 days on the train.
Usha Bhagwant Das, 28, assistant cook from Latur, employed for 25 days on the train.
In 1997, on one of his first trips aboard the Lifeline Express, chef Raj accompanied doctors to Kalahandi district in Orissa. At the initiative of the District Collector, the train arrived to treat its tribal communities. In Raj’s words it was “extremely backward”.
“No one in the tribal families knew what health problems they were suffering from or that they could be fixed. The concept of doctors all together was a totally brand new thing for the nature of that place.”
“We sent a bus into the jungle to collect them and bring them to the train. They came with their bow and arrows and their babies strapped to their backs. They were wearing practically no clothing. We assessed them and provided treatment and then transported them back to the forest.”
Raj’s stories reveal the special kind of trust locals place in the train.
Right now, the medical industry in India is wracked by a reputation problem, particularly among those living in poverty. Cut off from the public system which is free but urban centric, many of the poor are forced to turn to private practitioners. Paying out of their own pocket, already impoverished families can send themselves bankrupt trying to pay for medical care. Often, they can be conned by quack doctors. So to convince people a doctor will provide real treatment, for free, out here, is extraordinary.
“The Lifeline Express really is magic to them,” says orthopaedic surgeon Dr Rajesh Panchal, who’s from Mumbai.
“If you come for this surgery in a private hospital, it might cost you around $INR40,000 -50,000. Sometimes in a bigger hospital, it will cost you $INR100,000 or higher.”
“So for many, many people, coming here is a last chance for them.”
Dr Rajesh tells me the record number of surgeries he’s performed in one day is 40. He works fast and with a short fuse because he knows he is many people’s last hope.
At the train’s busiest, I watch him perform a non-stop chain of orthopaedic operations. He loosens tendons in twisted legs with tiny incisions that will enable children with cerebral palsy or polio to walk. As soon as one child is moved to post op care, another is already sedated. Every one of them will have had their lives changed forever.
Dr Nilesh Shende, plastic surgeon, Mumbai.
Dr Nilesh Shende, plastic surgeon, Mumbai.
Dr Nilesh Shende, plastic surgeon, Mumbai.
Dr Nilesh Shende, plastic surgeon, Mumbai.
For chef Raj, this means cooking up breakfast, lunch and tea for more than 30 people - from doctors, to nurses, to anaesthetists. I try to do the maths in my head. 30 meals, 3 times a day, over 27 years….
“I cannot give you an idea as to how many meals I’ve cooked,” he says, just as my translator erupts in wild coughs.
For a moment everyone in the kitchen feels their eyes start to burn.
“Chilli,” says Raj, pointing seriously at the wok.
No one has sacrificed more over the years than chef Raj. One of the train’s few permanent staff, he’s missed the funerals of both his parents who each died while he was away.
“When my mother died, I could not see her face or light the fire for her cremation,” he says, pausing between bangs of his mortar and pestle. “My family did everything for me and I could not be there. That is the most difficult thing.”
While the train’s operating theatres are where the magic takes place, the kitchen holds its heart. At lunch, Raj always makes sure to feed the littlest person first and in quiet moments between surgeries when the carriages are empty, I catch him servings seconds to anyone who might be hanging around.
The local staff he employs alongside him are mostly underprivileged themselves. The bond they form in the weeks they are together is meaningful and for some, the respect and kindness they receive working for Raj is the first they’ve ever known in their lives.
In every way this is how the Lifeline Express works. More than just health care, it returns respect and dignity to individuals regardless of their caste.
“There are many people whom I have carried on my shoulders and brought to this hospital to help them,” chef Raj tells me. “I have helped people who could not walk to get operations to their feet and now they are riding bicycles and teaching in schools. They have gotten married and have children.”
“Once I brought a man from my village who was Other Backward Class. He had cataracts and couldn't see from one eye. He was operated on and when the bandages were removed, he could see. He was over 80 years old and surrounded by doctors and nurses and he began to dance. He said, “Oh, I can now see!”
“Try to understand how much happiness he felt,” says Raj seriously, “that he began to dance.”
Cleaners take a break in the train's sleeping quarters.
Cleaners take a break in the train's sleeping quarters.
On the train’s last day in Latur, my final visit to the staff on board takes place in pitch black. The borrowed generator has finally broken. I find the Head of Operations working in the dark by the light of an iPhone, trying to negotiate with Indian Railways to clear the tracks so they can leave.
Outside the kitchen staff are saying their farewells too. It’s time for them to leave chef Raj and return to the village.
As we shake hands a young female kitchen hand starts to cry. In the fading light, she hugs me tight and for a moment weeps loudly. Chef Raj stands stoic and still, a tea towel on his shoulder. His eyes are a little red too.
“There is nothing better than serving others in life,” says Raj, after she leaves. “If I serve people maybe somebody will help me at some stage. Service to others is of the highest religion.”
Watch Dateline's film "India's Hospital Train" for more
