Twenty five years of combating cataract blindness: lifeline express(lle) the world's first hospital on a train

Session Details

Session Title: Orbis Free Paper Session

Session Date/Time: Monday 12/09/2016 | 11:30-12:45

Paper Time: 12:05

Venue: Room B10

First Author: : S.Jain INDIA

Co Author(s): :    R. Gourh   G. Saxena                 

Abstract Details

Purpose:

The purpose of our study is to show the effectiveness of this mobile hospital on a train to provide medical services in remote, inaccessible areas and to reduce the huge backlog of treatable cataract blindness thus improving the quality of life. The purpose of this mobile hospital is to offer on-the-spot surgical treatment free of cost for curative interventions to the disabled poor in rural India using the entire Indian railway network in a fully equipped and administered hospital train. As disabled and poor people cannot reach a hospital, the hospital should reach them. To create awareness among people.

Setting:

Cataract surgeries are performed in the Lifeline express launched by Impact India Foundation. It consists of five coaches.1- Generator cum staff car.2- Office/Store/Sterilizer car.3- Operation Theater car 1. 4- Operation Theater car 2 & 5- Conference/Auditorium car.Out Patients Department and post-operative ward are arranged separately close to the train.

Methods:

Planning and Preparation of project site. Permission from local authorities. Publicity via media, announcements, distribution of handbills, display of banners/posters/flags, cable TV and radio broadcast. The LLE is parked at a railway siding for the entire period.Primary screening of patients by medical officer and then by Ophthalmic surgeon. IOL power calculation by optometrist. Rule out Diabetes mellitus and hypertension.Routine fumigation of OT and sterlization of instruments. Pre-operative antibiotic drops and pupillary dilatation.Peribulbar block. SmallIncisionCataractSurgery with IOL Implantation. Patient shifted to ward. Eye patch removed next day. Uncorrected Visual Acuity and pinhole vision tested. Post-operative steroid antibiotic and cycloplegic drops started.

Results:

Until 8th march 2016, 170 projects have been completed since July 1991.100 districts in 19 states of India have been covered.Total number of cataract surgeries performed from 1991 until February 2016 is 74,913( 169 projects).Data of the last project is not included as it was completed few days ago.The number of surgeries at Zahirabad Station in September 2014 was 590. This is an example of one of the projects. Pre-operative and Post-Operative Best Corrected Visual Acuity (BCVA) of 161 out of these 590 patients were randomly selected and the data was applied in statistical analysis( paired t test- two tailed hypothesis)which showed a statistically significant improvement in BCVA. The value of p is<0.00001.The result is significant at p<0.05.

Conclusions:

The results clearly indicate that this is a unique concept in combating treatable blindness due to cataract, virtually at the doorstep of the patients. However, this is possible only by the combined efforts of the Government, voluntary agencies, voluntary medical and paramedical professionals , the sponsor or collaborator, LLE and the Indian railways The fact that this project has been replicated with four LLE trains in China, two in South Africa and Riverboat hospitals in Bangladesh and Cambodia proves its success and tremendous potential.This may be replicated by other nations where a similar need and situation exists.

Financial Disclosure:

NONE