Eyeworld

EW INTERNATIONAL 88 February 2017 by Stefanie Petrou Binder, MD, EyeWorld Contributing Writer projects), not including the data from the most recently completed project. In the last 25 years, Dr. Jain re- ported a constant rise in the number of cataract surgeries performed as well as an increase in the number of projects undertaken. In 1991 the LLE embarked on two excursions, setting up camps at each destination site, and performing 156 cataract surgeries in all. By 1993 this number increased to 1,100 cataract surgeries performed during four camps, with numbers continuing to rise over the years—one year demonstrating the completion of 6,813 cataract opera- tions that resulted from 10 camps. Highlighting the efficacy of the LLE in the Indian population, Dr. Jain reported significant BCVA outcomes. The number of cataract surgeries, for instance, at the project carried out at Zahirabad Station in September 2014 was 590. Preopera- tive and postoperative best corrected visual acuity (BCVA) of 161 out of these 590 patients was randomly selected and the data was applied in statistical analysis using paired t-test two-tailed hypothesis, which showed a statistically significant im- provement in BCVA (p<0.00001) and overall significant results (p<0.05). "On average, the LLE provides medical relief to about 5,000 people per project, each one lasting for about 3 to 4 weeks, and amounting to 10 projects a year," Dr. Jain said. "There are two fully equipped oper- ation theatres on the train that have a total of five operating tables. In addition to cataract surgery, the LLE offers other types of corrective sur- geries, medical services, and health education to the rural poor, totally free of cost." LLE services are offered in orthopedics, ophthalmology, ENT, plastic surgery, dental care, OB/GYN, epilepsy, and health education. The onboard medical staff specializes in the correction of post-polio contrac- tures, correction of club foot defor- mities, and lower limb deformities generally up to the age of 15 years, cataract, intraocular lens implan- tation, middle ear operations such as tympanoplasty, myringoplasty, and mastoid surgeries, cleft lip, burn contracture release, tongue tie release, and dental and oral health The LLE not only transports doctors and medical staff through- out rural India, it also functions as the hospital itself. The train consists of five coaches: the generator/staff car, the office/store/sterilizer car, the operation theatre car 1, the opera- tion theatre car 2, and the confer- ence/auditorium car. The outpatient department and postoperative ward are arranged separately, in close proximity to the train. Since its start in July 1991, the LLE has carried out 170 projects in India, including 100 districts in 19 states throughout the country. The total number of cataract surgeries performed within the time span of 1991 to March 2016 is 74,913 (169 "The purpose of the study was to show the effectiveness of this mobile hospital on a train to provide medical services in remote, inacces- sible areas and to reduce the huge backlog of treatable cataract blind- ness, thus improving the quality of life," Dr. Jain reported at ESCRS. "The purpose of this mobile hospi- tal 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. We also want to create awareness among people." A cataract "hospital on a train" offers a lifeline to India's remote and needy A concerted effort among medical and paramedical professionals, govern- ment, voluntary agen- cies, sponsors, and the railway system in India has brought to life the world's first "hospital on a train," the Lifeline Express (LLE), launched by the Impact India Foundation. The LLE has been combating cataract blindness and other ailments for 25 years, restoring sight in patients living in regions far too remotely situated for medical care. In addition to cataract surgery, the "hospital on a train" also offers other, much needed surgeries and medical care, covering a variety of health needs. Sunil Brijendra Jain, MD, Indi- ra Gandhi Eye Hospital and Research Center, Lucknow, India, spoke on behalf of the LLE during a free paper session on treatment and preven- tion of blindness in the developing world at the 2016 European Society of Cataract and Refractive Surgeons (ESCRS) Congress. Dr. Jain presented data from a study encompassing the past 25 years of LLE service. The hospital that reaches you Presentation spotlight continued on page 90

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