Around India in 80 Trains (37 page)

‘That is not the point.’

‘Try getting on the Tube in London. You wouldn’t last two minutes if you expected people to invite you into spare seats.’

‘Then you are living in a very selfish country.’

He was right. It did make me wonder about the indifference of travellers on the Underground: passengers only unite in the face of disaster, or in the presence of a wasp—or if an unaccustomed tourist fails to find a handhold and falls into someone’s lap. Even then, giggles are stifled behind newspapers and all eyes avert in denial of the incident.

‘You should not worry what people tell to you’, he grinned, ‘why are you caring if I am telling such a thing? Is it not wiser to leave this comment on the platform when you are getting on the train?’

He was right again, but my ego would not allow him the satisfaction of knowing I agreed with him.

‘You mustn’t form attachment to ideas or things; this can only lead to misery. You must learn that we are not those things, or those ideas, we are only owning them. They are not owning us.’

Sandeep reached into his backpack and pulled out a stout book which he touched lightly to his forehead before opening it up to read out a passage:

‘
The nature of the mind is flickering and unsteady. But a self-realized yogi has to control the mind; the mind should not control him
.’

It was the
Bhagavad-Gita As It Is
, a translated version of the original text.

‘If you read this you will see that it is possible to calm these thoughts you are currently allowing to affect you.’

‘If you have no attachment to things, then you won’t mind if I take your copy?’

Sandeep fell silent and my heart wriggled with delight.

‘You keep it ma’am, but you promise me one thing. You promise me that you will read it properly.’

Sheepish, I promised, thanked him and dropped it into my backpack as the entire compartment announced to me that we had arrived at Umaria station in Madhya Pradesh, the home of the Lifeline Express.

Night had fallen and the station cowered beneath a depressing blue light. Beyond the four empty tracks was nothing but blackness. For an Indian town it was spookily still; even the crickets rubbed their wings with reluctance. A band of dogs sauntered down the platform on a mission, stopping briefly to sniff round a sleeping family that had formed a protective circle around their cloth-wrapped belongings. On the fifth and furthest track, a train was resting, the rainbow on her side just visible under the light from a buzzing lamppost. Sliding off the platform, I stumbled over the tracks, and banged on the door of the Lifeline Express, the world’s first hospital train.

For many, Indian Railways provides little more than a mode of transport: a cheap and convenient way to commute, visit relatives, or simply while away the day. For others, it is a place of employment where generations have earned their livelihood. But for some, it is the bloodstream that keeps India’s heart beating. Nehru had once suggested using the railways to reach those who could not reach hospitals, but little surfaced until 1991 when a lady named Zelma Lazarus kicked the idea into action. Lazarus, who is the founder director and currently the chief executive officer of Impact India Foundation, an NGO, had loaned a minibus to a team of foreign surgeons travelling to the Himalayas to offer medical care to hill-dwellers. Having never visited the Himalayas herself, she travelled with them to observe their work.

One night a man came running towards the doctors carrying the body of a dead child. On inspection the child was not dead, but had suffered a burst appendix that had infected his whole body. The doctors worked all night and saved the boy’s life. The following night the team sat around a campfire discussing how they could bring medical care to the corners of the country, when a mountain train rattled by, hooting as it passed. Lazarus went to the Rail Bhavan in Delhi the next day and asked to meet the railway minister. His secretary shouted at her, told her to write letters or make an appointment and shooed her out—but she waited. George Fernandes, the railway minister at the time, spotted her and called her into his office where she proposed the idea of using a train as a mobile hospital. Impressed by her persistence, Fernandes gave Lazarus an engine and three coaches and on 16 July 1991, the world’s first hospital train began its journey around rural India to bring free medical services to the neglected poor.

Initially, patients were invited on board for cataract surgery, treatment for hearing afflictions and orthopaedic disabilities—particularly children who had suffered polio. In 1999 cleft lip surgery was introduced, followed by treatment for dental and oral problems, epilepsy and neurological disorders. Gynaecological check-ups had recently been introduced and the possibility of laparoscopic surgery was also on the cards. On average the train spends four weeks on each project at locations deemed worthy of medical attention, and patients are welcomed aboard for on-the-spot treatment. Each project costs around
`
30 lakh, which covers medicines, travel and lodging for volunteer doctors, patients’ food and accommodation, ambulances, fuel and water. The fee is met entirely by one sponsor which in the past had included the Rajiv Gandhi Foundation, Tata Steel and Dr Michael Chowen, a private sponsor in the UK. Lazarus hoped that the services offered by the train would push the poor to generate a demand from the government for a more efficient health system. Despite being behind on my schedule, the Lifeline Express was one train that I could not miss.

As I reached to knock again, a face appeared at the kitchen window and the door was heaved open by Rai, a driver who ferried staff around throughout the four weeks. He led me towards a jeep that bounced down Station Road to the Hotel Surya where I could sleep off my journey and wake fresh for what was to be a gruelling first day. What I did wake to was a timid knocking on the door at 6am.

Passepartout was back.

The following morning we met Gaurav, who manned the hotel’s reception. He had an endless supply of bottled drinks behind the front desk that he readily offered along with cautionary tales about bad western people, none of whom he had ever met. He and his staff were keen to clean my room, change light bulbs and service the air conditioner on a regular basis, which tended to coincide with when I was in nightwear or emerging from the shower. At precisely 8am a gentleman with soft jowls and closely cropped white hair appeared in the lobby. Randhir Singh Vishwen was a retired colonel from Lucknow and the CEO of the Lifeline Express, who oversaw every project. Punctuality was second nature to the colonel who herded us towards the jeep and back to the station where a scene wholly different from the previous night awaited.

Against the backdrop of a baby blue sky, train number 60 looked like a mobile kindergarten. A rainbow arced over five windows, threaded marigolds looped beneath the ledges and chunky red and yellow flowers swirled around the base. A stage had been erected alongside for the Umaria project’s inauguration ceremony and a canopy stretched overhead, creating a makeshift auditorium to keep out the heat. It was barely 8am but the sun was already burning the ground and turning the jeep to molten metal.

Hundreds of parents wandered around with dusty-haired children on their hips. The elderly squatted on plastic chairs, while others crouched on the cheap green matting, spreading out their food, sheets and babies. They knew it would be a long wait. A man with no legs from the knee down paddled by on a makeshift skateboard, watched by men idling in dhotis. A lady in a sunset-coloured sari carried her teenage son like a sack of rice, his withered legs bouncing off her with every step. A shy lady brought over her baby boy who squirmed and laughed in her arms, even though he had none of his own. Colonel Vishwen steered us onto the train.

To the left was a kitchen where Rajdeo, the chef, was sweating in his vest over a karahi of masala potato, while puris fizzed and swelled in another. To the right was a toilet complete with toilet paper, hand soap and an embroidered towel. An air-conditioned, carpeted room served as both a dining area and a lounge and was hung with articles about the train, certificates and an obligatory photo of Gandhi. Further compartments included the colonel’s office, changing rooms stacked with scrubs and two operating theatres—one with two tables, the other with three. After the tour Passepartout and I stood in the lounge as the colonel explained the format of the day, adding that two more volunteers would be joining us.

‘There is Helen, a medical student from Nottingham University who is going to be assisting, and also …’

The door slid back and a tall, tanned figure in a blue T-shirt and grey suit trousers entered. Ben was half Welsh, half Indian and lived in Hackney. He had a warm Scottish accent, tipped his head to one side when he spoke, and produced deep, dirty laughs from the pit of his stomach that lit up his eyes. He was also a photographer. The air in the room stiffened.

After breakfast Passepartout wandered off to photograph the crowds while Ben and I strolled along taking in the pomp and fanfare surrounding the chief guest, whose head was walled in by garlands. Local cameramen pushed patients out of the way, the jobless jerked the garlands into place, and the chief guest sat centre stage, flanked by nobodies.

‘I’m dyin’ here,’ Ben sighed, pulling at his trouser legs.

It was hot. Not tiring, humid heat, but heat so dry that sweat evaporated before it even appeared. It was nearing 48 degrees and emerging from the air-conditioned carriage was like walking into the barrel of a giant hairdryer, so we made a detour to the local sweet shop for a couple of Cornettos and a Sprite. It was a relief to have someone else for company. One week ago Passepartout had got in touch. He was keen to photograph the Lifeline Express and had arrived of his own accord, but to me nothing had changed. My plan was to simply crack on with my own business and allow him to do the same. Ben reached down and helped me up off the tracks and onto the platform as a toast-coloured mongrel trotted by and decided to join us for the day.

At the district hospital across town Dr Ashok Kumar Agarwal and his colleague Dr Vikas Verma had begun assessing patients for corrective surgery. The hospital was painted in duckling yellow and smelt of Dettol. Sunlight beamed through open windows and balconies, reflecting off the polished floors, but upstairs was a scene of wall-to-wall desperation. A tangled mass of sari-covered heads, misshapen limbs, mirrored bangles, sleeping babies, bent backs, cracked feet, moist eyes and pleading voices jammed the corridor leading to the screening room. Faces pressed against the glass door, hands gripped medical documents and bare feet stood their ground as the crowd heaved from all sides.

Screening took place in an unused classroom where several chairs were lined up against the wall around a rectangle of desks, at the front of which sat the two doctors and Helen. Dr Agarwal was a volunteer orthopaedic surgeon from Lucknow, who was on board for his sixth year. He was a slight man in his early 60s with a light frown of concentration that remained when he smiled. He had a noticeable aversion to verbosity, so when he did speak, it was worth hovering to catch his pearls.

He beckoned in the first patient, an elderly man with eyes like a bloodhound, leaning on a stick as tall as himself. Dr Agarwal scribbled down a referral to Jabalpur Medical College for treatment, as surgery was not possible, and called in the next patient. An anaemic toddler with cerebral palsy was helped in by his mother who held him up by his wrists, his toes trailing the floor like a puppet’s. He was turned away before being seated. Cerebral palsy and other neurological problems were untreatable by the team, who could only offer surgery for orthopaedic afflictions. A teenager playing with her plait hobbled in and parked her left leg on the table. Even though her foot was bent in half she had carefully painted each toenail crimson. She looked up and winked. Sixteen-year-old Roshni Gupta was given the first nod. After suffering polio as a child, her left foot had become severely deformed and she had already undergone unsuccessful surgery in Rajasthan, so the train was her last hope. She threw herself into one of the chairs at the back of the room and whipped out her phone to send a text.