Epilepsy Care by Rail

September 24, 2009


Singh, MamtaBy Mamta Bhushan Singh, MBBS, MD, DM, Department of Neurology, All India Institute of Medical Sciences, New Delhi, India

Mamta Singh is a 2008 Donald M. Palatucci Advocacy Leadership Forum graduate working to increase epilepsy awareness and improve epilepsy care in India. With up to eight million people suffering epilepsy and only about one thousand neurologists in the country, adequate treatment of this condition is far from guaranteed. Singh has found a way to spread her message and expertise where it is needed most using a train-hospital, the Lifeline Express. —AAN.com Advocacy Editor

India's many geographic locations suffer a gap in epilepsy treatment, a situation that underscores the mismatch between the numbers of patients and trained doctors in that country. While millions of Indians live in rural areas, few physicians practice there, and most people with epilepsy live their entire lives without being adequately treated. The problem is compounded by the failure of most of the rural population to accept or recognize epilepsy as a treatable disease.

"The Lifeline Express" is India's only train-hospital. Operated by the Impact India Foundation, the train has been chugging along since July 1991, having treated as many as 600,000 patients. The Lifeline Express provides health checks, surgeries for cleft palate and polio deformities, and corrective eye surgeries. Staying between two to three weeks at each of 10 rural destinations per year, the train provides a unique solution to the particular problems of health care in India.

Impact India's Lifeline Express Stamp, launched on
May 12, 2009.

Since July 2009, I have participated in one- to two-day stints on the Lifeline Express, holding an epilepsy clinic and awareness program at each stop. In my first train outing at Vidisha, near Bhopal, I saw many people, poorly educated about health and proper medical treatment, who had been scarred by damaged teeth, burns, and other injuries experienced during seizures. Most had been having seizures all their lives. There were many for whom the diagnosis and treatment could be finalized immediately by a trained neurologist. For those who needed further investigation, local administrators could be mobilized by the physician to help patients reach my institution, All India Institute of Medical Sciences (AIIMS). All patients were given information about epilepsy and a free month's supply of medicine.

I am working to expand epilepsy services for my future trips on the Lifeline Express. Plans include installing EEG machines and establishing a sustainable supply of medicine to indigent epilepsy patients. I have relied on the Lifeline Express's funding for introducing epilepsy services, but I am seeking funds from other sources to expand and improve the train's epilepsy services.

Author Disclosure

Within the past 24 months, Dr. Singh has served as an uncompensated member of the editorial advisory board for International Journal of BioSciences and Technology.