Normally a patient needs to go to hospital here is reverse way. The hospital goes to the patient.

A DOCTOR SHORTAGE

Lifeline express, lifeline express!

All this will be treated for free at our railway station.

BUT A TRAIN BRINGS HOPE

CAL: IS LIFELINE EXPRESS A LAST CHANCE FOR A LOT OF PEOPLE?

DR: Many people, many people. it is a one and only chance for them.

LIVES WILL BE CHANGED

Mum/ Oh my they have done a great job, they will become famous in the whole of India.

STORY TITLE:

INDIA’S HOSPITAL TRAIN

TITLES

MAP:  INDIA – MUMBAI – LATUR

VO: IN INDIA, TRAINS ARE A SYMBOL OF LIFE.  

BUT THERE’S ONE TRAIN LIKE NO OTHER… THE LIFELINE EXPRESS

DR NILESH: this train is a unique one.

UPSOT/ HI.

So, it is a totally different concept altogether.

A TEAM OF SURGEONS, AND SPECIALISTS,  COOKS AND CLEANERS ARE ABOUT TO EMBARK ON A 6 HOUR JOURNEY BRINGING HEALTHCARE TO THOSE WHO CAN’T AFFORD IT

 IT ALL HAPPENS ON BOARD THIS FULLY FUNCTIONING HOSPITAL ON WHEELS

DN: Lifeline Express is the first in the world, where there are operating theatres on the train and that train travels throughout the country especially in the areas where the basic facilities and amenities are also not available.

HERE ALMOST 900 MILLION PEOPLE - LIVE IN RURAL VILLAGES

WHERE FOR MOST - ACCESS TO MEDICAL CARE IS IMPOSSIBLE… …

TODAY, MUCH NEEDED DOCTORS ARE HEADING TO LATUR IN EASTERN MAHARASHTRA.

Crier in tuk tuk/ Lifeline express lifeline express lifeline express

CRIER/ Lifeline express, lifeline express, is here at latur railway.

Villager off cam:  What is it about? 

Crier/ Mouth cancer, eye problems, etc. Ear problems. Cleft lips. All this will be treated for free at our railway station. [00:30:53]

HERE IN LATUR, THIS IS SOCIAL MEDIA…

VO: MOST OF THESE VILLAGERS WILL HAVE NEVER VISITED A DOCTOR, BECAUSE THEY ARE TOO FAR AWAY AND TOO EXPENSIVE

CRIER: they will not charge anything, not even a rupee, everything free. [00:31:42]

OVER THE NEXT FEW DAYS - DR NILESH AND THE LIFELINE EXPRESS TEAM WILL PERFORM AS MANY OPERATIONS AS THEY CAN BEFORE THE TRAIN IS SCHEDULED TO DEPART. 

WORD HAS SPREAD FAST. FAMILIES TRICKLE IN FROM SURROUNDING TOWNS AND VILLAGES ALL HOPING FOR A MEDICAL MIRACLE.

MUM + DAUGHTER [00:22:15] M/ She is four years old. [00:22:18] M/ And she is not able to walk. [00:22:22] M/ It's from birth. One leg is bent, she can't Walk properly. [00:22:32]

CHECK SHIRT GFATHER [00:30:31] Man/ This right side is twisted. And therefore he has to walk bent. [00:30:39][00:35:55]

00:35:48] C/ How are you feeling today are you nervous? 

Boy/ I'm feeling good I'm hoping my leg will be cured.  

THE DOCTORS ARE LOOKING FOR PEOPLE WITH AILMENTS THAT CAN BE FIXED ON BOARD THE TRAIN.

NO ONE WANTS TO MISS OUT

D2 GH5 C1 DR RISHI IN SITU

we are only two doctors [01:35:47] here obviously there are a lot of patients,

[01:26:28] So we are screening the patients right now, we are examining them. We are preparing [01:26:32] our operation theatre list for whom we will be operating on in the next one or two days.

IT’S PRETTY MUCH ORGANISED CHAOS HERE TODAY. SOME FAMILIES HAVE TRAVELLED UP TO FOUR HOURS FROM NEARBY VILLAGES TO BE HERE. ALL OF THEM, ARE DESPERATE FOR JUST A FEW MINUTES WITH THESE DOCTORS.

Doc Rajesh/ Where's the child? [01:59:37] Put him on this table. [01:59:39] [02:00:11] Doc Rajesh/ When was he born? And where? [02:00:13] M/ He was born at home. [02:00:15] Rajesh/ Was he born full term or was it less? [02:00:20] M/ No it was full term. [02:00:20]

DR RAJESH IS AN ORTHOPAEDIC SURGEON FROM MUMBAI, HE’S EXAMINING TWO BROTHERS WITH CEREBAL PALSY TO SEE IF HE CAN HELP THEM

02:00:43] R/ Does he stand? Make him stand. [02:00:48]

[02:02:33] RAJESH/ Bring the second one. Who's this? [02:02:36] R/ [Off cam: Wait let me finish with him first] [02:02:43] R/ Ok leave him come. [02:02:48] Come! [02:02:51] R/ Very good. Come. [02:03:08] Come. here. [02:03:12] R/ wait wait. Let me check him first. [02:03:16]

[02:14:02] DR RAJESH: if you don't treat him now, okay over a period of time he will get bone deformities because muscles are very tight so they

IT’S GOOD NEWS FOR YOUNG VIRAT AND ADITYA. BOTH ARE APPROVED FOR SURGERY.

[02:01:58] R/ So we have to loosen up the muscles [02:02:08] There will be a small surgery, then there will be a plaster applied for 3 weeks - 20 days. [02:02:13]

[02:02:20] Do you understand? Parents/ Yes. R/ Ok? Admit him. [02:02:22] Bye bye.

THE DOCTORS ARE HERE TO TREAT A VARIETY OF CONDITIONS…FROM CANCER SCREENINGS TO CATARACTS, FOR THE OLD AND THE YOUNG, LIKE 4 MONTH OLD BABY ARUV WHO HAS A CLEFT LIP…

[00:36:57] Arti in situ/ He can't suckle hard enough to drink milk.

HIS MUM IS WORRIED BECAUSE HE CAN’T BREASTFEED PROPERLY.

He doesn't suckle with enough strength. And he gets distressed when he can't do that, and gets angry and cries. [00:37:10]  [00:37:52] Art/ Yes, I feel terrible when he starts to cry. [00:37:55] I blame myself for it. [00:37:58]

HE’LL NEED PLASTIC SURGERY TO JOIN THE MUSCLES IN HIS LIP. 

00:54:30] Doc/ Have you shown the child to any other doctor before?[00:54:31] Mum/ No. Doc/ No where? Mum/ No where.

BUT HIS LOW WEIGHT MAKES OPERATING RISKY.

[00:59:17] PRODUCER: Is he malnourished?
[00:59:17] DR RISHI: Yeah, he is malnourished

THE PLASTICS TEAM IS ASSESSING WHETHER HE’S FIT FOR SURGERY

Doc Rishi to patient/ Between three to six months old we can do it. But HIS WEIGHT IS LOW HE’LL NEED TO WEIGH MORE [00:55:13]THE MINIMUM WEIGHT RE REQUIRE IS BETWEEN 8 – 10 KILOS

BUT NO 3 MONTH OLD BABY WEIGHTS 8 KILOS

RIGHT

CLEFT LIP

WE’LL DO IT

THE DOCTORS AGREE TO GO AHEAD

AS THE SCREENINGS WRAP UP, MORE THAN 40 PATIENTS ARE SELECTED FOR SURGERY.

BACK AT HOME, IT’S AN ANXIOUS WAIT FOR THE FAMILY OF THE TWO YOUNG BROTHERS WITH CEREBRAL PALSY

Dad/ I never imagined that my kids would be like this, [01:19:44]

[01:21:05] Mum/ I was very sad. Everyone else's children were walking and mine weren't. I just kept thinking about this. [01:21:12] I would watch other children walking and wonder when WILL MY CHILDREN WALK? [01:21:18] 

LOOKING AFTER 7 YEAR OLD VIRAT AND 4 YEAR OLD ADITYA IS A FULL TIME JOB.

UPSOT MUM COMES OUT WITH FOOD

[01:22:50] Dad Master IV/ if they want to eat, we have to feed them. The boys they can't do anything on their own. [01:23:00] If they want to go to the toilet we have to take them and hold them up, [01:23:04]

[01:36:28] We spent $INR2000-$3000 on oil and tried it for a month but nothing happened. We were conned. [01:36:36] 

01:25:47] Dad Master IV/ We are daily wage earners, every time someone tells us about a clinic we go there, and so whatever I earn in the week that is spent on the travel to visit these clinics. We have borrowed about INR 150, 000 to INR 200,000 from others in the village. [01:26:03] 

[01:26:28] Calli/ Are you in debt

[01:26:33] Dad/ Yes we are in debt.  INR 150, 000 to INR 200,000

HARIDAS EARNS LESS THAN 3 DOLLARS A DAY – HE’S BORROWED ALMOST 4,000 DOLLARS SEEKING TREATMENT FOR HIS SONS - IT WILL TAKE YEARS TO PAY BACK

[01:34:43] Dad Master IV/ This is our last attempt. We are so tired of visiting doctors. so if everything goes well here, then that's great, but if nothing happens then we'll just stop looking for any further treatment. That will be it, we will look after them as they are. [01:35:09]

BACK AT THE LIFELINE EXPRESS, IT’S AS BUSY AS ANY BRICKS AND MORTAR HOSPITAL.

[00:48:38] This is chicken curry, okra fry

D7 GH5 C1 [00:28:26] In the train, each member of the staff has their own role to play. Everyone has a responsibility and if they don't perform their responsibility, the train will not be able to function. If I don't give tea, coffee or food on time, that will not be very responsible of me.[00:30:14]

RAJ – THE TRAIN’S HEAD CHEF HAS LIVED AND WORKED ON BOARD FOR A STAGGERING 26 YEARS.

[00:40:59] DR NILESH: Basically to operate on a train is coming out of your comfort zone of operating in the major hospitals. It is a challenging one because it is unfamiliar situation and you are not aware of many things but we have to put up with the limitations if we are to serve the people.

OUTSIDE EVERYONE IS WAITING TO BOARD THE TRAIN. UP FIRST ARE ADITYA AND VIRAT - THE TWO YOUNG BROTHERS WITH CEREBRAL PALSY. 

I can’t imagine how people here are feeling. They’re tired, they’re anxious, and in a minute they’re gonna walk through that door and hop on an operating table, for a surgery that could change their life. [00 36 55]

D4 GH5 C1 MASTER IV/  when I'm doing a one case that is only one case for me I don't think about anything else other than that particular case.

UPSOT RAJESH IN OP THEATRE/ 00.59.03 Rajesh looks at / **all medical terms..and cast. We will take this and start from here. It's a small child. 00.59.23 

D4 GH5 C1 MASTER IV/  So my hundred per cent, my brain and my heart both is with that patient. [01:13:05]

00.58.46 Rajesh Directing / Abishek, one minute. Take the gospis, hold his toe, and lift it up. / Asks about gloves. Who's painting? 00.58

are planning to release his (…) to his tendon.. (…)

01.00.08 / Rajesh/ He is walking on his toes. So when we release it, he will be able to get like this one. So that is why we are doing that. [01 00 14]

01.05.09/ Rajesh/ Inside. Ashiya, flex it. Take out the gown! 01.07.57 Just go below the skin, and start, and then cut cut cut. 01.08.00

IT’S A DELICATE SURGERY…ONE WRONG MOVE COULD END IN AMPUTATION

01.08.00 Just like you hold a pen, now see, you palpate it, and a bit higher, go in, stretch it, 01.08.18

[02:23:47] DR: No. if I cut it completely I have to repair it again. It comes with the time it comes with the experience. It looks simple but it's not simple. [02:24:44]

01.09.05 RAJESH SHOWS FLEX/ OK you can see this now. 01.09.15/ Rajesh/ Can you see the dociflection. Yes. I heard the click sound there, Rajesh/ Ok that’s fine, that's fine. Done done, we only have to do the cast now. 01.09.33 

I can’t quite believe how straightforward that operation seemed to be – a simple incision, manipulating the muscles, and putting on a plaster cast is the difference between that boy being able to walk and not

[01 10 54] CALLI: So it went well, it seems so easy!

[01 10 57] DR RAJESH: Yeah so easy right! It’s a technique, it’s a technique [01 11 00]

[01 11 09] CALLI: and are you able to shut out all the stress and the noise? I mean there’s a crying baby in here right now [01 11 13]

[01 11 13] DR RAJESH: I mean we are used to it, already, I mean we can’t help it [01 11 17] IN MARATHI TO BABY/  Okay, now! Enough, enough, enough baba.

AS SOON AS ONE PATIENT IS TAKEN TO RECOVERY, A NEW ONE IS SEDATED.

IT’S A NON STOP CHAIN OF OPERATIONS AND ALL OF THEM, INCLUDING THE BROTHERS, ARE A SUCCESS.

THOUGHT TRACK DR NILESH MASTER IV/  [00:28:00] Whenever I feel stressed and not able to focus I start, my favourite song starts ringing in my brain. So it helps to calm my nerves and able to concentrate on my job. [00:29:00]

That means " I have to go some where else but because of your beautiful face I drawn towards you."

TODAY, A YOUNG GIRL IS HAVING HER CLEFT LIP REPAIRED…

TOMORROW WILL BE BABY ARUV’S TURN BUT AT ONLY 4 MONTHS OLD, THE RISK WILL BE MUCH HIGHER  

N/ Hey baby!!! [00:10:21] Wife/ Hey baby. Look here

DR NILESH CAN’T HELP BUT THINK OF HIS OWN SON EVERYTIME HE OPERATES ON A CHILD

D5 GH5 C1 THOUGHT TRACK [00:59:21] DN I was very excited when he was born. We planned him for almost 2 years after our marriage. Because we wanted to make sure that we are, we are not like taking all the precautions that my child is not suffering from a birth defect.

 00:12:28] Hey baby.... I just reached here.... Go to the park and then call me later...

[00:16:47] DR NILESH: I am lucky that my child is absolutely normal. [00.17.00] So yeah I always keep on comparing that, that thought keeps on haunting me whenever I operate on a kid with a cleft so I try and give as much as possible to those babies. [00.17.15]

[00:19:58] PRODUCER: How do people treat babies with cleft lips in India?

[00:20:01]  DR NILESH: The generally have very like, callous attitude towards them, they are not accepting them with open hearts. Like they think that they may be a curse to the family So it is very troublesome for the father and mother to have, to be with a child with a cleft.

 [00:35:15] Arti/ Everyone said that during the lunar eclipse I USED A KNIFE, and that's why this has happened. [00:35:17]  [00:36:08] Mum/I feel like just because I cut something, now he must suffer for a lifetime. [00:36:18] 

BECAUSE OF HINDU SUPERSTITIONS AROUND PREGNANCY -  ARUV’S MOTHER FEARS SHE’S CURSED HER BABY. SHE HOPES TODAY THE DOCTORS CAN BREAK THE CURSE

[00:42:07] Arti/ When I hand my child over to the doctor, I will just be praying to god that everything will go well. [00:42:20] **Tears up** I just hope that there will be no complications during the operation. [00:42:24] 

The train has come, the train has come.[00:14:34] 

THE OPERATION IS SCHEDULED TO HAPPEN IN LESS THAN AN HOUR.  BUT ON BOARD THE TRAIN DOCTORS ARE DEBATING WHETHER OR NOT THEY CAN GO THROUGH WITH IT.

Rishi/ Patient's fitness is not ok.

A PHYSICAL EXAMINATION BY A LOCAL ANAESTHETIST HAS REVEALED BABY ARUV HAS A CHEST INFECTION.

D4 GH5 C1 00.28.56 Dr NIlesh in situ IV/ it is basically an infection of the lungs so he might be having some cough & cold, that sort of thing, running nose. So they are not planning to give it.

THE OPERATION CAN’T GO AHEAD.

Calli/ Have you told the family this already? Dr Nilesh/ No I will just tell them this now. 00.30.52

D4 GH5 C1 [00:42:19] Dr Rishi/ That's the mother. 

[00:42:20] Dr Nilesh/ Where's the father? Rishi/ Amar come here. 

[00:42:28] Dr NIlesh to Dad/ This anaesthetist feels there is an infection in the chest.

[00.44.31] ARTI LISTENING LOOKING ANNOYED

ADD THIS SOT AS THOUGHTTRACK/OLAY IT TO FLESH OUT- D5 GH5 CARD We cannot do it today. [01:08:20] So once the chest infection is settled, the operation can take place.[01:08:27]

00.44.43 WS DR RISHI + ARTI AND DAD Amar talking/ Dr Rishi/ We want to do the operation, but dealing with a small child his life is also important. 00.44.51 

THOUGHTRACK: [01:17:46] Amar/ The last three days have been really difficult. [01:17:51] All my focus has been on my child. [01:17:54

IT’S BEEN AN EMOTIONAL FEW DAYS AND AFTER WATCHING THE SUCCESS OF SO MANY OTHER OPERATIONS - ALL THEY CAN DO IS RETURN HOME.

The patient has to be fit to undergo the operation, there is no point putting the patient at risk, so THAT’S OK It is part and parcel of the surgery

WHILST ONE SET OF PARENTS WALK AWAY WITH HEARTCHE. ANOTHER …WILL LEAVE OVERJOYED

01.28.23 DR NILESH/ Open your mouth, open your mouth...Open your mouth wide, ahhh. 01.28.29

DR NILESH’S CLEFT LIP OPERATION ON THE YOUNG GIRL WAS A SUCCESS

01.28.43 Dr Nilesh/ The swelling will recede in seven days. During the operation, we took out some muscle from inside and fixed it - which is why there is some swelling there. 01.28.51

01.32.58 MUM SMILING/  SHE was not looking good before, she wouldn't go anywhere, she would cover her mouth in shame. 01.33.05 Now she goes everywhere, she even goes to school.

01.32.57 Mum/ now she will definitely get married. With a cleft, she wouldn't have got married. These people have completely fixed her.

Calli/ What do you think of the lifeline express? 

01.31.52 Mum/ Oh my they have done a great job, they will become famous in the whole of India! 01.31.49 

01.34.00. Mum/ Come on.... Bye bye. Say bye khushi. 01.34.16 Bye bye. 01.34.23

01.34.26 Doctors smile and wave * Bye bye. 

[00:03:22] MUM/ Don't cry don't cry we are close to home. 

Mum: Sleep here sleep here. D/ Don't cry don't cry. [00:04:29] Hold his legs. [00:04:35] D/ Put the pillow behind him. [00:04:47] 

[00:06:16] DAD/ You drink. Open your mouth, open your mouth. [00:06:22] Enough do you want more? [00:06:29] 

IT WILL BE A FEW MORE WEEKS, BEFORE ADITYA & VIRAT’S CASTS ARE REMOVED – BUT WHEN THEY DO, THEY WILL WALK.

[00:31:10] Dad/ We are feeling elated. [00:31:10] It's like a rebirth for our child and for ourselves as well. [00:31:13] We feel all our problems are over now. [00:31:16] 

[00:38:27] Mum/ They will stand on their two feet and they won't require our assistance anymore. [00:38:40]

GRANDMOTHER WITH KIDS/ [00:27:46] Grandmother to elder brother/ Why did the doctor do this? Did it hurt you? Did you cry? [00:28:07

 [00:37:15] Dad/ All this has happened because of the doctor's blessings, they came to us like god and helped us. [00:37:26] 

FOR A HEALTHCARE SYSTEM NEAR BREAKING POINT… THERE ARE ALWAYS MORE PATIENTS TO TREAT…

DR NILESH MASTER IV [01:07:31] CAL: DO YOU FEEL LIKE YOU'RE MAKING A DENT?

[01:07:33] DN: Not dent, not a dent just a scratch maybe.

01:07:41] DN: What ever we are doing it's just a small part in a big thing. Like it's just a drop of water from the ocean.

Both boys have had their casts removed

Now they are walking. 

Baby Aruv eventually got his operation.

IT WAS A SUCCESS