By Shweta Srinivasan, IANS,
New Delhi : “If you have fits, it can be treated. You are not possessed by evil spirits!” Trying to dispel myths about epilepsy in India’s rural hinterlands, the Lifeline Express – the country’s only hospital-on-tracks – has now introduced epilepsy treatment and awareness on board.
As per World Health Organisation (WHO) estimates, as many as 10 to 12 million Indians, the majority of whom are in rural India, are affected by epilepsy.
When the Lifeline Express, a five-coach train-hospital, chugged in at the Vidhisha station in Madhya Pradesh in July this year, Mamta Bhushan Singh, assistant professor of neurology at the All India Institute of Medical Sciences (AIIMS), was also on board as a guest.
She told the train’s in-charge, 64-year-old retired Colonel Randher Singh Vishwen, that she would be interested in seeing patients.
“Once I let them know that I would love to see some patients in the few hours that I was there, word spread quickly and by evening I had examined 30 patients of epilepsy. I could not finalise the diagnosis and line of treatment in all patients, but there were many where I could start treatment right away. Most patients were drug naive,” Bhushan Singh told IANS.
Bhushan Singh said she saw patients mutilated with scars of injuries, knocked-out teeth and burns – “who had been having seizures for most of their lives but had never ever been treated”.
She spoke of an 80 percent treatment gap for epilepsy patients in India.
“Adding to that there is mistreatment. Unaware, villagers often deem a person with epilepsy as someone taken by spirits. Superstition and myth coupled with discrimination – epilepsy patients are shunned,” she said.
In rural areas, people have little awareness about causes of epilepsy, she says.
“Poor sanitation, malnutrition, birth hypoxia, tumors, accidents or injury, all can cause various forms of epileptic attacks. The course for treatment is just regular medication to keep the condition in control,” Bhushan Singh added.
Awareness is poor about the widely found condition and instead “having fits or jerks is stigmatised”, the doctor said. “These patients need to be aware that they should not do work near fire, welding or heavy machinery. With medication they can lead normal lives.”
The Lifeline Express has treated as many as 600,000 patients since its inception in July 1991 and carried out general health checks and 81,000 surgeries for cleft lip and polio deformities as well as corrective eye surgeries. Since July it has introduced a dental department on board.
Now with Bhushan Singh’s involvement and a regular epilepsy care and awareness service, the train will halt for around two weeks each at destinations across rural Rajasthan, Uttar Pradesh, Jharkhand, West Bengal, Bihar and Madhya Pradesh till March 2010.
The train has seven to eight doctors who interact with around 300 patients a day. There are two operation theatres on the train, while one coach acts as an OPD.
The Lifeline Express covers 10 destinations a year. The train is booked for the next two years.
Vishwen says he came up with the idea to tap India’s strong railway network for providing public health care based on what former prime minister Jawaharlal Nehru had said and fondly quotes: “To serve the poor of the country, make use of the railways. That’s what we did taking a modern equipped hospital to remote corners.”
Vishwen said: “Often, coordinating with government machinery and the local health services is not easy. We need to spread awareness among them before we can expect patients to open up when the train reaches town. For this we have local NGOs and facilitators.”
(Shweta Srinivasan can be contacted at [email protected])