Back on track: China's rural poor regain sight and self-reliance aboard hospital train

The Lifeline Express deploys hospital trains to rural areas in China, where a poor, aging population can get on board and get free cataract operations.

Service offers free cataract surgery to aging population with little access to treatment

It's estimated tens of millions of people in rural China have cataracts but little to no access to the treatment they need. Along came the Lifeline Express, a private Hong Kong-based foundation that deploys hospital trains around the country, on which medical professionals perform free cataract operations. 

With contributions from Zhao Qian

See more photos on Instagram: @sasapetricic

Long wait, long trip

"The world is a blur, and I can't wait to see better."

For 76-year-old Tang Jin Mian, the trip from her village was far and the wait was long. But the promise of getting her sight back brought her here: a medical service that offers relief from cataracts to China's aging rural population.

(Saša Petricic/CBC)

Thousands of patients

Each of four trains goes to a different part of the countryside for several weeks at a time and sees more than 2,000 patients a year. This train is parked on an unused railroad siding in southern China, near the city of Guilin.

(Saša Petricic/CBC)

30-40 cataract operations a day

Aboard this train between 30 and 40 cataract operations are performed every day. China has the world's largest population of people with cataracts. Many of them are in remote areas, so exact figures are hard to come by, but estimates put the number well into the tens of millions of people.

(Saša Petricic/CBC)

Pre-op train carriage

In one specially equipped train carriage, patients get tests done then get diagnosed by nurses and prepared for surgery in two operating theatres. Most are in their 60s and 70s.

(Saša Petricic/CBC)

1st journey is getting to the train

Even getting to the trains isn't always easy. Cai Jing Zhen has to carry his mother on his back because she can neither see nor walk properly. "It's a big problem," he says. "These are seniors who need doctors and clinics nearby, and there's a huge shortage in rural China."

(Saša Petricic/CBC)

'China is very poor'

Patients spend the night in train compartments, watched by nurses. The founder of Lifeline Express says the high number of cataract sufferers in China reflects decades of health care shortages and uneven distribution of resources today. "China is actually very poor," says Nellie Fong. "There is richness in a very small group of people living in major cities. The rest of the country is still very, very poor."

(Saša Petricic/CBC)

'Making a difference'

The trains provide specialized training for nurses and doctors, some of whom are then posted to new rural clinics. "I really feel I'm making a difference for these patients," says nurse Wang Chang Qi. "It's what I saw myself doing at school, where my role model was Florence Nightingale."

(Saša Petricic/CBC)

Canadian doctors participate

The operations themselves take just minutes. Doctors remove the cataract-clouded lens in the patient's eye and replace it with a clear synthetic lens. On this train, the doctors are all Chinese, but the program has hosted many foreign specialists — including Canadian doctors — who operate and teach.

(Saša Petricic/CBC)

'I hope to be dancing better'

Once the operation is done, the dreaming begins. "I want to be free to climb mountains and go hunting again," says Xu Fang Neng, pictured at left, closest to the window. "I am a dancer," says Jiang Su Zhen, in the red coat. "I hope to be dancing better and better now."

(Saša Petricic/CBC)

Operation is free

Patients are usually back home within a day or two. About half a million more Chinese get cataracts every year, and most can't afford the $1,000 or so it costs for the operation at a hospital — if there is even one nearby. Aboard the trains, the operation is free.

(Saša Petricic/CBC)

'I will look for a wife'

For Xiong Zhi Lian, near-blindness meant years of poverty as the lenses in both eyes gradually clouded with cataracts and the jobs faded away. He's just returned home to his room in the isolated village of Bao Gu Tang. "It's great to see things more clearly already," he says, adding he will start looking for work right away. "And then, I will look for a wife."

(Saša Petricic/CBC)