India's Health On The Rails

Over last 3 months the world has been thrown into a situation of a magnitude, which no strategist could have predicted, neither any disaster management would have factored it in. The world has seen pandemics, within a limited zone and with controlled effect. COVID-19 has broken all records and literally brought the world on a standstill and its economy on its knees. Interestingly some of the most developed countries on the planet, with best medical facilities, are the worst affected ones. World leaders are struggling to bring things under control. We have a task in hand, to firstly secure the basic right to live, for the mankind. 

Comparing current global dynamics, to that of India’s, the 2nd highest population in the world with highest density per kilometer and limited healthcare infrastructure, the risk element is all that graver. Not to forget, a lower index in social hygiene.

Now let’s track back, to see, where we stand today with all the deficiencies we inherited, vis a vis how the developed world is stacked up against. I think we should take a heart and pat our back from the fact that, we learnt quickly and were very prompt to take decisive actions. A comparatively flatter trajectory of growth of the infected, vis a vis global trend, speaks for it. 

Be it the janta curfew to start with, partial lock down, curfews in few cities, followed by a total national lock down, entire government machinery getting into action on ground zero in no time, setting up testing and treatment facilities, and last but not the least, the larger section of our civil society responding to the clarion call as responsible citizens (barring scattered naysayers).

Inspite of all the early deployments on war footing, we are still far from being anywhere close to defeating this pandemic. The establishments both at center and states have done a commendable job till now. With no ready medicine or vaccination visible in any immediate near horizon, the pandemic might be at the cusp of getting into stage 3 (community spread stage). We need to ensure, we pull out the last straw to stop it at Stage 2, before it gets over the line.

The biggest handicap that we have, is our 1.3 billion, geographically, socially and culturally diverse population. While Social Distancing is the order of the day. we can’t ignore the fact that there are exposures happening and its still not done yet. What we need is a modular infrastructure for effective Isolation of the infected, followed by the treatment.

The one common infrastructure that connects the whole of India is Indian Railways. Not the obvious name that pops up in our mind when we talk about medical exigencies. 

How can Indian Railways be that game changer in India’s fight against this pandemic?

What makes Indian Railways that ace of card, that we have up our sleeves?

How much potential it has, to be a global use case of its kind, that the world has never thought they would ever see?

We know that Indian railways is working on converting the railway coaches into isolation and quarantine centers, under its LifeLine Express Model. A 6000 bed infra was put up right within 24 hrs. There is a further plan of 3 lacs + bed fully equipped medical ecosystem across the country.

Let’s eyeball on some ready data* available on the dynamics of India and Indian Railways, to know, how it’s all happening:

Indian Railways is divided into 17 zones and 69 divisions, covering 100% of India’s Urban locations and approx. 90% of Rural areas.

Now these are some staggering and mind baffling numbers. Isn’t it?

How does all these add up to India’s fight against COVID-19?

With Indian Railways on a complete commercial shutdown mode right now, because of lock down, we have access to a fleet of 70,000 + passenger coaches and 11,000 + locomotives.

For hypothetical purpose, let’s consider half of that number to be operation ready, as we speak.

Here are some exciting propositions that it adds up to, which is making the authorities confident to pull it through:

1)    Converting these coaches into not only isolation centers, but also test and treatment hubs on the rails.

2)    Purpose built configuration of an average of 10 coaches per train

3)    That gives us minimum of 3500 hospitals on rails. More can be easily retrofitted

4)    Typically,10 beds per coach for isolation purpose.

5)    We are talking about easily an 80 to 90 bed facility per train, with onboard testing lab and lodging facility for doctors and para medic staff 

6)    Suddenly we are talking about additional 3 Lac+ beds at the minimum across the country for patients.

This mobilisation is of a magnitude that might have never happened in any part of the planet till date.   

Indian Railways would get the length and breadth of India covered under the ambit of this mission. Be mindful that Indian Railways would still have enough reserve in hand to back fill, if required.

Let’s also not forget the army of healthcare personnel on railway payrolls. The 2nd line support of National Service Scheme volunteers (NSS), National Cadet Corps (NCC) and National Disaster Response Force (NDRF) are already called in for.

This whole exercise would not only reduce the load on the limited urban healthcare infrastructure but would also take the much needed critical medical ecosystem, right at the doorsteps of the last mile citizen down to the class C towns, deep districts and villages. These are the places where nearly 70% of India’s population still goes to sleep.

A bigger pie of our population gets covered. Necessary and applicable tests, quality treatment and quarantine facilities are made accessible to the larger section of our population. The local administration can ensure, there is a synergistic mobilisation of relevant people to these hospitals on rail.

The cost curve to the government would be significantly southward, as 80% to 90% of the base railway infrastructure is on operational readiness as we speak.

Beyond the funds getting raised from across civil society and corporate, the Indian Industry is also chipping in with its technical capabilities now.

We are already seeing some movement in this space of in-country production of Testing Kits, Ventilators, PPEs, Masks, Gloves and Other medical support. It needs to pick up pace.

Experience of our industry leaders and their quicker go to market SOPs, customised to this emergency, would do wonders for India’s battle readiness. All of these would help us support the purpose with higher availability, at a fraction of cost.

With the COVID-19 infected numbers set to surge, a deep deployment of these hospitals/isolation wards on rails, with backed up support from our establishment and industry, would allow India to, not loose life critical time and blunt the extent of collateral damage. 

“We Win This Battle For India, To Win The War For Humanity”

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*Data sourced from https://censusindia.gov.in/, Indian Railways Official Website and Wikipedia Page of Indian Railways