"In India, there is a train hospital, called the Life Train, which brings free medical care to people in need along the railway line. Perhaps, we can build one of these trains as well......"
It was 1997, before Hong Kong's return to the motherland, Fong Wong Jiwen, then a member of the Preparatory Committee of the Hong Kong Special Administrative Region, saw that various provinces across the country had prepared different gifts for Hong Kong, and she discussed with her friends, why not prepare a "health express" as a gift to the mainland?
So, on July 1 of that year, the day of Hong Kong's return to the motherland, this ophthalmic train hospital, which specializes in the treatment of cataracts, drove out of Hong Kong under the expectant eyes of the Hong Kong people and went straight to its first stop - Fuyang, Anhui.
The "Health Express" on the move. Xinhua News Agency
Why choose ophthalmology and why specialize in cataracts?
"Seeing is probably the hardest form of disability, and it has a huge impact on quality of life. As the founding chairman of Lifeline Express, Fang Huang Jiwen recalled that her idea was supported by the Hong Kong and Macao Affairs Office of the State Council, the former Ministry of Health and the former Ministry of Railways at that time.
Today, this "return gift" has changed the lives of 230,000 cataract patients, and continues to bring "visible" hope to those in need.
A patient who has undergone surgery on Lifeline Express. Xinhua News Agency
In 26 years, it has increased from 1 to 4 columns, passing through 28 provinces and municipalities and 5 countries under the Belt and Road Initiative.
In the past 26 years, Lifeline Express has passed through the lives of more than 230,000 cataract patients.
With the rollout of the "Belt and Road", the road ahead of the "Health Express" is becoming farther and longer......
This is a payment paid by Hong Kong citizens out of their own pockets
"Return gifts" to the mainland
As many people know, at 0:00 on July 1, 1997, the Chinese and British governments held a ceremony for the handover of power in Hong Kong at the Hong Kong Convention and Exhibition Center. But what most people don't know is that after the handover ceremony, Tung Chee-hwa, then chief executive of the Hong Kong Special Administrative Region, went to Kowloon Station to participate in the "Lifeline Express" car donation ceremony.
The Lifeline Express train departing from Hong Kong's Kowloon Railway Station arrived in Fuyang City, Anhui Province on 3 July 1997. The clinic was officially opened on July 9 for matters such as water connection, electricity connection, sewage discharge, communication line connection, and medical waste and household waste disposal. Profile picture
This is the first "Lifeline Express", and it is called "Hong Kong Guangming". To support the construction and operation of the train hospital, Hong Kong citizens donated more than HK$20 million. During the 45-day stay in Fuyang, the first stop, doctors from Hong Kong and mainland China performed free surgeries on 191 cataract patients at the mobile hospital, giving them back sight.
As a gift from Hong Kong to the mainland, why did Lifeline Express choose ophthalmology and why did it specialize in cataract treatment?
"Seeing is probably the hardest form of disability, and it has a huge impact on quality of life. As the founding chairman of Lifeline Express, Fong recalled that her idea was supported by the Hong Kong and Macao Affairs Office of the State Council, the Ministry of Health and the Ministry of Railways.
Therefore, after on-site visits and many discussions, various departments in Hong Kong and the mainland finally decided to build the "Lifeline Express", and chose cataract with a large number of patients and a short operation time as the treatment project.
In October 1996, Fang Huang Jiwen and a delegation composed of the Hong Kong and Macao Office of the State Council, the Ministry of Health and the Ministry of Railways went to India to inspect the operation of the "Life Train" train hospital. Profile picture
The "Lifeline Express" has been specially designed, consisting of 4 carriages: an operating car, a ward car, a power generation car, and a camping car, which is equipped with complete medical facilities, and excellent ophthalmic medical personnel from Beijing, Tianjin, Guangdong, Hong Kong and other parts of the country take turns to serve on the car.
In the past, cataract treatment technology in the mainland had not yet developed, and many places did not have advanced phacoemulsification equipment to carry out minimally invasive surgery.
The mainland cities of the Guangdong-Hong Kong-Macao Greater Bay Area have been associated with Lifeline Express for a long time. Doctors from Sun Yat-sen University's Zhongshan Eye Center have boarded the train five times to Hezhou in Guangxi, Shuozhou in Shanxi, and Guang'an in Sichuan to provide medical services to local patients. Lifeline Express has also driven to Zhaoqing three times, and has performed vision restoration surgeries for 3,435 cataract patients.
In addition to providing free treatment, Lifeline Express is also an ophthalmology training base. Lifeline Express will leave a series of "Lifeline Express" in the areas it serves: funding local hospitals to build "eye centers", training grassroots ophthalmologists, and sponsoring cataract surgery equipment so that they can perform cataract surgery independently.
Six months before Lifeline Express arrives in an area, local medical staff will go to remote areas to conduct initial examinations and screen out about 1,000 patients who are suitable for treatment. Among them, children and adolescents with cataracts, patients with blindness, and patients with intractable diseases will be given priority to undergo surgery.
After the "Lifeline Express" arrives, it usually stops at each station for about 3 months, and the patient will be transported to the train for surgery free of charge, and will be examined at a local hospital after the surgery to confirm that the wound has healed and there is no infection before being sent home.
Due to the difference in the width of the rails at home and abroad
What to do if it is difficult for physical trains to enter foreign countries
In 2013, China proposed the Belt and Road Initiative. Many domestic enterprises participate in the construction of the "Belt and Road" through foreign trade, investment and infrastructure, which also brings opportunities for the "Health Express" to go abroad.
"We thought that we might be able to respond to the Belt and Road Initiative through charity and medical assistance, so we had the Lifeline Express International Brightness Tour. Fang Huang Jiwen told reporters that with the development and improvement of domestic medical technology over the years, the Chinese medical team has enough ability to "go out" to help other countries.
However, in the process of practice, it is difficult for the physical trains of "Lifeline Express" to go directly to foreign countries due to the difference in track width at home and abroad.
As a last resort, on the basis of continuing the spirit of "Lifeline Express", the "Lifeline Express International Brightness Tour" adopted the method of cooperation with local hospitals, and the Chinese medical team of the "Lifeline Express" project went directly to the local hospital to perform surgery, and the instruments and equipment were sent to the local area by air and land.
On October 23, 2018, Lifeline Express International Eye Health Academy was established. Xinhua News Agency
In 2016, the Lifeline Express International Brightness Tour went to Sri Lanka for the first time.
When the Chinese medical team first arrived abroad, the first thing they faced was the language barrier. Although the medical team selected personnel who were fluent in English, it was overlooked that not all local patients knew English.
During the initial consultation, the Chinese doctor tried to repeat a simple medical order in English many times, but the patient still did not understand. Guo Lei, the coordinator of the trip, clearly remembers that the Chinese doctor kept explaining to the local nurses, and finally his voice gradually became hoarse.
Seeing this, the head nurse of the local nurse, who was not fluent in English, took the hand of a Chinese doctor very gratefully and said, "You think, I do" (you mean, I understand). Then there seemed to be a tacit understanding: the Chinese doctor would knock on the table and she would tell the patient to "look down", beckon, she would tell the patient to hold his forehead against the examination equipment, and she would point to the words on the medical record in her hand and she would tell the patient exactly what the doctor had ordered.
In the end, with the full cooperation of both parties, the Chinese medical team completed 503 cases of vision restoration surgery in Sri Lanka. "The simple phrase 'You think, I do' is full of the high level of trust and recognition of the local medical staff, as well as a heart full of gratitude. Guo Lei recalled.
Patients who have undergone surgery in the rest room of the "Lifeline Express". Xinhua News Agency
Foreign doctors "look stupid"
Chinese doctors performed 29 surgeries in one afternoon
"At that time, I didn't go to Germany, but chose to follow the 'Health Express' to Zunyi. Talking about the "one of the two" in 1999, Bao Yongzhen said, "I chose the right one, and after I went, I realized that the uneven distribution of medical resources is a very real problem, and the more remote areas, the more there is a shortage of medical treatment."
Today, Bao Yongzhen is the chief physician of the Department of Ophthalmology at Peking University People's Hospital. For more than 30 years, she has been associated with the "Lifeline Express" more than once, and talked about the reason, "Being a doctor is to relieve the pain of more people, and it can play a greater role than sitting in Beijing waiting for patients to come."
In April this year, the Lifeline Express International Brightness Tour traveled to Uzbekistan. Photo courtesy of the interviewee
In 2019, Bao Yongzhen once again went to Uzbekistan with the "Lifeline Express".
On this day, a mother brought her 3-year-old daughter and her son, who was only a few months old, all three of them suffered from cataracts, and pleaded with the Chinese medical team to treat them.
"There is a lot of risk in operating on a baby, both with the problem of anesthesia and with the possibility of more complications. It is difficult for local doctors to undertake such baby surgery, even Bao Yongzhen and they have to think twice, "If we don't do it, no one will be able to help them", so they decided to do it!
In April this year, when Bao Yongzhen led the team to Uzbekistan again, he met the family again. All three of them recovered well, and when they came to the hospital for a follow-up, they dressed up to thank the Chinese medical team. "I am very happy to see them again after four years, and I am even more determined to continue doing them. Bao Yongzhen said.
In September, Bao Yongzhen and a group of six colleagues went to Kyrgyzstan again to carry out 18 days of international medical assistance.
Cleaning and disinfection, dripping of mydriatic fluid, anesthetic, and then using an ultrasound probe to remove the cloudy lens and implant an artificial lens...... Under their fluent operation, a complete set of surgeries can be completed in more than ten minutes. On the afternoon of the first day of arrival, they performed 29 surgeries, making the director of the ophthalmology department of the local hospital "stupid".
After the operation, Bao Yongzhen (first from left) poses with a patient in Kyrgyzstan. Photo courtesy of the interviewee
Kyrgyzstan has a population of more than 7 million people, but there are only about 130 ophthalmologists. Due to the limitations of technology and medical environment, each team of doctors in the area can only perform 5 surgeries per day. Public hospitals do not have the equipment and technology to perform phacoemulsification surgery, and the traditional extracapsular removal surgery with large incision is time-consuming and slow to recover, coupled with the poor local economic situation, many people choose to suffer the pain of gradual blindness, and there are not many people who are really willing to pay for surgery, so the actual number of surgeries will only be less.
"When the residents heard that we were performing free surgery to restore their sight, they came to us on their own initiative. We had enough surgery in one day for months for a local doctor. During that time, Bao Yongzhen and his colleagues entered the operating room at about 8 o'clock in the morning every day, worked continuously until three or four o'clock in the afternoon, did not eat or rest, and could complete forty or fifty surgeries a day, allowing foreign doctors to see the "Chinese speed" at the medical level.
When you see you again in 4 years
Trained local doctors take the lead
After the "Lifeline Express" leaves the country, it can allow some local cataract patients to regain their sight without financial worries. But every trip across borders is short-lived, and "teaching people to fish" is the key to ensuring that local residents can receive high-quality treatment for a long time.
Bao Yongzhen introduced that every time the "Lifeline Express International Brightness Tour" goes to a region, it will send the equipment for cataract phacoemulsification surgery to the local hospital, and train local doctors to teach them how to do examinations, surgeries and operate equipment step by step.
When Bao Yongzhen came to Uzbekistan again this year, he met Timur, a local doctor who had been trained by the Chinese medical team in 2019, and he was particularly proud to say to Bao Yongzhen, "I am now the best doctor in our area who has done phacoemulsification surgery for cataracts!"
Bao Yongzhen also found that under the influence of the Chinese medical team, local doctors have a higher sense of professional fulfillment by mastering the latest technology, so they are more enthusiastic and motivated to work. "As soon as they have time, they come to us with questions and want to further improve the technique and efficiency of the surgery. ”
A nurse walks out of the Lifeline Express car. Xinhua News Agency
Follow the "Health Express" to go abroad, as well as "Made in China".
When Bao Yongzhen first led a team to do international medical assistance a few years ago, almost all of the medical equipment and consumables purchased by foreign countries such as the United States, Japan, and Germany were purchased. In recent years, with the substantial improvement of domestic manufacturing level, more and more "Made in China" has been recognized by the international medical community.
For example, on October 31 last year, the first domestic multifocal intraocular lens was officially approved, successfully breaking the monopoly of foreign companies for decades. Its diffraction technology is the core of achieving multifocus, and it is the first in the world and the first in China. This is also the first time that a domestic company has entered the field of high-end intraocular lenses, filling a gap in China.
"Now the intraocular lenses and ophthalmic examination equipment we use abroad are all domestically made. Chinese doctors perform surgeries and presuppose patients with intraocular lenses made in China. It makes me feel very proud. Bao Yongzhen plans to use domestic surgical equipment for international medical aid next year, "We must not only rely on the skills of our doctors and nurses, but also win the respect of foreign countries for our country through high-quality products." ”
As of this year, Lifeline Express has traveled to five countries: Sri Lanka, Myanmar, Pakistan, Uzbekistan and Kyrgyzstan, and has performed cataract surgery for thousands of local people.
It's like a seed
Spread to more places where light is needed
Twenty-six years have passed, and now the "Lifeline Express" has increased from one to four trains, passing through 28 provinces and municipalities across the country and 5 countries co-built by the "Belt and Road", and has also changed the lives of more than 230,000 cataract patients.
However, with the deepening of the aging of the Chinese population, the number of cataract patients in mainland China has also shown a certain upward trend. In the face of more and more treatment needs, Fang Huang Jiwen has also been thinking about what kind of help the "Lifeline Express" can provide for China's medical development.
On Lifeline Express, a female patient undergoes an eye examination after cataract surgery. Xinhua News Agency
In 2009, Fong noticed that there was no unified examination for ophthalmologists in the mainland. So, she contacted the International Ophthalmology Council (ICO) to introduce the International Ophthalmologist Examination to the mainland. At present, Lifeline Express organizes mainland ophthalmologists to participate in the unified examination every year, and arranges and sponsors ophthalmologists with outstanding results to study abroad.
In order to better promote the integration of ophthalmology in the mainland and international ophthalmology, Huang Huang and Professor David Taylor, Honorary Chairman of the ICO, jointly launched the Lifeline Express Overseas Expert Visit Program. At the beginning of the project in 2009, a total of 14 experts participated, including Professor David Taylor and 2 other UK professors, as well as 11 ophthalmologists from Hong Kong.
These experts will go to ophthalmology centers around the country to hold academic lectures, case discussions, outpatient clinics, surgical guidance and other activities to help the doctors of the ophthalmology centers understand the latest developments in international ophthalmology diagnosis and treatment. Every year since then, Lifeline Express has invited 60 or 70 domestic and foreign experts to visit the mainland.
In November this year, the project was restarted after three years, and 18 ophthalmologists from the United Kingdom, the United States, Canada, Ireland and other places visited 15 Lifeline Express Eye Centers. "In the future, the project will slowly return to normal, and more domestic and foreign experts will visit to benefit more ophthalmologists. Fang Huang Jiwen said.
The academic teaching activities of each visiting expert in the mainland will be made into a video on the website of the "Lifeline Express National Eye Health Training Center". Whether in a big city or a small county, ophthalmologists and medical students from all over the country can access the world's most cutting-edge ophthalmology resources on this open platform.
On December 7, 2019, at the Tashkent Eye Hospital in Uzbekistan, guests from China and Uzbekistan took a group photo at the launching ceremony of the second phase of the "Lifeline Express International Brightness Tour". Xinhua News Agency
Today's "Lifeline Express" is not only a mobile hospital and training base, but also a bridge connecting the mainland with medicine at home and abroad.
In Fang Huangjiwen's view, the "Lifeline Express" is like a seed, which can sow light in the mainland and the countries co-built by the "Belt and Road", and bring "visible" hope to those in need. And as this seed blossoms and bears fruit, more seeds can be cultivated and sown where more light is needed.
[Writing] Southern + reporter Wu Binbin, Chen Yu, GDToday reporter Chen Chen
【Co-ordinator】He Xuefeng
【Poster】Yu Yan
【Authors】 Wu Binbin, Chen Yu, He Xuefeng
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