A nurse on the Lifeline Express train helps patients get on the train and get ready for their cataract surgeries. (WANG HAO / FOR CHINA DAILY)

Nizamdin Arxidin barely speaks Mandarin, but he has traveled extensively across China because he used to make his living by selling naan bread, a staple food for people from the Xinjiang Uygur autonomous region.

However, the 68-year-old's travels were abruptly cut short about six years ago due to his fading eyesight, which had deteriorated because of cataracts.

Although an operation on his left eye was successful, the cataract in his right eye was so severe that it couldn't be treated by any of the doctors in his hometown of Korla in Xinjiang's Bayingolin Mongol autonomous prefecture.

In June, though, he was told that skilled specialists would treat him for free on a hospital train.

Lifeline Express was launched in 1997 by residents in the Hong Kong Special Administrative Region to commemorate the city's return to China. As a result of the project, more than 230,000 cataract patients who live in areas with poor healthcare services have regained full vision

"It was almost unbelievable that I got an operation on a train, free of charge," he said. "Now I am finally able to see things clearly through both eyes, I will definitely make naan again after I have made a full recovery."

The hospital train, part of the Lifeline Express fleet, arrived at Korla in early May. By late July, it had completed its mission of conducting operations for more than 1,000 cataract patients. The train is currently offering services in Shaoguan, Guangdong province, its final stop of the year.

Lifeline Express was launched in 1997 by residents in the Hong Kong Special Administrative Region to commemorate the city's return to China. As a result of the project, more than 230,000 cataract patients who live in areas with poor healthcare services have regained full vision.

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Moreover, for many aspiring ophthalmologists, the project has become an essential step in their careers as a way to polish their professional skills and relish the pure pleasure of curing ailments and helping people.

Cataracts form a dense white cloud over the eye's natural lens, causing blurred vision. If untreated, they block all light and result in blindness. The condition is linked to factors such as age, diabetes, harsh ultraviolet radiation and injuries in which the outer layer of the eye has been penetrated.

Feng Jing, an ophthalmologist from the Beijing Chaoyang Hospital affiliated to Capital Medical University, explains operation procedures. (WANG HAO / FOR CHINA DAILY)

Older patients

Wang Yuezhen, head manager of the train that called at Korla, said 80 percent of the local patients were age 60 or older, with the oldest being 92.

Feng Jing, one of five doctors and nurses on the train from the Beijing Chaoyang Hospital affiliated to Capital Medical University, said that most patients in the capital have cataracts that are as fragile as eggshells, but in Xinjiang, the cataracts become as hard as rock due to the intense sunlight and often long delays in treatment

"A normal cataract operation takes about 10 minutes and is very convenient, but cataracts can turn harder and harder over time, making it more difficult to remove them," said Wang, also a trained doctor.

"In rural Xinjiang, it is not uncommon to see elderly patients with extremely rigid cataracts."

Feng Jing, one of five doctors and nurses on the train from the Beijing Chaoyang Hospital affiliated to Capital Medical University, said that most patients in the capital have cataracts that are as fragile as eggshells, but in Xinjiang, the cataracts become as hard as rock due to the intense sunlight and often long delays in treatment.

"Another challenge is the high incidence of exfoliation syndrome, which makes the zonules (the threadlike fibers that hold the lens in place) especially weak and unstable," Feng said.

"We usually encounter a dozen cataract patients with the condition in Beijing, but in Korla, we handled a few cases on a daily basis."

Wang Yuezhen (left), head manager of the Lifeline Express train, talks with patients in Korla, Xinjiang Uygur autonomous region, in July. (WANG HAO / FOR CHINA DAILY)

She said that state-of-the-art equipment on the hospital train, coupled with the vast experience of the well-trained doctors, helped overcome the difficulties.

"We use the most advanced equipment for the operations, including imported surgical microscopes, ultrasound oscillation equipment and medical supplies, such as artificial lenses," she said.

"Because Xinjiang is prone to strong winds that carry heavy sand, we are very concerned about the risk of wound infections. To minimize the risk, we have adopted the most advanced surgical technology that involves an incision just 2.8 millimeters long. The incision is so small that there is no need to sew it up and the patients can be discharged the day after the operation," she said. "Postoperative care is relatively convenient."

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Feng added that many of the patients only spoke Mongolian and it was difficult to find a medical worker who could interpret during the operations.

"I encountered one such patient. We completed the operation by asking her to call her daughter via speakerphone so she could interpret for us and tell her mother what she should do during the surgery," Feng said.

A patient's wife applies eyedrops into the eyes of her husband. (WANG HAO / FOR CHINA DAILY)

Wang, the train manager, said some patients in sparsely populated Xinjiang were discouraged by the long journey to the hospital train, which was parked at a rail maintenance facility in the suburbs of Korla.

"Thankfully, local villages and hospitals had been promoting the project and spreading information about it for about a month before our visit, also during it," she said.

"Raising awareness about the condition and treatment options is important for the project's success."

I feel like all the outstanding seniors in college and top surgeons at the hospital who excel at performing cataract surgery have been on the train at least once ... So Lifeline Express is like an academy.

Feng Jing, an ophthalmologist from the Beijing Chaoyang Hospital affiliated to Capital Medical University

Long-held ambition

Feng first heard about the project a decade ago when she was studying at a top medical school in Beijing. After, she had looked for any opportunity to get on the train, earning herself a nickname — the Lifeline Express chaser — in the process.

"I feel like all the outstanding seniors in college and top surgeons at the hospital who excel at performing cataract surgery have been on the train at least once," the 35-year-old said. "So Lifeline Express is like an academy."

She grabbed any opportunity to get closer to the project, including interpreting for foreign experts who visited regularly, and giving lectures for a program under the project that teaches grassroots medical workers to conduct screenings for diabetic retinopathy, a condition that can cause blindness.

"Lifeline Express is like a totem, a lighthouse, in my eyes," Feng said. "A decade passed before I finally got a chance to join."

Patients line up before getting on the train. (WANG HAO / FOR CHINA DAILY)

She was not the only one who waited more than 10 years to get on the train. One of the most memorable operations she carried out was on a 30-something patient from the Uygur ethnic group in June.

"He had a traumatic injury to his left eye about 15 years ago and, to be honest, we were unsure of the possible success of surgery," Feng said.

"After communicating with the patient several times, he said that it might be the last opportunity for him to regain his sight, so he decided to take a chance."

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The operation was a complete success. "The patient said that he has already made plans to obtain a driver's license and earn more money to raise his children well," Feng said.

"I think the project means more than just bringing sight back to the blind. It not only changes the patient's life, but also their entire family's fate."

Contact the writer at wangxiaoyu@chinadaily.com.cn