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Indian Railway Health Service
The Indian Railway Health Service is one of the largest and most widely spread medical service models in the country. It has, over time, established a health infrastructure network, with 125 hospitals, 586 polyclinics, 92 lock-up dispensaries in its sector, and 686 hospitals recognised in the private sector for medical treatment. It provides comprehensive healthcare not only to railway employees and their families but also retired employees. If the railway health model is redeveloped and recreated to achieve the goal of universal health coverage, it can not only continue to provide robust healthcare facilities but also deliver quality people-centred integrated care.
With the advent of the railways and the construction of railroads in India in the 19th and the early 20th centuries, issues around worker safety and solutions for the same became a common concern. During this period, while the introduction of this miraculous “big technology” continued to amaze rail passengers and employees alike, they often experienced its ghastly dangers as well. For instance, in 1881, there were 30 derailments in the Madras Presidency itself, along with incidents of collisions, fires in trains, defects to train wheels, among others (Jineesh 2021). These grim realities sparked the development of a branch of medical practice termed “railway surgery” during the Victorian era. The railroads also connected different parts of the country and brought a huge number of people to remote, underdeveloped areas that lacked doctors and medical staff, further contributing to the development of these healthcare facilities.
In the “Train Doctors, A Detailed History of Railway Surgeons,” Robert Gillespie (2006) states: “Railway surgeons, nearly forgotten today, once formed the nucleus of a vast and innovative healthcare network.” As the number of railroads increased, railroad physicians and surgeons became essential in the healthcare system. According to Gillespie (2006):
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