China's Lifeline Express opens window of hope in Central Asia
Among the treasured memorabilia that eye specialist Hou Xianru keeps from his extensive medical missions to restore eyesight is an embroidered handmade cushion gifted by an Uzbek patient in her 80s.
"She regained her eyesight after I performed a surgery on her cataracts. Noticing that we spent long hours examining and operating on eyes under the microscope, she stitched the traditional gift and insisted we take it home before leaving," he said.
"She hoped her small gift could help ease our fatigue at work," said Hou, a senior ophthalmologist at Peking University People's Hospital. "Though modest in size, it carries the sincere gratitude of someone from afar. I've cherished it ever since."
Such heartwarming moments have defined Hou's journey with Lifeline Express over the past seven years as a medical aid worker, a project that transforms trains into mobile hospitals for cataract surgeries.
The project was launched in 1997 as a gift to the Chinese mainland from the people of Hong Kong to commemorate the city's return to the motherland. It has since provided free surgeries for 240,000 patients in 28 provincial-level regions across China.
Since 2016, the project has been assisting neighboring countries under the guidance of the National Health Commission, carrying out more than 4,300 operations overseas, including some in Kyrgyzstan, Tajikistan and Uzbekistan.
Hou first participated in Lifeline Express' domestic assignments in 2004, crisscrossing remote regions with scarce healthcare.
"I found the work on the train hospital to be very pure. Removed from the hustle and bustle of urban noise, my mind sharply focused on the single thought of helping more patients and restoring sight to those living in darkness," he said. "I was also able to hone my surgical skills during the process as well."
Hou had studied and trained in Russia for more than a decade since the 1990s, which gave him an edge in participating in overseas undertakings in Central Asian countries since 2018.
"During international missions, we face multiple challenges — communicating effectively with local officials and medical staff, optimizing efficient use of limited medical resources and mobilizing local teams to complete workloads on tight schedules with us," Hou said.
Reflecting on his work across five cities in Uzbekistan and Kyrgyzstan, Hou emphasized that trust and friendship develop incrementally through shared efforts.
"Sometimes, just as we wrapped up work in one city and were about to leave, local doctors would ask us to stay longer as hundreds of more patients had registered and were waiting," said Hou. "As a result, we often return to the same cities multiple times."
Hou said Chinese medical professionals have also helped train local doctors and nurses and kept in touch with them through online messaging platforms.
Guo Lei, head of the Lifeline Express' office at the commission's International Health Exchange and Cooperation Center, said 989 free cataract surgeries were successfully performed in Tajikistan, Kyrgyzstan and Uzbekistan last year, bringing the total number of surgeries carried out in Shanghai Cooperation Organization member-states to 2,187. This realization achieved the goal of offering 2,000 such surgeries by 2025, ahead of schedule.
Lifeline Express has set up four blindness prevention centers overseas, in Uzbekistan, Kyrgyzstan, Tajikistan and Nepal. "We intend to establish long-term and systematic cooperation with these countries to enhance care for local patients, foster medical exchanges and ensure that our work can achieve social, economic and humanistic objectives," she added.
At the center in Tajikistan's capital Dushanbe, which started functioning in late May, Guo said that the project donated two million yuan ($278,500) worth of ophthalmic equipment, medicines and other medical supplies; doctors from the Peking Union Medical College Hospital also pioneered an advanced technique called vitrectomy surgery.
Yu Weihong, chief of ophthalmology at the Peking hospital, has participated in Lifeline Express' overseas programs since 2016, including the recent expedition to Tajikistan from May 26 to June 2.
"Our sustained efforts have helped many cataract patients regain vision, and we have trained local doctors in basic surgical techniques," Yu said. "For this recent mission, we aimed to expand capabilities by introducing more advanced procedures to help patients with severe and complicated diseases."
Vitrectomy surgery involves removing vitreous gel for better access to the retina and replacing it with gas or liquids. It is used to treat a host of retinal conditions, including retinal detachment and diabetic retinopathy.
While cataract surgery typically focuses on the front part of the eyeball, vitrectomy cuts into the back segment that roughly makes up two-thirds of the eye.
Yu said her team donated a vitrectomy machine and a high-end surgical microscope to the center, and carried out four surgeries during their stay.
"These four patients were in different conditions. There was a nine-year-old boy who had been blinded for months by severe ocular trauma and an elderly patient with epiretinal membrane (a fibrous tissue layer forming on the retina's inner surface)," she said.
"All surgeries were successful. Due to their complex condition, it was impossible to completely recover their eyesight, which is possible with a regular cataract surgery. But they were all thrilled to be able to finally see again," she said.
Most gratifying for Yu was seeing the local doctors' growing enthusiasm for the technique.
"Tajik physicians had no experience with vitrectomy. They had a hard time screening for suitable patients and showed little interest at the beginning," she said.
"But after witnessing the marked improvement in the young boy's vision, their attitude changed immediately. They started referring potential patients and appeared eager to learn the technique," Yu added.
During the recent mission, Chinese doctors trained three local physicians in intravitreal injection techniques and supplied critical medications, establishing the groundwork for rolling out deeper training programs in the future, Yu said.
Due to the nation's location amid high mountain ranges and the lack of fresh vegetables in local diets, Yu said, there is a large number of diabetic retinopathy cases, creating an acute demand for vitrectomy services.
"Mastering vitrectomy requires plenty of practice and time, so we are actively developing future training opportunities," Yu said. "Medical science knows no borders and we aim to share our expertise to help more patients."
