For a railway employee stationed in Maharashtra’s Akola, Jalgaon or Manmad, seeing a doctor can mean travelling two to three hours to the Divisional Railway Hospital in Bhusawal. A routine consultation may require taking time away from work, making the journey, and deciding whether the symptoms feel serious enough to warrant it.
“Travelling two to three hours for a consultation is not something people can manage regularly,” says Punit Agrawal, Divisional Railway Manager (DRM) of Bhusawal. “Unless there is a pressing need, people tend to delay it. That delay is what we wanted to address.”
That is the gap ‘Rudra’, Bhusawal railway division’s ‘hospital on wheels’, was created to bridge.
Launched in January 2025, Rudra is a refurbished railway coach equipped with consultation spaces, diagnostic facilities and medicines. It travels across the division, stopping at different stations so railway employees and their families can access basic healthcare closer to where they live and work.
When The Better India first wrote about Rudra, the hospital on wheels had only recently begun its journey. To read how an old railway coach was transformed into a mobile medical unit, tap here.
More than a year later, the experiment has had time to play out across the division. Its experience now offers practical lessons on what it takes to make mobile healthcare work, from planning camps and staffing them to using technology for follow-up care.
How an old railway coach became a medical unit
The scale of the Bhusawal railway division makes that challenge particularly complex. Spread across more than 1,200 kilometres and handling over 225 passenger trains every day, it serves railway employees and families stationed far beyond Bhusawal itself.
That is the gap ‘Rudra’, Bhusawal railway division’s ‘hospital on wheels’, was created to bridge.
Rudra began with a practical idea: use an asset the railways already had.
Punit, in conversation with The Better India, shares, “In the railways, every asset has a defined life cycle. When coaches are taken out of service, some of them can still be used after proper rehabilitation. We identified one such coach and converted it into a medical unit.”
The coach was refurbished at a railway workshop and fitted with the medical infrastructure required for consultations and basic diagnostics. The result was a compact, functional healthcare space with diagnostic tools, consultation areas and medicines.
Inside, patients can access basic tests such as ECGs and pathology screenings, along with consultations from both general physicians and visiting specialists. For employees and families living far from Bhusawal, it brings services that would otherwise require hours of travel much closer to home.
When healthcare arrives before it’s too late
Since its launch in January 2025, the hospital on wheels has travelled across the division, stopping at different stations to conduct medical camps. Each visit lasts several hours, allowing people to come in at a time that suits them.
The longer window matters in places where a medical appointment has traditionally meant planning an entire journey around it.
As of March 2026, Rudra had conducted 28 camps and assisted 4,321 beneficiaries directly. For Punit, one of the most important outcomes has been detecting health concerns before they become more serious.
“There were people who did not realise they had certain medical conditions,” he says. “When they came for a routine check-up, issues were detected early, and they could begin treatment in time.”
For many families, especially those living far from Bhusawal, the ability to access care without travelling long distances has changed how they approach their health. “When the facility is available nearby, people are more willing to come forward. That is where prevention against fatal illnesses is possible,” he adds.
Taking care beyond the travelling coach
The mobile camps form the backbone of Rudra, but the team also had to account for one obvious limitation: the coach can only be in one location at a time. So, technology offered a way to extend access between visits.
The division introduced teleconsultation services. This allows patients to speak with doctors remotely, even when the hospital on wheels is not nearby.
“People in remote areas can at least get an initial consultation without travelling. Once we understand their condition, we guide them on what to do next,” he explains.
Launched in January 2025, Rudra is a refurbished railway coach equipped with consultation spaces, diagnostic facilities and medicines.
Digital health records and identification systems have also been introduced, making it easier to track patient histories and maintain continuity of care. Together, these systems allow support to continue even after a camp has moved to its next location.
For communities and institutions exploring a similar mobile healthcare model, Punit says Rudra’s experience offers a few practical lessons.
Step 1: Start with a needs assessment
For those hoping to replicate this model, the first step is understanding the ground reality. “You have to identify who needs the service and where the gaps are,” Punit explains. “Without that, you may create something that does not serve its purpose.”
This involves mapping populations, studying existing healthcare access, and identifying the areas where intervention is most needed.
Step 2: Map resources and build a plan
Once the need is established, the focus shifts to resources.
This includes identifying medical staff, equipment, and a suitable mobile platform. In rural settings, this could be a bus or van instead of a railway coach.
“You can have a good idea, but it has to be backed by proper planning. Resources have to be identified and organised in a way that they can be used without hassle,” Mr Punit explains.
Connecting the mobile unit to a larger healthcare facility is equally important, particularly when patients require follow-up care.
Step 3: Begin with a pilot
Rather than attempting large-scale implementation immediately, starting small can make all the difference.
“The hospital on wheels is an investment. Before scaling it up, you have to see whether it works in practice,” Punit notes.
A pilot project allows organisers to test logistics, understand patient response, and refine the model based on real-world experience.
Step 4: Make location and timing work for people
Accessibility depends on both where care is available and how long people have to access it.
“It should not be a short window that makes medical care feel rushed. We found that keeping it open for five to six hours gives people enough time to come in,” he explains.
Choosing locations that are easy and safe to access is equally important in ensuring that more people can benefit.
Step 5: Build the team behind the unit
The backbone of any such initiative is the team behind it. Doctors, paramedical staff, technicians, and administrative personnel all play a role in making the system work.
It travels across the division, stopping at different stations so railway employees and their families can access basic healthcare closer to where they live and work.
“There has to be a central authority to coordinate everything. At the same time, local teams must take responsibility on the ground,” he says.
This combination of leadership and local involvement helps maintain both efficiency and accountability.
Step 6: Keep coordination at the centre
Running a mobile healthcare unit requires close coordination between multiple teams.
From scheduling movements to providing electricity, water, and other basic facilities, every detail matters.
“In the end, it is coordination that holds everything together. Without it, even a well-planned initiative can face difficulties,” Punit says. Clear communication between teams, along with regular reviews, helps prevent these logistical gaps from disrupting care.
Step 7: Plan for challenges before they arise
No model is without its challenges. In Bhusawal, these include managing train schedules, confirming the availability of medical staff, and spreading awareness among beneficiaries.
“Our network is already very busy; adding another movement requires careful planning,” he explains.
Identifying these constraints early has helped the team plan Rudra’s movement and camps around an already crowded railway network.
Step 8: Use tech to scale
Technology has made it easier to expand and improve the model.
Facilities such as telemedicine, digital records, and patient tracking systems have all helped make the initiative more efficient and easier to access.
“Technology helps us reach more people and provide better care,” Punit notes. “It makes the system more responsive.”
Could this model work beyond the railways?
Although Rudra was developed within the railway system, its principles can be applied in many other settings. In rural areas, mobile medical units can be created using buses or vans, supported by local administrations, healthcare providers, or organisations.
“There has to be someone who takes ownership, not just to start it but to stay with it and see it grow over time,” Mr Punit says.
That ownership becomes especially important once the novelty of launching a mobile unit gives way to the everyday work of staffing it, moving it, maintaining equipment, following up with patients and coordinating with local teams.
Sustaining an initiative like Rudra depends on what happens after the first camp: whether teams keep showing up, patients return, follow-up care is available, and the system continues to work around people’s lives.
The coach was refurbished at a railway workshop and fitted with the medical infrastructure required for consultations and basic diagnostics.
For railway employees and their families across the Bhusawal division, that has changed something fundamental. A consultation no longer has to begin with a two-to-three-hour journey.
Rudra’s strongest lesson lies in its simplicity. The railways did not wait for a new hospital to be built. They took an existing coach, equipped it for medical care, and moved that care closer to the people who were delaying it.
Sometimes, access begins with one practical question: if people cannot reach healthcare in time, can healthcare reach them first?
All pictures courtesy Punit Agrawal.
