Ricardo Reyes
Medical Manager
Dr. Vagón, El Tren de la Salud

Railroad Health Delivery Closes Gaps in Rural Care

Wed, 09/05/2018 - 12:00

While medical care is a basic need, most doctors, hospitals and clinics are concentrated in larger cities and rural areas often isolated from the essential services required by their inhabitants. To address the gaps in the existing system, Fundacion Grupo México and Ferromex created the initiative called Dr. Vagón, El Tren de la Salud, a mobile railway-based clinic that provides free comprehensive medical services to populations with access issues and limited resources, promoting mainly the prevention, timely detection, early diagnosis and adequate control of diseases.

“Many remote communities do not have health services or only have access to a small local clinic. These are the main locations that Dr. Vagón, El Tren de la Salud visits and assists,” says Ricardo Reyes, Medical Manager of Dr. Vagón, El Tren de la Salud. “We closely coordinate with local ministries of health, which has allowed us to greatly speed up our services, including follow-ups as required. El Tren de la Salud also works as a tool for the diffusion of information related to health emergencies from the ministries of health, ensuring that populations in hard-toaccess areas have the tools for the prevention of diseases such as zika, dengue, chikungunya and risks associated with pregnancy.”

All services provided by Dr. Vagón, El Tren de la Salud are focused on attending the main morbidities that affect Mexico. Reyes says that while diabetes, obesity and cardiovascular diseases are often considered a priority for health services. “There are many other diseases that go unnoticed and that are often not treated, leading to later complications that affect the patient’s quality of life.”

The service, which provides free medical care to remote and often inaccessible regions in Mexico, began operating in May 2014 with 11 cars and a service capacity of 250 patients daily. Today, it has the capacity to assist 500 patients per day. “The Ministry of Health has recognized the impact that the train has had in contributing to the reduction of morbidity rates. For that reason, in 2018 the service will be increased up to 60 percent to provide coverage to more communities, which will allow us to treat 10,000 patients,” Reyes says. El Tren de la Salud has visited 24 of the 32 states in Mexico, although it can only visit places that are equipped with railroads and the necessary infrastructure to receive it. In addition, the location must provide alternative tracks for normal train traffic during the four days that Dr. Vagón is visiting a community. If they are not available, Ferromex can build temporary alternatives.

“We do not charge patients, hospitals or governments because all our services have the full support of Fundación Grupo México, our allies and collaborators, including Fundación Farmacias del Ahorro, Fundación MVS Radio, Fundación Audiotech, LAPI Laboratories, Onko Solutions and Cinemex, which allows us to offer a wide range of services,” Reyes says.

Dr. Vagón recently joined the Mexican Foundation for Breast Cancer (FUCAM), which will offer a comprehensive treatment that includes mammography and complementary studies. “Care for women is a priority for Dr. Vagón and in 2018 the train included a special car dedicated to the integral care of women, focusing on the timely detection of cervico-uterine cancer and breast cancer. Approximately 65 percent of our patients are women.”

Reyes says that when the project started he had no idea how long it would last and what impact it would have, but its excellent reception allowed the train to travel 43 routes by the end of 2017. “Now, we have more services and specialties and we are the only health service that provides physical rehabilitation for free.”