Krasnoyarsk Station. We have left the Trans-Siberian line to branch off onto the Baikal-Amur Main Line by night.

After a 12-hour trip, we arrive in Targiz. We step off the train, and we are in the middle of nowhere. Literally. There is no station or train platform.

Yet ten red, blue and white train cars marked with a red cross await. It’s Akademik Fyodor Uglov, the Russian train company’s rail hospital.

The hospital on rails started as a way to provide medical services to railway employees posted in distant regions. Today, the five medical trains treat people in remote areas hard hit by rural population drift.

Rail, the Only Link with the Rest of the World

Zinaida Mudovina, a village teacher, explains how the sawmill closed a few years ago and how about a dozen families left soon after. It’s a common Siberian refrain.

“Only the seniors are left here,” the teacher in her 50s laments. “We don’t have the internet, we don’t have phones, we don’t have roads and we don’t have a health clinic.”

Zina promised herself she would never leave, though. Her love of nature keeps her here.

The railway is the only link with the rest of the world. A muddy path links the wooden houses to one another, but it’s unfit for motor vehicles for most of the year.

Zina embarks on the 40-minute walk to the medical train. A four wheel drive ambulance of Soviet vintage passes her. It sputters along the trail, which has holes larger than the vehicle itself. It brings those with reduced mobility to the rail hospital.

“If they haven’t got broken bones before getting on, they’ll need casts when they arrive,” Zina jokes.

Like her, the entire village converges on the 10-car hospital train. It comes for only two or three days once a year. You don’t want to miss it.

An Army of Specialists On Board

The rail hospital offers the services of about 10 specialists free of charge, including a cardiologist, a gynecologist, a neurologist, and an ophthalmologist.

The travelling clinic also has its own medical imagery service and on-site lab that produce results immediately.

The patients’ average age is high, but the medical team is relatively young. Valeri Antonov, an ultrasound specialist, is in his 30s. Each member of the team works and lives on the train for a period of 15 days.

The job is difficult on family life, Antonov says, which explains why most of the doctors are relatively young. But he says he has never felt so useful.

It also gives him an opportunity to do some photography and discover remote areas of his country. His favourite part of the voyage are the train tunnels along Lake Baikal.

Jean-François Bélanger