Old Legs, No Help

Transport Hurdles Limit Healthcare Access for Nagpur’s Elderly

Nagpur has grown into one of Central India’s major medical hubs, attracting patients from across Maharashtra, neighbouring states, and distant districts.

Over the past few years, the city has witnessed the establishment of several healthcare facilities, including specialised services aimed at improving access for its growing elderly population.

Despite these developments, significant transportation hurdles continue to restrict senior citizens’ ability to reach medical services, exposing them to health risks and compounding the challenges of ageing.

Healthcare Infrastructure and the Growing Elderly Population

Maharashtra's elderly population represents a substantial share of its demographic profile, with around 12 percent of the state’s 12.5 crore residents aged sixty or above. In Nagpur, this segment forms a critical part of the healthcare demand base.

The city houses some of the region’s most important medical institutions, including Government Medical College and Hospital (GMCH), Indira Gandhi Government Medical College and Hospital (IGGMCH), Central India Institute of Medical Sciences (CIIMS), Meditrina Hospital, New Era Hospital, and Alexis Multispeciality Hospital.

These facilities are not limited to serving residents of Nagpur. Patients regularly travel from across Vidarbha, Marathwada, and neighbouring states like Madhya Pradesh, Chhattisgarh, and Telangana to access the specialised services offered here.

In recent years, efforts have been made to introduce geriatric-specific services in the city. This includes dedicated outpatient departments for the elderly at GMCH, along with physiotherapy centres designed to cater to the needs of senior citizens.

However, these services remain out of reach for many who require them the most.

Disruptions in Public Transportation

Access to healthcare in Nagpur is increasingly affected by limitations in the city’s public transport network. The Aapli Bus system, operated under the Nagpur Municipal Corporation (NMC) in partnership with Chalo Mobility Private Limited (CMPL), has been a lifeline for thousands of commuters, including senior citizens.

A significant proportion of these services have been cut since the beginning of April 2025, following a reduction in the number of operational buses across seven key routes.

Previously, 127 buses carried out around 900 trips each day, providing crucial connectivity between residential areas and medical facilities. This number has now been reduced to 102 buses, completing only 410 trips daily.

The most affected routes include those passing through Gondkhairi, Katol Naka, MIDC Hingna, YCCE Bahadura, Dabha, 14th Mile, and Patansavangi.

Many of these areas host healthcare centres or provide essential links to hospitals. Hingna village, Gramin Hospital, and Kalmeshwar have been particularly impacted by these service cuts, leaving a large number of elderly commuters with no reliable means to attend medical appointments.

The scale of the problem is reflected in the number of daily passengers affected. Around 25,000 commuters relied on these routes before the reduction, including hundreds of senior citizens who now struggle to find alternative transportation.

Financial and Administrative Roadblocks

The disruption in bus services is tied closely to administrative and financial mismanagement. Since the National Highways Authority of India (NHAI) enforced its FASTag-only toll collection mandate in May 2021, compliance issues have emerged. While several transport corporations, including the Maharashtra State Road Transport Corporation (MSRTC), adopted systems like monthly passes and toll exemptions to handle this change, NMC failed to equip its buses with FASTags or make other necessary arrangements.

This failure led to a sharp increase in operational costs. Daily toll expenditures for the Aapli Bus service escalated from around Rs 30,000 to Rs 90,000, making it economically difficult for the service operator, CMPL, to maintain pre-existing service levels.

The inability to absorb these costs resulted in the widespread curtailment of bus operations across critical routes.

These administrative decisions have had direct consequences on the lives of elderly residents, for whom public buses were often the most affordable and accessible means of transportation to healthcare facilities.

Without these services, many now face rising dependency on expensive private transport alternatives.

The Economic Strain of Private Transportation

The reduced availability of public buses has led to an increased dependence on private transport.

However, these services come with costs that place a significant burden on elderly citizens, particularly those living on fixed pension incomes.

Reports from affected commuters reveal that many spend up to Rs 300 each day on auto-rickshaws or other private vehicles to reach healthcare facilities.

Such high transport costs are particularly difficult for senior citizens who require frequent visits to hospitals for routine check-ups, chronic disease management, or ongoing treatment schedules.

The expense becomes even more pressing for patients who live on the city’s outskirts or in villages where healthcare infrastructure remains limited.

The challenges are not limited to urban Nagpur alone. Patients travelling from other districts or neighbouring states encounter compounded difficulties.

Long distances, unreliable transport options, and cost barriers often delay care or force patients to skip appointments.

During periods of heightened crises, such as the COVID-19 lockdown, patients reported paying double the usual rates for ambulance services.

One case involved an ambulance journey that cost Rs 4,500, a sharp rise from the previous rate of Rs 2,500.

Similar trends continue to be reported, indicating that financial exploitation remains a concern when regulated public transport options are unavailable.

Health Impacts of Transport Inaccessibility

The consequences of transportation challenges are deeply felt by the elderly who depend on regular medical care.

Missing appointments and delaying treatments due to a lack of transport can worsen health conditions, especially among those managing chronic illnesses.

Consistent care is essential for conditions such as hypertension, diabetes, and cardiovascular diseases, which are prevalent among the ageing population.

Interruptions in treatment schedules due to transport issues also create added stress for both patients and caregivers.

The physical strain of navigating unpredictable transport systems can have adverse effects on seniors, who may already face mobility issues and other age-related limitations.

In cases where patients manage to reach medical facilities, returning home poses an additional challenge.

During previous disruptions in the transport system, hospitals in Nagpur reported families of patients being forced to stay in hospital premises, including basements or unused wards, when they could not secure lodging elsewhere.

These makeshift accommodations add to the mental and physical strain of caregiving and create further discomfort for elderly patients.