Idealism versus realism: the case of overcrowding in railways amidst COVID-19 pandemic

Aditya Suhas Dhonde, Shiv Hiren Joshi

PAMJ. 2022; 42:87. Published 02 Jun 2022 | doi:10.11604/pamj.2022.42.87.35422

The image is a display of the stark reality of travelling in a general railway coach amidst the COVID-19 pandemic. This image was captured during a visit to Madhya Pradesh from Maharashtra five months ago. The government removed the COVID-19 restrictions from April 1st, 2022, which is three months after this image was taken. Overcrowding is an important public health problem which not only facilitates the disease transmission process but also expedites it. This issue gets further complicated while travelling in trains. Within the overcrowded coaches of the train, it is highly likely for the diseases to spread. While infections spreading through aerosols and droplets are a concern, especially for conditions like COVID-19, it must also be considered that the trains have multiple stops at multiple stations, which also leads to an exchange of travelers who may be infected asymptomatic as well as symptomatic patients. This pre disposes the travelers to a substantial risk of getting exposed to the pathogens due to greater opportunities for such exposure to happen. This image mocks the gap between the idealism of what should be done during the pandemic and reality. While it is the responsibility of the government to implement stringent public health interventions to prevent the spread of communicable diseases, it may be challenging to provide practical solutions to achieve a balance between idealism and realism in a developing country with such a large population. However, this image advocates the need for deliberations on how to effectively implement the public health intervention strategies.
Corresponding author
Shiv Hiren Joshi, Department of Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute Medical Sciences (Deemed to be University), Sawangi (Meghe), Wardha, Maharashtra, India (

The Pan African Medical Journal (ISSN: 1937-8688) is a subsidiary of the Pan African Medical Journal. The contents of this journal is intended exclusively for professionals in the medical, paramedical and public health and other health sectors.

Currently tracked by: DOAJ, AIM, Google Scholar, AJOL, EBSCO, Scopus, Embase, IC, HINARI, Global Health, PubMed Central, PubMed/Medline, ESCI

Physical address: Kenya: 3rd Floor, Park Suite Building, Parkland Road, Nairobi. PoBox 38583-00100, tel: +254 (0)20-520-4356 | Cameroon: Immeuble TechnoPark Essos, Yaounde, PoBox: 10020 Yaounde, tel: +237 (0)24-309-5880