Over the years, the Phelophepa eye clinics have established a register to track patients at the eye clinics referred for cataract operations and what happens to these patients. The ongoing evaluation and analysis of this data, revealed that the considerable number of Phelophepa patients referred for cataract removals are not attended to because of the huge backlogs at state hospitals. These patients gradually go blind which has a significant social and economic impact as many of them are sole income providers to families as head of households. For example, from January 2015 to September 2015 the Phelophepa eye clinics treated 49,521 patients, of which 3854 patients (approximately 7.8%) were diagnosed with cataracts and referred for treatment. In 2016 data reveled that that only an estimated 150 of referred patients (approximately 3.9%) were operated on. The rest of the 3704 patients were placed on waiting lists and will gradually go blind due to the maturing of the cataracts.

As a result, a joint undertaking to assess the feasibility of a third Transnet Phelophepa train commenced in June 2016, resulting in the decision to develop the concept a surgical train and begining fundraising. Given the existing demand to treat cataracts, a third Phelophepa surgical train will provide needed cataract operations and thereafter has the potential to evolve into other surgical procedures. Phelophepa III will enable high volume cataracts surgeries, as it takes approximately 30 minutes to perform a minimally invasive procedure with quick post-op recovery for patients.

Phelophepa III surgical train, a first on the African continent and the world, will have state of the art operating rooms initially for the removal of cataracts with a capacity to service a minimum of 10,000 patients during its nine-month operating cycle. In time, the surgical services have the potential to be expanded to provide other procedures, for example assisting patients with corrective surgeries for perforated eardrums, cleft lip and palettes and disabilities related to club foot.