"People thought we were mad": A Nepali surgeon’s life-changing vision

Ladakh 2016 Dr Sanduk Ruit and Tilganga Outreach team perform sight restoring surgery to thirty year old Thinles Lamo. RE : Possible appeal story for Fred Hollows Foundation.

Ladakh 2016 Dr Sanduk Ruit and Tilganga Outreach team perform sight restoring surgery to thirty year old Thinles Lamo. Source: Michael Amendolia

Dr Sanduk Ruit, a humble eye surgeon from Nepal has become a source of inspiration for many across the world. He has restored vision for more than a hundred thousand people from rural communities.

But had the international medical establishment had their way, Dr Ruit could have been barred from practising his innovative style of surgery.

His friendship with the renowned Australian eye surgeon, the late Dr Fred Hollows, and their work together to reduce blindness is what best describes Dr Ruit and his achievements.

Fate

Dr Sanduk Ruit, one of the leading eye surgeons in the world, has a complicated relationship with the word “fate”.

The 64-year-old is from Nepal, where the annual mortality rate for children under five years old was at 20,000 in 2016.

Many in the country see such deaths as fate, despite many of them being caused by preventable diseases. 
Sanduk was born in 1954 in a remote village of Olanchungola in Taplejung district, located in the north-eastern part of the country.

A year before his birth, his elder brother had died due to diarrhoea at the age of three. His younger sister passed away due to severe fever when she was eight.
Yangla
Sanduk’s little sister, Yangla. Source: Supplied
But the death of his 16-year-old younger sister from tuberculosis is what hit him the hardest.

After losing his younger sister, Sanduk knew he had to do something to stop others from losing their loved ones from curable diseases.

He had lost three of his siblings by the time he was 19.

He knew if they had received affordable medical treatment sooner, they would have survived.

“My younger sister, who was like my best friend, was my source of inspiration to study medicine”, Sanduk told SBS Nepali.
“Her death gave me the inspiration and strength to make a pledge to myself to try and help save lives of other Nepalis who couldn’t afford treatment for various illnesses”.
A few years later, his determination to become a doctor and help the poor became a reality after receiving a scholarship through the Colombo Plan.

In 1978 Sanduk received his medical degree from King George’s Medical University in the Indian city of Lucknow, one of the so-called “Ivy League” of Indian universities.
A young Sanduk (back row, second from right) at St Robert's boarding School, Darjeeling
A young Sanduk (back row, second from right) at St Robert's boarding School, Darjeeling Source: Supplied
An ordinary boy from an ordinary family in one of Nepal’s most remote villages had now become a doctor.

“One of the things I’ve been pretty strong at is that I did not lose my focus, and I was strongly determined”, he says.

Sanduk also credits his success to the support of his family and in recent years, his team of medical professionals.

“Maybe fate supported me as well”, he says laughing.

He started as a junior doctor at Bir hospital, a public hospital in Nepal’s capital Kathmandu.

A few months after working at the hospital, he got the chance to go to his birth village as a doctor for Nepali government officials who were tasked to survey the border with neighbouring China.

There he managed to save a four-year-old child’s life. The news about Sanduk saving the boy’s life spread quickly in his village. He was very proud of his work.
“This is what I was meant to be doing”.
That is how Sanduk described his feeling about becoming a doctor, at the time to Ali Gripper, author of his biography titled ‘The Barefoot Surgeon’.

He agrees that his work was now able to change the fate of other Nepalis, who would otherwise have left their illnesses untreated.

Working with Fred Hollows

Dr Hollows and Dr Ruit toasting over a drink, in 1980.
Dr Hollows and Dr Ruit toasting over a drink, in 1980. Source: Supplied
Fate is also what brought Dr Sanduk Ruit to his Australian friend and mentor, Dr Fred Hollows.

In 1985, Dr Hollows had been sent to Nepal to study trachoma, one of the leading causes of blindness, for the World Health Organization.

A senior Nepali doctor, who was to pick up Fred Hollows from Kathmandu airport, took Sanduk along as well.

“It seemed like God’s will for us to meet”, Sanduk says.

“At the airport, we were expecting someone wearing a suit, with a briefcase in hand and we couldn’t find anyone like that”.
“It really surprised me when someone with a husky voice, wearing a jacket and boots, with a leather bag on his shoulders and holding a smoking pipe introduced himself as Fred Hollows”.
From left to right: Dr Fred Hollows, Dr John Cooper, Darrell Campbell and Dr Sanduk Ruit in January 1992.
From left to right: Dr Fred Hollows, Dr John Cooper, Darrell Campbell and Dr Sanduk Ruit in January 1992. Source: Jonathan Chester
For Sanduk, Hollows didn’t match the image of a conventional doctor he was used to seeing. In the past, he had seen western doctors coming to Nepal with a patronising attitude.

It was an instant connection between the two due to their common ideas about uplifting marginalised communities.

That’s when their lifelong partnership started. In 1987 Sanduk and his wife Nanda were invited to Australia by Fred and his wife Gabi Hollows.

During their year in Australia, Sanduk and Fred would discuss how they could take world-class cataract surgery to Nepal.

Members of the Nepali community in Sydney were keen to provide any assistance they could to their cause.

The Nepal Eye Program Australia was then formed. The first fundraising they did for the organisation amounted to $150.
“That $150 sowed the seeds for our major entrance into the world of eye surgery”, Sanduk Ruit told SBS Nepali.
This was before The Fred Hollows Foundation was founded.
While visiting Dr Hollows, Dr Ruit and Dr Hollows are depicted conversing with one another in early 1990.
While visiting Dr Hollows, Dr Ruit and Dr Hollows are depicted conversing with one another in early 1990. Source: Supplied
Fred Hollows is credited with taking Sanduk’s career in Ophthalmology to new heights but it’s Sanduk’s ability to take risks that turned him into a leading surgeon in his own right.

Tackling cataracts

Dr Ruit examines the eyes of his patients in Nepal in September of 1992
Dr Ruit examines the eyes of his patients in Nepal in September of 1992 Source: Michael Amendolia
Cataracts are one of the major causes of blindness in Nepal, but the surgery to treat the illness was performed in an old-fashioned way, Sanduk says.

He wanted to change that. He wanted to perform the same type of surgery done in Western countries for ordinary people in Nepal.

With his goal of providing affordable and sustainable cataract surgery, he quit his job at the national eye hospital and put together a team to go to villages to perform surgery.

His innovative idea for surgery included simpler techniques and optimal conditions. Instead of taking a few days for the person to be able to see in the traditional way of surgery, Sanduk’s technique took only a few minutes.
Dr Ruit examines patients' eyes in Nepal, in late December of 1991.
Dr Ruit examines patients' eyes in Nepal, in late December of 1991. Source: Michael Amendolia
His move brought the ire of Nepals’ medical establishment. Sanduk was reported to the government, so as to stop him from providing eye surgeries.
“Cataract surgeries at that time were done without intraocular lens and lot of people thought that they should stick with the age-old proven technique and not go around completely changing the way cataracts were treated”, says Sanduk.
After nearly five years of successful cataract surgeries and usage of the intraocular lens, Sanduk Ruit and Fred Hollows took their idea to a major international medical conference in 1989.

But instead of receiving support, their ideas were slammed as “too complicated and too expensive”. They were told not to continue their work without doing clinical trials.

Sanduk and Fred’s response was that the people opposing them now would regret it later. They were determined to bring the affordable technology to Nepal and to other parts of the developing world.

After the conference, their journey to get international recognition for their technique got started.
In January 1992, Dr Hollows and Dr Ruit examine patients in an eye clinic in rural Nepal.
In January 1992, Dr Hollows and Dr Ruit examine patients in an eye clinic in rural Nepal. Source: Jonathan Chester
The risks they took paid off and they managed to develop a new type of intraocular lens that brought down the price of the lens from $200 to as little as $3.
“People thought we were mad – but we proved them wrong”, says Sanduk.

Changing the game

Dr Sanduk Ruit with Mei and Chui Chi Wen. Hetauda Eye Camp 2017.
Dr Sanduk Ruit with Mei and Chui Chi Wen. Hetauda Eye Camp 2017. Source: Michael Amendolia
Millions of people around the world can now access quality and affordable cataract surgery due to some of their “game-changing” achievements.

Sanduk and Fred continued to work together until 1993 when Fred died due to cancer.

Now, thousands of doctors from all over the world come to Nepal and learn from Sanduk Ruit and his Tilganga Eye Center in Kathmandu. The intraocular lenses made in Nepal are now used in over 30 countries.

In his career spanning more than three decades, Sanduk is said to have helped restore sight for more than 150,000 people in many parts of the world including Nepal, North Korea, Myanmar, Sudan, Ethiopia and Ghana.
Dr Ruit with Thai Princess Sirindhorn
Dr Ruit with Thai Princess Sirindhorn Source: Serabla Ruit
His work has received endorsements from the likes of Hollywood celebrities to the Dalai Lama. He’s also been awarded the Order of Australia.

Now a world leader in the field of ophthalmology, Sanduk has some great plans he wants to implement.
“Building community eye hospitals – what I call achievable, sustainable, high-quality models – with two doctors and 25 staff delivering service to about a million people. “This is a great model for eradicating avoidable blindness”, he said.
“Coming from the bottom tier of Nepali society and now being able to take Nepal to the international community, I feel really privileged”.
Book Cover: The Barefoot Doctor
The Barefoot Surgeon by Ali Gripper Source: Supplied
Dr Sanduk Ruit’s life story of his work across the world can be read in his biography, ’The Barefoot Surgeon’ by Ali Gripper.


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7 min read
Published 4 December 2019 3:29pm
Updated 4 December 2019 3:39pm
By Rajish Aryal

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