2006 Ramon Magsaysay Awardee Sanduk Ruit, through cheap, efficient and effective cataract microsurgeries, has restored the eyesight of hundreds of thousands of people in remote communities. In the process, he made the world realize that a man of great vision can come from anywhere – even the highlands of Nepal.
The kingdom of Nepal in Central Asia is home to the world’s highest mountain, Everest. Its peak and rugged terrain has posed a constant challenge to the daring and the adventurous. Its breathtaking view has been heralded for ages. Ironically, for some half a million people of Nepal, that scenery cannot be enjoyed because they are afflicted with blindness.
The country’s geography has proven to be both a blessing and a curse, because Nepal is one of the places in the world with the highest incidence of cataract, a condition that is the bane of aging but does not spare the young, either. Doctors theorize that it may be caused by high altitude ultraviolet rays which are intense in the area, genetics, smoke and glass blowing. No one is certain. What is known is that cataracts need not lead to blindness, as Dr. Sanduk Ruit, 2006 Ramon Magsaysay Awardee for Peace and International Understanding, has proven.
Ruit, Nepal’s first Lama opthalmologist, was born in a small remote village in a mountain area of eastern Nepal that had no electricity. The nearest school was eleven days away by foot. A promising student, he received a scholarship that allowed him to study at an English school in India. It was his older sister’s death from tuberculosis that led him to the study of medicine.
After completing opthalmology residency in India, he returned to Nepal as a government health officer. When he was medical officer with the Nepalese Prevention of Blindness Program, he met Professor Fred Hollows, a World Health Organization (WHO) consultant for the program. Hollows was an influential Australian eye surgeon known for his humanitarian endeavors in establishing eye care facilities especially in developing countries. This enduring friendship between kindred spirits was further strengthened when Ruit went to the Prince of Wales Hospital in Sydney to learn the latest techniques in cataract microsurgery using intraocular lens from Hollows.
This was not being used to treat cataract blindness in developing countries because it was considered too expensive, too risky and too difficult. Ruit and Hollows were determined to change that thinking.
They shared the same outlook on life and medical philosophies and believed that everyone, rich or poor, should have access to affordable and quality eye care. They wanted patients from developing countries to receive the same high quality of medical care as those from more affluent countries. Both wanted to prove that this modern technique was far superior and economical than the traditional method of removing the clouded lens of the eye and not replacing it, but rather giving the patient crude and thick spectacles that provided vision with distortions in peripheral vision.
When Ruit returned to Nepal in 1988, he began training local doctors in modern cataract surgery. Slowly, his technique began to be the standard. With support from the Nepal Eye Program Australia, he began taking the concept of cataract surgery to Nepal’s less accessible areas. Makeshift eye clinics were set up and on the spot surgeries performed with the same care, efficiency, and hygienic conditions that paying patients were accustomed to. His training in Australia, the Netherlands and the US has led him and his team to a refinement of the surgery, his famous suture-less procedure that makes the surgery even faster and reduces the patients’ recovery time.
The surgery can be completed in five minutes in the deft hands of Ruit, who says, “It is the best thing a human can do in five minutes.” With the negligible tugs and scratches felt on the anesthezised eyeball, the experience has been described as the optical equivalent of minor dental surgery.
Ruit is now medical director of the Tilganga Eye Centre (TEC) which opened in Kathmandu in 1994. It includes a network of eye-care services. In collaboration with the Himalayan Cataract Project, it manages six regional primary eye-care centers in Nepal. It operates the country’s only successful eye bank. It trains paramedics, medical residents, and nurses and visiting surgeons, more than five hundred to date, from all over the world who are eager to learn Ruit’s trail-blazing techniques. It manufactures high-quality intraocular lenses for surgery and makes these previously exorbitant implants—close to 1.5 million to date—available to needy recipients for less than US$ 5 a piece. TEC treats three thousand patients a week, has performed more than ninety thousand operations since 1994, and has become associated with quality training and concrete results. Its mobile eye camps have reached China, India, Bangladesh, Cambodia, and even North Korea in June 2006 where the highly respected and demanding Ruit and his team performed eye-restoring surgery on over a thousand patients in six days.
Ruit is legendary for his stamina at the operating table and can perform one hundred flawless surgeries in a single day, with much good humor at the end of his regular 12-hour day. The statistics may be astounding, but even more impressive is that the surgery is available to all. The cost is socialized depending on one’s ability to pay, with the indigent paying nothing at all.
Ruit continues to upgrade the state of eye care in Nepal, training surgeons and paramedics, and strives to reach the country’s many remaining remote areas rendered inaccessible by the geographical terrain. He teaches the cataract surgery technique at annual meetings of the American Academy of Opthalmology and the American Society of Cataract and Refractive Surgery. The 51-year old surgeon says, “We Nepalese have never been known to give anything to other parts of the world. I feel proud that we have given this expertise to many countries.”
TIME photographer Michael Amendolia documented on award-winning photos Ruit’s restoration of sight to Himalayan villagers, some of whom had been blind for decades. He relates that one of his favorite images was that moment when a 73-year old woman saw her daughter for the first time in three years. The woman just stared for a few seconds and then burst into tears. No words were necessary.
That scene is replicated many times over in Ruit’s practice. And each time, his words as a young doctor then, ring with conviction, “Everyone deserves good vision. There can be no children of a lesser god.”