Dr. Sanduk Ruit

The 2006 Ramon Magsaysay Award for International Understanding CITATION for Sanduk RuitRamon Magsaysay Award Presentation Ceremonies31 August 2006, Manila, Philippines

Cataracts, bane of the aging, are like clouds that gather over the eyes. They are the most common cause of blindness in Asia. In Nepal alone some half a million people are affected, the majority of whom live in remote areas where the curse of blindness is magnified by a harsh terrain and pervasive poverty. Yet, most of these people need not be blind at all, says Dr. Sanduk Ruit. Only the absence of medical care condemns them to darkness. Ruit, an eye surgeon and medical director of the Tilganga Eye Centre in Kathmandu, wants them to see again.

Sanduk Ruit was born in a mountain area of Nepal so poor and remote that the nearest school was eleven days away, by foot. Diligence brought him a scholarship to be educated in India. When he was seventeen, his older sister died of tuberculosis and this painful loss led him to medicine. Upon completing medical school in India, he returned to Nepal as a government health officer. Following an assignment with the WHO Nepal Blindness Survey in 1980, he completed a residency in ophthalmology. Later, in Australia, he learned from his friend and mentor Dr. Fred Hollows the latest techniques in cataract microsurgery using implanted intraocular lenses. By 1988, he was introducing the new techniques in Nepal.

There, Ruit faced the resistance of local eye surgeons. He patiently taught them the new procedures and began to win converts. With backing from the Nepal Eye Program Australia, he began trekking to Nepal’s far-flung towns to conduct eye camps, on-the-spot surgeries in which he almost instantly restored the sight of grateful country folk, hundreds at a time. While doing so, Ruit devised techniques to achieve hospital-quality standards of precision and sterility under makeshift conditions. These included his now-famous suture-less procedure that speeds cataract surgery and reduces patients’ recovery time.

Ruit opened the Tilganga Eye Centre (TEC) in 1994. It has become the hub of an ambitious expansion of eye-care services. In partnership with the Himalayan Cataract Project, TEC today manages six regional primary eye-care centers in Nepal. It operates Nepal’s only successful eye bank. It trains eye-care paramedics, medical residents, and nurses as well as visiting surgeons from Asia, North America, Europe, and Australia who come to learn Dr. Ruit’s techniques. It also manufactures extremely high-quality intraocular lenses for surgery and makes these once-exorbitant implants—nearly 1.5 million of them so far—available to needy recipients in some fifty countries for less than US $5.00 apiece. Meanwhile, the Centre treats three thousand patients a week and has performed more than ninety thousand operations since its inception. Surgery at TEC is inexpensive and prorated according to ability to pay; the poor pay nothing at all.

Today, Ruit’s mobile eye camps have expanded to China, India, Bangladesh, Cambodia, and even to North Korea, where in June 2006 he and his team performed sight-restoring surgery on over 1,000 patients in six days.

More than five hundred surgeons across Asia have now learned Dr. Ruit’s pathbreaking techniques. "We Nepalese have never been known to give anything to other parts of the world," he says. "I feel proud that we have given this expertise to many countries."

The good doctor Ruit is famous for his stamina at the operating table and can perform one hundred surgeries in a single day. At fifty-one, he remains inspired by the joyful satisfaction of giving the gift of sight, especially to the poor.

"Everyone deserves good vision," he says. "There can be no children of a lesser god."

In electing Sanduk Ruit to receive the 2006 Ramon Magsaysay Award for Peace and International Understanding, the board of trustees recognizes his placing Nepal at the forefront of developing safe, effective, and economical procedures for cataract surgery, enabling the needlessly blind in even the poorest countries to see again.

Dr. Sanduk Ruit, MD

Co-Director Himalayan Cataract Project

  

Dr. Sanduk Ruit grew up in a remote village in Eastern Nepal. He was educated in India and completed his three-year ophthalmology residency at the prestigious All India Institute of Medical Sciences in Delhi, India. He also completed fellowships in microsurgery in the Netherlands and Australia as well as additional ophthalmic training at the Wilmer Eye Institute of the Johns Hopkins University School of Medicine and the University of Michigan. Dr. Ruit met Professor Fred Hollows from Sydney, Australia in 1986 when Hollows visited Nepal as a World Health Organization consultant. He went on to study with him for 14 months at Sydney’s Prince of Wales Hospital. Hollows was Ruit’s mentor and an inspiration to him. The two men believed in the right of people with treatable blindness to have their sight restored, and that people in developing countries deserved access to the same quality of care and technology as those in the Developed World. They shared an ambitious vision: the elimination of avoidable blindness in the Himalayan region, a process they believed needed to be driven by local people.

When Dr. Ruit returned to Nepal he was instrumental in the formation of the Nepal Eye Program and worked on a large epidemiological survey of blindness in Nepal. He was the first Nepali doctor to perform cataract surgery with intraocular lens implants and pioneered the use of microsurgical extra-capsular cataract extraction with posterior chamber lens implants in remote eye camps. Although other important international organizations sponsored eye camps in the region providing eye care and training local ophthalmologists, the camps established by Dr. Ruit were the first to introduce the use of intraocular lenses in cataract surgery. Put simply, this is the removal of the cataract and insertion of a plastic intraocular lens. Before this, people who had cataract surgery in Nepal were given crude, Coke bottle-thick glasses that allowed only a poor quality of vision with terrible distortions in peripheral vision that made life on uneven trails difficult. Moreover, if the glasses were lost or broken the patients were unable to focus and again rendered blind.

Dr. Ruit later developed a sutureless form of the surgery, a technique that allows safe, high-volume, low-budget operations. A masterful surgeon, he can perform dozens of flawless cataract operations at eye camps over a 12-hour day – and laugh over a meal with his team at the end of it. Dr. Ruit insists on high standards from everyone and always raises the bar for his own work, an attitude that gains him enormous respect from all who work with him.

Dr. Ruit helped found the Tilganga Eye Centre, the Nepal Eye Program and its Australian counterpart, Nepal Eye Program Australia (NEPA). Using Tilganga as his base of operations, Ruit continues to upgrade the state of eye care in Nepal, training surgeons and paramedics, and furthering his vision to cure blindness throughout the Himalayas. Doctors Ruit and Tabin have been teaching their cataract surgery technique at the American Academy of Ophthalmology and at the American Society of Cataract and Refractive Surgeons annual meetings.

Dr. Sanduk Ruit awarded honorary order of australia

“If I've done nothing in my life but encourage Ruit, I'll have died a happy man.” Fred Hollows

Nepalese surgeon, Dr Sanduk Ruit, long-term friend and colleague of Fred Hollows, has been appointed an honoraryOfficer of the Order of Australia (AO).

Dr Ruit recently visited Australia to mark the 15th year of The Fred Hollows Foundation and to discuss future expansion plans for sight-saving programs in Nepal and around the world.

He has been a partner of The Fred Hollows Foundation since its inception in 1992.

In one of many interviews Fred gave during the final years of his battle with cancer he highlighted the high regard in which he held Dr Ruit.

“If I've done nothing in my life but encourage Ruit, I'll have died a happy man,” he said.

Since Fred’s death, Dr Ruit has worked tirelessly to end avoidable blindness in developing countries, personally performing approximately 70,000 sight-restoring operations.

“We are truly proud to work alongside the remarkable Dr Ruit, a man who has done more than anyone else to make Fred’s vision a reality,” said Brian Doolan, The Foundation’s CEO.

When Fred died in 1993, The Foundation continued its partnership with Dr Ruit, establishing the Tilganga Eye Centre in Kathmandu, incorporating the Fred Hollows Intraocular Lens (IOL) Laboratory, which produces the high-quality lenses necessary for modern cataract surgery.

Today, Dr Ruit and The Foundation continue to work together, training local doctors from countries such as Bangladesh, Cambodia and North Korea to perform modern cataract surgery, and carrying out thousands of sight-saving operations each year.

“There is no doubt Fred would be lifting a congratulatory glass of whisky for his great mate, Dr Ruit,” said Mr Doolan.

“However, both Fred and Dr Ruit would also see this as a time to draw attention to the work ahead,” Mr Doolan said.