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Surgeon Dr Sanduk Ruit revolutionising cataract surgery, gives sight to thousands

IT’S 6.17pm and Dr Sanduk Ruit’s 56th patient for the day has just laid down on his ­operating table.

The eye surgeon has never met 16-year-old Debaki Basnet, but the schoolgirl’s arduous 30km trip, with her two sisters, along earthquake-ravaged roads, has led to this life-changing mom­ent. Even in this remote region of northeast Nepal, at the foot of the Himalayas, Debaki has heard of Dr Ruit: the barefoot surgeon.

Dr Sanduk Ruit and Professor Fred Hollows in Hanoi, Vietnam in 1992.
Dr Sanduk Ruit and Professor Fred Hollows in Hanoi, Vietnam in 1992.

Mentored by the late Australian eye doctor Fred Hollows, Dr Ruit has revolutionised cataract surgery, giving sight to hundreds of thousands of people worldwide, too poor to travel to a hospital.

In only seven minutes, the highly skilled ophthalmologist extracts ­Debaki’s congenital cataract in her left eye, replacing it with a tiny new lens.

“This is 100 per cent world-class results with minimal resources,” Dr Ruit told The Sunday Telegraph.

Fred Hollows Foundation: Saving Nepal's eyes with Dr Sanduk Ruit

The next morning, he removes the plastic blue patch protecting ­Debaki’s eye.

Instantly, her face lights up.

By chance, Kathmandu-based Dr Ruit was performing free operations at an eye camp in Dolakha when Debaki’s parents, both farmers, sent their vision-impaired daughter for an eye check-up.

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Within hours, she was referred to him and prepped for surgery.

“I’m very happy,” Debaki said. Crying with relief, her overwhelmed and protective 18-year-old sister Chandika said: “I want to tell my parents how the doctors treated her very well.”

Examining the eye of his youngest patient at the camp, Dr Ruit said: “It’s probably better than they look in Sydney — they look beautiful.”  

Debaki Basnet suffered from a bilateral congenital cataract and was operated on in Nepal. Picture: Michael Amendolia <a class="capi-image" originid="crop-7e79ff35f5942bb766c0d9ee5b80db0e"></a>
Debaki Basnet suffered from a bilateral congenital cataract and was operated on in Nepal. Picture: Michael Amendolia

The “patches off” moment is one Dr Ruit never tires of.

The 63-year-old has restored sight to more than 120,000 patients — the most by any eye surgeon.

“Every moment is very powerful and every patient has a different story to tell,” Dr Ruit said.

“It’s filled with emotions. You can see that within a few seconds when the patch comes off.

“These are the things that ­recharge us to go and work more.”

Dr Sanduk Ruit has followed in the footsteps of Professor Fred Hollows. Picture: Michael Amendolia
Dr Sanduk Ruit has followed in the footsteps of Professor Fred Hollows. Picture: Michael Amendolia

In just one day at the eye camp, Dr Ruit carried out 62 back-to-back operations, only breaking to eat lunch. With a mix of Indian and Nepalese music from his iPod playing in the background, he sat on a stool — barefoot — removing cataract after cataract.

Displaying the stamina of a man half his age, Dr Ruit effortlessly performed the procedure he developed and perfected, known as small ­incision sutureless cataract surgery.

The quick operation — costing as little as $25 — has now been adopted in some of the world’s poorest ­countries.

Thousands of doctors have since learned the technique, many taught by Dr Ruit himself.

“It’s the most cost-effective and most predictable medical intervention,” he said.

“The thing that we have done is we have taken it to a community and made it possible, affordable and accessible.”

Dr Ruit’s remarkable work has been closely tied to Australia, stretching back 33 years when a colleague suggested he come to Kathmandu Airport to pick up a man by the name of Professor Fred Hollows.

Some of the people Dr Sanduk Ruit helps with their eye issues in Nepal. Picture: Michael Amendolia
Some of the people Dr Sanduk Ruit helps with their eye issues in Nepal. Picture: Michael Amendolia

Fortunately, he overcame a bad first impression of the notoriously direct Aussie.

“In the beginning, right at the ­airport, it wasn’t very good,” Dr Ruit said.

“But as I travelled with him to the western part of Nepal, I found him a very open person, very ­upfront.

“We used to sit outside and have a little drink and talk and I used to express my frustrations of what I find here. I told him that the biggest problem wasn’t trachoma but cataracts is by far the biggest problem.”  

For the next eight years — before Prof Hollows died in 1993 — the pair, described together as “cowboys”, were on a mission to develop cost-effective but high-quality cataract surgery for the world’s poorest countries.

Dr Sanduk Ruit’s patients are very thankful for all he has done to help them. Picture: Michael Amendolia <a class="capi-image" originid="crop-fff9d3b48f171ca527e6de3ec9c60de7"></a>
Dr Sanduk Ruit’s patients are very thankful for all he has done to help them. Picture: Michael Amendolia

Dr Ruit and his wife Nanda lived with Prof Hollows and his wife Gabi at Farnham House in Randwick in 1987 when he trained at the Prince of Wales Hospital.

He’s also godfather to the Hollows’ daughter Anna-Louise, who was born that same year.

Prof Hollows wasn’t alive when their shared plan to open a lens factory in Kathmandu became a reality 23 years ago, dramatically reducing the cost of cataract surgery in Nepal.

The price of a lens fell from about $200 to under $4.

Amrit Maya Nepali, 74, came to the Tilganga Institute of Ophthalmology Outreach Microsurgical Eye Clinic at Dolakha, Nepal for bilateral cataract treatment. Picture: Michael Amendolia <a class="capi-image" originid="crop-2f08bcb29c4b60211b2d937576459607"></a>
Amrit Maya Nepali, 74, came to the Tilganga Institute of Ophthalmology Outreach Microsurgical Eye Clinic at Dolakha, Nepal for bilateral cataract treatment. Picture: Michael Amendolia

Mrs Hollows, the founding director of the Fred Hollows Foundation which supports Dr Ruit’s work, ­described the father of three as a “walking God in ophthalmology”.

“When he and Nanda came to live with our family in the 1980s, that’s when we started the conversation about ending avoidable ­blindness,” she told The Sunday Telegraph.

“At first, it was simply about sending him home with the operating and surgical tools of his trade, which there weren’t enough of in Nepal, but we then set up the Nepal Eye Program Australia, which later became part of The Foundation.

“Fred was so confident Dr Ruit was going to go back home and do great things, and he would be so proud of Dr Ruit’s incredible achievements.”

Dr Sanduk Ruit has changed many lives, performing surgeries on people as old as 92 and as young as 16 in Nepal. Picture: Michael Amendolia
Dr Sanduk Ruit has changed many lives, performing surgeries on people as old as 92 and as young as 16 in Nepal. Picture: Michael Amendolia

Dr Ruit now plans to expand the lens factory at   his   eye hos­pital, the Tilganga Institute of ­Ophthalmology.

He’s also sharing his story in a new  Australian book The Barefoot Surgeon.

“I thought it was a good time that I let people know about my journey,” he said.

“I cannot find a cause more human than this.”

For Amrit Nepali, her cataract surgery meant seeing her one-year-old great-grandson for the first time. Blind in both eyes, Dr Ruit ­restored her sight at last month’s eye camp.

“He’s like a God to us,” the 74-year-old said after her patches were peeled off. Yesterday my life was full of darkness, like a door had been closed, and now it’s open.”

The Barefoot Surgeon book will be available from June 27.

Dr Ruit will attend book events in Australia next month.

*Miranda Wood travelled to Nepal as a guest of The Fred Hollows Foundation.

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Original URL: https://www.dailytelegraph.com.au/news/nsw/surgeon-dr-sanduk-ruit-revolutionising-cataract-surgery-gives-sight-to-thousands/news-story/dee1252e3f183f27e1d0d9c39f47e8d6