Second Suns

by David Oliver Relin

  Fred Hollows died on February 10, 1993. Michael Amendolia, a young photographer for Australia’s News Limited newspapers, who had accompanied Hollows and Ruit to Vietnam, visited Hollows frequently during the last months of his life. Amendolia was so moved by Hollows’s dignity and lack of self-pity that he shot hardly any images during the time he spent at Farnham House. “It was just such a privilege to be there that I didn’t want to poke a camera in Fred’s face. Not that he would have minded,” Amendolia says. “Fred’s dying was a very public event, and there was no solemnity allowed. There were always twenty or thirty people out on the terrace, drinking and carrying on, while one or two at a time came inside and shared a quiet word or a laugh with Fred. His behavior at the end cemented his status as a national hero. He had the courage to leverage his dying to make a difference.”

  Nearly two decades later, Gabi Hollows pointed out the spot where her husband’s life came to an end, a large drawing room cluttered with messy piles of books, too many framed awards to fit on the walls, and the heavy, hand-lathed wood furniture Fred built in such quantities that it made the enormous room seem paradoxically small. Though it looked frozen in time, Farnham House hadn’t become a museum. Far from it. Fred and Gabi Hollows’s college-aged children, as well as assorted houseguests, inhabited the rooms. The home was still crowded with an unpredictable assortment of diners during meals. But the presence of the departed doctor clung to the walls, like smoke from his omnipresent pipe.

  “You know what one of the last things Fred said before he died was?” Gabi asked, sitting at the heart of Farnham House, her scuffed kitchen table. “I’ll tell you,” she continued, without waiting for a reply. “He said, ‘You know, if all I’ve achieved is launching Ruit, then my life’s been a success, because I know he’ll change the world.’ ”

  “Fred gave orders to the end,” says Rex Shore, a British citizen who’d fled Europe for a more adventurous life in Australia. He’d worked for sixteen years as an ambulance driver and paramedic in Sydney before arthritis made lifting patients too painful. Shore had met Hollows in Sydney and had found the doctor’s disregard for convention refreshing.

  “I’ve never been very good at following rules,” Shore says. He found England “too organized and ritualistic” for his taste. Before his injury, he’d reveled in Australia’s freedom, skydiving, shooting, and sailing his way through the hours between his shifts in the ambulance. Shore took advantage of Australia’s proximity to Asia to travel widely when he took time off. On a trekking vacation in Nepal, he’d fallen in love with the country and had bonded with his porter, Prakash Sherpa. He’d returned frequently to visit Prakash’s family.

  During his time in Kathmandu, Shore had been introduced to Ruit by a common Sherpa friend. He was struck by the dream Hollows and Ruit shared of bringing high-quality eye care to the world’s poor, whatever the obstacles. “They really were soul mates in that way,” Shore says. He offered his skills as a fluent English speaker to help Ruit communicate with the diplomatic community, whose help, and funds, Ruit sought to make the hospital he envisioned a reality.

  That’s how Rex Shore found himself spending his days weaving through Kathmandu’s unpredictable traffic on a black Bajaj motorcycle, with a modest salary as a representative of the Nepal Eye Program Australia, traveling to meetings with government officials. “Everything was quite ad hoc in those days and we just got on with things,” Shore says. I thought Oz was adventurous at first, but compared to Kathmandu, it was predictable and boring. Nepal was the Wild, Wild West.”

  Hollows had also helped Ruit gain a powerful ally when he pressed Les Douglas, Australia’s ambassador to Nepal, to help Ruit any way he could. “You should support this man,” Douglas remembers Hollows saying. “He knows what he wants to achieve for his people … and he will be successful. If I needed a cataract operation, I would come to Nepal and get Ruit to do it.”

  “I did a thing or two to help Ruit get going,” Shore says, “but let’s be clear: If Les Douglas hadn’t been ambassador to Nepal, Tilganga would never have been founded.”

  Douglas arrived at a transformative time in Nepal’s political history. Nepal was still a kingdom, and the royal family’s power was firmly entrenched. But a nascent democracy movement had spread from rural areas to Nepal’s cities and had forced concessions from King Birendra. These culminated in 1991’s elections, which made Nepal a constitutional monarchy, with the king as the head of state and a prime minister as the head of government.

  Prime Minister G. P. Koirala had made his reputation as a leader of the labor movement, organizing workers in the jute mills of his hometown, Biratnagar, and he came to office promising to press for further democratic reforms. “What that meant, practically, was that Nepal’s political system was in chaos when I arrived,” Douglas says. “A lot of the politicians and bureaucrats I met with seemed to have no idea how to help the Nepalese people, and they were puzzled about who was actually in control of the country.”

  Douglas saw Ruit as someone who could get something done. “Before Ruit left the Nepal Eye Hospital, I went to watch him operate, and I came away impressed not just with his skill as a surgeon but by what an extraordinary human being he was. Ruit taught me not only a lot about Nepal, about the inefficiencies and corruption of the bureaucracy; he taught me how to live a meaningful life. And he explained very clearly that his vision was to develop a world-standard medical facility which was owned and run by the Nepalese.”

  During his twenty-eight-year diplomatic career, Douglas had become disenchanted with most development programs. He had seen too many aid efforts pander to what the donor countries wanted to do, rather than what the local people needed. “That wasn’t the case with Ruit,” Douglas says. “He knew exactly what he wanted to do, and he had no problem telling me not only what he needed but what I should do to make myself useful.”

  The first priority was finding a piece of land on which to locate the facility. “We were a pretty formidable little team,” Douglas says. “Rex was the administrator, zipping from meeting to meeting on his motorcycle. And as a diplomat, I used my influence to press the decision makers. That left Ruit free to focus on the big picture.”

  Douglas met regularly with Prime Minister Koirala and pressured the government to donate a suitable piece of land. “It was quite funny, actually,” Douglas says. “We went to the city surveyor’s office, pulled out maps of available land, and the prime minister said, ‘Pick whatever you want and I’ll make sure you get it.’ ” Unfortunately, the most recent survey maps available were from the 1940s. Every time Douglas contacted Koirala to request a particular piece of undeveloped real estate, he’d receive a phone call weeks later from a functionary who’d explain that the site he’d selected was already built up or reserved for a relative of the royal family.

  Finally, after months of runaround, Ruit and Douglas found a piece of land so modest that they couldn’t imagine any royal wanting to claim it. The land was on the eastern fringe of Kathmandu, near the airport, and across the Bagmati River from the cremation platforms of Pashupatinath. Occasionally, it was used to park buses that carried pilgrims to Pashupatinath from India. The rest of the time it served as the neighborhood dump. But the land belonged to a trust headed by Queen Aishwarya, which had no intention of donating property near the country’s most sacred Hindu site to a group led by a casteless Bhotia from the frontier of the kingdom.

  Embarrassed by his repeated inability to deliver, and determined to send a message to the royal family about a shift in the country’s power structure, the prime minister insisted that the land be handed over. And, grudgingly, it was.

  Ruit visited the site regularly, after excavation was under way. To the casual observer, it may have looked like little more than a dusty lot, strewn with mounds of rotting trash, scented with the smoke of burning flesh drifting across the Bagmati. But to Ruit it was a foundation sturdy enough to support a dream. He noticed a narrow, trash-choked stream, trickling through the lot t
oward the Bagmati from the slum in the hills above. He asked an old man hobbling by for its name and learned that the local people called it Tilganga, the “Stream of Sesame Seeds.”

  “In Nepal,” Ruit says, “hospitals and other institutions tend to have great big grand names—King this or Queen that—and achieve very little. I thought it was correct that we start with a very modest name like Tilganga and prove our worth with achievements. Besides, even the smallest, dirtiest stream eventually finds its way to a river and runs its course through the country.”

  Ruit rented a small office with NEPA funds and selected a team of board members for Tilganga formidable enough to break through Kathmandu’s daunting bureaucracy. He recruited Hari Bamsha Acharya, Nepal’s most famous comedian, for help publicizing their efforts; Shambu Tamang, the first non-Sherpa Nepalese to summit Everest, for his ability to organize expedition-type medical outreaches; Jagdish Ghimire, the local director of OXFAM, for his experience running an NGO; Suhrid Ghimire and Rabindra Shrestha, two successful entrepreneurs, for advice on managing a growing business; Sushil Pant, a powerful lawyer, to help steer Tilganga through Nepal’s corrupt legal system; and the industrialist Diwakar Golchha, so Tilganga would have access to his peers, Nepal’s wealthiest potential donors.

  Prime Minister Koirala laid Tilganga’s first foundation stone himself. With only $40,000 in hand from NEPA and the Australian government, little more than enough to lay a foundation, Ruit ordered architects to draw up plans for a fully outfitted three-story facility, built around the courtyard he pictured as Tilganga’s heart. The plans included a modern surgical center, a clinic, and a separate building for the Fred Hollows Intraocular Lens Laboratory, since a steady supply of inexpensive artificial lenses was the key to all the doors Ruit hoped to kick open. Ruit told the contractors he had funds to pay for the entire project, when, in fact, he had almost nothing. “I saw that there was a great light in front of me, so I knew I must keep my mind straight and move toward it,” Ruit says. “I just felt the money would fall into place.”

  And with the good fortune that has defined so much of his life, it did. Ruit was devastated to learn that his friend and supporter the Third Jamgon Kongtrul had been killed in a car crash on the plains of India. But his disciple Tenzeng Dorjee, the director of the Jamgon Kongtrul’s newly created trust, stepped forward as if the departed Rinpoche had read Ruit’s mind, and pledged funds to construct Tilganga’s operating theater. Additional money to keep the construction moving was donated by a Kathmandu temple trust, local businesspeople, and even a beer company. But whenever the cash on hand dipped dangerously low, Les Douglas scrounged up more from the Australian Agency for International Development.

  Meanwhile, “Ruit was busy operating and Les was busy ambassadoring,” Shore remembers. Even though he had no experience with construction, Shore found himself de facto foreman. Fortunately, his former porter Prakash had quit carrying loads, moved to Kathmandu, and started a contractor business. “My Sherpa brother was the only person in the trade I could trust,” he says, “and I hired him.” Together, they traveled to consult with Douglas. “I remember Les pointed at the brick walls of the Aussie embassy and said, ‘Build it solid, like this,’ ” Shore says. “So we did.”

  Word of Ruit’s project provoked jealousy among his superiors at the Nepal Eye Hospital. They wanted the lens laboratory built as an extension of the NEH and used their connections to promote it over Tilganga; they petitioned Prime Minister Koirala to stop the construction of Tilganga’s lens lab, but Koirala refused. “They even tried to have me thrown out of the country and get the government to gum up renewing my visa,” Shore says.

  Prakash’s crew completed the lens laboratory and the surgical center before turning their efforts toward raising the rest of Tilganga. The automated lathes, presses, and polishing tools required to produce the lenses were paid for by the recently founded Fred Hollows Foundation in Australia and installed by technicians sent from Sydney. Ruit recruited a brilliant local engineer named Rabindra Shrestha—no relation to the Tilganga board member of the same name—and hired him to supervise the lab’s entirely Nepali staff.

  Ambassador Douglas asked the Australian government to extend his appointment from three years to however long it took to open Tilganga. Douglas allayed Ruit’s eagerness to begin operating out of his own facility by suggesting a diversion he knew Ruit couldn’t resist.

  Mustang, in north-central Nepal, was one of the nation’s least developed and most inaccessible areas. Because of the ongoing conflict with the Chinese forces across its northern border, Mustang was militarily sensitive and restricted to outsiders. Douglas used his leverage with the newly democratic government to wrangle permission for Ruit to lead the first ophthalmic team into the region. Known within Nepal as Little Tibet, for its large population of Tibetan refugees and traditional Buddhist culture, Mustang loomed in Douglas’s imagination as a sort of Shangri-La, preserved by its isolation from the modern world. For Ruit, a population near the border with Tibet with no access to medical care was a powerful magnet.

  The team flew in prop planes to the district headquarters in Jomsom, where a train of twenty packhorses waited to take them into the mountains. Nabin Rai, along with five nurses and technicians Ruit had recruited to staff Tilganga when the construction was complete, accompanied them. And squeezed into one of Royal Nepal Airlines’ undersized seats, with his feet propped up on a burlap sack of rice they’d brought to feed themselves and their patients, sat Michael Amendolia, his photographer’s vest crammed with camera gear.

  The presence of a foreign ambassador can open only so many doors. The evening the members of the expedition gathered in Jomsom’s only guesthouse before their departure, Douglas asked Ruit, who’d invited Amendolia, how he’d arranged to get permission for a foreign photographer to enter a sensitive military region. “Oh,” Ruit said, grinning conspiratorially, “I didn’t worry so much about that.” They decided to deplete some of their precious stock of scotch to smooth over any difficulties and invited the district commissioner to their room to share a glass or three. “When I judged he was ripe enough, I poured him another drink,” Ruit says, “and asked him if he could help with our little problem.”

  “You’ve never seen a man sober up so fast,” Douglas says. “You could see the fellow’s career flashing before his eyes. He told us he couldn’t help us, but at least he said he wouldn’t report us, and we’d be on our own with the border guards.”

  “Bugger it,” Ruit said, pouring each of them a splash after the commissioner had gone. “Something will work out.”

  “At that moment,” Douglas says, “I remember thinking Ruit had never seemed more like our dear unflappable friend Fred.”

  They left at first light into a sharp-toothed wind, covering their faces with cloth, traveling within a long plume of dust stirred up by their small Tibetan horses. Ruit advised Amendolia to remove his photographer’s vest and hide his gear until they were well past Mustang’s border guards. And the doctor, who had never cared for riding horses, sat uncomfortably on his mount, his face covered tightly by a cloth.

  “We rode up a narrow trail, no more than two meters wide,” Douglas says. “I tried to enjoy the mountain scenery, which is stunning in those parts, and not look down at the sheer drop, but I confess I had a hard time keeping my eyes off our horses’ hooves, and watching how close they came to the edge.”

  The guard post was on a small plateau above a perilously steep portion of the trail. Anxiously, Amendolia rode toward the soldiers, who had automatic rifles slung casually over their shoulders. Ruit, bringing up the rear, was spurring his horse, coaxing it to climb, when suddenly it reared up on its hind legs and rolled over backward onto him.

  “Fortunately, when the horse fell on me, I landed in a sort of bathtub shape carved out of the rock and his weight didn’t crush me as it would have done on level ground,” Ruit says. “But then I was rolling downside, ass over teakettle. I couldn’t tell which way I was falling
, and I remember praying I didn’t go off the edge.”

  When horse and rider came to rest, after tumbling more than twenty yards straight down the spine of the trail, Ruit was bruised, badly shaken, and relieved to be alive. Despite the long fall, his rugged mountain pony seemed to have suffered nothing more than a few scratches, and he led the spooked animal back uphill by the reins to the post, where the border guards gaped at the man whose corpse they’d been preparing to recover. In the wind and dust and confusion, Amendolia slipped past the guards without being asked to produce the permit he didn’t have. And the expedition, complete with its photographer, proceeded on its way to Upper Mustang.

  “That tumble on the horse changed me,” Ruit said. “A few feet one way or the other and I would have fallen to my death. I told myself, ‘You have your family and your work. You can’t take this sort of senseless chance anymore.’ ” From that day forward, Ruit preferred to trust his own feet on the most treacherous portions of his travels. He avoided Nepal’s accident-prone small planes whenever it was possible to drive to his destination. And his companions and coworkers learned to settle back onto their saddles, or the seats of their SUV, as Ruit plodded slowly and deliberately along the edges of cliffside trails or crumbling roads on foot, refusing to trust his survival to the hands or hooves of others.

  They rode up a fourteen-thousand-foot pass toward Charang, where they had arranged to operate in the village veterinary clinic. Mustang was so sparsely populated that advance screening teams had been able to gather only fifty-five patients who could benefit from cataract surgery. “Charang was probably the poorest place I’d ever been,” Douglas says. “It was such an arid, desolate area that you couldn’t believe it could support human life. And the people were like something out of prehistory. They wore clothes made from the hides of their goats; you could smell them coming from a mile away.” The single piece of furniture they could find was a bench too rickety to serve as an operating table. There were only two scrawny trees standing within several hours of the village. Douglas convinced the villagers to let him cut one of them down, and they used its timber to brace the bench so it was stable enough to support patients.