The Barefoot Surgeon
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‘A true insight into
‘He reminds me of
‘If I’ve done one thing in life I’m proud of, it’s launching
SUR The B
my remarkable friend.’
Don Bradman. They both have
Ruit into the world.’ Fred Hollows
Gabi Hollows
a God-given talent and skill . .’
Ray Martin
‘One of the greatest people I’ve ever met.’ Joel Edgerton GEO arefoo
‘I’ve known Dr Sanduk Ruit for over thirty years. He is one
of our greatest living eye surgeons and humanitarians…
The Barefoot
Watching him give the gift of sight is like watching someone
give a second life.’ Richard Gere
Inspiring and uplifting, this is the extraordinary story of Dr N
SURGEON
Sanduk Ruit who, like his mentor Fred Hollows, took on the
t
world’s medical establishment to give the life-changing gift of The inspirational story of Dr Sanduk Ruit,
sight to hundreds and thousands of the world’s poorest and most ALI GRIPPER
the eye surgeon giving sight and hope
isolated people. It is the story of a boy from the lowest tiers of to the world’s poor
a rigid caste system who grew up in a tiny, remote Himalayan
vil age with no school to become one of the most respected
ophthalmologists in the world and a medical giant of Asia.
Compelling and compassionate, it is also the story of a young doctor who became Fred Hollows’ medical soul mate and who
chose to defy the world’s medical establishment and the lure
of riches to make the world a better place.
Cover design: Julia Eim
Cover photo: Michael Amendolia
ALI GRIPPER
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Photo by Gab Byrnes
Ali Gripper has written features for newspapers and maga-
zines for more than two decades including Good Weekend, the Sydney Morning Herald, the Australian, the Daily Tele-graph, the South China Morning Post and Country Style Magazine. She worked closely with Dr Ruit for three years to write his life story.
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THE BAREFOOT
SURGEON
Ali Gripper
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First published in 2018
Copyright © Ali Gripper 2018
All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without prior permission in writing from the publisher. The Australian Copyright Act 1968
(the Act) allows a maximum of one chapter or 10 per cent of this book, whichever is the greater, to be photocopied by any educational institution for its educational purposes provided that the educational institution (or body that administers it) has given a remuneration notice to the Copyright Agency (Australia) under the Act.
Allen & Unwin
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Crows Nest NSW 2065
Australia
Phone: (61 2) 8425 0100
Email: info@allenandunwin.com
Web: www.allenandunwin.com
A catalogue record for this
book is available from the
National Library of Australia
ISBN 978 1 76029 270 6
Set in 12/18 pt Sabon by Midland Typesetters, Australia
Printed and bound in Australia by Griffin Press
10 9 8 7 6 5 4 3 2 1
The paper in this book is FSC® certified.
FSC® promotes environmentally responsible,
socially beneficial and economically viable
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management of the world’s forests.
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Contents
Prologue
xv
1 Out of thin air
1
2 Vertigo
15
3 Hey, bhotey
21
4 Yangla’s song
33
5 The gift
43
6 Every little thing she does
59
7 Travelling light
73
8 Against the wind
81
9 Mavericks
93
10 Second chances
109
11 The wild west
117
12 For all the world to see
123
13 Farewell to a friend
139
14 The best of my love
147
15 Little river
151
16 Open for business
161
17 Pieces of magic
171
18 Lean on me
177
19 Blinded by the light
185
20 Kathmandu calling
191
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21 Shining star
197
22 On a clear day
203
23 Private heartache
221
24 Rebuilding from the ruins
235
25 Northern exposure
243
26 A land called paradise
255
27 Dragon of the sky
267
Epilogue
277
Postscript
279
Acknowledgements
281
Appendix The history of cataract surgery
283
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For Tuomo
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‘Ruit doesn’t overdo it with words and conversation. He’s quite sober in the way he interacts with people, but what
people pick up is the quality of his presence, someone who is enormously competent. When you are with him, and working
with him, there’s a feeling of trust and confidence that comes from his very being. It’s something that’s hard to describe, but which everyone feels somehow when they are with him. The
fact that he travels so far with the patients to be with them characterises a truly compassionate person. It’s not about
being sentimental, or sitting around thinking I’d really like to make a difference. He just gets up and does it, to places such as North Korea, because he knows how terrible it must be for
the blind there. He never thinks at all about how he can make a good impression. What he always asks himself is how he
can make a difference, with the means he has, and the skills
he has, and the capacity he has. He succeeds because he has
no agenda other than to help people. It’s a great joy to be with him, there’s a sense of deep complicity, of working for the
same purpose, without having to talk about it.’
— Matthieu Ricard, Buddhist monk and French writer
ix
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‘As Henry Ford changed the world by making an automobile affordable for ordinary Americans, Ruit changed the world
by devising an ingenious surgical technique and procedure
that made sight restoring intraocular lens implant cataract
surgery possible for people everywhere. Even for the poorest
people living in remote villages.’
— Garry Brian, Australian ophthalmologist
xi
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‘Fred Hollows and Sanduk Ruit were true soul mates. But now here is Ruit, a couple of decades later, and he’s gone out and he’s actually done it. It was Fred’s imprimatur that got
him launched, but Ruit just kept plugging away. He raised
the money, built the hospital, trained the surgeons, and
held the camps. Ruit has almost halved blindness in Nepal
and is spreading his technique to other countries. It’s amazing to think that, in my lifetime, or in my children’s lifetime, we will see cataract blindness ended. People will keep getting
cataracts—it’s part of the ageing process—but Ruit and the
army of surgeons he’s training are putting a lid on it. What
Ruit has achieved is well beyond Fred’s wildest dreams. Ruit
went on to become a God-like figure who looks after the blind.
He reminds me a lot of one of the other remarkable men
I’ve interviewed, Don Bradman. They both have a God-given
talent and skill that they both have harnessed in a highly disciplined way. Bradman had no ego at all; he just knew he was a
fantastic batsman. Ruit is also clearly a man without ego and a man with immense self-respect. He doesn’t need to boast
about how good he was. He didn’t ever need to tell people
he was a brilliant surgeon, he just is. He’s very humble but he certainly knows his place in medicine. He doesn’t dismiss
winning the Nobel Prize as ridiculous. He’s got great self-
respect. I’ve covered so many fascinating stories in my life and I’ll never forget the joy on the patients’ faces at an eye camp xiii
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Ruit held in Myanmar a few years ago. Ruit did 600 oper-
ations that week and there was this incredible collective joy as he looked at the rows and rows of his patients who could
see again and who were absolutely jubilant. They just sort of broke into dance and song. The surgeons watching him work
were just in wonderment at the pace and meticulousness of
his surgery. He is just so fast. We put a clock on him to watch him—he was doing operations in about five minutes, and the
other doctors were doing it in about 15 minutes. It was just
astonishing to stand there and watch.’
— Ray Martin, Australian journalist
xiv
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PROLOGUE
The morning sun was just beginning to light up the snow
peaks of the Himalayas in north- eastern Nepal as Kanchi
Maya’s brother brought her to the small community eye
centre. In the custom of the region, he carried his adult
sister on his back in a large wicker basket, attached to his
forehead on a tumpline—a mode of transport known as
‘basket taxi’. Kanchi was in patched clothes, her body rail-
thin from malnutrition. After her brother lowered her onto
the ground, she shuffled timidly with bare feet toward the
eye camp, holding her brother’s hand for support. Beside her
was her young daughter, who carried her sickly baby brother.
Despite being swaddled tightly in a blanket, the one- year- old boy looked close to perishing.
One of the assistants gently led Kanchi to Dr Sanduk
Ruit’s operating table. He asked her how she made a living.
Shaking with nerves, she whispered that she had been trying
to support her children by growing maize and tending goats.
She’d been blind in both eyes for almost four years and had
xv
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never seen her son. Like so many blind women in the devel-
oping world, she had been rejected by her husband and his
family after she had lost her sight and was no longer useful.
She’d been taken in by her brother instead.
Ruit examined her eyes, which were clouded with the
large pearly discs that signify advanced cataracts. He knew
that if the operation went well, Kanchi would be able to see
clearly the next day. An anaesthetic block was given under
the sides of her eyes. Half an hour later, a nurse swabbed
the rust- brown antiseptic over Kanchi’s eyes and draped a
green cloth with a hole cut out around the eyes. ‘Don’t be
scared,’ Ruit told her, as he separated her eyelids open with a small wire speculum, and then patted her gently on the
shoulder. ‘There is no pain, and I’m going to give you your
sight back.’
He lowered the microscope over her eye and went to work.
He quickly removed the first cataract, as hard as a walnut,
and replaced it with a plastic intraocular lens, which had
been specially measured for her, smaller than a contact lens.
The incision he made in her eye was so small and delicate that it would seal without stitches the next day.
Ten minutes later, the assistant lifted Kanchi up, turned her around and then lay her down on the other side of the table so Ruit could operate on her second eye. Once it was over, Kanchi shuffled out, led by two assistants, to the recovery room,
where she and her family were served the local staple dinner of dal bhat— lentil soup and rice — washed down with cups of chia the sweet, milky spiced tea the Nepalese drink all day.
Kanchi’s reaction the next morning, as the bandages and
plastic caps over her eyes were removed, was spellbinding.
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At first, she squinted, looking confused as she tried to take in her surroundings. As her line of sight extended and the realisation dawned that she could see, tears of joy rolled down
her broad cheeks. Ruit lifted Kanchi’s baby out of his cradle and into her arms. She held her little boy up close to her
face, looked at him incredulously, and kissed him softly. She was too overcome to talk, but her face, alight with love and
wonder, told a thousand words. ‘Seeing Kanchi kissing her
baby, that’s what sight is all about, it’s all about seeing loved ones again properly,’ Ruit says.
The surgeon’s smile that day was as broad as Kanchi’s.
After more than 120,000 similar operations in Nepal, and
hundreds of similar outreach camps throughout the world;
after being showered with awards and accolades for pioneer-
ing this unique, small- incision cataract surgery, it is still his patients’ beaming faces that gives Ruit the greatest satisfaction in life. What he loves, more than anything else in the world, is giving the gift of sight to people who would otherwise have been completely overlooked, and who are sometimes left in
back rooms to die.
He knows only too well that being blind in a country
like Nepal absolutely devastates the lives of people like
Kanchi.
The steep, narrow mountain roads are dangerous to
navigate. The blind have no braille, no guide dogs, no white
canes, and no special schools. They often cannot afford the
bus fare to Kathmandu or a local clinic. Despite the image
of village life as a supportive community, the harsh reality
in countries like Nepal is that, if the blind cannot contribute to their family’s subsistence farm, they are often shunned as just another mouth to feed.
xvii
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For more than three decades, Ruit’s mission has been to
take his life- transforming operations to the blind. He calls them ‘children of a lesser God’. No road has ever been too
far or too steep.
Kanchi could easily have been Ruit’s sister, his mother, his
aunt or his neighbour. Ruit knows these people; he has lived
their life.
xviii
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1
OUT OF THIN AIR
Sanduk was born in 1954, several hundred kilometres
away from the eye camp Kanchi was brought to, in the ice-
encrusted village of Olanchungola, 3200 metres above sea
level in north- eastern Nepal.
The village of 200 people lay huddled in the Tamor Gorge,
in the lee of Kanchenjunga, the third highest mountain in the world. Walung, as the village was also known, had been home
to the Walunga tribe, who had settled there after migrating
from Tibet seven generations previously. It’s one of the most desolate and isolated places in the world. Taplejung, the
nearest large town, is four days’ walk away, due south. On
top of a hill swathed in giant rhododendrons, Sanduk’s family would visit the 500- year- old monastery, Diki Choeling, one
of the oldest in the nation. The only thing beyond the monas-
tery were the Himalayas.
Sanduk was born in the lowest tier of a rigid class system,
with absolutely nothing to his name, no money and no connec-
tions. His father, Sonam Wangul Ruit (the family added ‘Ruit’
1
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to their surname ‘Wangul’, when they moved to Kathmandu in
the 1960s, after their ancestors from the village of Ruthok
in Tibet), is one of the few people left in the world who can tell you stories about yetis, the half- man, half- beast said to inhabit the high snowfields of north- eastern Nepal. With only half his teeth, almost completely deaf and a blanket wrapped