The Barefoot Surgeon

by Ali Gripper

  arrived at the Siddhartha Vanasthali School, Sanduk was fluent in Nepali, had reasonably good English, and had a flair for

  biology, literature and history. ‘I’d begun to enjoy the feeling of doing well,’ he says. He also knew that completing high school might open the door for him to study at university, something nobody in his family or village had ever considered possible.

  He put his head down and studied like a demon.

  By the time he was in high school, Sanduk was light years

  away from the mischievous village boy he’d once been. He

  was a conscientious student. He had an iron will to get ahead in life and make his mark on the world.

  A relative let him stay in his run- down old flat on the

  outskirts of the city. It was just one room and a kitchen, and 34

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  there was no electricity. He studied by candlelight, long into the night, every night. He was determined to win a scholarship to a prestigious university. He peddled the long distance from the flat to school on a shoddy second- hand bicycle.

  Ukyab noticed how focused his cousin had become. He

  seemed to know exactly what he wanted to do. ‘I knew even

  back then, that he would achieve what he was after.’

  While Sanduk was away at high school in Kathmandu,

  two dramatic events occurred that would change his life.

  Several years into his education, Sonam and Kesang suffered

  another devastating blow. Their youngest daughter Chundak

  developed a severe fever and died. She was eight years old.

  Although Sanduk hardly knew his little sister, he had watched his mother’s pride as her rosy- cheeked daughter helped her

  around the home. His parents had already lost their first son, before he was born, and now they had lost a daughter as well.

  Returning home to Hille during his school holiday shortly

  after Chundak’s death, Sanduk watched with quiet despera-

  tion at the way it changed his parents. Sonam, always a man

  of few words, refused to speak about it at all. But Sanduk

  noticed the deep worry lines that had etched his forehead. He suddenly looked a decade older. As for Kasang, the loss also

  aged her dramatically as well. She continued looking after the rest of the family, but to Sanduk, she seemed to have shrunk

  under the weight of her sorrow. She seemed shorter, and was

  rail thin. Sanduk felt his parents’ anguish keenly.

  ‘Child mortality rates were high at that time in countries

  like Nepal, about 25 to 30 per cent, but that didn’t stop the heartache,’ Sanduk says. ‘It was part of life at that time in Nepal. But I knew they must have been really heartbroken.

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  As a father, I can’t imagine anything worse. There’s nothing

  parents dread more than losing their own children.’

  No- one could have guessed there was worse to come.

  During Sanduk’s last year of high school, Sonam enrolled

  fifteen- year- old Yangla in a girls’ school not far from his, the Mahendra Bhawan Higher Secondary School. Yangla moved

  in with him and they soon created a special little world of

  their own.

  Her sweet demeanour and beautiful brown eyes fringed

  with dark lashes were like a balm after Sanduk’s six years of austerity at boarding school. He treasured every moment

  of domestic comfort. She would place a blanket over him

  when he was falling asleep, and after every meal, she would

  ask her brother, ‘Have you eaten enough?’

  He would buy the groceries and Yangla would cook. They

  went out to the movies. Their prized possession was a tran-

  sistor radio, and Yangla would sing as she’d cook, often to

  Nepali love songs by the likes of Aruna Lama. The flat was

  filled with her melodious voice.

  When Sanduk had examinations, she’d wake him up

  early with cups of chia, the sweet Nepalese tea brewed with cardamom, cloves, cinnamon, milk and sugar. ‘She’d say to

  me, “Brother, brother, you have to get up and study!” She

  was so proud of how well I was doing. They were such

  happy times.’

  For a year, their lives seemed to gleam with possibilities.

  Yangla was studying as hard as her brother. They dreamed

  about their futures: Yangla as a teacher, and Sanduk as a pilot or businessman. Yangla had admirers who wanted to ask her

  out, so Sanduk kept a protective, brotherly eye on her.

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  But in the second year of school, Yangla started losing weight.

  Fast. No matter how much she ate, she couldn’t seem to put it back on again. She was always coughing. Sanduk wrote a letter to his parents in Hille. Sonam came to Kathmandu as soon as

  he could, and they took her to two different hospitals. The

  doctors examined her skin, her phlegm, and gave her an X- ray.

  The tests confirmed their worst fears. She had tuberculosis.

  Yangla was taken to a sanatorium up in the hills, about

  10 kilometres out of Kathmandu. Sanduk used to cycle there

  every couple of days, and Yangla would always be sitting up

  in bed, looking out the window, waiting for him. They had

  long talks about life, and their family and friends. Within

  weeks, she started coming good. She put on weight. Her eyes

  were bright. She started singing her favourite songs softly

  under her breath.

  She even began working in the family’s shop in Hille,

  charming the customers with her pretty face. But just when

  they all thought she was out of danger, she started losing weight again. This time it just fell off her already bird- like frame.

  Their nearest hospital, in Dhankuta, was run by the British

  Nepal Medical Trust and they told the Ruit family that

  Yangla would probably need a second line of treatment. To

  their anguish, the medicine was too expensive and too hard

  to obtain. ‘Even if we’d sold everything we could, we still

  wouldn’t have been able to afford that medicine.’

  There was an unsaid expectation that as the elder brother

  with the most education, Sanduk would be the one most likely

  to be able to save her. But he was only eighteen years old. He didn’t have any medical connections yet, nor any money.

  He would never feel so helpless again in his life. He wanted

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  to scoop her up into his arms and knock on every door for

  help. He would have changed places with her in an instant.

  ‘It was horrific, watching her slip away from us, knowing

  the drugs that would have saved her were unobtainable to

  us. To hear the doctor say “We can’t do much about her,

  so maybe you should take her home” was one of the worst

  moments of my life. I wanted it to be me, not her.’

  The last time Sanduk ever saw Yangla, she was in their

  parents’ shop, trying valiantly to sell clothes. She had become so thin it was almost painful to look at her. Her eyes had

  become enormous as tuberculosis ravaged her slender figure.

  ‘Her skin had gone very dark and she was speaking slowly.

  She tried to be cheerfu
l but I think she was waiting for destiny; she had quietly accepted that she would not live for long. She was in a really bad way,’ he recalls. She told her brother she just felt so tired, and there was nothing left to do.

  One of the hardest things Ruit has ever had to do in his life was to go back to Kathmandu the next day to sit for his leaving certificate to graduate from high school. If he hadn’t gone, he would have to wait an entire year to sit the same exam.

  Sanduk held his sister’s hands in his. ‘She looked directly

  into my eyes and said, “I may not see you again, dear brother.

  Do good things in your life.” It was a look of both resignation and lost hope. The desperate grip of her hands was unforgettable. It was as if she was clinging to life itself.’ She was telling Sanduk, with her eyes, and with her grasp, with all the strength she had left in her, that he had to do something to help people like her, and that he had to do it now.

  Somehow Sanduk managed to get up and walk out of that

  room where she lay dying, go home and pack his bags, and

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  return to high school in Kathmandu. Yangla passed away a

  few days later. He walked around the school grounds in a daze.

  It seemed impossible to study. He was so restless, so agitated.

  His chest hurt. His throat ached. He couldn’t concentrate.

  He found it hard to talk to anyone. It seemed futile to start anything. He was haunted by the image of Yangla looking up

  at him, calling him ‘elder brother’ and placing all her hopes in him.

  ‘I kept thinking, What if? What if we’d had enough money?

  What if we’d taken her to a doctor sooner? What if we’d

  known people who could help? ’

  He couldn’t listen to the radio. Every song reminded him

  of the way she used to sing. Schoolchildren in the street

  reminded him of the classes she would never teach.

  He packed away her mattress and her clothes. He lay

  awake at night, tossing and turning, tormented by the thought that maybe Yangla could have been saved if they had known

  what to do, or had more money, or known more people in

  the right places.

  Before Sanduk had turned nineteen, he had already lost

  half his family. His elder brother to diarrhoea before he was born, then his eight- year- old sister Chundak to fever, and

  now his beloved Yangla to tuberculosis. But unlike his father, Sanduk could not accept such tragedy as simply his lot in

  life. Stripped raw by shock and grief, it was as if a veil had lifted. What had happened suddenly seemed like a monumental injustice.

  ‘It was not unusual for 50 per cent of your family members

  to die in Nepal. For most people, losing one out of four children was still considered normal fate. But suddenly, I simply could 39

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  not understand, and I could not accept, that half my family

  had to die simply because we were poor and lived in a remote

  part of the world. Losing Yangla, as well as Chundak, would

  be something that time would never really heal. Our family

  got on with life, but we never recovered from it.’

  He was infuriated that his siblings had died from diseases

  that were readily cured in the West. It suddenly seemed

  completely unacceptable. ‘I think what did it was the final

  connection with my sister, that moment that she looked at

  me, that I knew exactly what I had to do.’

  He had to be a doctor.

  At the time, it was unheard of for someone from such a

  remote mountain village with no school to study medicine.

  Sonam, a man of iron will himself, was firmly against it.

  ‘He just thought it was out of the box for someone from the

  Walung tribe. He wanted me to help him with the family

  business instead.’

  But Yangla’s death gave him courage and self- conviction.

  He put his head down and studied hard for a Colombo Plan

  scholarship, which uses foreign aid to pay for the university fees of the poorest but brightest Indian and Nepalese students.

  His aim: King George’s Medical University in Lucknow,

  northern India, known as one of the ‘Ivy League’ universities of the subcontinent.

  More than 150 students sat for the examination. Only eight

  were successful. When Sanduk received the news he’d been

  accepted, he didn’t feel jubilant, or exultant, the way you do if you’ve kicked a goal in the grand final. ‘I felt really calm.

  I knew I was on the right path. It was the first step I needed to take to make sure my brother and sisters had not died in vain.’

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  Yangla was cremated in Hille. There’s no trace of her,

  save for one poignant photograph of her about the age of

  eight, sitting demurely on a rock in the sunshine. There is

  no necklace, no earrings or keepsake to remember her by.

  Her gift was to steer her elder brother toward becoming

  a doctor. Yangla may be out of sight, but she is not out of

  mind. Sanduk’s love for her, as well as for Chundak, and his

  unknown brother, lives on in every patient he treats, every

  person he cares for.

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  5

  The gift

  For most Nepalese, gaining an education usually means trav-

  elling far from home, and in 1972, when Ruit was eighteen,

  he set off to study medicine in the third largest city of

  northern India. For the next six years he was to live among

  more than one million people, more than 1000 kilometres

  from his family.

  King George’s Medical University was a world away from

  St Robert’s School and the Siddhartha Vanasthali School; the

  term ‘Ivy League’ was used for good reason. Like many of

  the other buildings in Lucknow, King George’s was an elab-

  orate mixture of Indian and Victorian architecture. Its bright white pavilions, domes and scalloped arches, built in 1912,

  made it look more like a giant wedding cake than a campus.

  Ruit certainly found it intimidating. He felt sick with nerves as he crossed the emerald green lawn in his best clothes,

  carrying a small duffle bag from home.

  His hostel room had space within the chalky white walls

  and high ceilings for a bed, a desk and all his textbooks.

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  His 200 colleagues, apart from a handful from Malaysia,

  were sons of India’s upper class who went on to become the

  top specialists in India, the United Kingdom, the United States and Europe.

  Ruit had competed with more than 150 of India and

  Nepal’s brightest students to win a scholarship. He had just

  as much right to be there as everyone else. But as he sat down in the lectures of anatomy and physiology, biochemistry and

  pharmacology, he could not shake off the feeling of being an

  interloper. He was the son of a salt trader. He was an outsider.

  He was one of the few Nepalese among a sea of Indian

  faces. Who was he
to be there with the best and brightest of

  the subcontinent?

  ‘I was painfully aware that I came from one of the lowest

  castes. I still felt very much like that country hick I’d been dubbed in boarding school. I looked different to the others—a little bit Mongoloid. The other students joshed about with

  each other, saying, “Hey, man,” that sort of thing. But they

  didn’t mix with me at all. They kept their distance.’

  People often underestimated Ruit because he is quietly

  spoken. He downplays the caste system, but the reality was

  that the Sherpas and Walunga people were downtrodden by

  the higher castes, especially in a field like medicine. Ruit was determined to prove he could achieve things.

  But first there was the practical matter of adjusting to the

  climate. For someone who had grown up in a village with

  sub- zero temperatures near the third highest mountain in

  the world, the monsoonal rains and scorching heat nearly

  knocked him sideways. Most days in summer the tempera-

  ture soared well above 40 degrees. ‘I remember walking over

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  the bridge over the Gomati River to my hostel, and I could

  see that the bitumen was actually literally sizzling,’ he says.

  Despite being an outsider, Ruit made a couple of good,

  close friends and on Saturday nights they would go out in

  a rickshaw and feast on kebabs and biryanis, the northern

  Indian delicacy of aromatic rice, finishing with kulfi, the city’s famous frozen dessert, and see an English or a Hindi film. On the weekends, he would wend his way through the city’s laby-rinthine streets, staring in astonishment at the cornucopia of goods crammed into the city’s shops; colourful kites, bolts

  of expensive muslin, loaves of bread, handmade sweets, and

  fresh roses and jasmine.

  His familiar old nemesis, homesickness, turned up frequently.

  The post was slow between India and Nepal, and no-one in his

  family was a fluent writer, so often it was six months before he had news from home. During low moments, he would find

  consolation by strolling down to the river at sunset. Lucknow was famous for its grand palaces and tombs built during

  the Mogul empire, and one of the grandest of these was an

  18th- century mosque, the Bara Imambara. Somehow, gazing