by Ali Gripper
wasn’t really a shock to me,’ says Ruit. ‘I’ve seen a lot of that in Nepal as well as many places in Africa and Asia.’
But what he was shocked by was the severity of the cataracts
in the 1000 blind people awaiting him at a large, Soviet- style hospital. The examination room was crammed with farmers,
peasants, children and the elderly. All of them had been handpicked by the government and, as Ruit had rightly guessed,
all of them had been completely blind for years.
Over the years, Ruit has built up a lot of stamina; he
can easily operate all day, seeing an average of 70 patients.
But that bitterly cold surgery—it was on average minus
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10 degrees—working with the barest, most basic of equip-
ment, much of which his team had brought themselves from
Kathmandu, was a true test of his endurance.
He had a jacket and some sweaters, but it was still so cold
that he had to operate with a couple of blankets wrapped
around him. He kept his hands warm by constantly rubbing
them. There was no light and no electricity, forcing Ruit to
send Khim Gurung back to Pyongyang for a generator. The
government provided Khim with one, as well as car to take it
back to Haeju.
Most of the patients had never seen a doctor before. Many
of them were very fearful and Ruit tried to speak to them as
soothingly as he could through the interpreter.
Over the next eleven days, Ruit and his team screened 2230
patients who had been hand- chosen by government officials,
and restored sight to 702 people.
‘It was a very bleak scene. My heart went out to so many
of them. I’d never seen so many advanced cases. Everyone of
them had been blind in both eyes for years. Almost all of them had totally white cataracts. Once I saw the magnitude of the
problem, I was so glad we’d decided to come, despite all our
fear of being deported, or worse, thrown into prisons.’
Reeta Gurung has been back to North Korea several times
since that first trip to train more than 40 surgeons. ‘The atmosphere was like a big thick cloud covering you,’ she recalls.
‘You don’t have the freedom to do anything. It’s when you go
to a place like that and come back home that you realise what freedom really means. You really feel the tension. Everything is very tightly controlled. I remember getting a sense of how desperate the patients were when I peeked into the lunch room 226
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[of the hospital] one day. I saw a mother and an older person, maybe her dad, sitting on the floor, desperately clutching the papers for them to receive an examination. I saw then for
the first time how much they needed medical help.’
Ruit and his team were used to seeing all sorts of reac-
tions when patients can finally see again, but the scenes that they witnessed in North Korea astonished them. The patients
didn’t smile or laugh, or thank Ruit or the team. Instead, most of them rushed to express their adoration to the Dear Leader, bowing and crying in gratitude in front of giant portraits of Kim Jong- Il. ‘We praise you!’ they said, with tears running
down their cheeks.
They were convinced it was their supreme leader who had
restored their sight rather than modern surgical skills. ‘Some people might call it an extreme personality cult, but I had
no problem with their devotion to their leader,’ Ruit said.
‘I didn’t want any thanks. I did my job well, and the elation on their faces spoke a thousand words.
‘I wasn’t really affected by them prostrating to their
leader like that—they believe he is next to God. If it were a Muslim country, they would talk to Allah, and if it were
a Christian country, they would talk to Jesus and Mary. If
it is a Hindu country, they would talk to Lord Krishna or
Shiva. We weren’t there to change the political system, after all, we were there to help them see again.
‘People are the same wherever you go. They have two eyes,
two hands, and all the same desires as everyone else. They
were just a lot of people who needed our love. They are the
same as you or me. The two North Korean doctors watching
over us were totally amazed by the results. We had a meeting
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with the minister of health later that day, who said, ‘We want to make this an ongoing program.’ I don’t think I’ve ever felt so proud in my life.’
Since that first camp, Tilganga has held more than ten
surgical camps in North Korea, trained more than 40 doctors
and nurses, and performed operations on more than 7000
patients. ‘What I’m proud of is that we have helped them
believe in their own merits, that they can do it as well as
anywhere else in the world.’
On the first trip to Haeju in 2005, the most terrifying
moment came on the train trip back to Pyongyang. A guard
started opening up their luggage and rummaging, excruciat-
ingly slowly, through everyone’s belongings. Amendolia had
taken about 25 reels of photographs. He had been approved as
a member of the medical team, but he didn’t have permission
to be there as a journalist—let alone to take film out of the country—so they had divided it up among everyone’s luggage.
Ruit was trying hard not to look nervous, but the sweat
was trickling down the back of his hair into his collar. His
heart was pounding. He knew this was a country capable of
sending entire families and their children to notorious work
camps for the rest of their lives for minor transgressions, such as saying anything critical of the Dear Leader. And here they were with bags packed with hundreds of illegal photographs.
Ruit thought they were going to be arrested, thrown in jail
or deported. After what seemed like an eternity, the guard
moved onto another group, but everyone—Ruit and Amen-
dolia especially—felt as if they’d lost a few years of their lives.
~
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Despite all his success, there was one thing Ruit continued
to dread: live surgery. The largest crowd he performed in
front of was a gathering of 4000 public health profession-
als in the Philippines. In Hong Kong, Thailand and China,
he would submit to the public ordeal, as he simultaneously
explained his every move to audiences of more than 500 as
they watched his every microscopic move on a giant screen.
He’s one of the few surgeons in the world who can carry it
off with aplomb, but even he finds it an ordeal.
‘Live surgery is still very, very daunting for me,’ he says.
‘Nerve- wracking. You have to mentally prepare the night
before, rehearsing every move in your mind. And try to get
a really good night’s sleep. Then you need complete compo-
sure as you do it.’
But the gruelling process is also what he calls his ‘greatest public relations weapon’.
The public ordeal had a knack of paying off ev
ery time.
‘Seeing my work so clearly always seems to encourage gener-
ous people give something to Tilganga,’ he says. Witnessing his work has the same impact on smaller groups, too; a Nepalese
entrepreneur whose family were invited into his surgery to
watch him at work afterwards donated half a million rupees
toward his cause.
It doesn’t take long for most observers to tap into the magic of Ruit’s work. The operating chair is the most comfortable
place in the world for Ruit, and watching him at work is just as comforting.
The pre-
theatre atmosphere is similar to that of an
orchestra about to go out and perform. There’s the ebb and
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of a team who have worked together for decades and who
can anticipate each other’s every move.
A hush descends at the start of the day’s work as the door
swings open and the first patient is led inside.
The team moves into action, unwrapping the plastic around
new disposable instruments, adjusting the reassuring beeping
of the phacoemulsification machine as Ruit bends over his
patients with his Muller Corella microscope, the Rolls Royce
of microscopes, which shows his every move on a television
screen in the theatre for trainee surgeons to watch. He is
always barefoot, his wide sole on the floor pedal delicately
focusing the microscope.
Often, once the patients are helped off the operating table
and led toward the doors, they will turn and clasp their hands in gratitude, bowing to him. It’s one of the few times that
Ruit, who steadfastly keeps his cool when anyone praises
him, seems genuinely pleased.
One of the most difficult patients he’s ever operated on was
a mentally unstable man in China with an extremely mature
cataract. Ruit was making the initial entry into the eye with his knife when the patient rose up from the table and began
staggering around the room with the instruments still sticking into his eyeball, like something out of a horror movie.
‘You can’t physically force people, and we couldn’t speak
to him as he had no English or Nepali. It was a difficult
moment,’ Ruit recalls. Eventually, they found a nurse who
spoke Chinese and asked her to come in. She came running
into the theatre and spoke to him very quietly; in the end,
it was physical touch that helped—the loving touch of the
nurse who gently stroked his cheek, and spoke to him quietly, 230
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holding his hand. Slowly, she got the patient back down on
the table. As Ruit was approaching the sensitive part once the cataract was out, and was sealing the wound, the nurses held
him very firmly until they had finished the procedure.
‘We can communicate a lot without words. We never,
ever, try to do anything with force. If you do it by force
then the patients will rebound by force. If you try to caress them with a kind touch they always understand, I think. If
someone with soft gentle hands touches the cheeks and gives
them a little massage on the hand, they feel very comforted.
If someone is really caring, perhaps holding their hand and
caressing them, then that’s very good.’
Ruit swells with pride whenever he talks about his team.
‘I always say I have the blessing of a wonderful team. They
are so efficient and I don’t have to say anything. Everything gets done and not many people are lucky like that. I know
they have unquestionable faith in what I am doing, but, for
my part, I have tried to share my vision with them. I’d like to do more of that. Some of them have been with me for more
than 30 years. The staff completely spoil me—some of my
friends from the West really envy me. It’s taken a long time, but I feel that the team has been defined and sharpened so
well that they are one of the best teams in the world. We
spend the whole day together in Tilganga, and weeks together
when we are on the road. We work very hard together getting
our equipment on the back of trucks, holding the microscope
in our arms and carrying instruments in our bags, and, when
we first started, we’d sleep on the top of cow sheds if we had to. We almost always eat together and share drinks in the
evening. The camaraderie is fantastic. We always try to create 231
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financial incentives, always recognise everyone’s efforts, and give them the opportunity for training, and a better work-place. The main thing they all know, I hope, when they’re
working with me, is that I appreciate them.’
~
Despite Ruit’s love of being with his team, sharing his
thoughts and dreams with them, there were parts of his life
he kept private. What many would have had little idea about,
for instance, was that for many years he was in a state of
quiet desperation at home, spending hours on the phone and
online with an American security network that tracks missing
people. He was searching for his brother. After Ladenla had
left to study in the United States in 1990, the family had lost contact with him altogether. They were fraught with anxiety
about his health.
He traced Ladenla through the Nepalese communities in
the United States, and eventually found him repairing the
electronics and radio equipment in the boats in the harbour of Bellingham, Washington, just south of the Canadian border.
Ruit flew into Seattle Airport and met Dick Litwin, who had
driven there from Berkeley to offer his support.
It remains a baffling episode for Litwin. ‘Bellingham is a
beautiful spot with a small harbour by the ocean. I walked
ahead for about twenty minutes while Ruit and Lin [the
family’s name for Ladenla] stayed 30 paces behind me and
spoke softly to each other. Ruit didn’t tell me much; like a lot of Asians, he is very private, and if anything negative happens they don’t tend to talk about it too much or dwell on it. It was all a bit of a mystery.’
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Ruit recalls having a highly emotional lunch with Ladenla
that day. ‘I cried. Ladenla cried. The person who was looking after him cried. I was so relieved to see my long- lost brother in one piece.’
Eventually, in 2012, Ladenla returned home to Kath-
mandu, to spend time with his mother Kasang before she
succumbed to cancer.
Ruit was initially wary about his brother returning home.
He was worried about how this would influence Sagar, Serabla
and Satenla, who were all making their way in the world.
Despite his father’s urgings not to, Sagar had enrolled in
medicine at Manipal College of Medical Sciences in Pokhara,
in the foothills of the Himalayas in central Nepal. Serabla
had graduated from a business degree at HELP University in
Kuala Lumpur, Malaysia. Ruit had first flown with Serabla
to Kuala Lu
mpur to attend her orientation in 2008 and
help her settle in. ‘He was very emotional saying goodbye
to me,’ she says. She flew home for the semester breaks, and
Skyped home once a week. She had returned to work in
Kathmandu in 2013. Satenla, the youngest, was still studying
at St Mary’s in 2012, and was planning to enrol in Manipal
with her brother.
He was hugely protective of them. ‘My whole thought is
with my children and how I can help them do well.’
But Ruit’s fears were assuaged when Sonam bought
Ladenla a small house in Kathmandu, and he saw how
quietly Ladenla lived, going to the temples and visiting
family and friends, focusing on his recovery from his drug
addiction.
‘He’s well now,’ says Ruit. ‘His English is fantastic, he’s
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very well presented. He’s got wonderful computer skills and
some really great, close friends. But I must admit, the whole episode gave me a lot of compassion for anyone and any
family with a relative suffering an addiction. It’s a terrible thing that causes so much heartache and suffering, not just
for the person, but their entire family. I wouldn’t wish it upon anybody.’
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24
Rebuilding from
the ruins
It is no stretch of the imagination to see Ruit in another time and place as an army general, rallying the troops. He is at his best in a crisis. On Saturday, 25 April 2015, after a magnitude 7.8 earthquake tore central and eastern Nepal asunder,
Ruit, Reeta Gurung and Suhrid Ghimire, the chairman of the
Nepal Eye Program, quickly gathered to work out a plan to
turn Tilganga into a relief centre.
They decided to keep the hospital open to treat the hundreds
of earthquake victims with head, face or eye injuries. But they knew they had to help those most in need—the mountain
villagers who had lost everything, and who were stranded in
the heavy rains with no food or shelter—as fast as possible. The damage was catastrophic. Many of the villages where families
live in mud and thatch houses had been completely levelled.
They swung into action, ordering bulk supplies of instant
noodles, rice, dhal, lentils, salt, soap, tarpaulins, water puri-fying tablets and medicine. Even though it was Sunday,