The Barefoot Surgeon
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tual power, also welcomes all faiths. As well as both Hindu
and Buddhist shrines, a small Christian chapel has been built on one side, and a mosque on the other. On clear days, when
the pollution rolls away like a veil, you can see how beautiful Kathmandu Valley must have once been, it’s rough and lovely
maze of homes and offices punctuated by white and gold
temples encircled by the greatest mountain range on earth.
They both love the early morning light when the temple is
lit up with thousands of tiny butter lamps and the place thrums with the murmured invocations of Om Mani Padme Hum.
This is what Ruit misses, apart from his family, whenever he’s travelling, and it is the first place he seeks whenever he comes home. It is a place of profound consolation that never fails to restore him. ‘I don’t know how it works, but it always drains away anything that happened the previous day.’
Once at the top, Ruit and Nanda thread their way among
the golden spires and the forest of prayer flags flapping crisply in the breeze. Sometimes they might talk about the children,
but often they just walk together in companionable silence.
Ruit is a man of seemingly indomitable energy who, despite
all he has already achieved, still has much to give to the world.
But just for a few minutes every morning, he lets go, and,
with Nanda by his side, stops for a few moments to take in
the view of the eagles soaring effortlessly over the valley. He is Sanduk, Dragon of the Sky, after all, and this is his realm.
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Epilogue
Wiping out avoidable blindness is an audacious vision. Many
people have said it could never be done. Slowly but surely,
however, by sticking to the task with doggedness and dedi-
cation, Ruit and his international medical teams are tackling the world’s backlog of people who are needlessly blind. It
might not happen next year, or even in the next decade,
but this great injustice—something that affects more than
30 million people around the world—will one day be a thing
of the past.
Already in the last 30 years in Nepal, Tilganga has halved the number of people who are blind in Nepal. The rates have gone
down from 0.8 to 0.4 per cent of the population. Although
cataracts are not something that can ever be truly wiped out, as they are a natural part of ageing, the ones that Ruit and his teams see now are far less mature. Of course, he hasn’t been
able to do this alone. The results are the collective determination of powerful organisations supporting him including The
Fred Hollows Foundation in Australia, Vision Himalaya in
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Switzerland, and the Himalayan Cataract Project in the United States.
Despite the abundance of feel-
good patient stories, it
is often the economic logic of restoring sight that prompts
business people to support Ruit. More and more, Tilganga
is about sitting down with finance ministers as well as health ministers to show in hard- headed terms that investing in
vision is a huge boost for the economy. A study by Pricewater-houseCoopers showed that every dollar invested in restoring
sight in a developing nation generated more than four dollars in economic benefits. Restoring sight has the same economic
value to a community as providing primary school education
and building bridges.
The good news is not just found in Nepal. The world is on
the threshold of seeing the end of avoidable blindness. The
2013 Global Burden of Disease Study showed that, between
1990 and 2010, the combined effects of the growing and
ageing world population should have pushed the number
of blind people northward of 51 million, rather than the
32.4 million the tally stands at today. Simply put, that means that an additional 18.5 million people can now see because
of the work these medical teams are doing. Half of these are
from cataract surgery.
If you would like to help Sanduk Ruit’s work, go to: the
Tilganga Institute of Ophthalmology at tilganga.org (in
Nepal); the Himalayan Cataract Project at cureblindness.org
(in the United States); or The Fred Hollows Foundation at
hollows.org (in Australia).
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A young Sanduk
(back row, second
from right) at
St Robert’s boarding
school, Darjeeling.
Sanduk’s little sister, Yangla.
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‘Soulmates’. Ruit and Fred Hollows in Nepal, 1985.
Ruit and Nanda
exchange wedding rings,
26 January 1987.
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Ruit and Nanda on their extended honeymoon in Sydney, 1987.
(Left to right) Gabi holding her daughter Anna-Louise, Nanda holding her son Sagar, Ruit with Cam Hollows, Rex Shore and Fred Hollows holding Emma Hollows.
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(Left to right) Ruit’s father Sonam, his daughter Serabla, his mother Kasang, and on his lap, his second daughter Satenla. (Photo Michael Amendolia) Examining Tran van Giap in Hanoi, 1992. (Photo Michael Amendolia) The Barefoot Surgeon_ILLO.indd 4
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Ruit’s team crossing a river in Mustang, 1992. (Photo Michael Amendolia) Ruit with an ecstatic patient, Mustang, 1992. (Photo Michael Amendolia) The Barefoot Surgeon_ILLO.indd 5
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Ruit operating in a makeshift
surgery in Mustang, 1992.
(Photo Michael Amendolia)
Ruit with US surgeon Dick Litwin, Mustang, 1992. (Photo Michael Amendolia) The Barefoot Surgeon_ILLO.indd 6
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Scrubbing up before surgery. (Photo Rex Shore)
Taking a break with Australian Ambassador Les Douglas in Mustang, 1992.
(Photo Michael Amendolia)
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Hollywood actor Richard
Gere visiting Ruit at the
Tilganga Institute of
Ophthalmology, Kathmandu.
Ruit’s patients regard him as a God in Tibet, 1998. (Photo Michael Amendolia) The Barefoot Surgeon_ILLO.indd 8
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A corneal transplant by the
Bagmati River, Kathmandu.
(Photo Michael Amendolia)
The Tilganga Institute of Ophthalmology, Kathmandu, 2011. (Photo Michael Amendolia)
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Ruit restoring sight to a nine-year-old boy in Indonesia. (Photo Michael Amendolia)
With The Himalayan Cataract Project’s Dr Geoff Tabin in eastern Nepal.
(Photo Michael Amendolia)
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On a family trekking holiday near Mount Everest. (Left to right) Ruit, Satenla, Nanda, Sagar and Serabla.
The Hollows and Ruit families, Kathmandu, 2014. (Left to right) Rosa Hollows, Serabla Ruit, Nanda, Satenla Ruit, Ruit and Ruth Hollows.
(Photo Michael Amendolia)
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> Operating in his
famous barefoot
style in Ladakh,
Northern India.
(Photo Michael
Amendolia)
Examining patients
in Myanmar
with former Fred
Hollows Foundation
CEO Brian Doolan.
(Photo Michael
Amendolia)
A Muslim patient
gives prayers of
thanks for his new
vision in Indonesia.
(Photo Michael
Amendolia)
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Ruit training surgeons in
Pyongyang, North Korea.
(Photo Michael Amendolia)
A patient cries with happiness after Ruit has given her the gift of sight in North Korea. (Photo Michael Amendolia)
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Thai Princess
Sirindhorn at an
eye camp in
Lumbini, Nepal.
(Photo Serabla Ruit)
On the road in
Bhutan, 2016.
(Left to right) Serabla,
Ruit and the author.
(Photo Ronald Yeoh)
Bhutan, 2016.
(Left to right)
Dasho Palyor Dorji,
Ashi Saritri, Princess
Ashi Kesang Wangmo
Wangchuk, Her
Majesty The Queen
Grandmother, Princess
Beatrice of York,
Ruit and Mei Wen.
(Photo Michael
Amendolia)
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Training surgeons at Pullahari Monastery, Kathmandu, 2014. (Photo Michael Amendolia)
Ruit’s supporters Mei and Chiu Chi Wen just before a patches off moment in Hetauda, 2017. (Photo Michael Amendolia)
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Dr Reeta Gurung, CEO of The Tilganga Institute of Ophthalmology.
(Photo Michael Amendolia)
At home in Kathmandu.
(Clockwise from top):
Sagar, Satenla, Ruit,
Nanda and Serabla.
(Photo Michael Amendolia)
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Postscript
Rex Shore died on 16 December 2017. For the previous three
years he had lived within walking distance of Les and Una
Douglas in Mission Beach, Queensland, having finally retired
from ‘The Cause’. He requested that his ashes be scattered in the ocean in front of their home. Les and Una hung Nepalese
prayer flags down the path to the beach, lit incense sticks, and placed them in front of the small statue of Buddha which Rex
always placed flowers on every time he visited. At Tilganga,
Ruit and his staff commemorated his death by setting up a
new award, The Rex Shore Community Award. ‘I’m sure he
would have loved to have been remembered this way. We all
hold him in our hearts.’
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Acknowledgements
I owe a great debt to author Sue Williams, who believed in
this book as soon as I told her about it over a coffee in Kings Cross. Sue opened the door to publishing, and offered sterling advice whenever I faltered. She led by example, showing the
true grit needed to write a book. I honour the late author
David Oliver Relin, whose biography, Second Suns, laid the groundwork for my first interviews. My heartfelt thanks to
Marianne Gizycki and Carolyn Parfitt for advice on the early
draft. For their following people for their recollections, I am so grateful. In the United States: Lisa Ling, Richard Gere,
Professor David Chang, Dr Dick Litwin, Professor Alan
Robin, Professor Geoff Tabin, Job Heintz. In Nepal: Dr Reeta
Gurung, Shankya Twyna, Nanda Ruit and Serabla Ruit. In
Bhutan: Her Majesty the Queen Grandmother, Princess
Ashi Kesang Wangmo Wangchuck, Dr Dechen Wangmo,
Dr Kunzang Getshen, Matthieu Ricard, Mei and Chiu Chi
Wen. In India: The office of His Holiness the Dalai Lama,
Thinlay Ngodup, Princess Beatrice of York, Sanjay Bahadur
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Thapa. In Australia: David Britton, Professor Hugh Taylor,
Joel Edgerton, Les Douglas, Rex Shore, Mike Lynskey, Ray
Martin, Gabi Hollows, David Moran, Indra Ban, Sarah
Elliott, Catherine Marciniak, Pat Fiske. In New Zealand: Sir
Ray Avery.
I owe special thanks to Michael Amendolia for 30 years
of friendship and creative collaboration, for his world- class photographs and for introducing me to Dr Ruit. To ladies
of letters Joyce Morgan and Elizabeth Fortescue for cheering
me across the finishing line. And most importantly to my
parents, Jillian and Terry, and my siblings Neil and Jane,
Russell and Annabelle, and Anne and Dyanna, for a lifetime
of love and support. Praise is due to Serabla Ruit for her
superb translation and editing skills. Finally, to Sanduk Ruit, Dragon of the Sky, for taking me on the greatest ride of my
life. Thank you for the honour of asking me to tell your story.
May your work continue to strengthen and grow.
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Appendix
The history of cataract surgery
Couching was the only technique available until the late
1700s when French ophthalmologist Jacques Daviel worked
out a crude way to extract the calcified white discs known
as cataracts. The results varied from good to disastrous.
A 1- centimetre incision was made in the eye, and the lens
removed, after which the wound was stitched up with large
needles. The patients were forced to lie flat on their back for days with their heads wedged between two sandbags to stop
them from moving. Later on, doctors used forceps or suction
to capture the cataract, and the wound was closed with silk
sutures, but these were minor improvements; infection rates
were sky high.
After the lenses were removed, the patient was fitted
with spectacles so thick that they were dubbed ‘Coke- bottle
glasses’. The patient could see, but only through a narrow
tunnel, with very little peripheral vision. Everything was
also magnified by about one- third, so objects such as a cup
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“0ne of the great joys
of my life is having been
of tea or a stack of firewood would seem much closer than
part of the training
they really were. One patient described walking along steep
mountain paths in them as ‘like stepping into thin air’. If their of Sanduk Ruit and his
glasses were lost, the patient was left completely blind. This training others.”
technique was still the most common treatment used in Nepal
- Fred Hollows
until Ruit began performing modern intraocular surgery.
Internationally, the big breakthrough came in the 1950s, in
When Fred Hollows met Dr Sanduk
St T
homas’ Hospital, London, when British ophthalmologist
Ruit in the 1980s he found a kindred
Sir Harold Ridley came across a curious phenomenon. Oper-
spirit.
ating on World World II fighter pilots, he noticed that despite Both shared the same vision –
their Perspex windshields shattering during enemy fire, the
to make eye care, particularly modern
cataract surgery, accessible and
plastic fragments lodged in their eyes had not inflamed or
affordable for the poorest people in
damaged the tissue at all.
the world. Together, they made
Dr Ridley went on to pioneer a revolutionary technique by
it happen.
creating artificial lenses which were implanted in the eye after Their efforts to establish the
the clouded old lenses were removed. By the late 1970s and
Tilganga Institute of Ophthalmology
early 80s, the lens became much smaller and more sophisti-
and its revolutionary Fred Hollows
Intraocular Lens Factory in Kathmandu
cated, and the technique slowly gained widespread acceptance.
dramatically reduced the cost of high
It was regarded as the golden age of ophthalmology.
quality cataract surgery for people in
Nepal and other developing countries.
Now, The Fred Hollows Foundation
can restore sight for as little as $25
in some countries.
4 out of 5 people who are blind
don’t need to be.
Just $25 can restore sight.
Donate at www.hollows.org
or call 1800 352 352.
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“0ne of the great joys
of my life is having been
part of the training
of Sanduk Ruit and his
training others.”
- Fred Hollows
When Fred Hollows met Dr Sanduk
Ruit in the 1980s he found a kindred
spirit.
Both shared the same vision –
to make eye care, particularly modern