Doctor of the Poor

BY RUPAK D SHARMA
Feb 14, 2011

Dr. Sanduk Ruit's mission has been, and continues to be, to bring eyesight back to anyone who needs it, regardless of his or her ability to pay.

 

401 Dr. Ruit checking on one of his patients in the very remote village of Siwa, where the Himalayan Cataract Project operated on hundreds of cataract-blind patients. (Photo credit: Stefano Levi)

 

Around 37 years ago Sanduk Ruit endured one of the greatest sufferings of his life when his younger sister succumbed to tuberculosis. As an emotional adolescent of 16 at that time, he felt the grief more deeply and found himself entrapped in a web of depressing thoughts.

It was not that he blamed himself for her death: he had done all that he could to help her for two years before her demise. It was just that he was so devastated by the loss of someone so close to him, he was not able to find consolation in anything.

This intense feeling of personal loss, however, inspired Ruit to achieve something greater in life which unknowingly kindled a keen interest of “becoming a doctor” in him.

“Prior to the death of my sister, I always thought of becoming a pilot… Before that I used to look at my father and think of becoming a businessman… Her demise played a crucial role in moulding my career,” 53-year-old Ruit told Asia News Network.

Born in the laps of Mount Kanchanjunga, the world’s third-highest peak, in Olangchungola, northeastern Nepal, Ruit is now a world famous ophthalmologist who is known as “Doctor of the Poor” among the less privileged for introducing cheap suture-less operation technique to perform cataract surgery. He also started mass production of inexpensive high-quality intraocular lenses.

Had Dr Ruit not invented this operation technique and introduced low-priced intraocular lenses, millions of poor cataract patients in Asia and other continents would have either ended up blind or wearing glasses as thick as bottles of Coke, which offered poor vision quality.

For these contributions to the public health sector, he was recently awarded prestigious Prince Mahidol Award of Thailand. He is also the recipient of Ramon Magsaysay award, considered Asia’s Nobel Prize.

A modest and soft spoken but hard-headed Dr Ruit embarked on the mission to bring the cataract surgery within the reach of the poor.

A modest and soft spoken but hard-headed Dr Ruit embarked on the mission to bring the cataract surgery within the reach of the poor in 1984 soon after he completed his postgraduate training on ophthalmology.

Even as a fresh postgraduate student he was convinced that the only way to provide relief to poor cataract patients was through implantation of intraocular lens – an operation technique in which the eye’s lenses are replaced by a highly specialised clear plastic substitute.

But there was one obstacle: the high cost of lenses, which stood around US$100. For a poor person living in rural parts of Nepal, the amount was simply unaffordable.

“One way to overcome this problem was to get financial aid from developed countries or INGOs, which I was getting at that time. But I realised this would not be sustainable,” Dr Ruit, the founder of Nepal’s Tilganga Eye Centre, said.

He then started looking for alternatives to bring down the cost and in this course found out that the cost of the raw material, used in production of the lenses, was not more than 60 US cents. “The manufacturing companies were keeping huge profit margins,” he said.

Then in 1995 he started commercial production of the international standard intraocular lenses in Nepal at a cost 10 times less than that by companies in developed countries. The factory in Nepal now churns out 300,000 units of lenses every year. These lenses, which are exported to around 60 countries, cater to around 10% of the global demand.

Meanwhile, in the process of refining his surgical techniques and making it simpler and cost-effective, Dr Ruit and his team also developed a suture-less form of cataract surgery in 1996. Suture-less surgeries are performed by making tiny incisions on the eye through which cataract is removed and a new lens is inserted. The quick surgery, which does not require sutures due to tininess of the slits, costs as little as $20 per patient.

Dr Ruit found a new method of performing the operation but very few Nepali medical professionals supported his work. “I faced severe criticisms from medical professionals of my own country. A group of surgeons even went to meet the prime minister to complain that I was fooling around with the lives of poor people and that my invention was not of international standard,” he said.

Dr Ruit, however, stood strong and gradually medical professionals started endorsing his treatment model. Today, the surgical technique invented by Dr Ruit is a standarised treatment technology which is practiced not only by Nepali doctors but ophthalmologists around the world.

Reminiscing the days of struggle he said: “When you are right no one can prove you wrong… I took proving myself right as a challenge and I succeeded.”

 

This post was originally published on Rupak’s Bangkok Pages in March 2008.