“I can’t fetch firewood or water. I can’t cook food. I fall down many times. I’ve been burned by the fire.”
That was what 50-year old Nepalese Thuli Maya Thing told The New York Times in a recent report.
She was relating how cataracts have blinded her and had in fact incapacitated her as well, rendering her unable to care for her children, and made it impossible for her to work, which in turn meant her family suffering a loss of income and consequently having to go hungry because of this.
In poor and remote regions of the world, such as the Himalayas in Nepal, blindness is not just a medical problem but one which has real and serious consequences for those who suffer from it.
In Nepal, those who live in the higher altitudes especially are vulnerable to ultra-violet rays from the sun and prolonged exposure has resulted in more than 100,000 people suffering from cataracts. Most of these are the poor and elderly who have no access to proper or good medical care, or even if they did they would not be able to afford the costs.
But one doctor has changed all this.
He is Dr Sanduk Ruit, a Nepalese-born ophthalmologist who has pioneered a cheap and sutureless technique of removing cataracts and restoring the eyesights of hundreds of thousands of people not only in Nepal but all over the world.
And he often performs his operations in makeshift operating rooms in remote and hard-to-reach areas in the villages or high up in the mountains of Nepal and elsewhere.
Called the “God of sight” in his home country, Dr Ruit’s operation costs only US$25 and takes less than 10 minutes each. [In Singapore, for example, cataract operations can cost thousands of dollars. See here: “Cataract Surgery”.)
Yet Dr Ruit’s success rate is as high as any surgery in any private clinic or hospital in any developed country performed with the help of machines costing millions of dollars.
“A cataract is a cloudy or opaque area in the normally transparent lens of the eye. A cataract occurs when clumping of cells or protein causes a cloudy or opaque area in the transparent lens which, as it thickens, obstructs entering light.
“As the opacity thickens, it prevents light rays from passing through the lens and focusing on the retina, the light sensitive tissue lining the back of the eye.”
And this is how Dr Ruit’s technique works:
“Cataract surgeries are performed by making tiny incisions on the eye through which the cataract is removed and a new lens is inserted. The new lens that is implanted is an intraocular lens – a highly specialized clear plastic substitute.”
In its study comparing Dr Ruit’s method with that of western hospitals and clinics, the American Journal of Ophthalmology found that Dr Ruit’s technique had exactly the same outcome (98 percent success at a six-month follow-up) as the western one which used million-dollar machines.
“One difference was that Dr Ruit’s method was much faster and cheaper,” the New York Times reported.
Dr Ruit has also trained doctors from other parts of the world in his technique, which is now called “ruitectomy”, who have then gone on to perform the surgeries on their patients. These countries include Burma, Bhutan, India, Ghana, Ethiopia, Rwanda, and Indonesia.
In these countries, prolonged exposure to ultra violet rays, combined with poor nutrition and poor medical care make cataracts the leading cause of preventable blindness in the developing world.
So, Dr Ruit’s simple and inexpensive technique has brought hope and indeed has changed the lives of half a million people so far.
But this is a small number, compared to the 18 million needlessly blind people in the developing world today.
It is because of this, and also because he believes that proper medical care should be made available to even the poorest, that Dr Ruit has started The Himalayan Cataract Project.
“We aspire to cure the mountain of global blindness, one patient at a time,” the group’s website says.
“At the core of our work is our goal to achieve high-quality, low-cost eye care that can be sustained in the developing world for the long-term.”
Indeed, most of Dr Ruit’s patients are too poor to pay for the simple operation, and he waives the fee for most of them.
Described as “one of the most important ophthalmologists in the world”, Dr Ruit understood how a lack of access to medical care could be devastating.
Born and raised in the remote Olangchungola region of Nepal, where the nearest school would require a week’s walk and where there were no healthcare facilities, Dr Ruit’s sister died from tuberculosis when he was 17.
The experience made him determined to become a doctor.
After completing his medical studies in India, Dr Ruit returned to Nepal, where he met Dr Fred Hollows, a distinguished New Zealand and Australian ophthalmologist who became known for his work in restoring eyesight for thousands of people around the world.
Dr Ruit studied under Dr Hollows for 14 months and it was then that his goal became clear – to help restore sight to the needlessly blind.
While Dr Ruit has been recognised and been given many awards for his work, he remains focused on his goal of helping the blind see.
“I realised early on that the only strength that I have are my hands and my eyes,” he told a local newspaper. “I can utilise my eyes to see what my hands can do on the eyes.”
Yet, his work is not simply to wield a scalpel or speculum and finish an operation in a few minutes. It is more than that – it is also to trek for hours into the outer edges of villages and mountains to bring hope to those who have lost it and have resigned themselves to a life of darkness.
Like the lady who had to spend her twilight years holed up in her home 4,000 ft up in the mountains, after losing her sight because of the cataracts. She could no longer work the fields, and her elderly husband has had to quit his work in the fields to care for her.
So, when she heard the doctor had come to her village, after an eight-hour trek, she herself was carried on the backs of her brother-in-law for the two hour walk to the makeshift clinic.
The next day, her sight was restored.
And her life has once again changed – this time for the better.
The joy in her eyes, when she realised she could see again, is perhaps the priceless reward which Dr Ruit and his team receive, and which give them the encouragement to carry on.
“The smile you see on their faces really keeps me going,” Dr Ruit says. “That’s a very powerful moment, very powerful moment! Many people do not have the opportunity to do this. I have this abundance.”
And there have been countless people whose faces have brightened up when their sights were returned to them.
“[Thuli Maya Thing] was led to the operating theater, and her eyes were injected with local anesthetic. After hoisting her left eye wide open with an eyelid speculum, Dr. Ruit peered through a microscope as he made a tiny incision in her eyeball and then tugged out the cataract — and placed it in my palm. It was hard and yellowish, perhaps a third of an inch in diameter, a tiny opaque disk that had devastated Thuli Maya’s life.”
“A day after the surgery, she and the 101 other patients were ready to have their bandages removed. Dr. Ruit carefully pulled off Thuli Maya’s eye patches, and she blinked a couple of times — and took in her surroundings for the first time in years. She beamed as her eyesight was tested; it came out 20/20.
“I used to get around by crawling,” Thuli Maya said through her smiles, “and now I can get up and walk.” – New York Times.
“Dr. Ruit was the first doctor to put lenses in poor persons in the developing world,” said Dr Geoffrey Tabin of the University of Utah’s Moran Eye Center. “Nobody has restored sight to as many people.”
As for Dr Ruit, his mission continues.
“If we can do this in Nepal, it can be done anywhere in the world,” he said.