This conversation takes place at Tilganga in Kathmandu. On the other side, right across the Ring Road, is the Pashupatinath Temple complex where the cremation ghats are situated on the banks of the Bagmati River. “Meanwhile, I’m in a hurry to do whatever I can,” he says and he is doing his bit to create a world where no one is needlessly blind.
Starting at eight in the morning, he does 20 surgeries daily on the average by three in the afternoon in his second home -- the Tilganga Eye Center that has now become the Tilganga Institute of Ophthalmology with a new six-storey 135,000 square feet building. He then attends his private eye clinic at New Road till 7:30 in the evening, to earn for his family in his own words, before going to other hospital-related appointments.
That apart, he and his team from Tilganga conduct around 15 free health camps across the country every year doing around 9,000 surgeries. He conducts around 100 surgeries each day during these health camps.
INSPIRATION FROM PERSONAL TRAGEDY
Dr Ruit, who received the Ramon Magsaysay Award in 2006 for introducing cheap sutureless technique to perform cataract surgery and manufacturing inexpensive high-quality intraocular lens, would have been lost to the medical world had it not been for personal tragedies.
The ophthalmologist, whose inexpensive intraocular lenses have given sight to hundreds of thousands of poor cataract patients of Nepal and other countries, dreamt of becoming a pilot during his schooldays. His elder brother had died of diarrhea long before his birth. But the death of his younger sister of tuberculosis while she was a student at the Mahendra Bhawan School in Kathmandu in 1964 and another younger sister of pnuemonia later changed his heart.
“Treatment of tuberculosis wasn’t effective then. The small sister caught pneumonia and passed away. That pinched my heart and I decided to become a doctor,” the 54-year-old eyesight specialist reminisces.
Born in the remote Olangchungola Pass in Taplejung District of northeast Nepal of uneducated parents, Dr Ruit was fortunate that his father was passionate about providing proper education to his children. A smalltime businessman trading with the adjoining Tibet, his father sent Dr Ruit to St Robert’s School in Darjeeling for studies and also provided financial support in his early medical career.
Dr Ruit later joined Siddhartha Vanasthali School in Kathmandu and got his School Leaving Certificate (SLC) from there in 1969. He completed his MBBS from King George’s Medical College in Lucknow, India, and was fascinated by ophthalmology long before he joined the All India Institute of Medical Sciences (AIIMS) in Delhi for specialization in 1981.
INITIAL STRUGGLE
It was no coincidence, either, that he married an ophthalmic nurse in 1987. “I’ve gone against the norms in everything in my life,” he jokingly refers to his love marriage, which was a rarity in those days. He then turns serious and admits that his wife Nanda has been a pillar of strength to him in his difficult days while pursuing his dream project of Tilganga.
He waged many battles before he and a few likeminded people came together to start the Tilganga Eye Center on June 7, 1994. “Many failed to read the rationale behind starting a new eye hospital when there was already an eye hospital at Tripureshwar [in Kathmandu],” Dr Ruit explains. “So a big delegation met the then prime minister to prevent the opening of Tilganga. We virtually went underground for six months,” he says.
REALIZING THE DREAM
Sixteen years later, his dream project has now become a model institution for many countries, and he has realized his dream of providing state-of-the-art eye care in Nepal.
The cost of intraocular lens, that was around US$ 100, has now been reduced to US$ 3.5 giving ray of light to many poor cataract patients worldwide. The intraocular lens laboratory at Tilganga established with support from the Fred Hollows Foundation, Australia has produced around three million lenses since starting production in 1995. “We now produce around 250,000 lenses every year and export half of them to like-minded international institutions who serve the underprivileged,” Dr Ruit says.
“They (foreign ophthalmologists) used to mock our made-in-Nepal lenses in the beginning but now our lenses are rated second behind Americans in quality in South Africa,” Dr Ruit adds.
The dream project of Dr Ruit and a small core group has long achieved international fame. “Dr Jan Kok, who performed surgery on eyes of Queen Beatrix of the Netherlands in 1999, called his facility there a Mini Tilganga,” Dr Ruit says adding that his good friend has since passed away in 2003.
Lhasa Institute of Eye Care established in Tibet six years ago is a carbon copy of the old Tilganga building, Dr Ruit adds, while a hospital built in Da Nang, Vietnam, embracing Tilganga´s principles is the biggest eye hospital in Vietnam.
Similarly, the two-tier pricing system, that he calls cross-subsidy, has become successful and is being embraced by many more international hospitals. “We were short in finance at the beginning and used this system of charging a higher price for willing well-off patients which helped us to serve poor at a subsidized rate. And today it (cross-subsidy) provides us with 70 per cent of our running cost,” Dr Ruit explains.
Dr Ruit, who did his ophthalmology specialization from AIIMS and also attended University of New South Wales, Sydney, and University of Michigan, accepts that he never imagined that he would one day be providing training to doctors from these countries.
The institute provides training to more than 100 international ophthalmologists including Americans on techniques for cataract operation.
"It has been incredible. The training they are providing has been an eye opener for me. I never imagined that cataract surgery could be so simple,” Nicaraguan Dr Mariseulle, who was here on a two-month fellowship, had gushed in praise.
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We in North America are not familiar with this technique which is comparable to phacoemulsification technique that is much expensive in efficiency. I can now go back home and use this amazing technique,” the doctor who completed her specialization in ophthalmology from Mexico had said.
Doctors from every continent come to Tilganga to learn the Small Incision Cataract Surgery (SICS) technique that is much simpler and consequently cheaper than the techniques tried elsewhere in the world.
“This has once again vindicated my belief that what we can do here with our capacity and qualification cannot be achieved by going abroad. If we put on the level of effort that we are willing to give while abroad, we can achieve much more in every field here,” he maintains.
He feels proud that he became the first eye specialist to win the Ramon Magsaysay Award. “It brings a sense of excitement,” he concedes. “Being able to give light to patients is equally satisfying as it gives me very nice warmth in the heart,” he adds. And he is not willing to part ways with that feeling anytime soon.
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