CIA The World Factbook

Yuli Ismartono: Dr. Ruit, you came from humble beginnings but you overcame all your troubles and succeeded in becoming one of Nepal's first as an ophthalmologist, and then to become a respected doctor and surgeon. What motivated you to become a doctor?

Sanduk Ruit: One of the facts in life is when you grow in extreme necessity, then you tend to explore and struggle. My life has always been like that. I was born in a very small village, where there is no electricity, no schools, and my father was an ordinary trader who used to trade goods between Tibet and Nepal. From there, I had to go to school all the way in Darjeeling for almost two years. But what really pressed me to become a doctor was when one of my younger sisters---she was about 16 then---died of untreated tuberculosis, and I had been very close to her. I watched over her for nearly two years, and those were extremely difficult but motivating years for me, to see how best I could help. That was how I decided to become a doctor.

YI: When did you first begin to specialize in eye diseases and eye treatment? I suppose that was following your medical education.

Sanduk Ruit: Following my medical education, which I got in India, because we had no medical schools then in Nepal, I came back to Nepal and worked in the general hospital and I had some wonderful seniors. Somehow, I had an opportunity to go and attend one of these Eye-camps in the far west of Nepal, where we had to drive for nearly two days to get there. What really struck me was how quickly you could attend to so many people at such a short time and still be able to give them quite a good vision. That was really the point when I decided to take up studying again, (particularly about) the eye in the late 1970s.

YI: It was not perhaps because eye problems in Nepal were being neglected or that it was not being taken care of?

Sanduk Ruit: Yes, one of the big issues that really hit me as I continued my exploration in ophthalmology in Nepal as a young general doctor, that I came to know that the treatment of cataract---which was then taking the whole lens out---was very frustrating, was not giving much to the patients. I was trying to look at that, to find out, could we do something for these people who really need it?

YI: So you received further training in eye medicine, in which other countries was that?

Sanduk Ruit: Actually, I started my general residency program in Delhi, India, and then I was extremely hungry for modern technology, what was going on in the state of art in the beginning of the 1980s. Then I started to look at some places in the US, at some places in Europe, and later on in Australia. That kept me looking and I gave a lot of thought and give feelings at what was happening in ophthalmology, in state of art of that technology.

YI: Then you came back and started practicing in Nepal, in Kathmandu?

Sanduk Ruit: I started practicing Kathmandu, in the first eye hospital in Nepal.

YI: Tell us about the basic medical services in Nepal and your interest in helping people who could not afford eye operations, even as something simple as cataract treatment.

Sanduk Ruit: I think there is a lot to say about basic health services in terms of the index of health. For me as an individual or with some of my colleagues, I don't think I can change the whole scene of the health services. That was a limitation that I knew quite early on. I started to focus on what I could do in the field of ophthalmology. And what I can actually do to make a difference in the community. Basically, we are talking about what public health impact we could do. Another thing that really struck me in Nepal at those time was (the incidence of) blindness everywhere in 1980-81, and according to the survey, we found that cataract was the major cause of blindness, like it is in all developing countries and countries in the process of development. What was striking was that we found a large chunk of hydrogenic blindness. Hydrogenic blindness is a blindness that happens after an eye surgery. So what I am trying to say is the treatment for cataract in those days was quite primitive. We were not doing anywhere close to what we were supposed to do. And since these people were having their lenses removed straight away, and bottle glasses were being given to them, in a country like Nepal where getting this is very difficult, we found that nearly one third of these people don't wear glasses. And if you don't wear thick glasses, you don't see at all. So in effect, you had almost one third of the people are functionally blind. And then you had a large proportional people being blinded by bad surgery. And we were doing surgery with very minimal instruments, so these were areas that we were going to see what we could do. So I focused my self on how to bring the state of the art of cataract technology that was available in the west to Nepal and other such countries.