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interview with Sanduk Ruit

The PakistanCIA The World Factbook

YI: How did you do that?

Sanduk Ruit: I had clearly identified certain barriers, and one big barrier was the technology of the surgery, the surgical technology that was present in the west was a lot complicated. Countries like the US and other western countries can afford to have them complicated and expensive. But we cannot afford it. So, we had to make it simple and cost-effective. But it does not mean that it has to be second-class in terms of quality. So, with the nucleus, the idea in mind that we had to preserve the quality, and which is extremely important for something like sight restoration, qualitatively important, and keeping the quality in mind and simplifying the surgical procedure and adapting it to local conditions, and which we could reproduce and give to the other doctors, in terms of training and looking at keeping the cost down. So that was one issue. The second issue was the cost of some of the important consumables, for example, one of them was the cost of the small plastic materials, plastic lenses that we put inside the eyes, called intra-ocular lenses. These lenses, when we were doing surgery, back in the early 1980s, used to cost about US$ 100. And buying a $100-lens for one case in a country like Nepal was almost impossible to do for cataracts for the masses. So we had to bring the cost down. The third issue was training our local colleagues. So these are the three main obstacles that I envisaged and that I saw, and which I tried to look at how I could solve one at a time in order to tackle this problem.

YI: You did succeed, because this method that you just mentioned, is now being practiced after your introduction in those countries. Which other countries are they?

Sanduk Ruit: We always want to start from the most difficult places, and in the early 1990s, we started in Vietnam. In those days, Vietnam was quite difficult from what it is now. Vietnam was almost an iron gate. Then we started in in 1990, 1992 and 1993 in Tibet, which was again an iron gate. And about the same time in mainland China. Later on, about two years ago, in North Korea. And now we are starting in Myanmar. We wanted to go to places where people really need us.

YI: How were you able to convince these governments? Was it because of the inexpensiveness?

Sanduk Ruit: My philosophy is that I am totally clear about my limitations. And politics is not my profession. My profession is sight restoration, which I am pretty good at, and I have ways of showing to the smartest leaders, that this can be done cost-effectively, and this can deliver lot of good for the people they care for. Wherever these leaders are, they care for their people, when they see something that can help the people, they will do it. I have never really encountered serious (problems) about this.

YI: So, you were never refused, in other words.

Sanduk Ruit: No, never . We had difficulties in the begining. One of the difficulties I faced was whether I lay them at ease and convince people that the technology was coming from a country like Nepal. So I had to establish a lot of credibility before I could actually do it. This was very difficult for me, and for that matter, for us to send our lenses which were manufactured here in Nepal. There was a lot of difficult for people to understand this. But this is now history. We worked a lot to do that. But once we were established, this was not very difficult.

YI: Well, congratulations, I think you have succeeded. Now, you founded the Tilganga Eye Center and a program that’s called the Nepal Eye Program. Can you tell us something about that?

Sanduk Ruit: We had a group of friends and people in Nepal working in different sectors of the country, people involved with the NGOs, people who were involved in television, in mountaineering, business entrepreneurs, so we got together. They were wonderful people, young and successful at that time, who wanted to give back something to society. I posed the problems that I previously mentioned, the three obstacles we faced, mainly trying to find a cost-effective surgical technique. Second was to get easy and cost-effective consumables and the training of personnel. I told them this was what we needed to address. I told them this was what we needed to do. This was early in 1990, we sat down to lunch at a restaurant. Those days we had no resources, nothing at all. All our friends were very nice, they were totally sold on the idea. They said “let’s do it.” This group of people got together and we started with the Nepal Eye Program, which is the legal entity and the implementing body of the Tilganga Eye Center. So the Eye Center is a non-government organization, and slowly we started to move forward.

YI: Through this Eye Center, you also trained doctors and paramedics in the newest eye surgery technology.

Sanduk Ruit: If you look at Asia, which is very interesting because it’s a big land surface, and we represent 60 percent of the world population. In terms of cataract, we constitute about 60 percent of the world’s blindness, which is close to about 10 to 11 people who are actually blind due to cataract, but unfortunately, what is happening is that most of the blind are living in rural areas and they are poor people. So, our aim has always been, how to make the surgical system per se more affordable and more accessible to these people. It’s a very Herculean task and if you consider the concept where this really needs to be done in some of the Asian countries: in China, in Indonesia. My feeling is that if we can organize and manage itproperly, this can be done very well.

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