- The Washington Times - Friday, March 26, 2010


Raj Kaliya Dhanuk sits on a wooden bench, barefoot, with a tattered sari covering thin arms as rough as bark. Thick clear tears bleed from her eyes, milky saucers that stare at nothing.

For nearly a year, cataracts have clouded out all sight from the 70-year-old grandmother’s world. With no money, she assumed she’d die alone in darkness. But now she waits quietly outside the operating room for her turn to meet Nepal’s “god of sight.”

“I am desperate. If only I could see my family again,” she whispers in her native tongue. “I feel so bad when I hear the baby cry because I can’t help him. I want to pick him up.”

Mrs. Dhanuk and more than 500 others - most of whom have never seen a doctor before - have traveled for days by bicycle, motorbike, bus and even on their relatives’ backs to reach Dr. Sanduk Ruit’s mobile eye camp. Each hopes for the miracle promised in radio ads by the Nepalese master surgeon: He is able to poke, slice and pull the grape-like jelly masses out of an eye, then refill it with a tiny artificial lens, in about five minutes. Free of charge.

It’s an assembly line approach to curing blindness that’s possible thanks to a simple surgical technique Dr. Ruit pioneered, allowing cataracts to be removed safely without stitches through two small incisions. Once condemned by the international medical community as unthinkable and reckless, this mass surgery “in the bush” started spreading from Nepal to poor countries worldwide nearly two decades ago.

Thousands of doctors - from North Korea to Nicaragua to Nigeria - have since been trained to train others, with the hope of slowly lessening the leading cause of blindness, which affects 18 million people worldwide. And later this year, U.S. military surgeons will train under Dr. Ruit for the first time.

Dr. Ruit estimates sight has been restored to between 3 million and 4 million people through his method. Most of them live in the developing world, where a loss of vision can be worse than death because of the added burden thrust on families already drowning in hardship. The soft-spoken, portly doctor in acid-washed jeans and sneakers guesses he alone has removed 100,000 cataracts over his 30-year career.

“You realize there are drops which make an ocean,” says Dr. Ruit, 55, an ethnic Sherpa who grew up poor in a remote mountain village on the border near Tibet. “They’re such wonderful cases that make you fully convinced of the power of the work.”

Sometimes the four-day mass eye camps are held in hospitals. Other times the surgery is performed in a classroom or government building in areas so remote or mountainous, they can only be reached by helicopter. Dr. Ruit has traveled to Afghanistan, Myanmar, Tibet and many other difficult places to work.

“I’ve never seen anything like this,” said Dr. Paul Yang, chief resident at the University of Utah’s Moran Eye Center, who came to the Nepal eye camp to learn Dr. Ruit’s trademark technique. “In the U.S., all the technology is more modern and more optimized, but it can’t compete with the volume here. … You take back what’s learned here and apply it elsewhere for your whole life.”

Cataracts, which form a white film that cloud the eye’s natural lens, commonly occur in older people but also sometimes affect children or young adults. The condition first causes vision to blur or become foggy because the eye is unable to focus properly. As the cataract grows and matures, it can eventually block out all light. Exposure to harsh ultraviolet radiation, especially at high altitudes as in Nepal, is a major risk factor.

Mrs. Dhanuk is one of three elderly women at this camp who’s blind in both eyes from cataracts. She and the long queues of other skinny, barefoot patients move like choreographed ants from eye exams to dressing rooms for blue gowns and scrub caps, then to local anesthesia and finally to one of four operating tables.

Dr. Ruit is at ease while peering into the microscope hanging over the operating table as upbeat Nepalese music plays in the background. When the electricity goes out, his latex-clad fingers continue moving confidently with only one backup light shining into the eye he’s restoring.

Mrs. Dhanuk, who’s the size of a 10-year-old child, is carried in and laid on the table. She cannot see Dr. Ruit or the visiting Thai surgeon who’s practicing the technique on patients across the room.

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