future. It was like watching a chrysalis burst into life.
Despite the fact that he has operated on more than
120,000 people, Ruit still finds himself holding back tears
as he watches his patients set out on the road home, without
having to hold someone’s hand or the hem of their shirt.
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‘When I watch people seeing their loved ones again, and
returning home independently, I cannot put my feelings
and emotions into words,’ Ruit says. ‘All the money in the
world would never give me the same sense of fulfilment and
achievement.’
Ruit may give his patients the gift of sight, but they give him a great gift, too; the opportunity to witness such an incredible transformation. He has enjoyed this privilege almost every
day for more than 40 years. He says if he gets the chance to
be born again, he would definitely choose to be an ophthal-
mologist. ‘Patients often come up to me and say, “You are
like a god to us,” but the truth is, it is more that they are like a god to me. They are the reason that I gain so much joy from my work,’ says Ruit.
‘During the operation, I am giving them the best of my
skills and all of my love. And then experiencing all those
complex feelings in the room when the patients realise they
can see—the relief, the joy, the tears, the hugs, the jubila-
tion of seeing their children, their parents, their brothers and sisters again—is always such a powerful moment. It really
keeps me going. The rewards are just so rich.’
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15
Little river
Ruit fantasised about building a new hospital. The one he held in his mind’s eye was precise. It would be three storeys high, surrounded by a garden. Its foundation would be rock solid,
built with three or four times the normal amount of steel and concrete used in Nepal in order to withstand earthquakes. It would outlive him, and his children.
The operating theatres would gleam with the latest tech-
nology, and the spotlessly clean waiting rooms would be
bathed in sunshine. Ophthalmologists would fly in to learn
from Ruit from every corner of the world, before being set to work in the world’s blindness trouble spots.
An eye bank would be set up for corneal transplants. Inside
the front gates, a shaded courtyard with benches and clean
drinking water would greet patients. A factory would manu-
facture intraocular lenses for a fraction of the price of those made in the West, making them affordable for everyone.
That was his vision. Ruit was also painfully aware that,
in Nepal, building sites were easy targets for unscrupulous
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middlemen and corrupt contractors; tips and bribes—known
as ‘tea money’—were a way of life. Ruit knew Hollows was
sceptical about breaking away and building a new eye
hospital. The words ‘brick walls’ and ‘construction’ seemed
to equate with ‘empire- building’.
But Ruit was prepared to build it brick by brick with his
own hands if he had to.
He is a firm believer that if your motivation is right, you
meet the right people at the right time. When Ruit first met
Les Douglas in 1989, they liked each other immediately. As
the Australian ambassador to Nepal, Douglas was a straight-
talking, no- nonsense man, renowned for rolling his sleeves
up and getting the job done. He’d previously been posted to
Japan, Myanmar and Switzerland, but it was in Nepal that he
became more involved in his career than ever before.
Douglas saw the value of what Ruit was trying to do and
was prepared to use his position to knock down doors to
get the hospital and the intraocular lens factory built. He
could see how committed Ruit was. ‘He had such a vision.
He outlined that it would not be plain sailing, and, I don’t
know what it was, whether it was a unique quality in him,
but I knew I had to do everything I could to help him.’
Like most processes in Kathmandu, building a hospital
was a bureaucratic nightmare. Shore would zoom about on
his 100cc motorbike with ‘NEP’ written on the petrol tank,
visiting the endless list of officials from whom they needed to obtain building permission. Even the most straightforward
steps seemed to take months.
Meanwhile, Douglas was flexing his diplomatic skills to
persuade Prime Minister Koirala to grant Ruit some land on
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which to build his dream. Every week, Douglas and Shore
would troop out to the surveyor general’s office. The surveyor general would bring a dusty old map of the city, dating back
about 70 years, out of a metal cupboard and unroll it on
the table. The three of them would pore over it, looking for
unwanted tracts of land. Each time they found something, they were told it was already taken. ‘Usually, it was someone in
the royal family, or a friend of the royal family’s or the prime minister’s. It was unbelievably exasperating,’ Douglas recalls.
Finally, they found a parcel of land they thought no-one
would probably want, on the banks of the Bagmati River.
Slightly downstream from Pashupatinath temple, the Hindu
holy site where cremations were held on wooden funeral
pyres, the quarter of a hectare was overgrown with weeds and
surrounded by slums. It stood empty for the entire year apart from every February when thousands of Hindus thronged
into the city for the Shivaratri religious festival and it was used it as a parking lot for buses.
When construction commenced in 1991, Douglas became
so involved in the building of the hospital that Shore and Ruit called him ‘H.E.’—short for ‘His Excellency’. He was at the
site every day, making sure the concrete was poured perfectly, and every beam was as straight as an arrow. He’d often take
a carton of beer down to the site for the workers when they’d finished for the day. He even asked for his tenure as ambassador to be extended for eighteen months in order to see the
hospital finished.
Ruit has always been gifted at visualising. On long drives
out of Kathmandu into remote villages, lulled into drowsiness by the motion of the four- wheel drive, he will gaze quietly out 153
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the window for long periods of time, or his eyelids will start to droop.
It often looks like he’s dozing. What he’s really doing is a
form of meditation he calls ‘visualising with the third eye’.
He completely quietens his mind. ‘I try to empty myself
of everything, from the top of my head, out to the tips of
my fingers and toes, to create a vacuum. Then out of this
base level of absolute quiet comes the power to come up with
useful innovative ideas for my long- term vision,’ he says. He regards these times of deep introspection and insight, as his most precious and personal moments
. ‘They’re wonderful,
very constructive,’ he says.
But even Ruit’s legendary visualisation powers were tested
to the limit that first morning when he went out to look at
the site. Dogs picked their way through the weeds, cows
wandered through the rubbish and broken pottery. The din
of Kathmandu’s incessantly beeping tuktuks, cars, trucks and
mopeds filled his ears. Smoke and ash from the funeral pyres
drifted across the river from Pashupatinath.
Despite flowing past the holiest of Hindu shrines, the
stench of the river was so overpowering that it was impossible to stand next to it for long. The ashes of the dead weren’t the only things tipped into the water. Dead animals and rubbish
also floated down the river.
It was one of the most desolate spots in Kathmandu. But
standing there, the day the land was signed over to the Nepal Eye Program, was one of the great turning points in Ruit’s
life. Finally, he had land. It was going to be an almighty task, but, brick by brick, he was going to turn the rubbish tip into one of the finest hospitals in the world.
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He decided to call the hospital the Tilganga Eye Centre,
Tilganga meaning ‘a stream of sesame seeds’ or ‘little river’
after the small stream that ran through it. He loved the sweet, simple sound of it.
There were no strategic plans. Ruit and his supporters
simply had an innate confidence that things would work out.
‘I didn’t tell anyone except Nanda, but we didn’t even have
enough money to finish the foundations when we started
building. It was all done on a wing and a prayer. It probably wouldn’t have got through all the red tape, and would not
have happened at all, if we were trying to build it today.’
Douglas’s brother Brian, an architect, designed most of the
hospital from Australia. Plans for the lens factory were drawn up by The Fred Hollows Foundation in Sydney, which Fred
and Gabi had founded together in 1992 in order to continue
his work.
The labourers started pouring the concrete for the founda-
tion in July 1991. This took almost three months. They built
double- cavity brick walls, twice as strong as those usually
used in Kathmandu, using bricks of the highest grade of
cement. Sixty- five labourers and bricklayers went to work,
using bamboo scaffolding, and carrying the sand, gravel,
cement and bricks in baskets on their backs.
Ruit’s opponents, especially the doctors who worked at the
existing Nepal Eye Hospital that had been treating the blind
in Kathmandu since it opened in 1973, were outraged that
he was building a second eye hospital in the city. They were
jealous of his success, and threatened by his vision. ‘They said it would be disruptive to the community,’ says Ruit. ‘Others
called me demented, and crazy. I’m not one to raise my voice, 155
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but Les Douglas had raging arguments with some of the senior
ophthalmologists who were opposed to the new hospital. He
kept telling them they should cooperate with me rather than
trying to obstruct me.’
Douglas held his ground.
But as the hospital slowly rose from the ground, Ruit’s
health began to deteriorate. He felt worn down by the
constant stress of overwork and delivering results. His
insomnia kicked back in, and his blood pressure shot through
the roof. Nanda and Ruit had also just had their daughter
Serabla.
He was put on anti- hypertensive medication, and has
been on it since. He was a smoker. His family were still
living in the dingy, cramped apartment near the hospital,
with one bedroom, a combined kitchen and living room, and
an outdoor bathroom. He used to smoke on the bed as he
was reading or doing his work. It wasn’t until Nanda was
pregnant with Serabla that he finally stopped. Nanda pointed
to her belly and said, ‘You are giving this smoke to me, as
well as our child.’ That was the last cigarette he ever smoked.
Ruit was also still drinking far too much for his own liking.
‘I picked up some bad habits after I’d graduated from medical school. I drank every day, for many years.’
He started to slide dangerously close to being an alcoholic
during those years as the hospital was being built. Every day seemed like a marathon. As well as running as many eye camps
as he could, he continued running his own private practice
in the evening, as well as administration for Tilganga. There were also business dinners he needed to attend in order to
raise money.
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The drinking he most enjoyed was quiet, companionable
socialising with two or three friends. It was very easy for
them to finish a bottle of whisky, especially in the days that Hollows was there. ‘I never drank until the afternoon and it
never affected my surgery,’ Ruit says. A British friend taught him how to sober up in the morning with a cold shower, and
an Alka- Seltzer, with cold water and a drop of lemon.
Things came to a head for Ruit when he attended a party
for a friend of Tilganga’s chairman. He had done about 70
back- to- back operations that day and was enjoying unwind-
ing over a whisky. ‘Then someone gave me a gin, then a beer,
and on and on it went until I simply wasn’t aware of what
I was drinking at all. I must have left the party half- conscious and, somehow, by the grace of God, I made my way home.’
Nanda was furious. She refused to let him inside. ‘Coming
home at your age in this state, it’s just embarrassing,’ she told him. ‘You’re making a complete fool of yourself.’ Her words
hit home. He apologised and stopped drinking from that
He had terrible cravings for about a month, but since then,
he has not touched a drop. He admits to eating too much, and
that he was addicted to marsala tea for many years, drinking
it all day long, especially the way Nanda made it, with milk, cloves, cardamom, cinnamon and lots of sugar. These days
he’s even given that up too, and drinks endless cups of tea
with lemon and honey tea instead.
Fundraising was not Ruit’s forte at all, but Douglas was a
master of the art. He was not only charming and likeable, he
was totally committed to seeing the hospital and the intra-
ocular lens factory built. He had lines of communication
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going right up to Prime Minister Koirala, and he was not
afraid to use his connections to make things happen. He was
very persuasive.
‘This hospital is going to be a role model for our whole
country,’ he’d say. ‘It’s really going to put Nepal on the
map.’ The decision makers and influential businessmen of
Kathmandu soon became used to the sound of Douglas’s
voice. When the pr
ime minister dragged his heels approving
the latest plans, Douglas would knock on his door and say,
‘Look, we really need some decisions to be made.’ Douglas
and his wife Una would hold elaborate fundraising parties at
their home and the Australian embassy. They lobbied every-
where they went. Douglas persuaded Australia’s foreign aid
investment, AusAID, to donate $70,000.
And they lobbied whomever they met. Over lunch one day,
the Australian entrepreneur Dick Smith asked Douglas and
Una, ‘How can I help?’ ‘A hundred thousand will do,’ Douglas
instantly replied. The next morning, Dick’s wife Pip rang and asked, ‘Where do you want the hundred thousand sent?’
The Nepal Eye Program Australia donated $30,000,
and several wealthy Nepalese businessmen donated signifi-
cant sums. An unexpected windfall came from the Jamgon
Kongtrul Foundation, which donated $71,500—enough to
build the new operating theatre.
When the 3rd Jamgon Kongtrul first turned up for surgery,
Ruit thought he was ‘just an ordinary monk who happened
to be very smart’. He had no idea of the Rinpoche’s status.
‘When we realised he was actually a high lama—there
were hundreds of monks prostrating themselves before him—
our team made a small presentation at his temple, asking for
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funding through his charity. In retrospect, it was all quite
amateurish, but within a few days, they’d offered twice what
we’d asked for—enough to pay for the entire theatre.’
A month before the hospital opened, Les and Una Douglas
and Rex Shore took a driver and a truck up switchback roads
to the nurseries above Kathmandu. They returned with an
abundance of camellias, bottlebrushes, avocado trees and
flowers for a small army of volunteers to plant in the hospital’s garden. The date had been set for the opening of Tilganga:
7 June 1994.
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16
Open for business
Kathmandu usually begins to swelter under hot and humid days
in the middle of the year. The blanket of pollution from the