could do about it. ‘It’s a lot better now, but for a long time it was a feudal society where the innocent were quite badly
exploited.’
What saddens Ruit is that while the Maoist movement did
create some awareness about the vast inequity between the
haves and the have- nots, the violence and destruction only
led to Nepal floundering economically. It remains one of the
world’s poorest countries, with 80 per cent of the population living below the poverty line.
‘The timing was terrible. At the same time as our rivals,
India and China, were forging ahead, and really starting to
prosper, Nepal ended up going backwards. We lost so much
foreign investment because of the instability the Maoists
caused. Looking back, the ten- year struggle didn’t achieve
anything.’
Matthieu Ricard, the Buddhist monk and author of the book
Happiness, and a fan of Ruit’s, says the fact that the Maoist rebels allowed Ruit to work in their strongholds showed how
highly esteemed he had become.
‘The Maoists were very formidable, very tough on everyone,
and very protective of their turf. There were a lot of charities they didn’t let in at all, even those doing necessary things such as building wells. But when it came to Ruit, they just waved
him through. They saw that his only motivation was to help
people. He was a cultural hero to them.’
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Without realising it, Ruit has inspired countless young
people to have the courage of their convictions. The fact that a boy from the border of Tibet could go on to spearhead a world revolution in wiping out blindness has prompted many students in Nepal, India and Bhutan to enrol in medicine or go to university—even if nobody in their family had done so before.
One of the surgeons who works alongside him in Bhutan,
Dr Dechen Wangmo, says Ruit has inspired a whole gener-
ation of young people in the Dragon Kingdom to become
doctors—including her own daughter.
‘His sort of talent is so rare. He’s so physically heavy but
his hands are so delicate. There are no wasteful movements.
Everyone can learn to play the piano but only a few are as
truly gifted as he is. I remember the first camp we went to, we did about 700 cataracts in five days. It was absolutely incredible. And yet he made it look so easy. Only great surgeons
do that. Usually surgeons with great talent like him emigrate to the US or the UK, but he’s stayed here in the Himalayas to make a difference.’
Young doctors starting out at the hospital often ask Ruit for advice. What he tells them is that there are no shortcuts. ‘You have to be committed. Work out what you are really good at
and capitalise on your strengths. Then work really hard. If you can find work you love, then do it. Work with passion, with
your heart, as if every person you meet is the most important person you meet that day. It makes a huge difference. Every
kind of job has meaning if you have the right motivation,’ he tells them.
What about people stuck in a dead- end office job where
they spend much of the day staring out the window? If you
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are the breadwinner, and you need to feed your family, you
need to be practical, he says. Your family is your first priority.
But it’s also important to have a vision, too. ‘Everyone has the right to dream,’ he says. ‘If it means you get up early, before your family wakes up, or stay up late at night, to study, and move into a job that you’re passionate about, then you should definitely do that.’
Good management skills are drummed into the teams
that come to Tilganga. They learn how to communicate with
staff, how to inspire them, and how to set a good example.
His own team members are living proof that his approach
works. Many have been with him for more than 30 years;
they look like they’d run through fire for him. So what is his secret?
‘I see the best in others. I watch what people are good
at and then set them doing it. I harness their particular
talents. Everyone has strengths and weaknesses; being a good
manager means recognising and drawing on their strengths.
It’s also important to create a good atmosphere in your team.
To really care for each other. I try to really look after my staff.
I make sure they are all happy and well. I give them opportu-
nities, such as sending them to the US or Australia or the UK
to enhance their skills by learning with great surgeons. And
something greater than themselves.’
‘He can be a hard taskmaster but there’s no doubt he
brings out the best in people and inspires great loyalty,’
Tabin says. ‘He inspires through his charisma. His immedi-
ate team have been with him for decades and he has elevated
them through the system. To work at Tilganga is a really
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prestigious position in Kathmandu. He’s created some-
thing everyone has pride in. It’s not a job. He’s created a
mission people approach with joy. Everyone in Nepal knows
Tilganga. It’s become a household name because it is some-
thing they are so proud of.’
Matthieu Ricard often cites Ruit’s approach when asked
about successful leadership.
‘I realised I kept on bringing patients to him for treatment
just for the joy of seeing him and the way he treats them,
and his team. Some organisations just work really well—the
people there are efficient, good, and reliable and dedicated, but when you have hundreds working for him, as Ruit does,
and it still works brilliantly, it takes a special quality. It works because the leader himself is a great source of inspiration,
in terms of integrity, in terms of what he is achieving. What Ruit shows his team is that it is not how much money the
organisation made in the year, but how much suffering they
alleviated during the year. When you go to Tilganga, or to
one of their camps, immediately everybody is kind, efficient, and takes care of you. They find your files and go out of their way to help you if you need help getting home. They all seem
to be infused with the same kind of willingness to serve. That really comes from his inspiration, and not in an ordinary way but the sheer strength of what he is.’
Tilganga doctors have even started training days for
traditional healers from rural areas. These are the local
village men—some might derisively describe them as witch
doctors—who may unintentionally make matters worse by
telling patients that their blindness is a curse, bestowed from a past bad deed. They might suggest superstitious remedies
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such as killing goats or chicken, or even trying homemade
potions. Ruit, as diplomatic as ever, puts it this way: ‘What we have learnt is that we can’t change the healers’ livelihoods, but we can teach them how not to harm their community. We
encourage them to send the blind to Til
ganga or one of our
clinics or camps, so they are in expert hands.’
Of course, surgical mistakes still happen. He estimates
1 per cent of cases need to be corrected the next day. ‘I’ve had cases where the patient had to be re- stitched and blood had
to be washed away after surgery the next day. That happens.
Sometimes the intraocular lens is not positioned properly.
You have to insert it again a few days later.’
Ruit is devastated every time he comes across people who
have incurable blindness in remote areas and has to tell the
patient there is nothing that can be done. ‘The worst is telling parents nothing can be done for a blind child because they
have left it too long before they tried to get help. There is nothing worse than that. Nothing worse. It spurs me on to
work even harder that day to give sight to everyone else that I possibly can,’ he says.
The most infuriating are families who keep their older
blind relatives in a back room for so long that their blindness becomes incurable. They simply don’t care for them enough
to bring them to a hospital or clinic. ‘These poor souls are
treated worse than animals,’ Ruit says. ‘At least animals are led outside and in the sunshine, and are given enough food.’
These are the forgotten ones that are beyond help, who have
been left in a pitiful state; they are alone, dejected, depressed, malnourished, sometimes half- deranged. Having to tell them
and their families that it is too late to cure them, that nothing 219
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can be done, he says, is the ‘very worst feeling in the world’.
include them in family life, and give them all the medicine
and good food they can.
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23
Private heartache
By the mid 2000s, Ruit’s career had suddenly taken off to an
entirely new level. He was earning a reputation as one of the world’s finest surgeons and humanitarians, and was showered
in prestigious awards. In 2006, he won the Philippines’ Ramon Magsaysay Award, which many consider as the Asian equivalent of the Nobel Prize. The next year he was awarded both
Thailand’s Prince Mahidol Award and the Reader’s Digest
Asian of the Year award. He was asked to make speeches
and give media interviews. Long photographic features on his
work ran in TIME magazine and the South China Morning Post. American broadcaster Lisa Ling’s documentaries on his work in Nepal and North Korea for National Geographic
brought his work into the limelight in the United States.
As his cousin Tenzing Ukyab puts it: ‘There was a time
when I used to take him a present every time he got an award.
Then it became too many and too often, and I couldn’t keep
up. Many of them I didn’t even hear about because he would
be the last person to mention it.’
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Ruit used his growing reputation to continue spreading
his technique to the world’s blindness trouble spots. In 2005, he felt confident enough to venture into a part of the world
no-one would ever have dreamed possible: ‘The Hermit
Kingdom’ of North Korea.
Ruit’s life had been in danger during Nepal’s bloody
domestic war, but the most frightened he ever felt was
undoubtedly the fortnight he and his team spent at an eye
camp in the Democratic People’s Republic of Korea (DPRK).
How on earth did a Nepalese doctor end up performing
his medical miracles in one of the most forbidding countries
in the world? The opportunity arose to work in North Korea,
with its notorious human rights violations, and equally noto-
rious nuclear weapons program, when a patient he’d just seen
in his private clinic in Kathmandu, Mr Kim, handed him a
card that read, ‘Consul of DPRK’.
Ruit has never professed to be a human rights activist.
The higher the rate of blindness, the keener he is to help, no matter what the country’s political ideology or religion might be. He simply draws a line at war zones. One place he’d like
to work in, for instance, is Yemen, one of the Arab world’s
poorest countries. ‘It’s a small country and they really need help. But when bombs are falling and guns are shooting in a
country, cataracts are not usually a priority. That’s one place we can’t go to.’
All he knew was that North Korea was one of the world’s
worst trouble spots of blindness; it was a powerful pull. More than half a million people are estimated to be blind there,
a rate about ten times higher than in the West. Ruit knew
they would have had very little access to doctors. And that a 222
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good proportion of them would have been blind in both eyes
for years.
He immediately tried to build a rapport with the quietly
spoken consul.
He invited Mr Kim to visit Tilganga the next day. He
showed him the gleaming equipment, training centre and the
hundreds of patients treated every day. His eyes boggled, Ruit says, presumably as he realised how much Tilganga could
help the blind in his country.
Over dinner a few nights later, Ruit suggested to Mr Kim
that he hold a surgical workshop in the DPRK. If it worked,
he would train as many doctors and nurses as he could, so
they could stand on their own two feet, rather than relying on help from foreigners.
It took years of negotiations, as hatred of foreigners and
outside help, including humanitarian missions, was still
strong. But finally, in 2005, Ruit and his small team flew into the capital, Pyongyang.
From the air, it looked like they were entering a communist
country during the Cold War era in the 1950s. Interspersing
square, grim- looking concrete buildings were wide concrete
highways, which were almost completely empty as cars were
a luxury only for the elite.
Accompanying Ruit was Reeta Gurung, photographer
Michael Amendolia, and a small team led by his stalwart
camp coordinator Khim Gurung, known affectionately as
‘camp commandant’.
As soon as they landed in Pyongyang, their personal
freedom was curtailed. All phones, cameras and passports
were confiscated. Two guards accompanied them the entire
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trip, watching their every move and listening to everything
they said. There was not one moment when they could wander
off and walk around unobserved. There was no outside influ-
ence at all. Access to the internet, radio, books or magazines was forbidden. They were completely cut off from the world.
The American journalist Lisa Ling, who in 2006 accom-
panied Ruit into North Korea for the documentary television
channel National Geographic, remembers how unnerving it was to be so cut off from the world.
‘I was quite shocked by the protocols we had t
o adhere to
just to get in,’ she says. ‘We had to meet with the North Korean ambassador to Nepal before we’d even got on the plane. There
were all these formalities. I was really surprised they didn’t do any kind of Google search on me, because I was already on a
national daytime talk show in the US. I was probably a little naïve when I went in under the auspices of the medical team
because my understanding at that time was that if they found
out I was a journalist, then I would simply be ejected out of the country, or expelled. But as I found out later when my
sister was detained, it could have been far worse. (In 2009,
Lisa’s sister Laura, also a journalist, was detained by North Korean border guards and sentenced to twelve years’ hard
labour for not having a visa. Kim Jong- Il pardoned her and
her group of colleagues the day before American president
Bill Clinton arrived to lobby for their release.)
‘When we landed, they took our passports and our techno-
logical devices and they had about eight escorts monitoring
us all the time. They even stayed in our guesthouse. I was
permitted to go for a jog but I always had a couple of eyes
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a surreal experience because growing up in America I had no
experience of communism. I remember I brought a fashion
magazine in my bag with me, and the young man minding
me scolded me. He said it would give people wrong ideas.
I remember feeling very isolated. I felt if anything happened to me, no-one would know and there would be this inability to communicate with my loved ones. I didn’t think about
the fact that I could possibly be arrested and detained for a lengthy period of time.’
Officials picked them up in an old Mercedes Benz car.
As they swept through the capital, the only decorations
they could see were brightly lit monuments glorifying ‘Dear
Leader, Kim Jong Il’. There were no billboards or neon signs.
Everyone was in drab- coloured clothes. At night, the city was dark as the power was cut off. It was eerily quiet.
They travelled to the port city of Haeju, about 100 kilome-
tres south of the capital, the next day, sobered by the scenes from the train windows of lean- looking labourers doing
manual work on the farms. ‘I’m used to seeing poverty, so it