March 28, 2008
How medicine helps the poor in Nepal in the fight against blindness …
Corneal surgery in Nepal
Phiri Sherpa, 72, has seen a lot in her life. She looked how tourism and mountaineering were changing Solukhmubu, a region in Nepal where she 
was born. Annual hungers end with the introduction of potatoe farm. A group od Himalayan Trust by Sir Edmund Hillary has provided world-class education and health care in her village. Because of all these factors Phirina’s family is above average standards in Nepal. But now, despite the fact that she is physically resistant and in full intellectual forces, Phirin world is very limited. She can no longer see the world around her because of cataract in both eyes.
˝ On the left eye I can’t see for four years. ˝, Phiri says pointing to permanently closed eye on her wrinkled face. ˝ My vision on the second eye, I lost last year. ˝
Dr. Sanduk Ruit performes cataract surgery
˝Now I will see my grandchildren ˝
This is a classic problem in rural Nepal. To 70% of blindness is caused by cataracts. Phiri is one of the happy citizens of Nepal. Her family has organized for her a cataract removal in Tilganga Eye Center in Katmanduu – a unique institution founded in June 1994. ˝ There are no rich or poor, no child less valuable ˝, says founder and rector of the Center, Dr. Sanduk Ruit. „Everyone deserves good vision, and all deserve access to the best quality eye care. ˝ So Dr. Ruit and his medical staff – all from Nepal and Tibet spend most of their time providing free or subsidized eye care in the Center or dozens of field operations during a year. Hundereds from a thousand residents of Nepal and people from neighboring countries are receiving assistance through the work of Tilganga operating team. 
One of them is 60-year-old Maya Devi, who was at the second cataract removal in the mid October. She and her family have collected $ 80 for the first operation, and the other was done for free. She was one of 30 patients in the surgical Hall of dr. Ruita that day. When her bandages were removed the next day, she laughed while reading optotypes for the first time in a long time. ˝ I will see my grandchildren. I will not need their help anymore to find food ˝, said Maya Devi.
Tilgangin work does not stop at a routine eye surgery.
Maya Devi had two cataract surgeries.
Corneal donors
In the basement of a modern hospital is even greater work of art, The Fred Hollows Eye Lens Laboratory. Deceased dr. Fred Hollows from Australia was a friend and colleague of dr. Ruit. The two share a philosophy that drives Tilganga Center. In the laboratory, more than 300 000 tiny plastic lens are being produced by technicians in bio-protective clothes. Hygiene is crucial becuase of the export of lentils in Australia, Europe and Latin America that makes the vast majority of income of the Center. Poor patients do not have to pay for the lenses from the laboratory. The 
last example of superior access of the Eye Center Tilganga was found in the Pashupatinath temple on the edge of Kathmandu. Here, Nepals Hindus bring their dead to the cremation. Tilgangini technicians have been extremely successful in persuading orthodox Hindu families to donate their corneas of the deceased ones before the funeral stake was lighted. In the small room next to the holy river Bagmati, Roshan Dhungana is carefully cutting the cornea from the left eye of the deceased older women. Her family is, at first nervous then satisfied for simple operation didn’t injure the face of their loved one. ˝ This is amazing, says the son of the dead woman, ˝ she still seems calm and now her eyesight will continue to live ˝. The Tilganga Center is most proud that Nepal has enough cornea transplants for themselves, something that few countries can say.
But dr. Ruit is not completely satisfied. Optical problems do not go away. Blindness is still one of the common factors in the circle of poverty in countries like Nepal.˝ We have to continue doing this, he says by thinking on activities of Tilganga Center. „We have to give arms to the poor ones, train more local surgeons and technicians, and be more confident. Only then can we say that we made a big step towards victory of unnecessary blindness. ˝
Written by: Daniel Lak, BBC correspondent in Katmanduu