Nepali Opthalmologist invents microsurgery in 5 minutes – India

8 nov 2015

In 5 Minutes, He Lets the Blind See

He has restored eyesight to more than 100,000 people, perhaps more than any doctor in history, and still his patients come. They stagger and grope their way to him along mountain trails from remote villages, hoping to go under his scalpel and see loved ones again.

A day after he operates to remove cataracts, he pulls off the bandages – and, lo! They can see clearly. At first tentatively, then jubilantly, they gaze about. A few hours later, they walk home, radiating an ineffable bliss.

Dr. Sanduk Ruit, a Nepali ophthalmologist, may be the world champion in the war on blindness. Some 39 million people worldwide are blind – about half because of cataracts – and another 246 million have impaired vision, according to the World Health Organization.

If you’re a blind person in a poor country, then traditionally you have no hope. But Ruit has pioneered a simple cataract microsurgery technique that costs only $25 per patient and is virtually always successful. Indeed, his “Nepal method” is now taught in U.S. medical schools.

I’m on my annual win-a-trip journey, in which I take a university student with me on a trip to the developing world to cover underreported issues. The student, Austin Meyer of Stanford University, and I traveled to Hetauda in southern Nepal to watch Ruit perform his magic on 102 men and women.

One patient was Thuli Maya Thing, a woman of 50 who says she has struggled to look after her children since losing her sight to cataracts in the last few years. Because of her blindness and inability to work, the family sometimes goes hungry.

“I can’t fetch firewood or water,” Thuli Maya told me. “I can’t cook food. I fall down many times. I’ve been burned by the fire.”

So Thuli Maya was waiting outside the eye hospital that Ruit has established here, nervous but also eager with anticipation. “I will be able to see my children and husband again – that’s what I look forward to most,” she said.

She was led to the operating theater, and her eyes were injected with local anesthetic. After hoisting her left eye wide open with an eyelid speculum, Ruit peered through a microscope as he made a tiny incision in her eyeball and then tugged out the cataract – and placed it in my palm. It was hard and yellowish, perhaps a third of an inch in diameter, a tiny opaque disk that had devastated Thuli Maya’s life.

Ruit inserted a tiny new lens into the eye and he was done. The process took just five minutes. Then he repeated the process for Thuli Maya’s right eye, confident that she would see again.

“Here, the returns are so clear,” Ruit said as he bandaged her eye. “It’s like no other medical intervention.”

In the United States, cataract surgery is typically performed with complex machines. But these are unaffordable in poor countries, so Ruit built on the work of others (including the Aravind Eye Care System in India, a superb institution that performed 280,000 cataract surgeries last year) to pioneer and refine small-incision microsurgery to remove cataracts without sutures.

At first, skeptics denounced or mocked his innovations. But then the American Journal of Ophthalmology published a study of a randomized trial finding that Ruit’s technique had exactly the same outcome (98 percent success at a six-month follow-up) as the Western machines. One difference was that Ruit’s method was much faster and cheaper.

“The results are fantastic,” said Dr. Geoffrey Tabin, an eye specialist at the University of Utah’s Moran Eye Center. Tabin learned the technique from Ruit and was in Hetauda as well, removing cataracts beside Ruit, and he says the results in rural Nepal using this technique are as good as those of his patients in Salt Lake City paying for first-class care and benefiting from almost $1 million in the latest medical equipment.

Tabin said that when machines can’t be used for cataract surgery in the United States (if, for example, the cataract is too large), the standard American manual surgical technique is inferior to Ruit’s.

Tabin, a mountain climber whose interest in Nepal was sparked by summiting Mount Everest, leads the Himalayan Cataract Project, a U.S. charity that supports Ruit’s work and takes its techniques to other countries, like Ethiopia and Ghana. The battle against global blindness is now a joint Ruit/Tabin project, and they optimistically named their website

“Dr. Ruit was the first doctor to put lenses in poor persons in the developing world,” Tabin said. “Nobody has restored sight to as many people.”

By Ruit’s count, which others find credible, he has conducted 120,000 cataract surgeries, mostly on a single eye of a patient. But Ruit developed not just a surgical technique but an entire eye care system. He founded the Tilganga Institute of Ophthalmology, which includes hospitals, outreach clinics and training programs and an eye bank, using fees from better-off patients to support impoverished ones like Thuli Maya. Tilganga conducts eye surgery on 30,000 patients annually – half for a fee, half gratis.

Tilganga also manufactures 450,000 tiny lenses a year for use in cataract surgery, keeping costs to $3 a lens compared with $200 in the West. The quality seems excellent, and they are exported to 50 countries, some in Europe. And for those who lose an eye, Tilganga makes realistic-looking prosthetics that cost $3, compared with $150 for an imported false eye.

This system impresses experts around the world. Dr. David F. Chang, a past president of the American Society of Cataract and Refractive Surgery, describes Ruit as “one of the most important ophthalmologists in the world.”

Ruit, 61, who grew up in a remote part of northeastern Nepal and studied medicine in India, is now taking his model to other low-income countries.

“If we can do this in Nepal, it can be done anywhere in the world,” he said.

One reason to focus on vision on a win-a-trip journey: Blindness is both extremely debilitating and often easy to overcome or prevent. Vitamin A capsules cost 2 cents each and can prevent 250,000 or more cases of child blindness each year (half of those children die within a year of going blind). Blinding trachoma can be prevented with improved hygiene and donated antibiotics. River blindness is on its way out in part because of the heroic work of Jimmy Carter and medicine donated by Merck. And cataracts – we’ll, let’s pick up with Thuli Maya.

A day after the surgery, she and the 101 other patients were ready to have their bandages removed. Ruit carefully pulled off Thuli Maya’s eye patches, and she blinked a couple of times – and took in her surroundings for the first time in years. She beamed as her eyesight was tested; it came out 20/20.

“I used to get around by crawling,” Thuli Maya said through her smiles, “and now I can get up and walk.”

Readers often tell me of their doubts about humanitarian aid, and it’s true that helping people is always harder than it looks. But sometimes it’s almost miraculous: A $25 surgery, say $50 for both eyes, to restore a person’s sight. “This is such high impact, for so little money,” Ruit said as he watched his patients adjusting to sight again.

Meanwhile, Thuli Maya was dancing.

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Indian-origin doctor Shiv Pande receives honorary fellowship in UK – India

25 oct 2015

dr sanjay kumar cardiac surgeon

dr sanjay kumar cardiac surgeon

77-year-old Shiv Pande has been awarded an honorary fellowship of the University of Central Lancashire. – See more at:

An Indian-origin doctor has received the honorary fellowship by one of the leading British Universities for his contribution to the community as a general practitioner and medical educator. 77-year-old Shiv Pande has been awarded an honorary fellowship of the University of Central Lancashire. “Rarely has a medical doctor achieved so much in so many areas, not only within his own profession, but also in our broader community. As a dedicated medical practitioner, tireless charity campaigner, accomplished broadcaster and distinguished academic, Shiv Pande MBE represents a superb role model for any citizen of multicultural Britain,” said Michael Thomas, University’s Vice Chancellor. “I have enjoyed working as National Health Service General Practitioner, Justice of Peace, Broadcaster, charity worker all these years.

My work at General Medical Council took me a lot to London but happy to say as a past Treasurer of GMC, I was quietly pleased when we all at GMC decided to move it’s office and majority of work to Northwest in Manchester,” Pande, who is also a member of the Indian Journalists Association, said. Pande was presented the award at Preston Guildhall by The University of Central Lancashire (UCLan) to commemorate his lifelong help for local people but previously received an MBE from the Queen in 1989 for his community work, the University said in a statement. A Member of the Order of the British Empire (MBE) is awarded by the Queen for a significant achievement or outstanding service to the community.

Born and educated in India, Pande obtained his MBBS and Ms (General Surgery) degrees in India before moving to the UK in 1971 where he worked in cardio-thoracic surgery at London Chest Hospital, Broad Green Hospital and Fazakerley Hospital, Liverpool until 1974. In 1975 he entered general practice, eventually retiring in 2005 after 30 years.

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Indian doctors at higher lay-off risk in UK – India

25 oct 2015

DON: The maximum number of doctors sacked in the UK over the last five years is from India, Britain’s General Medical Council (GMC) has revealed.

In the past five years, one out of every 250 doctors of Indian origin lost their job. Data shows that doctors working in UK but trained in India are four times more likely to lose their job.

Since 2009, 117 doctors trained in India and Pakistan have been barred from working in Britain. India is followed by Pakistan, Egypt and Nigeria.
In 2013 alone, 75% of doctors who were struck off came to UK from foreign shores. In total, 458 doctors have been barred from working in the UK in the past five years.

The findings come days after British researchers called for making tests taken by foreign doctors who want to work in the NHS to be made harder to pass as half of all foreign doctors in Britain do not have the necessary skills to work here.
 The University College London said they found a performance gap between international and UK medical graduates and has suggested raising the pass mark from 63 to 76%.
 More than 95,000 foreign-trained doctors work in the UK, making up a quarter of the total number, majority of them being Indians.
 The British Association of Physicians of Indian Origin (BAPIO) had recently dragged both the Royal College of General Practitioners (RCGP) which conducts the exam and the General Medical Council (GMC) which is accountable for ensuring a fair process to Court alleging that UK based trainee GPs from Indian background were four times more likely to fail this assessment and international medical graduates were 16 times more likely to fail the exam than their white counterparts despite having successfully completed the same stringent training process up to this point. BAPIO lost the case.
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British Army used 10 year old Indian Children in World War 1 – India

25 oct 2015

Dr Sanjay Kumar Cardiac Surgeon

Dr Sanjay Kumar Cardiac Surgeon

File photo of Indian soldiers at a camp in Marseilles, France.

LONDON:  Britain’s World War I Army included Indian children as young as 10-years-old fighting against the Germans on the western front, according to a new book on the role of Indian soldiers in the Great War.

The youngsters were shipped over to France from the far reaches of the British Empire to carry out support roles, but were so close to the front line that many were wounded and admitted to hospital, according to ‘For King and Another Country: Indian Soldiers on the Western Front 1914-18’.

The account by writer and historian Shrabani Basu is based on official papers at the National Archives and British Library.

Some of the Indian children, including a 10-year-old “bellows blower”, and two grooms, both 12, provided support to cavalry regiments, a ‘Sunday Times’ report said.

One of the youngest boys involved in direct combat was a “brave little Gurkha” called Pim, 16, who was given an award for valour by Queen Mary while he was recuperating in hospital in Brighton.

Ms Basu believes many of the children came from poor families and that they would have lied about their age at recruitment offices in India, where they were encouraged to sign up for a monthly salary of Rs. 11.

“In the case of a 10-year-old, it should have been pretty obvious that they were underage,” she told the newspaper.

This embarrassment was shared by some British officials. In one dispatch to Lord Kitchener, secretary of state for war, Sir Walter Lawrence, a civil servant tasked with overseeing injured Indian troops, wrote: “It seems a great pity that children should have been allowed to come to Europe.”

About 1.5 million Indian soldiers fought for Britain in the First World War, with a handful being awarded the Victoria Cross bravery medal.

Ms Basu’s book, to be published by Bloomsbury on November 5, also reveals that British nurses were barred from treating Indian soldiers in war hospitals and were allowed only to supervise orderlies, leading to claims of discrimination.

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1 in 5 women in Britain UK faces sexual violence – India

21 march 2015

In January 2013, the Ministry of Justice (MoJ), Office for National Statistics (ONS) and Home Office released its first ever joint Official Statistics bulletin on sexual violence, entitled An Overview of Sexual Offending in England and Wales.

It reported that:

  • Approximately 85,000 women are raped on average in England and Wales every year
  • Over 400,000 women are sexually assaulted each year
  • 1 in 5 women (aged 16 – 59) has experienced some form of sexual violence since the age of 16.

On 8 March 2012 the government launched an updated action plan to tackle all aspects of violence against women and girls.

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Nirbhaya’s friend, who was with her on the fateful night, calls ‘India’s Daughter’ a fake British film – India

10 mar 2015

Nirbhaya’s friend, who was with her on the fateful night, calls ‘India’s Daughter’ a fake film

New Delhi: While the British filmmaker Leslee Udwin claims that her documentary on the horrific Nirbhaya gangrape and murder case, ‘India’s Daughter’, accurately depicts what happened on the night of December 16, 2012, the sole witness to the barbaric assault on the 23-year-old woman called the film “fake”.

Backing the Central government’s decision to ban ‘India’s Daughter’ featuring the interview of one of the convicts, Mukesh Singh who blames girls for rape and not men, Nirbhaya’s friend Avanindra Pandey speaking exclusively to IBNLive accused Leslee Udwin of insensitively handling the issue.

“The documentary is unbalanced as the victim’s viewpoint is missing. The facts are hidden and the content is fake. Only Jyoti and I know what happened on that night and the documentary is far from truth,” says Avanindra Pandey who fought with the rapists and murderers to save her friend but was overpowered and beaten up brutally.

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Indian-American Surgeon on a Mission to Save Lives on Indian – India

16  feb 2015

WASHINGTON:  An Indian-American surgeon is on a mission to save thousands of lives that are lost on Indian roads every day with an innovative training programme for trauma first responders using a $200,000 simulator dummy.

Rajasthan University educated surgeon Dr Dinesh Vyas, an assistant professor in the Department of Surgery at Michigan State University since 2011, estimates that the number of road deaths in India would in 10 years swell four times from current 1,000 a day.
“It’s a shameful figure for me as a physician,” he told IANS in an email interview outlining his strategy that could easily save at least half of the road accident victims, most of whom are sole earning members of their families.

“I can change the trauma situation with my existing team of 40 US surgeons and 50 Indian faculty members in the next four years,” said Mr Vyas.

He visits India four times a year to build up collaboration across the country to make it a self-sustaining process.
Most of Mr Vyas’s team is made up of surgeons and researchers of Indian origin settled in the US and the UK.
They have also formed an Indian American Surgeons Association with close to 1,000 members many of whom are interested in the cause of trauma care.
His team is also in touch with state governments in several states including Andhra Pradesh, Gujarat, Himachal Pradesh, Punjab, Rajasthan and Telangana, 15 medical schools and NITI Ayog to extend the programme across India.
“We plan to start at least 50 centres across India each costing $700,000 with roughly two centres in every state,” said Dinesh Vyas whose team has trained more than 400 people in the last four months.
“We add at least 100 every month from our three centres – AIIMS, Jodhpur, Dr SN medical College, Jodhpur, MG Medical University, Jaipur.”
Starting cost of the programme is at least $20,000. “Most of it is borne by me and the host institute bears some cost of logistics,” Mr Vyas said.
“We take the simulators on loan at this point from the company at a subsidised rate to keep cost down for the initial phase,” he added.
Some leading corporate houses have also shown interest in the project, he said. His team is also trying to raise money through the CSR funds of foundations interested in Indian road safety or health needs.
“It gives a unique opportunity to NRI academic surgeons to pull together, central and state governments, with various private and government medical schools contributing and building a system for trauma care,” he said.
“Our research team has improvised the programme over the last 7-8 years with more than 20 visits to India and other countries to design the programme and curriculum,” said Mr Vyas.
The programmes are largely conducted in native language with sophisticated simulator dummies and other equipment and educational videos followed by question- answer and video debriefing sessions to enable all trainees to learn from their and others’ mistakes.
Another key feature is that it’s a “Trainer-Trainee programme: meaning we train both trainers and trainees during our visit and observe local trainers educate more trainees,” Dinesh Vyas said.
“This helps us to identify the most involved, thoughtful, articulate and critical trainers to run and build a sustainable, high quality, motivated programme,” he said.
Later, the team stays engaged with the local trainers providing support through video conferences.
In addition, a pioneer free multi-lingual Massive Open Online Course (MOOC) for first responders has been designed to reach out to millions of students in all Indian languages through the internet using .
Run by a faculty of all dialect speakers from India recruited with the help of the Asian Studies Centre at Michigan State University, “This programme will train and educate people who cannot join the training centres we are starting in India,” Mr Vyas said.
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