Canadian fellowship program builds expertise in Nepal | Orbis

Canadian fellowship program builds expertise in Nepal

Globally, the leading causes of blindness and vision loss are cataracts and uncorrected refractive error. While these conditions are a concern in Nepal, so too is corneal blindness.

The high rate of corneal blindness in Nepal is due primarily to the prevalence of rural farming in the country, which frequently leads to corneal infection when farmers get vegetative matter in their eyes during their work in their fields.

This unique situation is what inspired the selection of Orbis Canada’s first fellowship recipient, Dr. Sagar Ruit, who travelled from Kathmandu, Nepal to Vancouver to pursue a corneal fellowship at the University of British Columbia (UBC). There, Dr. Ruit had the privilege of learning from leading experts in the field, including Dr. Matthew Bujak, a cornea specialist and longtime Orbis and Himalayan Cataract Project (HCP) volunteer, as well as Dr. Simon Holland, Chair of Orbis Canada’s Board of Directors, and the first-ever medical director of the Orbis Flying Eye Hospital.

The year-long fellowship, funded by Orbis Canada, HCP and an anonymous UBC donor, will ensure specialized expertise to treat corneal conditions prevalent in Nepal.

Dr. Ruit in his home country of Nepal, where he volunteers his time for various eye health outreach initiatives.

Dr. Ruit was working as a General Ophthalmologist at Tilganga Institute of Ophthalmology (TIO) in Nepal before the fellowship opportunity arose. Upon returning home, his plan is to shift his focus from general ophthalmology to a corneal specialist.

The fellowship itself was something Dr. Ruit heard about through Dr. Geoff Tabin, co-founder of HCP. Shortly thereafter, he connected with Dr. Simon Holland and Dr. Hunter Cherwek from Orbis. Together, the trio initiated this one-of-a-kind corneal fellowship, and Dr. Ruit was eager to apply. The COVID-19 pandemic made things more challenging, but Dr. Ruit was accepted, funding was secured, and he arrived in Vancouver in the summer of 2022 to start the program. This fellowship could not have happened without collaboration and partnerships across Canada, the United States and Nepal.

While no comparison to the peaks of Nepal, Dr. Ruit enjoyed the view in the BC mountains with Dr. Tabin and Dr. Bujak.

During his year in British Columbia, Dr. Ruit worked most closely with his mentor, Dr. Bujak, participating in surgeries and learning all the nuances of this specialty—from pre-op to post-op and all the steps in between. Dr. Bujak’s busy clinic, which sees 50 to 60 patients in a day, was a perfect training opportunity for Dr. Ruit, who credits his mentor’s patience and expert guidance for making the experience such a valuable one.

With corneal blindness being so prevalent in Nepal, Dr. Ruit is eager to hone his skills in this area. However, it is also important to him that he is able to train others in his community.

Dr. Sagar Ruit

Ophthalmologist, Tilganga Institute of Ophthalmology, Nepal

For me as a doc­tor, there have always been three com­po­nents. First is to treat patients, sec­ond is to always teach the health pro­fes­sion­als, res­i­dents, fel­lows or staff and pass on the knowl­edge so more doc­tors can be trained. In turn, they can treat more patients and pass on the knowl­edge to more peo­ple and in the long run mil­lions can ben­e­fit. The third is to reach the unreached, help those in need and the poor, that’s where the core of blind­ness lies. At home, we always think about how we can make the surgery more sim­ple, afford­able and acces­si­ble to the poor peo­ple in our com­mu­ni­ty. When I go back, I’ll be teach­ing the res­i­dents and the next batch of fel­lows. And I can con­tin­ue to be part of Orbis and HCP and help build upon this fel­low­ship program.”

The need for corneal surgeons in Nepal is growing, and Dr. Ruit would like to see more doctors trained in this area so that fewer people in his country go blind. “Most of the population in Nepal is engaged in farming, and that’s when they encounter trauma to the eyes and where they develop infections and ulcers in their cornea. There’s also a very devastating fungal infection that can happen. If not treated, this can lead to blindness, which will visually impair them for the rest of their lives,” he explains. “This fellowship will help me to go back and serve that majority of the population who are needlessly blind because of corneal diseases.”

The skills and techniques Dr. Ruit learned while in Canada will allow him to provide better care for more people in Nepal.

In Nepal, Dr. Ruit is eager to pay-it-forward and support others. He hopes one day he will be able to work on Orbis programs, like The Flying Eye Hospital or the many hospital-based training projects hosted globally. He will continue to share Orbis resources, like Cybersight, with his colleagues to help them continue to learn. He is incredibly grateful for this opportunity and for all those who made it possible. “I’m very privileged to be the first one enrolled in this program,” he says. “It’s not only the fellowship, but also the experience of living in Vancouver, meeting all these new people, treating people from all over the world and also the knowledge and surgical skills that I’ve gained throughout this year. These are the things I’ll take back with me.”

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