Kishore Returns To Nepal To Further Foundation’s Work

As much as he will be missed by his former colleagues and friends at the London Vision Clinic, ophthalmologist and refractive surgeon Dr Kishore Raj Pradhan, will be welcomed back at the Tilganga Institute of Ophthalmology in his native Nepal.

Kishore operating in Nepal

For the past five months – with a short break in the middle – Kishore has been training alongside Prof Reinstein and the team in all aspects of refractive surgery.

“I wanted to learn every part of the process as it is done here at the London Vision Clinic – from the ground to the top of the tree,” he told me just two days before returning home. And his experience even included learning the necessary “bedside manner”.

“I learned how to talk to patients – Glenn (Carp) taught me how important it is to smile. I think that before my manner might have appeared a little cruel!

“Everyone (at the London Vision Clinic) has been very kind. They have treated me like family.”

Meanwhile he will be happy to return to his own family: wife, daughter and five-year-old son. Although his eight-year-old daughter is following in her father’s “educational” steps – by attending the same Irish missionary school in India – she doesn’t yet have any desire to become a doctor.

Back home, Kishore will introduce to his country the London Vision Clinic’s state of the art method of vision correction by using the new laser and diagnostic equipment necessary to carry it out. In short, he will be bringing Dr Dan’s dream of creating “Humanitarian Laser Eye Surgery” and the work of the London Vision Clinic Foundation a giant step closer to be becoming a reality.

Kishore (right) and Gopal at the London Vision Clinic

Working alongside Kishore is ophthalmic technician, Gopal Karmacharaya. He has also been at 138 Harley Street getting to know the equipment which will be installed in the new refractive surgery unit at the Tilganga eye hospital. It is expected that the centre will be up and running by May 1st or possibly even earlier.

Since qualifying as an ophthalmic surgeon in India, KIshore has carried out more than 11,000 sight- restoring surgeries. Most have been cataract operations and an amazing 7,500 of the patients were from the remote regions of the country and unable to get to the eye hospital.

These people were treated in travelling medical camps which are set up under canvass in the inaccessible mountainous areas. A highly skilled medical team bringing electricity generators and food supplies as well as all the surgical instruments and medical equipment set out on these expeditions from the capital at monthly intervals. Blind patients are frequently carried on the backs of their relatives for many days to be assessed and treated.

The medical team is often forced to work in the most basic of conditions. At the launch of the London Vision Clinic Foundation Kishore shared with us one of his worst ordeals.

Having walked for seventeen days, near the Tibetan border, with very little food and sleeping by river banks or in caves the camp was set up in a shack of a building which was usually used as a school. A tent was put up inside the building to prevent dust and debris falling on the patient during surgery.

Fifty-four people, who would never have made it to the hospital, were awaiting surgery.

Kishore describes what happened next: “Before I started the first patient, I collapsed – because I was wearing a mask, inside a tent and inside a school at 4,500 m. The nurses took my mask off – I could have died there because of altitude sickness – no one could have carried me for seventeen days back home if I had got sick. The nurses helped me, they took the tent down, but I had to operate. The patients had come for days. I then did the 54 surgeries with a man holding an umbrella over the patient and the microscope.”

Working in such circumstances it is impossible to keep to a time table.

“On at least two occasions we have packed everything away and are ready to leave when a new patient arrives – desperate for help.

Checking patients in Nepal

“What can you do? Of course, we unpack and start again!”

One can only imagine the poverty and suffering they have had to endure prior to the miraculous sight-restoring operation. In the hard environment of rural Nepal, where families can only scrape a basic living, a blind relative quickly becomes an additional burden – just another mouth to feed. There certainly would not have been much to smile about before but, like any person from any country or background, there is always a huge grin afterwards.

It is perhaps surprising to discover that this was not a life-long calling for Kishore. After attending an Irish missionary school in West Bengal, he had been on the brink of joining the Indian navy when he received a call from the medical council of India that he had been accepted for medical school.

But it took a lot of family pressure to persuade him to rethink his career choice. Later, having started his medical studies, his first choice was to become a general surgeon. It was an aging uncle, who had trained at Moorfields Eye Hospital and was then involved in the early eye camps of Nepal, who first spoke to him of the need for eye doctors in his home country.

“He kept putting it into my head this is what I was meant to do – that I was needed. He suggested that I join him on one of the expeditions and I decided he was right after I saw the joy and how happy the people were being able to see again.”

Although it is relatively easy to find glasses in the large towns and cities of Nepal, it is a different situation in the countryside where most people are too poor to buy them and those that might own a pair would be unable to replace them if they break. Poor sight would make walking difficult and essential daily tasks like sewing or cleaning rice almost impossible.

As the laser equipment is too large to transport to the rural areas, these corrective procedures will not be included in the travelling eye camps. Although patients can be diagnosed and post operatively screened near their homes, they would have to make their way into the new unit for the Laser Eye Surgery itself.