Seyi Oyesola: Health care off the grid

Translator: Serv. de Norm. Lingüística U. de Santiago de Compostela Reviewer: Xusto Rodriguez

Just to put everything in context,

Só para poñer as cousas en contexto,

and to kind of give you a background to where I'm coming from,

e que saiban vostedes a miña bagaxe e de onde veño,

so that a lot of the things I'm going to say,

para que moitas das cousas que vou dicir,

and the things I'm going to do --

e as cousas que vou facer

or things I'm going to tell you I've done --

ou que vou dicir que fixen

you will understand exactly why and how I got motivated to be where I am.

e que entendan exactamente as razóns e as motivacións para estar onde estou.

I graduated high school in Cleveland, Ohio, 1975.

Gradueime no instituto de Cleveland, Ohio, en 1975.

And just like my parents did when they finished studying abroad, we went back home.

E como xa fixeran os meus pais ao terminar de estudar fóra, volvín á casa.

Finished university education, got a medical degree, 1986.

Rematei a universidade, gradueime en Medicina en 1986.

And by the time I was an intern house officer,

E cando era médico residente,

I could barely afford to maintain my mother's 13-year-old car --

case non podía manter o coche de trece anos de miña nai,

and I was a paid doctor.

e era un doutor cun soldo.

This brings us to why a lot of us, who are professionals,

Isto lévanos a preguntarnos por que moitos de nós, profesionais,

are now, as they say, in diaspora.

estamos agora, como din, na diáspora.

Now, are we going to make that a permanent thing,

Imos facer que isto sexa algo permanente,

where we all get trained, and we leave, and we don't go back?

que nos formemos e marchemos para non volver?

Perhaps not, I should certainly hope not --

Pode que non, oxalá non

because that is not my vision.

porque esa non é a miña visión.

All right, for good measure, that's where Nigeria is on the African map,

Ben, para termos unha idea, aí está Nixeria en África,

and just there is the Delta region that I'm sure everybody's heard of.

e xusto aí está a rexión do Delta da que seguro que oíron falar.

People getting kidnapped, where the oil comes from,

Persoas secuestradas, o sitio de onde procede o petróleo,

the oil that sometimes I think has driven us all crazy in Nigeria.

o petróleo que moitas veces parece que nos volveu a todos tolos en Nixeria.

But, critical poverty: this slide is from a presentation I gave

Pero hai pobreza extrema. Esta diapositiva é dunha presentación miña

not that long ago. Gapminder.org tells the story of the gap

de hai pouco. Gapminder.com explica a historia da fenda

between Africa and the rest of the world in terms of health care.

entre África e o resto do mundo en atención sanitaria.

Very interesting.

É moi interesante.

How many people do you think are on that taxi?

Cantas persoas dirían vostedes que viaxan neste taxi?

And believe it or not, that is a taxi in Nigeria.

E, créano ou non, isto é un taxi en Nixeria.

And the capital -- well, what used to be the capital of Nigeria -- Lagos,

E na capital, na que era capital de Nixeria, Lagos,

that's a taxi, and you have police on them.

isto é un taxi, e a policía vai nel.

So, tell me, how many policemen do you think are on this taxi? And now? Three.

Entón, digan, cantos policías pensan que van aí? E agora? Tres.

So, when these kind of people -- and, believe me, it's not just the police

Entón, cando esta xente --e créanme, non só é a policía

that use these taxis in Lagos. We all do. I've been on one of these,

a que utiliza estes taxis en Lagos. Faino todo o mundo, eu tamén,

and I didn't have a helmet, either.

e tampouco levaba casco.

And it just reminds me of the thought of what happens when one of us

E isto lémbrame o que pasa cando un de nós

on a taxi like this falls off, has an accident and needs a hospital.

cae dun destes taxis, ten un accidente e precisa dun hospital.

Believe it or not, some of us do survive.

Aínda que non o crean, algúns sobrevivimos.

Some of us do survive malaria; we do survive AIDS.

Algúns de nós sobrevivimos á malaria, á sida.

And like I tell my family, and my wife reminds me every time,

E como lle digo á miña familia, e a miña esposa lémbramo cada pouco

"You're risking your life, you know, every time you go to that country."

"Arriscas a túa vida, e sábelo, cada vez que visitas ese país."

And she's right. Every time you go there,

E ten razón. Cada vez que vas

you know that if you actually need critical care --

sabes que se precisas de coidados intensivos

critical care of any sort -- if you have an accident --

--coidados intensivos de calquera tipo-- se tes un accidente

of which there are many, there are accidents everywhere --

--e hai moitos, por todas partes--

where do they go?

onde van?

Where do they go when they need help for this kind of stuff?

Onde van se precisan axuda para todo isto?

I'm not saying instead of, I'm saying as well as,

E non digo no canto de, digo ademais de.

AIDS, TB, malaria, typhoid -- the list goes on.

Sida, tuberculose, malaria, febre tifoide... a lista continúa.

I'm saying, where do they go when they're like me?

Estou a dicir, onde van se están coma min?

When I go back home -- and I do all kinds of things,

Cando regreso á casa... e fago todas esas cousas,

I teach, I train -- but I catch one of these things,

ensino, formo... pero contraio algunha destas enfermidades,

or I'm chronically ill with one of those, where do they go?

ou son enfermo crónico, onde van?

What's the economic impact when one of them dies or becomes disabled?

Cal é o impacto económico cando algún deles morre ou queda discapacitado?

I think it's quite significant. This is where they go.

Penso que é bastante significativo. Aquí é onde van.

These are not old pictures and these are not from some downtrodden --

Non son imaxes antigas nin de ningún antro.

this is a major hospital. In fact, it's from a major teaching hospital in Nigeria.

É un hospital importante. De feito, é o maior hospital universitario de Nixeria.

Now that is less than a year old, in an operating room.

Agora unha de hai menos dun ano. Unha sala de operacións.

That's sterilizing equipment in Nigeria.

Este é un equipo de esterilización de Nixeria.

You remember all that oil?

Recordan todo aquel petróleo?

Yes, I'm sorry if it upsets some of you, but

Sinto se os afecta, pero

I think you need to see this. That's the floor, OK?

creo que teñen que ver isto. Este é o chan, vale?

You can say some of this is education.

Poden dicir que en parte é un problema de educación

You can say it's hygiene. I'm not pleading poverty.

Poden dicir que é de hixiene. Non pretendo usar a pobreza como escusa.

I'm saying we need more than just, you know, vaccination,

Digo que precisamos algo máis que, xa saben, vacinas,

malaria, AIDS, because I want to be treated

malaria, sida, porque quero ser tratado

in a proper hospital if something happens to me out there.

nun bo hospital se me pasa algo.

In fact, when I start running around saying,

De feito, cando ando dun lado para outro dicindo:

"Hey, boys and girls, you're cardiologists in the U.S.,

"Rapaces, rapazas, sodes cardiólogos nos EE. UU.,

can you come home with me and do a mission?"

podedes vir comigo a unha misión?"

I want them to think, "Well there's some hope."

Quero que pensen: "hai algunha esperanza".

Now, have a look at that. That's the anesthesiology machine.

Miren isto. É unha máquina de anestesia.

And that's my specialty, right?

É a miña especialidade, vale?

Anesthesiology and critical care -- look at that bag.

Anestesioloxía e coidados intensivos. Fíxense nesa bolsa.

It's been taped with tape that we even stopped using in the U.K.

Está arranxada cunha fita que xa nin utilizamos no Reino Unido.

And believe me, these are current pictures.

E créanme, son fotos recentes.

Now, if something like this, which has happened in the U.K.,

Se algo coma isto pasara no Reino Unido

that's where they go. This is the intensive care unit in which I work.

aquí sería onde irían. Esta é a UCI na que traballo.

All right, this is a slide from a talk I gave

Ben, esta é unha diapositiva dunha conferencia que dei

about intensive care units in Nigeria,

sobre as UCI en Nixeria

and jokingly we refer to it as "Expensive Scare."

e tiñamos a brincadeira de chamarlles "expensive scare" [medo caro].

Because it's scary and it's expensive, but we need to have it, OK?

Porque meten medo e son caras pero precisamos delas.

So, these are the problems.

Así que estes son os nosos problemas.

There are no prizes for telling us what the problems are, are there?

Non hai premios por enumerar problemas, non?

I think we all know. And several speakers before

Todos sabemos facelo. Varios oradores anteriores

and speakers after me are going to tell us even more problems.

e outros que virán a continuación exporán máis problemas.

These are a few of them. So, what did I do?

Estes son algúns deles. Así que, que fixen?

There we go -- we're going on a mission.

Imos alá, á nosa misión.

We're going to do some open-heart surgery. I was the only Brit,

Imos practicar unha operación a corazón aberto. Eu era o único "británico"

on a team of about nine American cardiac surgeons,

nun equipo duns nove cirurxiáns cardíacos americanos,

a enfermeira de cardioloxía e a de coidados intensivos.

cardiac nurse, intensive care nurse.

We all went out and did a mission and we've done three of them so far.

Levamos adiante a misión e xa levamos tres nestes momentos.

Just so you know, I do believe in missions, I do believe in aid

Para que o saiban, eu si creo nas misións, creo na axuda

and I do believe in charity. They have their place,

e na caridade. Teñen a súa función.

but where do they go for those things we talked about earlier?

Pero, onde buscan esas cousas das que falamos antes?

Because it's not everyone that's going to benefit from a mission.

Porque non todo o mundo pode beneficiarse dunha misión.

Health is wealth, in the words of Hans Rosling.

"A saúde é riqueza", dicía Hans Rosling.

You get wealthier faster if you are healthy first.

Faste rico máis rápido se tes saúde.

So, here we are, mission. Big trouble.

E aquí estamos, na misión. Gran problema.

Open-heart surgery in Nigeria -- big trouble.

Unha operación a corazón aberto en Nixeria. Gran problema.

That's Mike, Mike comes out from Mississippi.

Este é Mike. É de Mississippi.

Does he look like he's happy?

Parece feliz?

It took us two days just to organize the place, but hey,

Levou dous días organizar este sitio. Pero, ei,

you know, we worked on it. Does he look happy?

esforzámonos. Parece feliz?

Si, este é o consello que o presidente do comité deu

Yes, that's the medical advice the committee chairman says,

"Yes, I told you, you weren't going to be able to,

"Díxenvolo, non iades poder,

you can't do this, I just know it."

non podedes facelo, seino."

Look, that's the technician we had. So yes, you go on, all right?

Miren ao anestesista que tivemos. Entón si, de acordo, non?

(Laughter)

(Risas)

I got him to come with me -- anesthesia tech -- come with me from the U.K.

Logrei que fose comigo. Anestesista, vén comigo desde o Reino Unido.

Yes, let's just go work this thing out.

Fagamos que isto siga cara a adiante.

See, that's one of the problems we have in Nigeria and in Africa generally.

Miren, este é un dos problemas que temos en Nixeria e en África en xeral.

We get a lot of donated equipment.

Moito do equipamento é doado.

Equipment that's obsolete, equipment that doesn't quite work,

Está obsoleto, non funciona correctamente

or it works and you can't fix it. And there's nothing wrong with that,

ou funciona pero non o podes amañar. E non hai nada malo nisto

so long as we use it and we move on.

sempre que o utilicemos e vaia ben.

But we had problems with it. We had severe problems there.

Pero tivemos problemas. E moi serios.

He had to get on the phone. This guy was always on the phone.

El tivo que chamar por teléfono. Estivo sempre co teléfono.

So what we going to do now?

E que imos facer agora?

It looks like all these Americans are here and

Todos estes americanos están aí,

yes, one Brit, and he's not going to do anything --

tamén un británico, e non vai facer nada?

he thinks he's British actually, and he's actually Nigerian,

Cre que é británico e realmente é nixeriano.

I just thought about that.

Acábame de acordar.

We eventually got it working, is the truth,

Ao final conseguimos que funcionara

but it was one of these. Even older than the one you saw.

pero era un destes. Máis antigo que este.

The reason I have this picture here, this X-ray,

A razón de que estea esta imaxe aquí, esta radiografía,

it's just to tell you where and how we were viewing X-rays.

é para que vexan as condicións nas que estábamos.

Do you figure where that is? It was on a window.

Danse conta? É unha ventá.

I mean, what's an X-ray viewing box? Please.

Un negatoscopio? Por favor!

Well, nowadays everything's on PAX anyway.

Hoxe está todo no ordenador de todos os xeitos.

You look at your X-rays on a screen and you do stuff with them,

Miras as radiografías nunha pantalla e traballas nelas,

you email them. But we were still using X-rays,

envíalas por correo-e... nós empregabámolas

but we didn't even have a viewing box!

pero sen ter negatoscopio!

E estabamos a practicar operacións a corazón aberto.

And we were doing open-heart surgery.

OK, I know it's not AIDS, I know it's not malaria,

Seino, non é sida nin malaria

but we still need this stuff. Oh yeah, echo --

pero necesitamos estas cousas. Si, ecógrafos.

this was just to get the children ready and the adults ready.

Isto é para o preparatorio de nenos e adultos.

People still believe in Voodoo. Heart disease,

A xente aínda cre no vodú. Enfermidade cardíaca,

VSD, hole in the heart, tetralogies.

defecto ventricular, un burato no corazón, tetraloxías.

You still get people who believe in it and they came.

Aínda existe xente que cre no vodú e tamén veñen.

At 67 percent oxygen saturation, the normal is about 97.

A saturación de osíxeno ao 67%, o normal é sobre o 97%.

Her condition, open-heart surgery that as she required,

Isto require cirurxía cardíaca

would have been treated when she was a child.

e xa deberan operala de pequena.

We had to do these for adults. So, we did succeed and we still do.

Nós temos que facelo de adultos. E fixémolo.

We've done three. We're planning another one in July

Levamos xa tres e temos prevista outra operación para xullo

in the north of the country. So, we certainly still do open-heart,

no norte do país. A pesar de todo seguimos a operar a corazón aberto

but you can see the contrast between everything that was shipped in --

e poden ver o contraste entre todo o que enviamos

we ship everything, instruments. We had explosions

enviamos todo, o instrumental. Houbo explosións

because the kit was designed and installed by people who weren't used to it.

porque a sala deseñouna e instalouna xente que non estaba familiarizada con isto.

The oxygen tanks didn't quite work right.

O osíxeno non funcionou demasiado ben.

But how many did we do the first one? 12.

Pero, cantas persoas operamos a primeira vez?

Doce.

We did 12 open-heart surgical patients successfully.

Operamos do corazón a doce pacientes satisfactoriamente.

Here is our very first patient, out of intensive care,

O noso primeiro paciente, xa fóra da UCI.

and just watch that chair, all right?

Observen a cadeira. Exacto.

This is what I mean about appropriate technology.

A isto me refiro cando falo da tecnoloxía apropiada.

That's what he was doing, propping up the bed because the bed simply didn't work.

Isto facía, apuntalaba a cama porque non funcionaba.

Have you seen one of those before?

Viron algo así antes?

No? Yes? Doesn't matter, it worked.

Non? Si? Tanto ten, funcionou.

I'm sure you've all seen or heard this before:

Seguro que todos o viron antes:

"We, the willing, have been doing so much with so little for so long --

"nós, os voluntariosos, levamos tanto tempo facendo tanto con tan pouco

(Applause)

(Aplausos)

-- we are now qualified to do anything with nothing."

que xa podemos facer calquera cousa con nada.

(Applause)

(Aplausos)

Thank you. Sustainable Solutions -- this was my first company.

Grazas

Solucións sustentables. Esta foi a miña primeira empresa.

This one's sole aim is to provide the very things that I think are missing.

O meu propósito é ofrecer as cousas que penso que faltan.

So, we put my hand in my pocket and say, "Guys, let's just buy stuff.

Entón metemos a man no peto e dicimos: "Rapaces, vaiamos de compras.

Let's go set up a company that teaches people, educates them,

Imos facer unha compañía que ensine, que eduque a xente

gives them the tools they need to keep going."

que lles dea as ferramentas para saír adiante."

And that's a perfect example of one.

E este é un exemplo perfecto disto.

Usually when you buy a ventilator in a hospital,

Cando se compra un respirador nun hospital

you buy a different one for children,

normalmente compras outro diferente para nenos

you buy a different one for transport. This one will do everything,

e outro transportable. O noso serve para todo,

and it will do it at half the price and doesn't need compressed air.

coa metade de prezo e sen aire comprimido.

If you're in America and you don't know about this one, we do,

Se vostede está nos EE. UU. e non o coñece, nós si.

because we make it our duty to find out

Porque temos que atopar

what's appropriate technology for Africa -- what's appropriately priced,

tecnoloxía apropiada para África. Apropiada nos prezos

does the job, and we move on. Anesthesia machine:

e que funcione. Seguimos. Máquina de anestesia,

multi-parameter monitor, operating lights, suction.

monitor multiparámetros, luces de operación, succión.

This little unit here -- remember your little 12-volt plug in the car,

Esta pequena unidade, recordan o pequeno enchufe de 12 V do seu coche,

that charges your, whatever, Game Boy, telephone?

que carga calquera cousa? A Game Boy, o teléfono...

That's exactly how the outlets are designed.

Así están deseñados estes enchufes.

Yes, it will take a solar panel. Yes a solar panel will charge it.

Si, poden usar un panel solar. Un panel solar pode cargalos.

But if you've got mains as well, it will charge the batteries in there.

E se hai rede eléctrica esta tamén pode cargalos.

And guess what? We have a little pedal charger too, just in case.

E adiviñan que? Temos tamén un pequeno cargador de pedal, por se acaso.

And guess what, if it all fails,

E adiviñen, se todo isto falla,

if you can find a car that's still got a live battery

se podes atopar un coche coa batería cargada

and you stick it in, it will still work. Then you can customize it.

e o conectas a el tamén funcionará. Tamén é personalizable.

Is it dental surgery you want? General surgery you want?

Necesitas cirurxía dental? Cirurxía xeral?

Decide which instruments, stock it up with consumables.

Escolle o instrumental e almacénao cos consumibles.

And currently we're working on oxygen -- oxygen delivery on-site.

Agora mesmo estamos a traballar co osíxeno.

Na dispoñibilidade in situ.

The technology for oxygen delivery is not new.

Esta tecnoloxía non é nova.

Oxygen concentrators are very old technology. What is new,

Hai concentradores de osíxeno desde hai moito tempo.

O novo --e que agardo que o teñamos nuns meses--

and what we will have in a few months, I hope,

is that ability to use this same renewable energy system

é a capacidade de utilizar o mesmo sistema de enerxía

to provide and produce oxygen on site. Zeolite -- it's not new --

para prover e producir osíxeno in situ. A ceolita non é nova.

zeolite removes nitrogen from air and nitrogen is 78 percent of air.

Elimina o nitróxeno do aire e o nitróxeno é o 78% do aire.

If you take nitrogen out, what's left? Oxygen, pretty much.

Se quitas o nitróxeno, que queda? Osíxeno practicamente.

So that's not new. What we're doing is applying this technology to it.

Isto non é novo pero nós estamos utilizando esta tecnoloxía para facelo.

These are the basic features of my device, or our device.

Estas son as características básicas do meu dispositivo, do noso dispositivo.

This is what makes it so special.

Isto é o que o fai tan especial.

Apart from the awards it's won,

Á parte dos premios que leva gañados

it's portable and it's certified. It's registered, the MHRA --

é portátil e está certificado. Está rexistrado. A MHRA

and the CE mark, for those who don't know, for Europe, is the equivalent

e o selo CE, que para quen non o saiba é o equivalente en Europa

of the FDA in the U.S.

da FDA nos EE. UU.

If you compare it with what's on the market, price-wise,

Esta é a comparativa co que hai no mercado en prezo,

size-wise, ease of use, complexity ...

tamaño, facilidade de uso, complexidade...

This picture was taken last year.

Esta foto é do ano pasado.

These are members of my graduating class, 1986.

Son os membros da miña promoción, de 1986.

It was in this gentleman's house in the Potomac,

Foi na casa deste cabaleiro en Potomac

for those of you who are familiar with Maryland.

para os que lles sexa familiar Maryland.

There are too many of us outside and everybody,

Moitos de nós estamos fóra e todos,

just to borrow a bit from Hans -- Hans Rosling, he's my guy --

colléndolle algo prestado a Hans. Hans Rosling, o meu heroe.

if the size of the text represents what gets the most attention,

Se o tamaño do texto representara ao que prestamos máis atención

it's the problems. But what we really need are African solutions

é aos problemas. Pero en África o que necesitamos son solucións

that are appropriate for Africa -- looking at the culture,

e que sexan apropiadas para alí. Hai que ter en conta a cultura

looking at the people, looking at how much money they've got.

e a xente e os cartos que teñen.

African people, because they will do it with a passion, I hope.

Á xente africana, porque o farán con paixón, agardo.

And lots and lots of that little bit down there, sacrifice.

E moito, moito deste anaquiño de aquí embaixo, "sacrificio".

You have to do it. Africans have to do it,

Vostedes teñen que facelo. Os africanos teñen que facelo,

in conjunction with everyone else.

conxuntamente co resto.

Thank you.

Grazas.

(Applause)

(Aplausos)