Gail Reed: Where to train the world's doctors? Cuba.

82,286 views ・ 2014-10-01

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Prevoditelj: Marina Maras Recezent: Ivan Stamenković
00:12
I want to tell you
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Željela bih vam ispričati
00:14
how 20,000 remarkable young people
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kako je 20,000 izuzetnih mladih ljudi
00:18
from over 100 countries
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iz preko 100 zemalja
00:20
ended up in Cuba
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završilo na Kubi
00:22
and are transforming health in their communities.
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i kako mijenjaju zdravstvo u svojim zajednicama.
00:26
Ninety percent of them would never
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Devedeset posto njih nikada
00:28
have left home at all
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ne bi ni otišli od kuće
00:29
if it weren't for a scholarship to study medicine in Cuba
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da nije bilo stipendije za studiranje medicine na Kubi
00:33
and a commitment to go back
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i obećanja da će se vratiti natrag
00:35
to places like the ones they'd come from —
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u mjesta poput onih iz kojih su došli —
00:38
remote farmlands, mountains, ghettos —
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u udaljena poljoprivredna područja, planine, geta —
00:42
to become doctors for people like themselves,
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kako bi postali liječnici za ljude poput sebe,
00:45
to walk the walk.
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kako bi ostali snažni na svom putu.
00:47
Havana's Latin American Medical School:
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Latinskoamerički medicinski fakultet u Havani:
00:50
It's the largest medical school in the world,
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je najveći medicinski fakultet na svijetu,
00:53
graduating 23,000 young doctors
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na kojemu je diplomiralo 23,000 mladih doktora
00:56
since its first class of 2005,
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od prve generacije 2005. godine,
00:59
with nearly 10,000 more in the pipeline.
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a još skoro 10000 ih je u sustavu školovanja.
01:02
Its mission, to train physicians for the people
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Njegova misija jest školovati liječnike za ljude
01:06
who need them the most:
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koji ih najviše trebaju:
01:08
the over one billion
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za preko milijardu ljudi
01:10
who have never seen a doctor,
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koji nikada nisu vidjeli liječnika,
01:12
the people who live and die
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ljude koji žive i umiru
01:16
under every poverty line ever invented.
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ispod svake crte siromaštva koja je ikad smišljena.
01:20
Its students defy all norms.
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Njegovi studenti prkose svim norama.
01:22
They're the school's biggest risk
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Oni su najveći rizik ove škole
01:24
and also its best bet.
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ali također i najbolja prilika.
01:26
They're recruited from the poorest,
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Studente regrutira iz najsiromašnijih,
01:29
most broken places on our planet
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iz najuništenijih mjesta na našem planetu,
01:32
by a school that believes they can become
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škola koja vjeruje da oni mogu postati
01:34
not just the good
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ne samo dobri
01:35
but the excellent physicians
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već odlični liječnici
01:37
their communities desperately need,
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koji su očajnički potrebni svojim zajednicama,
01:40
that they will practice where most doctors don't,
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te da će obavljati svoju službu gdje većina doktora ne bi,
01:44
in places not only poor
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u mjestima koja nisu samo siromašna,
01:46
but oftentimes dangerous,
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već su često i opasna,
01:49
carrying venom antidotes in their backpacks
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noseći protuotrove u ruksacima
01:52
or navigating neighborhoods
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ili obilazeći susjedstva
01:54
riddled by drugs, gangs and bullets,
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prepuna drogom, bandama i metcima,
01:58
their home ground.
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obilazeći svoje teren.
02:00
The hope is that they will help
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Postoji nada da će oni pomoći
02:02
transform access to care,
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promijeniti dostupnost liječenju,
02:04
the health picture in impoverished areas,
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zdravstvenu situaciju općenito u osiromašnim područjima,
02:07
and even the way medicine itself
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i čak sami način kako se medicina
02:09
is learned and practiced,
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uči i prakticira,
02:11
and that they will become pioneers in our global reach
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i da će postati pioniri u našoj gobalnoj misiji
02:16
for universal health coverage,
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za univerzalnom zdravstvenom skrbi dostupnoj svima,
02:18
surely a tall order.
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uistinu teška misija.
02:21
Two big storms and this notion of "walk the walk"
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Dvije velike oluje i ideja 'koračanja težim putem'
02:25
prompted creation of ELAM back in 1998.
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potaknuli su osnivanje ELAM-a 1998. godine.
02:29
The Hurricanes Georges and Mitch
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Uragani Georges i Mitch
02:32
had ripped through the Caribbean
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poharali su Karibe
02:34
and Central America,
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i Srednju Ameriku,
02:36
leaving 30,000 dead
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ostavljajući za sobom 30, 000 mrtvih
02:38
and two and a half million homeless.
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i dva i pol milijuna ljudi bez doma.
02:41
Hundreds of Cuban doctors volunteered for disaster response,
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Stotine kubanskih doktora se dobrovoljno uključilo u misiju suzbijanja katastrofe,
02:45
but when they got there,
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ali kad su stigli tamo,
02:47
they found a bigger disaster:
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našli su još veću katastrofu:
02:49
whole communities with no healthcare,
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čitave zajednice bez postojeće zdravstvene skrbi,
02:52
doors bolted shut on rural hospitals
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lokote na vratima seoskih bolnica
02:54
for lack of staff,
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zbog nedostatka osoblja,
02:56
and just too many babies dying
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i jednostavno preveliki broj beba koje ne dožive
02:59
before their first birthday.
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svoj prvi rođendan.
03:02
What would happen when these Cuban doctors left?
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Što će se dogoditi kad ovi kubanski liječnici odu?
03:06
New doctors were needed to make care sustainable,
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Bili su potrebni novi liječnici da bi sustav bio održiv,
03:08
but where would they come from?
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ali odakle bi oni došli?
03:10
Where would they train?
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Gdje bi se obrazovali?
03:12
In Havana, the campus of a former naval academy
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U Havani, kampus bivše mornaričke akademije
03:17
was turned over to the Cuban Health Ministry
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je predan kubanskom ministarstvu zdravlja
03:20
to become the Latin American Medical School,
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kako bi postao latinskoamerički medicinski fakultet,
03:23
ELAM.
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ELAM.
03:25
Tuition, room and board, and a small stipend
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Školarina, smještaj i hrana i mala stipendija
03:28
were offered to hundreds of students
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ponuđene su stotinama studenata
03:30
from the countries hardest hit by the storms.
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iz zemalja najviše pogođenih olujama.
03:33
As a journalist in Havana,
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Kao novinarka u Havani,
03:35
I watched the first 97 Nicaraguans arrive
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svjedočila sam dolasku prvih 97 Nikaragvanaca
03:38
in March 1999,
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u ožujku 1999. godine,
03:40
settling into dorms barely refurbished
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i tome kako se smještaju u jedva obnovljene studentske sobe
03:43
and helping their professors not only sweep out the classrooms
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i kako pomažu svojim profesorima ne samo čistiti učionice
03:46
but move in the desks and the chairs and the microscopes.
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već i unositi stolove, stolice i mikroskope.
03:51
Over the next few years,
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Tijekom sljedećih nekoliko godine
03:53
governments throughout the Americas
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vlade diljem Amerike
03:55
requested scholarships for their own students,
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su tražile stipendije za svoje studente,
03:58
and the Congressional Black Caucus
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i Klub crnačkih zastupnika u Kongresu
04:00
asked for and received hundreds of scholarships
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je zatražio i primio stotine stipendija
04:03
for young people from the USA.
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za mlade ljude iz SAD-a.
04:07
Today, among the 23,000
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Danas se među 23,000 liječnika
04:10
are graduates from 83 countries
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nalaze diplomci iz 83 zemlje
04:13
in the Americas, Africa and Asia,
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iz Amerike, Afrike i Azije,
04:16
and enrollment has grown to 123 nations.
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a upis se proširio na 123 nacije.
04:22
More than half the students are young women.
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Više od polovice studenata su mlade žene.
04:24
They come from 100 ethnic groups,
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One dolaze iz 100 etničkih grupa,
04:26
speak 50 different languages.
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govore 50 različitih jezika.
04:28
WHO Director Margaret Chan said,
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Direktorica Svjetske zdravstvene organizacije Margaret Chan je rekla:
04:31
"For once, if you are poor, female,
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" Po prvi put, ako ste siromašni, žena
04:35
or from an indigenous population,
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ili pripadate domorodačkoj populaciji,
04:37
you have a distinct advantage,
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imate značajnu prednost,
04:39
an ethic that makes this medical school unique."
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etiku koja čini ovaj medicinski fakultet jedinstvenim."
04:43
Luther Castillo comes from San Pedro de Tocamacho
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Luther Castillo dolazi iz mjesta San Pedro de Tocamacho
04:48
on the Atlantic coast of Honduras.
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koje se nalazi na atlantskoj obali Hondurasa.
04:50
There's no running water,
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Tamo nema tekuće vode,
04:52
no electricity there,
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nema struje,
04:54
and to reach the village, you have to walk for hours
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a da biste došli do sela, morate hodati satima
04:58
or take your chances in a pickup truck like I did
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ili iskušati svoju sreću u kamionetu kao što sam ja napravila
05:01
skirting the waves of the Atlantic.
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izbjegavajući valove Atlantika.
05:04
Luther was one of 40 Tocamacho children
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Luther je bio jedno od 40 Tocamacho djece
05:09
who started grammar school,
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koja su krenula u školu,
05:11
the sons and daughters of a black indigenous people
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sinovi i kćeri crnih domorodaca,
05:13
known as the Garífuna,
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poznatiji kao Garífuna,
05:15
20 percent of the Honduran population.
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koji čine 20 posto honduraške populacije.
05:19
The nearest healthcare was fatal miles away.
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Prva dostupna zdravstvena skrb nalazila se nedostižnim miljama daleko.
05:24
Luther had to walk three hours every day
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Luther je morao svakodnevno tri sata pješačiti
05:27
to middle school.
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kako bi pohađao više razrede osnovne škole.
05:29
Only 17 made that trip.
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Samo 17 ih je išlo na taj put.
05:31
Only five went on to high school,
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Samo pet ih je prešlo u srednju školu
05:33
and only one to university:
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a samo jedan je otišao na fakultet:
05:36
Luther, to ELAM,
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Luther, na ELAM,
05:38
among the first crop of Garífuna graduates.
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i bio je među prvom žetvom Garífuna diplomaca.
05:42
Just two Garífuna doctors had preceded them
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Njemu su prethodila samo dva Garífuna liječnika
05:45
in all of Honduran history.
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u cijeloj povijesti Hondurasa.
05:48
Now there are 69, thanks to ELAM.
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Sada ih ima 69, zahvaljujući ELAM-u.
05:53
Big problems need big solutions,
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Veliki problemi zahtijevaju velika rješenja,
05:57
sparked by big ideas, imagination and audacity,
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potaknuta iskrom velikih ideja, mašte i odvažnosti,
06:00
but also solutions that work.
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ali i rješenja koja funkcioniraju.
06:03
ELAM's faculty had no handy evidence base
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ELAM-ovi profesori nisu imali zgodnu bazu podataka
06:07
to guide them, so they learned the hard way,
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koja bi ih vodila na njihovom putu stoga su morali učiti na teži način,
06:10
by doing and correcting course as they went.
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kako su išli naprijed i radili tako su ispravljali svoj put.
06:14
Even the brightest students
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Čak i najbistriji studenti
06:16
from these poor communities
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iz ovih siromašnih zajednica
06:18
weren't academically prepared
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nisu bili akademski pripremljeni
06:20
for six years of medical training,
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za 6 godina medicinske naobrazbe
06:23
so a bridging course was set up in sciences.
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tako da je uspostavljen prijelazni program iz znanosti.
06:26
Then came language:
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Tada se postavilo pitanje jezika:
06:28
these were Mapuche, Quechuas, Guaraní, Garífuna,
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ovdje su bili Mapuche, Quechuasi, Guaraní, Garífuna,
06:31
indigenous peoples
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domorodci
06:33
who learned Spanish as a second language,
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koji su naučili španjolski kao drugi jezik,
06:35
or Haitians who spoke Creole.
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ili Haićani koji su govorili kreolski.
06:38
So Spanish became part
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Tako da je 'Španjolski jezik' postao dio
06:40
of the pre-pre-med curriculum.
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pred-pred- pripremnog medicinskog kurikuluma.
06:44
Even so, in Cuba,
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Unatoč tome, na Kubi,
06:47
the music, the food, the smells,
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glazba, hrana, mirisi,
06:50
just about everything was different,
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gotovo sve je bilo drugačije,
06:53
so faculty became family, ELAM home.
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tako da je fakultetsko osoblje postalo obitelj, a ELAM dom.
06:58
Religions ranged from indigenous beliefs
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Religije su se kretale od domorodačkih vjerovanja
07:00
to Yoruba, Muslim and Christian evangelical.
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do jorube, muslimana i evangeličke kršćanske crkve.
07:05
Embracing diversity became a way of life.
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Prihvaćanje različitosti je postalo način života.
07:09
Why have so many countries
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Zašto je toliko zemalja
07:11
asked for these scholarships?
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zatražilo ove stipendije?
07:13
First, they just don't have enough doctors,
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Prvo, oni nemaju dovoljno liječnika,
07:17
and where they do, their distribution
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a tamo gdje ih imaju, raspoređeni su
07:18
is skewed against the poor,
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neravnomjerno, na štetu siromašnih,
07:21
because our global health crisis
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jer je naša globalna zdravstvena kriza
07:23
is fed by a crisis in human resources.
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potpomognuta krizom u ljudskim resursima.
07:26
We are short four to seven million health workers
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Nedostaje nam 4 do 7 milijuna zdravstvenih radnika
07:30
just to meet basic needs,
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i to samo kako bi pokrili osnovne potrebe,
07:33
and the problem is everywhere.
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a problem je isti posvuda.
07:35
Doctors are concentrated in the cities,
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Liječnici su koncentrirani u gradovima,
07:37
where only half the world's people live,
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gdje živi samo polovica svjetske populacije,
07:40
and within cities,
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i to unutar gradova,
07:41
not in the shantytowns or South L.A.
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a ne u sirotinjskim naseljima ili u južnom L. A-u.
07:46
Here in the United States,
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Ovdje u SAD-u,
07:47
where we have healthcare reform,
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gdje imamo reformu zdravstva,
07:50
we don't have the professionals we need.
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nemamo profesionalce koji su nam potrebni.
07:52
By 2020, we will be short
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Do 2020. godine nedostajat će nam
07:55
45,000 primary care physicians.
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45,000 liječnika primarne zdravstvene zaštite.
07:59
And we're also part of the problem.
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I mi smo dio problema.
08:01
The United States is the number one importer
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SAD je uvoznik broj jedan
08:04
of doctors from developing countries.
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liječnika iz zemalja u razvoju.
08:08
The second reasons students flock to Cuba
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Drugi razlog iz kojeg se studenti skupljaju na Kubi
08:11
is the island's own health report card,
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jest razina usluga zdravstvene skrbi na ovom otoku
08:13
relying on strong primary care.
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a koja se oslanja na snažnoj primarnoj zdravstvenoj zaštiti.
08:16
A commission from The Lancet
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Komisija iz Lanceta
08:18
rates Cuba among the best performing
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rangira Kubu među najboljim
08:20
middle-income countries in health.
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zemljama srednjeg prihoda po pitanju zdravstva.
08:23
Save the Children ranks Cuba
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Organizacija 'Spasimo djecu' daje Kubi titulu
08:25
the best country in Latin America to become a mother.
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najbolje zemlje Latinske Amerike za ostvarivanje majčinstva.
08:30
Cuba has similar life expectancy
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Kuba ima sličan očekivan životni vijek
08:33
and lower infant mortality than the United States,
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ali ujedno i nižu stopu mortaliteta dojenčadi od SAD-a,
08:36
with fewer disparities,
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s manje nejednakosti,
08:38
while spending per person
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dok je trošak po osobi
08:40
one 20th of what we do on health
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tek 20-eti dio onoga što mi trošimo na zdravstvo
08:43
here in the USA.
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ovdje u SAD-u.
08:45
Academically, ELAM is tough,
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Akademski gledano, ELAM je teška škola,
08:48
but 80 percent of its students graduate.
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ali 80 posto studenata diplomira.
08:52
The subjects are familiar —
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Predmeti su poznati —
08:53
basic and clinical sciences —
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osnovne i kliničke znanosti —
08:56
but there are major differences.
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ali također postoje značajne razlike.
08:58
First, training has moved out of the ivory tower
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Prvo, školovanje se premjestilo iz nedodirljivog tornja od bjelokosti
09:02
and into clinic classrooms and neighborhoods,
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u klinike i u susjedstvo,
09:05
the kinds of places most of these grads will practice.
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mjesta na kakvima će većina ovih diplomaca i raditi.
09:08
Sure, they have lectures and hospital rotations too,
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Oni, naravno, imaju predavanja i kliničke rotacije također,
09:12
but community-based learning starts on day one.
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ali učenje unutar zajednice počinje već prvi dan.
09:17
Second, students treat the whole patient,
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Drugo, studenti liječe pacijenta u cijelosti,
09:21
mind and body,
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i tijelo i duh,
09:23
in the context of their families, their communities
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2506
u kontekstu njihovih obitelji, zajednica
09:25
and their culture.
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i njihove kulture.
09:27
Third, they learn public health:
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Treće, oni uče o javnom zdravstvu,
09:30
to assess their patients' drinking water, housing,
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uče kako procijeniti kvalitetu pitku vodu, smještaj,
09:33
social and economic conditions.
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te socijalne i ekonomske uvjete u kojima žive pacijenti.
09:37
Fourth, they are taught
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Četvrto, uči ih se
09:39
that a good patient interview
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da dobar razgovor s pacijentom
09:42
and a thorough clinical exam
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i detaljan klinički pregled
09:44
provide most of the clues for diagnosis,
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daju najviše osnova za postavljanje dijagnoze,
09:47
saving costly technology for confirmation.
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tako štedeći na uporabi skupe tehnologije za njeno potvrđivanje.
09:51
And finally, they're taught over and over again
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I konačno, uči ih se iznova i iznova
09:54
the importance of prevention,
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važnost prevencije,
09:57
especially as chronic diseases
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pogotovo dok kronične bolesti
09:59
cripple health systems worldwide.
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sakate zdravstvene sustave diljem svijeta.
10:03
Such an in-service learning
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Takvu vrstu učenja kroz praksu
10:06
also comes with a team approach,
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prati timski pristup radu,
10:09
as much how to work in teams
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kako raditi u timu i
10:12
as how to lead them,
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kako voditi tim,
10:14
with a dose of humility.
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uvijek s dozom poniznosti.
10:16
Upon graduation, these doctors share
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Nakon diplome, ovi liječnici dijele
10:19
their knowledge with nurse's aids, midwives,
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2710
svoje znanje s pomoćnicima medicinskih sestara, babicama,
10:21
community health workers,
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1970
zdravstvenim djelatnicima u zajednicama,
10:23
to help them become better at what they do,
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kako bi im pomogli da postanu što bolji u onome što rade,
10:26
not to replace them,
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1945
a ne kako bi ih zamijenili,
10:28
to work with shamans and traditional healers.
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te kako bi radili sa šamanima i narodnim iscjeliteljima.
10:33
ELAM's graduates:
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ELAM-ovi diplomci:
10:35
Are they proving this audacious experiment right?
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Jesu li dokazali opravdanost ovog odvažnog eksperimenta?
10:40
Dozens of projects give us an inkling
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Veliki broj projekata nagovještava
10:42
of what they're capable of doing.
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što su oni sposobni učiniti.
10:45
Take the Garífuna grads.
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Uzmite naprimjer Garífuna diplomce.
10:47
They not only went to work back home,
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Ne samo da su se vratili raditi kući,
10:49
but they organized their communities to build
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2407
već su organizirali svoje zajednice kako bi izgradili
10:51
Honduras' first indigenous hospital.
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prvu domorodačku bolnicu u Hondurasu.
10:55
With an architect's help,
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S pomoću arhitekta,
10:57
residents literally raised it from the ground up.
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stanovnici su je doslovno izgradili iz temelja.
11:01
The first patients walked through the doors
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Prvi pacijenti su ušli u bolnicu
11:03
in December 2007,
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u prosincu 2007. godine,
11:06
and since then, the hospital has received
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2509
a otada je bolnica primila
11:08
nearly one million patient visits.
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gotovo milijun posjeta pacijenata.
11:11
And government is paying attention,
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I vlada obraća pozornost,
11:14
upholding the hospital as a model
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podržavajući bolnicu kao model
11:16
of rural public health for Honduras.
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ruralne zdravstvene javne usluge u Hondurasu.
11:21
ELAM's graduates are smart,
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ELAM-ovi diplomci su pametni,
11:25
strong and also dedicated.
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jaki i ujedno predani.
11:28
Haiti, January 2010.
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Haiti, siječanj 2010. godine
11:33
The pain.
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Bol.
11:35
People buried under 30 million tons of rubble.
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Ljudi zatrpani ispod 30 milijuna tona ruševina.
11:39
Overwhelming.
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Neopisivo riječima.
11:41
Three hundred forty Cuban doctors
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340 kubanskih doktora
11:43
were already on the ground long term.
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je već bilo na mjestu događaja na duže staze.
11:45
More were on their way. Many more were needed.
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Još ih je bilo na putu. A još mnogo ih je bilo potrebno.
11:47
At ELAM, students worked round the clock
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U ELAM-u, studenti su neprestance radili
11:51
to contact 2,000 graduates.
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kako bi kontaktirali 2,000 diplomaca.
11:54
As a result, hundreds arrived in Haiti,
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Kao rezultat ovih napora, stotine su došle na Haiti,
11:57
27 countries' worth, from Mali in the Sahara
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iz 27 zemalja, od Malija u Sahari
12:01
to St. Lucia, Bolivia, Chile and the USA.
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do Sv. Lucije, Bolivije, Čilea i SAD-a.
12:06
They spoke easily to each other in Spanish
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Oni su se lako sporazumijevali na španjolskom
12:09
and listened to their patients in Creole
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i slušali su svoje pacijente na kreolskom
12:12
thanks to Haitian medical students
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zahvaljujući studentima medicine iz Haitija
12:14
flown in from ELAM in Cuba.
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koji su doletjeli s ELAMA, s Kube.
12:16
Many stayed for months,
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Mnogi su ostali mjesecima,
12:18
even through the cholera epidemic.
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i tijekom epidemije kolere.
12:21
Hundreds of Haitian graduates
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Stotine haićanskih diplomaca
12:23
had to pick up the pieces,
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je moralo dovesti stvari u red,
12:26
overcome their own heartbreak,
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prevladati vlastitu bol u srcu
12:28
and then pick up the burden
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i tada preuzeti na sebe teret
12:30
of building a new public health system for Haiti.
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izgradnje novog javnog zdravstvnog sustava za Haiti.
12:33
Today, with aid of organizations and governments
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Danas, uz pomoć organizacija i vlada,
12:36
from Norway to Cuba to Brazil,
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2553
od Norveške do Kube, Brazila,
12:38
dozens of new health centers have been built,
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izgrađen je veliki broj novih zdravstvenih centara,
12:41
staffed, and in 35 cases, headed
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u kojima rade, a u 35 slučajeva kojima i upravljaju
12:44
by ELAM graduates.
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diplomci ELAM-a.
12:48
Yet the Haitian story
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Ipak priča sa Haitija
12:50
also illustrates some of the bigger problems
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također prikazuje neke od većih problema
12:52
faced in many countries.
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s kojima se suočavaju mnoge zemlje.
12:54
Take a look:
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Pogledajte:
12:56
748 Haitian graduates by 2012, when cholera struck,
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748 diplomaca s Haitija do 2012. godine, kad se pojavila kolera,
13:02
nearly half working in the public health sector
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gotovo polovica je radila u javnom zdravstvenom sektoru,
13:05
but one quarter unemployed,
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jedna četvrtina je bila nezaposlena,
13:07
and 110 had left Haiti altogether.
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a 110 ih je napustilo Haiti.
13:14
So in the best case scenarios,
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U najboljem slučaju,
13:16
these graduates are staffing
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ovi diplomci postaju osoblje
13:18
and thus strengthening public health systems,
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3249
unutar javnog zdravstvenog sustava i tako ga jačaju,
13:21
where often they're the only doctors around.
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i tu su često jedini doktori koji rade.
13:25
In the worst cases, there are simply not enough jobs
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U najgorem slučaju, jednostavno nema dovoljno poslova
13:27
in the public health sector,
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u javnom zdravstvenom sektoru,
13:29
where most poor people are treated,
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gdje se liječi većina siromašnih ljudi,
13:32
not enough political will, not enough resources,
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nedovoljno političke volje, nedovoljno sredstava,
13:34
not enough anything —
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nedovoljno ičega —
13:37
just too many patients with no care.
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jednostavno previše pacijenata bez skrbi.
13:40
The grads face pressure from their families too,
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Diplomci se također nalaze pod pritiskom svojih obitelji,
13:43
desperate to make ends meet,
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očajnih kako bi spojili kraj s krajem,
13:45
so when there are no public sector jobs,
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tako da kad nema poslova u javnom sektoru,
13:48
these new MDs decamp into private practice,
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2621
novi doktori medicine prelaze u privatnu praksu,
13:51
or go abroad to send money home.
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4015
ili odlaze u inozemstvo kako bi mogli slati novac kući.
13:55
Worst of all, in some countries,
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Što je najgore, u nekim zemljama,
13:58
medical societies influence accreditation bodies
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liječnička društva pritišću akreditacijska tijela
14:01
not to honor the ELAM degree,
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3015
da ne priznaju diplome ELAM-a,
14:04
fearful these grads will take their jobs
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2317
iz straha da će im njihovi diplomci uzeti poslove
14:06
or reduce their patient loads and income.
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ili smanjiti broj pacijenata pa tako i prihod.
14:10
It's not a question of competencies.
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To nije pitanje kompetencija.
14:13
Here in the USA, the California Medical Board
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Ovdje u SAD-u, Medicinski odbor Kalifornije
14:15
accredited the school after rigorous inspection,
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3600
je nakon rigorozne inspekcije, dao akreditaciju školi
14:19
and the new physicians are making good
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2048
i novi doktori su uspješni
14:21
on Cuba's big bet,
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2191
zahvaljujući velikom riziku Kube,
14:23
passing their boards and accepted
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1811
prolazeći njihove odbore i dobivanjem
14:25
into highly respected residencies
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2385
vrlo cijenjenih specijalizacija
14:27
from New York to Chicago to New Mexico.
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4091
od New Yorka, do Chicaga, Novog Meksika.
14:31
Two hundred strong, they're coming
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2625
Njih dvjesto vraćaju se
14:34
back to the United States energized,
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2385
natrag u SAD puni energije,
14:36
and also dissatisfied.
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2587
ali također i nezadovoljni.
14:39
As one grad put it,
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1631
Kako je to lijepo rekao jedan od diplomaca
14:40
in Cuba, "We are trained to provide quality care
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3454
na Kubi, "Uče nas da pružamo kvalitetnu skrb
14:44
with minimal resources,
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2002
s minimalnim sredstvima,
14:46
so when I see all the resources we have here,
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2576
tako da kad vidim sva sredstva koja imamo ovdje,
14:48
and you tell me that's not possible,
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2162
i vi mi kažete da to nije moguće,
14:51
I know it's not true.
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2170
ja znam da to nije istina.
14:53
Not only have I seen it work, I've done the work."
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5619
Ne samo da sam vidio da je to moguće, već sam to radio."
14:58
ELAM's graduates,
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1961
ELAM-ovi diplomci,
15:00
some from right here in D.C. and Baltimore,
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3517
neki upravo odavde, iz Washingtona i Baltimora,
15:04
have come from the poorest of the poor
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3168
su došli od najsiromašnijih od siromašnih
15:07
to offer health, education
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2333
kako bi dali zdravlje, obrazovanje
15:09
and a voice to their communities.
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2916
i glas svojim zajednicama.
15:12
They've done the heavy lifting.
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2652
Oni su napravili teži dio posla.
15:15
Now we need to do our part
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915496
2014
Sad mi moramo napraviti svoj dio
15:17
to support the 23,000 and counting,
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3617
kako bi poduprijeli tih 23,000 i više.
15:21
All of us —
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1354
Svi mi —
15:22
foundations, residency directors, press,
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3634
zaklade, ravnatelji specijalizanata, mediji,
15:26
entrepreneurs, policymakers, people —
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3184
poduzetnici, vlade, ljudi —
15:29
need to step up.
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2153
moramo se više uključiti.
15:31
We need to do much more globally
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931452
1991
Moramo učiniti mnogo više globalno
15:33
to give these new doctors the opportunity
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2939
kako bi dali priliku ovim liječnicima
15:36
to prove their mettle.
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2393
da dokažu svoj hrabrost.
15:38
They need to be able
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1003
Trebaju imati mogućnost da
15:39
to take their countries' licensing exams.
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3204
polažu ispite za licencu u svojim zemljama.
15:42
They need jobs in the public health sector
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Potrebni su im poslovi u javnom zdravstvenom sektoru
15:45
or in nonprofit health centers
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1755
ili u neprofitnim zdravstvenim centrima
15:47
to put their training and commitment to work.
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3847
kako bi iskoristili svoje obrazovanje i svoju predanost u dobre svrhe.
15:51
They need the chance to be
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2283
Trebaju imati šansu da budu
15:53
the doctors their patients need.
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4859
liječnici kakve njihovi pacijenti trebaju.
15:58
To move forward,
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1857
Kako bismo išli naprijed,
16:00
we may have to find our way back
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2992
možda budemo morali naći svoj put natrag
16:03
to that pediatrician who would
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2183
do onog pedijatra koji bi
16:05
knock on my family's door
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1687
pokucao na naša vrata
16:07
on the South Side of Chicago when I was a kid,
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3186
u južnom dijelu Chicaga kad sam bila dijete,
16:10
who made house calls,
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1910
koji je dolazio u kućne posjete,
16:12
who was a public servant.
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2891
koji je bio sluga naroda.
16:15
These aren't such new ideas
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1823
Ovo nisu tako nove ideje
16:17
of what medicine should be.
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2362
o tome što bi trebala biti medicina.
16:19
What's new is the scaling up
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2725
Ono što je novo jest veća razina na kojoj se sve odvija
16:22
and the faces of the doctors themselves:
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3383
kao i lica samih doktora:
16:25
an ELAM graduate is more likely to be a she
345
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3457
vjerojatnije je da će diplomac ELAM-a biti 'ona'
16:29
than a he;
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1930
a ne 'on':
16:31
In the Amazon, Peru or Guatemala,
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2927
U Amazoniji, Peruu, Guatemali,
16:33
an indigenous doctor;
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2351
doktor domorodac;
16:36
in the USA, a doctor of color
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3014
u SAD-u, crni doktor
16:39
who speaks fluent Spanish.
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2396
koji tečno govori španjolski.
16:41
She is well trained, can be counted on,
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3679
Ona je dobro obučena, pouzdana,
16:45
and shares the face and culture of her patients,
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3644
a dijeli lice i kulturu svojih pacijenata
16:49
and she deserves our support surely,
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3409
i ona zasigurno zaslužuje našu potporu
16:52
because whether by subway, mule, or canoe,
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jer bilo podzemnom, bilo na mazgi ili kanuom,
16:56
she is teaching us to walk the walk.
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ona nas uči kako koračati jak težim putem.
16:59
Thank you. (Applause)
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Hvala. (Pljesak)
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