Krista Donaldson: The $80 prosthetic knee that's changing lives

Translator: Sam HK Reviewer: Pei Fang Ng

Nine years ago, I worked

Sembilan tahun yang lalu, saya bekerja

for the U.S. government in Iraq,

untuk kerajaan Amerika di Iraq.

helping rebuild the electricity infrastructure.

Saya membantu membina semula infrastruktur elektrik.

And I was there, and I worked in that job

Saya bekerja di situ

because I believe that technology

kerana saya percaya bahawa teknologi

can improve people's lives.

dapat meingkatkan kualiti kehidupan.

One afternoon, I had tea with a storekeeper

Pada suatu petang, saya minum teh bersama seorang penjaga stor

at the Al Rasheed Hotel in Baghdad,

di Hotel Al Rasheed, Baghdad.

and he said to me, "You Americans,

Dia beritahu saya, "Orang Amerika

you can put a man on the moon,

mampu hantar orang ke bulan,

but when I get home tonight,

tapi apabila saya balik ke rumah nanti,

I won't be able to turn on my lights."

saya tidak dapat hidupkan lampu rumah."

At the time, the U.S. government had spent

Pada masa itu, kerajaan Amerika telah belanjakan

more than two billion dollars

lebih daripada USD2 juta

on electricity reconstruction.

dalam pembinaan semula elektrik.

How do you ensure technology reaches users?

Bagaimanakah kita pastikan teknologi sampai kepada pengguna?

How do you put it in their hands

Apakah yang perlu kita buat

so that it is useful?

agar ia berguna?

So those are the questions that my colleagues and I

Soalan-soalan inilah yang rakan sekerja saya dan saya

at D-Rev ask ourselves.

fikirkan di D-Rev.

And D-Rev is short for Design Revolution.

D-Rev ialah singkatan bagi "Design Revolution".

And I took over the organization four years ago

Saya ambil alih organisasi itu 4 tahun yang lalu

and really focused it on developing products

dan tumpukan pada cara untuk membangunkan produk

that actually reach users,

yang dapat sampai kepada pengguna.

and not just any users,

Ia bukannya untuk sesiapa saja,

but customers who live on less than four dollars a day.

tapi mereka yang tiada USD4 pun sehari.

One of the key areas we've been working on recently

Baru-baru ini, kami menumpukan pada

is medical devices, and while it may not be obvious

alat perubatan. Mungkin nampaknya

that medical devices have something in common

ia tidak berkaitan dengan

with Iraq's electricity grid then,

bekalan elektrik di Iraq,

there are some commonalities.

sebenarnya, ia berkaitan.

Despite the advanced technology,

Walaupun terdapat teknologi yang canggih,

it's not reaching the people who need it most.

ia tidak sampai kepada orang yang memerlukannya.

So I'm going to tell you about one of the projects we've been working on,

Saya akan bercakap tentang

the ReMotion Knee, and it's a prosthetic knee

projek ReMotion Knee, iaitu sebuah lutut

for above-knee amputees.

untuk mereka yang telah menjalani amputasi.

And this project started when the Jaipur Foot Organization,

Projek ini bermula apabila Jaipur Foot Organization,

the largest fitter of prosthetic limbs in the world,

pemasang kaki palsu terbesar di dunia,

came to the Bay Area and they said,

pergi ke Bay Area dan berkata,

"We need a better knee."

"Kami perlukan lutut yang lebih baik."

Chances are, if you're living on less than four dollars a day,

Bagi orang yang tiada USD4 pun sehari,

and you're an amputee,

dan telah menjalani amputasi,

you've lost your limb in a vehicle accident.

mungkin dia kehilangan kakinya dalam kemalangan,

Most people think it's land mines,

tapi banyak orang ingat sebabnya ranjau letupan darat.

but it's a vehicle accident.

tapi banyak orang ingat sebabnya ranjau letupan darat.

You're walking by the side of the road

Mungkin orang itu berjalan di tepi jalan

and you're hit by a truck,

dan dilanggar trak,

or you're trying to to jump on a moving train,

atau cuba melompat ke atas kereta api

you're late for work, and your pant leg gets caught.

dia lewat ke tempat kerja, dan kaki seluarnya tersangkut.

And the reality is that if you don't have much money,

Jika dia tiada wang yang cukup,

like this young named Kamal right here,

seperti anak muda ini, Kamal,

the option you really have

dia cuma boleh

is a bamboo staff to get around.

gunakan penyokong buluh untuk membantunya bergerak.

And how big a problem is this?

Betapa seriusnya masalah ini?

There's over three million amputees every year

Setiap tahun, lebih daripada 3 juta orang menjalani amputasi

who need a new or replacement knee.

dan memerlukan lutut yang baru.

And what are their options?

Apakah pilihan yang mereka ada?

This is a high-end. This is what we'd call a "smart knee."

Ini "lutut pintar" yang sangat canggih.

It's got a microprocessor inside.

Terdapat mikropemproses di dalam.

It can pretty much do anything,

Ia sangat membantu, tapi harganya USD20,000.

but it's 20,000 dollars,

Ia sangat membantu, tapi harganya USD20,000.

and to give you a sense of who wears this,

Rasanya anda tahu siapa yang mampu membelinya.

veterans, American veterans coming back from Afghanistan or Iraq

Veteran perang yang balik dari Afghanistan atau Iraq

would be fit with something like this.

mampu membelinya.

This is a low-end titanium knee.

Ini lutut yang tidak canggih.

It's a polycentric knee, and all that that means

Ia lutut polisentrik.

is the mechanism, is a four-bar mechanism,

Ia mempunyai mekanisme empat bar

that mimics a natural human knee.

yang meniru lutut manusia.

But at 1,400 dollars, it's still too expensive

Harganya USD1,400. Ia masih terlalu mahal

for people like Kamal.

bagi orang seperti Kamal.

And lastly, here you see a low-end knee.

Akhirnya, ini satu lagi lutut yang tidak canggih.

This is a knee that's been designed specifically

Ia direka khas untuk

for poor people.

orang miskin.

And while you have affordability,

Ia tidak mahal,

you've lost on functionality.

tapi fungsinya kurang.

The mechanism here is a single axis,

Ia cuma mempunyai satu paksi,

and a single axis is like a door hinge.

seperti engsel pintu.

So you can think about how unstable that would be.

Jadi, ia sangat tidak stabil.

And this is the type of mechanism

Inilah mekanisme yang pernah digunakan

that the Jaipur Foot Organization was using when they were looking for a better knee,

Jaipur Foot Organization.

and I just wanted to give you a sense of what a leg system looks like,

Saya mahu jelaskan sistem kaki kepada anda,

because I'm showing you all these knees

kerana saya bercakap tentang lutut.

and I imagine it's hard to think how it all fits together.

Saya tahu anda sukar membayangkannya.

So at the top you have a socket,

Ini soket.

and this fits over someone's residual limb,

Kaki residual dimasukkan ke sini.

and everyone's residual limb is a little bit different.

Kaki residual setiap orang adalah berbeza.

And then you have the knee,

Ini lutut.

and here I've got a single axis on the knee

Terdapat satu paksi di sini.

so you can see how it rotates,

Anda boleh lihat bagaimana ia bergerak.

and then a pylon, and then a foot.

Ini pilon dan kaki.

And we've been able to develop a knee,

Kami telah berjaya membangunkan

a polycentric knee, so that type of knee

lutut polisentrik.

that acts like a human knee, mimics human gait,

Ia meniru gaya jalan kaki manusia.

for 80 dollars retail.

Harganya USD80.

(Applause)

(Tepukan)

But the key is, you can have this great invention,

Walaupun mekanisme ini tercipta

you can have this great design, but how do you get it

dan reka bentuknya baik, tapi bagaimana caranya

to the people who most need it?

ia sampai kepada mereka yang memerlukannya?

How do you ensure it gets to them and it improves their lives?

Bagaimana ia meningkatkan kualiti kehidupan mereka?

So at D-Rev, we've done some other projects,

Di D-Rev, kami telah mengusahakan projek lain,

and we looked at three things that we really believe

dan kami menumpukan pada 3 perkara yang kami percaya

gets technologies to customers, to users,

membawa teknologi kepada orang

to people who need it.

yang memerlukannya.

And the first thing is that the product needs to be world class.

Perkara pertama, produk kami mesti bertaraf dunia.

It needs to perform on par

Ia mesti setanding dengan

or better than the best products on the market.

atau lebih baik daripada produk terbaik di pasaran.

Regardless of your income level,

Tak kira tahap berpendapatan anda,

you want the most beautiful,

anda mahukan produk yang

the best product that there is.

tercantik dan terbaik.

I'm going to show you a video now

Saya akan tunjukkan sebuah video.

of a man named Ash. You can see him walking.

Dia Ash.

He's wearing the same knee system here

Dia memakai sistem lutut

with a single axis knee.

yang mempunyai satu paksi.

And he's doing a 10-meter walk test.

Dia sedang mengujinya sejauh 10 meter.

And you'll notice that he's struggling with stability as he's walking.

Anda dapat lihat bahawa kestabilannya tidak baik.

And something that's not obvious, that you can't see,

Apa yang anda tidak dapat lihat ialah,

is that it's psychologically draining

dari segi psikologi, ia agak memenatkan

to walk and to be preventing yourself from falling.

untuk berjalan dan cuba mengelakkan diri terjatuh.

Now this is a video of Kamal.

Dia Kamal.

You remember Kamal earlier, holding the bamboo staff.

Dialah yang menggunakan penyokong buluh tadi.

He's wearing one of the earlier versions of our knee,

Dia memakai salah satu versi awal produk kami,

and he's doing that same 10-meter walk test.

dan dia sedang mengujinya sejauh 10 meter.

And you can see his stability is much better.

Anda boleh lihat bahawa kestabilannya lebih baik.

So world class isn't just about technical performance.

Maksud bertaraf dunia bukan saja dari segi prestasi teknikal,

It's also about human performance.

ia juga dari segi prestasi manusia.

And most medical devices, we've learned,

Banyak alat perubatan

as we've dug in, are really designed for Westerners,

direka bentuk untuk orang barat,

for wealthier economies.

untuk orang yang lebih kaya.

But the reality is our users, our customers,

Tapi pada hakibatnya, pelanggan kami

they do different things. They sit cross-legged more.

adalah berbeza. Mereka duduk bersila,

We see that they squat. They kneel in prayer.

bercangkung dan berlutut semasa bersembahyang.

And we designed our knee to have the greatest range of motion

Produk kami dapat menyokong pelbagai

of almost any other knee on the market.

jenis pergerakan berbanding produk lain.

So the second thing we learned, and this leads

Perkara kedua,

into my second point, which is that we believe

kami percaya bahawa reka bentuk

that products need to be designed to be user-centric.

produk kami perlu berpusatkan pengguna.

And at D-Rev, we go one step further and we say

Di D-Rev, kami mengutamakan pengguna kami.

you need to be user-obsessed.

Di D-Rev, kami mengutamakan pengguna kami.

So it's not just the end user that you're thinking about,

Kami bukan saja memikirkan tentang pengguna akhir,

but everyone who interacts with the product,

malahan setiap orang yang berkaitan dengan produk itu.

so, for example, the prosthetist who fits the knee,

Contohnya, pengguna produk kami

but also the context in which the knee is being fit.

dan konteks di mana ia dipakai.

What is the local market like?

Bagaimanakah keadaan pasaran tempatan?

How do all these components get to the clinic?

Bagaimanakah semua komponen ini sampai ke klinik?

Do they all get there on time? The supply chain.

Adakah bekalan sampai tepat pada masanya?

Everything that goes into ensuring

Semuanya untuk memastikan

that this product gets to the end user,

bahawa produk ini sampai kepada pengguna akhir,

and it goes in as part of the system, and it's used.

dan ia menjadi sebahagian daripada sistem dan digunakan.

So I wanted to show you some of the iterations

Saya mahu tunjukkan beberapa pengubahsuaian

we did between the first version, the Jaipur Knee,

yang telah dibuat pada versi yang pertama, Jaipur Knee.

so this is it right here.

Ini dia.

(Clicking)

(Bunyi klik)

Notice anything about it?

Adakah anda perasan?

It clicks.

Bunyi klik.

We'd seen that users had actually modified it.

Terdapat pengguna yang cuba mengubahsuainya.

So do you see that black strip right there?

Anda nampak benda hitam itu?

That's a homemade noise dampener.

Ia peredam bunyi buatan sendiri.

We also saw that our users had modified it

Pengguna lain juga mengubahsuainya

in other ways.

dengan cara lain.

You can see there that that particular amputee,

Orang ini telah membalut kakinya

he had wrapped bandages around the knee.

dengan kain pembalut.

He'd made a cosmesis.

Dia mencantikkannya.

And if you look at the knee,

Lihatlah lutut ini.

it's got those pointy edges, right?

Ia berbentuk segi empat, kan?

So if you're wearing it under pants or a skirt

Jika anda memakai seluar, skirt

or a sari, it's really obvious

atau sari, ia agak ketara

that you're wearing a prosthetic limb,

bahawa anda memakai lutut palsu.

and in societies where there's social stigma around being disabled,

Dalam masyarakat yang mempunyai stigma sosial terhadap orang kurang upaya,

people are particularly acute about this.

mereka amat sensitif terhadap hal ini.

So I'm going to show you some of the modifications we did.

Saya akan tunjukkan pengubahsuaian yang kami buat.

We did a lot of iterations, not just around this, but some other things.

Saya akan tunjukkan pengubahsuaian yang kami buat.

But here we have the version three, the ReMotion Knee,

Ini versi ketiga, ReMotion Knee.

but if you look in here, you can see

Anda dapat lihat

the noise dampener. It's quieter.

ini peredam bunyi. Ia lebih senyap.

The other thing we did is that we smoothed the profile.

Ia tidak lagi berbentuk segi empat.

We made it thinner.

kami telah mengubahnya.

And something that's not obvious is that we

Selain itu, kami mengeluarkannya

designed it for mass production.

secara besar-besaran.

And this goes into my last point.

Akhirnya, perkara ketiga.

We really, truly believe that if a product

Kami benar-benar percaya bahawa jika sesuatu produk itu

is going to reach users at the scale that it's needed,

perlu sampai kepada banyak pengguna,

it needs to be market-driven,

maka ia perlu dipasarkan.

and market-driven means that products are sold.

Maksudnya, produk itu perlu dijual.

They're not donated. They're not heavily subsidized.

Ia tidak didermakan. Ia tidak diberikan subsidi yang tinggi.

Our product needs to be designed to offer value

Produk kami perlu memberikan nilai

to the end user.

kepada pengguna akhir.

It also has to be designed to be very affordable.

Pengguna perlu berasa selesa semasa memakainya.

But a product that is valued by a customer

Produk yang bernilai

is used by a customer,

akan digunakan oleh pelanggan,

and use is what creates impact.

dan penggunaanlah yang mendatangkan kesan.

And we believe that as designers,

Sebagai pereka, kami percaya bahawa

it holds us accountable to our customers.

kami perlu bertanggungjawab terhadap pelanggan kami.

And with centralized manufacturing,

Dengan pengeluaran terpusat,

you can control the quality control,

kami dapat mengawal kualiti produk,

and you can hit that $80 price point

dan harga USD80 mendatangkan keuntungan.

with profit margins built in.

dan harga USD80 mendatangkan keuntungan.

And now, those profit margins are critical,

Keuntungan adalah penting

because if you want to scale, if you want to reach

kerana jika produk itu disasarkan kepada

all the people in the world who possibly need a knee,

semua orang di dunia ini yang memerlukan lutut palsu,

it needs to be economically sustainable.

maka harganya mesti dapat ditampung pembeli.

So I want to give you a sense of where we are at.

Saya mahu bercakap tentang pencapaian kami.

We have fit over 5,000 amputees,

Kami telah memasang lutut palsu untuk 5,000 orang.

and one of the big indicators we're looking at, of course,

Salah satu perkara yang kami ingin tahu ialah,

is, does it improve lives?

adakah ia meningkatkan kualiti kehidupan?

Well, the standard is, is someone

Piawaiannya ialah, adakah seseorang itu

still wearing their knee six months later?

masih memakai lutut palsunya selepas 6 bulan?

The industry average is about 65 percent.

Kadar purata dalam industri ini adalah kira-kira 65%.

Ours is 79 percent,

Kadar kami ialah 79%,

and we're hoping to get that higher.

dan kami berharap ia akan meningkat.

Right now, our knees are worn in 12 countries.

Kini, lutut palsu kami dipakai di 12 buah negara.

This is where we want to get, though,

Kami mempunyai sasaran

in the next three years.

untuk 3 tahun seterusnya.

We'll double the impact in 2015,

Kami mahu gandakannya pada tahun 2015,

and we'll double it each of the following years after that.

begitu juga pada tahun-tahun berikutnya.

But then we hit a new challenge,

Tapi, kami berdepan dengan satu cabaran,

and that's the number of skilled prosthetists

iaitu jumlah pemakai

who are able to fit knees.

yang tahu memakai lutut palsu.

So I want to end with a story of Pournima.

Akhirnya, saya mahu bercakap tentang Prinima.

Pournima was 18 years old

Prinima berusia 18 tahun

when she was in a car accident where she lost her leg,

semasa dia kemalangan dan kehilangan sebelah kaki.

and she traveled 12 hours by train

Dia menaiki kereta api selama 12 jam

to come to the clinic to be fit with a knee,

untuk pergi ke klinik agar lutut palsunya boleh dipasang.

and while all of the amputees who wear our knees

Pemakai lutut palsu kami

affect us as the designers,

telah meninggalkan kesan pada para pereka.

she's particularly meaningful to me as an engineer and as a woman,

Bagi saya, sebagai jurutera dan wanita, kes Prinima sangat bermakna

because she was in school,

kerana dia seorang pelajar.

she had just started school to study engineering.

Dia baru memulakan pengajian kejuruteraan.

And she said, "Well, now that I can walk again,

Dia berkata, "Oleh sebab saya boleh berjalan semula,

I can go back and complete my studies."

saya boleh balik dan menamatkan pengajian saya."

And to me she represents the next generation

Bagi saya, dia mewakili generasi jurutera seterusnya

of engineers solving problems

yang dapat menyelesaikan masalah

and ensuring meaningful technologies

dan memastikan teknologi yang bermakna

reach their users.

sampai kepada pengguna.

So thank you.

Terima kasih.

(Applause)

(Tepukan)