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

297,626 views ・ 2013-12-19

TED


Sila klik dua kali pada sari kata Inggeris di bawah untuk memainkan video.

Translator: Sam HK Reviewer: Pei Fang Ng
00:12
Nine years ago, I worked
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Sembilan tahun yang lalu, saya bekerja
00:14
for the U.S. government in Iraq,
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untuk kerajaan Amerika di Iraq.
00:16
helping rebuild the electricity infrastructure.
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Saya membantu membina semula infrastruktur elektrik.
00:19
And I was there, and I worked in that job
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Saya bekerja di situ
00:22
because I believe that technology
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kerana saya percaya bahawa teknologi
00:24
can improve people's lives.
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dapat meingkatkan kualiti kehidupan.
00:27
One afternoon, I had tea with a storekeeper
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Pada suatu petang, saya minum teh bersama seorang penjaga stor
00:29
at the Al Rasheed Hotel in Baghdad,
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di Hotel Al Rasheed, Baghdad.
00:32
and he said to me, "You Americans,
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Dia beritahu saya, "Orang Amerika
00:35
you can put a man on the moon,
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mampu hantar orang ke bulan,
00:36
but when I get home tonight,
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tapi apabila saya balik ke rumah nanti,
00:38
I won't be able to turn on my lights."
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saya tidak dapat hidupkan lampu rumah."
00:41
At the time, the U.S. government had spent
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Pada masa itu, kerajaan Amerika telah belanjakan
00:42
more than two billion dollars
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lebih daripada USD2 juta
00:45
on electricity reconstruction.
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dalam pembinaan semula elektrik.
00:47
How do you ensure technology reaches users?
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Bagaimanakah kita pastikan teknologi sampai kepada pengguna?
00:50
How do you put it in their hands
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Apakah yang perlu kita buat
00:52
so that it is useful?
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agar ia berguna?
00:55
So those are the questions that my colleagues and I
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Soalan-soalan inilah yang rakan sekerja saya dan saya
00:58
at D-Rev ask ourselves.
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fikirkan di D-Rev.
01:00
And D-Rev is short for Design Revolution.
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D-Rev ialah singkatan bagi "Design Revolution".
01:03
And I took over the organization four years ago
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Saya ambil alih organisasi itu 4 tahun yang lalu
01:05
and really focused it on developing products
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dan tumpukan pada cara untuk membangunkan produk
01:08
that actually reach users,
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yang dapat sampai kepada pengguna.
01:10
and not just any users,
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Ia bukannya untuk sesiapa saja,
01:11
but customers who live on less than four dollars a day.
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tapi mereka yang tiada USD4 pun sehari.
01:16
One of the key areas we've been working on recently
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Baru-baru ini, kami menumpukan pada
01:17
is medical devices, and while it may not be obvious
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alat perubatan. Mungkin nampaknya
01:20
that medical devices have something in common
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ia tidak berkaitan dengan
01:22
with Iraq's electricity grid then,
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bekalan elektrik di Iraq,
01:25
there are some commonalities.
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sebenarnya, ia berkaitan.
01:27
Despite the advanced technology,
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Walaupun terdapat teknologi yang canggih,
01:29
it's not reaching the people who need it most.
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ia tidak sampai kepada orang yang memerlukannya.
01:32
So I'm going to tell you about one of the projects we've been working on,
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Saya akan bercakap tentang
01:35
the ReMotion Knee, and it's a prosthetic knee
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projek ReMotion Knee, iaitu sebuah lutut
01:38
for above-knee amputees.
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untuk mereka yang telah menjalani amputasi.
01:40
And this project started when the Jaipur Foot Organization,
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Projek ini bermula apabila Jaipur Foot Organization,
01:43
the largest fitter of prosthetic limbs in the world,
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pemasang kaki palsu terbesar di dunia,
01:46
came to the Bay Area and they said,
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pergi ke Bay Area dan berkata,
01:47
"We need a better knee."
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"Kami perlukan lutut yang lebih baik."
01:50
Chances are, if you're living on less than four dollars a day,
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Bagi orang yang tiada USD4 pun sehari,
01:53
and you're an amputee,
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dan telah menjalani amputasi,
01:55
you've lost your limb in a vehicle accident.
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mungkin dia kehilangan kakinya dalam kemalangan,
01:57
Most people think it's land mines,
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tapi banyak orang ingat sebabnya ranjau letupan darat.
01:59
but it's a vehicle accident.
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tapi banyak orang ingat sebabnya ranjau letupan darat.
02:00
You're walking by the side of the road
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Mungkin orang itu berjalan di tepi jalan
02:02
and you're hit by a truck,
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dan dilanggar trak,
02:04
or you're trying to to jump on a moving train,
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atau cuba melompat ke atas kereta api
02:05
you're late for work, and your pant leg gets caught.
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dia lewat ke tempat kerja, dan kaki seluarnya tersangkut.
02:09
And the reality is that if you don't have much money,
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Jika dia tiada wang yang cukup,
02:13
like this young named Kamal right here,
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seperti anak muda ini, Kamal,
02:15
the option you really have
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dia cuma boleh
02:17
is a bamboo staff to get around.
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gunakan penyokong buluh untuk membantunya bergerak.
02:19
And how big a problem is this?
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Betapa seriusnya masalah ini?
02:22
There's over three million amputees every year
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Setiap tahun, lebih daripada 3 juta orang menjalani amputasi
02:25
who need a new or replacement knee.
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dan memerlukan lutut yang baru.
02:28
And what are their options?
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Apakah pilihan yang mereka ada?
02:30
This is a high-end. This is what we'd call a "smart knee."
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Ini "lutut pintar" yang sangat canggih.
02:32
It's got a microprocessor inside.
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Terdapat mikropemproses di dalam.
02:34
It can pretty much do anything,
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Ia sangat membantu, tapi harganya USD20,000.
02:37
but it's 20,000 dollars,
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Ia sangat membantu, tapi harganya USD20,000.
02:38
and to give you a sense of who wears this,
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Rasanya anda tahu siapa yang mampu membelinya.
02:40
veterans, American veterans coming back from Afghanistan or Iraq
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Veteran perang yang balik dari Afghanistan atau Iraq
02:44
would be fit with something like this.
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mampu membelinya.
02:46
This is a low-end titanium knee.
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Ini lutut yang tidak canggih.
02:49
It's a polycentric knee, and all that that means
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Ia lutut polisentrik.
02:51
is the mechanism, is a four-bar mechanism,
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Ia mempunyai mekanisme empat bar
02:53
that mimics a natural human knee.
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yang meniru lutut manusia.
02:56
But at 1,400 dollars, it's still too expensive
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Harganya USD1,400. Ia masih terlalu mahal
02:58
for people like Kamal.
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bagi orang seperti Kamal.
03:01
And lastly, here you see a low-end knee.
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Akhirnya, ini satu lagi lutut yang tidak canggih.
03:03
This is a knee that's been designed specifically
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Ia direka khas untuk
03:05
for poor people.
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orang miskin.
03:07
And while you have affordability,
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Ia tidak mahal,
03:09
you've lost on functionality.
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tapi fungsinya kurang.
03:10
The mechanism here is a single axis,
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Ia cuma mempunyai satu paksi,
03:13
and a single axis is like a door hinge.
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seperti engsel pintu.
03:15
So you can think about how unstable that would be.
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Jadi, ia sangat tidak stabil.
03:18
And this is the type of mechanism
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Inilah mekanisme yang pernah digunakan
03:20
that the Jaipur Foot Organization was using when they were looking for a better knee,
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Jaipur Foot Organization.
03:23
and I just wanted to give you a sense of what a leg system looks like,
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Saya mahu jelaskan sistem kaki kepada anda,
03:26
because I'm showing you all these knees
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kerana saya bercakap tentang lutut.
03:27
and I imagine it's hard to think how it all fits together.
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Saya tahu anda sukar membayangkannya.
03:29
So at the top you have a socket,
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Ini soket.
03:32
and this fits over someone's residual limb,
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Kaki residual dimasukkan ke sini.
03:33
and everyone's residual limb is a little bit different.
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Kaki residual setiap orang adalah berbeza.
03:36
And then you have the knee,
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Ini lutut.
03:37
and here I've got a single axis on the knee
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Terdapat satu paksi di sini.
03:39
so you can see how it rotates,
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Anda boleh lihat bagaimana ia bergerak.
03:41
and then a pylon, and then a foot.
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Ini pilon dan kaki.
03:45
And we've been able to develop a knee,
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Kami telah berjaya membangunkan
03:47
a polycentric knee, so that type of knee
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lutut polisentrik.
03:49
that acts like a human knee, mimics human gait,
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Ia meniru gaya jalan kaki manusia.
03:52
for 80 dollars retail.
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Harganya USD80.
03:55
(Applause)
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(Tepukan)
03:58
But the key is, you can have this great invention,
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Walaupun mekanisme ini tercipta
04:01
you can have this great design, but how do you get it
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dan reka bentuknya baik, tapi bagaimana caranya
04:03
to the people who most need it?
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ia sampai kepada mereka yang memerlukannya?
04:05
How do you ensure it gets to them and it improves their lives?
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Bagaimana ia meningkatkan kualiti kehidupan mereka?
04:08
So at D-Rev, we've done some other projects,
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Di D-Rev, kami telah mengusahakan projek lain,
04:11
and we looked at three things that we really believe
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dan kami menumpukan pada 3 perkara yang kami percaya
04:13
gets technologies to customers, to users,
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membawa teknologi kepada orang
04:17
to people who need it.
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yang memerlukannya.
04:19
And the first thing is that the product needs to be world class.
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Perkara pertama, produk kami mesti bertaraf dunia.
04:21
It needs to perform on par
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Ia mesti setanding dengan
04:23
or better than the best products on the market.
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atau lebih baik daripada produk terbaik di pasaran.
04:26
Regardless of your income level,
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Tak kira tahap berpendapatan anda,
04:28
you want the most beautiful,
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anda mahukan produk yang
04:30
the best product that there is.
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tercantik dan terbaik.
04:32
I'm going to show you a video now
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Saya akan tunjukkan sebuah video.
04:36
of a man named Ash. You can see him walking.
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Dia Ash.
04:37
He's wearing the same knee system here
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Dia memakai sistem lutut
04:39
with a single axis knee.
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yang mempunyai satu paksi.
04:41
And he's doing a 10-meter walk test.
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Dia sedang mengujinya sejauh 10 meter.
04:43
And you'll notice that he's struggling with stability as he's walking.
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Anda dapat lihat bahawa kestabilannya tidak baik.
04:47
And something that's not obvious, that you can't see,
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Apa yang anda tidak dapat lihat ialah,
04:49
is that it's psychologically draining
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dari segi psikologi, ia agak memenatkan
04:52
to walk and to be preventing yourself from falling.
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untuk berjalan dan cuba mengelakkan diri terjatuh.
04:56
Now this is a video of Kamal.
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Dia Kamal.
04:58
You remember Kamal earlier, holding the bamboo staff.
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Dialah yang menggunakan penyokong buluh tadi.
05:00
He's wearing one of the earlier versions of our knee,
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Dia memakai salah satu versi awal produk kami,
05:03
and he's doing that same 10-meter walk test.
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dan dia sedang mengujinya sejauh 10 meter.
05:06
And you can see his stability is much better.
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Anda boleh lihat bahawa kestabilannya lebih baik.
05:11
So world class isn't just about technical performance.
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Maksud bertaraf dunia bukan saja dari segi prestasi teknikal,
05:14
It's also about human performance.
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ia juga dari segi prestasi manusia.
05:18
And most medical devices, we've learned,
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Banyak alat perubatan
05:20
as we've dug in, are really designed for Westerners,
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direka bentuk untuk orang barat,
05:22
for wealthier economies.
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untuk orang yang lebih kaya.
05:24
But the reality is our users, our customers,
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Tapi pada hakibatnya, pelanggan kami
05:27
they do different things. They sit cross-legged more.
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adalah berbeza. Mereka duduk bersila,
05:30
We see that they squat. They kneel in prayer.
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bercangkung dan berlutut semasa bersembahyang.
05:33
And we designed our knee to have the greatest range of motion
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Produk kami dapat menyokong pelbagai
05:35
of almost any other knee on the market.
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jenis pergerakan berbanding produk lain.
05:39
So the second thing we learned, and this leads
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Perkara kedua,
05:41
into my second point, which is that we believe
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kami percaya bahawa reka bentuk
05:43
that products need to be designed to be user-centric.
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produk kami perlu berpusatkan pengguna.
05:46
And at D-Rev, we go one step further and we say
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Di D-Rev, kami mengutamakan pengguna kami.
05:49
you need to be user-obsessed.
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Di D-Rev, kami mengutamakan pengguna kami.
05:51
So it's not just the end user that you're thinking about,
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Kami bukan saja memikirkan tentang pengguna akhir,
05:53
but everyone who interacts with the product,
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malahan setiap orang yang berkaitan dengan produk itu.
05:55
so, for example, the prosthetist who fits the knee,
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Contohnya, pengguna produk kami
05:58
but also the context in which the knee is being fit.
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dan konteks di mana ia dipakai.
06:01
What is the local market like?
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Bagaimanakah keadaan pasaran tempatan?
06:03
How do all these components get to the clinic?
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Bagaimanakah semua komponen ini sampai ke klinik?
06:05
Do they all get there on time? The supply chain.
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Adakah bekalan sampai tepat pada masanya?
06:07
Everything that goes into ensuring
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Semuanya untuk memastikan
06:09
that this product gets to the end user,
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bahawa produk ini sampai kepada pengguna akhir,
06:11
and it goes in as part of the system, and it's used.
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dan ia menjadi sebahagian daripada sistem dan digunakan.
06:15
So I wanted to show you some of the iterations
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Saya mahu tunjukkan beberapa pengubahsuaian
06:17
we did between the first version, the Jaipur Knee,
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yang telah dibuat pada versi yang pertama, Jaipur Knee.
06:22
so this is it right here.
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Ini dia.
06:24
(Clicking)
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(Bunyi klik)
06:25
Notice anything about it?
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Adakah anda perasan?
06:28
It clicks.
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Bunyi klik.
06:30
We'd seen that users had actually modified it.
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Terdapat pengguna yang cuba mengubahsuainya.
06:33
So do you see that black strip right there?
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Anda nampak benda hitam itu?
06:37
That's a homemade noise dampener.
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Ia peredam bunyi buatan sendiri.
06:40
We also saw that our users had modified it
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Pengguna lain juga mengubahsuainya
06:42
in other ways.
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dengan cara lain.
06:43
You can see there that that particular amputee,
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Orang ini telah membalut kakinya
06:45
he had wrapped bandages around the knee.
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dengan kain pembalut.
06:47
He'd made a cosmesis.
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Dia mencantikkannya.
06:49
And if you look at the knee,
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Lihatlah lutut ini.
06:51
it's got those pointy edges, right?
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Ia berbentuk segi empat, kan?
06:55
So if you're wearing it under pants or a skirt
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Jika anda memakai seluar, skirt
06:57
or a sari, it's really obvious
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atau sari, ia agak ketara
06:59
that you're wearing a prosthetic limb,
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bahawa anda memakai lutut palsu.
07:01
and in societies where there's social stigma around being disabled,
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Dalam masyarakat yang mempunyai stigma sosial terhadap orang kurang upaya,
07:05
people are particularly acute about this.
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mereka amat sensitif terhadap hal ini.
07:08
So I'm going to show you some of the modifications we did.
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Saya akan tunjukkan pengubahsuaian yang kami buat.
07:10
We did a lot of iterations, not just around this, but some other things.
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Saya akan tunjukkan pengubahsuaian yang kami buat.
07:13
But here we have the version three, the ReMotion Knee,
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Ini versi ketiga, ReMotion Knee.
07:16
but if you look in here, you can see
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Anda dapat lihat
07:17
the noise dampener. It's quieter.
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ini peredam bunyi. Ia lebih senyap.
07:22
The other thing we did is that we smoothed the profile.
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Ia tidak lagi berbentuk segi empat.
07:26
We made it thinner.
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kami telah mengubahnya.
07:27
And something that's not obvious is that we
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Selain itu, kami mengeluarkannya
07:29
designed it for mass production.
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secara besar-besaran.
07:32
And this goes into my last point.
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Akhirnya, perkara ketiga.
07:34
We really, truly believe that if a product
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Kami benar-benar percaya bahawa jika sesuatu produk itu
07:36
is going to reach users at the scale that it's needed,
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perlu sampai kepada banyak pengguna,
07:38
it needs to be market-driven,
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maka ia perlu dipasarkan.
07:40
and market-driven means that products are sold.
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Maksudnya, produk itu perlu dijual.
07:43
They're not donated. They're not heavily subsidized.
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Ia tidak didermakan. Ia tidak diberikan subsidi yang tinggi.
07:46
Our product needs to be designed to offer value
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Produk kami perlu memberikan nilai
07:48
to the end user.
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kepada pengguna akhir.
07:50
It also has to be designed to be very affordable.
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Pengguna perlu berasa selesa semasa memakainya.
07:52
But a product that is valued by a customer
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Produk yang bernilai
07:54
is used by a customer,
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akan digunakan oleh pelanggan,
07:56
and use is what creates impact.
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dan penggunaanlah yang mendatangkan kesan.
07:58
And we believe that as designers,
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Sebagai pereka, kami percaya bahawa
08:00
it holds us accountable to our customers.
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kami perlu bertanggungjawab terhadap pelanggan kami.
08:03
And with centralized manufacturing,
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Dengan pengeluaran terpusat,
08:06
you can control the quality control,
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kami dapat mengawal kualiti produk,
08:08
and you can hit that $80 price point
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dan harga USD80 mendatangkan keuntungan.
08:09
with profit margins built in.
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dan harga USD80 mendatangkan keuntungan.
08:12
And now, those profit margins are critical,
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Keuntungan adalah penting
08:14
because if you want to scale, if you want to reach
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kerana jika produk itu disasarkan kepada
08:16
all the people in the world who possibly need a knee,
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semua orang di dunia ini yang memerlukan lutut palsu,
08:18
it needs to be economically sustainable.
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maka harganya mesti dapat ditampung pembeli.
08:21
So I want to give you a sense of where we are at.
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Saya mahu bercakap tentang pencapaian kami.
08:24
We have fit over 5,000 amputees,
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Kami telah memasang lutut palsu untuk 5,000 orang.
08:27
and one of the big indicators we're looking at, of course,
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Salah satu perkara yang kami ingin tahu ialah,
08:30
is, does it improve lives?
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adakah ia meningkatkan kualiti kehidupan?
08:31
Well, the standard is, is someone
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Piawaiannya ialah, adakah seseorang itu
08:33
still wearing their knee six months later?
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masih memakai lutut palsunya selepas 6 bulan?
08:36
The industry average is about 65 percent.
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Kadar purata dalam industri ini adalah kira-kira 65%.
08:38
Ours is 79 percent,
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Kadar kami ialah 79%,
08:41
and we're hoping to get that higher.
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dan kami berharap ia akan meningkat.
08:44
Right now, our knees are worn in 12 countries.
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Kini, lutut palsu kami dipakai di 12 buah negara.
08:47
This is where we want to get, though,
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Kami mempunyai sasaran
08:48
in the next three years.
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untuk 3 tahun seterusnya.
08:50
We'll double the impact in 2015,
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Kami mahu gandakannya pada tahun 2015,
08:52
and we'll double it each of the following years after that.
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begitu juga pada tahun-tahun berikutnya.
08:55
But then we hit a new challenge,
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Tapi, kami berdepan dengan satu cabaran,
08:57
and that's the number of skilled prosthetists
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iaitu jumlah pemakai
08:59
who are able to fit knees.
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yang tahu memakai lutut palsu.
09:02
So I want to end with a story of Pournima.
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Akhirnya, saya mahu bercakap tentang Prinima.
09:05
Pournima was 18 years old
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Prinima berusia 18 tahun
09:07
when she was in a car accident where she lost her leg,
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semasa dia kemalangan dan kehilangan sebelah kaki.
09:10
and she traveled 12 hours by train
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Dia menaiki kereta api selama 12 jam
09:13
to come to the clinic to be fit with a knee,
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untuk pergi ke klinik agar lutut palsunya boleh dipasang.
09:15
and while all of the amputees who wear our knees
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Pemakai lutut palsu kami
09:18
affect us as the designers,
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telah meninggalkan kesan pada para pereka.
09:20
she's particularly meaningful to me as an engineer and as a woman,
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Bagi saya, sebagai jurutera dan wanita, kes Prinima sangat bermakna
09:24
because she was in school,
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kerana dia seorang pelajar.
09:26
she had just started school to study engineering.
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Dia baru memulakan pengajian kejuruteraan.
09:29
And she said, "Well, now that I can walk again,
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Dia berkata, "Oleh sebab saya boleh berjalan semula,
09:31
I can go back and complete my studies."
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saya boleh balik dan menamatkan pengajian saya."
09:33
And to me she represents the next generation
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Bagi saya, dia mewakili generasi jurutera seterusnya
09:36
of engineers solving problems
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yang dapat menyelesaikan masalah
09:39
and ensuring meaningful technologies
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dan memastikan teknologi yang bermakna
09:42
reach their users.
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sampai kepada pengguna.
09:44
So thank you.
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Terima kasih.
09:46
(Applause)
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(Tepukan)
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