Seyi Oyesola: Health care off the grid

Traducător: Cristina Târşoagă Corector: Laszlo Kereszturi

Just to put everything in context,

Numai pentru a pune lucrurile intr-un context,

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

si pentru a va da o idee despre locurile de unde provin,

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

astfel incat dupa multe dintre lucrurile pe care le voi spune

and the things I'm going to do --

si le voi face --

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

sau lucruri despre care va voi povesti ca le-am realizat --

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

veti intelege exact de ce si in ce fel am fost motivat sa ajung unde sunt astazi.

I graduated high school in Cleveland, Ohio, 1975.

Am absolvit liceul in Cleveland, Ohio, in 1975.

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

Si la fel cum au facut si parintii mei cand si-au terminat studiile in strainatate, ne-am intors acasa.

Finished university education, got a medical degree, 1986.

Am terminat facultatea, mi-am luat diploma in medicina in 1986.

And by the time I was an intern house officer,

Iar in vremea rezidentiatului,

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

abia imi puteam permite sa intretin masina veche de 13 ani a mamei mele,

and I was a paid doctor.

si eram un medic cu salariu.

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

Acest lucru ne aduce la intrebarea de ce multi dintre noi, cei care suntem profesionisti

are now, as they say, in diaspora.

suntem in prezent, cum se spune, diaspora.

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

Deci, vom face din asta ceva permanent,

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

in care suntem cu totii pregatiti si apoi plecam, si nu ne mai intoarcem?

Perhaps not, I should certainly hope not --

Poate nu, cel putin eu asa sper --

because that is not my vision.

deoarece nu aceasta este viziunea mea.

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

In regula, pentru siguranta, aici este Nigeria pe harta Africii,

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

iar acolo este regiunea deltei de care sunt sigur ca ati auzit cu totii.

People getting kidnapped, where the oil comes from,

Oameni rapiti, locul de unde provine petrolul,

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

petrol care ma face sa cred uneori ca ne-a adus pe toti in pragul nebuniei in Nigeria.

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

Dar, saracia extrema, aceasta poza este de la o prezentare pe care am sustinut-o

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

nu cu mult timp in urma. Gapminder.org spune povestea prapastiei

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

dintre Africa si restul lumii, in ceea ce priveste serviciile medicale.

Very interesting.

Foarte interesant.

How many people do you think are on that taxi?

Cati oameni credeti ca sunt pe acel taxi?

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

Si fie ca va vine sa credeti sau nu, acela este un taxi in Nigeria.

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

Si capitala -- acea era pe vremuri capitala Nigeriei, Lagos,

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

acela este un taxi pe care se pot vedea politisti.

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

Deci spuneti-mi, cati politisti credeti ca sunt pe acel taxi? Si acum? Trei.

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

Deci, cand acesti oameni -- si credeti-ma, nu sunt numai politistii

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

cei care folosesc aceste taxiuri in Lagos, cu totii le folosim, si eu am urcat pe unul

and I didn't have a helmet, either.

si nici nu aveam casca.

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

Si asta imi reaminteste de ce se intampla cand unul dintre noi

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

cade de pe un astfel de taxi, are un accident si necesita spitalizare.

Believe it or not, some of us do survive.

Fie ca va vine sau nu sa credeti, unii dintre noi chiar supravietuiesc.

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

Unii dintre noi supravietuiesc malariei, supravietuiesc SIDA.

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

Si asa cum spun si familiei mele, iar sotia mea imi reaminteste de fiecare data,

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

iti risti viata, stiti, de fiecare data cand mergi in acea tara --

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

si are dreptate. De fiecare data cand mergi acolo,

you know that if you actually need critical care --

stii ca daca chiar ai nevoie de asistenta medicala de urgenta --

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

de orice fel -- daca ai un accident,

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

astfel de cazuri sunt multe, sunt accidente pretutindeni,

where do they go?

unde se pot duce?

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

Unde merg cand au nevoie de ajutor pentru astfel de lucruri?

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

Nu spun in loc de, spun in plus.

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

SIDA, tuberculoza, malarie, febra tifoida -- lista poate continua.

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

Ma intreb, unde pot merge cand sunt ca mine?

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

Cand ma intorc acasa -- si fac tot felul de lucruri,

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

predau, tin traininguri, dar contactez o astfel de boala,

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

sau sunt bolnav cronic cu o astfel de boala, cui ma adresez?

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

Care este impactul economic al unei persoane care moare sau ramane infirm?

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

Cred ca este semnificativ. Aici merg aceste persoane.

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

Acestea nu sunt poze vechi si nu sunt dintr-un spital de mana a doua --

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

acesta este un spital important. De fapt, pozele sunt dintr-un important spital universitar din Nigeria.

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

Aceasta poza nu e mai veche de un an, intr-o sala de operatii.

That's sterilizing equipment in Nigeria.

Asa se sterilizeaza instrumentarul in Nigeria.

You remember all that oil?

Va amintiti tot acel petrol?

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

Da, imi pare rau daca acest lucru este suparator pentru unii dintre voi, dar

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

cred ca trebuie sa vedeti aceste imagini. Aceea este podeaua, da?

You can say some of this is education.

Puteti spune ca o parte din asta este educatie.

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

Puteti spune ca e igiena. Nu pledez saracie.

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

Spun ca avem nevoie de ceva mai mult decat numai, stiti, vaccinare,

malaria, AIDS, because I want to be treated

malarie, SIDA, pentru ca vreau sa fiu tratat

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

intr-un spital corespunzator daca patesc ceva acolo.

In fact, when I start running around saying,

De fapt, cand incep sa spun in stanga si-n dreapta,

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

"Hei, oameni buni, sunteti cardiologi in Statele Unite,

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

va puteti intoarce acasa cu mine intr-o misiune umanitara?"

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

Mi-ar placea sa gandeasca, "Ei bine, exista speranta."

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

Acum, uitati-va la asta. Este un aparat pentru punerea sub anestezie.

And that's my specialty, right?

Iar asta este specializarea mea, nu?

Anesthesiology and critical care -- look at that bag.

Anestezie si medicina de urgenta -- uitati-va la acea punga.

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

A fost lipita cu banda adeziva de care am incetat sa mai folosim in Marea Britanie.

And believe me, these are current pictures.

Si credeti-ma, acestea sunt poze recente.

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

Deci, daca s-ar intampla asa ceva, cum s-a intamplat in Marea Britanie,

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

aici vin. Aceasta este unitatea de terapie intensiva in care lucrez.

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

In regula, acesta este o poza de la o prezentare pe care am tinut-o

about intensive care units in Nigeria,

despre unitatile de terapie intensiva din Nigeria,

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

si in gluma facem referire la ele ca "Sperieturi Scumpe" (joc de cuvinte).

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

Pentru ca este infricosator si presupun costuri mari, dar trebuie sa le avem.

So, these are the problems.

Deci, acestea sunt problemele.

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

Dar nu exista nici un premiu pentru identificarea problemelor, nu-i asa?

I think we all know. And several speakers before

Cred ca stim cu totii, si cativa vorbitori inaintea mea

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

si cativa de dupa mine va vor infatisa si mai multe probleme.

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

Acestea sunt doar cateva dintre ele. Deci, ce am facut?

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

Iata, mergem intr-o misiune umanitara.

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

Mergem sa facem operatii pe cord deschis, eram singurul britanic,

on a team of about nine American cardiac surgeons,

intr-o echipa de noua chirurgi cardiologi americani,

cardiac nurse, intensive care nurse.

asistente de cardiologie si asistente de terapie intensiva.

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

Am mers cu totii intr-o misiune umanitara, am fost in trei pana acum.

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

Pentru informatia dumneavoastra, cred in misiuni umanitare, cred in ajutor

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

si cred in caritate. Toate au locul lor,

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

dar unde se pot duce oamenii pentru rezolvarea acelor probleme medicale despre care am discutat mai devreme?

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

Pentru ca nu toata lumea va putea beneficia de ajutor prin aceste misiuni.

Health is wealth, in the words of Hans Rosling.

Sanatatea este bogatie, citandu-l pe Hans Rosling.

You get wealthier faster if you are healthy first.

Ajungi mai instarit, mai repede, daca esti intai de toate, sanatos.

So, here we are, mission. Big trouble.

Deci, iata-ne, misiune umanitara. Mari probleme.

Open-heart surgery in Nigeria -- big trouble.

Operatie pe cord deschis in Nigeria -- mari probleme.

That's Mike, Mike comes out from Mississippi.

Acela este Mike, Mike este din Mississippi.

Does he look like he's happy?

Arata ca si cand ar fi fericit?

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

Ne-au trebuit doua zile numai pentru a aranja locul, dar hei.

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

Stiti, am muncit acolo. Arata fericit?

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

Da, acela este sfatul medical pe care ni l-a dat seful comisiei,

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

"Da, v-am spus, nu veti reusi,

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

nu puteti face face asta, o stiu pur si simplu."

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

Uitati, acela este tehnicianul pe care l-am avut cu noi. Deci da, continuati, in regula?

(Laughter)

(Rasete)

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

L-am convins sa vina cu mine. Tehnician anestezist, vino cu mine din Marea Britanie.

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

Da, hai sa rezolvam aceasta problema.

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

Vedeti, aceasta este una dintre problemele pe care le avem in Nigeria si in Africa in general.

We get a lot of donated equipment.

Primim multe echipamente din donatii.

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

Echipamente invechite, echipamente care nu prea mai functioneaza,

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

sau fuctioneaza si nu le poti repara. Si nu este nimic in neregula cu asta,

so long as we use it and we move on.

atata vreme cat le folosim si mergem mai departe.

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

Dar am avut probleme cu ele. Am avut probleme grave acolo.

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

Trebuia sa stea la telefon. Tipul asta era tot timpul la telefon.

So what we going to do now?

Deci ce vom face de acum inainte?

It looks like all these Americans are here and

Se pare ca toti acesti americani care sunt aici

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

si da, un britanic, si nu va face nimic,

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

el crede ca este de fapt britanic, dar, in fapt, este nigerian,

I just thought about that.

tocmai mi-a venit aceasta idee.

We eventually got it working, is the truth,

In cele din urma am reusit sa-l facem sa mearga, acesta este adevarul,

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

dar era unul dintre acestea. Chiar mai vechi decat cel pe care l-ati vazut.

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

Motivul pentru care am aici aceasta fotografie, aceasta radiografie,

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

este pentru a va impartasi unde si in ce conditii examinam aceste radiografii.

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

Va dati seama unde este? Este pe un geam.

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

Vreau sa spun, ce este un panou pentru examinat radiografii? Va rog.

Well, nowadays everything's on PAX anyway.

Oricum, in zilele noastre totul e pe PAX.

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

Vezi radiografiile pe un ecran si faci fel de fel de lucruri cu ele,

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

le poti trimite chiar si prin email. Cu toate ca inca foloseam radiografiile,

but we didn't even have a viewing box!

nu avem un panou pentru a le analiza!

And we were doing open-heart surgery.

Si faceam operatii pe cord deschis.

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

Ok, stiu ca nu e SIDA, stiu ca nu e malarie,

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

dar tot ne sunt necesare aceste lucruri. Ah, da, ecograf --

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

era pentru a pregati copiii si adultii.

People still believe in Voodoo. Heart disease,

Oamenii inca cred in Voodoo -- boli de inima,

VSD, hole in the heart, tetralogies.

VSD, o perforatie pe cord, tetralogii.

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

Inca gasesti oameni care cred in aceste lucruri si cu toate acestea au venit.

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

La o saturatie cu oxigen de 67%, fata de rata normala de aproximativ 97%.

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

Starea ei, operatia pe cord deschis de care avea nevoie,

would have been treated when she was a child.

ar fi fost tratata cand era copil.

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

A trebuit sa facem asta pentru adulti. Si am reusit si inca reusim.

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

Am facut trei. Avem in plan inca una in iulie

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

in nordul tarii. Deci cu siguranta inca realizam aceste operatii,

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

dar puteti observa contrastul dintre tot ceea ce a fost adus --

we ship everything, instruments. We had explosions

ne aducem tot ce avem nevoie, instrumente -- s-au produs si explozii,

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

pentru ca echipamentul a fost proiectat si instalat de oameni care nu erau obisnuiti cu el.

The oxygen tanks didn't quite work right.

Rezervoarele de oxigen n-au functionat chiar cum ar fi trebuit.

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

Cate am facut prima data? 12.

We did 12 open-heart surgical patients successfully.

Am vindecat 12 oameni cu operatii pe cord deschis, cu succes.

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

Acesta este primul nostru pacient, iesit de la terapie intensiva,

and just watch that chair, all right?

si priviti acel scaun, in regula.

This is what I mean about appropriate technology.

La asta ma refer cand spun tehnologie corespunzatoare.

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

Asta facea: proptea patul pentru ca acesta pur si simplu nu functiona.

Have you seen one of those before?

Ati mai vazut asa ceva pana acum?

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

Nu? Da? Nu conteaza, a functionat.

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

Sunt convins ca ati mai vazut sau ati mai auzit cu totii asta pana acum.

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

Noi, cei care am avut vointa, am facut atat de multe, cu atat de putine, pentru atat de mult timp --

(Applause)

(Aplauze)

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

-- incat acum suntem in masura sa facem orice, cu nimic.

(Applause)

(Aplauze)

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

Multumesc. "Solutii sustenabile" -- aceasta este prima mea companie,

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

al carei singur scop este sa ofere exact acel lucru care cred ca ne lipseste.

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

Asa ca bag mana in buzunar si zic, "Baieti, hai sa cumparam ce ne trebuie."

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

Sa infiintam o companie care educa lumea, ii pregateste,

gives them the tools they need to keep going."

le da uneltele de care au nevoie pentru a continua.

And that's a perfect example of one.

Iar acesta este un exemplu perfect de un astfel de lucru.

Usually when you buy a ventilator in a hospital,

De obicei, cand cumperi un ventilator intr-un spital,

you buy a different one for children,

cumperi unul diferit pentru copii,

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

cumperi altul pentru transport. Acesta va indeplini toate functiile,

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

si va face asta la jumatate de pret si nu are nevoie de aer comprimat.

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

Daca esti in America si nu ai aflat despre asta, noi stim,

because we make it our duty to find out

pentru ca facem din asta datoria noastra sa aflam

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

care este tehnologia potrivita pentru Africa -- care este pretul corespunzator,

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

rezolva problema si trecem mai departe. Aparatul pentru anestezie,

multi-parameter monitor, operating lights, suction.

monitor cu mai multi parametri, lumini pentru operatie, aspiratie.

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

Acest aparat de aici -- va amintiti micuta priza de 12 volti din masina,

that charges your, whatever, Game Boy, telephone?

de unde va incarcati, ma rog -- Game Boy, telefonul?

That's exactly how the outlets are designed.

Exact asa sunt proiectate si aceste prize.

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

Da, este nevoie de un panou solar. Da un panou solar este suficient pentru a-l incarca.

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

Iar daca avem si retea electrica, va incarca bateriile inauntru.

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

Si ghiciti ce? Avem si o mica pedala pentru incarcare, pentru orice eventualitate.

And guess what, if it all fails,

Si ghiciti ce, daca totul esueaza,

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

daca puteti gasi o masina care are o baterie ce functioneaza

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

il conectezi la ea si inca merge. Apoi il poti adapta pentru nevoile tale.

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

Vrei o operatie de stomatologie? Sau ai o operatie de chirurgie generala?

Decide which instruments, stock it up with consumables.

Decide de ce instrumente ai nevoie, fa-ti stocuri de consumabile.

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

Si in momentul de fata lucram cu oxigen. Oxigen livrat la fata locului.

The technology for oxygen delivery is not new.

Tehnologia pentru livrarea oxigenului nu este noua.

Oxygen concentrators are very old technology. What is new,

Tehnologia concentratoarelor de oxigen nu este noua. Ceea ce este insa nou,

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

si ce vom avea in cateva luni, sper,

is that ability to use this same renewable energy system

este capacitatea de a folosi acelasi sistem de energie regenerabila

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

pentru a produce si furniza oxigen la fata locului. Zeolitul -- nu este nou --

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

zeolitul inlatura azotul din aer, iar azotul reprezinta 78% din aer.

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

Daca scoti azotul, ce ramane? Oxigen, in mare parte.

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

Deci asta nu e ceva nou. Ceea ce facem noi este sa aplicam aceasta tehnologie.

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

Acestea sunt elementele de baza ale dispozitivului meu, dispozitivului nostru.

This is what makes it so special.

Acest lucru il face atat de special.

Apart from the awards it's won,

In afara de premiile pe care le-a castigat,

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

este portabil si este certificat; este inregistrat, MHRA --

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

si marcajul CE, pentru cei care nu stiu este echivalentul european

of the FDA in the U.S.

al FDA-ului in Statele Unite.

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

Daca il compari cu alte produse similare de pe piata, in ce priveste pretul,

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

dimensiunile, usurinta de folosire, complexitatea.

This picture was taken last year.

Aceasta fotografie a fost facuta anul trecut.

These are members of my graduating class, 1986.

Acestia sunt colegii mei, promotia 1986.

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

Era in casa acestui domn in Potomac,

for those of you who are familiar with Maryland.

pentru aceia dintre voi care cunosc statul Maryland.

There are too many of us outside and everybody,

Prea multi dintre noi sunt in strainatate si cu totii,

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

ca sa il citez pe Hans -- Hans Rosling, preferatul meu --

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

daca marimea textului este cea care atrage cea mai multa atentie,

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

exista o problema. Dar ceea ce ne trebuie cu adevarat sunt solutii africane,

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

care sunt potrivite pentru Africa -- luand in considerare cultura,

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

oamenii, si cat de putini bani au.

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

Africanii, pentru ca vor pune suflet in ceea ce fac, sper,

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

vor sacrifica cu totii cate putin din ceea ce au.

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

Trebuie sa faceti asta. Africanii trebuie sa faca asta,

in conjunction with everyone else.

laolalta cu toti ceilalti.

Thank you.

Va multumesc.

(Applause)

(Aplauze)