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

296,189 views ・ 2013-12-19

TED


Za predvajanje videoposnetka dvakrat kliknite na spodnje angleške podnapise.

Translator: Nika Kotnik Reviewer: Klavdija Cernilogar
00:12
Nine years ago, I worked
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Pred devetimi leti sem delala
00:14
for the U.S. government in Iraq,
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za vlado ZDA v Iraku,
00:16
helping rebuild the electricity infrastructure.
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pomagala sem na novo zgraditi električno infrastrukturo.
00:19
And I was there, and I worked in that job
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Bila sem tam, delala v tej službi,
00:22
because I believe that technology
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zato ker verjamem, da lahko tehnologija
00:24
can improve people's lives.
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izboljša človeška življenja.
00:27
One afternoon, I had tea with a storekeeper
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Nekega popoldneva sem pila čaj z lastnikom trgovine
00:29
at the Al Rasheed Hotel in Baghdad,
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v Hotelu Al Rasheed v Bagdadu
00:32
and he said to me, "You Americans,
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in rekel mi je, "Vi Američani,
00:35
you can put a man on the moon,
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človeka ste uspeli poslati na Luno,
00:36
but when I get home tonight,
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ampak ko pridem zvečer domov,
00:38
I won't be able to turn on my lights."
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ne bom mogel prižgati luči."
00:41
At the time, the U.S. government had spent
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V tem času je vlada ZDA porabila
00:42
more than two billion dollars
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več kot dve milijardi dolarjev
00:45
on electricity reconstruction.
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za rekonstrukcijo elektrike.
00:47
How do you ensure technology reaches users?
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Kako zagotoviš, da tehnologija doseže uporabnike?
00:50
How do you put it in their hands
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Kako jim jo daš v roke,
00:52
so that it is useful?
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da je uporabna?
00:55
So those are the questions that my colleagues and I
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To so vprašanja, ki si jih s kolegi
00:58
at D-Rev ask ourselves.
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zastavljamo v D-Rev.
01:00
And D-Rev is short for Design Revolution.
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D-Rev je okrajšava za Revolucijo dizajna.
01:03
And I took over the organization four years ago
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To organizacijo sem prevzela pred štirimi leti
01:05
and really focused it on developing products
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in se res osredotočila na razvoj produktov,
01:08
that actually reach users,
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ki bi dejansko dosegli uporabnike,
01:10
and not just any users,
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in to ne katerekoli,
01:11
but customers who live on less than four dollars a day.
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ampak uporabnike, ki živijo z manj kot štirimi dolarji na dan.
01:16
One of the key areas we've been working on recently
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Eno izmed naših ključnih področij dela
01:17
is medical devices, and while it may not be obvious
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so zdravstvene naprave in čeprav morda ni očitno,
01:20
that medical devices have something in common
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da imajo medicinske naprave kaj skupnega
01:22
with Iraq's electricity grid then,
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z električno mrežo v Iraku,
01:25
there are some commonalities.
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obstajajo skupne točke.
01:27
Despite the advanced technology,
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Kljub napredni tehnologiji
01:29
it's not reaching the people who need it most.
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ne dosegajo ljudi, ki jih najbolj potrebujejo.
01:32
So I'm going to tell you about one of the projects we've been working on,
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Govorila bom o enem od svojih projektov,
01:35
the ReMotion Knee, and it's a prosthetic knee
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o Kolenu ReMotion, ki je protezno koleno
01:38
for above-knee amputees.
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za nadkolenske amputacije.
01:40
And this project started when the Jaipur Foot Organization,
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Ta projekt se je začel, ko je Organizacija Jaipur Foot,
01:43
the largest fitter of prosthetic limbs in the world,
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največji izdelovalec protetičnih udov na svetu,
01:46
came to the Bay Area and they said,
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prišla v Zaliv in rekla
01:47
"We need a better knee."
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"Potrebujemo boljše koleno."
01:50
Chances are, if you're living on less than four dollars a day,
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Velika možnost je, da če živite z manj kot štirimi dolarji na dan
01:53
and you're an amputee,
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in ste amputiranec,
01:55
you've lost your limb in a vehicle accident.
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ste izgubili svoj ud v prometni nesreči.
01:57
Most people think it's land mines,
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Večina pomisli na pehotne mine,
01:59
but it's a vehicle accident.
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ampak to so prometne nesreče.
02:00
You're walking by the side of the road
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Hodiš po robu ceste
02:02
and you're hit by a truck,
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in te zadene tovornjak,
02:04
or you're trying to to jump on a moving train,
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ali pa skočiš na premikajoči se vlak,
02:05
you're late for work, and your pant leg gets caught.
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zamujaš na delo in tvoja hlačnica se ujame.
02:09
And the reality is that if you don't have much money,
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In dejstvo je, da če nimaš veliko denarja,
02:13
like this young named Kamal right here,
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kot tale mladenič po imenu Kamal,
02:15
the option you really have
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je možnost, ki jo imaš za premikanje,
02:17
is a bamboo staff to get around.
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bambusova palica.
02:19
And how big a problem is this?
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In kako velik problem je to?
02:22
There's over three million amputees every year
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Vsako leto več kot tri milijone amputirancev
02:25
who need a new or replacement knee.
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potrebuje novo ali nadomestno koleno.
02:28
And what are their options?
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in kaj so njihove možnosti?
02:30
This is a high-end. This is what we'd call a "smart knee."
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To je visoka kvaliteta. Temu rečemo "pametno koleno."
02:32
It's got a microprocessor inside.
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Notri ima mikroprocesorje.
02:34
It can pretty much do anything,
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Lahko naredi praktično vse,
02:37
but it's 20,000 dollars,
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ampak stane 20,000 dolarjev,
02:38
and to give you a sense of who wears this,
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in da dobite občutek, kdo ga nosi:
02:40
veterans, American veterans coming back from Afghanistan or Iraq
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ameriški veterani, ki se vračajo iz Afganistana ali Iraka,
02:44
would be fit with something like this.
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bi dobili nekaj takega.
02:46
This is a low-end titanium knee.
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To je manj kvalitetno koleno iz titana.
02:49
It's a polycentric knee, and all that that means
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Je policentrično in to pomeni,
02:51
is the mechanism, is a four-bar mechanism,
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da mehanizem, štiriosni mehanizem,
02:53
that mimics a natural human knee.
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posnema naravno človeško koleno.
02:56
But at 1,400 dollars, it's still too expensive
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Ampak pri ceni 1,400$ je še vedno predrago
02:58
for people like Kamal.
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za ljudi, kot je Kamal.
03:01
And lastly, here you see a low-end knee.
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In na koncu je tu koleno najnižje kakovosti.
03:03
This is a knee that's been designed specifically
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To koleno je bilo oblikovano posebej
03:05
for poor people.
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za revne ljudi.
03:07
And while you have affordability,
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In ko dobite cenovno dostopnost,
03:09
you've lost on functionality.
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izgubite funkcionalnost.
03:10
The mechanism here is a single axis,
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Mehanizem tu je ena os
03:13
and a single axis is like a door hinge.
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in ena os je kot tečaj vrat.
03:15
So you can think about how unstable that would be.
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Lahko si mislite, kako nestabilno je.
03:18
And this is the type of mechanism
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To je vrsta mehanizma,
03:20
that the Jaipur Foot Organization was using when they were looking for a better knee,
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ki ga je uporabljala Organizacija Jaipur Foot, ko so iskali boljše koleno.
03:23
and I just wanted to give you a sense of what a leg system looks like,
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Naj vam dam občutek, kako izgleda sistem noge,
03:26
because I'm showing you all these knees
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ker vam kažem vsa ta kolena
03:27
and I imagine it's hard to think how it all fits together.
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in si je najbrž težko zamisliti, kako vse deluje.
03:29
So at the top you have a socket,
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Na vrhu imate ležišče,
03:32
and this fits over someone's residual limb,
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ki se prilega krnu uda,
03:33
and everyone's residual limb is a little bit different.
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in vsak krn je nekoliko drugačen.
03:36
And then you have the knee,
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Potem imate koleno,
03:37
and here I've got a single axis on the knee
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tu imam eno os na kolenu,
03:39
so you can see how it rotates,
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da lahko vidite, kako se obrača,
03:41
and then a pylon, and then a foot.
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potem drog in nato noga.
03:45
And we've been able to develop a knee,
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Razvili smo koleno,
03:47
a polycentric knee, so that type of knee
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policentrično koleno, torej tisto vrsto kolena,
03:49
that acts like a human knee, mimics human gait,
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ki posnema človeško koleno, človeško držo
03:52
for 80 dollars retail.
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za 80 dolarjev v maloprodaji.
03:55
(Applause)
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(Aplavz)
03:58
But the key is, you can have this great invention,
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Ampak ključno je, lahko imaš ta krasen izum,
04:01
you can have this great design, but how do you get it
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krasen dizajn, ampak kako ga dostaviš
04:03
to the people who most need it?
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do ljudi, ki ga najbolj potrebujejo?
04:05
How do you ensure it gets to them and it improves their lives?
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Kako zagotoviš, da pride do njih in izboljša njihova življenja?
04:08
So at D-Rev, we've done some other projects,
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Pri podjetju D-Rev smo naredili nekaj drugih projektov
04:11
and we looked at three things that we really believe
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in osredotočili smo se na tri stvari, za katere verjamemo,
04:13
gets technologies to customers, to users,
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da priskrbijo tehnologijo strankam, uporabnikom,
04:17
to people who need it.
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ljudem, ki jo potrebujejo.
04:19
And the first thing is that the product needs to be world class.
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Prva stvar je, da mora biti izdelek prvovrsten.
04:21
It needs to perform on par
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Mora se primerjati
04:23
or better than the best products on the market.
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ali biti boljši od najboljših izdelkov na tržišču.
04:26
Regardless of your income level,
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Ne glede na svoj prihodek
04:28
you want the most beautiful,
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si želiš najlepši,
04:30
the best product that there is.
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najboljši izdelek, kar jih je.
04:32
I'm going to show you a video now
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Pokazala vam bom posnetek moškega po imenu Ash
04:36
of a man named Ash. You can see him walking.
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Vidite ga kako hodi.
04:37
He's wearing the same knee system here
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Tu nosi isti sistem kolena
04:39
with a single axis knee.
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z eno osjo.
04:41
And he's doing a 10-meter walk test.
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Opravlja desetmetrski test hoje.
04:43
And you'll notice that he's struggling with stability as he's walking.
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Lahko vidite, da se med hojo muči z nestabilnostjo.
04:47
And something that's not obvious, that you can't see,
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In kar ni očitno, česar ne morete videti, je,
04:49
is that it's psychologically draining
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da je psihološko izčrpljujoče
04:52
to walk and to be preventing yourself from falling.
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hoditi in obenem paziti, da ne padeš.
04:56
Now this is a video of Kamal.
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Tu je video Kamala.
04:58
You remember Kamal earlier, holding the bamboo staff.
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Spomnite se Kamala od prej, ko je držal bambusovo palico.
05:00
He's wearing one of the earlier versions of our knee,
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Nosi eno izmed zgodnjih različic našega kolena
05:03
and he's doing that same 10-meter walk test.
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in opravlja enak desetmetrski test hoje.
05:06
And you can see his stability is much better.
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Lahko vidite, da je veliko bolj stabilen.
05:11
So world class isn't just about technical performance.
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Prvovrstnost torej ni samo v tehničnem pogledu.
05:14
It's also about human performance.
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Pomemben je tudi človeški vidik.
05:18
And most medical devices, we've learned,
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Ugotovili smo, da je večina medicinskih pripomočkov
05:20
as we've dug in, are really designed for Westerners,
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zasnovanih za Zahodnjake,
05:22
for wealthier economies.
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za bogatejša gospodarstva.
05:24
But the reality is our users, our customers,
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Ampak v resničnem svetu naše stranke
05:27
they do different things. They sit cross-legged more.
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počnejo drugačne stvari. Več sedijo po turško.
05:30
We see that they squat. They kneel in prayer.
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Čepijo. Gredo na kolena pri molitvi.
05:33
And we designed our knee to have the greatest range of motion
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Zasnovali smo koleno, ki ima največji razpon gibanja
05:35
of almost any other knee on the market.
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med skoraj vsemi koleni na tržišču.
05:39
So the second thing we learned, and this leads
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Druga stvar, ki smo jo spoznali,
05:41
into my second point, which is that we believe
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kar vodi k moji drugi točki, je, da verjamemo,
05:43
that products need to be designed to be user-centric.
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da mora biti produkt osredotočen na uporabnika.
05:46
And at D-Rev, we go one step further and we say
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V podjetju D-Rev gremo korak dlje in pravimo,
05:49
you need to be user-obsessed.
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da moramo biti obsedeni z uporabnikom.
05:51
So it's not just the end user that you're thinking about,
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Tako da ne mislimo samo na končnega uporabnika,
05:53
but everyone who interacts with the product,
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ampak na vse, ki se srečajo s produktom,
05:55
so, for example, the prosthetist who fits the knee,
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na primer protetik, ki namesti koleno,
05:58
but also the context in which the knee is being fit.
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ampak tudi okoliščine, v katerih ga namesti.
06:01
What is the local market like?
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Kakšen je lokalni trg?
06:03
How do all these components get to the clinic?
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Kako vse te komponente pridejo do klinike?
06:05
Do they all get there on time? The supply chain.
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Pridejo vse tja pravočasno? Veriga oskrbe.
06:07
Everything that goes into ensuring
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Vse, kar gre v zagotavljanje,
06:09
that this product gets to the end user,
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da izdelek pride do končnega uporabnika,
06:11
and it goes in as part of the system, and it's used.
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in gre noter kot del sistema in se uporabi.
06:15
So I wanted to show you some of the iterations
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Hotela sem vam pokazati nekaj različic,
06:17
we did between the first version, the Jaipur Knee,
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ki smo jih naredili med prvo verzijo, kolenom Jaipur,
06:22
so this is it right here.
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to je tole tukaj.
06:24
(Clicking)
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(Klikanje)
06:25
Notice anything about it?
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Opazite nekaj?
06:28
It clicks.
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Klika.
06:30
We'd seen that users had actually modified it.
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Videli smo, da so jih uporabniki dejansko predelali.
06:33
So do you see that black strip right there?
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Vidite ta črni trak tu?
06:37
That's a homemade noise dampener.
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To je doma narejen dušilec hrupa.
06:40
We also saw that our users had modified it
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Naši uporabniki so ga spremenili
06:42
in other ways.
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še na druge načine.
06:43
You can see there that that particular amputee,
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Lahko vidite, da je tale amputiranec
06:45
he had wrapped bandages around the knee.
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ovil povoje okoli kolena.
06:47
He'd made a cosmesis.
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Polepšal ga je.
06:49
And if you look at the knee,
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In če pogledate koleno,
06:51
it's got those pointy edges, right?
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ima te ostre robove, kajne?
06:55
So if you're wearing it under pants or a skirt
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Če ga torej nosite pod hlačami ali krilom
06:57
or a sari, it's really obvious
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ali sarijem, je res očitno,
06:59
that you're wearing a prosthetic limb,
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da nosite protezo,
07:01
and in societies where there's social stigma around being disabled,
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in v družbah, kjer je invalidnost družbeno stigmatizirana.
07:05
people are particularly acute about this.
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so ljudje na to zelo pozorni.
07:08
So I'm going to show you some of the modifications we did.
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Pokazala vam bom nekaj naših predelav.
07:10
We did a lot of iterations, not just around this, but some other things.
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Naredili smo veliko različnih ponovitev.
07:13
But here we have the version three, the ReMotion Knee,
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Tu je tretja različica kolena ReMotion,
07:16
but if you look in here, you can see
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ampak če pogledate sem,
07:17
the noise dampener. It's quieter.
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vidite dušilec hrupa. Tišji je.
07:22
The other thing we did is that we smoothed the profile.
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Druga stvar, ki smo jo naredili, je, da smo zgladili profil.
07:26
We made it thinner.
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Stanjšali smo ga.
07:27
And something that's not obvious is that we
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In čeprav to ni očitno,
07:29
designed it for mass production.
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smo ga zasnovali za množično proizvodnjo.
07:32
And this goes into my last point.
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Tu pridemo do zadnje točke.
07:34
We really, truly believe that if a product
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Resnično verjamemo, da če naj bi produkt
07:36
is going to reach users at the scale that it's needed,
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dosegel uporabnika v tisti meri, kot je potrebno,
07:38
it needs to be market-driven,
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mora biti osredotočen na trg,
07:40
and market-driven means that products are sold.
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kar pomeni, da se produkt prodaja.
07:43
They're not donated. They're not heavily subsidized.
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Ni podarjen. Ni subvencioniran.
07:46
Our product needs to be designed to offer value
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Proizvod mora biti zasnovan tako, da nudi vrednost
07:48
to the end user.
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končnemu uporabniku.
07:50
It also has to be designed to be very affordable.
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Biti mora oblikovan tako, da je dostopen.
07:52
But a product that is valued by a customer
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Ampak produkt, ki ga stranka ceni,
07:54
is used by a customer,
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ga tudi uporablja,
07:56
and use is what creates impact.
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in uporaba je tisto, kar ustvari učinek.
07:58
And we believe that as designers,
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Kot oblikovalci verjamemo,
08:00
it holds us accountable to our customers.
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da imamo odgovornost do naših strank.
08:03
And with centralized manufacturing,
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In s centralizirano proizvodnjo
08:06
you can control the quality control,
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lahko nadzoruješ kakovost
08:08
and you can hit that $80 price point
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in lahko dosežeš mejo 80 dolarjev
08:09
with profit margins built in.
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z že vštetimi profitnimi maržami.
08:12
And now, those profit margins are critical,
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In te profitne marže so ključne,
08:14
because if you want to scale, if you want to reach
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ker če se hočeš meriti, doseči
08:16
all the people in the world who possibly need a knee,
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vse ljudi na svetu, ki morda potrebujejo koleno,
08:18
it needs to be economically sustainable.
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mora proces biti ekonomsko vzdržen.
08:21
So I want to give you a sense of where we are at.
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Želim, da dobite občutek, kje smo.
08:24
We have fit over 5,000 amputees,
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Namestili smo proteze že več kot 5000 amputirancem
08:27
and one of the big indicators we're looking at, of course,
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in eden izmed glavnih indikatorjev, je vprašanje,
08:30
is, does it improve lives?
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ali proteza izboljšuje življenja?
08:31
Well, the standard is, is someone
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Torej, standard je tale: ali nekdo
08:33
still wearing their knee six months later?
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šest mesecev kasneje še vedno nosi koleno?
08:36
The industry average is about 65 percent.
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Povprečje v industriji je okrog 65 odstotkov.
08:38
Ours is 79 percent,
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Naše je 79 odstotkov
08:41
and we're hoping to get that higher.
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in želimo ga še zvišati.
08:44
Right now, our knees are worn in 12 countries.
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Zdaj naša kolena nosijo v 12 državah.
08:47
This is where we want to get, though,
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To pa želimo doseči
08:48
in the next three years.
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v naslednjih treh letih.
08:50
We'll double the impact in 2015,
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Vpliv bomo podvojili v letu 2015
08:52
and we'll double it each of the following years after that.
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in vsake naslednje leto ga bomo spet podvojili.
08:55
But then we hit a new challenge,
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Ampak potem se pojavi nov problem
08:57
and that's the number of skilled prosthetists
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in to je število izučenih protetikov,
08:59
who are able to fit knees.
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ki znajo nameščati kolena.
09:02
So I want to end with a story of Pournima.
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Rada bi končala z zgodbo o Prinimi.
09:05
Pournima was 18 years old
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Prinima je bila stara 18 let,
09:07
when she was in a car accident where she lost her leg,
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ko je doživela prometno nesrečo, kjer je izgubila nogo,
09:10
and she traveled 12 hours by train
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in 12 ur je potovala z vlakom,
09:13
to come to the clinic to be fit with a knee,
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da je prišla v kliniko na namestitev kolena.
09:15
and while all of the amputees who wear our knees
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Medtem ko se nas vsi, ki nosijo naša kolena,
09:18
affect us as the designers,
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dotaknejo kot oblikovalcev,
09:20
she's particularly meaningful to me as an engineer and as a woman,
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je ona še posebej pomembna zame kot inženirko in kot žensko,
09:24
because she was in school,
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ker se je šolala,
09:26
she had just started school to study engineering.
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pravkar je pričela s študijem inženirstva.
09:29
And she said, "Well, now that I can walk again,
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In rekla je: "Sedaj lahko spet hodim,
09:31
I can go back and complete my studies."
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lahko grem nazaj in zaključim svoj študij."
09:33
And to me she represents the next generation
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Zame predstavlja naslednjo generacijo
09:36
of engineers solving problems
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inženirjev, ki rešujejo probleme
09:39
and ensuring meaningful technologies
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in zagotavljajo, da pomembne tehnologije
09:42
reach their users.
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dosežejo svoje uporabnike.
09:44
So thank you.
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Torej hvala.
09:46
(Applause)
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(Aplavz)
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