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

Prevodilac: Eva Marjanovic Lektor: Ivana Korom

Nine years ago, I worked

Pre devet godina

for the U.S. government in Iraq,

radila sam za američku vladu u Iraku

helping rebuild the electricity infrastructure.

na obnovi električne infrastrukture.

And I was there, and I worked in that job

Razlog zbog kog sam se prihvatila tog zadatka

because I believe that technology

je taj da verujem da tehnologija

can improve people's lives.

može da pomogne ljudima.

One afternoon, I had tea with a storekeeper

Jednog popodneva, bila sam na čaju sa jednim trgovcem

at the Al Rasheed Hotel in Baghdad,

u hotelu Al Rašid u Bagdadu,

and he said to me, "You Americans,

te veli on meni: ''Vi Amerikanci,

you can put a man on the moon,

možete se vi popeti i na Mesec,

but when I get home tonight,

ali ja večeras neću imati svetla

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

kod kuće.''

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

Do tog dana, američka vlada je potrošila

more than two billion dollars

više od dve milijarde dolara

on electricity reconstruction.

na obnovu elektroenergetskog sistema.

How do you ensure technology reaches users?

Kako da znate da je tehnologija dospela do ljudi?

How do you put it in their hands

Kako možete biti sigurni da će im biti

so that it is useful?

od stvarne koristi?

So those are the questions that my colleagues and I

To su pitanja koja sebi postavljamo kolege i ja

at D-Rev ask ourselves.

u D-Rev-u.

And D-Rev is short for Design Revolution.

D-Rev je skraćenica za ''revolucija dizajna''.

And I took over the organization four years ago

Četiri godine je otkako sam došla na čelo organizacije

and really focused it on developing products

i u fokus istraživanja stavila proizvode u povoju

that actually reach users,

koji zapravo stignu do krajnjih potrošača

and not just any users,

i to ne bilo kojih,

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

već i do onih koji žive i sa par dolara dnevno.

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

Jedna od ključnih stvari na kojoj od nedavno radimo

is medical devices, and while it may not be obvious

jesu medicinska pomagala, i možda nije očigledno,

that medical devices have something in common

ali medicinska pomagala ipak

with Iraq's electricity grid then,

imaju nešto zajedničko sa problemom električne mreže

there are some commonalities.

u Iraku.

Despite the advanced technology,

Naime, napredna tehnologija izgleda nije od pomoći

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

onima kojima je najpotrebnija.

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

Predstaviću jedan projekat na kome radimo,

the ReMotion Knee, and it's a prosthetic knee

,,ReMotion Knee'' - radi se o protetskom kolenu

for above-knee amputees.

za one kojima je urađena natkolena amputacija noge.

And this project started when the Jaipur Foot Organization,

Ovaj projekat smo započeli kada je organizacija Jaipur Foot,

the largest fitter of prosthetic limbs in the world,

najveći proizvođač protetskih pomagala na svetu,

came to the Bay Area and they said,

došla do zaključka da bi trebalo napraviti

"We need a better knee."

bolje protetsko koleno.

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

Ono što je najverovatniji slučaj kada živite u bedi

and you're an amputee,

i pritom imate amputiran neki deo tela

you've lost your limb in a vehicle accident.

je da ste ga izgubili u saobraćajnoj nezgodi.

Most people think it's land mines,

Većina ljudi pomisli na nagazne mine

but it's a vehicle accident.

ali se ipak najčešće radi o saobraćajnoj nezgodi.

You're walking by the side of the road

Hodate pored puta

and you're hit by a truck,

i udari vas kamion

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

ili pokušavate da uskočite u voz u pokretu

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

i vaša nogavica se zapetlja.

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

Surova je realnost da ako nemate mnogo novca,

like this young named Kamal right here,

kao ovaj momak, Kamal,

the option you really have

jedina opcija je da se pomažete

is a bamboo staff to get around.

štapom za hodanje od bambusa.

And how big a problem is this?

Znate li koliki je ovo problem?

There's over three million amputees every year

Svake godine preko 3 miliona ljudi sa amputiranim udovima

who need a new or replacement knee.

treba novo koleno.

And what are their options?

Znate li koje su njihove opcije?

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

Poslednja reč tehnike. Ovo nazivamo ,,pametnim kolenom''.

It's got a microprocessor inside.

Ima u sebi mikroprocesor.

It can pretty much do anything,

Može da uradi skoro bilo šta

but it's 20,000 dollars,

ali košta 20 000 dolara

and to give you a sense of who wears this,

a uglavnom ga nose veterani,

veterans, American veterans coming back from Afghanistan or Iraq

mahom američki veterani po povratku iz Avganistana

would be fit with something like this.

ili Iraka.

This is a low-end titanium knee.

Evo jednog niskobudžetnog titanijumskog kolena.

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

To je policentrično koleno, što znači

is the mechanism, is a four-bar mechanism,

da ima mehanizam nalik

that mimics a natural human knee.

onom kod ljudskog kolena.

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

Međutim, cena mu je 1400 dolara, što je i dalje

for people like Kamal.

preskupo za čoveka koji živi od nekoliko dolara dnevno.

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

Stigosmo do kolena koje je takođe niskobudžetno

This is a knee that's been designed specifically

i dizajnirano je specijalno

for poor people.

za siromašno stanovništvo.

And while you have affordability,

I mada je pristupačno,

you've lost on functionality.

izgubilo je na funkcionalnosti.

The mechanism here is a single axis,

Mehanizam je jednoosni, što znači

and a single axis is like a door hinge.

da funkcioniše kao vratno krilo.

So you can think about how unstable that would be.

Možete zamisliti koliko je ovo nestabilno.

And this is the type of mechanism

Ovo je tip mehanizma koji je Jaipur Foot

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

koristila pre nego što su zatražili bolje rešenje za protetsko koleno,

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

te htedoh da vam pokažem

because I'm showing you all these knees

i izbliza jedan ovakav

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

mehanizam.

So at the top you have a socket,

Dakle na vrhu imate šupljinu koja treba

and this fits over someone's residual limb,

da se uklopi u nečiji amputacioni patrljak,

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

a svako ima malo drugačiji.

And then you have the knee,

Zatim imamo koleno,

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

dakle sa jednom jedinom osom rotacije

so you can see how it rotates,

i eto kako rotira

and then a pylon, and then a foot.

pa onda potkolenica, i na kraju stopalo.

And we've been able to develop a knee,

Mi smo proizveli policentrično protetsko koleno,

a polycentric knee, so that type of knee

koje bi vršilo funkciju ljudskog kolena,

that acts like a human knee, mimics human gait,

pomoću kog biste zaista hodali

for 80 dollars retail.

za samo 80 dolara.

(Applause)

(Aplauz)

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

Poenta je da iako imate ovaj sjajni izum,

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

a sa njim takođe i prelep dizajn, ostaje pitanje kako

to the people who most need it?

biti siguran da će ga kupiti oni

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

kojima je potreban, ne bi li im olakšao život?

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

Radimo i na drugim projektima,

and we looked at three things that we really believe

i uvek shvatimo da su najvažnije sledeće tri stvari

gets technologies to customers, to users,

ne bi li proizvod završio u rukama onih

to people who need it.

kojima i jeste najpotrebniji.

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

Prva je da proizvod treba da bude vrhunskog kvaliteta.

It needs to perform on par

Trebalo bi da ima performanse jednako dobre

or better than the best products on the market.

ili bolje nego najbolji proizvodi tog tipa na tržištu.

Regardless of your income level,

Bez obzira na platežnu moć kupca,

you want the most beautiful,

morate im ponuditi

the best product that there is.

najlepše i najbolje rešenje.

I'm going to show you a video now

Pustiću vam video snimak

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

čoveka zvanog Eš koji hoda

He's wearing the same knee system here

pomoću protetskog kolena

with a single axis knee.

koje ima jednu jedinu osu rotacije.

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

Testirali smo njegov hod na deset metara.

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

Primećujete kako se bori da održi ravnotežu dok hoda.

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

Nešto što je malo manje očigledno

is that it's psychologically draining

jeste to koliko iscrpljuje

to walk and to be preventing yourself from falling.

konstantna borba da ne padnete.

Now this is a video of Kamal.

Ovde vidite Kamala.

You remember Kamal earlier, holding the bamboo staff.

Sećate ga se od malopre, sa bambusovim štapom za hodanje.

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

Ovde nosi jednu od prvobitnih verzija našeg protetskog kolena,

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

i radi isti test na deset metara.

And you can see his stability is much better.

Vidite koliko je stabilniji njegov hod.

So world class isn't just about technical performance.

Dakle, vrhunski proizvod nije vrhunski slučajno.

It's also about human performance.

On čuva ljudsko dostojanstvo.

And most medical devices, we've learned,

Nažalost, većina medicinskih pomagala

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

je pravljena za zapadnjake,

for wealthier economies.

za jače ekonomije.

But the reality is our users, our customers,

Ali realnost čine naši korisnici, kupci

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

koji se bave različitim stvarima. Više sede prekrštenih nogu.

We see that they squat. They kneel in prayer.

Čuče, kleče tokom molitve.

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

Naše koleno smo dizajnirali tako da ima veći opseg pokreta

of almost any other knee on the market.

od skoro svakod drugog kolena na tržištu.

So the second thing we learned, and this leads

Druga stvar koja je veoma važna jeste da

into my second point, which is that we believe

proizvod treba da bude napravljen

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

tako da bude što je moguće više prilagođen kupcu.

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

U D-Rev-u, otišli smo korak dalje

you need to be user-obsessed.

pa mislimo na svaki detalj.

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

Ne samo da mislimo na krajnjeg kupca,

but everyone who interacts with the product,

već na svakog ko dolazi u kontakt sa proizvodom

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

na primer, protetičar koji treba da namesti koleno,

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

ali isto tako i uslove pod kojima je koleno namešteno.

What is the local market like?

Kakvo je lokalno tržište?

How do all these components get to the clinic?

Kako da svi sastavni delovi stignu na kliniku?

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

Stiže li sve na vreme? Drugim rečima, bavimo se i lancem isporuke.

Everything that goes into ensuring

Svime što osigurava

that this product gets to the end user,

da je proizvod stigao do krajnjeg potrošača

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

i što se u tu svrhu koristi.

So I wanted to show you some of the iterations

Sada ću vam pokazati neke verzije

we did between the first version, the Jaipur Knee,

koje smo napravili posle prvobitnog, Jaipur Knee protetskog kolena -

so this is it right here.

počnimo od ove.

(Clicking)

(Klik)

Notice anything about it?

Je l' primećujete isto što i ja?

It clicks.

Da, čuje se.

We'd seen that users had actually modified it.

Viđali smo pokušaje korisnika da reše ovaj problem sami.

So do you see that black strip right there?

Vidite li tu crnu traku?

That's a homemade noise dampener.

To je domaći prigušivač zvuka.

We also saw that our users had modified it

Bilo je tu još kreativnih pokušaja

in other ways.

da se buka utiša.

You can see there that that particular amputee,

Vidite tog čoveka sa amputiranom nogom

he had wrapped bandages around the knee.

kako je obmotao zavoj

He'd made a cosmesis.

oko kolena.

And if you look at the knee,

A ako još jednom pogledate koleno -

it's got those pointy edges, right?

vidite ove ispupčene ivice?

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

Ako nosite pantalone, suknju

or a sari, it's really obvious

ili sari preko, videće se

that you're wearing a prosthetic limb,

da nosite protetičko pomagalo,

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

a u društvima gde postoji stigma oko invaliditeta

people are particularly acute about this.

ljudi nisu ravnodušni prema ovom problemu.

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

Pokazaću vam neke usputne modifikacije koje su učinjene.

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

Dosta smo radili na poboljšanju karakteristika.

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

Ovde vidite treću verziju ReMotion Knee kolena,

but if you look in here, you can see

a ako pogledate ovde, možete videti

the noise dampener. It's quieter.

prigušivač buke. Mnogo bolje.

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

Primećujete da je i izgled mnogo, mnogo lepši.

We made it thinner.

Sada je tanje.

And something that's not obvious is that we

Nešto što nije očigledno je da smo koleno

designed it for mass production.

učinili pogodnim za masovnu proizvodnju.

And this goes into my last point.

Na kraju da spomenem i treću stvar koja je važna.

We really, truly believe that if a product

S obzirom da proizvod treba da dospe do naših korisnika

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

u onolikoj količini kolika je potreba za njim,

it needs to be market-driven,

mora biti vođen tržištem,

and market-driven means that products are sold.

što znači da mora da se prodaje.

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

Ova kolena nisu na poklon. Nisu subvencionisana u nekoj većoj meri.

Our product needs to be designed to offer value

Naš proizvod treba da nudi

to the end user.

vrednost krajnjem potrošaču.

It also has to be designed to be very affordable.

Takođe treba da bude pristupačan.

But a product that is valued by a customer

Proizvod koji je kupcu vredan,

is used by a customer,

kupac koristi,

and use is what creates impact.

a upotreba čini proizvod značajnim.

And we believe that as designers,

Mi smo kao dizajneri

it holds us accountable to our customers.

odgovorni mušterijama za naš proizvod.

And with centralized manufacturing,

Sa centralizovanom proizvodnjom

you can control the quality control,

u mogućnosti smo da kontrolišemo kvalitet,

and you can hit that $80 price point

a cenu od 80 dolara smo kreirali

with profit margins built in.

uzevši u obzir i isplativost.

And now, those profit margins are critical,

Isplativost je kritična,

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

jer ako želite da uspete i pomognete

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

svim ljudima kojima je potrebno koleno,

it needs to be economically sustainable.

to mora biti ekonomski održivo.

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

Gde smo trenutno na tom putu?

We have fit over 5,000 amputees,

Pomogli smo preko 5000 ljudi sa amputiranim udovima

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

a najveći pokazatelj uspeha za nas jeste odgovor na pitanje

is, does it improve lives?

da li koleno čini život lakšim?

Well, the standard is, is someone

Obično se pitamo da li naš kupac

still wearing their knee six months later?

i dalje nosi naše koleno i nakon šest meseci?

The industry average is about 65 percent.

Industrijski prosek bi bio 65 procenata mušterija.

Ours is 79 percent,

Naš iznosi 79 procenata,

and we're hoping to get that higher.

a potrudićemo se da bude i viši.

Right now, our knees are worn in 12 countries.

Trenutno se naše koleno nosi u dvanaest zemalja.

This is where we want to get, though,

I na ova tržišta želimo da dopremo

in the next three years.

u naredne tri godine.

We'll double the impact in 2015,

Udvostručićemo prodaju u 2015. godini,

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

a tako ćemo nastaviti i u godinama koje slede.

But then we hit a new challenge,

Pred nama je nov izazov,

and that's the number of skilled prosthetists

a to je broj stručno

who are able to fit knees.

usavršenih protetičara.

So I want to end with a story of Pournima.

Ovde bih završila izlaganje sa slučajem devojke Prinime.

Pournima was 18 years old

Prinima je imala 18 godina

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

kada je u saobraćajnoj nezgodi izgubila nogu,

and she traveled 12 hours by train

pa je putovala 12 sati vozom

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

da bi došla na kliniku gde je čeka koleno,

and while all of the amputees who wear our knees

i iako su nam izuzetno dragi svi ljudi s amputiranim udovima

affect us as the designers,

koji nose naše koleno,

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

ona je na mene ostavila poseban utisak kao žena inženjer,

because she was in school,

jer je završila školu

she had just started school to study engineering.

i upravo tada je krenula na studije inženjeringa.

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

Kaže: ''Pošto sad mogu ponovo da hodam,

I can go back and complete my studies."

mogu i da se vratim i dovršim studije.''

And to me she represents the next generation

Tako da je ona za mene oličenje generacije

of engineers solving problems

inženjera koji rešavaju probleme

and ensuring meaningful technologies

i staraju se da vredna tehnologija

reach their users.

dođe do korisnika.

So thank you.

Hvala vam.

(Applause)

(Aplauz)