The Most Powerful Untapped Resource in Health Care | Edith Elliott and Shahed Alam | TED

51,713 views ・ 2022-05-09

TED


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翻译人员: Rocky Stone 校对人员: Yuwei Wu
00:04
Shahed Alam: In the fall of 2021,
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沙赫德·阿拉姆: 2021 年秋天,
00:06
I arrived in the US to visit my parents
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我去美国看望父母,
00:09
after almost two years of not seeing one another.
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我们已经有近两年没有见面了。
00:12
I was coming from my home in Bangalore, in India,
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我的家在印度的班加罗尔,
00:14
where we were just getting out of a devastating second wave
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那里刚刚经历了第二波疫情,
00:17
of the pandemic.
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这造成了巨大的破坏。
00:19
Within weeks of my arrival, first my father, then me,
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在到达美国的数周内, 首先是我父亲,然后是我,
00:23
then my mother, all came down with COVID.
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接着是我母亲, 全部感染了新冠。
00:26
And it hit us hard.
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这给我们造成了很大打击。
00:28
My parents' age and their medical conditions
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我父母年迈体弱,医疗条件不佳,
00:31
threatened to make each day more severe than the last.
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情况一天比一天严重。
00:34
And despite my medical training, I was overwhelmed.
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尽管我接受了医疗培训, 我仍然感到不知所措。
00:37
It was a nightmare,
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这是一场噩梦,
00:39
one, I'm guessing, many of you all have faced.
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我想,大家许多人都有过这种经历。
00:42
I tried to get them tested at sites that were booked for days.
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多天来,我一直努力想让他们到 预约地点进行化验。
00:46
We called their doctors who were unavailable.
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我们给医生打电话,但他们没空。
00:48
We tried to get monoclonal antibodies,
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我们设法去购买单克隆抗体,
00:50
knowing that with every day that passed, that treatment became less effective.
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因为我们知道,每过一天, 治疗效果都会大打折扣。
00:54
And this was all while just trying to figure out what to eat
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与此同时,我还要决定吃些什么,
00:57
and how to make them feel better.
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以及怎么让他们好受一些。
01:00
Thankfully, we all recovered.
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谢天谢地,我们都康复了。
01:02
But I'll never forget the depths of how alone and helpless I felt.
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但我永远也忘不了, 我当时感受到的孤独和无助。
01:07
And my desperation to do anything I could to help.
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我可能提供帮助时的绝望情绪。
01:12
Edith Elliott: Like Shahed,
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伊迪丝·埃利奥特:像沙赫德一样,
01:14
and I'm guessing everyone in this room,
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我想在座的所有人,
01:16
at some point in your life,
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在你们生命的某个阶段,
01:17
you've been in the position of wanting to do whatever you can
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你们都希望尽最大能力
01:20
to take care of someone you love.
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去照顾你们所爱的人。
01:23
We're here to talk to you about how our organization,
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在这里,我们希望 向大家介绍我们的组织,
01:26
Noora Health, is rethinking health care.
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Noora Health, 在对医疗保健进行反思。
01:28
And yes, we have nearly a decade's track record,
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我们已经有近十年的从业记录,
01:30
we're driven by data and we leverage technology.
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我们是一个数据驱动型机构, 我们会利用技术。
01:33
But at the heart of what we do
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但从核心上说,我们所做的,
01:35
is a powerful force that might surprise you.
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是利用一种大家可能觉得 意外的强大力量。
01:38
It's love.
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它就是爱。
01:40
It’s that dogged determination to get your aging mom’s meds sorted out;
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它是一种给年迈母亲进行 药物分类的坚定决心,
01:44
that tenacious energy to get your kid to the ER.
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是送孩子去急诊的顽强力量。
01:47
Like oxygen,
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就像氧气一样,
01:49
it is essential to our health and our well-being.
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它对我们的健康和幸福非常重要。
01:51
It is ever present, but invisible.
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虽然我们看不到它, 但它却无处不在。
01:54
It's the fuel of family advocacy.
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它是家庭支持的源泉。
01:56
And for too long it's either been seen as a nuisance
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长久以来,在医疗保健环境中,
02:00
or it's been ignored altogether within health care settings.
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它被人们当作一种障碍, 或被完全忽略。
02:04
When Shahed and I met, we connected over many things,
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沙赫德和我见面后, 我们有了许多共识,
02:07
but we founded Noora on the shared belief that love is the most powerful,
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但我们创办Noora,却是基于 一个共同的信仰:爱是最强大的
02:12
untapped resource available.
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尚未开发的可用资源。
02:14
And when valued and made visible,
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如果受到重视,变得具体,
02:16
it can transform health systems.
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它可以转变卫生系统。
02:19
SA: We work in India and Bangladesh.
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沙赫德:我们在 印度和孟加拉开展工作。
02:22
When you stand outside one of the hospitals where we work,
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站在我们工作的一所医院外面,
02:25
the first thing you'll notice is the crowd.
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大家首先注意到的是人群拥挤。
02:27
When you walk in, you may see patients doubled up on beds,
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走进医院,大家可能会看到, 病床上挤满了病人;
02:31
and you'll see hallways and waiting areas filled with families and their belongings
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你会看到,走廊和候诊区 满是家属和行李,
02:35
because they've moved to the hospital to be there with their loved ones.
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因为他们已经搬来医院, 与自己爱的人呆在一起。
02:40
Families are spending their time anxiously waiting
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家属们焦急地等待着,
02:43
while providers are doing the best that they can
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医疗提供方则在尽可能地
02:45
to keep up with the intense demand.
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满足迫切的诊疗需求。
02:47
And we know this will only get worse.
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我们知道,这种情况只会 变得更加糟糕。
02:50
Globally, there will be a shortage of nearly 18 million health care workers
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全球来看,到 2030 年, 医疗护理人员的缺口将达到
02:54
by 2030.
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近 1800 万人。
02:56
The systems are overburdened
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医疗系统已经不堪重负,
02:58
and this has life and death consequences for patients.
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对患者来说,这种情况生死攸关。
03:02
Every year in South Asia alone,
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每年,仅在南亚,
03:04
nearly 1.5 million children under five die.
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就有约 150 万 五岁以下儿童死亡。
03:08
And far too many of these deaths can be prevented
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但是,通过改善在家的医疗护理,
03:11
with better health practices at home.
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这其中的许多死亡事件都可以避免。
03:14
At Noora Health, we train
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在Noora Health, 我们会进行培训,
03:15
and we support families with life-saving skills.
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借助救生技能为家庭提供支持。
03:19
We work with hospitals and clinics to meet people where they are,
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我们与医院和诊所合作, 在患者的病床旁、
03:22
at the patient's bedside, in the hallways, in the waiting areas.
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在走廊、在候诊区与人们接触。
03:27
We train nurses so that they can run sessions with groups of families
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我们对护士进行培训, 以便她们与家庭群体对话,
03:31
to teach them actionable skills.
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向他们传授一些切实可用的技能。
03:34
Things like wound care
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这包括伤口护理
03:36
and how to recognize warning signs, like jaundice in a newborn
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以及如何识别警报信号, 如新生儿黄疸,
03:40
or slurred speech for a cardiac patient.
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或心脏病患者言语不清。
03:43
And they leave plenty of time for questions and demonstrations.
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这省了大量提问和说明症状的时间。
03:47
Once families leave home, we stay connected with them,
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一旦家人离开家, 我们会与他们保持联系,
03:50
sending them messages, videos and reminders
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给他们发送与他们 所爱的人息息相关的
03:52
that are relevant for their loved ones,
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消息、视频和提醒,
03:54
and we're on the other side to answer any questions.
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另一方面,我们会解答任何问题。
03:58
So whether it's new parents,
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因此,无论是新父母、
04:01
surgical or oncology patients,
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外科还是肿瘤患者,
04:04
we've seen that this approach works across all types of care.
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我们发现,这种方法适用于 各种类型的护理。
04:09
Because the common thread is that loved ones are there,
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因为共同点在于, 人们所爱的人在那里,
04:12
and they want to help.
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并且他们需要帮助。
04:15
EE: Along the way, we've learned a few things.
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伊迪丝:在整个过程中, 我们学到了一些东西。
04:17
First, deep listening is key.
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首先,仔细倾听是关键。
04:20
Nurses, patients and families have guided us.
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护士、患者和家人都会 给我们提供指导。
04:23
They are the visionaries.
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他们具有远见。
04:24
They make sure our trainings incorporate objects that people have in their homes,
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他们会确保我们的培训 包含家庭设定的目标、
04:28
visuals that people see in their communities,
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人们在社区看到的情况,
04:31
and words and phrases that people actually use
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并采用人们日常使用的词汇,
04:34
instead of complex medical jargon.
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而不是复杂的医学术语。
04:36
Second, trust and timing are fundamental to behavior change.
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其次,信任和时机对于 改变行为至关重要。
04:41
Nurses and health care providers are the people families trust.
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护士和医疗保健提供商 受到家庭的信任。
04:45
So we work with them to provide the training
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因此,我们与他们合作,
04:47
at a time and in a place where families need it most.
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在家庭最需要的 时间和地点提供培训。
04:51
Third, you do not have to start from scratch.
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第三,你不需要从头开始。
04:54
We're not creating new systems,
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我们不是建立新的体制,
04:55
we’re building with and through existing infrastructure.
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而是依托现有的基础设施。
04:58
Yes, Noora is there to kick-start and support,
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确实,Noora会随时 迅速响应并提供支持,
05:01
but the trainings are designed and introduced in a way
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但会以确保可持续运行的方式
05:04
that ensures they will continue to run sustainably.
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设计和推出培训。
05:08
So far we've reached hundreds of hospitals and clinics
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到目前为止,我们已联系了 印度和孟加拉的
05:11
across India and Bangladesh,
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数百家医院和诊所,
05:13
and we've helped them change the way they deliver care.
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帮助他们改变了护理方式。
05:16
We’ve trained over 5,000 nurses,
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我们已培训了5000多名护士,
05:18
and we've reached over two million family caregivers.
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接触了超过 200 万名 家属护理人员。
05:21
(Applause)
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(掌声)
05:26
We have seen that this program reduces cardiac surgery complications
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我们发现,这个计划将 心脏手术并发症
05:30
by 71 percent,
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降低了 71%,
05:32
and our early data suggests that it reduces newborn deaths
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我们的早期数据表明, 它将新生儿死亡率
05:36
by 18 percent.
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降低了 18%。
05:38
(Applause)
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(掌声)
05:42
That would mean that over nine babies' lives are saved
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那意味着,在每 1000 位新生儿中,
05:45
for every 1,000 live births.
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有超过 9 名婴儿的生命 被挽救回来。
05:48
And it's all happening at an extremely low cost
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这一切只需要投入极低的成本,
05:50
because the solution leverages existing resources.
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因为解决方案利用了现有的资源。
05:54
SA: I had the chance to meet Bino.
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沙赫德:我曾有机会见过毕努。
05:57
He's a young man who had heart surgery at the nearest major hospital to him,
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他是一位年青人,在离家 最近的大型医院做过心脏手术,
06:00
which was in Kolkata.
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那是在加尔各答。
06:02
He was accompanied by his wife Sunita and his uncle,
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他的妻子桑妮塔和叔叔陪伴着他,
06:05
and both of them went through the training.
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他们两人都通过了培训。
06:08
Later on, when I visited them in their home,
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后来,我去他家看望他时,
06:11
Sunita had just wrapped up Bino's wound care,
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桑妮塔刚刚完成毕努的伤口护理,
06:13
commenting how she left it undressed, just like in the training.
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她告诉我说,她让伤口裸露着, 就像培训中讲的那样。
06:17
She showed me how she used the thermometer
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她向我演示了如何使用体温计,
06:19
and how she checked Bino's pulse
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如何检查毕努的脉搏,
06:21
and rattled off all of the normal ranges for blood pressure,
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并轻易说出了血压、心率和体温的
06:23
heart rate and temperature.
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各种正常范围。
06:25
She told me that they eat more fish now instead of red meat
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她告诉我,现在他们会吃 更多鱼而不是红肉,
06:28
and avoided foods with too much vitamin K because of his new medication.
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并避免吃含太多维生素K的食物, 因为毕努正在服用新药。
06:33
His uncle told me that they were able to avoid going to the local clinic
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他的叔叔告诉我, 每次需要基本的伤口护理时,
06:37
every single time they needed to do basic wound care.
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他们可以不必去当地诊所。
06:40
This saved them travel and also a dollar-fifty per visit.
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这样,他们就不必出门, 还可以节省每次看病的 50 美元。
06:44
This is a huge amount for a family
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这对他们家是一笔大开销,
06:46
that had to sell a part of their property to finance the operation.
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因为他们不得不出售一部分房产 才湊足钱去做手术。
06:50
Now Sunita never got the opportunity to learn how to read or write,
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虽然桑妮塔从未有机会 学习读书写字,
06:55
but hundreds of kilometers from the nearest major hospital,
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但在离最近的大型医院 数百公里的家中,
06:58
she confidently led Bino's recovery.
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她仍能够自信地帮助毕努康复。
07:01
EE: We are heartened by stories like Bino and Sunita's.
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伊迪丝:毕努和桑妮塔的 故事让我们鼓舞,
07:05
We have only scratched the surface.
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但这只是冰山一角。
07:08
Our audacious idea is to ignite a family caregiver movement
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我们的大胆想法是 激励家属护理人员行动起来,
07:12
that will revolutionize the way we experience health care.
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这会彻底改变我们的医疗保健体验。
07:15
Over the next six years,
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未来 6 年,
07:17
we will train over 70 million family caregivers
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我们将对超过 7000 万名 家属护理人员进行培训,
07:21
across India, Bangladesh, Indonesia and Nepal,
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范围遍及印度、孟加拉、 印度尼西亚和尼泊尔,
07:24
supporting health systems that provide care to over one billion people.
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为向超过 10 亿人提供 护理服务的医疗系统提供支持。
07:29
(Applause)
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(掌声)
07:36
But Noora can't be everywhere.
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但Noora并非无所不能。
07:39
And our ultimate dream is for health systems around the world
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我们的最终梦想,是全球医疗系统
07:42
to take what we've learned and make it their own,
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能够汲取我们的经验 并将它落到实处,
07:45
to include caregivers, make them a part of the health care team,
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以将护理人员纳入医疗护理团队,
07:49
give them confidence, skills, training.
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帮助他们建立自信, 学习技能,接受培训。
07:51
That should be standard practice.
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那应成为一种惯例。
07:53
It's almost too obvious, but we are not there yet.
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这一点显而易见, 但我们却尚未做到。
07:57
And that is our collective call to action.
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那是我们共同的行动呼吁。
08:01
SA: In every caregiver that we train,
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沙赫德:从我们培训的每一位 护理人员身上,
08:04
I see the triumphs and the struggles of my mother
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我看到了母亲在照顾 患神经衰弱的祖母时
08:07
caring for my grandmother through a debilitating neurological condition.
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所取得的成就和进行的抗争。
08:12
She was the most powerful steward of my grandmother's care,
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在照顾祖母的过程中, 她是最精明的管家,
08:16
yet seemingly invisible in the system.
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但在医疗系统中 几乎看不到她的存在。
08:19
EE: And I see my 13-year-old self
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伊迪丝:我也看到了自己 13 年来的经历,
08:21
helping my mom as she recovered from brain surgery
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我帮助母亲从脑部手术中恢复,
08:24
and relearned how to walk and talk and feed herself.
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帮助她重新学会走路、讲话和吃饭。
08:28
To this day, we carry the intimate understanding of that responsibility,
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直到今天,我们仍清楚地理解
08:33
the deep pride
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参与某人康复所带来的责任、
08:34
and the relief that comes with being part of someone's healing.
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深深的自豪感和如释重负。
08:38
At its core, this work is about honoring one of the most ancient human practices,
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从核心上说,这项工作是 尊重最古老的人类实践之一:
08:44
helping those we love.
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帮助那些我们所爱的人。
08:46
And it's about seeing compassion and community
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它将同情和社区活动
08:49
as essential medicines.
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作为基本的治疗手段。
08:51
Just imagine a world where
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想像一个这样的世界:
08:53
no matter who you are or where you're from,
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不论你是谁,不论你来自什么地方,
08:56
you know exactly how to take care of your loved ones
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你都知道怎么去照顾自己爱的人,
08:58
and where you are seen and acknowledged for this essential work.
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知道这项基本工作会在什么地方 得到赞同和认可。
09:03
We see every day that this is possible,
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我们看到,这种情况 正一天天成为现实,
09:05
and that in order to change health care,
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为了改变医疗护理,
09:07
it takes a family.
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需要家庭参与进来。
09:09
Thank you.
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谢谢大家!
09:10
(Applause and cheers)
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(掌声和欢呼声)
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