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

翻译人员: Rocky Stone 校对人员: Yuwei Wu

Shahed Alam: In the fall of 2021,

沙赫德·阿拉姆： 2021 年秋天，

I arrived in the US to visit my parents

我去美国看望父母，

after almost two years of not seeing one another.

我们已经有近两年没有见面了。

I was coming from my home in Bangalore, in India,

我的家在印度的班加罗尔，

where we were just getting out of a devastating second wave

那里刚刚经历了第二波疫情，

of the pandemic.

这造成了巨大的破坏。

Within weeks of my arrival, first my father, then me,

在到达美国的数周内， 首先是我父亲，然后是我，

then my mother, all came down with COVID.

接着是我母亲， 全部感染了新冠。

And it hit us hard.

这给我们造成了很大打击。

My parents' age and their medical conditions

我父母年迈体弱，医疗条件不佳，

threatened to make each day more severe than the last.

情况一天比一天严重。

And despite my medical training, I was overwhelmed.

尽管我接受了医疗培训， 我仍然感到不知所措。

It was a nightmare,

这是一场噩梦，

one, I'm guessing, many of you all have faced.

我想，大家许多人都有过这种经历。

I tried to get them tested at sites that were booked for days.

多天来，我一直努力想让他们到 预约地点进行化验。

We called their doctors who were unavailable.

我们给医生打电话，但他们没空。

We tried to get monoclonal antibodies,

我们设法去购买单克隆抗体，

knowing that with every day that passed, that treatment became less effective.

因为我们知道，每过一天， 治疗效果都会大打折扣。

And this was all while just trying to figure out what to eat

与此同时，我还要决定吃些什么，

and how to make them feel better.

以及怎么让他们好受一些。

Thankfully, we all recovered.

谢天谢地，我们都康复了。

But I'll never forget the depths of how alone and helpless I felt.

但我永远也忘不了， 我当时感受到的孤独和无助。

And my desperation to do anything I could to help.

我可能提供帮助时的绝望情绪。

Edith Elliott: Like Shahed,

伊迪丝·埃利奥特：像沙赫德一样，

and I'm guessing everyone in this room,

我想在座的所有人，

at some point in your life,

在你们生命的某个阶段，

you've been in the position of wanting to do whatever you can

你们都希望尽最大能力

to take care of someone you love.

去照顾你们所爱的人。

We're here to talk to you about how our organization,

在这里，我们希望 向大家介绍我们的组织，

Noora Health, is rethinking health care.

Noora Health， 在对医疗保健进行反思。

And yes, we have nearly a decade's track record,

我们已经有近十年的从业记录，

we're driven by data and we leverage technology.

我们是一个数据驱动型机构， 我们会利用技术。

But at the heart of what we do

但从核心上说，我们所做的，

is a powerful force that might surprise you.

是利用一种大家可能觉得 意外的强大力量。

It's love.

它就是爱。

It’s that dogged determination to get your aging mom’s meds sorted out;

它是一种给年迈母亲进行 药物分类的坚定决心，

that tenacious energy to get your kid to the ER.

是送孩子去急诊的顽强力量。

Like oxygen,

就像氧气一样，

it is essential to our health and our well-being.

它对我们的健康和幸福非常重要。

It is ever present, but invisible.

虽然我们看不到它， 但它却无处不在。

It's the fuel of family advocacy.

它是家庭支持的源泉。

And for too long it's either been seen as a nuisance

长久以来，在医疗保健环境中，

or it's been ignored altogether within health care settings.

它被人们当作一种障碍， 或被完全忽略。

When Shahed and I met, we connected over many things,

沙赫德和我见面后， 我们有了许多共识，

but we founded Noora on the shared belief that love is the most powerful,

但我们创办Noora，却是基于 一个共同的信仰：爱是最强大的

untapped resource available.

尚未开发的可用资源。

And when valued and made visible,

如果受到重视，变得具体，

it can transform health systems.

它可以转变卫生系统。

SA: We work in India and Bangladesh.

沙赫德：我们在 印度和孟加拉开展工作。

When you stand outside one of the hospitals where we work,

站在我们工作的一所医院外面，

the first thing you'll notice is the crowd.

大家首先注意到的是人群拥挤。

When you walk in, you may see patients doubled up on beds,

走进医院，大家可能会看到， 病床上挤满了病人；

and you'll see hallways and waiting areas filled with families and their belongings

你会看到，走廊和候诊区 满是家属和行李，

because they've moved to the hospital to be there with their loved ones.

因为他们已经搬来医院， 与自己爱的人呆在一起。

Families are spending their time anxiously waiting

家属们焦急地等待着，

while providers are doing the best that they can

医疗提供方则在尽可能地

to keep up with the intense demand.

满足迫切的诊疗需求。

And we know this will only get worse.

我们知道，这种情况只会 变得更加糟糕。

Globally, there will be a shortage of nearly 18 million health care workers

全球来看，到 2030 年， 医疗护理人员的缺口将达到

by 2030.

近 1800 万人。

The systems are overburdened

医疗系统已经不堪重负，

and this has life and death consequences for patients.

对患者来说，这种情况生死攸关。

Every year in South Asia alone,

每年，仅在南亚，

nearly 1.5 million children under five die.

就有约 150 万 五岁以下儿童死亡。

And far too many of these deaths can be prevented

但是，通过改善在家的医疗护理，

with better health practices at home.

这其中的许多死亡事件都可以避免。

At Noora Health, we train

在Noora Health， 我们会进行培训，

and we support families with life-saving skills.

借助救生技能为家庭提供支持。

We work with hospitals and clinics to meet people where they are,

我们与医院和诊所合作， 在患者的病床旁、

at the patient's bedside, in the hallways, in the waiting areas.

在走廊、在候诊区与人们接触。

We train nurses so that they can run sessions with groups of families

我们对护士进行培训， 以便她们与家庭群体对话，

to teach them actionable skills.

向他们传授一些切实可用的技能。

Things like wound care

这包括伤口护理

and how to recognize warning signs, like jaundice in a newborn

以及如何识别警报信号， 如新生儿黄疸，

or slurred speech for a cardiac patient.

或心脏病患者言语不清。

And they leave plenty of time for questions and demonstrations.

这省了大量提问和说明症状的时间。

Once families leave home, we stay connected with them,

一旦家人离开家， 我们会与他们保持联系，

sending them messages, videos and reminders

给他们发送与他们 所爱的人息息相关的

that are relevant for their loved ones,

消息、视频和提醒，

and we're on the other side to answer any questions.

另一方面，我们会解答任何问题。

So whether it's new parents,

因此，无论是新父母、

surgical or oncology patients,

外科还是肿瘤患者，

we've seen that this approach works across all types of care.

我们发现，这种方法适用于 各种类型的护理。

Because the common thread is that loved ones are there,

因为共同点在于， 人们所爱的人在那里，

and they want to help.

并且他们需要帮助。

EE: Along the way, we've learned a few things.

伊迪丝：在整个过程中， 我们学到了一些东西。

First, deep listening is key.

首先，仔细倾听是关键。

Nurses, patients and families have guided us.

护士、患者和家人都会 给我们提供指导。

They are the visionaries.

他们具有远见。

They make sure our trainings incorporate objects that people have in their homes,

他们会确保我们的培训 包含家庭设定的目标、

visuals that people see in their communities,

人们在社区看到的情况，

and words and phrases that people actually use

并采用人们日常使用的词汇，

instead of complex medical jargon.

而不是复杂的医学术语。

Second, trust and timing are fundamental to behavior change.

其次，信任和时机对于 改变行为至关重要。

Nurses and health care providers are the people families trust.

护士和医疗保健提供商 受到家庭的信任。

So we work with them to provide the training

因此，我们与他们合作，

at a time and in a place where families need it most.

在家庭最需要的 时间和地点提供培训。

Third, you do not have to start from scratch.

第三，你不需要从头开始。

We're not creating new systems,

我们不是建立新的体制，

we’re building with and through existing infrastructure.

而是依托现有的基础设施。

Yes, Noora is there to kick-start and support,

确实，Noora会随时 迅速响应并提供支持，

but the trainings are designed and introduced in a way

但会以确保可持续运行的方式

that ensures they will continue to run sustainably.

设计和推出培训。

So far we've reached hundreds of hospitals and clinics

到目前为止，我们已联系了 印度和孟加拉的

across India and Bangladesh,

数百家医院和诊所，

and we've helped them change the way they deliver care.

帮助他们改变了护理方式。

We’ve trained over 5,000 nurses,

我们已培训了5000多名护士，

and we've reached over two million family caregivers.

接触了超过 200 万名 家属护理人员。

(Applause)

（掌声）

We have seen that this program reduces cardiac surgery complications

我们发现，这个计划将 心脏手术并发症

by 71 percent,

降低了 71%，

and our early data suggests that it reduces newborn deaths

我们的早期数据表明， 它将新生儿死亡率

by 18 percent.

降低了 18%。

(Applause)

（掌声）

That would mean that over nine babies' lives are saved

那意味着，在每 1000 位新生儿中，

for every 1,000 live births.

有超过 9 名婴儿的生命 被挽救回来。

And it's all happening at an extremely low cost

这一切只需要投入极低的成本，

because the solution leverages existing resources.

因为解决方案利用了现有的资源。

SA: I had the chance to meet Bino.

沙赫德：我曾有机会见过毕努。

He's a young man who had heart surgery at the nearest major hospital to him,

他是一位年青人，在离家 最近的大型医院做过心脏手术，

which was in Kolkata.

那是在加尔各答。

He was accompanied by his wife Sunita and his uncle,

他的妻子桑妮塔和叔叔陪伴着他，

and both of them went through the training.

他们两人都通过了培训。

Later on, when I visited them in their home,

后来，我去他家看望他时，

Sunita had just wrapped up Bino's wound care,

桑妮塔刚刚完成毕努的伤口护理，

commenting how she left it undressed, just like in the training.

她告诉我说，她让伤口裸露着， 就像培训中讲的那样。

She showed me how she used the thermometer

她向我演示了如何使用体温计，

and how she checked Bino's pulse

如何检查毕努的脉搏，

and rattled off all of the normal ranges for blood pressure,

并轻易说出了血压、心率和体温的

heart rate and temperature.

各种正常范围。

She told me that they eat more fish now instead of red meat

她告诉我，现在他们会吃 更多鱼而不是红肉，

and avoided foods with too much vitamin K because of his new medication.

并避免吃含太多维生素K的食物， 因为毕努正在服用新药。

His uncle told me that they were able to avoid going to the local clinic

他的叔叔告诉我， 每次需要基本的伤口护理时，

every single time they needed to do basic wound care.

他们可以不必去当地诊所。

This saved them travel and also a dollar-fifty per visit.

这样，他们就不必出门， 还可以节省每次看病的 50 美元。

This is a huge amount for a family

这对他们家是一笔大开销，

that had to sell a part of their property to finance the operation.

因为他们不得不出售一部分房产 才湊足钱去做手术。

Now Sunita never got the opportunity to learn how to read or write,

虽然桑妮塔从未有机会 学习读书写字，

but hundreds of kilometers from the nearest major hospital,

但在离最近的大型医院 数百公里的家中，

she confidently led Bino's recovery.

她仍能够自信地帮助毕努康复。

EE: We are heartened by stories like Bino and Sunita's.

伊迪丝：毕努和桑妮塔的 故事让我们鼓舞，

We have only scratched the surface.

但这只是冰山一角。

Our audacious idea is to ignite a family caregiver movement

我们的大胆想法是 激励家属护理人员行动起来，

that will revolutionize the way we experience health care.

这会彻底改变我们的医疗保健体验。

Over the next six years,

未来 6 年，

we will train over 70 million family caregivers

我们将对超过 7000 万名 家属护理人员进行培训，

across India, Bangladesh, Indonesia and Nepal,

范围遍及印度、孟加拉、 印度尼西亚和尼泊尔，

supporting health systems that provide care to over one billion people.

为向超过 10 亿人提供 护理服务的医疗系统提供支持。

(Applause)

（掌声）

But Noora can't be everywhere.

但Noora并非无所不能。

And our ultimate dream is for health systems around the world

我们的最终梦想，是全球医疗系统

to take what we've learned and make it their own,

能够汲取我们的经验 并将它落到实处，

to include caregivers, make them a part of the health care team,

以将护理人员纳入医疗护理团队，

give them confidence, skills, training.

帮助他们建立自信， 学习技能，接受培训。

That should be standard practice.

那应成为一种惯例。

It's almost too obvious, but we are not there yet.

这一点显而易见， 但我们却尚未做到。

And that is our collective call to action.

那是我们共同的行动呼吁。

SA: In every caregiver that we train,

沙赫德：从我们培训的每一位 护理人员身上，

I see the triumphs and the struggles of my mother

我看到了母亲在照顾 患神经衰弱的祖母时

caring for my grandmother through a debilitating neurological condition.

所取得的成就和进行的抗争。

She was the most powerful steward of my grandmother's care,

在照顾祖母的过程中， 她是最精明的管家，

yet seemingly invisible in the system.

但在医疗系统中 几乎看不到她的存在。

EE: And I see my 13-year-old self

伊迪丝：我也看到了自己 13 年来的经历，

helping my mom as she recovered from brain surgery

我帮助母亲从脑部手术中恢复，

and relearned how to walk and talk and feed herself.

帮助她重新学会走路、讲话和吃饭。

To this day, we carry the intimate understanding of that responsibility,

直到今天，我们仍清楚地理解

the deep pride

参与某人康复所带来的责任、

and the relief that comes with being part of someone's healing.

深深的自豪感和如释重负。

At its core, this work is about honoring one of the most ancient human practices,

从核心上说，这项工作是 尊重最古老的人类实践之一：

helping those we love.

帮助那些我们所爱的人。

And it's about seeing compassion and community

它将同情和社区活动

as essential medicines.

作为基本的治疗手段。

Just imagine a world where

想像一个这样的世界：

no matter who you are or where you're from,

不论你是谁，不论你来自什么地方，

you know exactly how to take care of your loved ones

你都知道怎么去照顾自己爱的人，

and where you are seen and acknowledged for this essential work.

知道这项基本工作会在什么地方 得到赞同和认可。

We see every day that this is possible,

我们看到，这种情况 正一天天成为现实，

and that in order to change health care,

为了改变医疗护理，

it takes a family.

需要家庭参与进来。

Thank you.

谢谢大家！

(Applause and cheers)

（掌声和欢呼声）