Medical tech designed to meet Africa's needs | Soyapi Mumba

翻译人员: Conway Ye 校对人员: TED Translators admin

Like every passionate software engineer out there,

像每一位充满激情的 软件工程师一样，

I closely follow technology companies in Silicon Valley,

我密切跟踪着 硅谷科技公司的动向，

pretty much the same way soccer fans follow their teams in Europe.

就像足球粉关注 他们的欧洲球队一样。

I read articles on tech blogs

我看科技博客上的文章，

and listen to podcasts on my phone.

听手机上的播客。

But after I finish the article,

但是在我看完文章后，

lock my phone and unplug the headphones,

锁上手机屏幕，摘下耳机，

I'm back in sub-Saharan Africa,

我又回到了撒哈拉沙漠以南的非洲，

where the landscape is not quite the same.

这里的风景挺不一样的。

We have long and frequent power outages,

我们频繁有长时间的停电，

low penetration of computers,

低电脑普及率，

slow internet connections

缓慢的网速，

and a lot of patients visiting understaffed hospitals.

和人满为患，却人手不足的医院。

Since the HIV epidemic,

自从艾滋病爆发以来，

hospitals have been struggling to manage regular HIV treatment records

病例变得越来越多， 医院就很难妥善管理

for increasing volumes of patients.

艾滋病患者的治疗记录。

For such environments,

在这样的环境下，

importing technology systems developed elsewhere has not worked,

进口的医疗设备根本没法发挥作用。

but in 2006, I joined Baobab Health,

但是在2006年，我加入了 猴面包树医疗（Baobab Health），

a team that uses locally based engineers

这个组织雇用地方工程师，

to develop suitable interventions

进行因地制宜的研发工作

that are addressing health care challenges in Malawi.

来解决马拉维共和国的医疗问题。

We designed an electronic health record system

我们设计了一个电子医疗记录系统，

that is used by health care workers while seeing patients.

供医疗人员看病时使用。

And in the process we realized that we not only had to design the software,

在研发过程中我们意识到， 我们不仅要设计软件，

we had to implement the infrastructure as well.

还要提供配套的基础设施。

We don't have enough medical staff

我们没有足够的医疗人员

to comprehensively examine every patient,

来全面检查每一个病人，

so we embedded clinical guidelines within the software

所以我们在软件里置入了临床指南

to guide nurses and clerks

来帮助护士和工作人员，

who assist with handling some of the workload.

辅助他们的工作。

Everyone has a birthday,

每个人都有一个生日，

but not everyone knows their birthday,

但并不是每个人 都知道自己的出生日期，

so we wrote algorithms to handle estimated birthdates

所以我们写了能够估算生日的算法，

as complete dates.

能准确到某天。

How do we follow up patients living in slums

我们如何跟踪住在贫民窟的病人？

with no street and house numbers?

他们连门牌号都没有。

We used landmarks to approximate their physical addresses.

我们用地标来估计他们的位置。

Malawi had no IDs to uniquely identify patients,

马拉维没有能够 分辨病人的身份识别信息，

so we had to implement unique patient IDs

所以我们设计了独特的 病人身份识别系统，

to link patient records across clinics.

让病人的记录在 不同诊所之间实现连接。

The IDs are printed as barcodes

这些身份识别信息

on labels that are stuck on personal health booklets

以条形码的形式贴在病人的病历上，

kept by each patient.

由病人保管。

With this barcoded ID,

有了条形码身份证，

只要用扫描器一扫，

a simple scan with a barcode reader

quickly pulls up the patient's records.

就能拿到病人的记录。

No need to rewrite their personal details

没有必要在每次去医院的时候，

on paper registers at every visit.

重新填写他们的个人信息。

And suddenly, queues became shorter.

突然之间，看诊的队伍变短了。

This meant patients, typically mothers with little children on their backs,

这意味着病人， 很多是背着小孩的母亲，

had to spend less time waiting to be assisted.

不需要花那么多时间候诊了。

And if they lose their booklets,

如果他们丢失了自己的病历，

their records can still be pulled by searching with their names.

还能通过搜索他们的名字找到。

Now, the way we pronounce and spell names varies tremendously.

但是，不同的人读和拼写 名字的方式也大不相同。

We freely mix R's and L's,

我们不区分R和L，

English and vernacular versions of their names.

不区分英语和方言的名字。

Even soundex,

甚至是发音，

a standard method for grouping words by how similar they sound,

一个标准化的依据发音的拼写方法

was not good enough.

并不好用。

So we had to modify it

所以我们要改变它，

to help us link and match existing records.

来帮助连接和匹配现有的记录。

Before the iPhone,

在iPhone被发明以前，

software engineers developed for personal computers,

软件工程师只开发了 电脑版的软件，

but from our experience,

但是依据我们的经验，

我们的电力系统并不能为电脑提供

we knew our power system is not reliable enough

for personal computers.

可靠的电力供应。

So we repurposed touch screen point-of-sale terminals

所以我们把 触屏的销售点终端机，

that are meant for retail shops

就是在零售店里用的那种，

to become clinical workstations.

改成了医疗工作站。

At the time, we imported internet appliances called i-Openers

那个时候，我们进口了 网络工具，i-Openers，

that were manufactured during the dot-com era

这是在互联网热潮时期，

由一个破产的美国公司生产的。

by a failed US company.

We modified their screens

我们改造了它们的屏幕，

to add touch sensors

加上了触觉传感器，

and their power system to run from rechargeable batteries.

并改用可充电电池来供电。

When we started, we didn't find a reliable network to transmit data,

刚开始的时候，我们找不到 一个可靠的网络来传输数据，

especially from rural hospitals.

特别是在偏远的医院里。

So we built our own towers,

所以我们建造了自己的信号塔，

created a wireless network

创造了一个无线网络，

and linked clinics in Lilongwe,

并连接到了马拉维的首都，

Malawi's capital.

利隆圭的诊所。

(Applause)

（鼓掌）

With a team of engineers

和在医院工作的一群工程师一起

working within a hospital campus,

在医院内工作，

we observed health care workers use the system

我们目睹了医疗人员利用这个系统，

and iteratively build an information system

慢慢建立起了一个信息系统，

that is now managing HIV records

管理着马拉维所有主要公共医院中

in all major public hospitals in Malawi.

艾滋病人的医疗记录。

These are hospitals serving over 2,000 HIV patients, each clinic.

这些医院的每个诊所 都有超过2000个艾滋病人。

Now, health care workers who used to spend days

在以前，医疗人员要花几天时间

to tally and prepare quarterly reports

来计算和整理季度报告，

are producing the same reports within minutes,

现在只要几分钟就能完成，

and health care experts from all over the world

而全世界的医疗专家

are now coming to Malawi to learn how we did it.

都来马拉维来学习 我们是怎么做到的。

(Applause)

（鼓掌）

It is inspiring and fun

跟随全球科技潮流

to follow technology trends across the globe,

让人深受启发，而且乐在其中，

but to make them work

但是让这些科技

in low-resourced environments

在资源匮乏的环境下运行，

like public hospitals in sub-Saharan Africa,

像撒哈拉沙漠以南非洲的公共医院，

we have had to become jacks-of-all-trades

我们不得不成为万事通，

and build whole systems, including the infrastructure,

从零开始，搭建整个系统，

from the ground up.

包括基础设施。

Thank you.

谢谢。

(Applause)

（鼓掌）