Joel Selanikio: The surprising seeds of a big-data revolution in healthcare

翻译人员: Haocun Yu 校对人员: Coco Shen

有一个很古老的笑话，

There's an old joke about a cop

who's walking his beat in the middle of the night,

一个警察在深夜里巡逻时

and he comes across a guy under a street lamp

在路灯下遇到了一个男人

他一边盯着地面看一边来回走

who's looking at the ground and moving from side to side,

and the cop asks him what he's doing.

警察问他在做什么

The guys says he's looking for his keys.

那个男人说他正在找他的钥匙

So the cop takes his time

所以警察也花了时间仔细查看

and looks over and kind of makes a little matrix

并且做下一些小记号之类的，

and looks for about two, three minutes.

经过两三分钟。找不到钥匙。

No keys.

The cop says, "Are you sure?

警察说：“你确定吗？嘿， 朋友，

Hey buddy, are you sure you lost your keys here?"

你确定你在这里丢了你的钥匙吗？”

And the guy says, "No, actually I lost them

然后那个男人说：“不不，实际上我丢了他们

在街的那一边，

down at the other end of the street,

但是这里的灯光更亮。”

but the light is better here."

(Laughter)

There's a concept that people talk about nowadays called "big data."

现今，有一个人们谈论的概念

叫做大数据，他们谈论的

And what they're talking about is all of the information

是我们产生的所有信息

that we're generating through our interaction

在我们通过网络交流的时候

with and over the Internet,

everything from Facebook and Twitter

所有东西，从“脸书”和“推特”

到下载音乐，电影，流媒体，所有这种东西，

to music downloads, movies, streaming, all this kind of stuff,

the live streaming of TED.

TED的直播

And the folks who work with big data, for them,

对于这些负责处理大数据的人来说

they talk about that their biggest problem

他们最大的问题是

is we have so much information.

我们有这么多的信息，

The biggest problem is: how do we organize all that information?

我们该怎样组织这所有的信息？

我可以告诉你，在全球健康组织工作时，

I can tell you that, working in global health,

that is not our biggest problem.

这不是我们最大的问题。

Because for us, even though the light is better on the Internet,

因为对于我们来说，

即使灯在网络上比较亮

the data that would help us solve the problems we're trying to solve

即使网上数据会帮助我们解决一些问题

但我们正在努力解决的实际上并不会呈现在网络上

is not actually present on the Internet.

So we don't know, for example,

所以我们不知，比如说，有多少人

how many people right now are being affected by disasters

现在正在被疾病困扰着

或者是正处于战争中

or by conflict situations.

We don't know for, really, basically, any of the clinics

我们不知道现实中一个发展中国家的诊所里

in the developing world,

哪些有药物

which ones have medicines and which ones don't.

哪些没有

We have no idea of what the supply chain is for those clinics.

我们完全不知道这些诊所的供应链是怎样的

我们不知道——这真的让我很惊讶——

We don't know -- and this is really amazing to me -- we don't know

我们不知道有多少孩子出生，

how many children were born -- or how many children there are --

或者是有多少孩子，在玻利维亚

in Bolivia or Botswana or Bhutan.

或者博茨瓦纳，或者不丹

我们不知道上周有多少小孩夭折

We don't know how many kids died last week

在这些国家里的任一个。

in any of those countries.

We don't know the needs of the elderly, the mentally ill.

我们不知道老年病人和精神病人的需求。

For all of these different critically important problems

对于所有这些种种非常重要的问题

or critically important areas that we want to solve problems in,

或者是我们想解决问题的非常重要的地区

我们基本上一无所知。

we basically know nothing at all.

And part of the reason why we don't know anything at all

我们一无所知的部分原因

is that the information technology systems that we use in global health

是由于当我们在全球健康组织

用来寻找数据、解决问题

to find the data to solve these problems is what you see here.

所用的信息技术系统是你们所见的这个。

This is about a 5,000-year-old technology.

这是一个大约有5000年历史的技术。

Some of you may have used it before.

你们当中的一些可能以前用过。

它现在已经快过时了，可是我们仍在用它

It's kind of on its way out now,

but we still use it for 99 percent of our stuff.

百分之九十九的员工都在用。

这是一张纸质表格，你看到的

This is a paper form.

And what you're looking at is a paper form

是健康部护士手中的一张纸质表格

in the hand of a Ministry of Health nurse in Indonesia,

她正徒步穿行在印度尼西亚的乡下

who is tramping out across the countryside

in Indonesia on, I'm sure, a very hot and humid day,

在印尼，我相信，那是个热而潮湿的一天，

and she is going to be knocking on thousands of doors

并且她要去敲上千家的门

over a period of weeks or months,

在几周或几个月之中，

敲开门并且说：“打扰一下，

knocking on the doors and saying,

"Excuse me, we'd like to ask you some questions.

我们想问你一些问题。

Do you have any children? Were your children vaccinated?"

你有孩子吗？你的孩子打疫苗了吗？”

Because the only way we can actually find out

因为实际上这是我们唯一的方法，为了知道

在印尼乡下有多少孩子注射过疫苗，

how many children were vaccinated in the country of Indonesia,

注射过疫苗的百分比，实际上

what percentage were vaccinated,

is actually not on the Internet, but by going out and knocking on doors,

不在网络上，而是通过去挨家挨户地敲门，

有时候是成千上万的门。

sometimes tens of thousands of doors.

Sometimes it takes months to even years to do something like this.

有时候这要花去数月甚至几年时间

为了做一些这样的事情

You know, a census of Indonesia

你知道吗？在印尼的一次人口普查

would probably take two years to accomplish.

很可能要两年时间才能完成。

And the problem, of course, with all of this

当然，这其中的问题

is that, with all those paper forms --

在于所有这些纸质表格——而且我想告诉你们

and I'm telling you, we have paper forms for every possible thing:

什么事情都有纸质表格。

注射疫苗统计有纸质表格。

We have paper forms for vaccination surveys.

We have paper forms to track people who come into clinics.

调查去医院的人计有纸质表格。

We have paper forms to track drug supplies, blood supplies --

调查药物和血液供应有纸质表格。

所有这些不同的纸质表格

all these different paper forms for many different topics,

关于很多不同主题的，

they all have a single, common endpoint,

他们都有一个共同的终结点，

and the common endpoint looks something like this.

那个终结点看起来就像这样。

And what we're looking at here is a truckful of data.

我们现在看到的是一卡车的数据

这仅仅是一个疫苗注射覆盖范围的调查数据

This is the data from a single vaccination coverage survey

in a single district in the country of Zambia

仅仅是赞比亚乡下的一个地区

from a few years ago, that I participated in.

（数据）来自于前几年我参与的一次调查。

The only thing anyone was trying to find out

我们唯一想知道的事

is what percentage of Zambian children are vaccinated,

只是有多少百分比的赞比亚儿童注射过疫苗，

and this is the data, collected on paper over weeks,

这就是在几周里收集到纸上的数据，

from a single district,

仅仅是一个地区，有点像是我们在美国所说的

which is something like a county in the United States.

一个县。

You can imagine that, for the entire country of Zambia,

你可以想象一下，对于赞比亚整个国家，

只是回答那一个问题

answering just that single question ...

looks something like this.

看起来就像这样。

一车一车又一车

Truck after truck after truck,

装满着一叠一叠又一叠的数据。

filled with stack after stack after stack of data.

And what makes it even worse is that's just the beginning.

并且更糟糕的是

这只是开始，

Because once you've collected all that data,

因为一旦当你收集了所有那些数据

of course, someone -- some unfortunate person --

当然必须有一些人要去——

要有一些不幸的人不得不去把他们输入到计算机里。

is going to have to type that into a computer.

When I was a graduate student,

当我是研究生的时候，有时候我实际上就是

I actually was that unfortunate person sometimes.

那个不幸的人。

I can tell you, I often wasn't really paying attention.

我可以告诉你，我那时经常分心。

I probably made a lot of mistakes when I did it

很可能在输入时犯了很多错误

that no one ever discovered, so data quality goes down.

没有人会发现，所以数据质量会下降。

But eventually that data, hopefully, gets typed into a computer,

但是最终但愿那些数据被输入进了计算机里，

and someone can begin to analyze it,

然后一些人可以开始分析它们，

and once they have an analysis and a report,

一旦他们做出了一份分析和报告，

但愿你能拿着这些数据采集的结果

hopefully, then you can take the results of that data collection

and use it to vaccinate children better.

并且用它们能更好地给孩子们接种疫苗。

Because if there's anything worse in the field of global public health --

因为如果在全球公共健康的范畴，

有任何东西错了，

I don't know what's worse than allowing children on this planet

我不知道这世上还有什么比让孩子们

to die of vaccine-preventable diseases --

死于原本疫苗可预防的疾病更糟糕的事，

diseases for which the vaccine costs a dollar.

那些疾病的疫苗只价值一美元。

And millions of children die of these diseases every year.

但是每年有数以百万计的儿童死于这些疾病。

并且事实是，几百万只是一个粗略的估计因为

And the fact is, millions is a gross estimate,

because we don't really know how many kids die each year of this.

我们并不真的知道每年有多少小孩死于这些（疾病）。

What makes it even more frustrating is that the data-entry part,

更加令人沮丧的是，

数据输入的环节，也就是我作为研究生时曾做过的工作，

the part that I used to do as a grad student,

有时候会长达六个月之久。

can take sometimes six months.

Sometimes it can take two years to type that information into a computer,

有的时候可能需要两年时间把那些信息输入

到计算机里，而且有的时候，实际上这是常事，

And sometimes, actually not infrequently,

it actually never happens.

就是（那些数据）根本就没有被输入。

Now try and wrap your head around that for a second.

现在试着考虑一下这一点。

You just had teams of hundreds of people.

你只有一个几百人的团队。

They went out into the field to answer a particular question.

他们要去实地回答一个特定的问题。

你很可能花掉了成百上千美元

You probably spent hundreds of thousands of dollars

在汽油、复印和每日生活上，

on fuel and photocopying and per diem.

但是之后由于某些原因，没了劲头儿，

And then for some reason, momentum is lost

or there's no money left,

或者是没钱了，

and all of that comes to nothing,

然后所有那些全部就全都白费了

because no one actually types it into the computer at all.

因为实际上根本没有人把数据输入电脑里。

The process just stops.

进程就中断了。这常常发生。

Happens all the time.

This is what we base our decisions on in global health:

在全球健康组织，我们的决策所基于的就是：

little data, old data, no data.

少数据，旧数据，没数据。

So back in 1995,

所以，回到1995年，我开始思考

I began to think about ways in which we could improve this process.

我们能够改善这种过程的方法。

Now 1995 -- obviously, that was quite a long time ago.

现在说起1995年，很显然已经是很长时间以前了。

It kind of frightens me to think of how long ago that was.

想想那是多久以前真的有点吓到我了。

那年最火的电影是

The top movie of the year was "Die Hard with a Vengeance."

“龙胆虎威3”。

正如你所看到的，布鲁斯·威利斯那时候还有很多头发。

As you can see, Bruce Willis had a lot more hair back then.

I was working in the Centers for Disease Control

我那时候正在疾病控制中心工作，

and I had a lot more hair back then as well.

我那时候也有很多头发。

But to me, the most significant thing that I saw in 1995

但是对于我来说，在1995年我看到的最有意义的事

was this.

是这个。

我们很难想象，但是在1995年，

Hard for us to imagine, but in 1995,

this was the ultimate elite mobile device.

那时候这是当时最高端的移动装置。

It wasn't an iPhone. It wasn't a Galaxy phone.

对吧？那不是个iPhone，也不是三星Galaxy手机。

It was a PalmPilot.

它是个掌上电脑。

And when I saw the PalmPilot for the first time, I thought,

当我第一次看到掌上电脑的时候，我想：

"Why can't we put the forms on these PalmPilots?

我们为什么不能把那些表格放到这些掌上电脑里？

And go out into the field just carrying one PalmPilot,

然后去实地调查时就只带着一个掌上电脑，

它可以容载成千上万的

which can hold the capacity of tens of thousands of paper forms?

纸质表格。我们为什么不试着那么做做看？

Why don't we try to do that?

Because if we can do that,

因为如果我们能那么做，如果我们真的可以

if we can actually just collect the data electronically, digitally,

电子化、数字化地收集数据，

from the very beginning,

从最最开始，

we can just put a shortcut right through that whole process

我们就在整个过程中走了一个捷径，减省了

of typing, of having somebody type that stuff into the computer.

输入（数据的过程），

或是让某些人去把那些东西输入电脑。

We can skip straight to the analysis

我们可以直接跳到分析的过程

and then straight to the use of the data to actually save lives."

然后直接用这些数据去真真正正地挽救生命。

So that's what I began to do.

所以那就是我开始做的事。

Working at CDC, I began to travel to different programs around the world

在疾病防控中心工作时，我开始去到全世界不同的部门

并且训练他们用掌上电脑

and to train them in using PalmPilots to do data collection,

收集数据，而不是用纸。

instead of using paper.

And it actually worked great.

事实上一切都很顺利。

It worked exactly as well as anybody would have predicted.

它就像每个人所预计的那么好。

你知道吗？电子数据收集

What do you know?

Digital data collection is actually more efficient than collecting on paper.

实际上比用纸收集高效得多。

当我在做这件事的时候，我的生意伙伴，罗斯，

While I was doing it, my business partner,

她和他的丈夫，马太，就在观众席里，

Rose, who's here with her husband, Matthew, here in the audience,

罗斯也去美国红十字会做了同样的事。

Rose was out doing similar stuff for the American Red Cross.

问题是，在那几年之后，

The problem was, after a few years of doing that,

我意识到我已经办到的——我可能已经去了

I realized -- I had been to maybe six or seven programs --

六、七个组织，然后我想，

and I thought, you know, if I keep this up at this pace,

你知道，如果我持续进度的话，

over my whole career,

在我的整个工作生涯中，我可能会去

maybe I'm going to go to maybe 20 or 30 programs.

大概20到30个组织。

But the problem is, 20 or 30 programs,

但是问题是，20到30个组织，

like, training 20 or 30 programs to use this technology,

好比说，训练20到30个组织用这种技术，

that is a tiny drop in the bucket.

那仍然是杯水车薪。

这种要让数据更好地运作的需求，

The demand for this, the need for data to run better programs

just within health -- not to mention all of the other fields

仅仅是在健康方面，先暂不提其他领域

in developing countries -- is enormous.

在发展中国家，是巨大的。

There are millions and millions and millions of programs,

有成千上万无以计数的组织，

millions of clinics that need to track drugs,

数以百万的医院需要跟踪药物情况，

millions of vaccine programs.

数以百万的疫苗组织。

There are schools that need to track attendance.

有很多学校需要记录出勤率。

有各种各样这样不同的事情

There are all these different things for us to get the data that we need to do.

要我们取得我们所需要的数据

并且我意识到，如果我继续我以前的方式，

And I realized if I kept up the way that I was doing,

I was basically hardly going to make any impact

我基本上很难做出什么影响

在我的职业生涯结束前。

by the end of my career.

And so I began to rack my brain,

之后我开始开动脑筋

trying to think about, what was the process that I was doing?

努力思考，像你知道的那样，

我之前做是什么样的过程，

How was I training folks,

我如何训练那些人，遇到的瓶颈是什么

and what were the bottlenecks and what were the obstacles

以及是什么妨碍了让这些做到更快

to doing it faster and to doing it more efficiently?

做到更高效？

And, unfortunately, after thinking about this for some time,

但是不幸的是，在考虑了这些一段时间后，

I identified the main obstacle.

我意识到——我找到了最大的障碍。

And the main obstacle, it turned out --

这个主要的障碍，它出现了，

and this is a sad realization --

并且这是一个令人沮丧的认识，

这主要的障碍就是我自己。

the main obstacle was me.

So what do I mean by that?

那么我是什么意思呢？

I had developed a process

我已经开发了这个过程

whereby I was the center of the universe of this technology.

我是这项技术的集结点。

如果你想用这项技术，你必须要和我取得联系。

If you wanted to use this technology, you had to get in touch with me.

这意味着你必须知道有我在，

That means you had to know I existed.

然后你必须要有钱来付给我

Then you had to find the money to pay for me to fly out to your country

为了飞到你的国家去

然后钱用来让我住旅馆

and the money to pay for my hotel and my per diem and my daily rate.

和我的每日支出和日常开销

So you could be talking about 10- or 20- or 30,000 dollars,

所以你可以说是10,000或20,000或是30,000美元

if I actually had the time or it fit my schedule

如果我真的有时间或者是能把这件事提上日程

and I wasn't on vacation.

并且我没有在度假。

The point is that anything,

问题是不论任何东西，任何系统，只要是依赖于

any system that depends on a single human being

一两个或三五个人，

or two or three or five human beings --

it just doesn't scale.

它就不会成规模。

And this is a problem for which we need to scale this technology,

问题就是我们需要传播

这个技术并且我们现在就需要扩大它的规模。

and we need to scale it now.

And so I began to think of ways in which I could basically

所以我开始想能让我

把自己脱离出来的方法。

take myself out of the picture.

并且，如你所知，我在想，

And, you know, I was thinking,

"How could I take myself out of the picture?"

怎样能把我自己脱离出来呢？

for quite some time.

想了相当长的一段时间。

I'd been trained that the way you distribute technology

如你所知，我已经有了经验，

你在国际发展中传播科技

within international development

is always consultant-based.

常常是基于咨询顾问的。

It's always guys that look pretty much like me,

常常是有些像我一样的家伙，

flying from countries that look pretty much like this

从一些像这里的国家飞到

to other countries with people with darker skin.

有着黑皮肤人民的国家。

And you go out there, and you spend money on airfare

并且你去到那儿，你要花机票钱

and you spend time and you spend per diem

还要花时间，花钱在你的日常生活上，

and you spend for a hotel and all that stuff.

花钱在住旅馆等等这些东西上。

As far as I knew, that was the only way you could distribute technology,

据我所知，那是唯一的方法

你可以传播科技，并且我没法找到可以避开它的方法。

and I couldn't figure out a way around it.

但是奇迹发生了，

But the miracle that happened --

I'm going to call it Hotmail for short.

为了简约，我把他叫做Hotmail。

You may not think of Hotmail as being miraculous,

现在你可能不把Hotmail看做一个奇迹，

but for me it was miraculous,

但是对我来说那是个奇迹，因为我注意到，

because I noticed, just as I was wrestling with this problem --

就当我努力解决这个问题的时候，

I was working in sub-Saharan Africa, mostly, at the time --

那时候我大概正在非洲撒哈拉南部工作，

I noticed that every sub-Saharan African health worker

我注意到每一个和我一起工作的非洲撒哈拉南部的工作人员

that I was working with had a Hotmail account.

都有Hotmail账户。

于是我想，它给了我灵感，

And it struck me, "Wait a minute --

等一下，我知道Hotmail公司的人

I know the Hotmail people surely didn't fly to the Ministry of Health in Kenya

肯定不需要飞到肯尼亚健康部去

to train people in how to use Hotmail.

教人们怎么用Hotmail。

So these guys are distributing technology, getting software capacity out there,

所以这些人正在传播技术

他们让软件技术传播到那里，

but they're not actually flying around the world.

但是他们没有真的在世界到处飞。

我需要在多多考虑一下这个。

I need to think about this more."

While I was thinking about it,

当我正在想这个的时候，人们开始使用

people started using even more things like this, just as we were.

甚至更多的这种东西，就像我们也在用。

They started using LinkedIn and Flickr and Gmail and Google Maps --

他们开始用Linkedln和Flickr

谷歌邮箱和谷歌地图，所有的这些东西。

all these things.

Of course, all of these things are cloud based

当然，所有的这些东西都是基于云端技术

and don't require any training.

并且不需要任何训练。

They don't require any programmers.

他们不需要任何程序员。

They don't require consultants.

他们不需要任何咨询师，因为

Because the business model for all these businesses

所有这些公司的商业模式

requires that something be so simple we can use it ourselves,

需要的东西简单到我们可以自己使用它

with little or no training.

几乎不需要训练。

You just have to hear about it and go to the website.

你只需要听说它然后登陆网站。

因此我想，如果我们开发软件来做我做咨询的事

And so I thought, what would happen if we built software

to do what I'd been consulting in?

会发生什么呢？

Instead of training people how to put forms onto mobile devices,

而不是训练人们如何

把表格植入移动设备，

let's create software that lets them do it themselves with no training

让我们发明一些软件来让人们自己做这件事

不需要训练，也不需要我的参与

and without me being involved.

那就是我们所做的

And that's exactly what we did.

So we created software called Magpi, which has an online form creator.

所以我们发明了一种叫Magpi的软件，

它有一个网上表格生成器。

No one has to speak to me,

不需要有人来和我说话了。

you just have to hear about it and go to the website.

你只需要听说它然后登陆那个网站。

You can create forms, and once you've created the forms,

你可以生成表格，并且一旦你生成了表格，

you push them to a variety of common mobile phones.

你可以把它推送到许多普通的手机。

Obviously, nowadays, we've moved past PalmPilots to mobile phones.

当然了，现在我们已经把过去的掌上电脑换成了

手机。

And it doesn't have to be a smartphone, it can be a basic phone,

而且不需要是智能手机。

他可以是一个非智能手机，像右边的这个手机一样，

like the phone on the right, the basic Symbian phone

你知道，这种非智能的塞班手机

that's very common in developing countries.

在发展中国家是非常普遍的。

And the great part about this is it's just like Hotmail.

并且它最棒的部分是它就像Hotmail一样。

It's cloud based,

它基于云端技术，并且不需要任何训练，

and it doesn't require any training, programming, consultants.

编程，顾问咨询。

But there are some additional benefits as well.

而且还有一些更大的益处。

现在我们知道，当我们建立了这个系统，

Now we knew when we built this system,

就像用掌上电脑的时候，最重要的一点

the whole point of it, just like with the PalmPilots,

was that you'd be able to collect the data

是你不得不并且必须能够

采集数据并且立即上传数据以获得你的数据库。

and immediately upload the data and get your data set.

但是我们发现，当然了，因为数据已经在计算机中了，

But what we found, of course, since it's already on a computer,

我们可以产生即时图像并且分析画图。

we can deliver instant maps and analysis and graphing.

We can take a process that took two years

我们可以把一个需要花两年时间的过程

and compress that down to the space of five minutes.

压缩到只要五分钟的时间。

难以置信的效率提升。

Unbelievable improvements in efficiency.

Cloud based, no training, no consultants, no me.

基于云端的，不需要训练，不需要咨询，不需要我。

And I told you that in the first few years

并且我告诉过你们，在刚开始的几年

of trying to do this the old-fashioned way,

用老方法做这个的时候，

going out to each country,

到每个国家去，

我们达到了大约，我不确定，

we probably trained about 1,000 people.

可能是训练了1000人左右。

What happened after we did this?

我们在做了这些之后发生了什么呢？

In the second three years,

在第二个三年中，我们有14000个人

we had 14,000 people find the website,

找到了网站，注册，并且开始用它收集数据，

sign up and start using it to collect data:

data for disaster response,

疾病反馈的数据，

加拿大的养猪户用来跟踪记录猪的疾病和猪饲料，

Canadian pig farmers tracking pig disease and pig herds,

people tracking drug supplies.

人们跟踪记录药品供应。

One of my favorite examples, the IRC, International Rescue Committee,

我最喜欢的例子之一，是IRC

国际救援委员会，

they have a program where semi-literate midwives,

他们的程序，能让半文盲的产婆们

using $10 mobile phones,

用10美元的手机

send a text message using our software, once a week,

通过我们的软件每周发送一次短信息

出生的数量

with the number of births and the number of deaths,

死亡的数量，

which gives IRC something that no one in global health has ever had:

这是在全球健康组织都不曾有过的东西：

a near-real-time system of counting babies,

一个近乎实时的记录新生儿的系统，

of knowing how many kids are born,

能知道有多少婴儿出生了，

of knowing how many children there are in Sierra Leone,

能知道儿童的数量是多少

在塞拉利昂，人们就正在使用它，

which is the country where this is happening,

and knowing how many children die.

并且知道有多少孩子死去。

Physicians for Human Rights --

人权团体的内科医生

this is moving a little bit outside the health field --

现在我们说的有点超出了健康的领域—

they're basically training people to do rape exams in Congo,

他们正聚集在一起，在刚果训练人们

做关于强奸的测验，在刚果这是一种盛行，

where this is an epidemic,

a horrible epidemic,

一个非常可怕的盛行，

and they're using our software to document the evidence they find,

并且他们正在用我们的软件记录

他们找到的证据，包括图像上的，

including photographically,

so that they can bring the perpetrators to justice.

这样他们能够致以罪犯法律制裁。

Camfed, another charity based out of the UK --

Camfed，在英国的另一个慈善机构，

Camfed pays girls' families to keep them in school.

Camfed付给女孩子们家里钱好让她们能上学。

They understand this is the most significant intervention they can make.

他们明白这是他们能做的最有意义的干预。

他们过去在纸上跟踪支出，

They used to track the disbursements, the attendance, the grades, on paper.

出勤，成绩。

The turnaround time between a teacher writing down grades or attendance

这是一个转折点，从一个老师

写下成绩或出勤率

and getting that into a report was about two to three years.

然后在大约两三年后得出报告。

Now it's real time.

现在这是一个实时系统，并且因为这是如此

And because this is such a low-cost system and based in the cloud,

一个低花费的系统，基于云端，它的花费

it costs, for the entire five countries that Camfed runs this in,

对于Camfed资助的五个国家

千千万万的女孩子们，

with tens of thousands of girls,

所有花费每年只要10000美元。

the whole cost combined is 10,000 dollars a year.

That's less than I used to get

那比我原来

出去两周做一次咨询

just traveling out for two weeks to do a consultation.

So I told you before that when we were doing it the old-fashioned way,

所以我之前告诉过你

当我们用老式方法做这些的时候，我意识到

I realized all of our work was really adding up to just a drop in the bucket --

所有这些工作加起来也不过是滴水之于长河

10, 20, 30 different programs.

10个，20个，30个不同的程序。

我们已经做出了很多进展，但是我意识到

We've made a lot of progress,

but I recognize that right now,

现在，虽然我们所的工作

even the work that we've done with 14,000 people using this

有14000的人在用它，

is still a drop in the bucket.

这仍然是滴水之于长河。但是已经发生了一些改变。

But something's changed, and I think it should be obvious.

并且我觉得它应该很明显。

What's changed now is,

现在所发生的改变是，

instead of having a program in which we're scaling at such a slow rate

我们过去用的低效率的方式已经被取代

that we can never reach all the people who need us,

我们可以再也不用到需要我们的人那里去，

we've made it unnecessary for people to get reached by us.

我们已经做到不需要有人来找我们。

We've created a tool that lets programs keep kids in school,

我们已经发明了一个工具，可以让组织部门

记录在学校的孩子，跟踪新生儿的数量

track the number of babies that are born and the number of babies that die,

和婴儿的死亡数量，

catch criminals and successfully prosecute them --

用来逮捕罪犯并且成功诉讼他们，

to do all these different things to learn more about what's going on,

来做所有这些不同的事情从而知道的更多

关于正在发生什么，以便能理解的更多，看得更多，

to understand more,

to see more ...

and to save lives and improve lives.

来挽救生命并改善生活。

Thank you.

谢谢大家。

(Applause)

（掌声）