Aparna Hegde: The life-saving tech helping mothers make healthy decisions | TED Fellows

翻译人员: Robert Cheney 校对人员: Helen Chang

[SHAPE YOUR FUTURE]

[塑造你的未来]

Anita died in my presence while giving birth to life.

安妮塔在分娩时走了，当时我在现场。

She bled to death and lost her child.

她失血过多，孩子也没能保住。

The irony was that she had access to care.

讽刺的是，她本来有机会能得到护理。

In the first trimester of pregnancy,

在她早期妊娠的时候，

she had visited the antenatal clinic of the hospital in Mumbai

她去了孟买的一家医院接受产前门诊，

where I was doing residency.

那也是我实习的地方。

But over four hours of waiting in the hot, sweaty,

但是在闷热、汗津津、肮脏 且拥挤不堪的小诊所等待四个小时，

dingy, overcrowded clinic

只为花费一分钟的时间和我这个 忙碌过劳的医生见上一面，

just to get a minute with me,

a harried, overworked resident doctor,

meant that she never came back,

这意味着她以后再也不会回来了，

only to die in labor months later.

只能在数月后的生产中 接受死亡的命运。

I was wracked with guilt.

我非常愧疚。

If only I had counseled her about the danger signs,

要是我能提醒她注意危险征兆，

why she needed to access regular care.

以及为什么她需要接受定期护理，

Would she and her child have survived?

她和她的孩子是不是就能活下来了呢？

She did not die due to a terminal condition.

她不是因为晚期的状况而死的，

She died because of underlying anemia,

而是因为潜在的贫血症，

an easily treatable, preventable condition.

那是一种容易治疗与预防的疾病。

I saw these stories daily.

我每天都能看到像这样的故事。

Systemic, preventable problems resulting in mothers and children dying

在那些最缺乏公平正义的地方，

系统性的，可预防的问题 导致许多母亲与孩子死亡。

in the most unjust of circumstances.

In the next one hour,

在接下来的一个小时，

three women will die while giving birth somewhere in India.

在印度，三名妇女将因生产而死，

Two children under age five die every minute in India.

每五分钟就会有两名 小于5岁的孩子死亡。

I am a practicing urogynecologist,

我是一名执业泌尿妇科医生，

but very early in my medical training,

但在我接受医学训练的早期

I realized that hospital-based solutions were not enough.

就已意识到以医院为基础的解决对策 是远远不够的。

And given the sheer scale of India's problems,

考虑到印度的问题规模很大，

any solution that made a difference had to be scalable,

任何一种有效的解决方法 都必须可以随着规模扩大，

accessible to the last woman and child directly in their homes,

让每一个在家的妇女和孩子 都能够直接取得，

and yet cost-effective and resource-light.

并且要经济有效、节约资源。

And then the mobile phone came to India

在那之后，手机进入印度，

and within a few years everyone had a mobile phone.

在短短几年时间里， 几乎所有人都有了一部手机

There are currently more mobile phones in India than toilets.

最近，手机在印度的数量 甚至比厕所还多。

The idea then struck me.

我心中忽然产生一个念头。

Why not use a simple technological tool like a mobile phone,

为什么我们不用一种简易的科技工具，

which is available in almost every Indian household

像现在普及每一户 印度家庭的手机那样，

to bridge the yawning systemic gaps in health care?

去修补卫生保健领域里 系统性的漏洞呢？

Maybe we could have simply called Anita weekly

或许我们可以每周向安妮塔 提供重要的救生信息。

with critical lifesaving information.

On the other hand,

另一方面，

maybe we could have provided mobile-phone-based training

或许我们可以向社区里能够诊断 安妮塔的贫血症的健康工作者们

to the health worker who could have diagnosed Anita's anemia

提供以手机为基础的培训。

in the community itself.

Thus was born my NGO ARMMAN.

就这样，我的 NGO ARMMAN项目诞生了。

Our programs, mMitra and Kilkari,

我们的项目，mMitra和Kilkari完全免费，

are free, weekly voice call services.

提供每周的语音呼叫服务。

They provide preventive information directly to women

直接提供妇女预防性讯息，

直接提供妇女预防性讯息，

through pregnancy and infancy

涵盖整个怀孕期及婴儿期，

in their chosen time slot and language.

由他们选择时间段及语言， 提供预防性讯息。

There are multiple tries for every message,

每封讯息都会多次尝试发送，

a missed-call system,

有一个未接来电系统，

and mMitra also has a call center.

mMitra也有一个呼叫中心。

If only Anita had received this service.

要是安妮塔能在孕期第二个月 受到这种服务，

In the second month of pregnancy itself,

it would have told her about the need to take an iron pill daily

系统将会提醒她从第三个月开始 每天服用一片补铁片。

from the third month of pregnancy.

When the third month arrived,

第三个月的时候，

it would have sent her a reminder

系统会向她发送一个提示信号

and counseled her on how to take the iron pills.

并给她提供服用补铁片的建议。

For example, the need to avoid tea, coffee to improve the absorption of iron

比如说，她需要避免饮用茶和咖啡 来促进对铁的吸收，

and stress on why it is so necessary to prevent anemia.

并强调预防贫血症的必要性。

Two weeks later,

两周后，

it would have spoken about how to tackle the adverse effects of iron pills,

系统会告知她如何对抗补铁片的副作用，

like constipation.

比如便秘。

If she had any query,

如果她有任何疑惑，

she could have reached out to our call center staff.

她能联系到呼叫中心的工作人员。

These are simple voice calls.

这些都是简易的语音呼叫。

As a typical doctor,

作为一名专业医生，

I expected them to just inform

我期待它们能普及知识，

and hopefully lead to better health behaviors.

并希望能引领更健康的生活行为。

However, the one unexpected transformational benefit

然而，有一个非预期转变的优势

that has completely blown my mind is this:

让我感到兴奋：

Information is empowerment.

拥有信息也是拥有权力。

Armed with this information,

在这些信息的加持下，

women like Anita are upending patriarchal family dynamics,

像安妮塔一样的妇女 将动摇父系社会的发展动力，

challenging entrenched mores

挑战根深蒂固的风俗习惯，

and demanding care.

并且主动要求护理服务。

Karnam, the wife of a deeply conservative preacher,

作为一名极度保守的传教士的妻子，

convinced her husband to adopt family planning

Karnam说服她的丈夫实行计划生育，

because mMitra told her

因为mMitra告诉她

that spacing between pregnancies is necessary.

多次怀孕之间的间隔期是很有必要的。

And the change is intergenerational.

不仅如此，这种改变往往是跨代际的。

Punita, form a deeply conservative family,

Punita同样来自一个很保守的家庭，

sent her daughter to an English medium school.

她将她的女儿送到 以英语为授课语言的学校。

In addition to the big pictured messages,

除了显示在大图上的信息，

the most underprivileged of women want to know

那些最底层的妇女想知道

when their child will understand color,

她们的孩子什么时候会识别颜色，

how to ensure psychosocial stimulation of the child,

如何确保给孩子社会心理上的激励，

when their child will develop fingers in their womb and so on.

孩子的手指是什么时候 在子宫中形成的，等等。

Like any woman would.

像很多妇女一样，

Our services respect that.

我们的服务也很尊重妇女的诉求。

Over 20 million women in over 16 states in India

在印度超过 16 个州， 超过两千万的妇女，

have enrolled for these services since 2014.

自 2014 年以来 已经注册了这些服务。

This is testament to how easily scalable and replicable these solutions are

这些方法在世界上任何地方 都能简单量化与复用。

anywhere in the world.

这就是例证

Similarly, our mHealth-based refresher training program

类似地，我们以mHealth 为基础的进修培训计划

for government frontline health workers called Mobile Academy

名为“移动学校”，为政府 一线健康工作者量身定制，

has trained over 130,000 health workers in 13 states in India.

这个项目已经为印度13个州 超过13万的健康工作者提供过训练。

Both Kilkari and Mobile Academy, in collaboration with the government,

Kilkari和“移动学校”项目都与政府合作，

will extend through the country in the next three to five years.

将在接下来的三到五年内扩展到全国。

Our goal is to be able to reach

我们的目标是每年能够服务 超过一千五百万的妇女和孩子，

over 15 million women and their children every year,

and that would mean

这就意味着每年将有半数以上的母亲 和新降生的孩子能获得所需的信息。

over half of the mothers and children born every year

have the information they need.

And this massive scale is only possible

这个大规模的设想是非常有可能实现的，

because so many of our partners,

因为我们的许多搭档，

be it NGOs, hospitals and the government,

不论是非政府组织、医院还是政府部门，

recognize the value of this approach

都看到了这个方法的价值，

and provided the scaffold on which we grew.

并提供了供我们成长的平台。

Our quest in the next five years is to adopt multimedia approaches,

在接下来五年里，我们的诉求 是采用多媒体方法，

and given the massive amounts of data we have,

考虑到我们现有的大量数据，

use the power of AI and predictive analytics

我们将运用AI技术和预测分析

to better serve our mothers and children.

更好地服务母亲和孩子们。

And our tech platform and the networks we build are nimble.

我们建造的技术平台和网络相当灵敏。

When COVID-19 struck,

当新冠疫情来临，

lockdown was announced overnight.

封锁命令在一夜间下达，

Among the worst affected were the underprivileged women and children

这当中受灾最重的无疑是孟买和德里 贫民窟里的底层母亲和孩子们，

in the slums of Mumbai and Delhi,

which were declared as containment zones.

那些地方统统被划为疫区。

However, pregnancy and infancy can't wait for a lockdown.

但是，孕期和婴儿期 不会因为疫情封锁就中止。

When there's an emergency like bleeding, care is needed immediately.

当发生紧急状况，比如出血， 护理就是紧急需要了。

And we were right there and ready.

我们将坚守于此，严阵以待。

We repurposed our tech platform within a matter of days.

我们在短短几天内重整了技术平台，

We created a virtual clinic for antenatal pediatric care

创建了由专业医生支持的诊所，

manned by qualified doctors.

提供妊娠和小儿科的医疗服务。

Our call-center staff arranged logistic support, like ambulances.

呼叫中心的成员 提供后勤支持，如救护车。

We also sent COVID-specific information covering pregnancy and infancy

我们也为超过30万的孕期妇女和母亲，

to over 300,000 pregnant women and mothers through voice calls.

通过语音拨打，提供 新冠疫情相关的孕期与婴儿期知识。

But why should you care about our mothers and children?

为什么我们需要关心母亲和孩子们呢？

The pandemic has made us confront this most implacable of truths.

这次疫情使我们不得不 面对一个无情的真相：

A robust primary health care system is an absolute pillar

一个强有力的基础医疗保健系统

of a functioning and efficient society.

对一个运作良好高效的社会 起支柱性的作用。

Improvement in maternal and child health

对母亲和孩子医疗保健的改善

leads to horizontal development of health systems

能引领整个健康系统 从上到下全方位的发展，

and improved primary health care.

并且改提高基础的医疗质量。

A village that can look after its mothers and children well

一个能照看好母亲和孩子们的村子，

can look after all other conditions by ripple effect.

根据涟漪效应， 也能关照好其他种种情况。

And pregnancy is not a disease.

怀孕期不是疾病。

Childhood is not an ailment.

儿童期不是疾病。

Dying due to natural life event is not acceptable,

因为自然发生的生活事件而死 是不可接受的。

and we know why our mothers and children die.

何况我们已经知道 这些母亲和孩子的死因。

Yet we invest so little in preventing their deaths.

但我们在预防这些死亡的努力上 还投入太少。

There can be no global progress

除非母亲和孩子们能好好活着， 绝不会有全球性的进步出现。

until all our mothers and children do well.

I implore you to add your voices to ours.

我恳求你加入我们的行列，

To amplify this message loud and clear.

将这份帮助他人的福音更加发扬光大。

That maternal and child health is a human right.

保障母亲和孩子的健康就是保障人权。

Thank you.

谢谢。