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

譯者: Karen Feuerstein 審譯者: Shelley Tsang 曾雯海

Shahed Alam: In the fall of 2021,

沙赫德-阿拉姆：在2021年秋天，

I arrived in the US to visit my parents

我到達美國和父母見面，

after almost two years of not seeing one another.

已經將近兩年來， 雙方都没有見面了。

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

我來自印度的班加羅爾，

where we were just getting out of a devastating second wave

當時正在從第二波破壞性極大的流行病恢復中。

of the pandemic.

在我到逹的幾週內， 先是我父親，

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

then my mother, all came down with COVID.

然後我，再來是我的母親， 都得到了新冠肺炎。

And it hit us hard.

對我們的衝擊相當大。

My parents' age and their medical conditions

以我父母的年紀和他們的身體狀況,

threatened to make each day more severe than the last.

讓每天的威脅比前一天更加的嚴重。

And despite my medical training, I was overwhelmed.

僅管我的醫療訓練， 我被壓倒了， 真是一場惡夢。

It was a nightmare,

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

首先，我想在當中的你們都曾面對過。

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

我試著在測試網站中預定檢查要在很多天後。

We called their doctors who were unavailable.

我們打電話給他們的醫生都没有結果。

We tried to get monoclonal antibodies,

我們試著要得到新冠單株抗體的抗生素，

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

也知道一天天過去， 這個治療會越來越没有效。

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

我們在發生的當中試著找出要吃些什麼，

and how to make them feel better.

才能讓他們覺得好一點。

Thankfully, we all recovered.

非常感謝， 我們都康復了。

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

但是我將不會忘記我感到多麼的無助和孤單。

And my desperation to do anything I could to help.

我當時絶望的要做任何事來幫助他們。

Edith Elliott: Like Shahed,

伊迪絲-埃利奧特：就如同沙赫德

and I'm guessing everyone in this room,

我想在這個空間的每個人，

at some point in your life,

在你生活的有些時刻，

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

在你的崗位上想要做能做的任何事

to take care of someone you love.

來照顧你愛的某個人。

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

在這裏我來解釋一下我們的組織，

Noora Health, is rethinking health care.

諾拉健康，重新思考了健康照顧。

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

是的，我們有將近一年的追踪記錄。

we're driven by data and we leverage technology.

我們有數據在推動並且也利用科技。

But at the heart of what we do

但是在我們所做的事裏，

is a powerful force that might surprise you.

最有力量的點， 可能會讓你驚訝。

It's love.

就是愛。

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

它是堅定決心的讓你上年紀的媽媽找到醫療方式；

that tenacious energy to get your kid to the ER.

或是頑強的力量把你的孩子帶到急診室。

Like oxygen,

如同氧氣，

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

對我們的健康和幸福是基本的。

It is ever present, but invisible.

它永遠存在， 但是看不見的。

It's the fuel of family advocacy.

它是擁護家裏的燃料。

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

而且長久以來已經被視為干擾

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

或是被醫療保健機構長久下來的忽視。

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

當沙赫德和我相遇時， 我們有很多相同點。

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

當我們在諾拉健康分享愛是最有力量的信念。

untapped resource available.

是尚未被開發的資源。

And when valued and made visible,

而且當被重視且被看見，

it can transform health systems.

可以改變醫療系統。

SA: We work in India and Bangladesh.

沙赫德：我們在印度和孟加拉工作。

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

當你站在我們工作的其中一所醫院外面，

the first thing you'll notice is the crowd.

第一件事是你會注意到是擁擠。

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

當你走進去, 你可以看到病人比床位還多一倍，

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

你也會看到走廊和等待區擠滿了 家庭成員和他們的物品,

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

因為他們搬進醫院和他們愛的人在一起。

Families are spending their time anxiously waiting

家庭成員花時間焦急的等待,

while providers are doing the best that they can

當醫療提供者做他們所能做的最好

to keep up with the intense demand.

來趕上這些強烈的需求。

And we know this will only get worse.

並且我們知道這只會變得更糟。

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

在2030年全球將會有將近1千八百萬

by 2030.

健康照護工作者短缺。

The systems are overburdened

醫療系統會負荷過重

and this has life and death consequences for patients.

將會導致病人的是生是死的結果。

Every year in South Asia alone,

每一年單單在南亞一區，

nearly 1.5 million children under five die.

有將近1.5百萬名五歲以下的兒童死亡。

And far too many of these deaths can be prevented

在這些過多的死亡中, 在更好的健康習慣下,

with better health practices at home.

有許多是可以被預防的。

At Noora Health, we train

在諾拉健康， 我們訓練

and we support families with life-saving skills.

支持家庭一些拯救生命的技巧。

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

我們與醫院和診所和當地的人們見面，

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

在病人的床邊，在走道上，在等待區，

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

我們訓練護士能夠在不同的家庭圑體裏走動,

to teach them actionable skills.

教導他們可以應對的各種技能。

Things like wound care

事情像傷口照護，

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

如何看出警告狀況, 例如新生兒黃疸

or slurred speech for a cardiac patient.

或是心臟病人產生的口齒不清。

And they leave plenty of time for questions and demonstrations.

他們預留大量的時間展示和解答問題。

Once families leave home, we stay connected with them,

一旦家庭成員回家之後, 我們和他們保持連繫，

sending them messages, videos and reminders

給他們所愛的人相關的

that are relevant for their loved ones,

留言, 視頻和各種提醒。

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

並且我們也會在另一邊回答任何問題。

So whether it's new parents,

無論是新手父母，

surgical or oncology patients,

手術和腫瘤患者，

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

我們都已經用這種方式來涵蓋 各種的護理照護。

Because the common thread is that loved ones are there,

因為有所愛的人在那裏的連繫，

and they want to help.

他們想要幫助他們。

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

伊迪絲：一路上， 我們學了一些事情。

First, deep listening is key.

首先， 深切的傾聽是重點。

Nurses, patients and families have guided us.

護士， 病人和家庭成員會引導我們。

They are the visionaries.

他們是有遠見的人。

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

他們確認我們的訓練合作 目標的人是在他們的家中，

visuals that people see in their communities,

或是在社區中可以看到的人，

and words and phrases that people actually use

人們實際上所使用的字和短句，

instead of complex medical jargon.

取代了複雜的醫學術語。

Second, trust and timing are fundamental to behavior change.

第二，信任和時間是行為改變的基礎。

Nurses and health care providers are the people families trust.

護士和健康照顧提供者是 家庭成員信任的對象。

So we work with them to provide the training

因此在家庭最需要的時間和地點上，

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

我們和他們一起合作提供訓練。

Third, you do not have to start from scratch.

第三點，你不需要從零開始做。

We're not creating new systems,

我們不需要創建新系統，

we’re building with and through existing infrastructure.

我們從既有的基礎設施中建立起來。

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

是的， 諾拉有啟動和支持，

but the trainings are designed and introduced in a way

但是訓練是被設計和介紹在一個

that ensures they will continue to run sustainably.

可以確定繼續和永續經營下。

So far we've reached hundreds of hospitals and clinics

目前為止， 我們已經逹到了橫跨印度和孟加拉

across India and Bangladesh,

的數百間醫院和診所，

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

我們幫助他們改變傳遞照顧的方式。

We’ve trained over 5,000 nurses,

我們已經訓練超過五千名護士，

and we've reached over two million family caregivers.

我們也延申了超過二百萬的家庭照顧者。

(Applause)

（鼓掌）

We have seen that this program reduces cardiac surgery complications

我們已經看到了這個計劃減低了心臟手術的

by 71 percent,

複雜狀況高逹百分之七十一，

and our early data suggests that it reduces newborn deaths

我們早期資料建議降低了新生兒的死亡率

by 18 percent.

逹百分之十八。

(Applause)

（鼓掌）

That would mean that over nine babies' lives are saved

那表示每一千名新生兒出生，

for every 1,000 live births.

會有九個孩子被救活。

And it's all happening at an extremely low cost

而且是發生在極低成本的狀況之下

because the solution leverages existing resources.

因為解決的方案是利用現有的資源。

SA: I had the chance to meet Bino.

沙赫德： 我有機會和賓諾見面。

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

他是一個有動過心臟手術的年輕人， 在離他最近的大醫院

which was in Kolkata.

是在加爾各答。

He was accompanied by his wife Sunita and his uncle,

他和他的太太桑妮塔和叔叔 一起陪伴過來，

and both of them went through the training.

他們兩個人都經歷了訓練。

Later on, when I visited them in their home,

之後我們去他們的家裏拜訪，

Sunita had just wrapped up Bino's wound care,

桑妮塔才剛剛幫賓諾的傷口 護理包紮起來，

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

說著她讓傷口不穿著衣服就 如同訓練時一樣。

She showed me how she used the thermometer

她示範給我看如何量體温，

and how she checked Bino's pulse

她如何測量賓諾的心跳，

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

並告知所有正常範圍的血壓，

heart rate and temperature.

心跳率和體温。

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

她告訴我他們吃更多的魚取代紅肉

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

並且因為他的新的用藥避開了 過多的維生素K，

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

他的叔叔告訴我，他們每次需要 基本的傷口護理，

every single time they needed to do basic wound care.

能夠避免去當地診所。

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

這能省下來回跑和每次一點五元的費用。

This is a huge amount for a family

當他們必須賣掉他們的財產，

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

來支付這個手術時對一個家庭來說 是一筆大金額。

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

既使桑妮塔從没有得到機會學習 如何寫字和閱讀。

but hundreds of kilometers from the nearest major hospital,

但在離著主要醫院幾百公里之外，

she confidently led Bino's recovery.

她有信心賓諾的復原。

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

伊迪絲：我們被像賓諾和桑妮塔 的故事所鼓舞。

We have only scratched the surface.

我們只有觸及到表面。

Our audacious idea is to ignite a family caregiver movement

我們大膽的想法點燃了 家庭照護的運動,

that will revolutionize the way we experience health care.

將會徹底改變醫療照顧的方式。

Over the next six years,

在下一個六年裏，

we will train over 70 million family caregivers

我們將會訓練超過7千萬家庭照顧者

across India, Bangladesh, Indonesia and Nepal,

橫跨印度, 孟加拉, 印尼和尼泊爾,

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

支持健康系統將提供超過一億人的照顧。

(Applause)

(鼓掌)

But Noora can't be everywhere.

但是諾拉没有在每個地方。

And our ultimate dream is for health systems around the world

我們終極的夢想是在世界上的健康系統

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

可以使用我們所學到的變成是他們自己的，

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

包括照顧著, 給他們信心, 技能和訓練,

give them confidence, skills, training.

使他們成為健康系統的一部份。

That should be standard practice.

它必須是標準化的練習。

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

這似乎是很明顯的, 但是我們尚未逹到。

And that is our collective call to action.

這是我們集體行動的呼籲。

SA: In every caregiver that we train,

沙赫德：在我們訓練的每一位照顧者，

I see the triumphs and the struggles of my mother

我們從照顧我母親或是我祖母

caring for my grandmother through a debilitating neurological condition.

的神經系統衰弱的疾病照顧的掙札裏， 我看到了勝利。

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

在照顧我的祖母時， 愛是最有權勢的管家，

yet seemingly invisible in the system.

但是在系統裏是無法被看見的。

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

伊迪絲：我看見13歲的自己，

helping my mom as she recovered from brain surgery

幫助我的母親從腦部開刀中復原,

and relearned how to walk and talk and feed herself.

重新學會如何走路, 說話和自己吃飯。

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

到今天, 我們帶著緊密的 了解和責任，

the deep pride

十分驕傲

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

這份解脫是來自成為有些人 復原的一部份。

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

這份工作核心是尊重人類 最古老的習俗之一，

helping those we love.

幫助我們所愛的人。

And it's about seeing compassion and community

是關於看到和藥物一樣重要的

as essential medicines.

同情心和社區。

Just imagine a world where

想像一個世界,

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

無論你是誰, 從哪裏來的,

you know exactly how to take care of your loved ones

你知道如何照顧你所愛的人,

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

你看到也了認識這個基本的工作。

We see every day that this is possible,

我們看到每一天這是可能的，

and that in order to change health care,

為了要改變健康照護，

it takes a family.

需要家庭的投入。

Thank you.

謝謝你們。

(Applause and cheers)

(鼓掌和歡呼)