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

譯者: Ning Zhang 審譯者: Sophia Liu

有一個很老的笑話是說

There's an old joke about a cop

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

有一個警察在深夜裡巡邏，

and he comes across a guy under a street lamp

他遇到一個人在路燈下

一邊盯著地面看一邊來回走

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

and the cop asks him what he's doing.

警察問他在做什麼。

The guys says he's looking for his keys.

那人說他正在找他的鑰匙。

So the cop takes his time

所以警察也花時間幫他找

and looks over and kind of makes a little matrix

並且做了一些小記號，

and looks for about two, three minutes.

大概花了兩、 三分鐘。 還是沒找到鑰匙。

No keys.

The cop says, "Are you sure?

警察說，"嘿，朋友，你確定你的鑰匙

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

丟在這裡了嗎？”

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

這個人說 “不，不，其實我把它們丟在了

這條街的另一邊，

down at the other end of the street,

但是這裡的光更亮。”

but the light is better here."

(Laughter)

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

現如今，人們談論著一個概念叫大數據，

他們談論的是

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

我們通過網際網路互動時

that we're generating through our interaction

我們生成的所有資訊，

with and over the Internet,

everything from Facebook and Twitter

所有東西，從臉書、推特

到音樂下載、 電影、 串流媒體 所有這類的東西，

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,

對於那些處理大數據的人們來說，

they talk about that their biggest problem

他們談論的最大問題是

is we have so much information.

我們有太多的資訊，

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

我們面對的最大問題是， 我們如何整理所有的資訊？

我告訴你，在全球健康領域工作，

I can tell you that, working in global health,

that is not our biggest problem.

這不是我們最大的問題。

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

因為對我們來說，

即使網路上的燈更亮，

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

即使網上的數據能幫我們解決一些問題

但我們試圖去解決的問題 實際上卻並不存在於網路上。

is not actually present on the Internet.

So we don't know, for example,

所以我們不知道，

how many people right now are being affected by disasters

例如，有多少人正在遭受災難

或陷入戰爭囹圄之中。

or by conflict situations.

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

我們不知道發展中國家的診所裡

in the developing world,

哪些有藥品，

which ones have medicines and which ones don't.

哪些沒有藥品。

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

我們完全不知道這些診所的供應鏈是怎樣的。

我們不知道——這真得讓我很吃驚——

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

我們不知道有多少孩子出生，

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

或有多少兒童在玻利維亞

in Bolivia or Botswana or Bhutan.

博茨瓦納或不丹。

我們不知道在任何這些國家裡，

We don't know how many kids died last week

上星期有多少孩子死去。

in any of those countries.

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

我們不知道老年人和精神病患者的需要。

For all of these different critically important problems

對於所有這些不同的卻非常重要的問題

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

或我們想要解決問題的非常重要的領域，

我們基本上一無所知。

we basically know nothing at all.

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

造成我們一無所知的部分原因

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

是我們在全球健康組織工作時，

用來查找資料，解決問題的資訊技術系統

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

就是您在這裡看到的。

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

這是一個大約有五千年歷史的技術。

Some of you may have used it before.

你們有些人此前可能用過。

它現在已經過時了，

It's kind of on its way out now,

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

但我們 99% 的工作都使用它。

這是紙質表單，

This is a paper form.

And what you're looking at is a paper form

你正在看的是健康部護士 手中的一張紙質表單

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

她正徒步穿行在印度尼西亞的鄉下，

who is tramping out across the countryside

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

在印尼，我確信，那是個十分炎熱和潮濕的一天，

and she is going to be knocking on thousands of doors

她要在幾週或幾個月內

over a period of weeks or months,

去敲千家萬戶的門

邊敲門邊說，"打擾了，

knocking on the doors and saying,

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

我們想問你一些問題。

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

你有孩子嗎？你的孩子接種疫苗了嗎?"

Because the only way we can actually find out

因為讓我們可以找出

在印尼有多少兒童接種了疫苗

how many children were vaccinated in the country of Indonesia,

和他們接種了疫苗的百分比的唯一方法，

what percentage were vaccinated,

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

其實不在網際網路上， 而是通過走出去，敲那些門，

有時需要敲千千萬萬的門。

sometimes tens of thousands of doors.

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

有時需要幾個月甚至幾年

去做這樣的事情。

You know, a census of Indonesia

你知道，印尼的人口普查

would probably take two years to accomplish.

可能會兩年才能完成。

And the problem, of course, with all of this

當然，這其中的問題

is that, with all those paper forms --

在於所有那些紙質表單——我要告訴你

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

我們什麼事情都有紙質表單。

我們有接種疫苗調查的紙質表單。

We have paper forms for vaccination surveys.

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

我們用紙質表單來跟蹤到診所來的人。

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

我們用紙質表單來跟蹤藥品供應、

血液供應，所有這些不同的紙質表單

all these different paper forms for many different topics,

有許多不同的主題，

they all have a single, common endpoint,

他們都有一個共同終結點，

and the common endpoint looks something like this.

那個共同的終結點看起來就像這樣。

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

我們現在看到的是一卡車的數據。

這只是一個疫苗接種覆蓋範圍的調查資料

This is the data from a single vaccination coverage survey

in a single district in the country of Zambia

僅僅是尚比亞鄉下的一個地區而已

from a few years ago, that I participated in.

它們來自於前幾年我參加的一次調查。

The only thing anyone was trying to find out

我們唯一想找到的是

is what percentage of Zambian children are vaccinated,

尚比亞兒童接種疫苗的百分比，

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

這是在數週內收集到紙上的數據資料，

from a single district,

僅僅是一個地區，

which is something like a county in the United States.

有點像我們在美國的一個郡。

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

你可以想像，整個國家的尚比亞，

回答只是這一個問題

answering just that single question ...

looks something like this.

看起來這樣的。

一車一車又一車

Truck after truck after truck,

裝滿一堆一堆又一堆的數據資料。

filled with stack after stack after stack of data.

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

並且更糟糕的是，

這只是開始，

Because once you've collected all that data,

因為一旦你收集了所有的資料，

of course, someone -- some unfortunate person --

當然有一些人必須要去——

有些不幸的人必須要把它們輸入到電腦上。

is going to have to type that into a computer.

When I was a graduate student,

當我是研究生的時候，

I actually was that unfortunate person sometimes.

實際上我有時就是那不幸的人。

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

我可以告訴你，我那時經常分心。

I probably made a lot of mistakes when I did it

我大概做了很多錯誤的輸入，

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

沒有人會發現，所以數據資料的品質會下降。

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

但是最終希望那些數據被輸入到了電腦上，

and someone can begin to analyze it,

那樣有人就可以開始分析它們，

and once they have an analysis and a report,

一旦他們得出了一份分析和報告，

但願你能使用那些收集來的數據結果

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

and use it to vaccinate children better.

來更好地為孩子們接種疫苗。

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

因為如果在全球公共健康領域

有任何更糟的事情發生，

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

我不知道世上有什麼比讓孩子們

to die of vaccine-preventable diseases --

死於原本疫苗可預防的疾病更糟糕的事情，

diseases for which the vaccine costs a dollar.

那些疾病的疫苗成本也就 1 美元。

And millions of children die of these diseases every year.

但是，每年有數百萬的兒童死於這些疾病。

而且事實是，數百萬只是一個粗略的估計，

And the fact is, millions is a gross estimate,

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

因為我們真的不知道 每年究竟有多少孩子死於這些疾病。

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

讓人更加沮喪的是，

數據輸入的部分， 也就是我作為研究生時曾做過的工作，

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

有時會長達六個月之久。

can take sometimes six months.

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

有時，可以用兩年時間把那些資訊輸入到電腦

有時，其實經常發生，

And sometimes, actually not infrequently,

it actually never happens.

那些數據根本不會被輸入。

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

現在試著想一想這一點。

You just had teams of hundreds of people.

你只有一個幾百人的團隊。

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

他們要去實地回答一個特定的問題。

你很可能花掉了成百上千美元

You probably spent hundreds of thousands of dollars

在燃料、複印和每日生活開支上，

on fuel and photocopying and per diem.

然後出於某些原因，比如沒了勁頭兒

And then for some reason, momentum is lost

or there's no money left,

或者沒錢了，

and all of that comes to nothing,

所有這一切都落空了

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

因為實際上根本沒人把數據輸入到電腦裡。

The process just stops.

這個過程就中斷了。但這常常發生。

Happens all the time.

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

這就是我們在在全球健康組織裡頭的決策基礎：

little data, old data, no data.

少數據，舊數據，沒數據。

So back in 1995,

所以，我們再回到 1995 年，我開始思考

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

我們可以改善這一過程的方法。

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

1995 年，很明顯，那是很久以前了。

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

想想那有多久以前真得讓我有點害怕。

那年最精彩的電影是

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

"終極警探3"。

正如您所看到的， 布魯斯 · 威利斯那時還有很多頭髮。

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

I was working in the Centers for Disease Control

我那時正在疾病控制中心工作，

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

那時我也有很多頭髮。

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

但對我來說，在1995年， 我看到的最有意義的事

was this.

是這個。

我們很難想像，但是在1995 年，

Hard for us to imagine, but in 1995,

this was the ultimate elite mobile device.

這是那時候最精英的移動裝置。

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

對吧？這不是一部 iPhone， 也不是三星 Galaxy 手機。

It was a PalmPilot.

它是個掌上電腦。

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

當我第一次看到掌上電腦時，我想，

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

為什麼我們不能把那些表格放到掌上電腦上？

And go out into the field just carrying one PalmPilot,

然後去實地調查時就只帶著一個掌上電腦，

可以容納成千上萬的紙質表單。

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

我們為什麼不試著這樣做呢？

Why don't we try to do that?

Because if we can do that,

因為如果我們能那麼做，

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

我們實際上就可以電子化、數字化地收集數據，

from the very beginning,

從一開始，

we can just put a shortcut right through that whole process

我們就在整個過程中獲得了一個捷徑，

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

就不用打字，

不用讓人把那些數據輸入電腦裡了。

We can skip straight to the analysis

我們可以直接進行分析，

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

然後直接用那些數據去實際地挽救生命了。

So that's what I began to do.

所以那就是我開始做的事。

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

在疾病預防控制中心工作時， 我開始到全世界不同的部門

並且培訓他們用掌上電腦

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

收集數據，而不是用紙張。

instead of using paper.

And it actually worked great.

實際工作進展得很順利。

It worked exactly as well as anybody would have predicted.

它就像每個人預計得那樣運作良好。

你知道嗎？電子數據收集

What do you know?

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

實際上比用紙張收集高效很多。

當我在做這件事的時候， 我的生意夥伴，蘿絲，

While I was doing it, my business partner,

她和她的丈夫，馬修，就在觀眾席裡，

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

蘿絲也去美國紅十字會做了同樣的事情。

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

問題是，在那幾年之後，

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

我意識到我已經完成了——我可能已經去了

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

6 個或 7 個組織，我覺得，

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

你知道，如果再以這種速度繼續下去，

over my whole career,

我整個職業生涯，也許我要去

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

也許 20 或 30 個組織。

But the problem is, 20 or 30 programs,

但問題是，20或30個組織，

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

給 20 或 30 個組織培訓使用這種技術，

that is a tiny drop in the bucket.

這簡直就是杯水車薪。

這種要讓數據更好運行的需求，

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

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

僅僅是在健康領域，其他領域暫且不談，

in developing countries -- is enormous.

在發展中國家，這需求是巨大的。

There are millions and millions and millions of programs,

有成千上萬難以計數的組織，

millions of clinics that need to track drugs,

數以百萬的診所需要跟蹤藥品情況，

millions of vaccine programs.

數以百萬的疫苗組織。

There are schools that need to track attendance.

有很多學校需要紀錄出勤率。

有各種各樣這樣不同的事情，

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

並且我意識到，

如果我繼續以我以前的方式，

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

I was basically hardly going to make any impact

在我的職業生涯結束之前，

我基本上很難做出什麼影響。

by the end of my career.

And so I began to rack my brain,

於是，我開動腦筋

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

努力思考，

我在做的過程是什麼樣的，

How was I training folks,

我怎麼培訓人們，我遇到的瓶頸是什麼

and what were the bottlenecks and what were the obstacles

更快速、更有效的阻礙？

to doing it faster and to doing it more efficiently?

我意識到——我確定了主要的阻礙。

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

不幸的是，在思考這一段時間以後

I identified the main obstacle.

我意識到——我確定了主要的阻礙。

And the main obstacle, it turned out --

這個主要的阻礙出現了，

and this is a sad realization --

並且這個發現讓我很沮喪。

這個主要的障礙就是我本人。

the main obstacle was me.

So what do I mean by that?

這是什麼意思呢？

I had developed a process

我已經開發了這樣一個過程

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

我是這項技術的中心。

如果您想要使用這項技術，你必須聯絡我。

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

這意味著你必須知道我的存在。

That means you had to know I existed.

然後你不得不拿出錢來付給我

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

飛到你的國家

拿錢來支付我的旅館

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開銷。

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

所以你可以說是 1 萬或 2 萬或 3 萬美元

if I actually had the time or it fit my schedule

如果我真的有時間 或著能把這件事提上日程

and I wasn't on vacation.

而且我沒有在度假。

The point is that anything,

這個問題的關鍵在於任何事，任何系統

any system that depends on a single human being

只要是依靠一兩個或三五個人，

or two or three or five human beings --

it just doesn't scale.

它就不會成規模。

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

問題就是我們需要傳播

這項技術，並且我們現在就需要擴大它的規模。

and we need to scale it now.

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

所以我開始想

能讓我把自己脫離出來的方法。

take myself out of the picture.

你知道，我在想，

And, you know, I was thinking,

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

我如何把自己脫離出來？

for quite some time.

想了相當一段時間。

I'd been trained that the way you distribute technology

你知道，我習慣於認為

在國際發展中傳播科技

within international development

is always consultant-based.

總是基於諮詢顧問模式的。

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

總是看起來有些像我一樣的人

flying from countries that look pretty much like this

從一些像這裡的國家飛到

to other countries with people with darker skin.

有著深色皮膚人群的國家。

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

你去到那些國家，你要花機票錢

and you spend time and you spend per diem

要花時間，在日常生活上還要花錢，

and you spend for a hotel and all that stuff.

花錢在旅館上，等等這些東西上。

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

那時，據我所知，這是唯一傳播技術的方法，

我想不出其他解決辦法。

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

但是奇蹟發生了，

But the miracle that happened --

I'm going to call it Hotmail for short.

我把它簡稱為 Hotmail。

You may not think of Hotmail as being miraculous,

現在你可能不覺得的 Hotmail 有多神奇，

but for me it was miraculous,

但對我來說那是個奇蹟，

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

因為，正當我為解決這一問題而絞盡腦汁的時候，

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

那時我大部分時間都在撒哈拉南部非洲工作。

I noticed that every sub-Saharan African health worker

我注意到每個和我工作的 撒哈拉南部非洲的健康事業工作者

that I was working with had a Hotmail account.

都使用 Hotmail 帳戶。

我想，它啓發了我，

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

肯定不會飛到肯亞健康部去

to train people in how to use Hotmail.

培訓人們如何使用 Hotmail。

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

所以這些人正在傳播技術。

他們讓軟件應用能力傳播到那裡，

but they're not actually flying around the world.

但他們實際上並不在世界各地飛行。

關於這個我需要多想想。

I need to think about this more."

While I was thinking about it,

當我正在想這個的時候，人們開始使用

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

更多的東西，就像我們以前一樣。

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

他們開始使用 LinkedIn 和 Flickr

Gmail 和谷歌地圖，所有這些事情。

all these things.

Of course, all of these things are cloud based

當然，所有這些東西都是基於雲端的

and don't require any training.

不需要任何培訓。

They don't require any programmers.

他們不需要任何的程式員。

They don't require consultants.

因為他們不需要任何顧問，

Because the business model for all these businesses

因為所有這些企業的商業模式

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

需要的東西簡單到我們可以自己使用它

with little or no training.

只要很少或根本不需要訓練。

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

你只是聽說過它，然後登錄那個網站。

所以，如果我們開發軟體來做我的諮詢工作

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

to do what I'd been consulting in?

會發生什麼呢？

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

我們不是培訓人們

如何將表單放到移動裝置上，

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

是創建可以讓他們自己做事的軟體

不需培訓，也不需要我參與。

and without me being involved.

而這正是我們所做的。

And that's exactly what we did.

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

所以，我們創建了 Magpi 軟體

它有一個在線表單創建者。

No one has to speak to me,

不需要有人和我說話。

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

你只需要聽說過它，然後登錄那個網站。

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

您可以創建表單，一旦你創建了表單，

you push them to a variety of common mobile phones.

你可以把他們推送到各種常見的手機上。

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

很明顯的是，我們已經用移動電話

取代了掌上電腦。

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

它不需要是智慧型手機。

它可以是非智慧型手機，就像右邊的這個一樣，

like the phone on the right, the basic Symbian phone

你知道，這種非智慧型的塞班手機

that's very common in developing countries.

在發展中國家非常普遍。

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

最精彩的部分是，它就像 Hotmail 一樣。

It's cloud based,

它是基於雲端運算的，並不需要任何培訓，

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

程式設計和顧問諮詢。

But there are some additional benefits as well.

就像用掌上電腦一樣，最重要的一點是，

現在我們知道，當我們建立了這個系統，

Now we knew when we built this system,

就像用掌上電腦一樣，最重要的一點是

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

was that you'd be able to collect the data

你必須而且你能夠

收集數據並立即上載數據 以獲取您的數據庫。

and immediately upload the data and get your data set.

但是我們發現，當然，因為數據已經在電腦上了，

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

我們可以提供即時圖像並且分析畫面。

we can deliver instant maps and analysis and graphing.

We can take a process that took two years

我們可以將一個需要花費兩年時間的過程

and compress that down to the space of five minutes.

壓縮到只要五分鐘的時間。

令人難以置信的效率提升。

Unbelievable improvements in efficiency.

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

基於雲端的，不需要培訓、 不需要顧問，不需要我。

And I told you that in the first few years

我告訴過你們，在最初的幾年中

of trying to do this the old-fashioned way,

試圖用老方法做這個的時候，

going out to each country,

到每個國家去，

我們達到了大約，我不確定，

we probably trained about 1,000 people.

大概培訓了1000 人左右。

What happened after we did this?

在我們創建了軟體之後，發生了什麼事？

In the second three years,

在第二個三年中，有14000 人

we had 14,000 people find the website,

找到網站、 註冊，並開始使用它來收集數據，

sign up and start using it to collect data:

data for disaster response,

疾病反饋的數據，

加拿大養豬業者用來跟蹤豬的疾病和豬飼料，

Canadian pig farmers tracking pig disease and pig herds,

people tracking drug supplies.

人們跟蹤藥品供應。

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

我最喜歡的例子之一，

IRC，國際救援委員會

they have a program where semi-literate midwives,

他們有一個程式，能讓半文盲的助產士

using $10 mobile phones,

用 10 美元的手機

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

使用我們的軟體每週發送一次短消息

匯報出生人數量和死亡數量，

with the number of births and the number of deaths,

這給了全球救援委員會

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

在全球健康組織前所未見的東西：

a near-real-time system of counting babies,

一個近乎即時紀錄新生嬰兒數量的系統，

of knowing how many kids are born,

知道多少孩子出生，

of knowing how many children there are in Sierra Leone,

知道兒童的數量，

在塞拉里昂，人們正在使用它，

which is the country where this is happening,

and knowing how many children die.

並且知道有多少兒童死去。

Physicians for Human Rights --

人權組織的醫師——

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

現在我們所說的有點超出了健康的領域——

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

他們在收集，他們基本上是培訓人們

做關於強姦的測驗，在剛果這是一種流行病，

where this is an epidemic,

a horrible epidemic,

一個可怕的流行病，

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

他們可以使用我們的軟體紀錄

他們找到的證據，包括圖像上的，

including photographically,

so that they can bring the perpetrators to justice.

這樣，他們可以將犯罪者繩之以法。

Camfed, another charity based out of the UK --

Camfed，總部在英國的另一個慈善機構，

Camfed pays girls' families to keep them in school.

Camfed，支付給女孩的家庭，好讓她們繼續上學。

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

他們明白這是他們能做的最有意義的干預

他們過去用紙張來跟蹤支出，

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

出勤，成績。

The turnaround time between a teacher writing down grades or attendance

從一個老師

寫下成績或出勤率

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

然後大約兩至三年後得出報告。

Now it's real time.

現在這是一個實時系統，並且因為這是如此

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

低成本的系統，以雲計算為基礎，它的成本，

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

對於 Camfed 資助的五個國家

數以萬計的女孩子們，

with tens of thousands of girls,

所有成本加起來每年只需要一萬美金。

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

That's less than I used to get

這比我以前

出去做兩週諮詢的花費要少。

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，我之前告訴過你

當我們在用老式方法做的時候，

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

我意識到，我們所有的工作加起來 不過就是杯水車薪。

10, 20, 30 different programs.

只是10、 20、 30個不同的組織，

我們已經取得了很大進展，但我承認

We've made a lot of progress,

but I recognize that right now,

現在，即使我們所做的工作

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

有14000 人使用它，

is still a drop in the bucket.

這仍是杯水車薪。但是已經發生了一些改變

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

而且我認為它應該明顯。

What's changed now is,

現在的改變是，

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

我們過去用的低效率的方式已經被取代

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

我們再也不用到需要我們的人那裡去，

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

我們已經做到不需要有人來找我們了。

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

我們創造了一種工具，可以讓程式

可以讓孩子們留在學校，

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

跟蹤嬰兒的出生和死亡數量，

catch criminals and successfully prosecute them --

逮捕罪犯並成功起訴他們，

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

來做這些不同的事情從而瞭解更多

關於正在發生什麼，以便能瞭解更多，看得更多，

to understand more,

to see more ...

and to save lives and improve lives.

來拯救生命和改善生活。

Thank you.

謝謝。

(Applause)

（掌聲）