No one should die because they live too far from a doctor | Raj Panjabi

譯者: Lilian Chiu 審譯者: Wendy Chen

I want to share with you something my father taught me:

我想與大家分享的 是我父親教我的一個道理：

no condition is permanent.

沒有什麼狀況是永恆不變的。

It's a lesson he shared with me again and again,

他一再地告訴我這個道理，

and I learned it to be true the hard way.

我也花費了一番功夫才學會。

Here I am in my fourth-grade class.

照片是我與小學四年級的班級，

This is my yearbook picture taken in my class in school

來自學校的畢業紀念冊，

學校位在賴比瑞亞的蒙羅維亞市。

in Monrovia, Liberia.

My parents migrated from India to West Africa in the 1970s,

我父母在 70 年代 從印度移居到西非，

and I had the privilege of growing up there.

我有幸在那兒成長。

I was nine years old,

我當時九歲，

I loved kicking around a soccer ball,

熱愛踢足球，

and I was a total math and science geek.

更是個熱愛數學和科學的怪胎。

I was living the kind of life that, really, any child would dream of.

我過著所有孩子們所憧憬的生活，

But no condition is permanent.

但沒有什麼狀況是永恆不變的。

On Christmas Eve in 1989,

1989 年的聖誕夜，

civil war erupted in Liberia.

賴比瑞亞內戰爆發。

The war started in the rural countryside,

戰事從偏鄉引爆，

and within months, rebel armies had marched towards our hometown.

幾個月內，反叛軍進軍我們的家鄉。

My school shut down,

我的學校關閉，

and when the rebel armies captured the only international airport,

當反叛軍佔領唯一的國際機場時，

people started panicking and fleeing.

人們開始驚慌逃難。

My mom came knocking one morning and said, "Raj, pack your things --

某個早晨，我母親邊敲門邊說：

「拉吉，快打包，我們得離開了。」

we have to go."

We were rushed to the center of town,

我們趕往鎮中心，

and there on a tarmac, we were split into two lines.

在飛機跑道上， 人們被分成兩排隊伍。

I stood with my family in one line,

我和我家人置身其中一排，

and we were stuffed into the cargo hatch

然後從貨艙口

of a rescue plane.

擠進救援飛機裡。

And there on a bench, I was sitting with my heart racing.

坐在長凳上，我的心跳加速，

As I looked out the open hatch,

我從打開的貨艙口看出去，

I saw hundreds of Liberians in another line,

看到數以百計的賴比瑞亞人 在另一排隊伍中，

children strapped to their backs.

有人背著孩子。

When they tried to jump in with us,

當他們試圖跳上我們的飛機，

I watched soldiers restrain them.

我眼見士兵制止他們，

They were not allowed to flee.

他們不被允許逃離。

We were the lucky ones.

我們是幸運兒。

We lost what we had,

我們失去曾擁有的一切，

but we resettled in America,

但我們重新在美國落腳。

and as immigrants, we benefitted from the community of supporters

在新社區中，許多的支持者

that rallied around us.

對我們這些移民都非常的照顧。

They took my family into their home,

他們讓我們一家人住進他們家，

they mentored me.

他們教導我，

And they helped my dad start a clothing shop.

他們也協助我父親開了一間服飾店。

I'd visit my father on weekends as a teenager

我青少年時，週末都會拜訪父親，

to help him sell sneakers and jeans.

幫他賣運動鞋和牛仔褲。

And every time business would get bad,

每當生意不好時，

he'd remind me of that mantra:

他總會提醒我那句真言，

no condition is permanent.

沒有什麼狀況是永恆不變的。

That mantra and my parents' persistence and that community of supporters

因為那句真言、我雙親的堅持毅力、 和社區人們的支持下，

made it possible for me to go through college

我才得以上大學，

and eventually to medical school.

最終進入醫學院就讀。

I'd once had my hopes crushed in a war,

我的希望曾被戰爭毀滅，

but because of them,

但因為他們，

I had a chance to pursue my dream to become a doctor.

我有機會去追逐成為醫生的夢想，

My condition had changed.

我的狀況改變了，

It had been 15 years since I escaped that airfield,

我逃離那機場已是 15 年前的事，

but the memory of those two lines had not escaped my mind.

但那兩排隊伍的記憶， 仍在我腦海裡揮之不去。

I was a medical student in my mid-20s,

在我 25 歲左右， 還是醫學生的時候，

and I wanted to go back

我想要回去，

to see if I could serve the people we'd left behind.

看能否幫助被我們丟下的人們。

But when I got back,

但在我回去後，

what I found was utter destruction.

只看見滿目瘡痍，

The war had left us with just 51 doctors

一個四百萬人口的國家

to serve a country of four million people.

在戰後只剩下 51 名醫生在服務，

It would be like the city of San Francisco having just 10 doctors.

這就像整個舊金山 只有 10 個醫生一樣。

So if you got sick in the city where those few doctors remain,

若你在城市中生病， 有少數幾個醫生還留在那裡，

you might stand a chance.

你可能還有機會看病。

But if you got sick in the remote, rural rainforest communities,

但若你在偏僻的雨林社區裡生病，

where you could be days from the nearest clinic --

離最近的診所是好幾天的路程──

I was seeing my patients die from conditions no one should die from,

我曾目睹我的病患， 死於不該命絕的病症，

all because they were getting to me too late.

只因為他們太晚才來到我這裡。

Imagine you have a two-year-old who wakes up one morning with a fever,

想像你的兩歲小孩 某天早上起床就發起高燒，

and you realize she could have malaria,

你驚覺她可能染上瘧疾。

and you know the only way to get her the medicine she needs

你知道只有一個方法 可以取得她需要的藥物，

would be to take her to the riverbed,

就是帶著她到河邊，

get in a canoe, paddle to the other side

划著獨木舟到對岸，

and then walk for up to two days through the forest

然後走上兩天的路，穿過森林，

just to reach the nearest clinic.

只為了到達最近的診所。

One billion people live in the world's most remote communities,

十億人口住在世界最偏遠的社區，

and despite the advances we've made in modern medicine and technology,

儘管現代醫學與科技如此進步，

our innovations are not reaching the last mile.

我們的創新卻無法觸及 那些最後一英里的人們。

These communities have been left behind,

這些社區遭到遺忘，

because they've been thought too hard to reach

因為它們被認為太遠、難以抵達，

and too difficult to serve.

且太難給以協助。

Illness is universal;

疾病是全球性的；

access to care is not.

但醫療照護的資源卻不是。

And realizing this lit a fire in my soul.

了解到這點，點燃了我靈魂中的火。

No one should die because they live too far from a doctor or clinic.

沒有人應該因為住處 離醫生、診所太遠而喪命。

No condition should be permanent.

這樣的狀況不應該是永恆不變的。

And help in this case didn't come from the outside,

在這個案例中，他們沒有外援，

it actually came from within.

得到的協助是來自社區內部。

It came from the communities themselves.

來自於這個社區本身。

Meet Musu.

她是姆索。

Way out in rural Liberia,

在賴比瑞亞偏僻的鄉下，

where most girls have not had a chance to finish primary school,

當地大多數女孩都沒機會讀完小學。

Musu had been persistent.

但姆索堅毅不拔，

At the age of 18, she completed high school,

她 18 歲讀完了高中，

and she came back to her community.

然後返回自己的社區，

She saw that none of the children were getting treatment

眼見社區裡孩子

生病時無法能得到應有的治療──

for the diseases they needed treatment for --

deadly diseases, like malaria and pneumonia.

例如像可能致命的瘧疾和肺炎，

So she signed up to be a volunteer.

她因此自願成為義工。

There are millions of volunteers like Musu in rural parts around our world,

全世界偏遠區域 有數百萬名像姆索這樣的義工，

and we got to thinking --

這讓我們思考──

community members like Musu could actually help us solve a puzzle.

像姆索這樣的社區成員 能幫我們解決難題。

Our health care system is structured in such a way

我們的醫療保健制度的 結構是這樣的：

that the work of diagnosing disease and prescribing medicines

診斷疾病和開藥的工作

is limited to a team of nurses and doctors like me.

只能由像我這種醫師 及護士的團隊來做。

But nurses and doctors are concentrated in cities,

但醫生和護士都集中在城市，

so rural communities like Musu's have been left behind.

因此像姆索所居住的 偏鄉社區就被遺忘了。

So we started asking some questions:

這讓我們提出幾個問題：

What if we could reorganize the medical care system?

若我們能重整 醫療照護制度，會如何？

What if we could have community members like Musu

假如能讓像姆索這樣的社區成員，

be a part or even be the center of our medical team?

加入甚至成為 醫療團隊中的主要角色呢？

What if Musu could help us bring health care from clinics in cities

若姆索能幫我們 將城市診所提供的醫療

to the doorsteps of her neighbors?

帶到她鄰居的門口呢？

Musu was 48 when I met her.

我認識姆索時，她 48 歲。

And despite her amazing talent and grit,

儘管她擁有驚人的天賦與膽量，

she hadn't had a paying job in 30 years.

她 30 年來都沒有領過任何薪水。

So what if technology could support her?

所以如果科技能支助她呢？

What if we could invest in her with real training,

若我們能投資讓她受真正的訓練，

equip her with real medicines,

讓她帶著真正的藥品，

and have her have a real job?

擁有一份真正的工作呢？

Well, in 2007, I was trying to answer these questions,

2007 年，我試著去回答這些問題。

and my wife and I were getting married that year.

我和我太太在那年結婚，

We asked our relatives to forgo the wedding registry gifts

我們讓親友不要送新婚禮物，

and instead donate some money

而以捐款取代，

so we could have some start-up money to launch a nonprofit.

好讓我們有一些基金 去成立一個非營利機構。

I promise you, I'm a lot more romantic than that.

我保證，我其實比那更浪漫很多的。

(Laughter)

（笑聲）

We ended up raising $6,000,

我們最後籌到了六千元，

teamed up with some Liberians and Americans

與一些賴比瑞亞人和美國人合作，

and launched a nonprofit called Last Mile Health.

共同成立一個非營利組織 叫做「最後一英哩醫療」。

Our goal is to bring a health worker within reach of everyone, everywhere.

我們的目標是要讓每個地方每個人 都能接觸得到這些醫療工作者。

We designed a three-step process --

我們設計了一個三步驟的流程──

train, equip and pay --

訓練、裝備、付款──

to invest more deeply in volunteers like Musu

更扎實地資助像姆索這樣的義工，

to become paraprofessionals,

成為協助提供醫療的專業人員，

to become community health workers.

成為社區健康工作者。

First we trained Musu to prevent, diagnose and treat

我們先訓練姆索， 針對影響她村落族人的前十大疾病，

the top 10 diseases afflicting families in her village.

做預防、診斷、與治療。

A nurse supervisor visited her every month to coach her.

每月有護士訪視並指導姆索，

We equipped her with modern medical technology,

我們提供她現代醫療技術，

like this $1 malaria rapid test,

像這個一塊錢的瘧疾快速檢測，

and put it in a backpack full of medicines like this

放在裝滿這類配備的背包中，

to treat infections like pneumonia,

來治療像肺炎這類的感染。

and crucially,

重要的是，

a smartphone, to help her track and report on epidemics.

給她一隻智慧手機協助她 追蹤和回報傳染病。

Last, we recognized the dignity in Musu's work.

最後，我們表彰姆索的努力，

With the Liberian government, we created a contract,

和賴比瑞亞政府合作 我們立了一張合約，

paid her

來支付她薪水，

and gave her the chance to have a real job.

給她一個機會擁有一份真正的工作。

And she's amazing.

她真的很棒，

Musu has learned over 30 medical skills,

姆索學習了超過 30 種醫療技能，

from screening children for malnutrition,

從篩檢營養不良兒童，

to assessing the cause of a child's cough with a smartphone,

到用智慧手機來 評估孩童咳嗽的原因，

to supporting people with HIV

到協助愛滋病患者，

and providing follow-up care to patients who've lost their limbs.

並提供後續照護給失去肢體的病人。

Working as part of our team,

以我們團隊隊員的身份工作，

working as paraprofessionals,

以協助性醫療人員的身份工作，

community health workers can help ensure

讓社區健康工作者能確保

that a lot of what your family doctor would do

你家庭醫生能提供的那些服務，

reaches the places that most family doctors could never go.

大部份也能被提供到 多數家庭醫師不會去的地方。

One of my favorite things to do is to care for patients

我最喜歡做的事情之一， 就是與這些社區健康工作者

with community health workers.

一同照顧病人。

So last year I was visiting A.B.,

所以去年我去拜訪了艾畢，

and like Musu, A.B. had had a chance to go to school.

艾畢和姆索一樣有機會去上學。

He was in middle school, in the eighth grade,

他父母過世時，他讀中學，

when his parents died.

才八年級，

He became an orphan and had to drop out.

他因此成為孤兒，而必須輟學。

Last year, we hired and trained A.B. as a community health worker.

去年，我們僱用並訓練艾畢 成為社區健康工作者。

And while he was making door to door house calls,

當他出診挨家挨戶拜訪時，

he met this young boy named Prince,

他見到一個男孩，名叫普林斯，

whose mother had had trouble breastfeeding him,

他的母親無法餵母奶。

and by the age of six months, Prince had started to waste away.

六個月大時，普林斯開始消瘦。

A.B. had just been taught how to use this color-coded measuring tape

艾畢才剛學會如何用 有顏色編碼的檢測帶，

that wraps around the upper arm of a child to diagnose malnutrition.

繞著孩童的手臂來診斷營養不良。

A.B. noticed that Prince was in the red zone,

艾畢注意到普林斯 是落在紅色區域，

which meant he had to be hospitalized.

意味著他必須要住院。

So A.B. took Prince and his mother to the river,

所以艾畢帶著普林斯 和他的母親到河邊，

got in a canoe

上了獨木舟，

and paddled for four hours to get to the hospital.

划船划了四小時到醫院。

Later, after Prince was discharged,

之後，普林斯出院後，

A.B. taught mom how to feed baby a food supplement.

艾畢教母親如何 餵寶寶吃營養補給品。

A few months ago,

幾個月前，

A.B. took me to visit Prince, and he's a chubby little guy.

艾畢帶我去造訪普林斯， 他是個圓胖的小傢伙。

(Laughter)

（笑聲）

He's meeting his milestones, he's pulled himself up to a stand,

他走到了人生的幾個哩程碑， 他開始讓自己站立，

and is even starting to say a few words.

他甚至開始說了幾個字。

I'm so inspired by these community health workers.

這些社區健康工作者非常鼓舞我，

I often ask them why they do what they do,

我常問他們為什麼要做這些，

and when I asked A.B.,

當我問艾畢時，

he said, "Doc, since I dropped out of school, this is the first time

他說：「醫生，從我輟學之後，

這是我第一次有機會拿著筆寫字，

I'm having a chance to hold a pen to write.

My brain is getting fresh."

我的頭腦變得精力充沛。」

The stories of A.B. and Musu have taught me something fundamental

艾畢和姆索的故事教導了我關於

about being human.

身為人的根本道理。

Our will to serve others

我們願意去服務他人的意願，

can actually help us transform our own conditions.

其實能協助我們轉變 我們自身的現狀。

I was so moved by how powerful the will to serve our neighbors can be

幾年前，這樣服務鄰居的意願強大到

a few years ago,

讓我好感動。

when we faced a global catastrophe.

當時我們在面對全球性災難，

In December 2013,

2013 年 12 月，

something happened in the rainforests across the border from us in Guinea.

在幾內亞的雨林發生了些狀況。

A toddler named Emile fell sick with vomiting, fever and diarrhea.

一個才在學步的孩童艾米爾 感到噁心想吐、發燒、和痢疾。

He lived in an area where the roads were sparse

他所住的地方，道路很稀少，

and there had been massive shortages of health workers.

且健康工作者嚴重短缺。

Emile died,

後來艾米爾死了，

and a few weeks later his sister died,

幾週後，他的姐妹也死了，

and a few weeks later his mother died.

再幾週後，他的母親也死了。

And this disease would spread from one community to another.

而這個疾病 從一個社區傳到另一個，

And it wasn't until three months later

一直到三個月後，

that the world recognized this as Ebola.

世界才發現那是伊波拉病毒。

When every minute counted, we had already lost months,

當每一分鐘都是關鍵時， 我們卻已失去了幾個月的先機。

and by then the virus had spread like wildfire all across West Africa,

那時，病毒已經像野火 散佈到整個西非，

and eventually to other parts of the world.

後來也傳到世界的其他區域。

Businesses shut down, airlines started canceling routes.

商業停止，航空公司開始取消航線。

At the height of the crisis,

在危機的最高峰，

when we were told that 1.4 million people could be infected,

我們得知有 140 萬人可能受感染，

when we were told that most of them would die,

我們得知他們大多難逃一死，

when we had nearly lost all hope,

我們幾乎失去所有希望。

I remember standing with a group of health workers

我還記得我與一群醫療工作者

in the rainforest where an outbreak had just happened.

站在剛暴發過病情的雨林。

We were helping train and equip them to put on the masks,

我們協助訓練他們， 讓他們戴上面罩、

the gloves and the gowns that they needed

手套、手術衣等等，

他們需要這些裝備， 以防止在服務他們的病人時

to keep themselves safe from the virus

while they were serving their patients.

被病毒感染。

I remember the fear in their eyes.

我記得他們眼中的恐懼，

And I remember staying up at night, terrified if I'd made the right call

我記得晚上無法入睡， 因為深怕我做錯決定，

to keep them in the field.

讓他們留在現場。

When Ebola threatened to bring humanity to its knees,

當伊波拉病毒威脅要讓人類屈服，

Liberia's community health workers didn't surrender to fear.

賴比瑞亞社區健康工作者 並沒有向恐懼投降，

They did what they had always done:

他們做的是他們一直在做的，

they answered the call to serve their neighbors.

他們回應了鄰居的求助。

Community members across Liberia learned the symptoms of Ebola,

整個賴比瑞亞的社區成員 學到了伊波拉病毒的症狀，

teamed up with nurses and doctors to go door-to-door to find the sick

與護士及醫生合作 挨家挨戶去找出病人，

and get them into care.

讓他們受到照護。

They tracked thousands of people who had been exposed to the virus

他們追蹤了數千名 曝露在病毒中的人，

and helped break the chain of transmission.

協助破壞了傳染鏈。

Some ten thousand community health workers risked their own lives

數萬名社區健康工作者 冒著生命危險，

to help hunt down this virus and stop it in its tracks.

協助這些防止病毒傳播的工作。

(Applause)

（鼓掌）

Today, Ebola has come under control in West Africa,

現今在西非，伊波拉病毒已受控制。

and we've learned a few things.

我們學到了幾件事，

We've learned that blind spots in rural health care

我們學到偏遠地區健康照護的盲點，

can lead to hot spots of disease,

可能是疾病中重要的關鍵，

and that places all of us at greater risk.

而那個關鍵使我們暴露在高風險下。

We've learned that the most efficient emergency system

我們學到，最有效的緊急系統，

is actually an everyday system,

其實來自於日常的系統，

and that system has to reach all communities,

且那系統必須要能觸及所有社區，

including rural communities like Emile's.

包括偏遠地區社區， 像艾米爾的社區。

And most of all,

最重要的，

we've learned from the courage of Liberia's community health workers

賴比瑞亞社區健康工作者的 勇氣讓我們學到，

that we as people are not defined by the conditions we face,

我們身為人並不是由 我們所面對的狀況所定義的，

no matter how hopeless they seem.

不論那些狀況看來有多無望，

We're defined by how we respond to them.

是我們如何應對這些狀況 定義了我們。

For the past 15 years,

過去 15 年，

I've seen the power of this idea

我見識到這個想法的力量，

to transform everyday citizens into community health workers --

將平日的市民轉變成 社區健康工作者──

into everyday heroes.

變成日常的無名英雄。

And I've seen it play out everywhere,

我看到這個現象在各處上演，

from the forest communities of West Africa,

從西非的森林社區，

to the rural fishing villages of Alaska.

到阿拉斯加的偏遠漁村。

It's true,

是真的。

these community health workers aren't doing neurosurgery,

這些社區健康工作者 並不是在做神經外科手術，

but they're making it possible

但他們讓健康照護

to bring health care within reach of everyone everywhere.

有機會被帶給任何地方的任何人。

So now what?

所以現在呢？

Well, we know that there are still millions of people dying

我們知道在全世界的偏遠社區中，

from preventable causes

還有數百萬的人正在與 可預防的疾病做死亡搏鬥，

in rural communities around the world.

And we know that the great majority of these deaths are happening

且我們知道這些死亡 絕大多數發生在

in these 75 blue-shaded countries.

這 75 個標示藍色的國家。

What we also know

我們同時知道，

is that if we trained an army of community health workers

如果我們能訓練 一群社區健康工作者，

to learn even just 30 lifesaving skills,

即使只是學習 30 項救命技能，

we could save the lives of nearly 30 million people by 2030.

到 2030 年時， 也能夠拯救三千萬條性命。

Thirty services could save 30 million lives by 2030.

到 2030 年，30 項服務就能夠 拯救近三千萬條性命，

That's not just a blueprint --

那不只是藍圖──

we're proving this can be done.

我們在證明它是可行的。

In Liberia,

在賴比瑞亞，

the Liberian government is training thousands of workers like A.B. and Musu

賴比瑞亞政府正在訓練數以千計 像艾畢及姆索這樣的工作者，

after Ebola,

在伊波拉事件之後，

to bring health care to every child and family in the country.

將健康照護帶給該國的 每個孩童與家庭。

And we've been honored to work with them,

我們過去有榮幸能與他們共事，

and are now teaming up with a number of organizations

現在我們在與其他國家的

that are working across other countries

幾個組織合作，

to try to help them do the same thing.

試著協助他們做同樣的事。

If we could help these countries scale,

如果我們能協助這些國家成長，

we could save millions of lives,

我們就能拯救數百萬人的性命，

and at the same time,

同時，

we could create millions of jobs.

我們能創造數百萬個工作機會。

We simply can't do that, though, without technology.

但，沒有科技我們是做不到的。

People are worried that technology is going to steal our jobs,

人們在擔心科技可能會 搶了我們的飯碗，

but when it comes to community health workers,

但對社區健康工作者的情況來說，

technology has actually been vital for creating jobs.

科技是創造工作機會的關鍵。

Without technology -- without this smartphone,

若沒有科技──沒有這些智慧手機、

without this rapid test --

沒有這種快速檢測──

it would have been impossible for us to be able to employ A.B. and Musu.

我們就不可能僱用艾畢及姆索。

And I think it's time for technology to help us train,

我想，該是用科技 來協助我們訓練的時候了，

to help us train people faster and better than ever before.

協助我們用比以前 更快更好的方式來訓練人。

As a doctor,

身為醫生，

I use technology to stay up-to-date and keep certified.

我用科技來跟上最新發展 並保持讓自己隨時學習最新知識，

I use smartphones, I use apps, I use online courses.

我用智慧手機、我用 app、 我用線上課程。

But when A.B. wants to learn,

但當艾畢想要學習時，

he's got to jump back in that canoe

他得要跳上那獨木舟，

and get to the training center.

前往訓練中心。

And when Musu shows up for training,

當姆索出席訓練時，

her instructors are stuck using flip charts and markers.

她的指導員只能用 活動掛圖和麥克筆。

Why shouldn't they have the same access to learn as I do?

為什麼他們不能和我 有同樣的學習資源？

If we truly want community health workers to master those lifesaving skills

如果我們真的想要讓社區健康 工作者能精通那些救命技能，

and even more,

甚至做更多，

we've got to change this old-school model of education.

那麼我們就得改變 這個老派的教育方式。

Tech can truly be a game changer here.

在這裡，科技會是這個 遊戲規則顛覆者。

I've been in awe of the digital education revolution

可汗學院及 edX 一直在引領

that the likes of Khan Academy and edX have been leading.

數位教育革命，這讓我心存敬畏。

And I've been thinking that it's time;

我一直在想，該是時候了，

it's time for a collision

該是讓數位教育革命

between the digital education revolution

與社區健康革命

and the community health revolution.

互相激起花火的時候了。

And so, this brings me to my TED Prize wish.

所以這就帶到了 我的 TED 得獎願望，

I wish --

我希望──

I wish that you would help us recruit

我希望你們能協助我們徵召

the largest army of community health workers the world has ever known

世上前所未有最大的 社區健康工作者軍團，

by creating the Community Health Academy,

做法是創立社區健康學院，

a global platform to train, connect and empower.

它是個全球平台， 用來訓練、連結、使人們更有能力。

(Applause)

（鼓掌）

Thank you.

謝謝大家。

(Applause)

（鼓掌）

Thank you.

謝謝大家。

Here's the idea:

想法是這樣的：

we'll create and curate

我們會創造和策劃

the best in digital education resources.

最好的數位教育資源，

We will bring those to community health workers around the world,

把這些資源帶給 全世界的社區健康工作者，

including A.B. and Musu.

包括艾畢與姆索。

They'll get video lessons on giving kids vaccines

他們能看到如何為孩童 施打疫苗的教學課程影片，

and have online courses on spotting the next outbreak,

能取得關於如何發現 下次疫情爆發的線上課程，

so they're not stuck using flip charts.

所以他們不會只用活動掛圖。

We'll help these countries accredit these workers,

我們會協助這些國家 來認可這些工作者，

so that they're not stuck remaining an under-recognized, undervalued group,

他們才不會一直 不被承認、不被重視，

but become a renowned, empowered profession,

而能成為有聲譽有能力的專業人士，

just like nurses and doctors.

就像護士與醫生一樣。

And we'll create a network of companies and entrepreneurs

我們會針對在拯救人命上

who've created innovations that can save lives

做創新的公司及企業創立一個網路，

and help them connect to workers like Musu,

協助他們連結像姆索這樣的工作者，

so she can help better serve her community.

讓她能為她的社區做更好的服務。

And we'll work tirelessly to persuade governments

我們會不屈不撓地去說服政府，

to make community health workers a cornerstone of their health care plans.

讓社區健康工作者成為 其健康照護計畫的基石。

We plan to test and prototype the academy in Liberia

我們計畫要在賴比瑞亞 測試這個學院的原型，

and a few other partner countries,

另外也會在幾個合作國家進行，

and then we plan to take it global,

接著我們的計畫是擴展到全球，

including to rural North America.

包擴北美偏遠地區。

With the power of this platform,

有這個平台的力量，

we believe countries can be more persuaded

我們相信更有可能會說服各國，

that a health care revolution really is possible.

健康照護革命是真的可行的。

My dream is that this academy will contribute to the training

我的夢想是，這個學院能夠為訓練

of hundreds of thousands of community members

無數社區成員上有所貢獻，

to help bring health care to their neighbors --

協助他們將健康照護 帶給他們的鄰居──

the hundreds of millions of them

數千萬的人，

that live in the world's most remote communities,

住在世界上最偏遠社區的人。

from the forest communities of West Africa,

從西非森林中的社區，

to the fishing villages of rural Alaska;

到阿拉斯加偏遠漁村；

from the hilltops of Appalachia, to the mountains of Afghanistan.

從阿帕拉契山山頂， 到阿富汗的山區。

If this vision is aligned with yours,

如果這個憧憬跟你的相符，請造訪

head to communityhealthacademy.org,

communityhealthacademy.org，

and join this revolution.

加入這場革命。

Let us know if you or your organization or someone you know could help us

如果你、你的組織、或你認識的人 能夠協助我們，請讓我們知道，

as we try to build this academy over the next year.

協助我們在明年開始打造這所學院。

Now, as I look out into this room,

我在這間演講廳中看過去，

I realize that our journeys are not self-made;

我了解到我們的旅程 並不是靠自己獨立建造的，

they're shaped by others.

是由他人所塑造的。

And there have been so many here that have been part of this cause.

這裡有這麼多人為了 這個理想而努力，

We're so honored to be part of this community,

我們很榮幸能成為 這個社群的一份子，

and a community that's willing to take on a cause

這個社群願意挑戰去達成一個理想，

as audacious as this one,

像這個理想一樣大膽無畏的理想。

so I wanted to offer, as I end,

所以我在最後，

a reflection.

我想要提出一個反思。

I think a lot more about what my father taught me.

我想了很多我父親教我的事，

These days, I too have become a dad.

這些日子，我自己也成了一個父親，

I have two sons,

我有兩個兒子，

and my wife and I just learned that she's pregnant with our third child.

我和我太太剛知道 她又懷了第三個孩子。

(Applause)

Thank you.

（鼓掌）

(Applause)

謝謝大家。

（鼓掌）

I was recently caring for a woman in Liberia

最近我在賴比瑞亞照顧一個女子，

who, like my wife, was in her third pregnancy.

她跟我太太一樣懷了第三胎。

But unlike my wife,

但跟我太太不一樣的是，

had had no prenatal care with her first two babies.

她懷前兩個孩子時沒得到產前照護。

She lived in an isolated community in the forest that had gone for 100 years

她居住在森林中與世隔離的社區，

without any health care

這裡 100 年來都沒有任何健康照護，

until ...

直到……

until last year when a nurse trained her neighbors

直到去年一名護士訓練她的鄰居

to become community health workers.

成為社區健康工作者。

So here I was,

所以，我在那裡

seeing this patient who was in her second trimester,

幫這個懷孕中期的病人看病。

and I pulled out the ultrasound to check on the baby,

我拿出超音波來檢查寶寶，

and she started telling us stories about her first two kids,

她開始告訴我們 她前兩個孩子的故事，

and I had the ultrasound probe on her belly,

我用超音波在她的肚子上探測時，

and she just stopped mid-sentence.

她停下了說到一半的句子。

She turned to me and she said,

她轉向我，說：

"Doc, what's that sound?"

「醫生，那是什麼聲音？」

It was the first time she'd ever heard her baby's heartbeat.

那是她初次聽見她寶寶的心跳聲，

And her eyes lit up in the same way my wife's eyes and my own eyes lit up

她的眼睛亮起來， 就像我太太和我在聽到我們寶寶的

when we heard our baby's heartbeat.

心跳聲時眼睛也亮起來那樣。

For all of human history,

在所有的人類歷史上，

illness has been universal and access to care has not.

疾病都是全球性的， 而照護資源卻不是。

But as a wise man once told me:

但有位智者曾告訴我，

no condition is permanent.

沒有什麼狀況是永恆不變的。

It's time.

該是時候了，

It's time for us to go as far as it takes

該是我們盡所能一起去

to change this condition together.

改變這個狀況的時候了。

Thank you.

謝謝大家。

(Applause)

（鼓掌）