What if we eliminated one of the world's oldest diseases? | Caroline Harper

譯者: Lilian Chiu 審譯者: SF Huang

I'd like you to imagine, just for a moment,

我想請各位想像一下，

that your eyelashes grew inwards instead of outwards,

你的睫毛是向內長， 而不是向外長，

so that every time you blinked,

所以每當你眨眼時，

they would scrape the front of your eyeballs,

它們就會刮過你的眼球前面，

damaging the corneas,

造成角膜損傷，

so that slowly and painfully, you went blind.

你會以痛苦的方式慢慢失明。

Well, that's what happens to a person who has trachoma.

有砂眼的人面對的就是這種情況。

Now, this little boy here, Pamelo, from Zambia, he has trachoma.

這位來自尚比亞小男孩 叫做帕梅洛，他就有砂眼。

And if we don't do anything, he's going to go blind.

若我們什麼也不做，他就會失明。

Trachoma is a curious disease.

砂眼是種很奇怪的疾病。

It's a bacterial infection that's passed from person to person

它是一種細菌感染， 會由一個人傳染給另一個人，

and by flies.

且由蒼蠅傳染。

The repeated infection will scar your eyelids

重覆的感染會讓你的眼瞼結疤

so that they contract and they turn inside out.

造成眼瞼萎縮使其外翻。

It particularly affects women,

女性特別容易受到影響，

because they have the contact with children.

因為她們會和孩童接觸。

So what you'll often see in places like Ethiopia

所以，在衣索比亞 這類地方你常常會看見

are girls who have tweezers like this around their necks,

女孩會在她們的脖子上 掛著這種鑷子，

and they use them to pluck out their eyelashes.

用它來拔她們的睫毛。

But of course, that only gives them temporary respite,

但當然，這麼做 只有暫時緩解的功能，

because they just grow back more vicious than before.

因為睫毛會再長回來且症狀會惡化。

There are around two million people in the world

全世界有大約兩百萬人

who are blind or visually impaired because of trachoma.

因為砂眼而失明或造成視障。

And we believe there may be as many as 200 million people

我們相信多達二億人

who are at risk.

暴露在感染的風險中。

Now, it's a very old disease.

砂眼是種很古老的疾病。

What you can see is a photo of a wall of a tomb in Northern Sudan.

這張照片是北蘇丹一座墓的牆壁。

A colleague and I were traveling in a very remote village,

我和一位同事去了 一個很偏遠的村落，

and we asked an old man to take us down into a little tomb.

我們請一位老人帶我們 進到一個小墓去。

Now, on the wall, we saw two eyes.

在牆壁上，我們看見兩隻眼睛。

One is crying,

一隻眼睛在哭泣，

and you can see there are tweezers next to it.

你們可以看見它的旁邊就有支鑷子。

Simon said to me, "My God, do you think that's trachoma?"

賽門對我說：「我的天， 你認為那是砂眼嗎？」

So we sent this picture to the British Museum,

之後我們把這張圖傳給大英博物館，

and they confirmed that, yes, this is trachoma.

他們確認了，沒錯！這是砂眼。

So, thousands of years ago,

所以，數千年前，

the ancient Nubians were painting pictures of trachoma

古代的努比亞人就已經在墳墓的牆上

on the walls of their tomb.

畫下砂眼的圖。

And the tragedy is

不幸的是，

that disease is still rampant in that area today.

現今那個區域砂眼仍然很猖獗。

And the crazy thing is, we know how to stop it.

很瘋狂的是， 我們知道如何阻止它。

And what's great is that the trachoma community have all come together

很棒的是砂眼團體已經團結在一起，

to pool their efforts.

同心協力。

We don't compete; we collaborate.

我們不競爭，我們合作。

I have to tell you, that's not always the case

我得告訴各位，依我在 非政府組織世界的經驗，

in my experience in the NGO world.

通常不見得會是如此。

We've created something

我們創設了

called the International Coalition for Trachoma Control.

所謂的「砂眼控制國際聯盟」。

And together, we've developed a strategy to fight it.

我們共同發展出對抗砂眼的策略。

This strategy is called the SAFE strategy,

稱為「安全」（SAFE ）策略，

and it's been approved by the World Health Organization.

已經得到世界衛生組織的核准。

The "S" stands for "surgery."

「S」代表的是「手術」。

It's very straightforward procedure

ㄧ個簡易的小手術

to turn the eyelids back the right way.

就能將眼瞼翻回歸位。

We train nurses to do it,

我們訓練護士來做，

and they use local anesthetics.

她們用當地的麻醉劑。

And as you can see, you can do it in somebody's front porch, if need be.

如各位所見，若有必要的話， 在患者家前的門廊就能進行手術。

Then "A" stands for "antibiotics."

「A」代表的是「抗生素」。

These are donated by Pfizer,

抗生素是由輝瑞公司所捐贈，

who also pay for those drugs to be transported to the port in-country.

該公司亦負擔運送藥品的國際運費。

From there, they're taken to the villages,

藥物進港上岸後會被送到村落，

where hundreds of thousands of community volunteers

在村落中成千上百名社區志工

will distribute those drugs to the people.

會將這些藥物分發給大家。

Now, we train those volunteers,

我們訓練這些志工，

and we also help the ministries with all that complex logistics.

我們也協助各部進行複雜的物流。

And every one of those volunteers has a pole like this.

每一位志工都有一根像這樣的竿子。

It's called a "dose pole."

它叫做「劑量竿」。

This one's from Cameroon.

這一根來自喀麥隆。

And you can see it's marked different colors,

可以看到它上面標記了不同顏色，

and you can tell how many pills you should give somebody,

用它就能分辨出應該要 給一個病人多少顆藥，

based on how tall they are.

依據的是病人的身高。

"F" stands for "face washing."

「F」代表的是「洗臉」。

Now, we used to have trachoma in the UK and in the US.

以前在英國和美國也都有砂眼。

In fact, President Carter,

事實上，卡特總統

he talks about how trachoma was a real problem in Georgia

談過他幼時居住的喬治亞州

砂眼的危害是主要的問題。

when he was a little boy.

And in the UK, the famous eye hospital, Moorfields,

在英國，摩菲醫院是 一間著名的眼科醫院，

was originally a trachoma hospital.

它以前原本是間砂眼醫院。

What we do is teach kids like this how important it is to wash their faces.

我們做的事就是去教導 像這樣的孩子，洗臉有多麼重要。

And finally, "E" stands for "environment,"

最後，「E」代表的是「環境」，

where we help the communities build latrines,

我們協助社區建立公廁，

and we teach them to separate their animals from their living quarters

我們教導他們將動物和住處分開，

in order to reduce the fly population.

以減少蒼蠅的數量。

So we know how to tackle the disease.

所以，我們知道如何處理砂眼。

But we need to know where it is.

但我們得要知道它在哪裡。

And we do,

而我們確實知道，

because a few years ago, Sightsavers led an incredible program

因幾年前 Sightsavers （拯救視力組織，講者的慈善團體）

主導了一項很棒的 「全球砂眼地圖繪製計畫」。

called the Global Trachoma Mapping Project.

It took us three years,

它花了我們三年時間，

but we went through 29 countries,

但我們去了 29 個國家，

and we taught local health workers to go district by district,

我們教導當地的醫療保健工作者 需走訪每個行政區，

and they examined the eyelids of over two and a half million people.

他們檢查超過 250 萬人的眼瞼。

And they used Android phones in order to download the data.

他們用安卓系統的手機來下載資料。

And from that, we were able to build a map

用那些資料，我們就 能夠製作一張地圖，

that showed us where the disease was.

顯示出疾病的所在區域。

Now, this is a very high-level map

這是個非常高階的地圖，

that shows you which countries had a problem with trachoma.

它讓我們知道哪些國家有砂眼問題。

And you may ask me, "Well, does this strategy actually work?"

各位可能會想問我： 「這項策略真的有用嗎？」

Yes, it does.

是的，有用。

This map shows you the progress that we've made to date.

從這張地圖可以看出 我們至今的進展。

The green countries believe they've already eliminated trachoma,

綠色的國家相信它們 已經消除了砂眼，

and they have either been through or are in the process of

且它們若不是已經通過 世界衛生組織的驗證，

having that validated by the WHO.

就是正在接受驗證當中。

Countries in yellow have the money they need,

黃色的國家有它們所需的經費，

they have the resources to eliminate trachoma.

及所需的資源可以消滅砂眼。

And some of them are really nearly there.

且當中有些國家已經快要成功。

But the red countries, they don't have enough funding.

但紅色的國家， 它們沒有足夠的資金。

They cannot eliminate trachoma unless they get more.

若無法得到更多的經費 它們就無法消滅砂眼。

And we're quite concerned, though, that the progress to date may stall.

不過，我們十分擔心一件事， 就是至今的進展可能會停滯下來。

So when we were talking to the Audacious ideas guys,

所以，當我們和 「大無畏計畫」的人談論時，

we asked ourselves:

我們問自己：

If we really, really pushed ourselves over the next four or five years

如果在接下來的四或五年， 我們真的用力加把勁

and we had the money,

且經費充足，

what do we think we could achieve?

我們能夠達成什麼？

Well, we believe that we can eliminate trachoma

我們相信我們能夠消滅

in 12 African countries

12 個非洲國家、

and across the Americas

全美洲

and all across the Pacific.

和整個太平洋的砂眼。

And we can make significant progress

而且我們能夠在砂眼問題 擔子最重的兩個國家，

in two countries which have the highest burden of the disease,

即衣索比亞和奈及利亞，

which is Ethiopia and Nigeria.

達成顯著的進展。

And in doing all of that,

如果能做到這些，

we can leverage more than two billion dollars' worth of donated drugs.

我們就能讓價值二十億元的 捐贈藥品發揮更大的效用。

(Applause)

（掌聲）

Now, this map here shows you the impact that we'll have --

這張地圖呈現的是我們 將來會有的影響力──

look how many countries are going green.

看看有多少國家變成綠色了。

And there, you can see progress in Ethiopia and Nigeria.

在那裡，各位可以看到 衣索比亞和奈及利亞的進展。

Now, yes, there are some countries that are still red.

是的，還有一些國家是紅色。

These are mainly countries which are in conflict --

這些國家多半是在衝突中的國家──

places like Yemen, South Sudan -- where it's very difficult to work.

像是葉門、南蘇丹── 在那些地方很難進行這些工作。

So, we have the team, the strategy and the map.

所以，我們有團隊、 有策略、還有地圖。

And we also have the relationships with the governments

還與各個政府維持良好的關係，

so that we can make sure that our program is coordinated

以確保我們的計畫

與其他疾病控制計畫做好協調，

with other disease-control programs,

so that we can be efficient.

這樣我們才能有效率。

Wouldn't it be amazing if we could do this?

如果我們能做到這樣， 不是很了不起嗎？

We'd have trachoma on the run.

我們會把砂眼趕走。

We would be on the home straight

我們僅僅幾步之遙，

to eliminate this disease from the whole world.

就可以讓砂眼從世界上消滅。

But before I finish, I just want to share with you

但在我結束演說之前， 我還想與各位分享

some words from the founder of Sightsavers,

拯救視力組織的創立者所說的話，

a guy called Sir John Wilson.

他是約翰．威爾森爵士。

Now, he was blinded at the age of 12.

他在 12 歲時就失明了。

And he said,

他說：

"People don't go blind by the million.

「百萬人並非突然同時失明。

They go blind one by one."

他們是一個接著一個失明的。」

And in the excitement of being able to say

雖然我們可以很興奮地說，

we've got rid of trachoma for the whole country,

我們整個國家都已經脫離了砂眼，

let's not forget that, actually, this is a devastating disease

但我們也不能忘記， 砂眼是種極具破壞性的疾病，

that destroys the lives of individual people.

它能摧毀一個人的人生。

People like Twiba.

像特威巴這樣的人。

Now, I met Twiba last year in Tanzania.

我是去年在坦尚尼亞 認識特威巴的。

She had had trachoma for as long as she could remember.

從她有記憶以來她就有砂眼。

And a couple of months before I met her, she'd had the operation.

在我認識她的前幾個月， 她動了手術。

It's no exaggeration to say

說她的人生完全翻轉了，

that this had totally transformed her life.

並不誇張。

We'd saved the sight that she had left, and she was free of pain.

我們拯救了她剩下的視力， 她再也不痛苦了。

She could sleep.

她能睡覺了。

She could work, she could socialize.

她能工作，她能社交。

And she said to me,

她對我說：

"I have my life back."

「我重拾我的人生了。」

And it was impossible not to be moved by her story.

無法不被她的故事所感動。

But there are so many Twibas.

但還有好多特威巴。

I want to find all the Twibas,

我想要找到所有的特威巴，

and I don't want anyone to go blind in agony anymore.

我不希望再有人承受失明的痛苦。

Now, you know, there are so many intractable problems in this world.

世界上有好多棘手的問題。

But this is not one of them.

但這個問題並非其中之一。

This is something that we can solve.

我們能解決這個問題。

And we can ensure

且我們能確保

that kids like this can grow up free from the fear of trachoma.

像這樣的孩子也能安心長大， 不用害怕得到砂眼。

So, for the sake of kids like this,

所以，為了這樣的孩子，

and for the sake of people like Twiba,

為了像特威巴的人，

let's get rid of trachoma.

咱們來消滅砂眼吧。

Do you think we can?

你們認為我們能做到嗎？

Well, yeah, if we really, really want to.

可以的，如果我們 真的真的很想做的話。

Yes, we can.

是的，我們可以的。

So thank you.

謝謝各位。

(Applause)

（掌聲）