TEDGlobal 2007
Ernest Madu: World-class health care
Ernest Madu o zdravstvenoj skrbi svjetske klase
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Dr. Enest Madu vodi Karipski Institut za srce u Kingstonu na Jamajci gdje dokazuje da je -- uz pažljiv dizajn, pametan odabir tehnike i istinsku želju za služenje korisnicima -- moguće pružiti zdravstvenu skrb svjetske klase u zemljama u razvoju.
Ernest Madu - Cardiologist
Ernest Madu founded the Heart Institute of the Caribbean, a revolutionary clinic for cardiovascular diseases in Kingston, Jamaica -- revolutionary for offering first-class health care in a developing nation. His next stop: Nigeria. Full bio
Ernest Madu founded the Heart Institute of the Caribbean, a revolutionary clinic for cardiovascular diseases in Kingston, Jamaica -- revolutionary for offering first-class health care in a developing nation. His next stop: Nigeria. Full bio
Double-click the English transcript below to play the video.
00:19
It is interesting that in the United States,
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Zanimljivo je da se u Sjedinjenim Američkim Državama,
00:21
the most significant health-care budget
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najznačajni dio proračuna zdravstvene skrbi
00:23
goes to cardiovascular disease care, whether it's private or public.
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troši na skrb o kardiovaskularnim bolestima, bila ona privatna ili javna.
00:29
There's no comparison at all.
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Nema usporedbe s tim.
00:32
In Africa -- where it is a major killer -- it is totally ignored.
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U Africi -- gdje je značajan uzrok smrtnosti -- ona je potpuno zapostavljena.
00:37
And that situation cannot be right. We must do something about it.
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Takvo stanje ne smije biti prihvatljivo. Moramo nešto poduzeti oko toga.
00:43
A health status of a nation parallels development of that nation.
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Zdravstveni status naroda oslikava razvijenost te iste države.
00:49
17 million people die every year from heart disease.
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Srčana bolest odgovorna je za smrt 17 milijuna ljudi godišnje.
00:53
32 million heart attacks and strokes occur.
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Svake godine događa se 32 milijuna srčanih infarkta.
00:56
Most of this is in developing countries, and the majority is in Africa.
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Većina njih je u zemljama u razvoju, a ponajviše u Africi.
01:01
85 percent of global disease burden for cardiovascular disease
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85 posto troškova kardiovaskularne bolesti na svjetskoj razini
01:05
is in developing countries -- not in the West --
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snose zemlje u razvoju -- ne zapadne zemlje --
01:08
and yet 90 percent of the resources are in the West.
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i unatoč tome 90 posto raspoloživih sredstava nalaze se u zapadnim zemljama.
01:13
Who is at risk? People like you.
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Tko je time ugrožen? Ljudi poput Vas.
01:16
It's not just the Africans that should be concerned about that.
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Afrikanci nisu jedini koji bi trebali biti zabrinuti ovim stanjem.
01:19
All friends of Africa, that will have reason to be in Africa at some point in time,
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Svi prijatelji Afrike, koji će imati razloga biti u Africi u nekom trenutku,
01:25
should be very concerned about this deplorable situation.
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bi trebali biti iznimno zabrinuti ovim žalosnim stanjem.
01:28
Has anyone here wondered what will happen
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Je li se itko od vas upitao što će se dogoditi
01:31
if you go back to your room at night,
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ako se vratite u svoju sobu navečer
01:33
and you start getting chest pains, shortness of breath, sweating?
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i pojavi Vam se bol u prsima, praćena nedostatkom daha i znojenjem?
01:37
You're having a heart attack. What are you going to do?
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Naime, imate srčani udar. Što ćete tada poduzeti?
01:41
Will you fly back to the U.S., Germany, Europe?
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Hoćete li odletjeti u SAD, Njemačku, Europu?
01:46
No, you will die. 50 percent will die within 24 hours, if not treated.
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Ne, umrijet ćete. U prva 24 sata umrijet će 50 posto neliječenih.
01:51
This is what's going on.
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Eto, o tome se radi.
01:54
In a look at the map of the U.S. -- the graph here,
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Kada pogledamo kartu SAD-a -- odnosno ovaj grafikon,
01:57
10 million people here, 10 million here.
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deset milijuna ljudi s lijeve strane (SAD) i deset milijuna ljudi s desne (Nigerija).
02:00
By the time you get to 50, it's almost no one left in Nigeria --
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Kada dođete do 50 godina, gotovo da nema ljudi u Nigeriji.
02:05
life expectancy is 47.
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Očekivana životna dob je 47 godina.
02:07
It's not because some people don't survive childhood illnesses --
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To nije zato što ljudi ne prežive dječje bolesti --
02:12
they do -- but they do not survive after the time that they reach
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naime oni prežive -- ali ne prežive nakon što dosegnu
02:18
about 45 years old and 50 years old.
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dob od oko 45 do 50 godina starosti.
02:22
And those are the times they're most productive.
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Ljudi su upravo u to vrijeme najpoduzetniji.
02:24
Those are the times that they should be contributing
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Upravo tada trebaju pridonositi
02:26
to Africa's development. But they're not there.
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razvoju Afrike. Nažalost oni tada više nisu tu.
02:30
The best way to spiral into a cycle of poverty is to kill the parents.
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Najjednostavniji način za ulazak u krug siromaštva je uklanjanjem roditelja.
02:35
If you cannot secure the parents,
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Ako ne možete zaštiti roditelje,
02:38
you cannot guarantee the security of the African child.
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ne možete ni pružiti sigurnost djeci Afrike.
02:40
What are the risk factors?
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Koji su faktori rizika?
02:43
It's very well known. I'm not going to spend a lot of time on those.
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To se dobro zna. Neću se puno zadržavati na ovome.
02:45
These are just for information:
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Ovo je samo informativno:
02:47
hypertension, diabetes, obesity, lack of exercise. The usual suspects.
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hipertenzija, šećerna bolest, pretilost, nedostatak tjelesnog vježbanja. Uobičajeni osumnjičenici.
02:52
Right here in Tanzania, 30 percent of individuals have hypertension.
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Upravo ovdje u Tanzaniji, 30 posto ljudi boluje od hipertenzije.
02:58
20 percent are getting treated.
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Samo 20 posto njih je liječeno.
03:00
Only less than one percent are adequately treated.
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Manje od 1 posto je liječeno na odgovarajući način.
03:03
If we can treat hypertension alone in Africa,
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Kad bismo liječiti samo hipertenziju u Africi,
03:06
we'll save 250,000 lives a year. That's quite significant!
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spasiti ćemo 250,000 života godišnje. To je prilično značajno!
03:11
Easy to treat. Look at the situation in Mauritius.
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Liječenje je lako moguće. Pogledajmo stanje na Mauricijusu.
03:14
In eight short years -- we're here talking about HIV, malaria,
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U osam kratkih godina -- riječ je o HIV-u, malariji,
03:19
which is all good.
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što je sasvim u redu.
03:20
We cannot make the mistakes we've made with malaria and HIV.
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Ne smijemo napraviti pogreške kakve smo počinili s malarijom i HIV-om.
03:24
In eight short years, non-communicable diseases
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U osam kratkih godina, neprenosive bolesti
03:27
will become the leading causes of death in Africa.
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će postati vodeći uzrok smrti u Africi.
03:31
That is something to keep in mind. We can't deal with it with situations like this.
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To treba imati na umu. S tim se ne možemo nositi u ovakvim uvjetima.
03:36
This is a typical African hospital. We can't depend on the elites --
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Ovo je tipična bolnica u Africi. Ne možemo se uzdati u elite --
03:40
they go to USA, Germany, U.K. for treatment. Unbelievable.
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oni se odlaze liječiti u SAD, Njemačku i Ujedinjeno Kraljevstvo. Nevjerovatno.
03:48
You can't depend on foreign aid alone.
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Ne možemo ni ovisiti samo o stranoj pomoći.
03:50
Here is the situation: countries are turning inwards.
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Situacija je sljedeća: države se okreću prema sebi.
03:53
Post-9/11, [the] United States has had a lot of trouble
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Nakon 11. rujna Sjedinjene Američke Države su imale velike vlastite probleme
03:56
to deal with, their own internal issues.
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kojima su se morali baviti.
03:58
So, they spend their money trying to fix those problems.
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Pa su i trošili svoj novac pokušavajući rješiti te probleme.
04:02
You can't rightly -- it's not their responsibility,
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Ne može od njih ni očekivati -- to nije njihova odgovornost,
04:05
it is my responsibility. I have to take care of my own problems.
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to je moja odgovornost. Moram se sam pobrinuti za svoje probleme.
04:09
If they help, that's good! But that is not my expectation.
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Ako pomognu, to bi bilo odlično! No to od njih ne očekujem.
04:14
These worsening indices of health care or health studies in Africa
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Sve lošiji indikatori zdravstvene skrbi i zdravstvenih studija u Africi
04:17
demand a new look. We cannot keep on doing things
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zahtjevaju novi pogled na problem. Ne možemo nastaviti raditi
04:21
the way we've always done them.
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kako smo uvijek radili.
04:22
If they have not worked, we have to look for alternative solutions.
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Ako nešto nije funkcioniralo, moramo potražiti alternativna rješenja.
04:26
I'm here to talk to you about solutions.
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Ovdje sam da bih govorio o rješenjima.
04:28
This has been -- what has been a difficult sign to some of us.
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Upravo je to bilo pitanje velike važnosti nekima od nas.
04:33
Several years ago, we started thinking about it.
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O tome smo počeli razmišljati prije nekoliko godina.
04:36
Everyone knows the problem. No one knows what the solutions are.
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Svi znaju za problem. Nitko ne zna koja su rješenja.
04:40
We decided that we needed to put our money where our mouth is.
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Odlučili smo uložiti u ono u što smo vjerovali i govorili.
04:45
Everyone is ready to throw in money,
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Svi su spremni dati novac
04:48
in terms of free money aid to developing countries.
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u obliku strane pomoći za zemlje u razvoju.
04:51
Talk about sustainable investment, no one is interested.
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Spomenite održivo ulaganje! To nikoga ne zanima.
04:55
You can't raise money.
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Za to ne možete skupiti novac.
04:57
I have done businesses in healthcare in the United States --
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Radio sam kao dio zdravstvenog sustava u Sjedinjenim Američkim Državama --
05:00
I live in Nashville, Tennessee, health care capital of America.
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Živim u Nashvilleu, Tennessee koji se diči kao glavni grad zdravstvene skrbi Amerike.
05:03
[It's] very easy to raise money for health-care ventures.
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Lako je skupiti novac za zdravstvena ulaganja.
05:06
But start telling them, you know,
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Ali ako krenete s pričom da
05:08
we're going to try to do it in Nigeria -- everyone runs away.
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to želite pokušati ostvariti u Nigeriji -- svi bježe.
05:10
That is totally wrong. Those of you in the audience here,
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To je potpuno krivo. Oni među vama u publici ovdje,
05:16
if you want to help Africa, invest money in sustainable development.
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koji želite pomoći Africi: uložite novac u održivi razvoj.
05:19
Let me lead you through a day in the life of the Heart Institute,
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Dopustite da Vas provedem kroz jedan dan života Instituta za srce
05:23
so you get a glimpse of what we do,
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pa ćete imati mali uvid čime se bavimo,
05:25
and I'll talk a little bit more about it.
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stoga ću pričati malo više o tome.
06:28
What we have done is to show that high-quality health care,
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Zapravo smo uspjeli pokazati da se zdravstvena skrb visoke kvalitete,
06:34
comparable to the best anywhere in the world,
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usporediva s najboljom bilo gdje u svijetu,
06:36
can be done in a developing country environment.
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može pružati i u zemljama u razvoju.
06:39
We have 25 positions right now -- all of them trained,
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Trenutno imamo 25 zaposlenih -- svi redom obučeni,
06:44
board certified in the USA, Canada or Britain.
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i ovlašteni od strane službenih tijela u SAD-u, Kanadi ili Velikoj Britaniji.
06:47
We have every modality that can be done in Vanderbilt,
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Pružamo sve usluge koje možete dobiti u klinici Vanderbilt,
06:51
Cleveland Clinic -- everywhere in the U.S. --
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iz Clevelanda -- zapravo bilo gdje u SAD-u --
06:54
and we do it for about 10 percent of the cost
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i to pružamo za otprilike 10 posto troškova
06:57
that you will need to do those things in the United States.
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koje biste imali kada biste te usluge koristili u Sjedinjenim Američkim Državama.
07:01
(Applause)
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(Pljesak)
07:06
Additionally, we have a policy
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Također imamo politiku
07:08
that no one is ever turned away because of ability to pay.
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koja kaže: "Nitko neće biti odbijen zbog nemogućnosti plaćanja troškova."
07:12
We take care of everyone.
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Mi se brinemo za svakoga.
07:14
(Applause)
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(Pljesak)
07:15
Whether you have one dollar, two dollars -- it doesn't matter.
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Bilo da imate jedan dolar ili dva -- nije bitno.
07:18
And I will tell you how we're able to do it.
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Sada ću Vam reći kako to postižemo.
07:21
We make sure that we select our equipment properly.
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Pažljivo odabiremo opremu.
07:25
We go for modular units. Units that have multi-modality functions
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Odabiremo modularnu opremu. Opremu koja ima višenamjensku primjenu
07:29
have modular components. Easy to repair, and because of that,
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ima dijelove koji se mogu mijenjati. Takva oprema je lako popravljiva i u tom smislu
07:34
we do not take things that are not durable and cannot last.
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ne odabiremo opremu koja nije izdržljiva i ne može dugo trajati.
07:38
We emphasize training,
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Poseban naglasak stavljamo na obuku,
07:40
and we make sure that this process is regenerative.
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i brinemo se da se taj proces održava dalje.
07:43
Very soon we will all be dead and gone, but the problems will stay,
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Naime, vrlo brzo mi ćemo svi umrijeti, ali problemi će ostati
07:47
unless we have people taking over from where we stopped.
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ukoliko ne bude ljudi koji će nastaviti tamo gdje smo mi stali.
07:51
We made sure that we produced some things ourselves.
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Osigurali smo i vlastitu proizvodnju pojedinih stvari.
07:54
We do not buy unit doses of radiopharmaceuticals.
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Ne kupujemo jedinične doze radioaktivnih pripravaka.
07:57
We get the generators from the companies.
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Umjesto toga nabavljamo generatore tih istih pripravaka.
08:00
We manufacture them in-house, ourselves. That keeps the costs down.
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Osobno ih proizvodimo unutar Instituta. To uvelike umanjuje troškove.
08:04
So, for a radiopharmaceutical in the U.S. --
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Tako za radioaktivni pripravak u SAD-u --
08:07
that you'll get a unit dose for 250 dollars --
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koji se po jediničnoj dozi plaća 250 dolara --
08:10
when we're finished manufacturing it in-house,
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nakon što ga proizvedemo unutar Instituta,
08:12
we come at a price of about two dollars.
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potrošimo samo oko dva dolara.
08:14
(Applause)
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(Pljesak)
08:18
We recognize that the only way to bridge the gap
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Jedini način za premostiti jaz između
08:21
between the rich and poor countries
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bogatih i siromašnih zemalja
08:24
is through education and technology.
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je putem obrazovanja i tehnologije.
08:27
All these problems we're talking about --
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Svi ovdje spomeniti problemi --
08:29
if we bring development, they will all disappear.
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će nestati ako omogućimo razvoj.
08:32
Technology is a great equalizer. How do we make it work?
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Tehnologija ima snagu uravnoteženja. Kako to možemo ostvariti?
08:37
It's been proved: self-care is cost-effective.
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Dokazano je: samoupravljanje je troškovno učinkovito.
08:39
It extends opportunity to the rural centers,
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Pruža priliku ruralnim središtima,
08:43
and we can use expertise in a very smart way.
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a na taj način možemo i vrlo mudro iskorisititi stručnjake.
08:46
This is the way our centers are set up.
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Upravo tako su i uspostavljeni naši centri.
08:49
We currently have three locations in the Caribbean,
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Trenutno imamo tri lokacije na Karibima,
08:52
and we're planning a fourth one.
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a planiramo i četvrtu.
08:54
And we have now decided to go into Africa.
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Sada smo odlučili otići u Afriku.
08:57
We will be doing the West African Heart Institute
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Realizirati ćemo Institut za srce Zapadne Afrike
09:00
in Port Harcourt, Nigeria. That project will be starting
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u Port Harcourtu u Nigeriji. Ovaj projekt počinje
09:03
within the next few months. We hope to open in 2008-09.
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kroz sljedećih nekoliko mjeseci. Nadamo se otvaranju u 2008/09. godini.
09:07
And we will do other centers.
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Izgraditi ćemo i druge centre.
09:09
This model can be adapted to every disease process.
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Ovaj model možemo primjeniti na svaki skup bolesti.
09:13
All the units, all the centers, are linked
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Sve jedinice, svi centri su povezani
09:15
through a switched hub to a central server,
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računalnom mrežom na središnji server,
09:19
and all the images are populated to review stations.
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i sve su slike prebačene na računala specijalistima.
09:22
And we designed this telemedicine solution. It's proprietary to us,
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Sami smo osmislili ovo telemedicinsko rješenje. Vlasnička prava pripadaju nama
09:27
and we are happy to share what we have learned with anyone
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i rado ćemo podijeliti što smo naučili sa svima
09:30
who is interested in doing it. You can still be profitable.
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koji su zainteresirani. Svejedno se može biti profitabilan.
09:35
We make sure that the telemedicine platform gives access
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Telemedicinskoj platformi mogu pristupiti
09:41
to expert medical specialists anywhere in the world,
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stručni medicinski specijalisti diljem svijeta,
09:45
just by a click of the button.
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jednostavnim klikom gumba.
09:47
I'll lead you through, to see how this happens.
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Provesti ću Vas kroz taj proces.
09:50
This is at the Heart Institute. The doctors from anywhere can log in.
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Ovo je web stranica Instituta za srce. Liječnici joj mogu pristupiti od bilo kuda.
09:54
I can call you in Switzerland and say, "Listen, go into our system.
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Mogu Vas nazvati u Švicarsku i reći: "Čuj, uđi u naš sustav.
09:58
Look at Mrs. Jones. Look at the study, tell me what you think."
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Pogledaj gđu. Jones. Pregledaj njezin slučaj i daj mi svoje mišljenje."
10:02
They'll give me that information,
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Kada primim povratnu informaciju,
10:04
and we'll make the care of the patient better.
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moći ću se bolje pobriniti za pacijenta.
10:07
The patient doesn't have to travel.
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Pacijent ne mora putovati.
10:09
He doesn't have to experience the anxiety of not knowing
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Ne mora iskusiti tjeskobu neznanja
10:12
because of limited expertise.
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zbog manjka stručnjaka.
10:16
We also use [an] electronic medical record system.
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Također koristimo elektronički sustav za pohranu medicinskih zapisa.
10:19
I'm happy to say that the things we have implemented --
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Sretan sam što mogu izjaviti da stvari koje smo uveli --
10:23
80 percent of U.S. practices do not have them, and yet the technology is there.
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nema u 80 posto službi u SAD-u, iako je tehnologija dostupna.
10:30
But you know, they have that luxury.
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Naravno kod njih je to moguće.
10:31
Because if you can't get it in Nashville, you can travel to Birmingham,
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Ako im nešto nije dostupno u Nashvilleu, mogu jednostavno otputovati u Birmingham,
10:36
two hours away, and you'll get it. If you can't get it in Cleveland,
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samo dva sata udaljen i tamo će dobiti tu uslugu. Ako nešto ne možete dobiti u Clevelandu,
10:39
you can go to Cincinnati. We don't have that luxury,
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možete otići u Cincinnati. Mi nemamo taj luksuz
10:42
so we have to make it happen.
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pa to moramo sami osigurati.
10:44
When we do it, we will put the cost of care down.
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Na taj ćemo način smanjiti troškove skrbi.
10:48
And we'll extend it to the rural centers and make it affordable.
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Osigurati ćemo isto za ruralna središta i tako ih učiniti dostupnima.
10:52
And everyone will get the care they deserve.
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Svima ćemo pružiti skrb koju zaslužuju.
10:55
It cannot just be technology, we recognize that.
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Tehnologija nije jedino rješenje i toga smo svjesni.
10:59
Prevention must be part of the solution -- we emphasize that.
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Bitan naglasak je i na prevenciji kao dijelu rješenja.
11:03
But, you know, you have to tell people what can be done.
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Naravno ljudima se mora reći što se može napraviti.
11:07
It's not possible to tell people to do what is going to be expensive,
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Ne može se im se reći da rade nešto što će biti skupo.
11:10
and they go home and can't do it.
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jer kad dođu kući neće to moći napraviti.
11:13
They need to be alive, they need to feed.
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Moraju preživjeti, moraju se prehraniti.
11:15
We recommend exercise as the most effective, simple, easy thing to do.
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Preporučujemo tjelesnu vježbu kao najučinkovitiju, najjednostavniju i najlakšu stvar koju mogu učiniti.
11:21
We have had walks every year -- every March, April.
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Svake godine održavamo šetnje -- svakog ožujka i travnja.
11:25
We form people into groups and make them go into challenges.
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Organiziramo se u grupe i zatim prolazimo izazove.
11:30
Which group loses the most weight, we give them prizes.
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Grupu koja izgubi najviše tjelesne težine nagrađujemo.
11:33
Which groups record more walking distance by pedometer,
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Grupu koja propješači najveću udaljenost mjerenu pedometrom
11:37
we give them prizes. We do this constantly.
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također nagrađujemo. To opetovano radimo.
11:40
We encourage them to bring children.
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Potičemo dovođenje djece.
11:42
That way we start exposing the children from very early on,
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Tako djecu od vrlo rane dobi izlažemo
11:45
on what these issues are. Because once they learn it,
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ovim problemima. Ukoliko to usvoje,
11:49
they will stay with it. In doing this we have created
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ostati će ustrajni u tome. Ovim postupcima smo stvorili
11:53
at least 100 skilled jobs in Jamaica alone,
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bar stotinu kvalificiranih poslova na Jamajci samoj,
11:56
and these are physicians with expertise and special training.
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a nekih od tih su liječnici stručnjaci sa specijalističkom obukom.
12:00
We have taken care of over 1,000 indigent patients that could have died,
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Pružili smo skrb preko tisuću siromašnih pacijenata koji bi inače umrli,
12:04
including four free pacemakers in patients
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kao i ugradnju četiri besplatna pejsmejkera pacijentima
12:06
with complete heart block. For those that understand cardiology,
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s potpunim srčanim blokom. Za one koji su upućeni u kardiologiju,
12:10
complete heart block means certain death.
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potpuni srčani blok znači sigurnu smrt.
12:13
If you don't get this pacemaker, you will be dead.
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Ako vam se ne ugradi pejsmejker, umrijet ćete.
12:16
So we are pleased with that.
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Time smo iznimno zadovoljni.
12:17
Indirectly, we have saved the government of Jamaica five million dollars
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Posredno smo uštedjeli 5 milijuna dolara vladi Jamajke
12:21
from people that would have gone to Miami or Atlanta for care.
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preko ljudi koji bi inače išli na liječenje u Miami ili Atlantu.
12:26
And we've hopefully saved a lot of lives.
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Usput smo, nadamo se, spasili puno života.
12:29
By the end of this year, we would have contributed over one million dollars
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Do kraja ove godine ćemo pokloniti preko milijun dolara
12:34
in indigent care. In the first four months, it's been 340,000 dollars,
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za skrb siromašnih. U prva četiri mjeseca smo ostvarili 340,000 dolara,
12:38
averaging 85,000 dollars a month. The government will not do that,
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što izlazi 85,000 dolara mjesečno. Vlast to neće učiniti,
12:44
because they have competing needs.
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jer imaju i druge potrebe.
12:45
They need to put resources elsewhere. But we can still do it.
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Sredstva moraju usmjeriti drugdje. Unatoč tome možemo uspjeti.
12:48
People say, "How can you do that?" This is how we can do that.
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Ljudi pitaju: "Kako je to moguće?" Na sljedeći način.
12:53
At least 4,000 rich Jamaicans that were heading to Miami for treatment
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Barem 4,000 bogatih Jamajčana, koji su išli u Miami na liječenje,
12:58
have self-confessed that they did not go to Miami
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sami priznaju da to više ne rade,
13:03
because of the Heart Institute of the Caribbean.
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upravo zbog Karipskog Instituta za srce.
13:05
And, if they went to Miami, they will spend significantly more --
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Da su otišli u Miami potrošili bi znatno više --
13:10
eight to 10 times more. And they feel happy spending it at home,
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osam do deset puta više. Rado će trošiti novac kod kuće,
13:15
getting the same quality of care.
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za skrb iste kvalitete.
13:16
And for that money -- for every one patient that has the money to pay,
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S tim novcem -- za svakog pacijenta koji plati --
13:22
it gives us an opportunity to take care of at least four people
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možemo se pobriniti za bar četvero ljudi
13:25
that do not have the resources to pay.
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koji nemaju sredstva za plaćanje.
13:28
(Applause)
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(Pljesak)
13:33
For this to work, this progress must be sustainable.
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Da bi to sve funkcioniralo, moramo imati održivi razvoj.
13:36
So, we emphasize training. Training is critical.
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Zato naglašavamo obuku. Obuka je presudna.
13:39
We have gone further: we have formed a relationship
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Otišli smo korak dalje: ostvarili smo suradnju
13:43
with the University of Technology, Jamaica,
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sa Sveučilištem Tehnologije, Jamajka,
13:46
where I now have an appointment.
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gdje sam dobio mjesto.
13:47
And we are starting a biomedical engineering program,
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Započeli smo biomedicinski inžinjerski program,
13:50
so that we will train people locally, who can repair that equipment.
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kroz koji ćemo obučavati lokalne ljude pa će moći popravljati opremu.
13:55
That way we're not going to deal with obsolescence and all those kinds of issues.
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Time ćemo se pobrinuti za zastarjevanje i probleme koji usput nastaju.
13:59
We're also starting ancillary health-care technology training programs --
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Pokrećemo i dodatne programe obuke za zdravstvenu tehnologiju --
14:04
training people in echocardiography, cardiac ultrasound,
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ljude obučavamo za ehokardiografiju, ultrazvuk srca,
14:08
those kinds of things. Now, with that kind of training,
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i slične stvari. Uz ovakvu obuku,
14:11
it gives people motivation.
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ljudi su motivirani.
14:13
Because now they will get a bachelors degree in medical imaging
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Mogu postati bakalaureati iz područja medicinskih snimki
14:16
and all that kind of stuff. In the process, I want you to just hear
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i tome srodnih stvari. Poslušajte što su tijekom tog procesa
14:22
from the trainees themselves what it has meant for them.
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rekli sami polaznici o tome što im je to značilo.
14:26
(Video) Dr. Jason Topping: My name is Jason Topping.
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(Video snimak) Zovem se Jason Topping,
14:27
I'm a senior resident in anesthesia in intensive care
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stariji sam specijalist anestezije na intenzivnoj skrbi
14:30
at the University Hospital of the West Indies.
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Sveučilišne bolnice Zapadnoindijskih otoka (Kariba).
14:33
I came to the Heart Institute in 2006,
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U Institut za srce sam došao 2006. godine
14:36
as part of my elective in my anesthesia and intensive care program.
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u sklopu izbornog dijela programa anestezije i intenzivne njege.
14:41
I spent three months at the Heart Institute.
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Tri mjeseca sam proveo na Institutu az srce.
14:44
There's been no doubt around my colleagues
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Moji kolege nisu sumnjali
14:46
about the utility of the training I received here,
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o korisnosti obuke koju sam primio ovdje,
14:49
and I think there's been an increased interest now in --
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i mislim da postoji sve veći interes
14:54
particularly in echocardiography and its use in our setting.
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osobito za ehokardiografiju i njezinu primjenu u našim uvjetima.
14:58
Sharon Lazarus: I am an echocardiographer at the Heart Institute of the Caribbean,
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Sharon Lazarus: Ehokardiografkinja sam na Karipskom Institutu za srce
15:03
since the past two years. I received training at this institution.
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protekle dvije godine. U ovoj ustanovi sam i obučena.
15:08
I think this aspect of training in cardiology
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Ovaj aspekt obuke iz kardiologije
15:13
that the Heart Institute of the Caribbean has introduced in Jamaica
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koji je na Jamajku uveo Karipski Institut za srce smatram
15:17
is very important in terms of diagnosing cardiac diseases.
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vrlo važnim u svrhu dijagnosticiranja srčanih bolesti.
15:26
Ernest Madu: The lesson in this is that it can be done, and it can be sustained,
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Ernest Madu: Želim da ovo ponesete sa sobom: "Ostvarivo je i održivo
15:31
and you can make it possible for everyone.
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i možete to pružiti svima."
15:35
Who are we to decide that poor people cannot get the best care?
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Tko smo mi da odlučimo da siromašni ljudi ne mogu dobiti najbolju moguću skrb?
15:39
When have you been appointed to play God?
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Kada smo postavljeni za Svemogućeg?
15:43
It is not my decision. My job is to make sure that every person,
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To nije moja odluka. Moj je posao osigurati da svaka osoba,
15:48
no matter what fate has assigned to you, will have the opportunity
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bez obzira na sudbinu, ima priliku
15:53
to get the best quality health care in life.
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za najbolju moguću zdravstvenu skrb tijekom života.
15:56
Next stop is West African Heart Institute,
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Sljedeća postaja je Institut za srce Zapadne Afrike,
16:00
that we are going to be doing in Port Harcourt, Nigeria,
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koji ćemo graditi u Post Harcourtu u Nigeriji,
16:03
as I said before. We will do other centers across West Africa.
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kao što sam već rekao. Graditi ćemo centre diljem Zapadne Afrike.
16:07
We will extend the same system into other areas,
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Proširiti ćemo isti sustav i na druga područja,
16:12
like dialysis treatment.
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kao što su dijaliza, odnosno bubrežna oboljenja.
16:13
And anyone who is interested in doing it in any health care situation,
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Bilo kome tko je zainteresiran to ostvariti u bilo kojem dijelu zdravstvenog sustava,
16:17
we will be happy to assist you and tell you how we've done it,
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spremni smo pomoći i podijeliti s vama kako smo to ostvarili
16:22
and how you can do it. If we do this,
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i kako to vi možete napraviti. Ako ovo učinimo
16:26
we can change the face of health care in Africa.
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možemo promijeniti naličje zdravstvene skrbi u Africi.
16:30
Africa has been good to us; it is time for us to give back to Africa.
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Afrika je bila dobra prema nama; vrijeme je da uzvratimo Africi.
16:34
I am going. Those who want to come,
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Ja budem. One koji također žele pomoći,
16:37
I welcome you to come along with me.
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pozvani su poći sa mnom.
16:39
Thank you.
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Hvala Vam.
16:41
(Applause)
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(Pljesak)
ABOUT THE SPEAKER
Ernest Madu - CardiologistErnest Madu founded the Heart Institute of the Caribbean, a revolutionary clinic for cardiovascular diseases in Kingston, Jamaica -- revolutionary for offering first-class health care in a developing nation. His next stop: Nigeria.
Why you should listen
Dr. Ernest Chijioke Madu believes that people in the developing world have a right to world-class health care. At his three Heart Institute of the Caribbean clinics --in Kingston and Mandeville, Jamaica, and in the Cayman Islands -- he delivers more than $1 million a year in free or reduced-care treatment, a significant contribution in an area where 56% of hospital deaths are caused by cardiovascular disease.
Now Dr. Madu is hoping to transfer HIC's mission and achievements into other low-resource nations. His next target is Nigeria, his home country, where the Heart Institute of West Africa is scheduled to open in 2009. Though AIDS and malaria are huge factors for Africa, Dr. Madu emphasizes the importance of treating cardiovascular disease, which is the second leading cause of death in sub-Saharan Africa, after HIV/AIDS, and the leading cause of death for people over 30.
Dr. Madu's work on noninvasive evaluation of coronary artery disease in obese individuals has become a standard evaluating tool.
Ernest Madu | Speaker | TED.com