TEDGlobal 2007
Ernest Madu: World-class health care
Ernest Madu despre asistenta medicala la nivel mondial.
Filmed:
Readability: 3.7
426,962 views
Dr. Ernest Madu conduce Institutul de Inima pentru Caraibe in Kingston, Jamaica, unde dovedeste printr-un design atent, alegeri tehnice inteligente si o adevarata dorinta de deservire, ca este posibil sa se ofere asistenta medicala la un nivel inalt si in tarile in dezvoltare.
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,
0
1000
2000
Este interesant ca in Statele Unite,
00:21
the most significant health-care budget
1
3000
2000
cel mai semnificativ buget pentru asistenta medicala
00:23
goes to cardiovascular disease care, whether it's private or public.
2
5000
6000
se acorda in cazul bolilor cardiovasculare, indiferent de sectorul privat sau cel public.
00:29
There's no comparison at all.
3
11000
3000
Nici nu se poate compara.
00:32
In Africa -- where it is a major killer -- it is totally ignored.
4
14000
5000
In Africa, unde produc enorm de multe decese, sunt ignorate in totalitate.
00:37
And that situation cannot be right. We must do something about it.
5
19000
6000
Aceasta situatie nu poate fi corecta. Trebuie sa facem ceva in privinta asta.
00:43
A health status of a nation parallels development of that nation.
6
25000
6000
Starea sanatatii unei natiuni reflecta nivelul de dezvoltare al acesteia.
00:49
17 million people die every year from heart disease.
7
31000
4000
17 milioane de oameni mor anual din cauza afectiunilor cardiace.
00:53
32 million heart attacks and strokes occur.
8
35000
3000
Se inregistreaza 32 milioane de cazuri de infarct si accidente vasculare.
00:56
Most of this is in developing countries, and the majority is in Africa.
9
38000
5000
Toate au loc in tarile in dezvoltare, majoritatea in Africa.
01:01
85 percent of global disease burden for cardiovascular disease
10
43000
4000
85% din cazurile raportate la nivel mondial de boli cardiovasculare
01:05
is in developing countries -- not in the West --
11
47000
3000
sunt raportate in tarile in dezvoltare, nu in cele vestice,
01:08
and yet 90 percent of the resources are in the West.
12
50000
5000
si totusi 90% din resursele alocate pentru aceasta sunt in tarile vestice.
01:13
Who is at risk? People like you.
13
55000
3000
Cine se afla in risc? Oamenii ca voi.
01:16
It's not just the Africans that should be concerned about that.
14
58000
3000
Nu doar africanii trebuie sa fie preocupati de asta.
01:19
All friends of Africa, that will have reason to be in Africa at some point in time,
15
61000
6000
Orice prieten al Africii, care ar avea un motiv sa se afle in Africa la un moment dat,
01:25
should be very concerned about this deplorable situation.
16
67000
3000
ar trebui sa se gandeasca bine la aceasta situatie deplorabila.
01:28
Has anyone here wondered what will happen
17
70000
3000
Si-a pus cineva intrebarea ce se va intampla
01:31
if you go back to your room at night,
18
73000
2000
daca te intorci in camera ta noaptea
01:33
and you start getting chest pains, shortness of breath, sweating?
19
75000
4000
si incepi sa acuzi dureri de piept, respiratie greoaie, transpiratii?
01:37
You're having a heart attack. What are you going to do?
20
79000
4000
Inseamna ca faci infarct. Ce optiuni ai?
01:41
Will you fly back to the U.S., Germany, Europe?
21
83000
5000
Sa zbori inapoi in SUA, Germania, Europa?
01:46
No, you will die. 50 percent will die within 24 hours, if not treated.
22
88000
5000
Nu, vei muri. 50% din persoane mor in 24 de ore daca nu primesc ingrijiri.
01:51
This is what's going on.
23
93000
3000
Asta se intampla.
01:54
In a look at the map of the U.S. -- the graph here,
24
96000
3000
Sa privim harta Statelor Unite -- din graficul acesta
01:57
10 million people here, 10 million here.
25
99000
3000
10 milioane de oameni aici, 10 milioane dincoace.
02:00
By the time you get to 50, it's almost no one left in Nigeria --
26
102000
5000
Cand ajungi la varsta de 50 de ani, nu mai ramane aproape nimeni in Nigeria --
02:05
life expectancy is 47.
27
107000
2000
speranta de viata e de 47 de ani.
02:07
It's not because some people don't survive childhood illnesses --
28
109000
5000
Si nu e fiindca unele persoane nu supravietuiesc unor boli din copilarie --
02:12
they do -- but they do not survive after the time that they reach
29
114000
6000
ei supravietuiesc - insa nu supravietuiesc
02:18
about 45 years old and 50 years old.
30
120000
4000
dupa ce ajung la varsta de 45 sau 50 de ani.
02:22
And those are the times they're most productive.
31
124000
2000
Si asta e varsta la care oamenii sunt cei mai productivi.
02:24
Those are the times that they should be contributing
32
126000
2000
E varsta cand ar trebui sa contribuie
02:26
to Africa's development. But they're not there.
33
128000
4000
la dezvoltarea Africii. Dar ei lipsesc.
02:30
The best way to spiral into a cycle of poverty is to kill the parents.
34
132000
5000
Cea mai buna metoda de a cadea intr-un ciclu al saraciei e sa ucizi categoria parintilor.
02:35
If you cannot secure the parents,
35
137000
3000
Daca parintii nu sunt salvati
02:38
you cannot guarantee the security of the African child.
36
140000
2000
nu poti garanta securitatea copilului african.
02:40
What are the risk factors?
37
142000
3000
Care sunt factorii de risc?
02:43
It's very well known. I'm not going to spend a lot of time on those.
38
145000
2000
Se stie foarte bine. Nu o sa intru in detalii asupra acestora.
02:45
These are just for information:
39
147000
2000
Sunt doar pentru informarea voastra:
02:47
hypertension, diabetes, obesity, lack of exercise. The usual suspects.
40
149000
5000
hipertensiunea, diabetul, obezitatea, lipsa de exercitiu. Suspiciunile obisnuite.
02:52
Right here in Tanzania, 30 percent of individuals have hypertension.
41
154000
6000
Chiar aici in Tanzania, 30% din populatie are hipertensiune.
02:58
20 percent are getting treated.
42
160000
2000
20% primesc ingrijiri medicale.
03:00
Only less than one percent are adequately treated.
43
162000
3000
Insa mai putin de 1% sunt tratati cum trebuie.
03:03
If we can treat hypertension alone in Africa,
44
165000
3000
Daca am putea trata numai hipertensiunea in Africa,
03:06
we'll save 250,000 lives a year. That's quite significant!
45
168000
5000
deja am salva 250.000 de vieti pe an. Un numar semnificativ!
03:11
Easy to treat. Look at the situation in Mauritius.
46
173000
3000
E usor de tratat. Priviti situatia din Mauritiu.
03:14
In eight short years -- we're here talking about HIV, malaria,
47
176000
5000
Doar in 8 ani -- vorbim de HIV, malarie
03:19
which is all good.
48
181000
1000
lucururi ok.
03:20
We cannot make the mistakes we've made with malaria and HIV.
49
182000
4000
Nu putem face aceleasi greseli ca si in cazul malariei si al HIV-ului.
03:24
In eight short years, non-communicable diseases
50
186000
3000
Doar in 8 ani, bolile netransmisibile
03:27
will become the leading causes of death in Africa.
51
189000
4000
vor deveni principala cauza a mortalitatii in Africa.
03:31
That is something to keep in mind. We can't deal with it with situations like this.
52
193000
5000
Sa tinem minte asta. Nu putem face fata unor situatii de acest gen.
03:36
This is a typical African hospital. We can't depend on the elites --
53
198000
4000
Acesta este un spital african obisnuit. Nu putem depinde de elitele -
03:40
they go to USA, Germany, U.K. for treatment. Unbelievable.
54
202000
8000
care au plecat in State, Germania, Marea Britanie pentru a fi tratati. Incredibil.
03:48
You can't depend on foreign aid alone.
55
210000
2000
Nu te poti baza doar pe ajutorul altor tari.
03:50
Here is the situation: countries are turning inwards.
56
212000
3000
Asta este situatia actuala: ficare tara isi vede de problemele ei interne.
03:53
Post-9/11, [the] United States has had a lot of trouble
57
215000
3000
Dupa 9/11, Statele Unite au avut dificultati mari
03:56
to deal with, their own internal issues.
58
218000
2000
in a se ocupa de problemele lor interne.
03:58
So, they spend their money trying to fix those problems.
59
220000
4000
Iar banii si i-au folosit incercand sa rezolve aceste probleme.
04:02
You can't rightly -- it's not their responsibility,
60
224000
3000
Nu poti sa astepti -- nu e responsabilitatea lor,
04:05
it is my responsibility. I have to take care of my own problems.
61
227000
4000
e a mea. Eu trebuie sa am grija de problemele proprii.
04:09
If they help, that's good! But that is not my expectation.
62
231000
5000
Daca ne ajuta, e bine! Dar nu astea sunt asteptarile mele.
04:14
These worsening indices of health care or health studies in Africa
63
236000
3000
Acesti indici din ce in ce mai gravi ai asistentei medicale sau al studiilor de sanatate in Africa
04:17
demand a new look. We cannot keep on doing things
64
239000
4000
trebuie priviti din nou. Nu putem sa facem lucrurile
04:21
the way we've always done them.
65
243000
1000
la fel ca si pana acum.
04:22
If they have not worked, we have to look for alternative solutions.
66
244000
4000
Daca nu au functionat, trebuie sa cautam solutii alternative
04:26
I'm here to talk to you about solutions.
67
248000
2000
Sunt aici sa va vorbesc despre solutii.
04:28
This has been -- what has been a difficult sign to some of us.
68
250000
5000
Acesta a fost un semn dificil petru unii dintre noi.
04:33
Several years ago, we started thinking about it.
69
255000
3000
Acum cativa ani am inceput sa ne gandim la asta.
04:36
Everyone knows the problem. No one knows what the solutions are.
70
258000
4000
Toata lumea cunoaste problema. Insa nimeni nu are solutii pentru ea.
04:40
We decided that we needed to put our money where our mouth is.
71
262000
5000
Am decis ca e necesar sa investim bani.
04:45
Everyone is ready to throw in money,
72
267000
3000
Lumea e pregatita sa ofere ajutoare in bani
04:48
in terms of free money aid to developing countries.
73
270000
3000
pentru tarile in curs de dezvoltare.
04:51
Talk about sustainable investment, no one is interested.
74
273000
4000
Insa cand vine vorba de o investite sustinuta, nimeni nu e interesat.
04:55
You can't raise money.
75
277000
2000
Nu ai cum sa aduni bani.
04:57
I have done businesses in healthcare in the United States --
76
279000
3000
Am facut afaceri in domeniul asistentei medicale in Statele Unite --
05:00
I live in Nashville, Tennessee, health care capital of America.
77
282000
3000
Traiesc in Nashville, Tennessee, capitala asistentei medicale din America.
05:03
[It's] very easy to raise money for health-care ventures.
78
285000
3000
Acolo e foarte usor sa aduni bani pentru cooperari in domeniul asistentei medicale
05:06
But start telling them, you know,
79
288000
2000
Cand incerci sa le zic, stiti,
05:08
we're going to try to do it in Nigeria -- everyone runs away.
80
290000
2000
o sa incercam sa facem asta in Nigeria -- toata lumea dispare.
05:10
That is totally wrong. Those of you in the audience here,
81
292000
6000
Asta este in totalitate gresit. Voi, cei din audienta,
05:16
if you want to help Africa, invest money in sustainable development.
82
298000
3000
daca vreti sa ajutati Africa: investiti bani pentru o dezvoltare sustinuta.
05:19
Let me lead you through a day in the life of the Heart Institute,
83
301000
4000
Lasati-ma sa va descriu o zi din viata Institutului Inimii
05:23
so you get a glimpse of what we do,
84
305000
2000
ca sa intelegeti ceea ce facem noi
05:25
and I'll talk a little bit more about it.
85
307000
4000
si sa va spun putin mai multe despre asta.
06:28
What we have done is to show that high-quality health care,
86
370000
6000
Am aratat ca o asistenta medicala la nivel inalt,
06:34
comparable to the best anywhere in the world,
87
376000
2000
comparabila cu cele mai bune din lume,
06:36
can be done in a developing country environment.
88
378000
3000
poate fi oferita intr-o tara in dezvoltare.
06:39
We have 25 positions right now -- all of them trained,
89
381000
5000
Avem 25 de posturi -- toate cu educatie
06:44
board certified in the USA, Canada or Britain.
90
386000
3000
si acreditate in SUA, Canada sau Marea Britanie.
06:47
We have every modality that can be done in Vanderbilt,
91
389000
4000
Exista toate procedurile care pot fi facute, spre exemplu, in Vanderbilt,
06:51
Cleveland Clinic -- everywhere in the U.S. --
92
393000
3000
Clinica din Cleveland -- sau oriunde in Statele Unite --
06:54
and we do it for about 10 percent of the cost
93
396000
3000
si noi le facem petru doar 10%
06:57
that you will need to do those things in the United States.
94
399000
4000
din cat ar costa aceste proceduri in Statele Unite.
07:01
(Applause)
95
403000
5000
(Aplauze)
07:06
Additionally, we have a policy
96
408000
2000
Mai mult decat atat, avem o politica
07:08
that no one is ever turned away because of ability to pay.
97
410000
4000
prin care nimeni nu este refuzat daca nu poate plati.
07:12
We take care of everyone.
98
414000
2000
Avem grija de toata lumea.
07:14
(Applause)
99
416000
1000
(Aplauze)
07:15
Whether you have one dollar, two dollars -- it doesn't matter.
100
417000
3000
Daca ai un dolar sau doi -- nu conteaza.
07:18
And I will tell you how we're able to do it.
101
420000
3000
Si o sa va explic cum reusim sa facem asta.
07:21
We make sure that we select our equipment properly.
102
423000
4000
Ne alegem echipamentul cu grija.
07:25
We go for modular units. Units that have multi-modality functions
103
427000
4000
Alegem unitati modulare. Unitati care sa fie multi-functionale
07:29
have modular components. Easy to repair, and because of that,
104
431000
5000
si sa aiba componente modulare. Sunt usor de reparat, si de aceea,
07:34
we do not take things that are not durable and cannot last.
105
436000
4000
nu achizitionam lucruri care nu sunt rezistente si durabile.
07:38
We emphasize training,
106
440000
2000
Punem accentul pe training
07:40
and we make sure that this process is regenerative.
107
442000
3000
si ne asiguram ca acest proces este regenerativ.
07:43
Very soon we will all be dead and gone, but the problems will stay,
108
445000
4000
Foarte curand o sa fim una cu pamantul, dar problemele vor ramane
07:47
unless we have people taking over from where we stopped.
109
449000
4000
daca nu avem oameni pregatiti sa preia stafeta.
07:51
We made sure that we produced some things ourselves.
110
453000
3000
Ne-am asigurat ca unele lucruri sunt produse de noi insine.
07:54
We do not buy unit doses of radiopharmaceuticals.
111
456000
3000
Nu cumparam unitati de radiofarmaceutice.
07:57
We get the generators from the companies.
112
459000
3000
Luam generatoarele de la companii.
08:00
We manufacture them in-house, ourselves. That keeps the costs down.
113
462000
4000
Producem dozele la noi. Asta mentine costurile scazute.
08:04
So, for a radiopharmaceutical in the U.S. --
114
466000
3000
Deci, pentru o unitate de radiofarmaceutice pe care in Statele Unite
08:07
that you'll get a unit dose for 250 dollars --
115
469000
3000
o poti lua la 250 de dolari,
08:10
when we're finished manufacturing it in-house,
116
472000
2000
in momentul in care am finalizat procesul de productie la noi
08:12
we come at a price of about two dollars.
117
474000
2000
ajungem la un pret de aproximativ 2 dolari.
08:14
(Applause)
118
476000
4000
(Aplauze)
08:18
We recognize that the only way to bridge the gap
119
480000
3000
Ne dam seama ca singura modalitate de a traversa prapastia
08:21
between the rich and poor countries
120
483000
3000
dintre tarile bogate si cele sarace
08:24
is through education and technology.
121
486000
3000
este prin educatie si tehnologie.
08:27
All these problems we're talking about --
122
489000
2000
Toate aceste probleme cu care ne confruntam
08:29
if we bring development, they will all disappear.
123
491000
3000
vor disparea daca investim in dezvoltare.
08:32
Technology is a great equalizer. How do we make it work?
124
494000
5000
Tehnologia este un important egalizator. Cum o facem sa functioneze?
08:37
It's been proved: self-care is cost-effective.
125
499000
2000
Este dovedit: asistenta prin masuri proprii reduce costurile.
08:39
It extends opportunity to the rural centers,
126
501000
4000
Oportunitatile se extind catre centre rurale,
08:43
and we can use expertise in a very smart way.
127
505000
3000
iar noi putem folosi expertiza intr-un mod inteligent.
08:46
This is the way our centers are set up.
128
508000
3000
Centrele noastre sunt astfel gandite.
08:49
We currently have three locations in the Caribbean,
129
511000
3000
Momentan avem trei locatii in Caraibe
08:52
and we're planning a fourth one.
130
514000
2000
si planuim sa deschidem o a patra.
08:54
And we have now decided to go into Africa.
131
516000
3000
Si am luat decizia sa intram in Africa.
08:57
We will be doing the West African Heart Institute
132
519000
3000
Vom construi Institutul Inimii al Africii de Vest
09:00
in Port Harcourt, Nigeria. That project will be starting
133
522000
3000
in Port Harcourt din Nigeria. Acest proiect va incepe
09:03
within the next few months. We hope to open in 2008-09.
134
525000
4000
in urmatoarele luni. Speram sa il deschidem in 2008-09.
09:07
And we will do other centers.
135
529000
2000
Si vom face si alte centre.
09:09
This model can be adapted to every disease process.
136
531000
4000
Acest model poate fi adaptat pentru orice alta boala.
09:13
All the units, all the centers, are linked
137
535000
2000
Toate unitatile si centrele sunt legate
09:15
through a switched hub to a central server,
138
537000
4000
la un hub al unui server central
09:19
and all the images are populated to review stations.
139
541000
3000
si toate imaginile sunt prezentate prin statii care au rolul de a supraveghea.
09:22
And we designed this telemedicine solution. It's proprietary to us,
140
544000
5000
Noi am realizat aceasta solutie de telemedicina. Ne apartine
09:27
and we are happy to share what we have learned with anyone
141
549000
3000
si suntem fericiti sa o impartasim cu oricine
09:30
who is interested in doing it. You can still be profitable.
142
552000
5000
e interesat sa faca acelasi lucru. Si tot este profitabil.
09:35
We make sure that the telemedicine platform gives access
143
557000
6000
Ne asiguram ca aceasta platforma de telemedicina ofera acces
09:41
to expert medical specialists anywhere in the world,
144
563000
4000
expertilor in medicina oriunde in lume,
09:45
just by a click of the button.
145
567000
2000
doar printr-o apasare de buton.
09:47
I'll lead you through, to see how this happens.
146
569000
3000
O sa va explic cum se intampla asta.
09:50
This is at the Heart Institute. The doctors from anywhere can log in.
147
572000
4000
Acesta este Instatutul Inimii. Doctori de oriunde se pot loga aici.
09:54
I can call you in Switzerland and say, "Listen, go into our system.
148
576000
4000
Pot sa va sun in Elvetia si sa va spun: "Intrati in sistemul nostru.
09:58
Look at Mrs. Jones. Look at the study, tell me what you think."
149
580000
4000
Uitati-va la cazul doamnei Jones si spuneti-mi ce credeti."
10:02
They'll give me that information,
150
584000
2000
Ei imi vor da acea informatie,
10:04
and we'll make the care of the patient better.
151
586000
3000
iar noi vom imbunatati asistenta pentru pacientul respectiv.
10:07
The patient doesn't have to travel.
152
589000
2000
Pacientul nu are nevoie sa calatoreasca.
10:09
He doesn't have to experience the anxiety of not knowing
153
591000
3000
Nu trebuie sa se ingrijoreze ca medicii nu au destule informatii
10:12
because of limited expertise.
154
594000
4000
din cauza unei expertize limitate.
10:16
We also use [an] electronic medical record system.
155
598000
3000
Totodata folosim si un sistem electronic pentru inregistrarea fiselor medicale.
10:19
I'm happy to say that the things we have implemented --
156
601000
4000
Ma bucur sa va pot spune ca lucrurile pe care le-am implementat --
10:23
80 percent of U.S. practices do not have them, and yet the technology is there.
157
605000
7000
80 % din cabinetele din Statele Unite nu au acest sistem desii tehnologia este disponibila.
10:30
But you know, they have that luxury.
158
612000
1000
Insa ei isi permit acest lux.
10:31
Because if you can't get it in Nashville, you can travel to Birmingham,
159
613000
5000
Pentru ca daca nu exista in Nashville, poti merge la Birmingham,
10:36
two hours away, and you'll get it. If you can't get it in Cleveland,
160
618000
3000
la doua ore distanta, si acolo o primesti. Daca nu o gasesti in Cleveland,
10:39
you can go to Cincinnati. We don't have that luxury,
161
621000
3000
poti merge in Cincinnati. Noi nu avem acest lux,
10:42
so we have to make it happen.
162
624000
2000
deci trebuie sa il realizam.
10:44
When we do it, we will put the cost of care down.
163
626000
4000
Cand facem asta, reducem costurile necesare asistentei medicale.
10:48
And we'll extend it to the rural centers and make it affordable.
164
630000
4000
Si o extindem si in centrele rurale si o facem astefel incat oamenii sa si-o permita.
10:52
And everyone will get the care they deserve.
165
634000
3000
Toata lumea va primi asistenta bine-meritata.
10:55
It cannot just be technology, we recognize that.
166
637000
4000
Tehnologia nu e totul, ne dam seama de asta.
10:59
Prevention must be part of the solution -- we emphasize that.
167
641000
4000
Prevenirea trebuie sa fie o parte din solutie, asta vrem sa subliniem.
11:03
But, you know, you have to tell people what can be done.
168
645000
4000
Dar trebuie sa fii in stare sa spui oamenilor ca se poate face.
11:07
It's not possible to tell people to do what is going to be expensive,
169
649000
3000
Nu poti spune oamenilor sa faca ceva costisitor
11:10
and they go home and can't do it.
170
652000
3000
si ei merg acasa si nu au cu ce.
11:13
They need to be alive, they need to feed.
171
655000
2000
Ei trebuie sa traiasca, sa se hraneasca.
11:15
We recommend exercise as the most effective, simple, easy thing to do.
172
657000
6000
Noi recomandam exercitiul ca cel mai eficient, simplu si usor lucru pe care il pot face.
11:21
We have had walks every year -- every March, April.
173
663000
4000
Organizam marsuri in fiecare an, in fiecare luna de martie, aprilie.
11:25
We form people into groups and make them go into challenges.
174
667000
5000
Noi organizam oamenii in grupuri si ii incurajam sa participe la provocari.
11:30
Which group loses the most weight, we give them prizes.
175
672000
3000
Grupul care pierde cel mai mult din greutate, castiga premii.
11:33
Which groups record more walking distance by pedometer,
176
675000
4000
Grupul care inregistreaza cea mai mare distanta parcursa folosind un pedometru,
11:37
we give them prizes. We do this constantly.
177
679000
3000
primeste premii. Facem asta in mod constant.
11:40
We encourage them to bring children.
178
682000
2000
Ii incurajam sa-si aduca si copiii.
11:42
That way we start exposing the children from very early on,
179
684000
3000
In felul acesta ii invatam pe copii chiar de la inceput
11:45
on what these issues are. Because once they learn it,
180
687000
4000
care sunt problemele posibile. O data ce invata,
11:49
they will stay with it. In doing this we have created
181
691000
4000
se vor tine de program. Prin asta am creat numai in Jamaica
11:53
at least 100 skilled jobs in Jamaica alone,
182
695000
3000
cel putin 100 de locuri de munca
11:56
and these are physicians with expertise and special training.
183
698000
4000
iar acestia sunt doctori cu experienta si pregatire speciala.
12:00
We have taken care of over 1,000 indigent patients that could have died,
184
702000
4000
Am tratat peste 1.000 de pacienti indigeni care au fi putut muri,
12:04
including four free pacemakers in patients
185
706000
2000
inclusiv patru pacienti care au avut nevoie de pacemaker
12:06
with complete heart block. For those that understand cardiology,
186
708000
4000
pentru ca aveau inima complet blocata. Pentru cei ce inteleg cardiologia,
12:10
complete heart block means certain death.
187
712000
3000
blocajul total la nivelul inimii inseamna moarte sigura.
12:13
If you don't get this pacemaker, you will be dead.
188
715000
3000
Daca nu primesti acest pacemaker, esti mort.
12:16
So we are pleased with that.
189
718000
1000
Suntem multumiti cu aceste rezultate.
12:17
Indirectly, we have saved the government of Jamaica five million dollars
190
719000
4000
Indirect, am scutit guvernul din Jamaica cu 5 milioane de dolari
12:21
from people that would have gone to Miami or Atlanta for care.
191
723000
5000
pentru pacientii care ar fi trebuit sa mearga la Miami sau Atlanta pentru asistenta.
12:26
And we've hopefully saved a lot of lives.
192
728000
3000
Si speram ca am salvat si numeroase vieti.
12:29
By the end of this year, we would have contributed over one million dollars
193
731000
5000
Pana la sfarsitul anului acesta vom fi contribuit cu peste un milion de dolari
12:34
in indigent care. In the first four months, it's been 340,000 dollars,
194
736000
4000
in asistenta pentru indigeni. In primele 4 luni au fost 340.000 de dolari,
12:38
averaging 85,000 dollars a month. The government will not do that,
195
740000
6000
in medie 85.000 pe luna. Guvernul nu ar da atatia bani
12:44
because they have competing needs.
196
746000
1000
fiindca pentru ei exista si alte nevoi.
12:45
They need to put resources elsewhere. But we can still do it.
197
747000
3000
Trebuie sa investeasca resursele in altceva. Dar noi putem face asta.
12:48
People say, "How can you do that?" This is how we can do that.
198
750000
5000
Oamenii ne intreaba: "Cum reusiti?". Iata cum reusim.
12:53
At least 4,000 rich Jamaicans that were heading to Miami for treatment
199
755000
5000
Cel putin 4.000 de jamaicani bogati care trebuiau sa ajunga la Miami pentru tratament
12:58
have self-confessed that they did not go to Miami
200
760000
5000
au recunoscut singuri ca nu au mers la Miami,
13:03
because of the Heart Institute of the Caribbean.
201
765000
2000
fiindca exista Institutul Inimii din Caraibe.
13:05
And, if they went to Miami, they will spend significantly more --
202
767000
5000
Si daca ar fi mers in Miami ar fi cheltuit cu mult mai multi bani --
13:10
eight to 10 times more. And they feel happy spending it at home,
203
772000
5000
de 8 pana la 10 ori mai multi. Si sunt multumiti ca ii pot cheltui acasa,
13:15
getting the same quality of care.
204
777000
1000
si primesc acelasi nivel de ingrijire.
13:16
And for that money -- for every one patient that has the money to pay,
205
778000
6000
Si pentru acei bani -- pentru fiecare pacient care are bani sa plateasca --
13:22
it gives us an opportunity to take care of at least four people
206
784000
3000
noi avem posibilitatea sa ne ingrijim de cel putin 4 oameni
13:25
that do not have the resources to pay.
207
787000
3000
care nu isi permit sa plateasca.
13:28
(Applause)
208
790000
5000
(Aplauze)
13:33
For this to work, this progress must be sustainable.
209
795000
3000
Ca aceasta sa functioneze, acest progres trebuie sa fie sustinut.
13:36
So, we emphasize training. Training is critical.
210
798000
3000
Deci ne concentram pe training. Trainigul e critic.
13:39
We have gone further: we have formed a relationship
211
801000
4000
Am mers si mai departe si am stabilit o legatura
13:43
with the University of Technology, Jamaica,
212
805000
3000
cu Universitatea Tehnologica din Jamaica,
13:46
where I now have an appointment.
213
808000
1000
unde am acum o intalnire.
13:47
And we are starting a biomedical engineering program,
214
809000
3000
O sa incepem un program de inginerie biomedicala,
13:50
so that we will train people locally, who can repair that equipment.
215
812000
5000
astfel incat sa educam localnici sa poata repara echipamentul.
13:55
That way we're not going to deal with obsolescence and all those kinds of issues.
216
817000
4000
In felul acesta o sa eliminam problemele cu uzura echipamentelor.
13:59
We're also starting ancillary health-care technology training programs --
217
821000
5000
De asemenea, incepem si programe auxiliare de training in tehnologia in asistenta medicala --
14:04
training people in echocardiography, cardiac ultrasound,
218
826000
4000
educarea oamenilor in ecocardiograma, examinare cardiaca cu ultrasunete,
14:08
those kinds of things. Now, with that kind of training,
219
830000
3000
si toate aceste lucruri. Aceste tipuri de training
14:11
it gives people motivation.
220
833000
2000
ofera oamenilor motivatie.
14:13
Because now they will get a bachelors degree in medical imaging
221
835000
3000
Pentru ca acum vor primi o diploma universitara in imagistica medicala
14:16
and all that kind of stuff. In the process, I want you to just hear
222
838000
6000
si altele. Vreau doar sa auziti de la cei ce au urmat trainingul
14:22
from the trainees themselves what it has meant for them.
223
844000
4000
ce a insemnat acest proces pentru ei.
14:26
(Video) Dr. Jason Topping: My name is Jason Topping.
224
848000
1000
(Video) Dr. Jason Topping: Numele meu este Jason Topping,
14:27
I'm a senior resident in anesthesia in intensive care
225
849000
3000
Sunt rezident senior in anestezia in terapie intensiva
14:30
at the University Hospital of the West Indies.
226
852000
3000
la Spitalul Universitar din Indiile de Vest.
14:33
I came to the Heart Institute in 2006,
227
855000
3000
Am venit la Institutul Inimii in 2006
14:36
as part of my elective in my anesthesia and intensive care program.
228
858000
5000
prin programul universitar de anestezie si terapie intensiva.
14:41
I spent three months at the Heart Institute.
229
863000
3000
Am petrecut 3 luni la Institutul Inimii.
14:44
There's been no doubt around my colleagues
230
866000
2000
Nu a existat nici un dubiu printre colegii mei
14:46
about the utility of the training I received here,
231
868000
3000
in privinta utilitatii acestui training pe care l-am primit aici.
14:49
and I think there's been an increased interest now in --
232
871000
5000
Si cred ca acum exista un interes crescut
14:54
particularly in echocardiography and its use in our setting.
233
876000
4000
in special in ecocardiografie si la ceea ce foloseste aceasta.
14:58
Sharon Lazarus: I am an echocardiographer at the Heart Institute of the Caribbean,
234
880000
5000
Sharon Lazarus: Sunt specialist in ecocardiografie la Institutul Inimii din Caraibe
15:03
since the past two years. I received training at this institution.
235
885000
5000
de doi ani. Am urmat trainingul in aceasta institutie.
15:08
I think this aspect of training in cardiology
236
890000
5000
Cred ca acest aspect al trainingului in cardiologie
15:13
that the Heart Institute of the Caribbean has introduced in Jamaica
237
895000
4000
pe care Institutul Inimii din Caraibe l-a introdus in Jamaica
15:17
is very important in terms of diagnosing cardiac diseases.
238
899000
9000
este foarte important in ceea ce priveste diagnosticarea problemelor cardiace.
15:26
Ernest Madu: The lesson in this is that it can be done, and it can be sustained,
239
908000
5000
Ernest Madu: Lectia ce rezulta de aici este ca se poate face si se poate sustine,
15:31
and you can make it possible for everyone.
240
913000
4000
si ca poate fi posibil pentru toata lumea.
15:35
Who are we to decide that poor people cannot get the best care?
241
917000
4000
Cine suntem noi sa decidem ca oamenii saraci nu pot primi cea mai buna asistenta?
15:39
When have you been appointed to play God?
242
921000
4000
Cine te-a numit Dumnezeu?
15:43
It is not my decision. My job is to make sure that every person,
243
925000
5000
Nu este decizia mea. Sarcina mea este sa ma asigur ca fiecare persoana,
15:48
no matter what fate has assigned to you, will have the opportunity
244
930000
5000
indiferent de ce soarta ar avea, are posibilitatea
15:53
to get the best quality health care in life.
245
935000
3000
sa primeasca cea mai buna asistenta medicala in timpul vietii.
15:56
Next stop is West African Heart Institute,
246
938000
4000
Urmatoarea oprire este Institutul Inimii din Africa de Vest
16:00
that we are going to be doing in Port Harcourt, Nigeria,
247
942000
3000
pe care il vom construi in Port Harcourt, Nigeria,
16:03
as I said before. We will do other centers across West Africa.
248
945000
4000
asa cum am mentionat mai devreme. Vom face si alte centre in Africa de Vest.
16:07
We will extend the same system into other areas,
249
949000
5000
Vom extinde acelasi sistem in alte zone,
16:12
like dialysis treatment.
250
954000
1000
cum ar fi tratamentul prin dializa.
16:13
And anyone who is interested in doing it in any health care situation,
251
955000
4000
Si oricine este interesat sa faca asta pentru orice alte scopuri in asistenta medicala,
16:17
we will be happy to assist you and tell you how we've done it,
252
959000
5000
vom fi bucurosi sa ajutam si sa impartasim cum am facut noi
16:22
and how you can do it. If we do this,
253
964000
4000
si cum se poate face de altii. Daca reusim asta,
16:26
we can change the face of health care in Africa.
254
968000
4000
putem schimba fata asistentei medicale din Africa.
16:30
Africa has been good to us; it is time for us to give back to Africa.
255
972000
4000
Africa a fost buna cu noi; acum e timpul sa da si noi ceva inapoi.
16:34
I am going. Those who want to come,
256
976000
3000
Eu am pornit. Cei ce vor sa ma insoteasca,
16:37
I welcome you to come along with me.
257
979000
2000
sunt binevoiti.
16:39
Thank you.
258
981000
2000
Va multumesc.
16:41
(Applause)
259
983000
4000
(Aplauze)
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