TEDMED 2014
Gail Reed: Where to train the world's doctors? Cuba.
Gejl Rid (Gail Reed): Gde obučavati svetske lekare? Na Kubi
Filmed:
Readability: 5.1
824,908 views
Veliki problemi traže velika rešenja, iznedrena velikim idejama, maštom i odvažnošću. U ovom govoru, novinarka Gejl Rid profiliše jedno veliko rešenje vredno pažnje: Latinoamerički medicinski fakultet u Havani, u kojem se obučavaju lekari iz celog sveta kako bi služili u lokalnim zajednicama kojima su najpotrebniji.
Gail Reed - Cuban health care expert
American journalist and Havana resident Gail Reed spotlights a Cuban medical school that trains doctors from low-income countries who pledge to serve communities like their own. Full bio
American journalist and Havana resident Gail Reed spotlights a Cuban medical school that trains doctors from low-income countries who pledge to serve communities like their own. Full bio
Double-click the English transcript below to play the video.
Želim da vam ispričam
00:12
I want to tell you
0
537
1622
00:14
how 20,000 remarkable young people
1
2159
4691
kako je 20.000 izuzetnih mladih ljudi,
00:18
from over 100 countries
2
6850
1856
iz više od 100 zemalja
00:20
ended up in Cuba
3
8706
1812
završilo na Kubi.
00:22
and are transforming health in their communities.
4
10518
3803
I kako menjaju zdravstvo
u svojim zajednicama.
u svojim zajednicama.
00:26
Ninety percent of them would never
5
14321
2080
Devedest procenata od njih ne bi nikada
00:28
have left home at all
6
16401
1572
ni otišlo od kuće,
00:29
if it weren't for a scholarship
to study medicine in Cuba
to study medicine in Cuba
7
17973
3344
da nije bilo školarina za
studije medicine na Kubi
studije medicine na Kubi
00:33
and a commitment to go back
8
21317
1811
i obavezanosti da se vrate u mesta
00:35
to places like the ones they'd come from —
9
23128
3628
poput onih iz kojih su došli:
00:38
remote farmlands, mountains, ghettos —
10
26756
3447
udaljenih poljoprivrednih područja,
planina, getoa.
planina, getoa.
00:42
to become doctors for people like themselves,
11
30203
3486
Kako bi postali lekari ljudima poput sebe,
00:45
to walk the walk.
12
33689
2092
kako bi prešli sa reči na delo.
00:47
Havana's Latin American Medical School:
13
35781
2666
Latinoamerički medicinski
fakultet u Havani
fakultet u Havani
00:50
It's the largest medical school in the world,
14
38447
2925
je najveći medicinski fakultet na svetu,
00:53
graduating 23,000 young doctors
15
41372
2902
na kome je diplomiralo 23.000
mladih doktora
mladih doktora
00:56
since its first class of 2005,
16
44274
2728
od njegovog osnivanja 2005. godine,
00:59
with nearly 10,000 more in the pipeline.
17
47002
3609
sa još gotovo 10.000 studenata u sistemu.
01:02
Its mission, to train physicians for the people
18
50611
3821
Njegova misija, da obrazuje lekare
za one kojima su najpotrebniji:
01:06
who need them the most:
19
54432
2051
01:08
the over one billion
20
56483
1936
za preko milijardu ljudi
01:10
who have never seen a doctor,
21
58419
2263
koji nikada nisu videli lekara.
01:12
the people who live and die
22
60682
3833
Za ljude koji žive i umiru
01:16
under every poverty line ever invented.
23
64515
3494
u najgorem mogućem siromaštvu.
01:20
Its students defy all norms.
24
68009
2250
Njegovi studenti poriču sve norme.
01:22
They're the school's biggest risk
25
70259
2271
Oni su najveći rizik ove škole
01:24
and also its best bet.
26
72530
2460
ali i najbolje rešenje.
01:26
They're recruited from the poorest,
27
74990
2515
Njih je iz najsiromašnijih,
01:29
most broken places on our planet
28
77505
2571
najuništenijih delova sveta
01:32
by a school that believes they can become
29
80076
2274
regrutovala škola koja veruje
01:34
not just the good
30
82350
1507
da oni mogu postati
01:35
but the excellent physicians
31
83857
1935
ne samo dobri, već odlični lekari
01:37
their communities desperately need,
32
85792
2753
koji su očajnički potrebni
svojim zajednicama.
svojim zajednicama.
01:40
that they will practice where most doctors don't,
33
88545
3652
Da će oni lečiti tamo gde većina
lekara ne leči,
lekara ne leči,
01:44
in places not only poor
34
92197
2426
u mestima koja su ne samo siromašna
01:46
but oftentimes dangerous,
35
94623
2553
već često i opasna.
01:49
carrying venom antidotes in their backpacks
36
97176
3026
Da će nositi protivotrove u rancima
01:52
or navigating neighborhoods
37
100202
2619
ili se kretati u kvartovima
01:54
riddled by drugs, gangs and bullets,
38
102821
3321
razrivenim drogom, bandama i mecima,
01:58
their home ground.
39
106142
2700
njihovom domaćem terenu.
02:00
The hope is that they will help
40
108842
1326
Postoji nada da će oni pomoći
02:02
transform access to care,
41
110168
2600
da se promeni dostupnost lečenju,
02:04
the health picture in impoverished areas,
42
112768
2419
zdravstvena situacija
u osiromašenih krajevima,
u osiromašenih krajevima,
02:07
and even the way medicine itself
43
115187
2159
pa čak i način na koji se sama medicina
02:09
is learned and practiced,
44
117346
2543
uči i praktikuje,
02:11
and that they will become pioneers in our global reach
45
119889
4251
i da će oni postati pioniri
našeg globalnog dosega
našeg globalnog dosega
02:16
for universal health coverage,
46
124140
2520
ka univerzalnoj
zdravstvenoj pokrivenosti,
zdravstvenoj pokrivenosti,
02:18
surely a tall order.
47
126660
2718
sigurno težak zadatak.
02:21
Two big storms and this notion of "walk the walk"
48
129378
4126
Dve velike oluje i ova ideja
"sa reči na delo"
"sa reči na delo"
02:25
prompted creation of ELAM back in 1998.
49
133504
4084
podstakla je osnivanje
ELAM-a 1998. godine.
ELAM-a 1998. godine.
02:29
The Hurricanes Georges and Mitch
50
137588
3003
Uragani Džordž i Mič
02:32
had ripped through the Caribbean
51
140591
1552
besneli su kroz Karibe
02:34
and Central America,
52
142143
2205
i Centralnu Ameriku,
02:36
leaving 30,000 dead
53
144348
2379
ostavivši iza sebe 30.000 mrtvih
02:38
and two and a half million homeless.
54
146727
2883
i dva i po miliona ljudi bez doma.
02:41
Hundreds of Cuban doctors
volunteered for disaster response,
volunteered for disaster response,
55
149610
3693
Stotine kubanskih lekara se dobrovoljno
uključilo u odgovor na katastrofu,
uključilo u odgovor na katastrofu,
02:45
but when they got there,
56
153303
1845
ali kada su tamo stigli,
02:47
they found a bigger disaster:
57
155148
2083
zatekli su još veću katastrofu:
02:49
whole communities with no healthcare,
58
157231
3196
čitave zajednice bez zdravstvene nege,
02:52
doors bolted shut on rural hospitals
59
160427
2324
katance na vratima seoskih bolnica
02:54
for lack of staff,
60
162751
1879
zbog nedostatka medicinskog osoblja,
02:56
and just too many babies dying
61
164630
2671
i jako puno beba koje umiru
02:59
before their first birthday.
62
167301
2935
pre svog prvog rođendana.
03:02
What would happen when these Cuban doctors left?
63
170236
3834
Šta će se dogoditi kada
ovi kubanski lekari odu?
ovi kubanski lekari odu?
03:06
New doctors were needed to make care sustainable,
64
174070
2714
Bili su potrebni novi lekari
koji će održavati medicinsku negu,
koji će održavati medicinsku negu,
03:08
but where would they come from?
65
176784
1312
ali odakle bi oni mogli da dođu?
03:10
Where would they train?
66
178096
2805
Gde bi se obučavali?
03:12
In Havana, the campus of a former naval academy
67
180901
4443
U Havani, kampus bivše
mornaričke akademije
mornaričke akademije
03:17
was turned over to the Cuban Health Ministry
68
185344
2925
bio je predat kubanskom
Ministarstvu zdravlja
Ministarstvu zdravlja
03:20
to become the Latin American Medical School,
69
188269
3351
kako bi postao
Latinoamerički medicinski fakultet,
Latinoamerički medicinski fakultet,
03:23
ELAM.
70
191620
2013
ELAM.
Školovanje, smeštaj, ishrana
i mala stipendija
i mala stipendija
03:25
Tuition, room and board, and a small stipend
71
193633
2474
03:28
were offered to hundreds of students
72
196107
1911
bile su ponuđene stotinama studenata
03:30
from the countries hardest hit by the storms.
73
198018
3033
iz zemalja najgore pogođenih olujama.
03:33
As a journalist in Havana,
74
201051
2279
Kao novinar u Havani,
03:35
I watched the first 97 Nicaraguans arrive
75
203330
2717
gledala sam kako je stiglo
prvih 97 Nikaragvanaca
prvih 97 Nikaragvanaca
03:38
in March 1999,
76
206047
2542
u martu 1999,
03:40
settling into dorms barely refurbished
77
208589
2716
kako su se uselili u jedva
obnovljene spavaonice
obnovljene spavaonice
03:43
and helping their professors not
only sweep out the classrooms
only sweep out the classrooms
78
211305
3679
i kako su pomagali svojim profesorima
ne samo da počiste učionice
ne samo da počiste učionice
03:46
but move in the desks and the
chairs and the microscopes.
chairs and the microscopes.
79
214984
4679
već i da unesu stolove,
stolice i mikroskope.
stolice i mikroskope.
03:51
Over the next few years,
80
219663
1879
Tokom nekoliko narednih godina,
03:53
governments throughout the Americas
81
221542
1912
vlade širom Amerike
03:55
requested scholarships for their own students,
82
223454
3173
zahtevale su stipendije za svoje studente,
03:58
and the Congressional Black Caucus
83
226627
1878
i Kongresni odbor Crnaca
04:00
asked for and received hundreds of scholarships
84
228505
3375
je tražio i dobio stotine stipendija
04:03
for young people from the USA.
85
231880
3240
za mlade ljude iz SAD-a.
04:07
Today, among the 23,000
86
235120
3712
Danas se među 23.000
04:10
are graduates from 83 countries
87
238832
3015
nalaze diplomci iz 83 zemlje
04:13
in the Americas, Africa and Asia,
88
241847
3004
iz Amerike, Afrike i Azije,
04:16
and enrollment has grown to 123 nations.
89
244851
5603
a upis se proširio na 123 nacije.
04:22
More than half the students are young women.
90
250454
2204
Više od polovine studenata su mlade žene.
04:24
They come from 100 ethnic groups,
91
252658
1392
One dolaze iz 100 etničkih grupa,
04:26
speak 50 different languages.
92
254050
2025
govore 50 različitih jezika.
Direktorka Svetske zdravstvene
organizacije Margaret Čen je rekla:
organizacije Margaret Čen je rekla:
04:28
WHO Director Margaret Chan said,
93
256075
3141
04:31
"For once, if you are poor, female,
94
259216
4038
"Po prvi put,
ukoliko ste siromašni, žensko,
ukoliko ste siromašni, žensko,
04:35
or from an indigenous population,
95
263254
2262
ili iz urođeničke populacije,
04:37
you have a distinct advantage,
96
265516
1705
imate jasnu prednost,
04:39
an ethic that makes this medical school unique."
97
267221
4729
princip koji ovaj medicinski fakultet
čini jedinstvenim."
čini jedinstvenim."
04:43
Luther Castillo comes from San Pedro de Tocamacho
98
271950
4150
Luter Kastiljo je
iz San Pedro de Tokamačo,
iz San Pedro de Tokamačo,
04:48
on the Atlantic coast of Honduras.
99
276100
2870
sa atlantske obale Hondurasa.
04:50
There's no running water,
100
278970
1912
Tamo nema tekuće vode,
04:52
no electricity there,
101
280882
1800
niti struje,
04:54
and to reach the village, you have to walk for hours
102
282682
3600
a da bi se došlo do sela,
neophodno je hodati satima
neophodno je hodati satima
04:58
or take your chances in a pickup truck like I did
103
286282
2913
ili iskušavati sreću u kamionu kao ja
05:01
skirting the waves of the Atlantic.
104
289195
3295
izbegavajući talase Atlantika.
05:04
Luther was one of 40 Tocamacho children
105
292490
4641
Luter je bio jedno od 40 Tokamačo dece
05:09
who started grammar school,
106
297131
2003
koja su krenula u školu,
05:11
the sons and daughters of a black indigenous people
107
299134
2744
sinova i kćeri crnih urođenika
05:13
known as the Garífuna,
108
301878
1856
poznatih kao Garifuna,
05:15
20 percent of the Honduran population.
109
303734
3476
koji čine 20 procenata
populacije Hondurasa.
populacije Hondurasa.
05:19
The nearest healthcare was fatal miles away.
110
307210
5153
Najbliža zdravsotvena nega je bila
udaljena smrtonosnim kilometrima.
udaljena smrtonosnim kilometrima.
05:24
Luther had to walk three hours every day
111
312363
3487
Luter je svakodnevno morao
da pešači tri sata
da pešači tri sata
kako bi išao u više
razrede osnovne škole,
razrede osnovne škole,
05:27
to middle school.
112
315850
1901
05:29
Only 17 made that trip.
113
317751
2081
Samo njih 17 se prihvatilo tog puta.
05:31
Only five went on to high school,
114
319832
2104
Samo petoro je išlo u srednju školu,
05:33
and only one to university:
115
321936
2164
i samo jedan na univerzitet:
05:36
Luther, to ELAM,
116
324100
2021
Luter, na ELAM,
05:38
among the first crop of Garífuna graduates.
117
326121
4009
i bio je među prvim Garifuna diplomcima.
Njemu su prethodila samo
dva Garifuna lekara
dva Garifuna lekara
05:42
Just two Garífuna doctors had preceded them
118
330130
2870
05:45
in all of Honduran history.
119
333000
3044
u čitavoj istoriji Hondurasa.
05:48
Now there are 69, thanks to ELAM.
120
336044
5901
Sada ih je 69, zahvaljujući ELAM-u.
05:53
Big problems need big solutions,
121
341945
3200
Veliki problemi traže velika rešenja,
05:57
sparked by big ideas, imagination and audacity,
122
345145
3792
iznedrena velikim idejama,
maštom i odvažnošću,
maštom i odvažnošću,
06:00
but also solutions that work.
123
348937
3003
ali i rešenja koja daju rezultate.
06:03
ELAM's faculty had no handy evidence base
124
351940
3330
ELAM-ovi profesori nisu imali
pogodnu bazu činjenica
pogodnu bazu činjenica
06:07
to guide them, so they learned the hard way,
125
355270
3520
kojom bi se vodili, tako
da su učili na teži način,
da su učili na teži način,
06:10
by doing and correcting course as they went.
126
358790
3689
predavajući i usput
ispravljajući tečajeve.
ispravljajući tečajeve.
06:14
Even the brightest students
127
362479
2262
Čak i najsjajniji studenti
06:16
from these poor communities
128
364741
1913
iz ovih siromašnih krajeva
06:18
weren't academically prepared
129
366654
1676
nisu bili akademski pripremljeni
06:20
for six years of medical training,
130
368330
2693
za šest godina učenja medicine,
06:23
so a bridging course was set up in sciences.
131
371023
3657
tako da je ustanovljen
prelazni kurs iz nauke.
prelazni kurs iz nauke.
06:26
Then came language:
132
374680
1575
Onda su na red došli jezici:
06:28
these were Mapuche, Quechuas, Guaraní, Garífuna,
133
376255
3161
to su bili Mapuča, Kečua,
Guarani, Garifuna,
Guarani, Garifuna,
06:31
indigenous peoples
134
379416
1777
urođenički narodi
06:33
who learned Spanish as a second language,
135
381193
2200
koji su španski učili kao drugi jezik,
06:35
or Haitians who spoke Creole.
136
383393
2797
ili Haićani koji su govorili kreolski.
06:38
So Spanish became part
137
386190
1937
Tako da je španski postao deo
06:40
of the pre-pre-med curriculum.
138
388127
4158
pred-pripreme za studije medicine.
06:44
Even so, in Cuba,
139
392285
2942
Pa čak i tako, na Kubi,
06:47
the music, the food, the smells,
140
395227
3234
muzika, hrana, mirisi,
06:50
just about everything was different,
141
398461
2689
gotovo sve je bilo drugačije,
06:53
so faculty became family, ELAM home.
142
401150
5005
tako da je fakultetski kadar
postao porodica, ELAM kuća.
postao porodica, ELAM kuća.
06:58
Religions ranged from indigenous beliefs
143
406155
2813
Religije su se kretale od
urođeničkih verovanja
urođeničkih verovanja
07:00
to Yoruba, Muslim and Christian evangelical.
144
408968
4032
do jorube, muslimana i
hrišćanskih evangelista.
hrišćanskih evangelista.
07:05
Embracing diversity became a way of life.
145
413000
4484
Prihvatanje različitosti
je postao način života.
je postao način života.
07:09
Why have so many countries
146
417484
1990
Zašto je tako mnogo zemalja
07:11
asked for these scholarships?
147
419474
2475
zatražilo ove školarine?
07:13
First, they just don't have enough doctors,
148
421949
3252
Kao prvo, oni prosto nemaju
dovoljno lekara,
dovoljno lekara,
07:17
and where they do, their distribution
149
425201
1766
a tamo gde ih imaju, raspoređeni su
07:18
is skewed against the poor,
150
426967
2442
neravnomerno, na štetu siromašnih,
07:21
because our global health crisis
151
429409
2462
jer je naša globalna zdravstvena kriza
07:23
is fed by a crisis in human resources.
152
431871
2965
posledica krize u ljudskim resursima.
07:26
We are short four to seven million health workers
153
434836
3852
Nedostaje nam između četiri i sedam
miliona zdravstvenih radnika
miliona zdravstvenih radnika
07:30
just to meet basic needs,
154
438688
2464
samo da bi se zadovoljile osnovne potrebe,
07:33
and the problem is everywhere.
155
441152
1858
a problemi su svuda.
07:35
Doctors are concentrated in the cities,
156
443010
2552
Doktori su grupisani u gradovima,
07:37
where only half the world's people live,
157
445562
2610
u kojima živi samo polovina
svetske populacije,
svetske populacije,
07:40
and within cities,
158
448172
1788
a unutar gradova,
07:41
not in the shantytowns or South L.A.
159
449960
4179
ne u divljim naseljima ili
južnom Los Anđelesu.
južnom Los Anđelesu.
07:46
Here in the United States,
160
454139
1766
Ovde u SAD-u,
07:47
where we have healthcare reform,
161
455905
2501
gde imamo reformu zdravstva,
07:50
we don't have the professionals we need.
162
458406
2548
nemamo onoliko profesionalaca
koliko nam je potrebno.
koliko nam je potrebno.
07:52
By 2020, we will be short
163
460954
2515
Do 2020, nedostajaće nam
07:55
45,000 primary care physicians.
164
463469
4139
45.000 lekara
primarne zdravstvene zaštite.
primarne zdravstvene zaštite.
07:59
And we're also part of the problem.
165
467608
2157
A mi smo i deo problema.
08:01
The United States is the number one importer
166
469765
2467
SAD je najveći uvoznik
08:04
of doctors from developing countries.
167
472232
4364
lekara iz zemalja u razvoju.
08:08
The second reasons students flock to Cuba
168
476596
2869
Drugi razlog iz kojeg se studenti
skupljaju na Kubi
skupljaju na Kubi
08:11
is the island's own health report card,
169
479465
2227
je stanje zdravstvene nege u ovoj zemlji,
08:13
relying on strong primary care.
170
481692
2970
koja se zasniva na snažnoj
primarnoj zaštiti.
primarnoj zaštiti.
08:16
A commission from The Lancet
171
484662
1822
Komisija iz Lanseta
08:18
rates Cuba among the best performing
172
486484
2506
rangira Kubu među one
sa najboljim rezultatima
sa najboljim rezultatima
08:20
middle-income countries in health.
173
488990
2849
u zdravstvu od zemalja
sa srednjim dohotkom.
sa srednjim dohotkom.
08:23
Save the Children ranks Cuba
174
491839
1946
"Spasimo decu" navodi Kubu
08:25
the best country in Latin
America to become a mother.
America to become a mother.
175
493785
4636
kao najbolju zemlju
u Južnoj Americi za majke.
u Južnoj Americi za majke.
08:30
Cuba has similar life expectancy
176
498421
2989
Kuba ima sličan očekivan životni vek
08:33
and lower infant mortality than the United States,
177
501410
3232
i nižu stopu mortaliteta odojčadi
od Sjedinjenih Država,
od Sjedinjenih Država,
08:36
with fewer disparities,
178
504642
2181
sa malo razlika,
08:38
while spending per person
179
506823
1800
a trošeći po osobi
08:40
one 20th of what we do on health
180
508623
3015
jednu dvadesetinu onoga
što mi trošimo na zdravstvo
što mi trošimo na zdravstvo
08:43
here in the USA.
181
511638
2149
ovde u SAD-u.
08:45
Academically, ELAM is tough,
182
513787
2992
Akademski, ELAM je zahtevan,
08:48
but 80 percent of its students graduate.
183
516779
3631
ali 80% njegovih studenata diplomira.
08:52
The subjects are familiar —
184
520410
1346
Predmeti su poznati:
08:53
basic and clinical sciences —
185
521756
2474
osnovne i kliničke nauke,
08:56
but there are major differences.
186
524230
2426
ali postoje velike razlike.
08:58
First, training has moved out of the ivory tower
187
526656
3611
Kao prvo, obuka je preseljena
iz izolovanosti fakultetskih učionica
iz izolovanosti fakultetskih učionica
09:02
and into clinic classrooms and neighborhoods,
188
530267
2902
na klinike i u susedstvo,
09:05
the kinds of places most of these grads will practice.
189
533169
3364
na mesta slična onima u kojima će
ovi dimplomci raditi.
ovi dimplomci raditi.
09:08
Sure, they have lectures and hospital rotations too,
190
536533
4094
Oni naravno slušaju predavanja
i stažiraju u bolnicama,
i stažiraju u bolnicama,
09:12
but community-based learning starts on day one.
191
540627
5030
ali učenje u okviru zajednice
počinje prvog dana.
počinje prvog dana.
09:17
Second, students treat the whole patient,
192
545657
3766
Kao drugo, studenti
posmatraju celokupnog pacijenta,
posmatraju celokupnog pacijenta,
09:21
mind and body,
193
549423
1914
duh i telo,
09:23
in the context of their
families, their communities
families, their communities
194
551337
2506
u kontekstu njihovih
porodica, zajednica
porodica, zajednica
09:25
and their culture.
195
553843
2147
i kulture.
09:27
Third, they learn public health:
196
555990
2900
Treće, oni uče zdravstvenu zaštitu:
09:30
to assess their patients' drinking water, housing,
197
558890
3100
da procene kvalitet pijaće vode, smeštaj,
09:33
social and economic conditions.
198
561990
3296
socijalne i ekonomske uslove.
09:37
Fourth, they are taught
199
565286
2531
Četvrto, uče ih da
09:39
that a good patient interview
200
567817
2767
dobar razgovor sa pacijentom
09:42
and a thorough clinical exam
201
570584
2104
i detaljan klinički pregled
09:44
provide most of the clues for diagnosis,
202
572688
2835
daju dovoljno osnova
za postavljanje dijagnoze,
za postavljanje dijagnoze,
i tako štede na skupim tehnologijama
za njeno potvrđivanje.
za njeno potvrđivanje.
09:47
saving costly technology for confirmation.
203
575523
3903
09:51
And finally, they're taught over and over again
204
579426
3550
I konačno, uče ih iznova i iznova
09:54
the importance of prevention,
205
582976
2044
značaju prevencije,
09:57
especially as chronic diseases
206
585020
2400
naročito s obzirom da hronične bolesti
09:59
cripple health systems worldwide.
207
587420
4160
parališu zdravstvene sisteme širom sveta.
10:03
Such an in-service learning
208
591580
3190
Takvo učenje u službi zajednice
10:06
also comes with a team approach,
209
594770
2600
je praćeno i timskim radom,
10:09
as much how to work in teams
210
597370
2867
u podjednakoj meri uče
kako raditi u timovima i
kako raditi u timovima i
10:12
as how to lead them,
211
600237
1946
kako ih voditi,
10:14
with a dose of humility.
212
602183
2127
sa dozom poniznosti.
10:16
Upon graduation, these doctors share
213
604310
2800
Nakon što diplomiraju, ovi lekari dele
10:19
their knowledge with nurse's aids, midwives,
214
607110
2710
svoje znanje sa pomoćnicima
medicinskih sestara, babicama,
medicinskih sestara, babicama,
10:21
community health workers,
215
609820
1970
zdravstvenim radnicima u zajednici,
10:23
to help them become better at what they do,
216
611790
2386
kako bi im pomogli da
postanu bolji u svom poslu,
postanu bolji u svom poslu,
10:26
not to replace them,
217
614176
1945
a ne da ih zamene,
10:28
to work with shamans and traditional healers.
218
616121
3129
da rade sa šamanima i
narodnim isceliteljima.
narodnim isceliteljima.
10:33
ELAM's graduates:
219
621311
2559
ELAM-ovi diplomci.
10:35
Are they proving this audacious experiment right?
220
623870
4657
Da li oni opravdavaju
ovaj odvažni eksperiment?
ovaj odvažni eksperiment?
10:40
Dozens of projects give us an inkling
221
628527
2295
Desetine projekata nagoveštavaju
10:42
of what they're capable of doing.
222
630822
2568
šta su oni sposobni da urade.
10:45
Take the Garífuna grads.
223
633390
1763
Uzmimo Garifuna diplomce.
10:47
They not only went to work back home,
224
635153
2190
Oni ne samo da su se vratili
kući da rade,
kući da rade,
10:49
but they organized their communities to build
225
637343
2407
već su organizovali
svoje zajednice da izgrade
svoje zajednice da izgrade
10:51
Honduras' first indigenous hospital.
226
639750
3401
prvu urođeničku bolnicu u Hondurasu.
10:55
With an architect's help,
227
643151
2149
Uz pomoć arhitekte,
10:57
residents literally raised it from the ground up.
228
645300
4477
stanovnici su je doslovno
podigli od temelja do krova.
podigli od temelja do krova.
11:01
The first patients walked through the doors
229
649777
2182
Prvi pacijenti su se u njoj lečili
11:03
in December 2007,
230
651959
2340
u decembru 2007,
11:06
and since then, the hospital has received
231
654299
2509
a od tada je bolnica primila
11:08
nearly one million patient visits.
232
656808
3150
skoro milion poseta pacijenata.
11:11
And government is paying attention,
233
659958
2161
Vlada o njoj vodi računa,
11:14
upholding the hospital as a model
234
662119
2521
i podržava bolnicu kao model
11:16
of rural public health for Honduras.
235
664640
5179
ruralnog zdravstva za Honduras.
11:21
ELAM's graduates are smart,
236
669819
3648
ELAM-ovi diplomci su pametni,
11:25
strong and also dedicated.
237
673467
3453
jaki i takođe posvećeni.
11:28
Haiti, January 2010.
238
676920
4354
Haiti, januar 2010.
11:33
The pain.
239
681274
1835
Bol.
11:35
People buried under 30 million tons of rubble.
240
683109
4003
Ljudi zatrpani ispod 30 miliona
tona krhotina.
tona krhotina.
11:39
Overwhelming.
241
687112
2149
Poražavajuće.
11:41
Three hundred forty Cuban doctors
242
689261
1878
340 kubanskih lekara
11:43
were already on the ground long term.
243
691139
2441
su već bili na terenu na duže vreme.
11:45
More were on their way. Many more were needed.
244
693580
2403
Još ih je stizalo.
Mnogo ih je više bilo potrebno.
Mnogo ih je više bilo potrebno.
11:47
At ELAM, students worked round the clock
245
695983
3244
Na ELAM-u, studenti su radili neprekidno
11:51
to contact 2,000 graduates.
246
699227
3218
kako bi kontaktirali 2000 diplomaca.
11:54
As a result, hundreds arrived in Haiti,
247
702445
3184
Kao rezultat ovih napora,
stotine ih je stiglo na Haiti,
stotine ih je stiglo na Haiti,
11:57
27 countries' worth, from Mali in the Sahara
248
705629
4297
iz 27 zemalja, od Malija u Sahari
12:01
to St. Lucia, Bolivia, Chile and the USA.
249
709926
4488
do Sv. Lucije, Bolivije, Čilea i SAD-a.
12:06
They spoke easily to each other in Spanish
250
714414
3296
Oni su međusobno lako
komunicirali na španskom
komunicirali na španskom
12:09
and listened to their patients in Creole
251
717710
2689
i slušali pacijente na kreolskom
12:12
thanks to Haitian medical students
252
720399
2126
zahvaljujući studentima
medicine sa Haitija
medicine sa Haitija
12:14
flown in from ELAM in Cuba.
253
722525
2227
koji su doleteli iz ELAM-a iz Kube.
12:16
Many stayed for months,
254
724752
1688
Mnogi su ostali mesecima,
12:18
even through the cholera epidemic.
255
726440
2778
čak i tokom epidemije kolere.
12:21
Hundreds of Haitian graduates
256
729218
2340
Stotine diplomaca sa Haitija
12:23
had to pick up the pieces,
257
731558
2722
je moralo da ponovo dovede stvari u red,
12:26
overcome their own heartbreak,
258
734280
2014
prevaziđu sopstvenu tugu,
12:28
and then pick up the burden
259
736294
1866
a onda preuzmu teret
12:30
of building a new public health system for Haiti.
260
738160
3568
izgradnje novog zdravstvenog
sistema Haitija.
sistema Haitija.
12:33
Today, with aid of organizations and governments
261
741728
2497
Danas, uz pomoć organizacija i vlada
12:36
from Norway to Cuba to Brazil,
262
744225
2553
od Norveške do Kube i Brazila,
12:38
dozens of new health centers have been built,
263
746778
2226
grade se desetine novih
zdravstvenih centara,
zdravstvenih centara,
12:41
staffed, and in 35 cases, headed
264
749004
3571
u kojima rade, a u 35 slučajeva
kojima i upravljaju
kojima i upravljaju
12:44
by ELAM graduates.
265
752575
3922
diplomci sa ELAM-a.
12:48
Yet the Haitian story
266
756497
1868
Ipak, priča sa Haitija
12:50
also illustrates some of the bigger problems
267
758365
2059
takođe ilustruje neke od većih problema
12:52
faced in many countries.
268
760424
2216
sa kojima se suočavaju mnoge zemlje.
12:54
Take a look:
269
762640
1744
Pogledajte:
12:56
748 Haitian graduates by
2012, when cholera struck,
2012, when cholera struck,
270
764384
5782
748 diplomaca sa Haitija
do 2012, kada je izbila kolera,
do 2012, kada je izbila kolera,
13:02
nearly half working in the public health sector
271
770166
3746
gotovo polovina je radila u
javnom zdravstvenom sistemu
javnom zdravstvenom sistemu
13:05
but one quarter unemployed,
272
773912
2071
ali jedna četvrtina je bila nezaposlena,
13:07
and 110 had left Haiti altogether.
273
775983
6110
a 110 ih je potpuno napustilo Haiti.
13:14
So in the best case scenarios,
274
782093
2768
Tako da u najboljem slučaju,
13:16
these graduates are staffing
275
784861
1870
ovi diplomci rade
13:18
and thus strengthening public health systems,
276
786731
3249
i tako jačaju javne zdravstvene sisteme,
13:21
where often they're the only doctors around.
277
789980
3179
tamo gde su često jedini lekari.
13:25
In the worst cases, there are simply not enough jobs
278
793159
2791
U najgorim slučajevima,
prosto nema dovoljno radnih mesta
prosto nema dovoljno radnih mesta
13:27
in the public health sector,
279
795950
1642
u javnom zdravstvenom sistemu,
13:29
where most poor people are treated,
280
797592
2566
u kojem se leči većina
siromašnog stanovništva,
siromašnog stanovništva,
13:32
not enough political will, not enough resources,
281
800158
2799
nema dovoljno političke spremnosti,
ni dovoljno sredstava,
ni dovoljno sredstava,
13:34
not enough anything —
282
802957
2206
ničega nema dovoljno -
13:37
just too many patients with no care.
283
805163
3453
samo previše pacijenata bez nege.
13:40
The grads face pressure from their families too,
284
808616
2984
Diplomci se suočavaju i sa
pritiskom od strane svojih porodica,
pritiskom od strane svojih porodica,
13:43
desperate to make ends meet,
285
811600
2303
očajnih da sastave kraj sa krajem,
13:45
so when there are no public sector jobs,
286
813903
2576
tako da kada nema posla u javnom sektoru,
13:48
these new MDs decamp into private practice,
287
816479
2621
ovi novi lekari prelaze u privatnu praksu,
13:51
or go abroad to send money home.
288
819100
4015
ili se sele u inostranstvo
kako bi mogli da kući šalju novac.
kako bi mogli da kući šalju novac.
13:55
Worst of all, in some countries,
289
823115
3185
A što je najgore, u nekim zemljama,
13:58
medical societies influence accreditation bodies
290
826300
2936
medicinska udruženja utiču
na organe koji izdaju dozvole
na organe koji izdaju dozvole
14:01
not to honor the ELAM degree,
291
829236
3015
da ne priznaju diplome sa ELAM-a,
14:04
fearful these grads will take their jobs
292
832251
2317
u strahu da će ovi diplomci
da im preuzmu posao
da im preuzmu posao
14:06
or reduce their patient loads and income.
293
834568
3555
ili im smanje broj pacijenata i prihod.
14:10
It's not a question of competencies.
294
838123
2981
To nije pitanje kompetentnosti.
14:13
Here in the USA, the California Medical Board
295
841104
2508
Ovde, u SAD-u,
Medicinski odbor Kalifornije
Medicinski odbor Kalifornije
14:15
accredited the school after rigorous inspection,
296
843612
3600
je nakon rigorozne inspekcije
akreditovao ovu školu
akreditovao ovu školu
14:19
and the new physicians are making good
297
847212
2048
i novi lekari su uspešni
14:21
on Cuba's big bet,
298
849260
2191
zahvaljujući velikom riziku Kube,
14:23
passing their boards and accepted
299
851451
1811
prolaze odbore i prihvataju ih
14:25
into highly respected residencies
300
853262
2385
na visoko cenjene specijalizacije
14:27
from New York to Chicago to New Mexico.
301
855647
4091
od Njujorka do Čikaga i Novog Meksika.
14:31
Two hundred strong, they're coming
302
859738
2625
Njih više od dve stotine se vraća
14:34
back to the United States energized,
303
862363
2385
u SAD puni entuzijazma,
14:36
and also dissatisfied.
304
864748
2587
ali i nezadovoljni.
14:39
As one grad put it,
305
867335
1631
Kao što je rekao jedan od diplomaca:
14:40
in Cuba, "We are trained to provide quality care
306
868966
3454
"Na Kubi nas uče da
pružimo kvalitetnu negu
pružimo kvalitetnu negu
14:44
with minimal resources,
307
872420
2002
uz minimalna sredstva,
14:46
so when I see all the resources we have here,
308
874422
2576
tako da kada vidim sredstva
kojima ovde raspolažemo,
kojima ovde raspolažemo,
14:48
and you tell me that's not possible,
309
876998
2162
i kada mi se kaže da to
nije moguće,
nije moguće,
14:51
I know it's not true.
310
879160
2170
znam da to nije tačno.
14:53
Not only have I seen it work, I've done the work."
311
881330
5619
Ne samo da sam video da je moguće,
sam sam to radio".
sam sam to radio".
14:58
ELAM's graduates,
312
886949
1961
ELAM-ovi diplomci,
15:00
some from right here in D.C. and Baltimore,
313
888910
3517
neki baš odavde,
iz Vašingtona i Baltimora,
iz Vašingtona i Baltimora,
15:04
have come from the poorest of the poor
314
892427
3168
potiču iz daleko najsiromašnijih krajeva
15:07
to offer health, education
315
895595
2333
kako bi pružili zdravlje, obrazovanje
15:09
and a voice to their communities.
316
897928
2916
i glas svojim zajednicama.
15:12
They've done the heavy lifting.
317
900844
2652
Oni su obavili težak deo posla.
15:15
Now we need to do our part
318
903496
2014
Sada mi moramo da uradimo naš deo
15:17
to support the 23,000 and counting,
319
905510
3617
i podržimo tih 23.000 i više.
15:21
All of us —
320
909127
1354
Svi mi:
15:22
foundations, residency directors, press,
321
910481
3634
fondacije, odgovorni za
dodelu specijalizacija, štampa,
dodelu specijalizacija, štampa,
15:26
entrepreneurs, policymakers, people —
322
914115
3184
preduzetnici, zakonodavci, narod,
15:29
need to step up.
323
917299
2153
moramo da istupimo.
15:31
We need to do much more globally
324
919452
1991
Moramo da globalno učinimo mnogo više
15:33
to give these new doctors the opportunity
325
921443
2939
kako bismo ovim novim
lekarima pružili mogućnost
lekarima pružili mogućnost
15:36
to prove their mettle.
326
924382
2393
da dokažu svoje sposobnosti.
15:38
They need to be able
327
926775
1003
Mora im biti omogućeno
15:39
to take their countries' licensing exams.
328
927778
3204
da polažu ispite za licencu
u svojim zemljama.
u svojim zemljama.
15:42
They need jobs in the public health sector
329
930982
2948
Potrebni su im poslovi u
javnom zdravstvenom sektoru
javnom zdravstvenom sektoru
15:45
or in nonprofit health centers
330
933930
1755
ili u neprofitnim zdravstvenim centrima
15:47
to put their training and commitment to work.
331
935685
3847
kako bi uposlili
svoje obrazovanje i predanost.
svoje obrazovanje i predanost.
15:51
They need the chance to be
332
939532
2283
Potrebna im je šansa da budu
15:53
the doctors their patients need.
333
941815
4859
lekari koji su potrebni
njihovim pacijentima.
njihovim pacijentima.
15:58
To move forward,
334
946674
1857
Kako bismo išli napred,
16:00
we may have to find our way back
335
948531
2992
možda treba da nađemo put nazad
16:03
to that pediatrician who would
336
951523
2183
do onog pedijatra koji bi
16:05
knock on my family's door
337
953706
1687
pokucao na naša vrata
16:07
on the South Side of Chicago when I was a kid,
338
955393
3186
na južnoj strani Čikaga,
kada sam bila dete,
kada sam bila dete,
16:10
who made house calls,
339
958579
1910
koji bi dolazio u kućne posete,
16:12
who was a public servant.
340
960489
2891
koji je bio javni službenik.
16:15
These aren't such new ideas
341
963380
1823
Ovo nisu tako nove ideje
16:17
of what medicine should be.
342
965203
2362
o tome kakva bi trebalo da bude medicina.
16:19
What's new is the scaling up
343
967565
2725
Ono što je novo je povećanje razmere
16:22
and the faces of the doctors themselves:
344
970290
3383
i lica samih lekara:
16:25
an ELAM graduate is more likely to be a she
345
973673
3457
verovatnije je da će
ELAM-ov diplomac biti ženskog
ELAM-ov diplomac biti ženskog
16:29
than a he;
346
977130
1930
nego muškog roda;
16:31
In the Amazon, Peru or Guatemala,
347
979060
2927
U Amazoniji, Peruu ili Gvatemali,
16:33
an indigenous doctor;
348
981987
2351
urođenički lekar,
16:36
in the USA, a doctor of color
349
984338
3014
u SAD, obojeni lekar
16:39
who speaks fluent Spanish.
350
987352
2396
koji tečno govori španski.
16:41
She is well trained, can be counted on,
351
989748
3679
Ona je dobro obrazovana, pouzdana,
16:45
and shares the face and culture of her patients,
352
993427
3644
i deli uverenja i
kulturu svojih pacijenata,
kulturu svojih pacijenata,
16:49
and she deserves our support surely,
353
997071
3409
i ona zasigurno zaslužuje našu podršku,
16:52
because whether by subway, mule, or canoe,
354
1000480
4466
jer da li metroom, na mazgi ili u kanuu,
16:56
she is teaching us to walk the walk.
355
1004946
2998
ona nas uči da pređemo sa reči na delo.
16:59
Thank you. (Applause)
356
1007944
5570
Hvala vam. (Aplauz)
ABOUT THE SPEAKER
Gail Reed - Cuban health care expertAmerican journalist and Havana resident Gail Reed spotlights a Cuban medical school that trains doctors from low-income countries who pledge to serve communities like their own.
Why you should listen
Many of the doctors treating ebola patients in Africa were trained in Cuba. Why? In this informative talk, journalist Gail Reed spotlights a Cuban medical school that trains doctors from low-income countries -- if they pledge to serve the communities who need them most.
More profile about the speakerGail Reed | Speaker | TED.com