TEDGlobal 2009
Marc Koska: 1.3m reasons to re-invent the syringe
重新设计注射器的130万个理由
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每年因为资金不足而重复使用的注射器导致130万人死亡。 Marc Koska通过数据、图片和偷拍的录像向我们展示了这个世界性的问题。他跟我们分享了他的解决方案：一种低廉的不可重复使用的注射器。
Marc Koska - Inventor
Marc Koska wants to improve health care in the developing world by re-designing dangerous medical tools -- and offering education to practitioners in under-funded clinics. Full bio
Marc Koska wants to improve health care in the developing world by re-designing dangerous medical tools -- and offering education to practitioners in under-funded clinics. Full bio
Double-click the English transcript below to play the video.
00:18
Twenty-five-and-a-quarter years ago I read
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25年以前我读过
00:20
a newspaper article which said
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一篇文章，说有一天
00:22
that one day syringes would be
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注射器将会成为
00:25
one of the major causes of the spread of AIDS,
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艾滋病传播的
00:27
the transmission of AIDS.
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和感染的最主要途径
00:29
I thought this was unacceptable. So I decided to do something about it.
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绝不可如此。所以我想略尽微薄之力。
00:33
Sadly, it's come true. Malaria, as we all know,
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不幸的是，这件事已成为现实。众所周知，
00:36
kills approximately one million people a year.
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疟疾每年会导致约一百万人死亡。
00:39
The reuse of syringes now exceeds that
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岂料因重复使用注射器而导致的死亡人数已超过了疟疾，
00:41
and kills 1.3 million people a year.
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每年它会杀死130万人。
00:46
This young girl and her friend
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照片里面的这个小女孩和她的朋友
00:48
that I met in an orphanage in Delhi
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是我在德里的孤儿院碰到的
00:50
were HIV positive from a syringe.
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因为使用已用过的注射器而感染了艾滋病。
00:55
And what was so sad about this particular story
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更为不幸的是
00:58
was that once their parents had found out --
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当他们的父母发现之后
01:01
and don't forget, their parents took them to the doctor --
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他们的父母就带他们去医生那里做检查。
01:05
the parents threw them out on the street.
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确认之后，就把他们遗弃了
01:07
And hence they ended up in an orphanage.
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最后他们就成了孤儿。
01:10
And it comes from situations like this where
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这样的情况
01:12
you have either skilled or unskilled practitioners,
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无论是在熟练还是不熟练的护士身上都会发生
01:15
blindly giving an injection to someone.
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盲目的给人注射
01:18
And the injection is so valuable,
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因为注射很贵
01:21
that the people basically trust
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所以人们通常都很相信医生
01:23
the doctor, being second to God, which I've heard many times,
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仅次于相信上帝，我经常听别人说
01:26
to do the right thing. But in fact they're not.
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医生们总是对的，但是，事实上，他们不总是对的
01:29
And you can understand, obviously, the transmission problem
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正如你们所料，这种问题
01:31
between people in high-virus areas.
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于HIV病毒盛行的地方的严重性。
01:35
This video we took undercover,
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现在看一下我们在印度的公立医院里面拍的这个小视频，
01:37
which shows you, over a half an hour period,
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于半小时以内
01:39
a tray of medicines of 42 vials,
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托盘里面一共有42剂药
01:43
which are being delivered with only 2 syringes in a public hospital in India.
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但是仅仅使用了2支注射器
01:48
And over the course of half an hour, not one syringe
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在半个小时里面，再也没有
01:50
was filmed being unwrapped.
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打开一支新的注射器
01:52
They started with two and they ended with two.
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开始用两个最后还是那两个
01:55
And you'll see, just now, a nurse coming back to the tray,
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看，一个护士走到托盘这里
01:58
which is their sort of modular station,
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这是他们放注射器的地方
02:01
and dropping the syringe she's just used
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把刚刚用过的注射器扔到里面
02:04
back in the tray for it to be picked up and used again.
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走到托盘这里，拿起来接着用
02:07
So you can imagine the scale of this problem.
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你想想这个问题有多么严重
02:10
And in fact in India alone, 62 percent
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事实上，仅仅在印度，62%
02:12
of all injections given
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的注射
02:14
are unsafe.
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根本就不安全。
02:16
These kids in Pakistan don't go to school.
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巴基斯坦的这些小孩根本不上学
02:18
They are lucky. They already have a job.
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他们比较“幸运”。他们找到了工作
02:20
And that job is that they go around and pick up syringes
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工作就是在医院后面到处转
02:22
from the back of hospitals,
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拾起用过的注射器
02:24
wash them, and in the course of this,
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洗干净，然后洗的时候
02:26
obviously picking them up they injure themselves.
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尤其是捡这些注射器的时候经常会划伤流血。
02:29
And then they repackage them and sell them out on markets
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然后冲洗包装，且拿到市场上面去卖
02:32
for literally more money
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因为这样可以挣更多的钱
02:34
than a sterile syringe in the first place, which is quite bizarre.
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跟一个消毒的注射器相比的话。太怪了
02:37
In an interesting photo, their father, while we were talking to him,
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这个照片比较有意思。当我们跟他们爸爸聊天的时候
02:40
picked up a syringe and pricked his finger --
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他拿起一个注射器，刺破了他的手指
02:42
I don't know whether you can see the drop of blood on the end --
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不知道你们有没有看到注射器末端的的那滴血
02:45
and immediately whipped out a box of matches,
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然后他打开一盒火柴
02:48
lit one, and burned the blood off the end of his finger,
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点着，烧掉了从他指头尖往下滴的那滴血
02:51
giving me full assurance
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信誓旦旦地保证
02:53
that that was the way that you stopped the transmission of HIV.
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这样做就能阻止HIV的传播
02:57
In China, recycling is a major issue.
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在中国，注射器的回收是个大问题
03:01
And they are collected en mass -- you can see the scale of it here --
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注射器被成堆的堆在这里，这个图里面能看出来
03:04
and sorted out, by hand, back into the right sizes,
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然后手工按照注射器大小分类
03:08
and then put back out on the street.
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然后分好类，弄在一起
03:10
So recycling and reuse
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所以，注射器的回收和再利用
03:13
are the major issues here.
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在中国是个很大的问题
03:15
But there was one interesting anecdote that I found in Indonesia.
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我还在印度尼西亚发现了一个有趣的事
03:18
In all schools in Indonesia,
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在印度尼西亚的学校里边
03:20
there is usually a toy seller in the playground.
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通常学校操场旁边会有卖玩具的
03:22
The toy seller, in this case,
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这里面这个卖玩具的
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had syringes, which they usually do,
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他们通常也卖注射器
03:26
next door to the diggers, which is obviously
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跟你猜的差不多
03:28
what you would expect.
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他们是从拾荒者那里弄来的
03:30
And they use them, in the breaks, for water pistols.
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这些孩子课间的时候拿这些注射器当水枪玩
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They squirt them at each other, which is lovely and innocent.
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他们总是灌上水互相喷着玩。挺可爱，也挺天真
03:34
And they are having great fun.
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他们玩的也很高兴
03:36
But they also drink from them
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但是有的时候他们也用注射器喝水
03:38
while they're in their breaks, because it's hot.
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尤其是课间休息的时候，他们经常这样，因为天很热
03:40
And they squirt the water into their mouths.
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他们对着嘴用水枪喷水
03:43
And these are used with traces of blood visible.
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这些水枪里面有的时候会有血迹
03:48
So we need a better product. And we need better information.
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所以我们需要一种更好的注射器，让大家都知道怎么正确使用注射器
03:50
And I think, if I can just borrow this camera,
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我想，能不能拍一下这个
03:55
I was going to show you my invention,
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这就是我的发明
03:57
which I came up with.
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我自己想出来的
04:00
So, it's a normal-looking syringe.
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恩，很普通的一个注射器。
04:02
You load it up in the normal way. This is made
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使用跟普通的注射器完全一样。有14个我们给了许可证
04:04
on existing equipment in 14 factories that we license.
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的企业里面都能生产。
04:08
You give the injection and then put it down.
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你注射完然后扔到一边
04:11
If someone then tries to reuse it,
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如果有人想重新使用这个注射器的话
04:13
it locks and breaks afterwards.
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这个注射器就会自锁，再也没法用了
04:15
It's very, very simple. Thank you.
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非常非常简单。谢谢大家。
04:17
(Applause)
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（掌声）
04:20
And it costs the same as a normal syringe.
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这种新型注射器与普通的注射器成本完全一样
04:22
And in comparison, a Coca-Cola
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对比一下，大约仅相当于一瓶可口可乐
04:24
is 10 times the price.
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价钱的十分之一。
04:26
And that will stop reusing a syringe 20 or 30 times.
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同时呢，如果用这种注射器，那种一个注射器用二三十次的事情就再也不会发生了。
04:29
And I have an information charity
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我在印度做了
04:31
which has done huge scale amount of work in India.
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很多免费的宣传
04:35
And we're very proud of giving information to people,
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我们竭尽全力把这种信息告诉人们
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so that little kids like this don't do stupid things.
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这样，小孩子就再也不干这种傻事了。
04:40
Thank you very much.
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谢谢大家。
04:42
(Applause)
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（掌声）
ABOUT THE SPEAKER
Marc Koska - InventorMarc Koska wants to improve health care in the developing world by re-designing dangerous medical tools -- and offering education to practitioners in under-funded clinics.
Why you should listen
In 1984, Marc Koska read an article that predicted HIV would spread widely through unsafe injections. He writes, "Appalled at the prospect of such an avoidable catastrophe, I decided there and then to try and do something about it." The prediction, sadly, turned out to be true: syringe reuse now accounts for 1.3 million deaths -- more than malaria. In the next years, Koska undertook the study of public health to find out what could be done. He determined that the design of syringes was the critical issue.
Today, Koska's solution to the problem, the K1 syringe -- it locks down after a single injection, preventing reuse -- is in use by millions. But he hasn't stopped there: In 2005, he founded a nonprofit, SafePoint, which aims to educate people in the developing world about the dangers of reusing any instruments that come into contact with blood.
Marc Koska | Speaker | TED.com