TEDxMidAtlantic
Erica Frenkel: The universal anesthesia machine
Erica Frenkel: Univerzalni stroj za anesteziju
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Što ako ste usred operacije i nestane struje? Bez svijetla, bez kisika -- i anestezija prestane teći. To se neprestano događa u bolnicama diljem svijeta, pretvarajući rutinske postupke u tragedije. Erica Frenkel pokazuje jedno rješenje: univerzalni stroj za anesteziju.
Erica Frenkel - Medical technologist
At Gradian Health Systems, Erica Frenkel works to bring safe anesthesia to hospitals all over the world. Full bio
At Gradian Health Systems, Erica Frenkel works to bring safe anesthesia to hospitals all over the world. Full bio
Double-click the English transcript below to play the video.
00:15
I'm going to talk to you today
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Danas ću vam pričati
00:17
about the design of medical technology for low resource settings.
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o konstruiranju medicinske tehnologije za okolnosti u kojima se teško snaći.
00:20
I study health systems in these countries.
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Proučavam zdravstvene sustave u ovim zemljama.
00:22
And one of the major gaps in care,
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I jedan od najvećih propusta u zaštiti,
00:24
almost across the board,
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gotovo duž cijele zemlje
00:26
is access to safe surgery.
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je pristup sigurnoj operaciji.
00:28
Now one of the major bottlenecks that we've found
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Jedna od najvećih prepreka na koju smo naišli,
00:31
that's sort of preventing both the access in the first place
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a koja na neki način na prvom mjestu sprječava dostupnost,
00:34
and the safety of those surgeries that do happen
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a onda i sigurnost tih operacija,
00:36
is anesthesia.
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je anestezija.
00:38
And actually, it's the model that we expect to work
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I zapravo, to je model za koji očekujemo
00:40
for delivering anesthesia
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da će funkcionirati pri dostavljanju anestezije
00:42
in these environments.
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u takvim uvjetima.
00:44
Here we have a scene that you would find
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Ovdje imamo prizor koji ćete zateći
00:46
in any operating room across the U.S. or any other developed country.
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u bilo kojoj operacijskoj sali diljem SAD-a ili u bilo kojoj drugoj razvijenoj zemlji.
00:49
In the background there
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U pozadini
00:51
is a very sophisticated anesthesia machine.
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je sofisticirani stroj za anesteziju.
00:53
And this machine is able
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I ovaj je stroj sposoban
00:55
to enable surgery and save lives
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omogućiti operaciju i spasiti živote
00:57
because it was designed
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zato što je napravljen
00:59
with this environment in mind.
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s ovim uvjetima u vidu.
01:01
In order to operate, this machine needs a number of things
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Da bi radio, taj stroj treba niz stvari
01:04
that this hospital has to offer.
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koje ova bolnica treba moći ponuditi.
01:06
It needs an extremely well-trained anesthesiologist
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Treba krajnje dobrog anesteziologa
01:09
with years of training with complex machines
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s godinama vježbe sa složenim strojevima,
01:11
to help her monitor the flows of the gas
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da mu pomogne nadzirati tok plina
01:14
and keep her patients safe and anesthetized
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i održati pacijente sigurnima i uspavanima
01:16
throughout the surgery.
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tijekom operacije.
01:18
It's a delicate machine running on computer algorithms,
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To je osjetljiv stroj koji radi uz pomoć kompjuterskih algoritama,
01:21
and it needs special care, TLC, to keep it up and running,
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i treba posebnu brigu da bi ispravno radio,
01:24
and it's going to break pretty easily.
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i vrlo će se lako pokvariti.
01:26
And when it does, it needs a team of biomedical engineers
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A kada se pokvari, treba tim inženjera biomedicine
01:29
who understand its complexities,
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koji razumiju njegovu složenost,
01:31
can fix it, can source the parts
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mogu ga popraviti, mogu pronaći dijelove
01:33
and keep it saving lives.
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i omogućiti mu da nastavi spašavati živote.
01:35
It's a pretty expensive machine.
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To je prilično skup stroj.
01:37
It needs a hospital
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Treba bolnicu
01:39
whose budget can allow it to support one machine
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čiji budžet može dopustiti uzdržavanje jednog stroja
01:41
costing upwards of 50 or $100,000.
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koji stoji od 50 do 100.000 dolara.
01:44
And perhaps most obviously,
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I možda najočitije
01:46
and perhaps most importantly --
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i možda najvažnije --
01:48
and the path to concepts that we've heard about
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i put do koncepata o kojima smo čuli
01:50
kind of illustrate this --
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donekle prikazuje to --
01:52
it needs infrastructure
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treba infrastrukturu
01:54
that can supply an uninterrupted source
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koja može priskrbiti neprekinuti izvor
01:56
of electricity, of compressed oxygen
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struje, komprimiranog kisika
01:59
and other medical supplies
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i ostalih medicinskih potrepština
02:01
that are so critical to the functioning
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koje su toliko bitne za rad
02:03
of this machine.
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tog stroja.
02:05
In other words, this machine requires a lot of stuff
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Drugim riječima, taj stroj zahtjeva puno stvari
02:08
that this hospital cannot offer.
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koje ova bolnica ne može ponuditi.
02:10
This is the electrical supply
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Ovo je izvor struje
02:12
for a hospital in rural Malawi.
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za bolnicu u ruralnom Malawiju.
02:14
In this hospital,
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U ovoj je bolnici
02:16
there is one person qualified to deliver anesthesia,
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jedna osoba kvalificirana za obavljanje anestezije,
02:18
and she's qualified
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i kvalificirana je
02:20
because she has 12, maybe 18 months
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jer ima 12, možda 18 mjeseci
02:22
of training in anesthesia.
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prakse u anesteziji.
02:24
In the hospital and in the entire region
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U bolnici i u cijeloj regiji
02:26
there's not a single biomedical engineer.
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nema niti jednog inžinjera biomedicine.
02:28
So when this machine breaks,
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Stoga kad se ovaj stroj pokvari,
02:30
the machines they have to work with break,
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kada se stroj s kojim moraju raditi pokvari,
02:32
they've got to try and figure it out, but most of the time, that's the end of the road.
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moraju pokušati shvatiti kako ga popraviti, ali većinu vremena, to je kraj puta.
02:35
Those machines go the proverbial junkyard.
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Ti strojevi idu na poznata smetlišta.
02:38
And the price tag of the machine that I mentioned
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I cijena stroja koji sam spomenula
02:41
could represent maybe a quarter or a third
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može predstavljati možda četvrtinu ili trećinu
02:43
of the annual operating budget
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godišnjeg operacijskog budžeta
02:45
for this hospital.
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za ovu bolnicu.
02:47
And finally, I think you can see that infrastructure is not very strong.
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I konačno, mislim da možete vidjeti da infrastruktura nije vrlo jaka.
02:50
This hospital is connected to a very weak power grid,
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Ova je bolnica povezana s vrlo slabim izvorom struje,
02:53
one that goes down frequently.
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koji redovito zakaže.
02:55
So it runs frequently, the entire hospital,
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Stoga cijela bolnica često radi
02:57
just on a generator.
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samo na generatoru.
02:59
And you can imagine, the generator breaks down
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I možete zamisliti, generator se pokvari
03:01
or runs out of fuel.
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ili ostane bez goriva.
03:03
And the World Bank sees this
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I Svjetska banka to vidi
03:05
and estimates that a hospital in this setting in a low-income country
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i procijeni da bolnica u takvim okolnostima u zemlji s niskim prihodom
03:08
can expect up to 18 power outages
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može očekivati do 18 nestanaka struje
03:11
per month.
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u jednom mjesecu.
03:13
Similarly compressed oxygen and other medical supplies
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Slično, komprimirani kisik i ostale medicinske potrepštine
03:15
are really a luxury
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zapravo su luksuz
03:17
and can often be out of stock
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i često mogu nedostajati
03:19
for months or even a year.
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mjesecima ili čak godinu dana.
03:21
So it seems crazy, but the model that we have right now
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Čini se ludo, ali model koji trenutačno imamo,
03:24
is taking those machines
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uzima strojeve
03:26
that were designed for that first environment that I showed you
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koji su dizajnirani za onu prvu okolinu koju sam vam pokazala
03:28
and donating or selling them
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i donira ih ili prodaje
03:30
to hospitals in this environment.
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bolnicama s ovakvim uvjetima.
03:33
It's not just inappropriate,
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Nije samo neprikladno,
03:35
it becomes really unsafe.
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nego postaje i stvarno nesigurno.
03:38
One of our partners at Johns Hopkins
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Jedan od naših partnera u John Hopkinsu
03:40
was observing surgeries in Sierra Leone
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promatrao je operaciju u Sierra Leoneu
03:43
about a year ago.
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prije godinu dana.
03:45
And the first surgery of the day happened to be an obstetrical case.
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I prva operacija tog dana bio je porod.
03:48
A woman came in, she needed an emergency C-section
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Žena je došla, trebala je hitan carski rez
03:51
to save her life and the life of her baby.
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da spasi svoj i djetetov život.
03:54
And everything began pretty auspiciously.
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I sve je počelo prilično obećavajuće.
03:56
The surgeon was on call and scrubbed in.
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Kirurg je pozvan i pojavio se.
03:58
The nurse was there.
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Sestra je bila tamo.
04:00
She was able to anesthetize her quickly,
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Uspjela ju je brzo anestezirati
04:02
and it was important because of the emergency nature of the situation.
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i to je bilo važno zbog hitnosti situacije.
04:05
And everything began well
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I sve je krenulo dobro
04:07
until the power went out.
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dok nije nestalo struje.
04:10
And now in the middle of this surgery,
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I sada, usred ove operacije,
04:12
the surgeon is racing against the clock to finish his case,
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kirurg se bori s vremenom da završi slučaj,
04:15
which he can do -- he's got a headlamp.
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što uspijeva -- ima lampu na glavi.
04:17
But the nurse is literally
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Ali sestra doslovno
04:19
running around a darkened operating theater
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trči okolo po mračnoj operacijskoj sali
04:22
trying to find anything she can use to anesthetize her patient,
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pokušavajući naći bilo što što će moći upotrijebiti da anestezira svoju pacijenticu,
04:24
to keep her patient asleep.
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da ju održi uspavanom.
04:26
Because her machine doesn't work when there's no power.
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Jer njezin stroj ne radi kada nema struje.
04:30
And now this routine surgery that many of you have probably experienced,
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I sada je ta rutinska operacija koju su mnogi od vas vjerojatno iskusili,
04:33
and others are probably the product of,
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a ostali su vjerojatno njezin produkt,
04:35
has now become a tragedy.
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postala tragedija.
04:38
And what's so frustrating is this is not a singular event;
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I ono što je toliko frustrirajuće jest što to nije izdvojeni slučaj;
04:41
this happens across the developing world.
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to se događa diljem zemalja u razvoju.
04:43
35 million surgeries are attempted every year
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35 milijuna operacija se pokušava izvesti svake godine
04:46
without safe anesthesia.
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bez sigurne anestezije.
04:48
My colleague, Dr. Paul Fenton,
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Moj kolega, dr. Paul Fenton
04:50
was living this reality.
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živio je tu stvarnost.
04:52
He was the chief of anesthesiology
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Bio je glavni anesteziolog
04:54
in a hospital in Malawi, a teaching hospital.
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u bolnici u Malawiju, obrazovnoj bolnici.
04:56
He went to work every day
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Išao je na posao svaki dan
04:58
in an operating theater like this one,
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u operacijsku salu poput ove,
05:00
trying to deliver anesthesia and teach others how to do so
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pokušavajući anestezirati i poučavati druge kako to učiniti
05:03
using that same equipment
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pomoću te iste opreme
05:05
that became so unreliable, and frankly unsafe,
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koja je postala toliko nepouzdana i potpuno nesigurna
05:07
in his hospital.
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u njegovoj bolnici.
05:09
And after umpteen surgeries
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I nakon bezbroj operacija
05:11
and, you can imagine, really unspeakable tragedy,
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i , možete zamisliti, neopisive tragedije,
05:14
he just said, "That's it. I'm done. That's enough.
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samo je rekao: „To je to. Gotov sam. Dosta je.
05:16
There has to be something better."
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Mora postojati nešto bolje.“
05:18
So he took a walk down the hall
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Prošetao je niz hodnik
05:20
to where they threw all those machines that had just crapped out on them --
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do mjesta gdje bacaju sve te strojeve koji su jednostavno otišli u klinac --
05:22
I think that's the scientific term --
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mislim da je to znanstveni izraz --
05:24
and he just started tinkering.
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i jednostavno je počeo sastavljati.
05:26
He took one part from here and another from there,
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Uzeo je jedan dio odavde i drugi odande
05:28
and he tried to come up with a machine
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i pokušao je sastaviti stroj
05:30
that would work in the reality that he was facing.
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koji će raditi u okolnostima s kojima se on susretao.
05:33
And what he came up with was this guy,
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I ono što je smislio bio je ovaj frajer,
05:36
the prototype for the Universal Anesthesia Machine --
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prototip univerzalnog stroja za anesteziju --
05:39
a machine that would work
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stroj koji će raditi
05:41
and anesthetize his patients
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i anestezirati njegove pacijente
05:43
no matter the circumstances that his hospital had to offer.
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bez obzira na okolnosti koje njegova bolnica može ponuditi.
05:47
Here it is back at home
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Ovdje je ponovno kod kuće
05:49
at that same hospital, developed a little further, 12 years later,
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u toj istoj bolnici, malo razvijeniji, 12 godina kasnije,
05:52
working on patients from pediatrics to geriatrics.
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radeći na pacijentima od pedijatrije do gerijatrije.
05:55
Now let me show you a little bit about how this machine works.
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Sada mi dopustite da vam pokažem malo kako ovaj stroj radi.
05:58
Voila!
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Voila!
06:00
Here she is.
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Evo ga.
06:02
When you have electricity,
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Kada imate struje,
06:04
everything in this machine begins in the base.
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sve u ovom stroju počinje u bazi.
06:06
There's a built-in oxygen concentrator down there.
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Tu je ugrađeni koncentrator kisika ovdje dolje.
06:09
Now you've heard me mention oxygen a few times at this point.
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Dakle, čuli ste me da spominjem kisik nekoliko puta ovdje.
06:12
Essentially, to deliver anesthesia,
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U suštini, da biste ostvarili anesteziju,
06:14
you want as pure oxygen as possible,
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želite što je moguće čistiji kisik,
06:16
because eventually you're going to dilute it essentially
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jer ćete ga u konačnici zapravo razrijediti
06:18
with the gas.
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s plinom.
06:20
And the mixture that the patient inhales
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I smjesa koju pacijent udiše
06:22
needs to be at least a certain percentage oxygen
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mora biti barem određeni postotak kisika
06:24
or else it can become dangerous.
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ili može postati opasna.
06:26
But so in here when there's electricity,
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Dakle, kada ovdje ima struje,
06:28
the oxygen concentrator takes in room air.
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koncentrator kisika uvlači sobni zrak.
06:31
Now we know room air is gloriously free,
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Znamo da je sobni zrak veličanstveno besplatan,
06:34
it is abundant,
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ima ga u obilju,
06:36
and it's already 21 percent oxygen.
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i već sadrži 21 posto kisika.
06:38
So all this concentrator does is take that room air in, filter it
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Dakle, sve što ovaj koncentrator radi jest da uvlači taj sobni zrak, filtrira ga
06:41
and send 95 percent pure oxygen
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i šalje 95 posto čistog kisika
06:43
up and across here
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gore i ovdje preko
06:45
where it mixes with the anesthetic agent.
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gdje se miješa s anestetskim sredstvom.
06:48
Now before that mixture
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Prije nego ta mješavina
06:50
hits the patient's lungs,
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dosegne pacijentova pluća,
06:52
it's going to pass by here --
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proći će ovdje --
06:54
you can't see it, but there's an oxygen sensor here --
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ne možete to vidjeti, ali ovdje je senzor kisika --
06:56
that's going to read out on this screen
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koji će očitati na ovaj zaslon
06:58
the percentage of oxygen being delivered.
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postotak kisika koji se dostavlja.
07:01
Now if you don't have power,
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Sada, ako nemate struje,
07:03
or, God forbid, the power cuts out in the middle of surgery,
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ili, ne daj Bože, struje nestane usred operacije,
07:06
this machine transitions automatically,
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ovaj se stroj automatski prebacuje,
07:08
without even having to touch it,
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bez da ga čak morate dotaknuti,
07:10
to drawing in room air from this inlet.
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na uvlačenje sobnog zraka iz ovog odjeljka.
07:13
Everything else is the same.
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Sve ostalo je isto.
07:15
The only difference is that now
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Jedina razlika je što sada
07:17
you're only working with 21 percent oxygen.
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radite s 21 postotnim kisikom.
07:20
Now that used to be a dangerous guessing game,
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To je prije bila opasna igra pogađanja,
07:23
because you only knew if you had given too little oxygen once something bad happened.
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jer ste mogli znati da ste dali premalo kisika jedino kad bi se nešto loše dogodilo.
07:26
But we've put a long-life battery backup on here.
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Ali stavili smo dugoročnu baterijsku nadopunu ovdje.
07:29
This is the only part that's battery backed up.
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To je jedini dio koji podupire baterija.
07:31
But this gives control to the provider,
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Ali to daje kontrolu opskrbljivaču,
07:33
whether there's power or not,
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neovisno o tome ima li struje ili ne,
07:35
because they can adjust the flow
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jer mogu namjestiti tok
07:37
based on the percentage of oxygen they see that they're giving their patient.
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temeljeno na postotku kisika koji vide da daju svom pacijentu.
07:40
In both cases,
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U oba slučaja,
07:42
whether you have power or not,
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imali vi struje ili ne,
07:44
sometimes the patient needs help breathing.
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nekada pacijent treba pomoć pri disanju.
07:46
It's just a reality of anesthesia. The lungs can be paralyzed.
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To je jednostavno stvarnost anestezije. Pluća mogu biti paralizirana.
07:49
And so we've just added this manual bellows.
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Stoga smo samo dodali ovaj priručni mijeh.
07:51
We've seen surgeries for three or four hours
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Vidjeli smo operacije od tri ili četiri sata
07:54
to ventilate the patient on this.
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u kojima ventiliraju pacijenta s time.
07:57
So it's a straightforward machine.
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Dakle to je neposredan stroj.
08:00
I shudder to say simple;
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Drhtim da kažem jednostavno:
08:02
it's straightforward.
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neposredan je.
08:04
And it's by design.
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I takav je po dizajnu.
08:06
And you do not need to be
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I nemorate biti
08:08
a highly trained, specialized anesthesiologist to use this machine,
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visoko obrazovani, specijalizirani anesteziolog da koristite taj stroj,
08:11
which is good because, in these rural district hospitals,
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što je dobro jer, u ovim ruralnim bolnicama,
08:14
you're not going to get that level of training.
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nećete dobiti tu razinu obrazovanja.
08:17
It's also designed for the environment that it will be used in.
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Također je dizajniran za okolinu u kojoj će biti korišten.
08:20
This is an incredibly rugged machine.
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To je nevjerojatno moćan stroj.
08:22
It has to stand up
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Mora podnijeti
08:24
to the heat and the wear and tear that happens
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vrućinu i sito i rešeto koje se događa
08:26
in hospitals in these rural districts.
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u bolnicama u ovim ruralnim okružjima.
08:29
And so it's not going to break very easily,
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Stoga se neće pokvariti tako lako,
08:31
but if it does, virtually every piece in this machine
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ali ako se pokvari, praktički svaki dio u ovom stroju
08:34
can be swapped out and replaced
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može biti izvađen i zamijenjen
08:37
with a hex wrench and a screwdriver.
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uz pomoć inbus-ključa ili odvijača.
08:40
And finally, it's affordable.
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I napokon, pristupačne je cijene.
08:42
This machine comes in
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Ovaj stroj košta
08:44
at an eighth of the cost
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osminu cijene
08:46
of the conventional machine that I showed you earlier.
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uobičajnog stroja koji sam vam pokazala ranije.
08:49
So in other words, what we have here
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Dakle drugim riječima, ono što imamo ovdje
08:52
is a machine that can enable surgery and save lives
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je stroj koji može omogućiti operaciju i spasiti živote
08:55
because it was designed for its environment,
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jer je dizajniran za svoj okoliš,
08:58
just like the first machine I showed you.
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baš kao i prvi stroj koji sam vam pokazala.
09:00
But we're not content to stop there.
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Ali neće nas zadovoljiti ako ovdje stanemo.
09:02
Is it working?
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Radi li?
09:04
Is this the design that's going to work in place?
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Je li ovo oblik koji će raditi kako treba?
09:06
Well we've seen good results so far.
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Pa dosad smo vidjeli dobre rezultate.
09:08
This is in 13 hospitals in four countries,
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Ovo je u 13 bolnica u 4 zemlje,
09:11
and since 2010,
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i od 2010. godine,
09:13
we've done well over 2,000 surgeries
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napravili smo više od 2.000 operacija
09:15
with no clinically adverse events.
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bez klinički štetnih situacija.
09:17
So we're thrilled.
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Stoga smo uzbuđeni.
09:19
This really seems like a cost-effective, scalable solution
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Čini se stvarno isplativim, podesivo rješenje
09:23
to a problem that's really pervasive.
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za vrlo raširen problem.
09:26
But we still want to be sure
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Ali još uvijek želimo biti sigurni
09:28
that this is the most effective and safe device
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da je to najdjelotvorniji i najsigurniji stroj
09:30
that we can be putting into hospitals.
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koji možemo staviti u bolnice.
09:32
So to do that we've launched a number of partnerships
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Stoga da bismo to napravili pokrenuli smo nekoliko partnerstva
09:34
with NGOs and universities
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s nevladinim organizacijama i sveučilištima
09:36
to gather data on the user interface,
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da skupimo podatke na korisničkom sučelju,
09:39
on the types of surgeries it's appropriate for
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o tipovima operacija za koje je prikladan
09:41
and ways we can enhance the device itself.
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i načinima na koje možemo poboljšati sam uređaj.
09:43
One of those partnerships
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Jedno od tih partnerstva je
09:45
is with Johns Hopkins just here in Baltimore.
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s Johnom Hopkinsom upravo ovdje u Baltimoru.
09:48
They have a really cool anesthesia simulation lab out in Baltimore.
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Imaju stvarno super simulacijski laboratorij za anesteziju u Baltimoru.
09:52
So we're taking this machine
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Stoga smo uzeli ovaj stroj
09:54
and recreating some of the operating theater crises
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i ponovno stvaramo neke od kriza u operacijskoj sali
09:57
that this machine might face
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s kojima se stroj može susresti
09:59
in one of the hospitals that it's intended for,
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u nekoj od bolnica za koju je namijenjen,
10:01
and in a contained, safe environment,
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i u kontroliranom, sigurnom okolišu,
10:04
evaluating its effectiveness.
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procjenjujemo njegovu djelotvornost.
10:06
We're then able to compare the results from that study
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Onda možemo usporediti rezultate te studije
10:09
with real world experience,
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s iskustvom stvarnog svijeta,
10:11
because we're putting two of these in hospitals
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jer stavljamo dva ovakva u bolnice
10:13
that Johns Hopkins works with in Sierra Leone,
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s kojima John Hopkins radi u Sierra Leoneu,
10:15
including the hospital where that emergency C-section happened.
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uključujući i bolnicu u kojoj se onaj hitni carski rez dogodio.
10:20
So I've talked a lot about anesthesia, and I tend to do that.
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Dakle, pričala sam puno o anesteziji, i često to činim.
10:23
I think it is incredibly fascinating
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Mislim da je to nevjerojatno fascinantan
10:25
and an important component of health.
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i važan dio zdravlja.
10:27
And it really seems peripheral, we never think about it,
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I zapravo se čini perifernom, nikada ne razmišljamo o njoj,
10:30
until we don't have access to it,
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dok joj nemamo pristup,
10:32
and then it becomes a gatekeeper.
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a onda postane najvažnija.
10:34
Who gets surgery and who doesn't?
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Tko dobije operaciju, a tko ne?
10:36
Who gets safe surgery and who doesn't?
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Tko dobije sigurnu operaciju, a tko ne?
10:39
But you know, it's just one of so many ways
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Ali znate, to je samo jedan od toliko mnogo načina
10:42
that design, appropriate design,
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u kojima dizajn, prikladan dizajn,
10:45
can have an impact on health outcomes.
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može imati utisak na zdravstene rezultate.
10:48
If more people in the health delivery space
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Kada bi više ljudi u sferi zdravstvene njege,
10:50
really working on some of these challenges in low-income countries
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koji rade na nekom od ovih izazova u zemljama s niskim prihodima,
10:53
could start their design process,
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počelo vlastiti proces stvaranja,
10:55
their solution search,
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njihova potraga za rješenjem,
10:57
from outside of that proverbial box
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izvan one opće poznate kutije
10:59
and inside of the hospital --
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i unutar bolnice --
11:01
in other words, if we could design
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drugim riječima, kada bismo mogli dizajnirati
11:03
for the environment that exists in so many parts of the world,
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za uvjete koji postoje u mnogim dijelovima svijeta,
11:06
rather than the one that we wished existed --
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radije nego za one za koje bismo htjeli da postoje --
11:08
we might just save a lot of lives.
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mogli bismo spasiti mnogo života.
11:11
Thank you very much.
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Hvala vam lijepa.
11:13
(Applause)
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(Pljesak)
ABOUT THE SPEAKER
Erica Frenkel - Medical technologistAt Gradian Health Systems, Erica Frenkel works to bring safe anesthesia to hospitals all over the world.
Why you should listen
Erica Frenkel helps lead Gradian Health Systems, a social enterprise enabling safe surgery through innovative anesthesia technology. She has been a Peace Corps volunteer, managed the Global Media AIDS Initiative for the Kaiser Family Foundation and helped shape public health initiatives as a consultant for the Clinton Foundation, the Liberian Ministry of Health, Merck Vaccines, and the Wellcome Trust.
Erica Frenkel | Speaker | TED.com