TEDxMidAtlantic
Erica Frenkel: The universal anesthesia machine
Erika Frenkel (Erica Frenkel): Univerzalna naprava za anesteziju
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Šta ako ste na operaciji i nestane struje? Nema svetla, nema kiseonika - i vaša anestezija prestane da radi. To se stalno dešava u bolnicama širom sveta i pretvara rutinske postupke u tragedije. Erika Frenkel predstavlja jedno rešenje - univerzalnu napravu 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 dizajnu tehnologije u medicini
za okruženja sa manjkom resursa.
za okruženja sa manjkom resursa.
00:20
I study health systems in these countries.
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U ovim zemljama proučavam
sisteme zdravstva.
sisteme zdravstva.
00:22
And one of the major gaps in care,
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Jedna od velikih rupa u zdravstvu,
00:24
almost across the board,
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skoro svuda,
00:26
is access to safe surgery.
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je pristup bezbednim operacijama.
00:28
Now one of the major bottlenecks that we've found
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Jedno od većih uskih grla koje smo pronašli
00:31
that's sort of preventing both the access in the first place
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i koje na neki način
isprva onemogućava pristup
isprva onemogućava pristup
00:34
and the safety of those surgeries that do happen
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i bezbednost operacija koje se dešavaju
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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Zapravo to je model za koji očekujemo
da funkcioniše
da funkcioniše
00:40
for delivering anesthesia
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kod davanja anestezije
00:42
in these environments.
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u ovim okruženjima.
00:44
Here we have a scene that you would find
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Ovde imamo prizor koji biste videli
00:46
in any operating room across the U.S. or any other developed country.
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u bilo kojoj operacionoj sali u SAD
ili nekoj drugoj razvijenoj zemlji.
ili nekoj drugoj razvijenoj zemlji.
00:49
In the background there
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U pozadini se nalazi
00:51
is a very sophisticated anesthesia machine.
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veoma sofisticirana naprava za anesteziju.
00:53
And this machine is able
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Ova naprava može
00:55
to enable surgery and save lives
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da omogući operacije i spasi živote
00:57
because it was designed
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jer je smišljena
00:59
with this environment in mind.
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za ovo okruženje.
01:01
In order to operate, this machine needs a number of things
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Kako bi radila, ovoj napravi je potreban
određen broj stvari
određen broj stvari
01:04
that this hospital has to offer.
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koje ova bolnica može da ponudi.
01:06
It needs an extremely well-trained anesthesiologist
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Potreban joj je veoma obučen anesteziolog
01:09
with years of training with complex machines
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sa godinama iskustva
sa kompleksnim napravama
sa kompleksnim napravama
01:11
to help her monitor the flows of the gas
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da pomogne sa praćenjem protoka gasa
01:14
and keep her patients safe and anesthetized
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i da pacijente drži bezbednim
i pod anestezijom
i pod anestezijom
01:16
throughout the surgery.
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kroz tok operacije.
01:18
It's a delicate machine running on computer algorithms,
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To je prefinjena naprava
koju pokreću kompjuterski algoritmi
koju pokreću kompjuterski algoritmi
01:21
and it needs special care, TLC, to keep it up and running,
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i potrebna joj je posebna nega
kako bi funkcionisala,
kako bi funkcionisala,
01:24
and it's going to break pretty easily.
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i lako će se kvariti.
01:26
And when it does, it needs a team of biomedical engineers
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A kada se pokvari, potreban je
tim biomedicinskih inženjera
tim biomedicinskih inženjera
01:29
who understand its complexities,
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koji razumeju njene pojedinosti,
01:31
can fix it, can source the parts
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koji mogu da je poprave, pronađu delove
01:33
and keep it saving lives.
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i omoguće joj da nastavi da spašava živote.
01:35
It's a pretty expensive machine.
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To je prilično skupa naprava.
01:37
It needs a hospital
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Potrebna joj je bolnica
01:39
whose budget can allow it to support one machine
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čiji budžet može da dozvoli jednu napravu
01:41
costing upwards of 50 or $100,000.
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koja košta od 50 do 100 000 dolara.
01:44
And perhaps most obviously,
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Ono što je možda najočiglednije
01:46
and perhaps most importantly --
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i možda najbitnije -
01:48
and the path to concepts that we've heard about
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i put do koncepata o kojima smo slušali
01:50
kind of illustrate this --
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na neki način ovo ilustruje -
01:52
it needs infrastructure
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potrebna joj je infrastruktura
01:54
that can supply an uninterrupted source
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koja može da doprema neprekidan izvor
01:56
of electricity, of compressed oxygen
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struje, kompresovanog kiseonika
01:59
and other medical supplies
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i drugih medicinskih zaliha
02:01
that are so critical to the functioning
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koje su toliko bitne
02:03
of this machine.
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za funkcionisanje ove naprave.
02:05
In other words, this machine requires a lot of stuff
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Drugim rečima, ovoj napravi
je potrebno puno toga
je potrebno puno toga
02:08
that this hospital cannot offer.
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što ova bolnica ne može da ponudi.
02:10
This is the electrical supply
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Ovo je snabdevanje strujom
02:12
for a hospital in rural Malawi.
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za bolnicu u zabačenom delu Malavija.
02:14
In this hospital,
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U ovoj bolnici
02:16
there is one person qualified to deliver anesthesia,
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postoji jedna osoba
kvalifikovana za davanje anestezije
kvalifikovana za davanje anestezije
02:18
and she's qualified
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i kvalifikovana je
02:20
because she has 12, maybe 18 months
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jer ima 12, možda 18 meseci
02:22
of training in anesthesia.
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obuke za anesteziju.
02:24
In the hospital and in the entire region
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U bolnici i u celom okrugu
02:26
there's not a single biomedical engineer.
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nema nijednog biomedicinskog inženjera.
02:28
So when this machine breaks,
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Kada se ova naprava pokvari,
02:30
the machines they have to work with break,
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naprave sa kojima rade se kvare,
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 da pokušaju da to reše,
ali to je većinom kraj priče.
ali to je većinom kraj priče.
02:35
Those machines go the proverbial junkyard.
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Ove naprave idu na poslovičnu deponiju.
02:38
And the price tag of the machine that I mentioned
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A cena naprave koju sam spomenula
02:41
could represent maybe a quarter or a third
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mogla bi da predstavlja četvrtinu ili trećinu
02:43
of the annual operating budget
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godišnjeg budžeta za operacije
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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Konačno, mislim da možete videti
da infrastruktura nije veoma jaka.
da infrastruktura nije veoma jaka.
02:50
This hospital is connected to a very weak power grid,
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Bolnica je povezana
na veoma slabu energetsku mrežu
na veoma slabu energetsku mrežu
02:53
one that goes down frequently.
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koja često nije u funkciji.
02:55
So it runs frequently, the entire hospital,
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Tako da cela bolnica veoma često
02:57
just on a generator.
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radi samo na generatoru.
02:59
And you can imagine, the generator breaks down
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Kao što možete zamisliti, generator se kvari
03:01
or runs out of fuel.
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i nestane mu goriva.
03:03
And the World Bank sees this
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I Svetska banka vidi ovo
03:05
and estimates that a hospital in this setting in a low-income country
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i procenjuje da bolnica u ovom okruženju,
u zemlji sa malim primanjima,
u zemlji sa malim primanjima,
03:08
can expect up to 18 power outages
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može da ima i do 18 nestanaka struje
03:11
per month.
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svakog meseca.
03:13
Similarly compressed oxygen and other medical supplies
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Slično tome,
zalihe kompresovanog kiseonika i druge
zalihe kompresovanog kiseonika i druge
03:15
are really a luxury
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su zaista luksuz
03:17
and can often be out of stock
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i često ih nema
03:19
for months or even a year.
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mesecima ili čak godinu dana.
03:21
So it seems crazy, but the model that we have right now
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Možda izgleda ludo,
ali model koji imamo sada
ali model koji imamo sada
03:24
is taking those machines
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uzima te naprave
03:26
that were designed for that first environment that I showed you
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koje su smišljene za prvo okruženje
koje sam vam pokazala
koje sam vam pokazala
03:28
and donating or selling them
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i onda ih donira ili prodaje
03:30
to hospitals in this environment.
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bolnicama u ovom okruženju.
03:33
It's not just inappropriate,
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To nije samo neodgovarajuće
03:35
it becomes really unsafe.
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nego i veoma opasno.
03:38
One of our partners at Johns Hopkins
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Jedan od naših partnera
iz Džons Hopkinsa
iz Džons Hopkinsa
03:40
was observing surgeries in Sierra Leone
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je posmatrao operacije u Sijera Leoneu
03:43
about a year ago.
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pre oko godinu dana.
03:45
And the first surgery of the day happened to be an obstetrical case.
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Prva operacija tog dana
je bila akušerski slučaj.
je bila akušerski slučaj.
03:48
A woman came in, she needed an emergency C-section
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Došla je žena kojoj je hitno
bio potreban carski rez
bio potreban carski rez
03:51
to save her life and the life of her baby.
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kako bi se spasio život nje i njenog deteta.
03:54
And everything began pretty auspiciously.
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Sve je počelo prilično uspešno.
03:56
The surgeon was on call and scrubbed in.
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Pozvan je hirurg i dezinfikovao je ruke.
03:58
The nurse was there.
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Medicinska sestra je bila tu.
04:00
She was able to anesthetize her quickly,
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Brzo joj je dala anesteziju
04:02
and it was important because of the emergency nature of the situation.
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i to je bilo bitno zbog hitnosti situacije.
04:05
And everything began well
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Sve je počelo 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 operacije
04:12
the surgeon is racing against the clock to finish his case,
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hirurg se bori s vremenom
da završi sa operacijom,
da završi sa operacijom,
04:15
which he can do -- he's got a headlamp.
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što može da uradi - ima naglavnu lampu.
04:17
But the nurse is literally
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Ali medicinska sestra bukvalno
04:19
running around a darkened operating theater
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trči po zamračenoj operacionoj sali
04:22
trying to find anything she can use to anesthetize her patient,
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i pokušava da pronađe
bilo šta da pacijentu da anesteziju,
bilo šta da pacijentu da anesteziju,
04:24
to keep her patient asleep.
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kako bi pacijent ostao u snu.
04:26
Because her machine doesn't work when there's no power.
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Jer njena naprava ne radi
kada nema struje.
kada nema struje.
04:30
And now this routine surgery that many of you have probably experienced,
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I sada ova rutinska operacija
koju je verovatno mnogo vas iskusilo
koju je verovatno mnogo vas iskusilo
04:33
and others are probably the product of,
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i čiji su drugi ljudi proizvod,
04:35
has now become a tragedy.
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postaje tragedija.
04:38
And what's so frustrating is this is not a singular event;
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Ono što je frustrirajuće je to
što ovo nije pojedinačan događaj,
što ovo nije pojedinačan događaj,
04:41
this happens across the developing world.
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ovo se dešava širom dela sveta u razvoju.
04:43
35 million surgeries are attempted every year
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35 miliona operacija
se započinje svake godine
se započinje svake godine
04:46
without safe anesthesia.
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bez bezbedne anestezije.
04:48
My colleague, Dr. Paul Fenton,
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Moj kolega, dr Pol Fenton,
04:50
was living this reality.
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je živeo u ovoj stvarnosti.
04:52
He was the chief of anesthesiology
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On je bio šef anesteziologije
04:54
in a hospital in Malawi, a teaching hospital.
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u pripravničkoj bolnici u Malaviju.
04:56
He went to work every day
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Svakog dana išao je na posao
04:58
in an operating theater like this one,
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u operacionoj sali poput ove,
05:00
trying to deliver anesthesia and teach others how to do so
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pokušavajući da da anesteziju
i nauči druge kako da to urade
i nauči druge kako da to urade
05:03
using that same equipment
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koristeći istu opremu
05:05
that became so unreliable, and frankly unsafe,
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koja je postala toliko nepouzdana,
i iskreno opasna,
i iskreno opasna,
05:07
in his hospital.
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u ovoj 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 kao što možete zamisliti,
neopisive tragedije,
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. Bilo je dosta.
Gotov sam. Bilo je dosta.
05:16
There has to be something better."
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Mora da postoji nešto bolje."
05:18
So he took a walk down the hall
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Prošetao je hodnikom
05:20
to where they threw all those machines that had just crapped out on them --
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do mesta gde bacaju
sve te mašine koje crknu -
sve te mašine koje crknu -
05:22
I think that's the scientific term --
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mislim da je to naučni izraz -
05:24
and he just started tinkering.
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i počeo je da čačka po njima.
05:26
He took one part from here and another from there,
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Uzeo je jedan deo odavde,
jedan odande,
jedan odande,
05:28
and he tried to come up with a machine
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i pokušao da smisli napravu
05:30
that would work in the reality that he was facing.
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koja bi radila u situacijama
sa kojima se suočavao.
sa kojima se suočavao.
05:33
And what he came up with was this guy,
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Smislio je ovo,
05:36
the prototype for the Universal Anesthesia Machine --
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prototip Univerzalne naprave za anesteziju,
05:39
a machine that would work
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naprave koja bi radila
05:41
and anesthetize his patients
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i pružala pacijentima anesteziju
05:43
no matter the circumstances that his hospital had to offer.
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bez obzira na okolnosti u bolnici.
05:47
Here it is back at home
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Evo je kod kuće
05:49
at that same hospital, developed a little further, 12 years later,
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u istoj toj bolnici, u daljem stupnju razvoja,
12 godina kasnije,
12 godina kasnije,
05:52
working on patients from pediatrics to geriatrics.
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u radu sa pacijentima,
od pedijatrije do gerijatrije.
od pedijatrije do gerijatrije.
05:55
Now let me show you a little bit about how this machine works.
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Dozvolite da vam pokažem
kako radi ova naprava.
kako radi ova naprava.
05:58
Voila!
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Opa!
06:00
Here she is.
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Evo je.
06:02
When you have electricity,
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Kada imate struju,
06:04
everything in this machine begins in the base.
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sve u ovoj napravi počinje u osnovi.
06:06
There's a built-in oxygen concentrator down there.
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Postoji ugrađeni koncentrator kiseonika dole.
06:09
Now you've heard me mention oxygen a few times at this point.
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Dosad ste čuli već nekoliko puta
da pominjem kiseonik.
da pominjem kiseonik.
06:12
Essentially, to deliver anesthesia,
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U principu, da biste dali anesteziju,
06:14
you want as pure oxygen as possible,
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želite najčistiji mogući kiseonik,
06:16
because eventually you're going to dilute it essentially
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jer ćete u nekom trenutku da ga u osnovi
06:18
with the gas.
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razblažite gasom.
06:20
And the mixture that the patient inhales
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Mešavina koju udiše pacijent
06:22
needs to be at least a certain percentage oxygen
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mora da bude najmanje
određeni procenat kiseonika
određeni procenat kiseonika
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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Ali kada ovde imate struju,
06:28
the oxygen concentrator takes in room air.
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koncentrator kiseonika uzima
vazduh iz prostorije.
vazduh iz prostorije.
06:31
Now we know room air is gloriously free,
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Znamo da je ovaj vazduh
veličanstveno besplatan,
veličanstveno besplatan,
06:34
it is abundant,
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ima ga puno,
06:36
and it's already 21 percent oxygen.
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i već se sastoji od 21% kiseonika.
06:38
So all this concentrator does is take that room air in, filter it
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Sve što ovaj koncentrator radi je
da uzima taj vazduh, filtrira ga,
da uzima taj vazduh, filtrira ga,
06:41
and send 95 percent pure oxygen
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i šalje čist kiseonik od 95%
06:43
up and across here
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gore i preko ovoga
06:45
where it mixes with the anesthetic agent.
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gde ga meša sa anestetičkim agensom.
06:48
Now before that mixture
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Pre nego što ta mešavina
06:50
hits the patient's lungs,
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dopre do pluća pacijenta,
06:52
it's going to pass by here --
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proći će ovuda -
06:54
you can't see it, but there's an oxygen sensor here --
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ne možete to videti,
ali postoji senzor kiseonika ovde -
ali postoji senzor kiseonika ovde -
06:56
that's going to read out on this screen
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to će se očitati na ovom ekranu,
06:58
the percentage of oxygen being delivered.
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procenat kiseonika koji se doprema.
07:01
Now if you don't have power,
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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 struja nestane
u sred operacije,
u sred operacije,
07:06
this machine transitions automatically,
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ova naprava se automatski prebacuje,
07:08
without even having to touch it,
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bez ijednog dodira,
07:10
to drawing in room air from this inlet.
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na korišćenje vazduha iz prostorije
kroz ovaj ulaz.
kroz ovaj ulaz.
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 to što sada
07:17
you're only working with 21 percent oxygen.
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radite samo sa kiseonikom od 21%.
07:20
Now that used to be a dangerous guessing game,
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To je 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 da znate da ste dali premalo kiseonika
jedino kada se desi nešto loše.
jedino kada se desi nešto loše.
07:26
But we've put a long-life battery backup on here.
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Ali smo ovde stavili dugotrajnu
rezervnu bateriju.
rezervnu bateriju.
07:29
This is the only part that's battery backed up.
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To je jedini deo koji ima rezervnu bateriju.
07:31
But this gives control to the provider,
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Ali ovo snabdevaču daje kontrolu,
07:33
whether there's power or not,
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bez obzira da li ima ili nema struje,
07:35
because they can adjust the flow
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jer može da podesi tok
07:37
based on the percentage of oxygen they see that they're giving their patient.
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na osnovu procenta kiseonika
koji vidi da daje svom pacijentu.
koji vidi da daje 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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bez obzira da li imate struje ili ne,
07:44
sometimes the patient needs help breathing.
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ponekad je pacijentu potrebna pomoć
oko disanja.
oko disanja.
07:46
It's just a reality of anesthesia. The lungs can be paralyzed.
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To je stvarnost anestezije -
pluća mogu biti paralizovana.
pluća mogu biti paralizovana.
07:49
And so we've just added this manual bellows.
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I upravo smo dodali ove ručne mehove.
07:51
We've seen surgeries for three or four hours
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Viđali smo operacije od 3 ili 4 sata
07:54
to ventilate the patient on this.
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gde su pacijentima davali vazduh preko ovoga.
07:57
So it's a straightforward machine.
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Tako da je to jednostavna naprava.
08:00
I shudder to say simple;
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Stresem se na reč "prosta" -
08:02
it's straightforward.
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jednostavna je.
08:04
And it's by design.
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I to je po dizajnu.
08:06
And you do not need to be
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I ne morate biti
08:08
a highly trained, specialized anesthesiologist to use this machine,
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visoko obučen, stručan anesteziolog
da biste je koristili,
da biste je koristili,
08:11
which is good because, in these rural district hospitals,
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što je dobro jer se u ovim bolnicama
u ruralnim krajevima
u ruralnim krajevima
08:14
you're not going to get that level of training.
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ne može videti taj nivo obuke.
08:17
It's also designed for the environment that it will be used in.
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Takođe je dizajnirana za okruženje
u kom će se koristiti.
u kom će se koristiti.
08:20
This is an incredibly rugged machine.
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Ovo je neverovatno izdržljiva naprava.
08:22
It has to stand up
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Mora da se odupre
08:24
to the heat and the wear and tear that happens
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vrelini i habanju koje se dešavaju
08:26
in hospitals in these rural districts.
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u bolnicama u ovim ruralnim krajevima.
08:29
And so it's not going to break very easily,
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Tako da se neće lako pokvariti,
08:31
but if it does, virtually every piece in this machine
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ali ako se to desi, bukvalno
svaki delić ove naprave
svaki delić ove naprave
08:34
can be swapped out and replaced
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može da se izvadi i zameni
08:37
with a hex wrench and a screwdriver.
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sa običnim ključem i šrafcigerom.
08:40
And finally, it's affordable.
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I konačno, jeftina je.
08:42
This machine comes in
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Ova naprava košta
08:44
at an eighth of the cost
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osminu sume
08:46
of the conventional machine that I showed you earlier.
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klasičnih naprava koje sam vam ranije pokazala.
08:49
So in other words, what we have here
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Drugim rečima, ovo što imamo ovde
08:52
is a machine that can enable surgery and save lives
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je naprava koja može
omogućiti operacije i spašavati živote
omogućiti operacije i spašavati živote
08:55
because it was designed for its environment,
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jer je smišljena za svoje okruženje,
08:58
just like the first machine I showed you.
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baš kao prva mašina koju sam vam pokazala.
09:00
But we're not content to stop there.
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Ali nećemo se ovde zaustaviti.
09:02
Is it working?
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Da li radi?
09:04
Is this the design that's going to work in place?
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Da li je ovo dizajn
koji će raditi na svom mestu?
koji će raditi na svom mestu?
09:06
Well we've seen good results so far.
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Do sada smo videli 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.,
09:13
we've done well over 2,000 surgeries
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izvršili smo preko 2000 operacija
09:15
with no clinically adverse events.
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bez klinički štetnih događaja.
09:17
So we're thrilled.
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Tako da smo uzbuđeni.
09:19
This really seems like a cost-effective, scalable solution
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Ovo zaista izgleda kao jeftino,
skalabilno rešenje
skalabilno rešenje
09:23
to a problem that's really pervasive.
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za problem koji je stvarno sveprisutan.
09:26
But we still want to be sure
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Ali opet želimo da se postaramo
09:28
that this is the most effective and safe device
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da je ovo najefektivnija
i najbezbednija naprava
i najbezbednija naprava
09:30
that we can be putting into hospitals.
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koja se može staviti u bolnice.
09:32
So to do that we've launched a number of partnerships
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Da bismo to uradili pokrenuli smo
nekoliko partnerstava
nekoliko partnerstava
09:34
with NGOs and universities
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za NVO i univerzitetima
09:36
to gather data on the user interface,
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da bismo skupili podatke
o korisničkom interfejsu,
o korisničkom interfejsu,
09:39
on the types of surgeries it's appropriate for
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o tipovima operacija za koje je pogodna
09:41
and ways we can enhance the device itself.
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i o načinima na koje možemo
unaprediti samu napravu.
unaprediti samu napravu.
09:43
One of those partnerships
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Jedno od tih partnerstava
09:45
is with Johns Hopkins just here in Baltimore.
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je sa Džons Hopkinsom odavde iz Baltimora.
09:48
They have a really cool anesthesia simulation lab out in Baltimore.
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U Baltimoru imaju sjajnu laboratoriju
za simulaciju anestezije.
za simulaciju anestezije.
09:52
So we're taking this machine
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Uzimamo ovu napravu
09:54
and recreating some of the operating theater crises
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i simuliramo neke od kriza u operacionoj sali
09:57
that this machine might face
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sa kojim se može susresti ta naprava
09:59
in one of the hospitals that it's intended for,
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u nekoj od bolnica za koju je namenjena,
10:01
and in a contained, safe environment,
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i u zatvorenom, bezbednom okruženju,
10:04
evaluating its effectiveness.
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procenjujemo njenu efektivnost.
10:06
We're then able to compare the results from that study
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Onda možemo uporediti
rezultate iz tog istražiivanja
rezultate iz tog istražiivanja
10:09
with real world experience,
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sa stvarnim iskustvom
10:11
because we're putting two of these in hospitals
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jer stavljamo dve naprave u bolnice
10:13
that Johns Hopkins works with in Sierra Leone,
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sa kojima Džons Hopkins radi u Sijera Leoneu,
10:15
including the hospital where that emergency C-section happened.
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uključujući i onu gde se desio
onaj hitni carski rez.
onaj hitni carski rez.
10:20
So I've talked a lot about anesthesia, and I tend to do that.
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Puno sam pričala o anesteziji,
imam običaj da radim to.
imam običaj da radim to.
10:23
I think it is incredibly fascinating
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Mislim da je neverovatno očaravajuća
10:25
and an important component of health.
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i bitna komponenta zdravlja.
10:27
And it really seems peripheral, we never think about it,
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I zaista se čini nebitnom,
nikada ne razmišljamo o njoj
nikada ne razmišljamo o njoj
10:30
until we don't have access to it,
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dok ne dobijemo pristup njoj
10:32
and then it becomes a gatekeeper.
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i onda postane faktor odluke.
10:34
Who gets surgery and who doesn't?
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Ko će se operisati, a ko ne?
10:36
Who gets safe surgery and who doesn't?
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Ko će se bezbedno operisati, a ko 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 mnogih načina
10:42
that design, appropriate design,
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kako dizajn, odgovarajući dizajn,
10:45
can have an impact on health outcomes.
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može da ima uticaj
na ishode u zdravstvu.
na ishode u zdravstvu.
10:48
If more people in the health delivery space
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Kada bi više ljudi iz sektora zdravstva
10:50
really working on some of these challenges in low-income countries
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zaista radilo na nekim od ovih izazova
u zemljama sa malim primanjima
u zemljama sa malim primanjima
10:53
could start their design process,
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i započelo proces dizajniranja,
10:55
their solution search,
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njihova potraga za rešenjem,
10:57
from outside of that proverbial box
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van te poslovične zatvorene 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 rečima, kada bismo dizajnirali
11:03
for the environment that exists in so many parts of the world,
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za okruženje koje postoji
u toliko delova sveta,
u toliko delova sveta,
11:06
rather than the one that we wished existed --
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umesto za ono za koje želimo da postoji -
11:08
we might just save a lot of lives.
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možda bismo spasili puno života.
11:11
Thank you very much.
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Puno vam hvala.
11:13
(Applause)
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(Aplauz)
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