TEDGlobal 2013
Sonia Shah: 3 reasons we still haven’t gotten rid of malaria
Sonia Shah: Sababu tatu kwa nini hatujaitokomeza malaria
Filmed:
Readability: 4
1,233,836 views
Tumejua jinsi ya kutibu malaria tangu 1600,kwanini ugonjwa huu bado unaua maelfu ya mamia kila mwaka?ni zaidi ya tatizo la kitabibu,anasema mwandishi wa habari Sonia Shah.Mtazamo wa historia ya malaria unaweka wazi sababu tatu kwanini ni ngumu kutokomeza malaria
Sonia Shah - Science writer
Science historian Sonia Shah explores the surprisingly fascinating story behind an ancient scourge: malaria. Full bio
Science historian Sonia Shah explores the surprisingly fascinating story behind an ancient scourge: malaria. Full bio
Double-click the English transcript below to play the video.
00:12
So over the long course of human history,
0
822
3435
Kwa muda mrefu katika historia ya mwanadamu,
00:16
the infectious disease that's killed more humans
1
4257
2492
ugonjwa wa kuambukiza ambao umeua wanadamu wengi
00:18
than any other is malaria.
2
6749
2486
kuliko mwingine ni malaria.
00:21
It's carried in the bites of infected mosquitos,
3
9235
2861
Unabebwa katika ving'atio vya mbu,
00:24
and it's probably our oldest scourge.
4
12096
2209
na inawezekana ni janga letu la muda mrefu.
00:26
We may have had malaria since we evolved from the apes.
5
14305
3887
Inawezekana tulikuwa na malaria tangu tulipotokea kwenye enzi za sokwe.
00:30
And to this day, malaria takes a huge toll on our species.
6
18192
3602
Na mpaka leo,malaria inachukua inasababisha madhara makubwa katika jamii yetu.
00:33
We've got 300 million cases a year
7
21794
2451
Malaria inagundulika mara milioni 300 kwa mwaka
00:36
and over half a million deaths.
8
24245
2992
na vifo vipatavyo nusu milioni
00:39
Now this really makes no sense.
9
27237
2965
Sasa,hii haiingii akilini kabisa.
00:42
We've known how to cure malaria
10
30202
2652
Tumejua jinsi ya kutibu malaria
00:44
since the 1600s.
11
32854
1640
tangu mwaka 1600.
00:46
That's when Jesuit missionaries in Peru
12
34494
2297
Wakati huo wamissionari wa Peru
00:48
discovered the bark of the cinchona tree,
13
36791
2902
waligundua gamba la mti wa cinchona,
00:51
and inside that bark was quinine,
14
39693
1873
na ndani ya gamba hilo kulikuwa na quinine,
00:53
still an effective cure for malaria to this day.
15
41566
3338
ambayo ndiyo tiba ya malaria mpaka leo.
00:56
So we've known how to cure malaria for centuries.
16
44904
2901
Kwa hiyo tumejua jinsi ya kutibu malaria kwa karne sasa.
00:59
We've known how to prevent malaria since 1897.
17
47805
3184
Tumejua jinsi ya kuzuia malaria tangu mwaka 1897.
01:02
That's when the British army surgeon Ronald Ross
18
50989
2273
Ambapo ndiyo kipindi ambacho daktari mwanajeshi wa Kiingereza Ronald Ross
01:05
discovered that it was mosquitos that carried malaria,
19
53262
3358
aligundua kwamba alikuwa ni mbu ambaye anaambukiza malaria,
01:08
not bad air or miasmas, as was previously thought.
20
56620
4192
sio hewa chafu au anga chafu ,kama ilivyokuwa ikifikiriwa mwanzoni.
01:12
So malaria should be a relatively simple disease to solve,
21
60812
5283
Kwa hiyo malaria inatakiwa iwe ni gonjwa rahisi kutibu,
01:18
and yet to this day, hundreds of thousands of people
22
66095
3930
lakini mpaka leo,mamia ya maelfu ya watu
01:22
are going to die from the bite of a mosquito.
23
70025
3475
wanakufa kutokana na kung'atwa na mbu.
01:25
Why is that?
24
73500
1245
Kwanini iwe hivyo?
01:26
This is a question that's
25
74745
1530
Hili ni swali ambalo
01:28
personally intrigued me for a long time.
26
76275
2155
binafsi limenifanya niwe mdadisi kwa muda mrefu.
01:30
I grew up as the daughter of Indian immigrants
27
78430
2759
Nimelelewa na wazazi wahamiaji wa kutoka India
01:33
visiting my cousins in India every summer,
28
81189
2259
nikiwatembelea mabinamu zangu nchini india kila kiangazi,
01:35
and because I had no immunity to the local malarias,
29
83448
3188
na kwa sasa sikuwa na kinga ya malaria,
01:38
I was made to sleep under this hot, sweaty mosquito net every night
30
86636
4234
Nilikuwa nalala kwenye chandarua chenye joto sana kila siku
01:42
while my cousins, they were allowed to sleep
31
90870
1691
wakati binamu zangu,waliruhusiwa kulala
01:44
out on the terrace and have
32
92561
1229
nje kwenye mitaro na
01:45
this nice, cool night breeze wafting over them.
33
93790
2762
kupata hewa nzuri ya usiku.
01:48
And I really hated the mosquitos for that.
34
96552
3524
Na nilichukia sana mbu kwa hilo.
01:52
But at the same time, I come from a Jain family,
35
100076
3368
Lakini wakati huohuo,nilitokea katika familia ya Jain,
01:55
and Jainism is a religion that espouses
36
103444
2314
na dini ya jaini inaunga mkono
01:57
a very extreme form of nonviolence.
37
105758
3138
sana aina ya kutofanya fujo.
02:00
So Jains are not supposed to eat meat.
38
108896
3328
Watu wa dini ya jain hawaruhusiwi kula nyama.
02:04
We're not supposed to walk on grass,
39
112224
1857
Hatutakiwi kutembea kwenye nyasi,
02:06
because you could, you know,
40
114081
1261
kwa sababu unaweza
02:07
inadvertently kill some insects when you walk on grass.
41
115342
1900
kuua wadudu unapotembea kwenye nyasi.
02:09
We're certainly not supposed to swat mosquitos.
42
117242
2777
Haturuhusiwi kuwaua mbu.
02:12
So the fearsome power of this little insect
43
120019
3716
Uoga wa kumuogopa mdudu huyu mdogo
02:15
was apparent to me from a very young age,
44
123735
1979
ulianza tangu nilipokuwa na umri mdogo,
02:17
and it's one reason why I spent five years as a journalist
45
125714
3271
na ndiyo sababu kwanini nimetumia miaka mitano kama mwandishi wa habari
02:20
trying to understand, why has malaria
46
128985
2688
nikijaribu kuelewa,kwanini malaria
02:23
been such a horrible scourge for all of us for so very long?
47
131673
4540
imekua adui mbaya sana kwetu sote kwa muda mrefu?
02:28
And I think there's three main reasons why.
48
136213
2657
Na nafikiri kuna sababu kuu tatu ni kwanini.
02:30
Those three reasons add up to the fourth reason,
49
138870
2468
Hizo sababu tatu zinaingizwa kwenye sababu ya nne,
02:33
which is probably the biggest reason of all.
50
141338
2811
ambayo inawezekana ndiyo sababu kubwa kuliko zote.
02:36
The first reason is certainly scientific.
51
144149
2961
Sababu ya kwanza ni ya kisayansi.
02:39
This little parasite that causes malaria,
52
147110
2315
Mdudu huyu mdogo anayesababisha malaria,
02:41
it's probably one of the most complex
53
149425
1927
ni mmoja wa vijidudu watata
02:43
and wily pathogens known to humankind.
54
151352
2591
wanaojulikana kwa mwanadamu.
02:45
It lives half its life inside the cold-blooded mosquito
55
153943
3340
Anaishi nusu ya maisha yake katika mbu mwenye damu baridi
02:49
and half its life inside the warm-blooded human.
56
157283
4402
na nusu nyingine ndani ya binadamu mwenye damu vuguvugu.
02:53
These two environments are totally different,
57
161685
2998
Haya mazingira mawili ni tofauti kabisa,
02:56
but not only that, they're both utterly hostile.
58
164683
3016
lakini si hivyo tu,yana uhamasa mkubwa sana.
02:59
So the insect is continually trying to fight off the parasite,
59
167699
4007
Kwa hiyo mdudu anaendelea kujaribu kupambana na vimelea,
03:03
and so is the human body continually trying to fight it off.
60
171706
2961
na binadamu nae anaendelea kupambana na vimelea.
03:06
This little creature survives under siege like that,
61
174667
3750
Mdudu anaendelea kuishi pamoja na mashambulizi haya,,
03:10
but not only does it survive, it has thrived.
62
178417
3075
sio tu anaishi,anastawi pia.
03:13
It has spread. It has more ways to evade attack than we know.
63
181492
4322
Amesambaa.Ana njia nyingi za kukimbia kushambuliwa zaidi ya tunavyojua.
03:17
It's a shape-shifter, for one thing.
64
185814
2114
Huwa vinabadili umbo,kwa kitu kimoja
03:19
Just as a caterpillar turns into a butterfly,
65
187928
3159
Kama vile funza anavyobadilika kuwa kipepeo,
03:23
the malaria parasite transforms itself like that
66
191087
2639
vimelea vya malaria vinajibadili kwa aina hiyo
03:25
seven times in its life cycle.
67
193726
3223
mara saba katika maisha yake.
03:28
And each of those life stages not only looks totally different from each other,
68
196949
4257
Na hatua hizo zote za maisha sio tu zipo tofauti,
03:33
they have totally different physiology.
69
201206
3064
zina mfumo wa tofauti kabisa.
03:36
So say you came up with some great drug
70
204270
1992
Kwa hiyo tuseme unagundua dawa nzuri sana ya kutibu
03:38
that worked against one stage of the parasite's life cycle.
71
206262
2940
inayopambana na hatua moja ya maisha ya vimelea hivi.
03:41
It might do nothing at all to any of the other stages.
72
209202
3465
Haitafanya kazi katika hatua nyingine yoyote.
03:44
It can hide in our bodies, undetected,
73
212667
2863
Vitajificha kwenye miili yetu,bila kugundulika,
03:47
unbeknownst to us, for days, for weeks,
74
215530
2364
bila kujulikana ,kwa siku,kwa wiki kadhaa,
03:49
for months, for years, in some cases even decades.
75
217894
3799
kwa miezi,kwa miaka,na wakati mwingine hadi kwa miongo.
03:53
So the parasite is a very big scientific challenge to tackle,
76
221693
4384
Kwa hiyo vimeleani changamoto kubwa sana kuishinda,
03:58
but so is the mosquito that carries the parasite.
77
226077
3205
mbu ambaye ndiye anaambukiza malaria.
04:01
Only about 12 species of mosquitos
78
229282
2298
aina 12 tu za mbu
04:03
carry most of the world's malaria,
79
231580
1934
zinabeba malaria yanayoambukizwa duniani
04:05
and we know quite a bit about the kinds of
80
233514
2476
na tunajua kidogo tabia ya
04:07
watery habitats that they specialize in.
81
235990
2925
umajimaji waliyozoea
04:10
So you might think, then, well, why don't we just
82
238915
2282
Kwa hiyo unaweza fikiria,kwanini
04:13
avoid the places where the killer mosquitos live? Right?
83
241197
3156
tusiepukane na sehemu ambazo mbu wanaishi?Sawa?
04:16
We could avoid the places where the killer grizzly bears live
84
244353
2278
Tunaweza epuka wanapoishi dubu
04:18
and we avoid the places where the killer crocodiles live.
85
246631
2759
na tunaweza epuka sehemu ambapo mamba anaishi.
04:21
But say you live in the tropics
86
249390
3230
Lakini tuseme unaishi kwenye maeneo ya tropiki
04:24
and you walk outside your hut one day
87
252620
3273
na unatoka nje ya tembe yako siku moja
04:27
and you leave some footprints in the soft dirt
88
255893
2022
na unaacha alama za miguu kwenye uchafu laini
04:29
around your home.
89
257915
1923
karibu na nyumbani kwako.
04:31
Or say your cow does, or say your pig does,
90
259838
3230
Au tuseme ng'ombe wako kafanya hivyo,au nguruwe kafanya hivyo,
04:35
and then, say, it rains,
91
263068
2134
na baadaye mvua ikanyesha,
04:37
and that footprint fills up with a little bit of water.
92
265202
2368
na hizo alama za miguu zikajaa maji.
04:39
That's it. You've created the perfect
93
267570
2081
Unakuwa umetengeneza
04:41
malarial mosquito habitat that's right outside your door.
94
269651
3578
makazi mazuri sana nje ya nyumba yako.
04:45
So it's not easy for us to extricate ourselves from these insects.
95
273229
2862
Inakuwa sio rahisi kuondokana na mbu.
04:48
We kind of create places that they love to live
96
276091
2634
Tunatengeneza sehemu wanazopendelea kuishi
04:50
just by living our own lives.
97
278725
1999
kwa kuishi maisha yetu.
04:52
So there's a huge scientific challenge,
98
280724
1379
Kwa hiyo kuna changamoto kubwa sana ya kisayansi
04:54
but there's a huge economic challenge too.
99
282103
2207
lakini kuna changamoto kubwa sana ya kiuchumi.
04:56
Malaria occurs in some of the poorest
100
284310
1935
Malaria inatokea katika sehemu masikini sana
04:58
and most remote places on Earth,
101
286245
1939
na sehemu za nje ya miji duniani,
05:00
and there's a reason for that.
102
288184
1845
na kuna kwa hilo.
05:02
If you're poor, you're more likely to get malaria.
103
290029
2700
Kama wewe ni masikini,una uwezekano mkubwa wa kupata malaria.
05:04
If you're poor, you're more likely to live
104
292729
2153
Kama wewe ni masikini,una uwezekano mkubwa wa kuishi
05:06
in rudimentary housing on marginal land that's poorly drained.
105
294882
4069
katika makazi duni katika ardhi ambayo ni yenye madimbwi mengi.
05:10
These are places where mosquitos breed.
106
298951
2589
Hizi ndizi sehemu ambapo mbu wanazaliana.
05:13
You're less likely to have door screens or window screens.
107
301540
3600
Uwezekano wa kuwa na nyavu za mbu milangoni na madirishani unakuwa mdogo.
05:17
You're less likely to have electricity
108
305140
1903
Uwezekano wa kuwa na umeme, unakuwa mdogo.
05:19
and all the indoor activities that electricity makes possible,
109
307043
3006
na shughuli zote ambazo zinawezeshwa na umeme ndani ya nyumba,
05:22
so you're outside more.
110
310049
1233
unakuwa upo nje zaidi.
05:23
You're getting bitten by mosquitos more.
111
311282
2332
Unang'atwa na mbu.
05:25
So poverty causes malaria,
112
313614
1625
Kwa hiyo tunaona umasikini unasababisha malaria,
05:27
but what we also know now is that malaria itself
113
315239
3033
lakini tunajua sasa kwamba malaria yenyewe
05:30
causes poverty.
114
318272
1647
inasababisha umasikini.
05:31
For one thing, it strikes hardest during harvest season,
115
319919
2651
Kwa kitu kimoja,huwa inakumba muda wa mavuno,
05:34
so exactly when farmers need to be out in the fields
116
322570
2756
muda uleule ambapo wakulima wanakuwa mashambani
05:37
collecting their crops, they're home sick with a fever.
117
325326
3909
kuvuna mazao yao,wanakuwa nyumbani wakiumwa homa.
05:41
But it also predisposes people to death
118
329235
2861
Lakini pia inawaweka watu katika hatari ya kifo
05:44
from all other causes.
119
332096
1785
kutokana sababu nyingine zote.
05:45
So this has happened historically.
120
333881
1360
Hili limetokea kihistoria.
05:47
We've been able to take malaria out of a society.
121
335241
3382
Tumeweza kuondoa malaria kwa jamii.
05:50
Everything else stays the same,
122
338623
1457
Kila kitu kinabaki vilevile,
05:52
so we still have bad food, bad water, bad sanitation,
123
340080
2675
tuna chakula kibaya,maji yasiyo salama,mazingira bora,
05:54
all the things that make people sick.
124
342755
1761
na haya yote yanasababisha watu kuumwa.
05:56
But just if you take malaria out,
125
344516
2144
Lakini kama utaondoa malaria,
05:58
deaths from everything else go down.
126
346660
3812
vifo kutokana na sababu nyingine vitapungua.
06:02
And the economist Jeff Sachs has actually quantified
127
350472
2711
Na mwanauchumi Jeff Sachs ameonesha
06:05
what this means for a society.
128
353183
2185
hii ina maana gani kwa jamii.
06:07
What it means is, if you have malaria in your society,
129
355368
2754
Inachomaanisha ni kwamba,kama una malaria katika jamii yako,
06:10
your economic growth is depressed
130
358122
2461
ukuaji wako wa uchumi unadidimia
06:12
by 1.3 percent every year,
131
360583
3970
kwa asilimia 1.3 kila mwaka,
06:16
year after year after year, just this one disease alone.
132
364553
3799
mwaka baada ya mwaka,kwa hili gonjwa moja tu.
06:20
So this poses a huge economic challenge,
133
368352
2564
Hii inaleta changamoto kubwa sana ya kiuchumi,
06:22
because say you do come up with your great drug
134
370916
2184
kwa sababu unasema umeleta dawa bora
06:25
or your great vaccine -- how do you deliver it
135
373100
2210
au chanjo bora-- unaitoa vipi
06:27
in a place where there's no roads,
136
375310
2570
kwenye sehemu ambazo hazina barabara,
06:29
there's no infrastructure,
137
377880
1193
hazina miundombinu,
06:31
there's no electricity for refrigeration to keep things cold,
138
379073
3334
hazina umeme kwa kugandisha vitu kwenye jokofu,
06:34
there's no clinics, there's no clinicians
139
382407
2720
hazina zahanati,hazina wataalamu wa afya.
06:37
to deliver these things where they're needed?
140
385127
2534
kutoa huduma hizi zinapohitajika
06:39
So there's a huge economic challenge in taming malaria.
141
387661
4003
Kwa hiyo kuna changamoto kubwa katila kupambana na malaria.
06:43
But along with the scientific challenge and the economic challenge,
142
391664
3056
Lakini pamoja na changamoto ya kisayansi na changamoto ya kiuchumi,
06:46
there's also a cultural challenge,
143
394720
1812
kuna changamoto ya kitamaduni pia,
06:48
and this is probably the part about malaria
144
396532
3385
na hii moja ya upande wa malaria
06:51
that people don't like to talk about.
145
399917
2301
ambayo watu hawapendelei kuiongelea.
06:54
And it's the paradox that the people
146
402218
2711
na ni mkanganyiko kwamba watu
06:56
who have the most malaria in the world
147
404929
1808
wenye malaria sana duniani
06:58
tend to care about it the least.
148
406737
2580
wanalichukulia hawajali kwa uzito.
07:01
This has been the finding of medical anthropologists again and again.
149
409317
3412
Haya yamekuwa matokeo ya tafiti za wataalamu wa afya tena na tena.
07:04
They ask people in malarious parts of the world,
150
412729
2767
Wanawauliza watu katika sehemu zenye malaria duniani,
07:07
"What do you think about malaria?"
151
415496
2056
"Unafikiri nini kuhusu malaria?"
07:09
And they don't say, "It's a killer disease. We're scared of it."
152
417552
3909
Na hawasemi"Ni ugonjwa unaoua.Tunauogopa"
07:13
They say, "Malaria is a normal problem of life."
153
421461
5338
Wanasema"Malaria ni tatizo la kawaida katika maisha"
07:18
And that was certainly my personal experience.
154
426799
1766
Haya ndiyo majibu niliyopata binafsi.
07:20
When I told my relatives in India
155
428565
2019
Nilipowaambia ndugu zangu nchini India
07:22
that I was writing a book about malaria,
156
430584
1484
kwamba nilikuwa nikiandika kitabu kuhusu malaria
07:24
they kind of looked at me like
157
432068
1967
waliniangalia kama
07:26
I told them I was writing a book about warts or something.
158
434035
2701
Niliwaambia nilikuwa naandika kitabu kuhusu majipu au kitu fulani.
07:28
Like, why would you write about something so boring,
159
436736
3047
kama,kwanini uandike kuhusu kitu kinachochosha.
07:31
so ordinary? You know?
160
439783
1666
cha kawaida sana?unajua?
07:33
And it's simple risk perception, really.
161
441449
2728
Na ni muonekano rahisi lakini ni hatari.
07:36
A child in Malawi, for example,
162
444177
2435
Mtoto nchini Malawi,kwa mfano,
07:38
she might have 12 episodes of malaria before the age of two,
163
446612
4812
Anaweza akaugua malaria mara 12 kabla hajafika umri wa miaka miwili,
07:43
but if she survives,
164
451424
2053
lakini anaishi,
07:45
she'll continue to get malaria throughout her life,
165
453477
2614
ataendelea kupata malaria maisha yake yote,
07:48
but she's much less likely to die of it.
166
456091
2723
lakini uwezekano wa kufa kwa ugonjwa huo ni mdogo sana kwake.
07:50
And so in her lived experience,
167
458814
1952
Kwa katika kuishi kwake,
07:52
malaria is something that comes and goes.
168
460766
3331
malaria ni kitu kinachokuja na kuondoka.
07:56
And that's actually true for most of the world's malaria.
169
464097
2030
Na hiyo ni kweli kwa malaria duniani.
07:58
Most of the world's malaria comes and goes on its own.
170
466127
3577
Malaria sehemu nyingi huja na kuondoka.
08:01
It's just, there's so much malaria
171
469704
3124
Ni kwamba,kuna malaria sana
08:04
that this tiny fraction of cases that end in death
172
472828
3771
kwamba sehemu hi ndogo ya matukio yanayopelekea kifo
08:08
add up to this big, huge number.
173
476599
2961
yanaongezeka kuwa katika namba kubwa.
08:11
So I think people in malarious parts of the world
174
479560
1993
Kwa hiyi nadhani watu katika sehemu zenye malaria
08:13
must think of malaria the way
175
481553
1522
wanatakiwa kufikiri malaria katika njia
08:15
those of us who live in the temperate world
176
483075
1659
ambayo sisi tunaoishi kwenye baridi
08:16
think of cold and flu. Right?
177
484734
2251
tunafikiri kifua na mafua.Sawa?
08:18
Cold and flu have a huge burden on our societies
178
486985
3406
Mafua na kifua vina mzigo mkubwa sana katika jamii yetu
08:22
and on our own lives,
179
490391
1681
na katika maisha yetu,
08:24
but we don't really even take
180
492072
1264
lakini hatuchukui
08:25
the most rudimentary precautions against it because
181
493336
2542
tahadhari zozote kwa sababu
08:27
we consider it normal to get cold and flu
182
495878
2721
tunaona ni kawaida kupata mafua na kifua
08:30
during cold and flu season.
183
498599
2237
wakati wa nyakati za baridi.
08:32
And so this poses a huge cultural challenge in taming malaria,
184
500836
4412
Hii inaleta changamoto kubwa ya kitamaduni katika kupambana na malaria
08:37
because if people think it's normal to have malaria,
185
505248
3774
kwa sababu kama watu wanadhani ni kawaida kuwa na malaria,
08:41
then how do you get them to run to the doctor
186
509022
3458
sasa kwa nini wanaenda kwa daktari
08:44
to get diagnosed, to pick up their prescription,
187
512480
3146
kwenda kupimwa,kuandikiwa dawa wanazotakiwa tumia,
08:47
to get it filled, to take the drugs,
188
515626
1522
kuchukua dawa zao,
08:49
to put on the repellents, to tuck in the bed nets?
189
517148
3479
kuweka vifukuza mbu,kutumia chandarua?
08:52
This is a huge cultural challenge in taming this disease.
190
520627
4667
Hii inafanya kuendelea kuifuga malaria
08:57
So take all that together.
191
525294
1502
Kwa hiyo chukua yote hayo.
08:58
We've got a disease. It's scientifically complicated,
192
526796
4452
Tuna ugonjwa.Kisayansi umefumbika,
09:03
it's economically challenging to deal with,
193
531248
2428
una changamoto ya kiuchumi,
09:05
and it's one for which the people who stand
194
533676
1645
na ndiyo watu ambao wanaosimama
09:07
to benefit the most care about it the least.
195
535321
2304
kufaidika wanaujali kwa hali ya chini sana.
09:09
And that adds up to the biggest problem of all,
196
537625
2088
Na hiyo inaongeza tatizo kubwa sana katika yote,
09:11
which, of course, is the political problem.
197
539713
2949
ambapo,kiukweli,ni tatizo la kisiasa.
09:14
How do you get a political leader to do anything
198
542662
2858
Unampata wapi kiongozi wa siasa kufanya chochote
09:17
about a problem like this?
199
545520
2061
kwa tatizo kama hili?
09:19
And the answer is, historically, you don't.
200
547581
4625
Na jibu ni kwamba,kihistoria,huwezi.
09:24
Most malarious societies throughout history
201
552206
2133
Jamii nyingi zenye malaria kwa kipindi chote
09:26
have simply lived with the disease.
202
554339
2116
wameishi na ugonjwa.
09:28
So the main attacks on malaria have come
203
556455
2003
Kwa hiyo mashambulizi halisi kwenye malaria yametokea
09:30
from outside of malarious societies,
204
558458
2624
nje ya jamii zenye malaria,
09:33
from people who aren't constrained
205
561082
1794
kutoka kwa watu ambao hawalazimishwi
09:34
by these rather paralyzing politics.
206
562876
2979
na hizi siasa zilizokufa.
09:37
But this, I think, introduces a whole host of other kinds of difficulties.
207
565855
3295
Lakini,nadhani,inaongeza aina nyingine za ugumu.
09:41
The first concerted attack against malaria
208
569150
2420
Shambulio la kwanza la kuangamiza malaria
09:43
started in the 1950s.
209
571570
1746
lilianza mwakani 1950.
09:45
It was the brainchild of the U.S. State Department.
210
573316
3090
Ilikuwa ni mpangi uliosimamiwa na serikali.
09:48
And this effort well understood the economic challenge.
211
576406
3037
Na hizi juhudi zingekuwa na gharama sana kiuchumi.
09:51
They knew they had to focus on cheap, easy-to-use tools,
212
579443
3481
Walijua wanatakiwa kutumia zana na njia nafuu,
09:54
and they focused on DDT.
213
582924
1775
wakawaza kutumia DDT.
09:56
They understood the cultural challenge.
214
584699
1439
Walielewa changamoto ya kitamaduni.
09:58
In fact, their rather patronizing view was that
215
586138
3005
Kiukweli,mtazamao wao badala shupavu ulikuwa
10:01
people at risk of malaria shouldn't be asked to do anything at all.
216
589143
2903
watu waliopo katika hatari ya malaria hawakutakiwa kufanya chochote kabisa.
10:04
Everything should be done to them and for them.
217
592046
3722
Kila kilitakiwa wafanyiwe.
10:07
But they greatly underestimated the scientific challenge.
218
595768
3120
Lakini walididimiza sana changamoto ya kisayansi.
10:10
They had so much faith in their tools
219
598888
2327
Walikuwa na imani katika zana zao
10:13
that they stopped doing malaria research.
220
601215
2991
ambapo wakaacha kufanya tafiti za malaria.
10:16
And so when those tools started to fail,
221
604206
2468
na wakati zana hizo zilipoanza kufeli,
10:18
and public opinion started to turn against those tools,
222
606674
2700
na maoni ya watu yakaanza kuziponda zana hizo,
10:21
they had no scientific expertise to figure out what to do.
223
609374
4194
hawakauwa na wataalamu wa kisayansi kugundua ni lipi la kufanya.
10:25
The whole campaign crashed, malaria resurged back,
224
613568
3451
Kampeni hiyo ikaharibika,malaria ikarudi tena,
10:29
but now it was even worse than before
225
617019
1814
lakini sasa ni mbaya sana kuliko mwanzoni
10:30
because it was corralled into the hardest-to-reach places
226
618833
2761
kwa sababu ilifanyika katika sehemu ngumu kufikia
10:33
in the most difficult-to-control forms.
227
621594
3186
katika njia ngumu za kudhibiti.
10:36
One WHO official at the time actually called that whole campaign
228
624780
3299
Mmoja wa wafanyakazi wa WHO aliita kampeni yote hii
10:40
"one of the greatest mistakes ever made in public health."
229
628079
5057
"moja ya kosa kubwa lililowahi fanyika katika sekta ya afya"
10:45
The latest effort to tame malaria started in the late 1990s.
230
633136
2507
Juhudi ya hivi karibuni ya kudhibiti malaria ilianza mwaka 1990.
10:47
It's similarly directed and financed primarily
231
635643
3712
Iliongozwa na kupewa msaada wa kifedha
10:51
from outside of malarious societies.
232
639355
2148
kutoka katika jamii zisizo na malaria.
10:53
Now this effort well understands the scientific challenge.
233
641503
2504
Juhudi hizi sasa zinatambua kabisa changamoto ya kisayansi.
10:56
They are doing tons of malaria research.
234
644007
2221
Wanafanya tafiti nyingi sana za malaria.
10:58
And they understand the economic challenge too.
235
646228
2453
Na wanaelewa changamoto ya kiuchumi pia.
11:00
They're focusing on very cheap, very easy-to-use tools.
236
648681
3560
Wanatumia vifaa nafuu sana na rahisi kutumia.
11:04
But now, I think, the dilemma is the cultural challenge.
237
652241
3892
Lakini sasa,nafikiri,njia panda ni changamoto ya ktamaduni.
11:08
The centerpiece of the current effort is the bed net.
238
656133
3634
Juhudi za sasa ni chandarua.
11:11
It's treated with insecticides.
239
659767
1776
Kinawekewa dawa ya kuua mbu.
11:13
This thing has been distributed across the malarious world
240
661543
2370
Hiki kitu kimesambazwa kote katika sehemu zenye malaria
11:15
by the millions.
241
663913
1433
kwa mamilioni.
11:17
And when you think about the bed net,
242
665346
2232
Na unapofikira kuhusu chandarua,
11:19
it's sort of a surgical intervention.
243
667578
2559
ni aina ya kuingilia upasuaji.
11:22
You know, it doesn't really have any value
244
670137
2146
Unajua,haiongezi kitu chochote
11:24
to a family with malaria except that it helps prevent malaria.
245
672283
3663
kwenye familia yenye malaria bali inasaidia kujikinga tu na malaria.
11:27
And yet we're asking people to use these nets every night.
246
675946
4009
Na tunawaambia watu watumie vyandarua kila usiku.
11:31
They have to sleep under them every night.
247
679955
1277
Wanatakiwa walale kwenye vyandarua kila usiku.
11:33
That's the only way they are effective.
248
681232
2037
Na hivyo ndiyo njia pekee bora.
11:35
And they have to do that
249
683269
1353
Na wanatakiwa kufanya hivyo
11:36
even if the net blocks the breeze,
250
684622
3086
na hata kama chandarua kinazuia upepo mwanana,
11:39
even if they might have to get up in the middle of the night
251
687708
3145
hata kama watatakiwa kuamka katikati ya usiku
11:42
and relieve themselves,
252
690853
1534
na kujipooza,
11:44
even if they might have to move all their furnishings
253
692387
2249
hata kama watatakiwa kutoa vyombo vyao vyote
11:46
to put this thing up,
254
694636
1467
ili kuweka chandarua,
11:48
even if, you know, they might live in a round hut
255
696103
2853
hata kama,unajua,wanaweza kuwa wanaishi kwenye nyumba za tembe za mviringo
11:50
in which it's difficult to string up a square net.
256
698956
3737
ambapo ni ngumu kuweka chandarua ya pembe nne.
11:54
Now that's no big deal if you're fighting a killer disease.
257
702693
4938
Sasa,hiyo haina maana kama unapambana na ugonjwa unaoua.
11:59
I mean, these are minor inconveniences.
258
707631
2331
Namaanisha,huu ni usumbufu mdogo.
12:01
But that's not how people with malaria think of malaria.
259
709962
3839
Lakini sivyo watu wenye malaria wanafikiri kuhusu malaria.
12:05
So for them, the calculus must be quite different.
260
713801
4880
Kwao,itakuwa tofauti kidogo.
12:10
Imagine, for example, if a bunch of well-meaning Kenyans
261
718681
3918
Fikiri,kwa mfano,kundi la Wakenya wenye nia njema
12:14
came up to those of us in the temperate world and said,
262
722599
2081
wakaja kwa sisi tuliopo katika nchi za baridi na wakasema,
12:16
"You know, you people have a lot of cold and flu.
263
724680
2822
"Unajua,nyie watu mna mafua na kifua sana.
12:19
We've designed this great, easy-to-use, cheap tool,
264
727502
3128
Tumetangeneza hiki kifaa bora kabisa ambacho ni nafuu na rahisi kutumia,
12:22
we're going to give it to you for free.
265
730630
1070
tutawapa bure.
12:23
It's called a face mask,
266
731700
1433
Inaitwa kinyago cha sura,
12:25
and all you need to do is
267
733133
3873
na mnachohitaji ni
12:29
wear it every day during cold and flu season
268
737006
2410
kuvaa kila siku wakati wa kifua na mafua
12:31
when you go to school and when you go to work."
269
739416
2754
mnapoenda shule na mnapoenda kazini"
12:34
Would we do that?
270
742185
1930
Tutafanya hivyo?
12:36
And I wonder if that's how people
271
744115
2136
Na nashangaa kama ni hivyo kwa watu
12:38
in the malarious world thought of those nets
272
746251
2066
katika sehemu zenye malaria wanafikiria hivi kwa hivyo vyandarua
12:40
when they first received them?
273
748317
1703
wanapovipokea?
12:42
Indeed, we know from studies
274
750020
3398
Tunajua kutoka katika tafiti
12:45
that only 20 percent of the bed nets
275
753418
2678
kwamba asilimia 20 ya vyandarua
12:48
that were first distributed were actually used.
276
756096
3168
ambazo zimesambazwa ndiyo zinazotumika.
12:51
And even that's probably an overestimate,
277
759264
1711
Na hiyo imepigia hesabu za juu sana,
12:52
because the same people who distributed the nets
278
760975
2422
kwa sababu watu haohao wanaosambaza vyandarua
12:55
went back and asked the recipients,
279
763397
1491
walirudi na kuwauliza watumiaji,
12:56
"Oh, did you use that net I gave you?"
280
764888
2473
"mmetumia vyandarua nilivyowapa?"
12:59
Which is like your Aunt Jane asking you,
281
767361
2612
Ni sawa na shangazi yako Jane anakuuliza,
13:01
"Oh, did you use that vase I gave you for Christmas?"
282
769973
2961
"Umetumia chombo nilichokupa kwa ajili ya Krismas?"
13:04
So it's probably an overestimate.
283
772934
1866
Kwa hiyo ni makadirio ya juu.
13:06
But that's not an insurmountable problem.
284
774800
3324
Lakini si kwamba tatizo suala la kupuuzia.
13:10
We can do more education,
285
778124
1830
Tunaweza kutoa elimu zaidi,
13:11
we can try to convince these people to use the nets.
286
779954
2675
tunaweza kuwashawishi hawa watu kutumia vyandarua.
13:14
And that's what happening now.
287
782629
1275
Na hicho ndicho kinachotokea sasa.
13:15
We're throwing a lot more time and money
288
783904
1704
Tunatumia muda na hela nyingi sana
13:17
into workshops and trainings and musicals and plays
289
785608
4517
katika warsha na mafunzo na matamasha na michezo
13:22
and school meetings,
290
790125
2413
na vikao mashuleni,
13:24
all these things to convince people
291
792538
2295
haya yote kushawishi watu
13:26
to use the nets we gave you.
292
794833
2484
kutumia vyandarua tulivyowapa.
13:29
And that might work.
293
797317
2140
Na hiyo inaweza kufanya kazi.
13:31
But it takes time. It takes money.
294
799457
2678
Lakini inatumia muda.Inagharimu pia.
13:34
It takes resources. It takes infrastructure.
295
802135
2780
Inatumia rasilimali.Inatumia miundombinu.
13:36
It takes all the things that that cheap,
296
804915
2682
Inachukua vitu vyote nafuu,
13:39
easy-to-use bed net was not supposed to be.
297
807597
2779
ambazo vyandarua havikutakiwa.
13:42
So it's difficult to attack malaria from inside malarious societies,
298
810376
3404
Kwa hiyo ni ngumu kushambulia malaria kutoka ndani ya jamii yenye malaria,
13:45
but it's equally tricky when we try to attack it
299
813780
2538
Lakini inakuwa kidogo changamoto unapojaribu kushambulia malaria
13:48
from outside of those societies.
300
816318
2810
kutoka nje ya jamii hizo.
13:51
We end up imposing our own priorities
301
819128
1787
Tunaweka vipaumbele vyetu
13:52
on the people of the malarious world.
302
820915
1544
katika jamii ya watu wenye malaria.
13:54
That's exactly what we did in the 1950s,
303
822459
2794
Na hiki ndicho tulichofanya mwaka 1950.
13:57
and that effort backfired.
304
825253
1878
na hizo juhudi zilishindikana.
13:59
I would argue today,
305
827131
1631
Nitasema leo,
14:00
when we are distributing tools that we've designed
306
828762
4230
tunaposambaza vifaa ambavyo tumetengeneza
14:04
and that don't necessarily make sense in people's lives,
307
832992
3753
na ambavyo havina maana katika maiasha ya watu,
14:08
we run the risk of making the same mistake again.
308
836745
3553
tunajiweka katika hali ya kufanya kosa lingine.
14:12
That's not to say that malaria is unconquerable,
309
840298
1808
Hiyo si kusema malaria kwamba hatuwezi kuishinda Malaria,
14:14
because I think it is,
310
842106
1463
kwa sababu nadhani tunaweza,
14:15
but what if we attacked this disease
311
843569
2208
lakini inakuwaje kama tukishambulia gonjwa hili
14:17
according to the priorities of the people who lived with it?
312
845777
3543
kutokana na vipaumbele kwa watu walioishi nao?
14:21
Take the example of England and the United States.
313
849320
2436
Chukua mfano wa Uingereza na Marekani.
14:23
We had malaria in those countries for hundreds of years,
314
851756
3171
Tulikuwa na ugonjwa huo katika hizo nchi kwa mamia ya miaka,
14:26
and we got rid of it completely,
315
854927
2158
na tukaondokana nalo kabisa,
14:29
not because we attacked malaria. We didn't.
316
857085
3009
sio kwamba tulishambulia malaria.Hapana.
14:32
We attacked bad roads and bad houses
317
860094
4107
Tulishambulia barabara mbovu na nyumba mbovu
14:36
and bad drainage and lack of electricity and rural poverty.
318
864201
4882
na utoaji majitaka mbaya na ukosefu wa umeme na umasikini sehemu za vijijini.
14:41
We attacked the malarious way of life,
319
869083
3317
Tulishambulia maisha ya kuwa na malaria,
14:44
and by doing that, we slowly built malaria out.
320
872400
5720
na kwa kufanya hivyo,taratibu tukaondoa malaria.
14:50
Now attacking the malarious way of life,
321
878120
1638
Sasa kushambulia maisha ya ki-malaria,
14:51
this is something -- these are things people care about today.
322
879758
3562
hiki ni kitu-hivi ni vitu watu wanavyojala leo.
14:55
And attacking the malarious way of life,
323
883320
2387
Na kushambulia maisha ya kuishi na malaria,
14:57
it's not fast, it's not cheap, it's not easy,
324
885707
4759
sio haraka,sio nafuu,sio rahisi,
15:02
but I think it's the only lasting way forward.
325
890466
3068
lakini nafikiri ni njia pekee ya kusonga mbele.
15:05
Thank you so much.
326
893534
1293
Asante sana
15:06
(Applause)
327
894827
5447
(Makofi)
ABOUT THE SPEAKER
Sonia Shah - Science writerScience historian Sonia Shah explores the surprisingly fascinating story behind an ancient scourge: malaria.
Why you should listen
Aided by economics, culture, its own resilience and that of the insect that carries it (the mosquito), the malaria parasite has determined for thousands of years the health and course not only of human lives, but also of whole civilizations. In her book The Fever, author Sonia Shah outlines the epic and devastating history of malaria and shows how it still infects 500 million people every year, and kills half a million, in a context where economic inequality collides with science and biology.
Shah’s previous book The Body Hunters established her as a heavy hitter in the field of investigative human rights reporting. She is a frequent contributor to publications such as Scientific American, The Nation and Foreign Affairs.
Sonia Shah | Speaker | TED.com