TEDGlobal 2007
Seyi Oyesola: A hospital tour in Nigeria
欧叶索拉医生巡回演讲--尼日利亚的医院
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欧叶索拉医生密切关注欠发达国家的医疗保健事业。他的尼日利亚培训医院巡回图片展中所展示的那些低技术含量的工人以及捐献的设备，对于实施基本的医疗工作都是挑战。
Seyi Oyesola - Doctor
Physician Seyi Oyesola co-developed the "Hospital in a Box" -- a pop-up, portable, solar-powered OR for off-grid medicine in Africa and elsewhere. But, he says, Africa needs more than new tools to heal itself. Full bio
Physician Seyi Oyesola co-developed the "Hospital in a Box" -- a pop-up, portable, solar-powered OR for off-grid medicine in Africa and elsewhere. But, he says, Africa needs more than new tools to heal itself. Full bio
Double-click the English transcript below to play the video.
00:18
Just to put everything in context,
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为了了解事情的来龙去脉
00:20
and to kind of give you a background to where I'm coming from,
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以及介绍一下我们国家的背景情况
00:24
so that a lot of the things I'm going to say,
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要说的事情有很多
00:26
and the things I'm going to do --
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包括我将去做的事
00:29
or things I'm going to tell you I've done --
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和已经做过的事
00:31
you will understand exactly why and how I got motivated to be where I am.
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你们会确切的明白我为什么以及怎样被鼓励着走到今天这一步。
00:38
I graduated high school in Cleveland, Ohio, 1975.
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1975年我高中毕业于俄亥俄州的克利夫兰。
00:42
And just like my parents did when they finished studying abroad, we went back home.
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正如我的父母在国外完成学业后一样，我们回到自己的祖国。
00:48
Finished university education, got a medical degree, 1986.
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1986年，我大学毕业取得医学学位。
00:53
And by the time I was an intern house officer,
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我在做驻院实习医生的时候
00:57
I could barely afford to maintain my mother's 13-year-old car --
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我只能勉强负担得起维修我母亲那辆开了13年的车
01:02
and I was a paid doctor.
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那时我是一名挣薪水的医生。
01:06
This brings us to why a lot of us, who are professionals,
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这也解释了为什么我们当中许多职业医生
01:10
are now, as they say, in diaspora.
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现在分散在世界不同的地方。
01:14
Now, are we going to make that a permanent thing,
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那么，难道我们要把这变成无法改变的事实吗，
01:17
where we all get trained, and we leave, and we don't go back?
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我们都只接受培训，离开后就不再回来了吗？
01:24
Perhaps not, I should certainly hope not --
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也许不会，我当然不希望这样
01:27
because that is not my vision.
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因为那和我预料的不同。
01:31
All right, for good measure, that's where Nigeria is on the African map,
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为了更好的估量尼日利亚，这是一张尼日利亚所在的非洲地图，
01:37
and just there is the Delta region that I'm sure everybody's heard of.
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那里就是众所周知的三角洲。
01:42
People getting kidnapped, where the oil comes from,
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在那里人们被绑架，也是石油的来源地，
01:46
the oil that sometimes I think has driven us all crazy in Nigeria.
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有时我觉得在尼日利亚石油已经把我们逼疯了。
01:51
But, critical poverty: this slide is from a presentation I gave
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但是，“极端”贫困，这张幻灯片来源于不久前
01:54
not that long ago. Gapminder.org tells the story of the gap
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我做的一个介绍。Gapminder.org介绍了为什么
02:00
between Africa and the rest of the world in terms of health care.
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非洲与世界其他地方在医疗方面存在差距。
02:04
Very interesting.
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非常有趣。
02:07
How many people do you think are on that taxi?
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你猜在那辆出租车上有几个人？
02:11
And believe it or not, that is a taxi in Nigeria.
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信不信由你，在尼日利亚那确实是一辆出租车。
02:14
And the capital -- well, what used to be the capital of Nigeria -- Lagos,
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尼日利亚过去的首都--拉各斯，
02:17
that's a taxi, and you have police on them.
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那是一辆出租车，还有警察坐在上面。
02:20
So, tell me, how many policemen do you think are on this taxi? And now? Three.
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所以，告诉我，你觉得上面有几个警察？现在呢？3个。
02:28
So, when these kind of people -- and, believe me, it's not just the police
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相信我，在拉各斯不仅仅是警察
02:33
that use these taxis in Lagos. We all do. I've been on one of these,
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乘坐这些出租车，我们都坐，我也坐过，
02:38
and I didn't have a helmet, either.
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我也没戴头盔。
02:41
And it just reminds me of the thought of what happens when one of us
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照片让我想到该怎么办，如果有人
02:49
on a taxi like this falls off, has an accident and needs a hospital.
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在这种车上掉下来，发生事故，急需医院。
02:55
Believe it or not, some of us do survive.
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不管你信不信，有些人确实是死里逃生。
02:59
Some of us do survive malaria; we do survive AIDS.
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有人确实战胜了疟疾，我们逃出了艾滋的威胁。
03:03
And like I tell my family, and my wife reminds me every time,
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我也这样告诉我家人，我妻子每次都提醒我，
03:07
"You're risking your life, you know, every time you go to that country."
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你知道吗，每次你去那个国家，你是在拿生命冒险。
03:11
And she's right. Every time you go there,
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她说得对。每次你去到那里，
03:14
you know that if you actually need critical care --
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你都会明白。如果你真的需要紧急护理
03:19
critical care of any sort -- if you have an accident --
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不管是任何类型的--如果发生意外，
03:22
of which there are many, there are accidents everywhere --
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意外又很多，那里到处都是意外，
03:26
where do they go?
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他们去哪里?
03:29
Where do they go when they need help for this kind of stuff?
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当他们因为这种事需要帮助，要去哪里呢？
03:34
I'm not saying instead of, I'm saying as well as,
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不仅仅是上面提到的意外，还有
03:37
AIDS, TB, malaria, typhoid -- the list goes on.
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艾滋病，肺结核，疟疾，伤寒--等等许多。
03:43
I'm saying, where do they go when they're like me?
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我是想说，当他们处在我的位置上他们会何去何从？
03:47
When I go back home -- and I do all kinds of things,
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当我回家后--我要做各种事。
03:50
I teach, I train -- but I catch one of these things,
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我要教学，要培训，但如果我得了其中一种病，
03:54
or I'm chronically ill with one of those, where do they go?
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或是其中一种病的慢性病，他们要去哪里？
04:00
What's the economic impact when one of them dies or becomes disabled?
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当他们中有人死亡或残疾，会造成什么样的经济影响？
04:06
I think it's quite significant. This is where they go.
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我觉得影响很显著。这就是他们去的地方
04:10
These are not old pictures and these are not from some downtrodden --
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这些不是旧照片，这些人也不是受压迫的人。
04:14
this is a major hospital. In fact, it's from a major teaching hospital in Nigeria.
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这是一家大医院。事实上，这是尼日利亚的一家主要的培训医院。
04:20
Now that is less than a year old, in an operating room.
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这是在一个手术室里，用了还不到一年。
04:25
That's sterilizing equipment in Nigeria.
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这是尼日利亚的消毒设备。
04:28
You remember all that oil?
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你们还记得我说过的关于石油的事吗？
04:30
Yes, I'm sorry if it upsets some of you, but
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我很抱歉如果这让你感到不舒服，但
04:34
I think you need to see this. That's the floor, OK?
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我觉得你还得看看这个，这是地面。
04:38
You can say some of this is education.
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你可以说这是教育的问题
04:40
You can say it's hygiene. I'm not pleading poverty.
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也可以说是卫生的问题，我不是在以贫穷为借口
04:44
I'm saying we need more than just, you know, vaccination,
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我想说我们需要的不仅仅是疫苗，
04:50
malaria, AIDS, because I want to be treated
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疟疾，艾滋，因为我希望能
04:53
in a proper hospital if something happens to me out there.
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在一家正规医院接受治疗，如果我发生意外或有病的话。
04:56
In fact, when I start running around saying,
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事实上，当我开始四处游说
04:58
"Hey, boys and girls, you're cardiologists in the U.S.,
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‘嘿，年轻人，你们在美国是心脏专家，
05:01
can you come home with me and do a mission?"
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能和我一起回家进行义诊吗？’
05:04
I want them to think, "Well there's some hope."
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我想让他们觉得，‘仍然有希望。’
05:06
Now, have a look at that. That's the anesthesiology machine.
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接下来，看看这个，这是麻醉机。
05:09
And that's my specialty, right?
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这是我的专长，对吧？
05:11
Anesthesiology and critical care -- look at that bag.
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麻醉及紧急护理--看看那个包。
05:15
It's been taped with tape that we even stopped using in the U.K.
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它是用胶带缠住的，那种胶带在英国已经停止使用了。
05:19
And believe me, these are current pictures.
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相信我，这真的是现在的照片。
05:22
Now, if something like this, which has happened in the U.K.,
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如果有这样的事发生，在英国发生过，
05:27
that's where they go. This is the intensive care unit in which I work.
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那就是他们去的地方。这就是我工作的重症监护病房。
05:32
All right, this is a slide from a talk I gave
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这是我演讲中的一张幻灯片
05:37
about intensive care units in Nigeria,
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关于尼日利亚的重症监护病房。
05:41
and jokingly we refer to it as "Expensive Scare."
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我们把它开玩笑的称为‘expensive scare'(贵的吓人)
05:46
Because it's scary and it's expensive, but we need to have it, OK?
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因为那间病房很吓人，也很贵，但我们需要。
05:54
So, these are the problems.
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所以，这些就是问题。
05:57
There are no prizes for telling us what the problems are, are there?
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告诉我们问题是什么是没有奖励的，对吧？
06:01
I think we all know. And several speakers before
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我想我们都知道，但我之前的几位演讲者
06:04
and speakers after me are going to tell us even more problems.
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以及之后的几位还是会告诉我们更多的问题。
06:08
These are a few of them. So, what did I do?
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这些是他们中的几位。那么，我干了什么呢？
06:12
There we go -- we're going on a mission.
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在这儿，我们正在进行义诊。
06:15
We're going to do some open-heart surgery. I was the only Brit,
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我们正准备做开胸手术，我是队里唯一的英国人，
06:19
on a team of about nine American cardiac surgeons,
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其他9人是美国人，包括心脏外科医生，
06:24
cardiac nurse, intensive care nurse.
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心脏外科护士，特别护理护士。
06:26
We all went out and did a mission and we've done three of them so far.
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我们全部外出进行义诊，到现在已经做过3次了。
06:31
Just so you know, I do believe in missions, I do believe in aid
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我想让你们知道，我真得相信义诊，相信帮助
06:35
and I do believe in charity. They have their place,
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我也相信慈善。他们是有作用的。
06:38
but where do they go for those things we talked about earlier?
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但他们如果遇到我们之前谈到的那些意外或疾病要去哪里呢？
06:43
Because it's not everyone that's going to benefit from a mission.
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因为不是每一个人都能享受到义诊。
06:48
Health is wealth, in the words of Hans Rosling.
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健康就是财富，用汉斯罗斯林的话说就是
06:51
You get wealthier faster if you are healthy first.
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首先要健康才能更快的致富。
06:57
So, here we are, mission. Big trouble.
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所以，我们在做义诊，但有很大的困难。
07:01
Open-heart surgery in Nigeria -- big trouble.
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尼日利亚的开胸手术--很困难。
07:04
That's Mike, Mike comes out from Mississippi.
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那是麦克，麦克刚结束在密西西比的义诊。
07:07
Does he look like he's happy?
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他看上去快乐吗？
07:09
It took us two days just to organize the place, but hey,
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光是整理这个地方就用了我们两天的时间，但是，瞧啊，
07:13
you know, we worked on it. Does he look happy?
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我们致力于此，但他看起来高兴吗？
07:18
Yes, that's the medical advice the committee chairman says,
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是的，这是委员会主席提出的医疗建议，
07:20
"Yes, I told you, you weren't going to be able to,
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’是的，我已经告诉过你，你根本做不了，
07:22
you can't do this, I just know it."
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你干不了，我确定。‘
07:24
Look, that's the technician we had. So yes, you go on, all right?
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看，那就是我们的技工。那么，你来接着干，怎么样？
07:29
(Laughter)
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（笑声）
07:30
I got him to come with me -- anesthesia tech -- come with me from the U.K.
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我说服他跟我一起来的。麻醉技术，和我一起从英国来的。
07:34
Yes, let's just go work this thing out.
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让我们一起解决问题。
07:38
See, that's one of the problems we have in Nigeria and in Africa generally.
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看，那通常是我们在尼日利亚和在非洲遇到的问题。
07:42
We get a lot of donated equipment.
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我们得到了许多捐助的设备。
07:44
Equipment that's obsolete, equipment that doesn't quite work,
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过时的设备，不怎么好用的设备。
07:47
or it works and you can't fix it. And there's nothing wrong with that,
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或者是能用但没法修理。这种现象没什么不对的，
07:51
so long as we use it and we move on.
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只要我们还能用它，我们就能继续前进。
07:54
But we had problems with it. We had severe problems there.
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但我们有困难，我们有很严重的问题。
07:56
He had to get on the phone. This guy was always on the phone.
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他必须要打通电话，这个家伙总是在讲电话。
07:59
So what we going to do now?
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那么我们现在该怎么办呢？
08:01
It looks like all these Americans are here and
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看上去所有的美国人都在这
08:03
yes, one Brit, and he's not going to do anything --
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对，还有一个英国人，他不打算做任何事，
08:07
he thinks he's British actually, and he's actually Nigerian,
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他觉得他是英国人，事实上他是尼日利亚人，
08:09
I just thought about that.
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我就是那么觉得。
08:11
We eventually got it working, is the truth,
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我们最终会让这个机器工作，这是一定的，
08:13
but it was one of these. Even older than the one you saw.
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但它只是其中一件，甚至比你看到的这个还要老，
08:17
The reason I have this picture here, this X-ray,
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之所以要给出这张照片，这张x光片，
08:20
it's just to tell you where and how we were viewing X-rays.
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就是想告诉你我们是在哪儿，以及如何观察x光片的。
08:26
Do you figure where that is? It was on a window.
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看出是在哪儿了吗？是在窗户上。
08:29
I mean, what's an X-ray viewing box? Please.
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拜托，难道不是有x光片机吗？
08:34
Well, nowadays everything's on PAX anyway.
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现在做所有事都能用PAX。
08:37
You look at your X-rays on a screen and you do stuff with them,
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你在屏幕上看x光片，然后进行诊断，
08:41
you email them. But we were still using X-rays,
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然后将结果用邮件发送出去。但我们还在用x光
08:43
but we didn't even have a viewing box!
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但我们甚至没有x光片机！
08:45
And we were doing open-heart surgery.
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我们正在做开胸手术。
08:47
OK, I know it's not AIDS, I know it's not malaria,
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我知道那不是艾滋，不是疟疾，
08:49
but we still need this stuff. Oh yeah, echo --
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但我们仍然需要这个
08:53
this was just to get the children ready and the adults ready.
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这只是想让孩子们准备好，大人们准备好。
08:57
People still believe in Voodoo. Heart disease,
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还有人相信伏都教--心脏病，
09:00
VSD, hole in the heart, tetralogies.
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心室中隔缺损，心脏里的洞，四联症。
09:04
You still get people who believe in it and they came.
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还是有人相信科学，他们来检查
09:07
At 67 percent oxygen saturation, the normal is about 97.
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氧饱和度是67%，正常是97%。
09:12
Her condition, open-heart surgery that as she required,
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她的情况，她所要求的开胸手术，
09:15
would have been treated when she was a child.
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当她是个孩子时就该治疗了。
09:18
We had to do these for adults. So, we did succeed and we still do.
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我们还得为大人做。我们确实成功了，因此我们还在做。
09:22
We've done three. We're planning another one in July
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我们已经做过三次，正准备在7月
09:25
in the north of the country. So, we certainly still do open-heart,
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在这个国家的北部再做一次。因此我们当然还在做开胸手术，
09:29
but you can see the contrast between everything that was shipped in --
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但你们能看出装运前后所有东西都有差别
09:34
we ship everything, instruments. We had explosions
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我们什么都要运输，设备会爆炸
09:38
because the kit was designed and installed by people who weren't used to it.
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因为制作安装设备的人以前不是做这个的。
09:45
The oxygen tanks didn't quite work right.
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氧气瓶不太好用。
09:47
But how many did we do the first one? 12.
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但我们第一次就做了几个手术？12个。
09:51
We did 12 open-heart surgical patients successfully.
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我们成功地做了12例开胸手术。
09:55
Here is our very first patient, out of intensive care,
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这是我们的第一位病人，刚从重症监护室里出来，
09:59
and just watch that chair, all right?
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看看那张椅子，好吗。
10:02
This is what I mean about appropriate technology.
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这就是我所指的恰当的科技。
10:06
That's what he was doing, propping up the bed because the bed simply didn't work.
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那就是他正在做的，把床垫高，因为这张床根本不能用。
10:12
Have you seen one of those before?
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你们以前看过这种情景吗？
10:15
No? Yes? Doesn't matter, it worked.
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没有？看过？没关系，那样做很管用。
10:18
I'm sure you've all seen or heard this before:
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我肯定你以前已经看过或听过。
10:20
"We, the willing, have been doing so much with so little for so long --
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我们，心甘情愿，已经用这么简陋的条件做了这么多事并且坚持了这么久，
10:24
(Applause)
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（鼓掌）
10:25
-- we are now qualified to do anything with nothing."
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我们现在不用任何条件就能做任何事。
10:29
(Applause)
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（鼓掌）
10:32
Thank you. Sustainable Solutions -- this was my first company.
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谢谢。这是我的第一家公司--Sustainable Solutions --
10:37
This one's sole aim is to provide the very things that I think are missing.
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它的唯一目的就是提供我觉得需要的任何东西。
10:42
So, we put my hand in my pocket and say, "Guys, let's just buy stuff.
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所以我们把手放进口袋里，说：“各位，我们尽情的买东西吧。”
10:46
Let's go set up a company that teaches people, educates them,
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我们创立一个公司来传授知识，教育人们
10:50
gives them the tools they need to keep going."
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给予他们前进所需的工具吧。
10:53
And that's a perfect example of one.
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那是一个完美的例子。
10:55
Usually when you buy a ventilator in a hospital,
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通常当你在医院里买呼吸机时
10:57
you buy a different one for children,
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你会为孩子买一个不同的，
11:00
you buy a different one for transport. This one will do everything,
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买一个能运输的。这个能做任何事，
11:03
and it will do it at half the price and doesn't need compressed air.
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只要一半的价钱，还不需要压缩空气。
11:05
If you're in America and you don't know about this one, we do,
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如果在美国，你不会知道这个，我们知道，
11:08
because we make it our duty to find out
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因为这是我们的义务去发现
11:11
what's appropriate technology for Africa -- what's appropriately priced,
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对非洲人来说什么是适合的科技--就是用适当的价格
11:16
does the job, and we move on. Anesthesia machine:
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就能工作，因此我们继续研究。麻醉机，
11:20
multi-parameter monitor, operating lights, suction.
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多参数监护仪，手术灯，抽吸装置。
11:23
This little unit here -- remember your little 12-volt plug in the car,
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这个小部件，像不像你们车上12伏的插头
11:27
that charges your, whatever, Game Boy, telephone?
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给像game boy ,手机之类的充电用的？
11:31
That's exactly how the outlets are designed.
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端口就是这样设计的。
11:34
Yes, it will take a solar panel. Yes a solar panel will charge it.
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是的，它会带上太阳能板，是靠太阳能充电，
11:38
But if you've got mains as well, it will charge the batteries in there.
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但如果你也有电源，就在这里给电池充电。
11:43
And guess what? We have a little pedal charger too, just in case.
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猜猜还有什么？我们还设计了踏板充电器，以防万一。
11:47
And guess what, if it all fails,
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还有，如果这些都不能用，
11:49
if you can find a car that's still got a live battery
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如果你能找到一辆车，电池还有电
11:52
and you stick it in, it will still work. Then you can customize it.
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把它插上，还是能用。然后就能定做了。
11:57
Is it dental surgery you want? General surgery you want?
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你想牙科手术用呢，还是一般的手术用？
12:00
Decide which instruments, stock it up with consumables.
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确定用哪种设备，和必需品一起储存
12:06
And currently we're working on oxygen -- oxygen delivery on-site.
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目前我们在研究氧气。现场供给氧气。
12:15
The technology for oxygen delivery is not new.
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氧供给技术并不是新技术。
12:24
Oxygen concentrators are very old technology. What is new,
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制氧机是很老的技术，新的是
12:29
and what we will have in a few months, I hope,
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并且我希望几个月后能拥有的
12:31
is that ability to use this same renewable energy system
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是使用可再生能源系统的能力
12:34
to provide and produce oxygen on site. Zeolite -- it's not new --
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来现场提供制造氧气。沸石--这并不新奇--
12:41
zeolite removes nitrogen from air and nitrogen is 78 percent of air.
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沸石能去掉空气中的氮气，而氮气占空气的78%。
12:48
If you take nitrogen out, what's left? Oxygen, pretty much.
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把氮气去掉，剩下什么？氧气，很多的氧气。
12:53
So that's not new. What we're doing is applying this technology to it.
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所以这并不新奇，我们要做的就是将这种技术运用到其中。
12:57
These are the basic features of my device, or our device.
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这些是我的也是我们的装置的基本特点。
13:01
This is what makes it so special.
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这就是特别的地方。
13:03
Apart from the awards it's won,
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除了它获得的奖以外，
13:05
it's portable and it's certified. It's registered, the MHRA --
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它还可手提，得到认证，被注册过的，有MHRA
13:09
and the CE mark, for those who don't know, for Europe, is the equivalent
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和CE标志，可能有人不知道，这在欧洲等同于
13:12
of the FDA in the U.S.
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美国的FDA。
13:16
If you compare it with what's on the market, price-wise,
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如果和市场上的商品对比，价格更便宜，
13:20
size-wise, ease of use, complexity ...
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大小更合适，使用方便，更加复合性。
13:25
This picture was taken last year.
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这张照片是去年拍的。
13:27
These are members of my graduating class, 1986.
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这些是我1986年毕业班的同学。
13:31
It was in this gentleman's house in the Potomac,
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这是在波托马克，这位先生的家里，
13:33
for those of you who are familiar with Maryland.
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熟悉马里兰州的人也许知道。
13:37
There are too many of us outside and everybody,
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我们人太多都在屋外，
13:41
just to borrow a bit from Hans -- Hans Rosling, he's my guy --
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引用汉斯--汉斯罗斯林的话，他是我崇拜的人--
13:47
if the size of the text represents what gets the most attention,
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如果篇幅代表了什么得到了最多的关注，
13:52
it's the problems. But what we really need are African solutions
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那就是问题。但我们真正需要的是非洲的解决方案
13:57
that are appropriate for Africa -- looking at the culture,
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即适用于非洲的，看看他们的文化
14:00
looking at the people, looking at how much money they've got.
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看看人民，看看他们挣得那点钱。
14:04
African people, because they will do it with a passion, I hope.
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非洲人民，因为他们带着激情，（我希望如此），
14:09
And lots and lots of that little bit down there, sacrifice.
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还有那里的许多许多的牺牲。
14:13
You have to do it. Africans have to do it,
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你们必须那么做。非洲人民必须做，
14:16
in conjunction with everyone else.
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其他人也要联合起来。
14:18
Thank you.
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谢谢
14:20
(Applause)
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（观众鼓掌）
ABOUT THE SPEAKER
Seyi Oyesola - DoctorPhysician Seyi Oyesola co-developed the "Hospital in a Box" -- a pop-up, portable, solar-powered OR for off-grid medicine in Africa and elsewhere. But, he says, Africa needs more than new tools to heal itself.
Why you should listen
Beyond high-visibility illnesses like HIV/AIDS, Dr. Seyi Oyesola points out that common, survivable ailments and injuries -- burns, trauma, heart attacks -- kill thousands of Africans each year because basic medical care can be so hard to get. To help bring surgical care to every region of the continent, Oyesola co-developed CompactOR, or the "Hospital in a Box": a portable medical system that contains anesthetic and surgical equipment. The operating suite is light enough to be dropped into inaccessible zones by helicopter, and can be powered by solar panels.
Although the Hospital-in-a-Box may save lives, Oyesola reminds us that with meager pay and inadequate facilities, there is still little incentive for medical professionals to remain in Africa. Proper education and technical training could pave the way for more, and more capable, new physicians to learn and stay in Africa -- and start the healing of the continent.
Seyi Oyesola | Speaker | TED.com