TEDGlobal 2017
Soyapi Mumba: Medical tech designed to meet Africa's needs
索亚皮·姆巴: 为满足非洲需求设计的医疗科技
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在撒哈拉沙漠以南的非洲，频繁停电、科技普及率低、网速慢和人手不足的医院困扰着医疗系统。为了解决在马拉维共和国的这些问题，科技人和TED成员索亚皮·姆巴和他的团队从零开始，创造了一个新的系统。他们研发了从支持他们电子医疗记录系统的软件，到支撑这些东西的基础设施。在这个简短的演讲中，姆巴分享了他的万事通能力是如何帮助重塑资源匮乏环境里的医疗系统。
Soyapi Mumba - Technology innovator
TED Fellow Soyapi Mumba creates technology solutions for low-resource environments. Full bio
TED Fellow Soyapi Mumba creates technology solutions for low-resource environments. Full bio
Double-click the English transcript below to play the video.
00:12
Like every passionate
software engineer out there,
software engineer out there,
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像每一位充满激情的
软件工程师一样，
软件工程师一样，
我密切跟踪着
硅谷科技公司的动向，
硅谷科技公司的动向，
00:16
I closely follow technology
companies in Silicon Valley,
companies in Silicon Valley,
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00:19
pretty much the same way soccer fans
follow their teams in Europe.
follow their teams in Europe.
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就像足球粉关注
他们的欧洲球队一样。
他们的欧洲球队一样。
00:23
I read articles on tech blogs
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我看科技博客上的文章，
00:25
and listen to podcasts on my phone.
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听手机上的播客。
00:29
But after I finish the article,
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但是在我看完文章后，
00:30
lock my phone and unplug the headphones,
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锁上手机屏幕，摘下耳机，
00:34
I'm back in sub-Saharan Africa,
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我又回到了撒哈拉沙漠以南的非洲，
00:36
where the landscape is not quite the same.
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这里的风景挺不一样的。
00:40
We have long and frequent power outages,
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我们频繁有长时间的停电，
00:43
low penetration of computers,
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低电脑普及率，
00:45
slow internet connections
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缓慢的网速，
00:47
and a lot of patients
visiting understaffed hospitals.
visiting understaffed hospitals.
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和人满为患，却人手不足的医院。
自从艾滋病爆发以来，
00:52
Since the HIV epidemic,
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病例变得越来越多，
医院就很难妥善管理
医院就很难妥善管理
00:54
hospitals have been struggling
to manage regular HIV treatment records
to manage regular HIV treatment records
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艾滋病患者的治疗记录。
00:59
for increasing volumes of patients.
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01:02
For such environments,
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在这样的环境下，
01:04
importing technology systems
developed elsewhere has not worked,
developed elsewhere has not worked,
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进口的医疗设备根本没法发挥作用。
但是在2006年，我加入了
猴面包树医疗（Baobab Health），
猴面包树医疗（Baobab Health），
01:08
but in 2006, I joined Baobab Health,
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这个组织雇用地方工程师，
01:11
a team that uses locally based engineers
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进行因地制宜的研发工作
01:15
to develop suitable interventions
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来解决马拉维共和国的医疗问题。
01:17
that are addressing
health care challenges in Malawi.
health care challenges in Malawi.
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我们设计了一个电子医疗记录系统，
01:21
We designed an electronic
health record system
health record system
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供医疗人员看病时使用。
01:25
that is used by health care workers
while seeing patients.
while seeing patients.
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在研发过程中我们意识到，
我们不仅要设计软件，
我们不仅要设计软件，
01:28
And in the process we realized that we
not only had to design the software,
not only had to design the software,
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还要提供配套的基础设施。
01:33
we had to implement
the infrastructure as well.
the infrastructure as well.
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01:36
We don't have enough medical staff
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我们没有足够的医疗人员
01:38
to comprehensively examine every patient,
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来全面检查每一个病人，
所以我们在软件里置入了临床指南
01:41
so we embedded clinical guidelines
within the software
within the software
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01:44
to guide nurses and clerks
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来帮助护士和工作人员，
辅助他们的工作。
01:47
who assist with handling
some of the workload.
some of the workload.
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01:50
Everyone has a birthday,
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每个人都有一个生日，
01:51
but not everyone knows their birthday,
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但并不是每个人
都知道自己的出生日期，
都知道自己的出生日期，
01:54
so we wrote algorithms
to handle estimated birthdates
to handle estimated birthdates
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所以我们写了能够估算生日的算法，
能准确到某天。
01:58
as complete dates.
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02:00
How do we follow up
patients living in slums
patients living in slums
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我们如何跟踪住在贫民窟的病人？
02:04
with no street and house numbers?
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他们连门牌号都没有。
02:07
We used landmarks to approximate
their physical addresses.
their physical addresses.
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我们用地标来估计他们的位置。
02:12
Malawi had no IDs
to uniquely identify patients,
to uniquely identify patients,
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马拉维没有能够
分辨病人的身份识别信息，
分辨病人的身份识别信息，
02:16
so we had to implement unique patient IDs
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所以我们设计了独特的
病人身份识别系统，
病人身份识别系统，
让病人的记录在
不同诊所之间实现连接。
不同诊所之间实现连接。
02:19
to link patient records across clinics.
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02:22
The IDs are printed as barcodes
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这些身份识别信息
02:26
on labels that are stuck
on personal health booklets
on personal health booklets
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以条形码的形式贴在病人的病历上，
02:29
kept by each patient.
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由病人保管。
02:31
With this barcoded ID,
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有了条形码身份证，
只要用扫描器一扫，
02:33
a simple scan with a barcode reader
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02:35
quickly pulls up the patient's records.
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就能拿到病人的记录。
02:38
No need to rewrite their personal details
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没有必要在每次去医院的时候，
02:40
on paper registers at every visit.
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重新填写他们的个人信息。
02:43
And suddenly, queues became shorter.
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突然之间，看诊的队伍变短了。
这意味着病人，
很多是背着小孩的母亲，
很多是背着小孩的母亲，
02:45
This meant patients, typically mothers
with little children on their backs,
with little children on their backs,
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02:50
had to spend less time
waiting to be assisted.
waiting to be assisted.
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不需要花那么多时间候诊了。
02:53
And if they lose their booklets,
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如果他们丢失了自己的病历，
02:55
their records can still be pulled
by searching with their names.
by searching with their names.
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还能通过搜索他们的名字找到。
但是，不同的人读和拼写
名字的方式也大不相同。
名字的方式也大不相同。
02:59
Now, the way we pronounce
and spell names varies tremendously.
and spell names varies tremendously.
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03:04
We freely mix R's and L's,
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我们不区分R和L，
03:07
English and vernacular
versions of their names.
versions of their names.
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不区分英语和方言的名字。
03:10
Even soundex,
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甚至是发音，
03:12
a standard method for grouping words
by how similar they sound,
by how similar they sound,
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一个标准化的依据发音的拼写方法
并不好用。
03:16
was not good enough.
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所以我们要改变它，
03:18
So we had to modify it
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来帮助连接和匹配现有的记录。
03:19
to help us link and match
existing records.
existing records.
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03:26
Before the iPhone,
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在iPhone被发明以前，
03:28
software engineers
developed for personal computers,
developed for personal computers,
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软件工程师只开发了
电脑版的软件，
电脑版的软件，
但是依据我们的经验，
03:31
but from our experience,
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我们的电力系统并不能为电脑提供
03:33
we knew our power system
is not reliable enough
is not reliable enough
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可靠的电力供应。
03:36
for personal computers.
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03:38
So we repurposed touch screen
point-of-sale terminals
point-of-sale terminals
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所以我们把
触屏的销售点终端机，
触屏的销售点终端机，
就是在零售店里用的那种，
03:43
that are meant for retail shops
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03:44
to become clinical workstations.
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改成了医疗工作站。
03:47
At the time, we imported
internet appliances called i-Openers
internet appliances called i-Openers
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那个时候，我们进口了
网络工具，i-Openers，
网络工具，i-Openers，
03:52
that were manufactured
during the dot-com era
during the dot-com era
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这是在互联网热潮时期，
由一个破产的美国公司生产的。
03:56
by a failed US company.
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03:59
We modified their screens
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我们改造了它们的屏幕，
加上了触觉传感器，
04:01
to add touch sensors
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04:02
and their power system
to run from rechargeable batteries.
to run from rechargeable batteries.
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并改用可充电电池来供电。
04:06
When we started, we didn't find
a reliable network to transmit data,
a reliable network to transmit data,
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刚开始的时候，我们找不到
一个可靠的网络来传输数据，
一个可靠的网络来传输数据，
04:11
especially from rural hospitals.
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特别是在偏远的医院里。
04:14
So we built our own towers,
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所以我们建造了自己的信号塔，
04:17
created a wireless network
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创造了一个无线网络，
04:19
and linked clinics in Lilongwe,
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并连接到了马拉维的首都，
利隆圭的诊所。
04:22
Malawi's capital.
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04:24
(Applause)
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（鼓掌）
04:29
With a team of engineers
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和在医院工作的一群工程师一起
04:32
working within a hospital campus,
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在医院内工作，
04:34
we observed health care workers
use the system
use the system
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我们目睹了医疗人员利用这个系统，
慢慢建立起了一个信息系统，
04:37
and iteratively
build an information system
build an information system
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管理着马拉维所有主要公共医院中
04:40
that is now managing HIV records
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艾滋病人的医疗记录。
04:44
in all major public hospitals in Malawi.
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这些医院的每个诊所
都有超过2000个艾滋病人。
都有超过2000个艾滋病人。
04:47
These are hospitals serving
over 2,000 HIV patients, each clinic.
over 2,000 HIV patients, each clinic.
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04:54
Now, health care workers
who used to spend days
who used to spend days
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在以前，医疗人员要花几天时间
来计算和整理季度报告，
04:57
to tally and prepare quarterly reports
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04:59
are producing the same reports
within minutes,
within minutes,
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现在只要几分钟就能完成，
05:02
and health care experts
from all over the world
from all over the world
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而全世界的医疗专家
都来马拉维来学习
我们是怎么做到的。
我们是怎么做到的。
05:06
are now coming to Malawi
to learn how we did it.
to learn how we did it.
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05:10
(Applause)
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（鼓掌）
05:14
It is inspiring and fun
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跟随全球科技潮流
05:16
to follow technology trends
across the globe,
across the globe,
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让人深受启发，而且乐在其中，
05:19
but to make them work
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但是让这些科技
05:21
in low-resourced environments
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在资源匮乏的环境下运行，
05:24
like public hospitals
in sub-Saharan Africa,
in sub-Saharan Africa,
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像撒哈拉沙漠以南非洲的公共医院，
05:27
we have had to become jacks-of-all-trades
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我们不得不成为万事通，
05:31
and build whole systems,
including the infrastructure,
including the infrastructure,
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从零开始，搭建整个系统，
包括基础设施。
05:34
from the ground up.
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05:36
Thank you.
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谢谢。
（鼓掌）
05:37
(Applause)
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ABOUT THE SPEAKER
Soyapi Mumba - Technology innovatorTED Fellow Soyapi Mumba creates technology solutions for low-resource environments.
Why you should listen
As Director of Public Health Informatics at Baobab Health Trust, Soyapi Mumba oversees development of electronic health surveillance and reporting systems for public hospitals in Malawi. Previously, he led the software development of Malawi's national electronic health record system which empowers low-resourced public clinics to serve large volumes of patients while following treatment guidelines and meeting reporting requirements.
Mumba is a TED Fellow and a prize winner of "Share an Idea, Save a Life" national competition for innovations in maternal, newborn and child health. His work has been featured in the book The Bright Continent: Breaking Rules and Making Change in Modern Africa.
Mumba lives in Lilongwe, Malawi, with his wife Miriam and their twin boys. He holds a Master of Science degree in Biomedical Informatics from University of Pittsburgh, Pennsylvania and a Bachelor of Science degree in Computer Science from University of Hertfordshire, England.
Soyapi Mumba | Speaker | TED.com