ABOUT THE SPEAKER
Gary Slutkin - Epidemiologist
Could our culture have misdiagnosed violence? As the director of the initiative Cure Violence, Gary Slutkin approaches gunfire on neighborhood streets as a contagious disease, looking to science and public health for strategies to stop it.

Why you should listen

Gary Slutkin is an epidemiologist, an innovator in violence reduction, and the Founder/Executive Director of Cure Violence, formerly known as CeaseFire. As a physician, he began his career working in Somalian refugee camps, where tuberculosis and cholera epidemics flared up regularly. He went on to work for the World Health Organization on reversing epidemics, supporting Uganda’s AIDS program which helped the country reversed the course of the disease. Upon returning to the United States, it occurred to him: could gun violence function like an epidemic? And could it be fought, and even stopped, using the principles of public health?

Slutkin has applied the lessons learned over a decade of fighting epidemics to the creation of Cure Violence, a public health approach that has been statistically validated by two independent evaluations by the Department of Justice and Centers for Disease Control. Cure Violence has been called a "pioneering violence reduction model" and its methods have received nods from the Institute of Medicine and the U.S. Conference of Mayors. The program is being replicated at more than 50 sites in 15 U.S. cities, as well as in many countries abroad.

Dr. Sultkin is an Ashoka Fellow, a Professor of Epidemiology and International Health at the University of Illinois at Chicago, and a senior advisor to the World Health Organization.

More profile about the speaker
Gary Slutkin | Speaker | TED.com
TEDMED 2013

Gary Slutkin: Let's treat violence like a contagious disease

加裏•斯拉金: 像治療傳染病那樣處理暴力事件

Filmed:
817,401 views

加裏•斯拉金醫生用了十年多的時間在非洲防治結核病、霍亂和艾滋病等傳染病。回到美國後, 他以為自己已經從殘酷的傳染病死亡中脫身。當他開始認真研究槍支犯罪時,他發現暴力的蔓延模式和感染性疾病的擴散模式相似。這是一個對很多社區所無奈接受的暴力問題的全新視角。斯拉金醫生說,我們已經成功地防止了很多疾病,我們對暴力事件也可以這樣做。
- Epidemiologist
Could our culture have misdiagnosed violence? As the director of the initiative Cure Violence, Gary Slutkin approaches gunfire on neighborhood streets as a contagious disease, looking to science and public health for strategies to stop it. Full bio

Double-click the English transcript below to play the video.

00:12
I'm a physician醫師 trained熟練 in infectious傳染病 diseases疾病,
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我是一名治療傳染性疾病的醫生
00:17
and following以下 my training訓練,
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學業結束以後
00:19
I moved移動 to Somalia索馬里
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我從舊金山
00:22
from San Francisco弗朗西斯科.
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搬到索馬利亞
00:24
And my goodbye再見 greeting歡迎
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當時舊金山綜合醫院的
00:26
from the chief首席 of infectious傳染病 diseases疾病
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傳染科主任
00:28
at San Francisco弗朗西斯科 General一般 was,
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送給我的離別致辭是
00:30
"Gary加里, this is the biggest最大 mistake錯誤 you'll你會 ever make."
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”蓋瑞,這是你一生中最錯的決定。“
00:34
But I landed登陸 in a refugee難民 situation情況
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當我在難民營落腳時
00:38
that had a million百萬 refugees難民 in 40 camps營地,
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那裏有40個難民營收容了100萬難民
00:42
and there were six of us doctors醫生.
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卻只有我們6個醫生
00:44
There were many許多 epidemics流行病 there.
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流行病隨處可見
00:47
My responsibilities責任 were largely大部分 related有關 to
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我的職責主要是
00:49
tuberculosis結核,
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肺結核
00:51
and then we got struck來襲 by an epidemic疫情 of cholera霍亂.
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但我們隨即遇上了流行性霍亂。
00:55
So it was the spread傳播 of tuberculosis結核
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我負責阻止肺結核
00:57
and the spread傳播 of cholera霍亂
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和霍亂的
00:59
that I was responsible主管 for inhibiting抑制.
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大幅擴散。
01:04
And in order訂購 to do this work, we, of course課程,
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為了讓工作得以順利進行,
01:07
because of the limitation局限性 in health健康 workers工人,
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我們數量有限的醫護人員
01:09
had to recruit refugees難民 to be a specialized專門
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不得不從難民中招人
01:13
new category類別 of health健康 worker工人.
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特訓成醫護人員。
01:16
Following以下 three years年份 of work in Somalia索馬里,
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在索馬利亞工作了三年以後,
01:19
I got picked採摘的 up by the World世界 Health健康 Organization組織,
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我被世界衛生組織選中
01:22
and got assigned分配 to the epidemics流行病 of AIDS艾滋病.
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從事防治愛滋病流行的工作。
01:25
My primary responsibility責任 was Uganda烏干達,
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我的主要工作是在烏干達。
01:28
but also I worked工作 in Rwanda盧旺達 and Burundi布隆迪
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我也在盧安達、蒲隆地、
01:31
and Zaire扎伊爾, now Congo剛果,
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薩伊、現在的剛果、
01:34
Tanzania坦桑尼亞, Malawi馬拉維, and several一些 other countries國家.
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坦尚尼亞、馬拉威和其他幾個國家。
01:37
And my last assignment分配 there was to run a unit單元
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我最後一個任務是負責一個
01:40
called intervention介入 development發展,
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叫介入性發展的機構。
01:42
which哪一個 was responsible主管 for designing設計 interventions干預措施.
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這個機構主要負責設計介入性治療。
01:45
After 10 years年份 of working加工 overseas海外,
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10年的海外工作
01:48
I was exhausted.
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令我身心俱疲
01:50
I really had very little left.
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我幾乎身無分文
01:52
I had been traveling旅行 to one country國家 after another另一個.
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常年的四處奔波,
01:57
I was emotionally感情上 feeling感覺 very isolated孤立.
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令我倍感孤獨無助。
02:00
I wanted to come home.
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我想回家歇歇。
02:02
I'd seen看到 a lot of death死亡,
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我看過太多的死亡,
02:04
in particular特定 epidemic疫情 death死亡,
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尤其是流行病造成的死亡,
02:07
and epidemic疫情 death死亡 has a different不同 feel to it.
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它與一般死亡有些不同。
02:10
It's full充分 of panic恐慌 and fear恐懼,
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它充滿痛苦和恐懼
02:14
and I'd heard聽說 the women婦女 wailing and crying哭了
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我在沙漠中聽過女人的
02:18
in the desert沙漠.
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慟哭和哀號。
02:20
And I wanted to come home and take a break打破
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我很想回家歇歇
02:22
and maybe start開始 over.
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也許重新開始。
02:25
I was not aware知道的 of any epidemic疫情 problems問題
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在美國,我沒發現任何
02:28
in America美國.
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流行病的問題。
02:30
In fact事實, I wasn't aware知道的 of any problems問題 in America美國.
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實際上,我沒覺得美國有任何問題。
02:33
In fact事實 -- seriously認真地.
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我是說真的。
02:35
And in fact事實 I would visit訪問 friends朋友 of mine,
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我去拜訪我的朋友時
02:38
and I noticed注意到 that they had water
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我看到他們家裏有水
02:41
that came來了 right into their homes家園.
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直接地流到家裏來
02:43
How many許多 of you have such這樣 a situation情況?
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你們當中有多少人有這種設備?
02:45
(Laughter笑聲)
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(笑聲)
02:46
And some of them, many許多 of them actually其實,
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有些朋友,其實是很多朋友,
02:49
had water that came來了 into more than one room房間.
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可以在家裏的不同房間取用水。
02:51
And I noticed注意到 that they would move移動
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我還發現他們在家裏安裝了
02:54
this little thermoregulatory體溫調節 device設備
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小巧的溫度調節器,
02:56
to change更改 the temperature溫度 in their home
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可以一度一度地或者兩度兩度地調節
02:59
by one degree or two degrees.
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家裏的室內溫度。
03:01
And now I do that.
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我家現在也是這樣。
03:03
And I really didn't know what I would do,
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所以我不知道我該做什麽好。
03:07
but friends朋友 of mine began開始 telling告訴 me
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但我的一個朋友告訴我
03:10
about children孩子 shooting射擊 other children孩子 with guns槍砲.
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關於青少年之間的槍擊事件。
03:14
And I asked the question,
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我就想
03:16
what are you doing about it?
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對這樣的事件你該做些什麽?
03:18
What are you in America美國 doing about it?
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在美國你該些做什麼?
03:20
And there were two essential必要 explanations說明
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大家都知道主要有兩種方案
03:22
or ideas思路 that were prevalent流行.
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或者說方法。
03:24
And one was punishment懲罰.
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一個是懲罰。
03:26
And this I had heard聽說 about before.
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我以前就聽說過的方法。
03:29
We who had worked工作 in behavior行為
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我們以前研究行為學
03:31
knew知道 that punishment懲罰 was something that was discussed討論
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知道懲罰是經常被探討的方法。
03:35
but also that it was highly高度 overvalued高估.
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但它也是個被高估的方法。
03:38
It was not a main主要 driver司機 of behavior行為,
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它不是行為的主要動力,
03:40
nor也不 was it a main主要 driver司機 of behavior行為 change更改.
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也不是改變行為的主要動力。
03:44
And besides除了 that, it reminded提醒 me
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而且,它讓我意識到
03:46
of ancient epidemics流行病
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過去歷史上的流行病
03:48
that were previously先前 completely全然 misunderstood誤解
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就曾經被完全曲解。
03:51
because the science科學 hadn't有沒有 been there before,
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因為當時的科學尚未發展足夠
03:54
epidemics流行病 of plague鼠疫
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瘟疫、
03:56
or typhus斑疹傷寒 or leprosy麻風,
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斑疹傷寒和麻瘋病的疫區中
03:59
where the prevalent流行 ideas思路 were that there were
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大家都普遍認為
04:02
bad people or bad humors幽默 or bad air空氣,
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疫區裡有不好的人、不好的環境、或不好的空氣
04:06
and widows寡婦 were dragged around the moat護城河,
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解決方式之一是
04:08
and dungeons地牢 were part部分 of the solution.
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把寡婦被拖到護城河或地牢中
04:12
The other explanation說明 or, in a way,
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另一種方案,或者說,
04:14
the solution suggested建議,
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解決方法是
04:16
is please fix固定 all of these things:
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改善所有的設施:
04:19
the schools學校, the community社區, the homes家園, the families家庭,
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學校、公共場所、私人住處、各個家庭,以及
04:22
everything.
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所有的東西。
04:23
And I'd heard聽說 this before as well.
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我也同樣知道這個方法
04:25
I'd called this the "everything" theory理論,
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我把這叫做“凡事”理論
04:28
or EOEEOE: Everything On Earth地球.
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又稱世上萬物
04:31
But we'd星期三 also realized實現
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但是我們也認識到
04:32
in treating治療 other processes流程 and problems問題
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在治療的過程中
04:36
that sometimes有時 you don't need to treat對待 everything.
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有時候你並不需要改變所有的東西。
04:39
And so the sense that I had
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所以我感覺
04:41
was there was a giant巨人 gap間隙 here.
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人們的認知上有一個鴻溝。
04:44
The problem問題 of violence暴力 was stuck卡住,
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暴力問題陷入僵局
04:46
and this has historically歷史 been the case案件
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這歷來都是
04:49
in many許多 other issues問題.
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其他重大問題的特點。
04:50
Diarrheal腹瀉 diseases疾病 had been stuck卡住.
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腹瀉病曾陷入僵局
04:51
Malaria瘧疾 had been stuck卡住.
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瘧疾也曾陷入僵局
04:53
Frequently經常, a strategy戰略 has to be rethought再思考.
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通常情況下,一個治療方案必需進行反思。
04:55
It's not as if I had any idea理念 what it would look like,
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不是說我知道應該怎麽做,
04:59
but there was a sense that we would have to do
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我是覺得我們需要
05:02
something with new categories類別 of workers工人
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和新類型的工作者一起來解決這個問題,
05:04
and something having to do with behavior行為 change更改
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改變人們的行事態度,
05:06
and something having to do with public上市 education教育.
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與公家教育體制一起合作。
05:11
But I began開始 to ask questions問題
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我開始提出問題,
05:13
and search搜索 out the usual通常 things
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和搜尋以前研究過的
05:15
that I had been exploring探索 before,
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一些常見指標
05:17
like, what do the maps地圖 look like?
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比如說,分布圖是什麽樣的?
05:19
What do the graphs look like?
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圖表是什麽樣的?
05:20
What does the data數據 look like?
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數據又是什麽樣的?
05:22
And the maps地圖 of violence暴力
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在美國大部分的城市,
05:25
in most U.S. cities城市
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暴力事件的分布圖
05:26
looked看著 like this.
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就像這個。
05:28
There was clustering集群.
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是叢集分布的
05:30
This reminded提醒 me of clustering集群 that we'd星期三 seen看到 also
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這讓我意識到我們以前見過的流行傳染病
05:33
in infectious傳染病 epidemics流行病,
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就是叢集分布的。
05:35
for example cholera霍亂.
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比如說霍亂
05:37
And then we looked看著 at the maps地圖,
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我們觀察曲線圖發現
05:40
and the maps地圖 showed顯示 this typical典型 wave
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曲線圖裏有這樣的典型曲線。
05:42
upon wave upon wave,
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一個波形疊著一個波形的分布。
05:44
because all epidemics流行病
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因為所有的流行病
05:45
are combinations組合 of many許多 epidemics流行病.
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都跟著其他流行病發生。
05:48
And it also looked看著 like infectious傳染病 epidemics流行病.
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而暴力事件的曲線圖和流行病的曲線圖也很相似。
05:51
And then we asked the question,
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然後我們問,
05:53
well what really predicts預測 a case案件 of violence暴力?
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怎樣預警暴力案件呢?
05:56
And it turns out that the greatest最大 predictor預報器
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結果我們發現 對一個暴力事件的最好預警
05:59
of a case案件 of violence暴力 is a preceding case案件 of violence暴力.
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就是上一次的暴力事件
06:02
Which哪一個 also sounds聲音 like, if there is a case案件 of flu流感,
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這就跟流感疫情相似,
06:05
someone有人 gave someone有人 a case案件 of flu流感, or a cold,
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就像某人把流感,或者感冒傳給別人
06:08
or the greatest最大 risk風險 factor因子 of tuberculosis結核
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結核病最大的罹患因素就是
06:10
is having been exposed裸露 to tuberculosis結核.
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結核病的接觸史。
06:13
And so we see that violence暴力 is, in a way,
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我們發現暴力事件,在某種程度上,
06:16
behaving行為 like a contagious傳染性的 disease疾病.
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很像傳染病的爆發。
06:19
We're aware知道的 of this anyway無論如何
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其實,我們可以了解到
06:21
even in our common共同 experiences經驗
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在日常生活中
06:23
or our newspaper報紙 stories故事
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或者媒體的報導中
06:25
of the spread傳播 of violence暴力 from fights打架
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爭吵中的暴力會蔓延成
06:28
or in gang結夥 wars戰爭 or in civil國內 wars戰爭
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幫派鬥爭,內戰,
06:31
or even in genocides種族滅絕.
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甚至種族屠殺。
06:33
And so there's good news新聞 about this, though雖然,
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但有個好消息,就是
06:36
because there's a way to reverse相反 epidemics流行病,
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我們有治療傳染病的方式。
06:39
and there's really only three things that are doneDONE
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只要做好三件事就可以
06:41
to reverse相反 epidemics流行病,
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阻止傳染病的發生。
06:43
and the first of it is interrupting中斷 transmission傳輸.
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第一點就是切斷傳播途徑。
06:45
In order訂購 to interrupt打斷 transmission傳輸,
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為了切斷傳播途徑,
06:47
you need to detect檢測 and find first cases.
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我們需要找到第一個案例。
06:51
In other words, for T.B. you have to find somebody
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就是說,如果是結核病,你必須要找到
06:54
who has active活性 T.B. who is infecting感染 other people.
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誰有活動性結核病菌,誰會把結核病傳染給別人。
06:57
Make sense?
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合理吧?
06:59
And there's special特別 workers工人 for doing that.
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我們有專業人員來做這個工作。
07:01
For this particular特定 problem問題,
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對這樣特定的問題,
07:03
we designed設計 a new category類別 of worker工人
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我們設計出新類型的工作者
07:05
who, like a SARSSARS worker工人
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就像 SARS (非典) 的工作者,
07:06
or someone有人 looking for bird flu流感,
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或禽流感的工作者,
07:08
might威力 find first cases.
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他們可能找到首例患病者
07:10
In this case案件, it's someone有人 who's誰是 very angry憤怒
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在暴力事件裏,起因是有人
07:12
because someone有人 looked看著 at his girlfriend女朋友
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因為別人看了他的女朋友一眼
07:14
or owes him money,
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或者欠了他的錢而動怒
07:16
and you can find workers工人 and train培養 them
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你可以找到一些人,訓練他們成為
07:18
into these specialized專門 categories類別.
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特殊類型的工作者。
07:21
And the second第二 thing to do, of course課程,
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第二點呢,當然就是
07:23
is to prevent避免 further進一步 spread傳播,
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防止擴散。
07:24
that means手段 to find who else其他 has been exposed裸露,
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就是說,要找到誰有可能被牽涉進去。
07:28
but may可能 not be spreading傳播 so much right now
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雖然他可能不會很快被牽涉
07:30
like someone有人 with a smaller case案件 of T.B.,
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就像在結核病傳染的小型案例裏一樣。
07:33
or someone有人 who is just hanging out in the neighborhoods社區,
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有人可能只是的街頭鄰居
07:36
but in the same相同 group,
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但是在同個活動範圍裏
07:37
and then they need to be, in a way,
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那麽這些人就需要以某種方式,
07:40
managed管理 as well,
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被好好管理
07:41
particular特定 to the specific具體 disease疾病 process處理.
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就象處理某些特殊疾病的過程一樣
07:44
And then the third第三 part部分, the shifting the norms規範,
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第三點就是,恢復到正常。
07:47
and that means手段 a whole整個 bunch of community社區 activities活動,
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就是整個社區活動的
07:51
remodeling重塑, public上市 education教育,
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重新建構和公共教育
07:53
and then you've got what you might威力 call
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然後你可以做到所謂的
07:55
group immunity免疫.
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“群體免疫”。
07:56
And that combination組合 of factors因素
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這幾個因素的結合
07:58
is how the AIDS艾滋病 epidemic疫情 in Uganda烏干達
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當年使我們成功地阻止了
08:01
was very successfully順利 reversed反向的.
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愛滋病在烏干達的擴散
08:03
And so what we decided決定 to do in the year 2000
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在2000年我們決定嘗試
08:06
is kind of put this together一起 in a way
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把這些因素結合起來。
08:08
by hiring招聘 in new categories類別 of workers工人,
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首先我們雇用了一些新類型的工作者,
08:10
the first being存在 violence暴力 interruptors遮斷.
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也就是首起暴力事件的阻止人。
08:13
And then we would put all of this into place地點
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然後我們把三個因素全部運用到
08:16
in one neighborhood鄰里
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某個社區,
08:17
in what was the worst最差 police警察 district
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也就是美國國內
08:19
in the United聯合的 States狀態 at the time.
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某個治安最差的地區。
08:21
So violence暴力 interruptors遮斷 hired僱用 from the same相同 group,
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暴力阻止者是從同一社區子裡選出來
08:24
credibility可信性, trust相信, access訪問,
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有信譽、值得信任、能接近他人,
08:27
just like the health健康 workers工人 in Somalia索馬里,
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就像在索馬利亞的那些醫護工作者一樣
08:30
but designed設計 for a different不同 category類別,
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只不過他們為不同的目的而工作
08:32
and trained熟練 in persuasion勸說,
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他們受訓學習如何勸說別人,
08:34
cooling冷卻 people down, buying購買 time, reframing重新定義.
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讓人息怒,拖延時間,轉變他的態度。
08:38
And then another另一個 category類別 of worker工人,
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1966
還有其他類別的員工,
08:40
the outreach推廣 workers工人, to keep people
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外展服務人員
08:42
in a way on therapy治療 for six to 24 months個月.
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讓人接受6到24個月的“治療”。
08:46
Just like T.B., but the object目的 is behavior行為 change更改.
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就像結核病的治療,但目標是行為上的改變。
08:49
And then a bunch of community社區 activities活動
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然後一些社區活動就會
08:51
for changing改變 norms規範.
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恢復正常
08:53
Now our first experiment實驗 of this
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我們首次實驗結果
08:55
resulted導致 in a 67-percent-百分 drop下降
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顯示在芝加哥的西加菲爾德地區
08:58
in shootings槍擊事件 and killings殺人
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槍擊和殺人案件
08:59
in the West西 Garfield加菲貓 neighborhood鄰里 of Chicago芝加哥.
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減少了67%
09:02
(Applause掌聲)
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(掌聲)
09:04
And this was a beautiful美麗 thing
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這對一個社區來說
09:05
for the neighborhood鄰里 itself本身,
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是一件非常好的事
09:07
first 50 or 60 days, then 90 days,
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剛開始堅持了50或60天,然後是90天,
09:10
and then there was unfortunately不幸 another另一個 shooting射擊
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在接下來的90天中
09:11
in another另一個 90 days,
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僅發生了一件不幸的槍擊事件。
09:13
and the moms媽媽 were hanging out in the afternoon下午.
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2440
那些社區裏的媽媽們開始在下午一起出來散步
09:15
They were using運用 parks公園 they weren't using運用 before.
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他們開始利用他們以前不曾利用的公園
09:18
The sun太陽 was out. Everybody每個人 was happy快樂.
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太陽出來了。每個人都很開心。
09:20
But of course課程, the funders資助者 said, "Wait a second第二,
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當然,有些捐款人會說
09:23
do it again."
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“等等,再試一次。”
09:25
And so we had to then, fortunately幸好,
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所以呢,我們幸運地
09:28
get the funds資金 to repeat重複 this experience經驗,
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拿到了資金來重複這個實驗。
09:31
and this is one of the next下一個 four neighborhoods社區
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2011
在實驗中的四個社區之一
09:33
that had a 45-percent-百分 drop下降 in shootings槍擊事件 and killings殺人.
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槍擊和殺人案件減少了45%
09:36
And since以來 that time, this has been replicated複製
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從那時開始,這個實驗已經被重複了
09:38
20 times.
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20次
09:40
There have been independent獨立 evaluations評估
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我們的實驗被獨立評估過
09:42
supported支持的 by the Justice正義 Department
227
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1946
評估是由司法部門和
09:44
and by the CDCCDC and performed執行 by Johns約翰斯 Hopkins霍普金斯
228
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2777
疾病預防控制中心和約翰霍普金斯大學來進行
09:47
that have shown顯示 30-to--至-50-percent-百分 and 40-to--至-70-percent-百分
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評估結果顯示,使用我們的新方法
09:51
reductions減少 in shootings槍擊事件 and killings殺人
230
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槍擊和殺人案件
09:53
using運用 this new method方法.
231
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1922
減少到了 30~50% 和 40~60%
09:55
In fact事實, there have been three independent獨立
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實際上,我們的工作到目前為止已經通過了
09:56
evaluations評估 of this now.
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三次的獨立評估。
09:58
Now we've我們已經 gotten得到 a lot of attention注意 as a result結果 of this,
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我們的工作也因此受到了很多人的矚目
10:00
including包含 being存在 featured精選 on
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其中包括
10:03
The New York紐約 Times'時報“ Sunday星期日 magazine雜誌 cover story故事.
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《紐約時報》周日雜誌的封面故事
10:07
The Economist經濟學家 in 2009
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2009年的《經濟學家》雜誌曾說
10:09
said this is "the approach途徑 that will come to prominence突出物."
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"這種方法將被廣泛使用“
10:12
And even a movie電影 was made製作 around our work.
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2337
甚至有一部電影是講述關於我們的工作
10:14
[The Interrupters滅弧]
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[中斷]
10:15
However然而, not so fast快速,
241
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2504
但是,先不要急,
10:18
because a lot of people did not agree同意
242
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1862
因為很多人還不同意
10:19
with this way of going about it.
243
607979
1981
我們的做法。
10:21
We got a lot of criticism批評,
244
609960
1963
我們受到了很多的批評,
10:23
a lot of opposition反對,
245
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很多的反對意見,
10:25
and a lot of opponents對手.
246
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1735
很多的敵對態度。
10:27
In other words, what do you mean, health健康 problem問題?
247
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2851
像是,為什麼你說這是健康問題?
10:30
What do you mean, epidemic疫情?
248
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2586
為什麼你稱它為流行病?
10:32
What do you mean, no bad guys?
249
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為什麼你說沒有壞人?
10:35
And there's whole整個 industries行業 designed設計
250
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2153
整個業界早已經有
10:37
for managing管理的 bad people.
251
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2958
管理壞人的方法
10:40
What do you mean, hiring招聘 people
252
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3043
你說雇用有(不良)背景的人
10:43
who have backgrounds背景?
253
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1949
是什麽意思?
10:45
My business商業 friends朋友 said,
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4499
我商界的朋友說,
10:50
"Gary加里, you're being存在 criticized批評 tremendously異常.
255
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3347
”蓋瑞,你竟然受到這麼多批評
10:53
You must必須 be doing something right."
256
641591
1998
你一定是做了一些好事!“
10:55
(Laughter笑聲)
257
643589
2009
(笑聲)
10:57
My musician音樂家 friends朋友 added添加 the word "dude花花公子."
258
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3255
我的音樂家朋友還外加了 ”兄弟“ 一詞
11:00
So anyway無論如何, additionally另外,
259
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3771
總之
11:04
there was still this problem問題,
260
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1825
這仍然是個問題
11:06
and we were getting得到 highly高度 criticized批評 as well
261
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2905
還有另外一種批評是
11:09
for not dealing交易 with all of these other problems問題.
262
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3296
我們的工作無法處理所有的問題。
11:12
Yet然而 we were able能夠 to manage管理 malaria瘧疾
263
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3130
目前為止,我們能控制瘧疾,
11:15
and reduce減少 HIVHIV and reduce減少 diarrheal腹瀉 diseases疾病
264
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2752
減少愛滋病和腹瀉的發病,
11:18
in places地方 with awful可怕 economies經濟
265
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1938
在那些貧困的
11:20
without healing復原 the economy經濟.
266
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1820
經濟沒有復甦的地區。
11:22
So what's actually其實 happened發生 is,
267
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2535
所以實際上,
11:24
although雖然 there is still some opposition反對,
268
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2445
儘管有一些反對意見,
11:27
the movement運動 is clearly明確地 growing生長.
269
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1820
很明顯大家都行動起來了。
11:29
Many許多 of the major重大的 cities城市 in the U.S.,
270
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2084
美國的很多大城市,
11:31
including包含 New York紐約 City and Baltimore巴爾的摩
271
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2238
包括紐約市、巴爾的摩
11:33
and Kansas堪薩斯 City,
272
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1265
和堪薩斯城
11:34
their health健康 departments部門 are running賽跑 this now.
273
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1933
他們的衛生部門在開展著類似的工作
11:36
Chicago芝加哥 and New Orleans奧爾良, the health健康 departments部門
274
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2621
芝加哥和紐奧良的衛生部門
11:39
are having a very large role角色 in this.
275
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2531
扮演著重大的角色
11:41
This is being存在 embraced擁抱 more by law enforcement強制
276
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2855
執法單位也比過去
11:44
than it had been years年份 ago.
277
692617
1979
更能接受這些做法
11:46
Trauma外傷 centers中心 and hospitals醫院
278
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2054
創傷中心和醫院
11:48
are doing their part部分 in stepping步進 up.
279
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2294
也在不斷跟進
11:50
And the U.S. Conference會議 of Mayors市長
280
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1893
美國市長聯會
11:52
has endorsed贊同 not only the approach途徑
281
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2593
已經核准不僅要開展類似的工作
11:55
but the specific具體 model模型.
282
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2293
而且要作為特別模式來做
11:57
Where there's really been uptake攝取 even faster更快
283
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3249
在國際上
12:00
is in the international國際 environment環境,
284
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1997
有著更迅速的行動
12:02
where there's a 55-percent-百分 drop下降
285
710969
1756
在波多黎各的第一個施行社區
12:04
in the first neighborhood鄰里 in Puerto波多黎各 Rico波多黎各,
286
712725
2424
案件減少了55%
12:07
where interruptions中斷 are just beginning開始 in Honduras洪都拉斯,
287
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2806
在宏都拉斯的工作正在著手進行
12:09
where the strategy戰略 has been applied應用的 in Kenya肯尼亞
288
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2914
在肯亞最近的選舉活動中
12:12
for the recent最近 elections選舉,
289
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2646
我們的方式也被列入政策中
12:15
and where there have been 500 interruptions中斷 in Iraq伊拉克.
290
723515
3173
伊拉克已經完成了500次阻斷犯罪的工作
12:18
So violence暴力 is responding響應 as a disease疾病
291
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3275
所以,暴力事件可以當作疾病來對待,
12:21
even as it behaves的行為 as a disease疾病.
292
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2265
它的表現形式就像是疾病一樣
12:24
So the theory理論, in a way,
293
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2203
這個理論在某方面來說
12:26
is kind of being存在 validated驗證 by the treatment治療.
294
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4165
在處理的過程中得到了驗證
12:30
And recently最近, the Institute研究所 of Medicine醫學
295
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2934
最近,美國醫學研究所 (IOM)
12:33
came來了 out with a workshop作坊 report報告
296
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2137
提出一個研究報告
12:35
which哪一個 went through通過 some of the data數據,
297
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1864
根據一些數據
12:37
including包含 the neuroscience神經科學,
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1545
其中包括神經科學
12:39
on how this problem問題 is really transmitted發送.
299
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4323
來解釋暴力是如何傳播的
12:43
So I think this is good news新聞,
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2911
我認為這是一個好消息
12:46
because it allows允許 us an opportunity機會
301
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1864
因為這些研究讓我們有機會
12:48
to come out of the Middle中間 Ages時代,
302
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1555
走出以往的
12:49
which哪一個 is where I feel this field領域 has been.
303
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3042
中世紀般的陳舊思維。
12:52
It gives us an opportunity機會 to consider考慮 the possibility可能性
304
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3106
這些研究給我們重新考慮
12:55
of replacing更換 some of these prisons監獄
305
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2796
把一些監獄變成
12:58
with playgrounds遊樂場 or parks公園,
306
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3282
休閒場所和公園的可能性。
13:01
and to consider考慮 the possibility可能性
307
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2668
重新考慮
13:04
of converting轉換 our neighborhoods社區 into neighborhoods社區,
308
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3687
重建我們的社區的可能性
13:08
and to allow允許 there to be a new strategy戰略,
309
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3454
採用新的策略
13:11
a new set of methods方法, a new set of workers工人:
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新的方法,新類型的工作者
13:15
science科學, in a way, replacing更換 morality道德.
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某方面用科學的方法來替代道德
13:19
And moving移動 away from emotions情緒
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平息情緒
13:21
is the most important重要 part部分 of the solution
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是解決問題中最重要的一部分
13:24
to science科學 as a more important重要 part部分 of the solution.
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用科學的方法是更加重要的。
13:28
So I didn't mean to come up with this at all.
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我不是說全部都能用我們的方法來解決
13:33
It was a matter of,
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重要的是,
13:36
I wanted actually其實 a break打破,
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我想要突破,
13:37
and we looked看著 at maps地圖, we looked看著 at graphs,
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讓我們能夠看著分布圖,看著圖表,
13:42
we asked some questions問題
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提出一些問題,
13:43
and tried試著 some tools工具
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然後使用一些
13:46
that actually其實 have been used many許多 times before
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以前在其他方面運用過很多次的
13:49
for other things.
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方法。
13:51
For myself, I tried試著 to get away from
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對我自己來說,我曾試圖從
13:54
infectious傳染病 diseases疾病,
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感染性疾病中脫身
13:56
and I didn't.
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可是我沒有。
13:58
Thank you.
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謝謝大家!
13:59
(Applause掌聲)
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(掌聲)
Translated by Lin Piao
Reviewed by Wen-Hsin (Willy) Feng

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ABOUT THE SPEAKER
Gary Slutkin - Epidemiologist
Could our culture have misdiagnosed violence? As the director of the initiative Cure Violence, Gary Slutkin approaches gunfire on neighborhood streets as a contagious disease, looking to science and public health for strategies to stop it.

Why you should listen

Gary Slutkin is an epidemiologist, an innovator in violence reduction, and the Founder/Executive Director of Cure Violence, formerly known as CeaseFire. As a physician, he began his career working in Somalian refugee camps, where tuberculosis and cholera epidemics flared up regularly. He went on to work for the World Health Organization on reversing epidemics, supporting Uganda’s AIDS program which helped the country reversed the course of the disease. Upon returning to the United States, it occurred to him: could gun violence function like an epidemic? And could it be fought, and even stopped, using the principles of public health?

Slutkin has applied the lessons learned over a decade of fighting epidemics to the creation of Cure Violence, a public health approach that has been statistically validated by two independent evaluations by the Department of Justice and Centers for Disease Control. Cure Violence has been called a "pioneering violence reduction model" and its methods have received nods from the Institute of Medicine and the U.S. Conference of Mayors. The program is being replicated at more than 50 sites in 15 U.S. cities, as well as in many countries abroad.

Dr. Sultkin is an Ashoka Fellow, a Professor of Epidemiology and International Health at the University of Illinois at Chicago, and a senior advisor to the World Health Organization.

More profile about the speaker
Gary Slutkin | Speaker | TED.com