TEDGlobal 2009
Marc Koska: 1.3m reasons to re-invent the syringe
馬克.柯斯卡：重新改造針筒的一百三十萬個理由
Filmed:
Readability: 3.3
698,306 views
經費不足的診所裏重復使用的針筒每年帶走一百三十萬條生命。馬克.柯斯卡用事實數據，照片，和偷拍的影片跟我們介紹這個全球性的災難問題。他並和我們分享他的解決方法：一個單次使用的低價針筒。
Marc Koska - Inventor
Marc Koska wants to improve health care in the developing world by re-designing dangerous medical tools -- and offering education to practitioners in under-funded clinics. Full bio
Marc Koska wants to improve health care in the developing world by re-designing dangerous medical tools -- and offering education to practitioners in under-funded clinics. Full bio
Double-click the English transcript below to play the video.
00:18
Twenty-five-and-a-quarter years ago I read
0
0
2000
二十五年又三個月前我在報紙上
00:20
a newspaper article which said
1
2000
2000
讀到一篇文章說
00:22
that one day syringes would be
2
4000
3000
在未來針筒將成爲
00:25
one of the major causes of the spread of AIDS,
3
7000
2000
傳染愛滋病，散播愛滋病
00:27
the transmission of AIDS.
4
9000
2000
的主要原因之一。
00:29
I thought this was unacceptable. So I decided to do something about it.
5
11000
4000
我覺得這是令人無法接受的。所以我決定要有所改變
00:33
Sadly, it's come true. Malaria, as we all know,
6
15000
3000
可悲的是，這已是事實。虐疾，如我們所知
00:36
kills approximately one million people a year.
7
18000
3000
每年奪走大約一百萬條人命
00:39
The reuse of syringes now exceeds that
8
21000
2000
重復使用的針筒已經比這還嚴重
00:41
and kills 1.3 million people a year.
9
23000
5000
每年奪走一百三十萬條人命
00:46
This young girl and her friend
10
28000
2000
這個小女孩和她的朋友
00:48
that I met in an orphanage in Delhi
11
30000
2000
是我在德里的孤兒院遇到的
00:50
were HIV positive from a syringe.
12
32000
5000
她們是因爲針筒而成爲愛滋病帶原者
00:55
And what was so sad about this particular story
13
37000
3000
這個故事最讓人感到心酸的是
00:58
was that once their parents had found out --
14
40000
3000
當她們的父母發現她們得病時
01:01
and don't forget, their parents took them to the doctor --
15
43000
4000
別忘了，最初是父母帶她們到醫生那裏去看病才染病的
01:05
the parents threw them out on the street.
16
47000
2000
就把她們遺棄在街上
01:07
And hence they ended up in an orphanage.
17
49000
3000
從此她們就只能被孤兒院收容
01:10
And it comes from situations like this where
18
52000
2000
這種情況的起因
01:12
you have either skilled or unskilled practitioners,
19
54000
3000
是因爲這些有照或無照的醫護人員
01:15
blindly giving an injection to someone.
20
57000
3000
盲目地幫人打針
01:18
And the injection is so valuable,
21
60000
3000
打針在那裏是如此地珍貴
01:21
that the people basically trust
22
63000
2000
人們基本上十分信任醫生
01:23
the doctor, being second to God, which I've heard many times,
23
65000
3000
我常常聽到這種説法說，醫生是僅次於上帝
01:26
to do the right thing. But in fact they're not.
24
68000
3000
會做正確的事。事實並非如此。
01:29
And you can understand, obviously, the transmission problem
25
71000
2000
很明顯地，你不難去了解
01:31
between people in high-virus areas.
26
73000
4000
在病毒密度高的地方的傳染問題
01:35
This video we took undercover,
27
77000
2000
我們用隱藏的攝影機拍攝這個影片
01:37
which shows you, over a half an hour period,
28
79000
2000
你可以看到在半個鐘頭裏面
01:39
a tray of medicines of 42 vials,
29
81000
4000
這推車上有42管的注射劑
01:43
which are being delivered with only 2 syringes in a public hospital in India.
30
85000
5000
這在印度的一個公立醫院裏，全部只用兩支針筒來注射
01:48
And over the course of half an hour, not one syringe
31
90000
2000
在半個鐘頭的影片裏
01:50
was filmed being unwrapped.
32
92000
2000
沒有看到任何拆封新針筒的畫面
01:52
They started with two and they ended with two.
33
94000
3000
這兩支針筒從頭用到尾
01:55
And you'll see, just now, a nurse coming back to the tray,
34
97000
3000
你可以看到，這裡，護士回到這個推車
01:58
which is their sort of modular station,
35
100000
3000
這是類似她們的護理站
02:01
and dropping the syringe she's just used
36
103000
3000
把她剛用過的針筒放下來
02:04
back in the tray for it to be picked up and used again.
37
106000
3000
放在推車上等一下再拿起來繼續使用
02:07
So you can imagine the scale of this problem.
38
109000
3000
你可以想見這個問題的嚴重性
02:10
And in fact in India alone, 62 percent
39
112000
2000
事實上光在印度
02:12
of all injections given
40
114000
2000
百分之62的注射
02:14
are unsafe.
41
116000
2000
是不安全的。
02:16
These kids in Pakistan don't go to school.
42
118000
2000
這些巴基斯坦的小孩子不上學
02:18
They are lucky. They already have a job.
43
120000
2000
他們很幸運，他們已經有工作了
02:20
And that job is that they go around and pick up syringes
44
122000
2000
他們的工作是到醫院的後面
02:22
from the back of hospitals,
45
124000
2000
去收集針筒
02:24
wash them, and in the course of this,
46
126000
2000
並清洗針筒，這麽做的同時
02:26
obviously picking them up they injure themselves.
47
128000
3000
他們當然會扎傷自己
02:29
And then they repackage them and sell them out on markets
48
131000
3000
他們把針筒重新包裝拿到市場上去賣
02:32
for literally more money
49
134000
2000
可以賣到很好的價錢
02:34
than a sterile syringe in the first place, which is quite bizarre.
50
136000
3000
比全新無菌的針筒還貴。這挺奇怪的。
02:37
In an interesting photo, their father, while we were talking to him,
51
139000
3000
在這個照片裏，我們跟小孩的爸爸談話
02:40
picked up a syringe and pricked his finger --
52
142000
2000
他拿起了一個針筒時扎傷了自己
02:42
I don't know whether you can see the drop of blood on the end --
53
144000
3000
我不知道你們有沒有看到流出的血滴
02:45
and immediately whipped out a box of matches,
54
147000
3000
他趕快拿出一盒火柴
02:48
lit one, and burned the blood off the end of his finger,
55
150000
3000
點亮一支火柴把手指上的血燒乾
02:51
giving me full assurance
56
153000
2000
他跟我保證
02:53
that that was the way that you stopped the transmission of HIV.
57
155000
4000
這麽做就可以防止愛滋病的傳染。
02:57
In China, recycling is a major issue.
58
159000
4000
在中國針筒的回收是個大問題
03:01
And they are collected en mass -- you can see the scale of it here --
59
163000
3000
針筒被大批地回收，你可以在這裡看到它的規模
03:04
and sorted out, by hand, back into the right sizes,
60
166000
4000
按大小來分類，全部用手
03:08
and then put back out on the street.
61
170000
2000
再送囘市場上去賣
03:10
So recycling and reuse
62
172000
3000
所以再回收再使用
03:13
are the major issues here.
63
175000
2000
在這裡是個大問題。
03:15
But there was one interesting anecdote that I found in Indonesia.
64
177000
3000
我在印尼倒是遇到一個有趣的故事
03:18
In all schools in Indonesia,
65
180000
2000
在印尼所有的學校裏
03:20
there is usually a toy seller in the playground.
66
182000
2000
在操場上通常有一個賣玩具的人
03:22
The toy seller, in this case,
67
184000
2000
在這裡這個賣玩具的人
03:24
had syringes, which they usually do,
68
186000
2000
把針筒當玩具賣，這並不少見
03:26
next door to the diggers, which is obviously
69
188000
2000
針筒和鏟子一類的玩具擺在一起
03:28
what you would expect.
70
190000
2000
這是常可預見的。
03:30
And they use them, in the breaks, for water pistols.
71
192000
2000
學童們在下課時間用針筒當水槍玩
03:32
They squirt them at each other, which is lovely and innocent.
72
194000
2000
他們把水射來射去，看來很天真可愛
03:34
And they are having great fun.
73
196000
2000
他們玩得很開心
03:36
But they also drink from them
74
198000
2000
但他們也從針筒裏喝水
03:38
while they're in their breaks, because it's hot.
75
200000
2000
在下課的時間，因爲天氣很熱
03:40
And they squirt the water into their mouths.
76
202000
3000
他們用針筒把水射到嘴裏
03:43
And these are used with traces of blood visible.
77
205000
5000
而在這些針筒裏面常常還有殘留的血。
03:48
So we need a better product. And we need better information.
78
210000
2000
所以我們需要更好的產品，更好的資訊
03:50
And I think, if I can just borrow this camera,
79
212000
5000
我想，讓我借這台攝影機
03:55
I was going to show you my invention,
80
217000
2000
我要讓你們看看我的發明
03:57
which I came up with.
81
219000
3000
我的新主意。
04:00
So, it's a normal-looking syringe.
82
222000
2000
這看起來跟一般的針筒沒兩樣
04:02
You load it up in the normal way. This is made
83
224000
2000
用一樣的方法把藥劑吸入
04:04
on existing equipment in 14 factories that we license.
84
226000
4000
我們發給了十四家廠商許可來製造這針筒
04:08
You give the injection and then put it down.
85
230000
3000
打完了針以後放下針筒
04:11
If someone then tries to reuse it,
86
233000
2000
如果有人要再去使用它
04:13
it locks and breaks afterwards.
87
235000
2000
它會鎖死並會斷裂
04:15
It's very, very simple. Thank you.
88
237000
2000
這是十分十分簡單的。謝謝
04:17
(Applause)
89
239000
3000
（掌聲）
04:20
And it costs the same as a normal syringe.
90
242000
2000
這和一般的針筒的價格是一樣的
04:22
And in comparison, a Coca-Cola
91
244000
2000
跟可口可樂比起來
04:24
is 10 times the price.
92
246000
2000
可口可樂比它貴了十倍
04:26
And that will stop reusing a syringe 20 or 30 times.
93
248000
3000
這可以防止針筒重復被使用20或30遍。
04:29
And I have an information charity
94
251000
2000
我有一個資訊慈善機構
04:31
which has done huge scale amount of work in India.
95
253000
4000
在印度已經做了很多工作
04:35
And we're very proud of giving information to people,
96
257000
3000
我們對提供資訊給人們感到很自豪
04:38
so that little kids like this don't do stupid things.
97
260000
2000
這使得小朋友們不會去作傻事
04:40
Thank you very much.
98
262000
2000
謝謝你們
04:42
(Applause)
99
264000
1000
（掌聲）
ABOUT THE SPEAKER
Marc Koska - InventorMarc Koska wants to improve health care in the developing world by re-designing dangerous medical tools -- and offering education to practitioners in under-funded clinics.
Why you should listen
In 1984, Marc Koska read an article that predicted HIV would spread widely through unsafe injections. He writes, "Appalled at the prospect of such an avoidable catastrophe, I decided there and then to try and do something about it." The prediction, sadly, turned out to be true: syringe reuse now accounts for 1.3 million deaths -- more than malaria. In the next years, Koska undertook the study of public health to find out what could be done. He determined that the design of syringes was the critical issue.
Today, Koska's solution to the problem, the K1 syringe -- it locks down after a single injection, preventing reuse -- is in use by millions. But he hasn't stopped there: In 2005, he founded a nonprofit, SafePoint, which aims to educate people in the developing world about the dangers of reusing any instruments that come into contact with blood.
Marc Koska | Speaker | TED.com