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AparnaHegde_2020F-_救生技术帮助母亲做出健康决定_-
[SHAPE YOUR FUTURE] [塑造你的未来]
Anita died in my presence while giving birth to life. 安妮塔在分娩时走了,当时我在现场。
She bled to death and lost her child. 她失血过多,孩子也没能保住。
The irony was that she had access to care. 讽刺的是,她本来有机会能得到护理。
In the first trimester of pregnancy , she had visited the antenatal clinic of the hospital in Mumbai where I was doing residency . 在她早期妊娠的时候, 她去了孟买的一家医院接受产前门诊, 那也是我实习的地方。
presence:n.存在;出席;参加;风度;仪态; bled:v.流血;失血;给(某人)放血;长期榨取(某人的钱);(bleed的过去分词和过去式) irony:n.讽刺;反语;具有讽刺意味的事;adj.铁的;似铁的; trimester:n.三个月;一学期; pregnancy:n.怀孕;丰富,多产;意义深长; antenatal:adj.产前的;出生前的; clinic:n.诊所;临床实习;(医院的)门诊部;门诊时间; residency:n.住处;住院医生实习期;
But over four hours of waiting in the hot, sweaty , dingy , overcrowded clinic just to get a minute with me, a harried , overworked resident doctor, meant that she never came back, only to die in labor months later. 但是在闷热、汗津津、肮脏 且拥挤不堪的小诊所等待四个小时, 只为花费一分钟的时间和我这个 忙碌过劳的医生见上一面, 这意味着她以后再也不会回来了, 只能在数月后的生产中 接受死亡的命运。
I was wracked with guilt. 我非常愧疚。
If only I had counseled her about the danger signs, why she needed to access regular care. 要是我能提醒她注意危险征兆, 以及为什么她需要接受定期护理,
Would she and her child have survived? 她和她的孩子是不是就能活下来了呢？
sweaty:adj.出汗的;吃力的;使人出汗的; dingy:adj.昏暗的;肮脏的; overcrowded:adj.过度拥挤的;v.拥挤(overcrowd的过去分词); harried:v.(不断)烦扰;折磨;反复进攻;不断袭击;(harry的过去分词和过去式) overworked:adj.工作过多的; v.(使)过度劳累,过分努力; (overwork的过去分词和过去式) resident:adj.居住的;住院医师;定居的;n.居民; wracked:n.失事船只;破坏;[植]漂积海草;vt.严重伤害;遇难;vi.彻底破坏; counseled:v.劝告,建议;(counsel的过去式与过去分词形式)
She did not die due to a terminal condition. 她不是因为晚期的状况而死的,
She died because of underlying anemia , an easily treatable , preventable condition. 而是因为潜在的贫血症, 那是一种容易治疗与预防的疾病。
I saw these stories daily. 我每天都能看到像这样的故事。
Systemic , preventable problems resulting in mothers and children dying in the most unjust of circumstances . 在那些最缺乏公平正义的地方, 系统性的,可预防的问题 导致许多母亲与孩子死亡。
terminal:n.终端;航站楼;终端机;航空终点站;adj.晚期的;不治的;致命的;患绝症的; underlying:adj.根本的; v.构成…的基础; (underlie的现在分词) anemia:n.贫血;贫血症; treatable:adj.能治疗的;好对付的;能处理的; preventable:adj.可预防的;可阻止的;可防止的; Systemic:adj.系统的;全身的;体系的; unjust:adj.不公平的,不公正的;非正义的; circumstances:n.情况;环境;情形;(circumstance的复数)
In the next one hour, three women will die while giving birth somewhere in India. 在接下来的一个小时, 在印度,三名妇女将因生产而死,
Two children under age five die every minute in India. 每五分钟就会有两名 小于5岁的孩子死亡。
I am a practicing urogynecologist, but very early in my medical training, 我是一名执业泌尿妇科医生, 但在我接受医学训练的早期
I realized that hospital-based solutions were not enough. 就已意识到以医院为基础的解决对策 是远远不够的。
And given the sheer scale of India's problems, any solution that made a difference had to be scalable , accessible to the last woman and child directly in their homes, and yet cost-effective and resource-light. 考虑到印度的问题规模很大, 任何一种有效的解决方法 都必须可以随着规模扩大, 让每一个在家的妇女和孩子 都能够直接取得, 并且要经济有效、节约资源。
under age:未成年;未到法定年龄; sheer:adj.纯; v.十足地; n.透明薄纱; v.[航海](使)偏航; (使)转向; scale:n.规模;比例;鳞;刻度;天平;数值范围;v.衡量;攀登;剥落;生水垢; solution:n.解决方案;溶液;溶解;解答; scalable:adj.可攀登的;可去鳞的;可称量的; accessible:adj.易接近的;可进入的;可理解的; directly:adv.直接地;立即;马上;正好地;坦率地;conj.一…就; cost-effective:adj.划算的;成本效益好的(等于cost-efficient);
And then the mobile phone came to India and within a few years everyone had a mobile phone. 在那之后,手机进入印度, 在短短几年时间里, 几乎所有人都有了一部手机
There are currently more mobile phones in India than toilets. 最近,手机在印度的数量 甚至比厕所还多。
The idea then struck me. 我心中忽然产生一个念头。
Why not use a simple technological tool like a mobile phone, which is available in almost every Indian household to bridge the yawning systemic gaps in health care ? 为什么我们不用一种简易的科技工具, 像现在普及每一户 印度家庭的手机那样, 去修补卫生保健领域里 系统性的漏洞呢？
mobile phone:移动电话 currently:adv.当前;一般地; technological:adj.技术[工程](上)的;因工艺技术高度发展而引起的; household:n.家庭;一家人;同住一所(或一套)房子的人;adj.家庭的;家常的;王室的; yawning:v.打哈欠;非常宽;难以逾越;(yawn的现在分词) gaps:n.差异,缺口;缝隙(gap的复数形式);v.裂开;使豁裂(gap的第三人称单数形式); health care:n.卫生保健;
Maybe we could have simply called Anita weekly with critical lifesaving information. 或许我们可以每周向安妮塔 提供重要的救生信息。
On the other hand , maybe we could have provided mobile-phone-based training to the health worker who could have diagnosed Anita's anemia in the community itself. 另一方面, 或许我们可以向社区里能够诊断 安妮塔的贫血症的健康工作者们 提供以手机为基础的培训。
critical:adj.鉴定的;[核]临界的;批评的,爱挑剔的;危险的;决定性的;评论的; lifesaving:adj.救命的;救生用的;n.救生; On the other hand:另一方面; provided:conj.假如; v.提供; (provide的过去分词和过去式) diagnosed:v.诊断(疾病);判断(问题的原因);(diagnose的过去分词和过去式) community:n.社区;[生态]群落;共同体;团体;
Thus was born my NGO ARMMAN. 就这样,我的 NGO ARMMAN项目诞生了。
Our programs, mMitra and Kilkari, are free, weekly voice call services. 我们的项目,mMitra和Kilkari完全免费, 提供每周的语音呼叫服务。
They provide preventive information directly to women through pregnancy and infancy in their chosen time slot and language. 直接提供妇女预防性讯息, 涵盖整个怀孕期及婴儿期, 由他们选择时间段及语言, 提供预防性讯息。
There are multiple tries for every message, a missed-call system, and mMitra also has a call center. 每封讯息都会多次尝试发送, 有一个未接来电系统, mMitra也有一个呼叫中心。
If only Anita had received this service. In the second month of pregnancy itself, it would have told her about the need to take an iron pill daily from the third month of pregnancy. 要是安妮塔能在孕期第二个月 受到这种服务, 系统将会提醒她从第三个月开始 每天服用一片补铁片。
preventive:n.预防药;预防法;adj.预防的,防止的; infancy:n.初期;婴儿期;幼年; slot:n.位置;狭槽;水沟;硬币投币口;v.跟踪;开槽于; multiple:adj.数量多的;多种多样的;n.倍数; pill:n.[医]药丸;药品;
When the third month arrived, it would have sent her a reminder and counseled her on how to take the iron pills . 第三个月的时候, 系统会向她发送一个提示信号 并给她提供服用补铁片的建议。
For example, the need to avoid tea, coffee to improve the absorption of iron and stress on why it is so necessary to prevent anemia. 比如说,她需要避免饮用茶和咖啡 来促进对铁的吸收, 并强调预防贫血症的必要性。
Two weeks later, it would have spoken about how to tackle the adverse effects of iron pills, like constipation . 两周后, 系统会告知她如何对抗补铁片的副作用, 比如便秘。
pills:n.药丸; v.起球; (pill的第三人称单数和复数) improve:v.改进;改善; absorption:n.吸收;全神贯注,专心致志; tackle:v.处理; n.用具; adverse:adj.不利的;相反的;敌对的(名词adverseness,副词adversely); constipation:n.[临床]便秘;受限制;
If she had any query , she could have reached out to our call center staff. 如果她有任何疑惑, 她能联系到呼叫中心的工作人员。
These are simple voice calls. 这些都是简易的语音呼叫。
As a typical doctor, 作为一名专业医生,
I expected them to just inform and hopefully lead to better health behaviors. 我期待它们能普及知识, 并希望能引领更健康的生活行为。
However, the one unexpected transformational benefit that has completely blown my mind is this: 然而,有一个非预期转变的优势 让我感到兴奋:[03:48]
query:n.疑问,质问;疑问号;[计]查询;vt.询问;对…表示疑问;vi.询问;表示怀疑; typical:adj.典型的;特有的;象征性的; inform:v.通知;告诉;报告;告发;告密; unexpected:adj.意外的,想不到的; transformational:adj.转换的;改变的;转换生成的;
Information is empowerment . 拥有信息也是拥有权力。
Armed with this information, women like Anita are upending patriarchal family dynamics , challenging entrenched mores and demanding care. 在这些信息的加持下, 像安妮塔一样的妇女 将动摇父系社会的发展动力, 挑战根深蒂固的风俗习惯, 并且主动要求护理服务。
empowerment:n.许可,授权; upending:v.(使)颠倒;(upend的现在分词) patriarchal:adj.家长的;族长的;由族长统治的; dynamics:n.动力学,力学; entrenched:adj.根深蒂固的;v.使处于牢固地位;牢固确立;(entrench的过去式和过去分词) mores:n.风俗习惯;传统;
Karnam, the wife of a deeply conservative preacher , convinced her husband to adopt family planning because mMitra told her that spacing between pregnancies is necessary. 作为一名极度保守的传教士的妻子, Karnam说服她的丈夫实行计划生育, 因为mMitra告诉她 多次怀孕之间的间隔期是很有必要的。
And the change is intergenerational . 不仅如此,这种改变往往是跨代际的。
Punita, form a deeply conservative family, sent her daughter to an English medium school. Punita同样来自一个很保守的家庭, 她将她的女儿送到 以英语为授课语言的学校。
In addition to the big pictured messages, the most underprivileged of women want to know when their child will understand color, how to ensure psychosocial stimulation of the child, when their child will develop fingers in their womb and so on. 除了显示在大图上的信息, 那些最底层的妇女想知道 她们的孩子什么时候会识别颜色, 如何确保给孩子社会心理上的激励, 孩子的手指是什么时候 在子宫中形成的,等等。
conservative:adj.保守的;n.保守派,守旧者; preacher:n.牧师;传教士;鼓吹者; convinced:adj.坚信; v.使确信; (convince的过去分词和过去式) adopt:v.采取;接受;收养;正式通过; family planning:n.计划生育;家庭计划; pregnancies:n.怀孕;丰富,多产;意义深长; intergenerational:adj.两代间的; medium:n.(传播信息的)媒介;手段;工具;方法;adj.中等的;中号的; In addition to:除…之外; underprivileged:adj.贫困的;被剥夺基本权力的;社会地位低下的; ensure:vt.保证,确保;使安全; psychosocial:adj.社会心理的;心理社会学的; stimulation:n.刺激;激励,鼓舞; womb:n.[解剖]子宫;发源地;vt.容纳;
Like any woman would. 像很多妇女一样,
Our services respect that. 我们的服务也很尊重妇女的诉求。
Over 20 million women in over 16 states in India have enrolled for these services since 2014. 在印度超过 16 个州, 超过两千万的妇女, 自 2014 年以来 已经注册了这些服务。
This is testament to how easily scalable and replicable these solutions are anywhere in the world. 这些方法在世界上任何地方 都能简单量化与复用。 这就是例证
Similarly , our mHealth-based refresher training program for government frontline health workers called Mobile Academy has trained over 130,000 health workers in 13 states in India. 类似地,我们以mHealth 为基础的进修培训计划 名为“移动学校”,为政府 一线健康工作者量身定制, 这个项目已经为印度13个州 超过13万的健康工作者提供过训练。
enrolled:v.(使)加入;注册;登记;(enroll的过去分词和过去式) testament:n.[法]遗嘱;圣约;确实的证明; Similarly:adv.同样地;类似于; refresher:n.可提神的人或物;补习课程;清凉饮料;增加报酬;adj.专业性复习进修的; frontline:n.前线;锋线(包括大前锋,小前锋,中锋); Academy:n.学院;研究院;学会;专科院校;
Both Kilkari and Mobile Academy, in collaboration with the government, will extend through the country in the next three to five years. Kilkari和“移动学校”项目都与政府合作, 将在接下来的三到五年内扩展到全国。
Our goal is to be able to reach over 15 million women and their children every year, and that would mean over half of the mothers and children born every year have the information they need. 我们的目标是每年能够服务 超过一千五百万的妇女和孩子, 这就意味着每年将有半数以上的母亲 和新降生的孩子能获得所需的信息。
collaboration:n.合作;勾结;通敌; extend:vt.延伸; vi.延伸;
And this massive scale is only possible because so many of our partners, be it NGOs, hospitals and the government, recognize the value of this approach and provided the scaffold on which we grew. 这个大规模的设想是非常有可能实现的, 因为我们的许多搭档, 不论是非政府组织、医院还是政府部门, 都看到了这个方法的价值, 并提供了供我们成长的平台。
Our quest in the next five years is to adopt multimedia approaches , and given the massive amounts of data we have, use the power of AI and predictive analytics to better serve our mothers and children. 在接下来五年里,我们的诉求 是采用多媒体方法, 考虑到我们现有的大量数据, 我们将运用AI技术和预测分析 更好地服务母亲和孩子们。
massive:adj.大量的;巨大的,厚重的;魁伟的; recognize:v.认识;认出;辨别出;承认;意识到; approach:n.方法;路径;v.接近;建议;着手处理; scaffold:n.脚手架;鹰架;绞刑台;vt.给…搭脚手架;用支架支撑; quest:n.追求;寻找;vi.追求;寻找;vt.探索; multimedia:n.多媒体;adj.多媒体的; approaches:v.靠近,接近; n.方式,方法,态度; predictive:adj.预言性的;成为前兆的; analytics:n.[化学][数]分析学;解析学;
And our tech platform and the networks we build are nimble . 我们建造的技术平台和网络相当灵敏。
When COVID-19 struck, lockdown was announced overnight . 当新冠疫情来临, 封锁命令在一夜间下达,
Among the worst affected were the underprivileged women and children in the slums of Mumbai and Delhi , which were declared as containment zones. 这当中受灾最重的无疑是孟买和德里 贫民窟里的底层母亲和孩子们, 那些地方统统被划为疫区。
platform:n.平台; v.把…放在台上[放在高处; nimble:adj.敏捷的;聪明的;敏感的; lockdown:n.一级防范禁闭(期); overnight:adj.夜间的; v.在夜间; n.(美)前一天的晚上; slums:n.贫民,[经]贫民区(slum的复数); v.到贫民窟去; Delhi:n.德里(印度城市名); containment:n.包含;牵制;容量;密闭度;抑制,牵制;牵制[遏制]政策;
However, pregnancy and infancy can't wait for a lockdown. 但是,孕期和婴儿期 不会因为疫情封锁就中止。
When there's an emergency like bleeding , care is needed immediately. 当发生紧急状况,比如出血, 护理就是紧急需要了。
And we were right there and ready. 我们将坚守于此,严阵以待。
We repurposed our tech platform within a matter of days. 我们在短短几天内重整了技术平台,
We created a virtual clinic for antenatal pediatric care manned by qualified doctors. 创建了由专业医生支持的诊所, 提供妊娠和小儿科的医疗服务。
emergency:n.紧急情况;突发事件;非常时刻;adj.紧急的;备用的; bleeding:n.出血;渗色;adj.流血的;同情的;v.出血;渗出;(bleed的现在分词) repurposed:vt.改换意图;重新目的化; virtual:adj.[计]虚拟的;实质上的,事实上的(但未在名义上或正式获承认); pediatric:adj.小儿科的; qualified:adj.有资格的; v.合格; (qualify的过去分词和过去式)
Our call-center staff arranged logistic support, like ambulances . 呼叫中心的成员 提供后勤支持,如救护车。
We also sent COVID-specific information covering pregnancy and infancy to over 300,000 pregnant women and mothers through voice calls. 我们也为超过30万的孕期妇女和母亲, 通过语音拨打,提供 新冠疫情相关的孕期与婴儿期知识。
But why should you care about our mothers and children? 为什么我们需要关心母亲和孩子们呢？
arranged:adj.安排的;v.安排;计划;准备(arrange的过去式和过去分词); logistic:adj.后勤学的;[数]符号逻辑的; ambulances:n.[车辆][医]救护车(ambulance的复数); pregnant:adj.怀孕的;富有意义的;
The pandemic has made us confront this most implacable of truths. 这次疫情使我们不得不 面对一个无情的真相:
A robust primary health care system is an absolute pillar of a functioning and efficient society. 一个强有力的基础医疗保健系统 对一个运作良好高效的社会 起支柱性的作用。
Improvement in maternal and child health leads to horizontal development of health systems and improved primary health care. 对母亲和孩子医疗保健的改善 能引领整个健康系统 从上到下全方位的发展, 并且改提高基础的医疗质量。
pandemic:adj.(疾病等)全国流行的;普遍的;n.流行性疾病; confront:v.直面;无法回避;降临于;处理;对抗; implacable:adj.不能安抚的;难和解的;不能缓和的; robust:adj.强健的;健康的;粗野的;粗鲁的; pillar:n.支柱; v.用柱子装饰[支持]; efficient:adj.有效率的;有能力的;生效的; Improvement:n.改进,改善; maternal:adj.母亲的;母性的;母系的;母体遗传的; horizontal:n.水平线;水平面;横线;水平位置;adj.水平的;与地面平行的;横的; improved:adj.改良的:v.改进:改善(improve的过去分词和过去式)
A village that can look after its mothers and children well can look after all other conditions by ripple effect . 一个能照看好母亲和孩子们的村子, 根据涟漪效应, 也能关照好其他种种情况。
And pregnancy is not a disease . 怀孕期不是疾病。
Childhood is not an ailment . 儿童期不是疾病。
Dying due to natural life event is not acceptable , and we know why our mothers and children die. 因为自然发生的生活事件而死 是不可接受的。 何况我们已经知道 这些母亲和孩子的死因。
ripple effect:n.连锁反应; disease:n.病,[医]疾病;弊病;vt.传染;使…有病; Childhood:n.童年;幼年;孩童时期 ailment:n.小病;不安; acceptable:adj.认同的;可接受的;令人满意的;
Yet we invest so little in preventing their deaths. 但我们在预防这些死亡的努力上 还投入太少。
There can be no global progress until all our mothers and children do well. 除非母亲和孩子们能好好活着, 绝不会有全球性的进步出现。
I implore you to add your voices to ours. 我恳求你加入我们的行列,
To amplify this message loud and clear. 将这份帮助他人的福音更加发扬光大。
invest:v.投资;(把资金)投入;投入(时间、精力等);授予; global:adj.全球的;总体的;球形的; implore:vt.恳求或乞求;vi.恳求或乞求; amplify:vt.放大,扩大;增强;详述;vi.详述;
That maternal and child health is a human right . 保障母亲和孩子的健康就是保障人权。
Thank you. 谢谢。
human right:n.人权;