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BillClinton_2007-_重建卢旺达_
I thought in getting up to my TED wish 在我正式阐述我的TED愿望之前,
I would try to begin by putting in perspective what I try to do and how it fits with what they try to do. 我希望可以解释一下我的追求, 并点明我的追求是如何和这些人的追求联系在一起的。
perspective:n.观点;远景;透视图;adj.透视的;
We live in a world that everyone knows is interdependent , but insufficient in three major ways. 众所周知,我们生活在一个息息相关彼此依存的世界, 但却在三个主要的方面存在欠缺。
interdependent:adj.相互依赖的;互助的; insufficient:adj.不足的,不充足的;n.不足;
It is first of all , profoundly unequal . 首先,我们的世界是极其不平等的。
first of all:adv.首先; profoundly:adv.深刻地;深深地;极度地; unequal:adj.不平等的;不规则的;不胜任的;n.不等同的事物;
Half the world's people still living on less than two dollars a day, a billion people with no access to clean water, two and a half billion no access to sanitation , a billion going to bed hungry every night. 世界上一半人口的日均生活费用低于两美元, 十亿人无法获取洁净的用水, 二十五亿人没有基本的卫生系统, 十亿人每晚挨着饿睡觉。
sanitation:n.[医]环境卫生;卫生设备;下水道设施;
One in four deaths every year from AIDS, TB, malaria and the variety of infections associated with dirty water -- 80 percent of them under five years of age. 每四例死亡中,就有一例是因为艾滋病、肺结核、疟疾 以及其它脏水疾病所造成的疾病── 这其中百分之八十是不满五岁的孩子。
malaria:n.[内科]疟疾;瘴气; variety:n.多样;种类;杂耍;变化,多样化; infections:n.传染病;口腔病害(infection复数形式); associated:adj.有关联的; v.联想; (associate的过去分词和过去式)
Even in wealthy countries it is common now to see inequality growing. 即使是在富裕的国家,与日俱增的贫富差距也是变得日渐明显。
In the United States, since 2001 we've had five years of economic growth, five years of productivity growth in the workplace , but median wages are stagnant and the percentage of working families dropping below the poverty line is up by four percent. 在美国,从2001年起,我们经历了连续五年的经济增长, 五年的生产力增长, 但工资中位数却是停滞不前,贫困线以下的工薪家庭 的比例上升了百分之四。
United:adj.联合的; v.联合,团结; (unite的过去分词和过去式) economic:adj.经济的,经济上的;经济学的; productivity:n.生产力;生产率;生产能力; workplace:n.工作场所;车间; median:n.n.中值,中位数;三角形中线;梯形中位线;adj.中值的;中央的; wages:n.[劳经]工资; v.开展(运动等)(wage的第三人称单数形式); stagnant:adj.停滞的;不景气的;污浊的;迟钝的; percentage:n.百分比;百分率;利润的分成;提成; poverty line:n.贫困线(政府规定维持最低生活水平所需的收入标准);
The percentage of working families without health care up by four percent. 没有医疗保险的工薪家庭比例上升了百分之四。
health care:n.卫生保健;
So this interdependent world which has been pretty good to most of us -- which is why we're all here in Northern California doing what we do for a living, enjoying this evening -- is profoundly unequal. 现今这个彼此依存的世界对我们大多数人来讲都有好处, 这也就是为什么我们今晚可以齐聚北加州,享受生活, 但事实上,它极不平等。
It is also unstable . 与此同时,它又极不稳定。
unstable:adj.不稳定的;变化莫测的;(行为、情绪)反复无常的
Unstable because of the threats of terror, weapons of mass destruction , the spread of global disease and a sense that we are vulnerable to it in a way that we weren't not so many years ago. 不稳定的原因是多样的:恐怖袭击的威胁、 大规模杀伤性武器、全球范围内的疾病扩散、 以及一种史无前例的脆弱感。
mass:n.块,团; adj.群众的,民众的; v.聚集起来,聚集; destruction:n.破坏,毁灭;摧毁; global:adj.全球的;总体的;球形的; disease:n.病,[医]疾病;弊病;vt.传染;使…有病; vulnerable:adj.易受攻击的,易受…的攻击;易受伤害的;有弱点的;
And perhaps most important of all, it is unsustainable because of climate change, resource depletion and species destruction. 但最重要的是,这个世界是不可持续的── 环境变化、资源匮竭、物种灭绝。
unsustainable:adj.无法支撑的;不可证实的;不能成立的; resource:n.资源;资料;才智;财力;v.向…提供资金(或设备); depletion:n.消耗;损耗;放血; species:n.[生物]物种;种类;
When I think about the world I would like to leave to my daughter and the grandchildren I hope to have, it is a world that moves away from unequal, unstable, unsustainable 每当我想到我的子孙后代 以及我想要留给他们的世界时, 我所想到的是一个从不平等、不稳定、不可持续的彼此依存
interdependence to integrated communities -- locally , nationally and globally -- that share the characteristics of all successful communities. 迈向地区、国家、全球间互相协调的世界, 一个拥有所有成功社会的特质的世界。
interdependence:n.互相依赖; integrated:adj.综合的; v.整合; (integrate的过去式和过去分词) communities:n.社区;社会;团体;共有(community的复数) locally:adv.在本地;局部地;在地方上; nationally:adv.全国性地;以国民立场地;举国一致地; characteristics:n.特征;特点;品质;(characteristic的复数)
A broadly shared, accessible set of opportunities, a shared sense of responsibility for the success of the common enterprise and a genuine sense of belonging. 充满了面向所有人的机遇, 以及为了人类的共同美好而努力的责任感, 还有真正意义上的归属感。
broadly:adv.明显地;宽广地;概括地;露骨地;粗鄙地; accessible:adj.易接近的;可进入的;可理解的; genuine:adj.真实的,真正的;诚恳的;
All easier said than done . 但这一切都是说起来容易做起来难。
easier said than done:说起来容易做起来难;
When the terrorist incidents occurred in the United Kingdom a couple of years ago, 当英国几年前遭受恐怖袭击的时候,
occurred:v.发生;出现;存在于;出现在;(occur的过去分词和过去式) United Kingdom:n.英国;
I think even though they didn't claim as many lives as we lost in the United States on 9/11, 我意识到虽然他们当时丧失的生命并没有美国9-11袭击中的那么多,
claim:v.要求;声称;需要;认领;n.要求;声称;索赔;断言;值得;
I think the thing that troubled the British most was that the perpetrators were not invaders , but homegrown citizens whose religious and political identities were more important to them 但真正让英国人揪心担忧的是 当时的那些犯案者并不是外来的侵略者,而是本土的公民。 对这些人来说,他们的宗教信仰和政治理念
perpetrators:n.作恶者;行凶者;犯罪者;(perpetrator的复数) invaders:n.侵略者(invader的复数);侵入种; homegrown:adj.国产的;自家种植的; religious:adj.宗教的;虔诚的;严谨的;修道的;n.修道士;尼姑; identities:n.身份;本身;本体;特征;同一性;相同;(identity的复数)
than the people they grew up with, went to school with, worked with, shared weekends with, shared meals with. 要比那些跟他们共同长大、一同吃饭、一起过周末的同学同事们 更加重要。
In other words, they thought their differences were more important than their common humanity . 换言之,他们认为人类彼此间的不同 要比我们共有的人性更加重要。
humanity:n.人类;人道;仁慈;人文学科;
It is the central psychological plague of humankind in the 21st century. 这就是21世纪我们人类所面临的最主要的心理瘟疫。
psychological:adj.心理的;心理学的;精神上的; plague:n.瘟疫;灾祸;麻烦;讨厌的人;vt.折磨;使苦恼;使得灾祸; humankind:n.人类(总称);
Into this mix, people like us who are not in public office, have more power to do good than at any time in history, because more than half the world's people live under governments they voted in and can vote out. 在这种状况下,我们这些不为公家工作的人 起到了史无前例的作用, 因为世界上一半以上的人口 可以民主地选举或是罢免他们的政府。
And even non-democratic governments are more sensitive to public opinion . 即使是那些非民主的政府,也开始更加注重民意。
sensitive:adj.敏感的;感觉的;易受影响的;n.敏感的人;有灵异能力的人; public opinion:n.舆论;民意;
Because primarily of the power of the Internet, people of modest means can band together and amass vast sums of money that can change the world for some public good if they all agree. 再有,随着互联网的日趋强大, 手无寸铁的人们只要志同道合,便可以聚集起来 筹集大笔的善款改变世界、播撒善行。
primarily:adv.首先;主要地,根本上; modest:adj.些许的;谦虚的; band:n.带;波段;频带;箍;v.加彩条(或嵌条等);(将价格、收入等)划分档次; amass:vt.积聚,积累; sums:n.算术题;总数;全部;v.归纳;总计;(sum的第三人称单数和复数)
When the tsunami hit South Asia, the United States contributed 1.2 billion dollars. 当大海啸袭击东南亚时,美国捐赠了十二亿美元。
tsunami:n.海啸; contributed:v.捐献,捐赠(尤指款或物); (contribute的过去式和过去分词)
30 percent of our households gave. 百分之三十的家庭参与了募捐。
households:n.家庭;拆迁户;家户(household的复数);
Half of them gave over the Internet. 其中一半是通过互联网捐赠的。
The median contribution was somewhere around 57 dollars. 捐款的中位数是在57美元左右。
contribution:n.捐款;捐资;定期缴款;贡献;促成作用;稿件;
And thirdly, because of the rise of non-governmental organizations . 第三个原因则是因为非政府性组织的崛起。
non-governmental:非政府的;非官方的; organizations:n.组织,构造,有机体(organization的复数);组织机构;
They, businesses, other citizens' groups, have enormous power to affect the lives of our fellow human beings. 他们──企业家、其他公民团体,拥有着巨大的力量 来改变人们的生活。
enormous:adj.庞大的,巨大的;凶暴的,极恶的;
When I became president in 1993, there were none of these organizations in Russia. 当我在1993年刚当上总统的时候, 俄罗斯没有一个这样的组织机构。
There are now a couple of hundred thousand. 现在却有十几万个。
None in India. There are now at least a half a million active. 印度当时一个都没有。现在却至少有五十万个。
None in China. There are now 250,000 registered with the government, probably twice again that many who are not registered for political reasons. 中国当时一个都没有。现在却有二十五万个已经在政府注册, 如果我们算上那些因为政治原因没有在政府注册的机构,这个数字可能要翻倍。
registered:adj.登记过的;记名的;挂号的;v.登记;注册;(register的过去式和过去分词)
When I organized my foundation , and I thought about the world as it is and the world that I hope to leave to the next generation, and I tried to be realistic about what I had cared about all my life that I could still have an impact on. 当我刚成立我的基金会的时候,我想到了我们现今的世界 以及我希望留给下一代的世界, 我尽可能地做到切合实际,追求我生命中真正关心 并且依靠我的微薄之力可以产生一些影响的事业。
organized:adj.有组织的; v.组织; (organize的过去分词和过去式) foundation:n.基础;地基;基金会;根据;创立; realistic:adj.现实的;现实主义的;逼真的;实在论的; impact:n.影响;效果;碰撞;冲击力;v.挤入,压紧;撞击;对…产生影响;
I wanted to focus on activities that would help to alleviate poverty, fight disease, combat climate change, bridge the religious, racial and other divides that torment the world, but to do it in a way that would either use 我希望可以卯足力气专门鼓舞如下的几项活动── 缓解贫穷、铲除疾病、阻止气候变化、 化解宗教、种族以及其他种种折磨世界的隔阂。 而开展这些活动的方式则是通过将我们已有的各项技能
alleviate:v.减轻,缓和; combat:v.战斗;防止;减轻;与…搏斗;n.战斗;搏斗;打仗; racial:adj.种族的;人种的; torment:v.折磨,使痛苦;纠缠,作弄;n.痛苦,苦恼;痛苦的根源;
whatever particular skills we could put together in our group to change the way some public good function was performed so that it would sweep across the world more. 运用到我们的团队中 来改变一些公益活动运行的方式 以求惠及世界的每个角落。
put together:..放在一起;组合;装配; performed:v.表演;执行;履行;演出;工作,运转(好/不好)(perform的过去分词和过去式)
You saw one reference to that in what we were able to do with AIDS drugs. 其中的一个例子就是我们对艾滋药物所做的改变。
reference:n.参考,提及;参考书目;证明书;v.引用;
And I want to say that the head of our AIDS effort, and the person who also is primarily active in the wish I'll make tonight, 在这里,我想提到我们艾滋病团队的领导者 并且对我今晚所要许下的愿景起着关键作用的Ira Magaziner
Ira Magaziner, is here with me and I want to thank him for everything he's done. 就在现场。我要感谢他所做的一切。
He's over there. 他就坐在那边。
(Applause) （掌声）
When I got out of office and was asked to work, first in the Caribbean , to try to help deal with the AIDS crisis , generic drugs were available for about 500 dollars a person a year. 当我刚刚离职时,被邀请到加勒比海 去帮忙解决当地的艾滋危机。 当时那里治疗艾滋病的非名牌药物的价钱大概是每人每年500美元。
Caribbean:adj.加勒比海的;加勒比人的;加勒比语的;n.加勒比海; crisis:n.危机;危险期;决定性时刻;adj.危机的;用于处理危机的; generic:adj.类的;一般的;属的;非商标的;
If you bought them in vast bulks , you could get them at a little under 400 dollars. 如果你大量购买的话, 要花400美元不到。
bulks:n.体积,容量;大多数,大部分;大块;vt.使扩大,使形成大量;使显得重要;
The first country we went to work in, the Bahamas , was paying 3,500 dollars for these drugs. 我们当时去的第一个国家,巴哈马群岛 那里的药物价格高达三千五百美元。
Bahamas:n.巴哈马群岛(拉丁美洲国家);
The market was so terribly disorganized that they were buying this medicine through two agents who were gigging them sevenfold . 当地的药物市场极其混乱, 病人不得不经过两层的代理商才能买到药物, 药物的价格因此被哄抬七倍。
disorganized::v.瓦解;打乱;(disorganize的过去式和过去分词形式) agents:n.代理人,经纪人;原动力;(agent的复数) gigging:n.活儿; v.坐小快艇; (gig的现在分词); sevenfold:adj.七倍的;七重的;adv.七倍地;
So the very first week we were working, we got the price down to 500 dollars. 而在我们开始工作的第一个星期, 就成功地把药物的价格降低到了五百美元。
And all of a sudden , they could save seven times as many lives for the same amount of money. 突然间,他们可以利用同样的财力资源 来拯救七倍的生命。
all of a sudden:突然地,出乎意料地;
Then we went to work with the manufacturers of AIDS medicines, one of whom was cited in the film, and negotiated a whole different change in business strategy . 随后我们又开始和艾滋药物的制造商合作, 影片中提到了其中的一位。 我们和他们协调磋商,希望可以发展一套全新的商业策略。
manufacturers:n.生产者;制造者;生产商;(manufacturer的复数) cited:v.提及(原因);举出(示例);列举;引用;传讯;(cite的过去分词和过去式) negotiated:adj.商谈的;v.谈判,协商(negotiate过去式和过去分词形式); strategy:n.策略;行动计划;部署;战略;
Because even at 500 dollars, these drugs were being sold on a high-margin, low-volume, uncertain-payment basis. 因为即使是在500美元的价格,这些药物的销售仍旧是 高利润、低销量,外加上不稳定的付款。
So we worked on improving the productivity of the operations and the supply chain , and went to a low-margin, high-volume , absolutely certain-payment business. 所以我们加强提高了他们营销和供应的生产力, 构建了一个薄利多销、付款稳定的 商业模式。
improving:v.改进;改善;(improve的现在分词) supply chain:n.供应链; high-volume:adj.大容量; absolutely:adv.绝对地;完全地;
I joked that the main contribution we made to the battle against AIDS was to get the manufacturers to change from a jewelry store to a grocery store strategy. 我曾开玩笑的说道,我们对于这场艾滋战役 所做出的最重要的贡献,就是说服药物厂商放弃珠宝店的经营模式, 转而投靠杂货店的商业策路。
grocery:n.食品杂货店;食品杂货;
But the price went to 140 dollars from 500. 但药物价钱则是从500美元降低到140美元,
And pretty soon, the average price was 192 dollars. 不久后,平均价钱稳定在192美元。
Now we can get it for about 100 dollars. 现在我们只需大概100美元便可得到这些药物。
Children's medicine was 600 dollars, because nobody could afford to buy any of it. 儿童药物当时的价钱是600美元, 因为没有人可以承担得起。
afford:v.给予,提供;买得起;
We negotiated it down to 190. 我们通过协商,将价钱降到190美元。
Then, the French imposed their brilliantly conceived airline tax to create a something called UNITAID, got a bunch of other countries to help. 法国人还颁布了他们别具匠心的航空税, 创办了UNITAID, 说服了一些其他的国家共同参与帮助。
imposed:adj.强加的;施加的;应用的;v.欺骗(impose的过去分词);把…强加于; brilliantly:adv.灿烂地;辉煌地;光亮地; conceived:v.构思;设想;(conceive的过去式); airline:n.航空公司; a bunch of:一群;一束;一堆;
Children's medicine is now 60 dollars a person a year. 现在儿童药物的人均价钱是每年60美元。
The only thing that is keeping us from basically saving the lives of everybody who needs the medicine to stay alive are the absence of systems necessary to diagnose , treat and care for people and deliver this medicine. 而我们拯救生命、将药物传递给那些需要的人的梦想 只剩下最后的一个阻隔, 那就是体制的欠缺。我们缺少一个可以诊察、治疗、运送药物 的体制。
basically:adv.主要地,基本上; absence:n.没有;缺乏;缺席;不注意; diagnose:vt.诊断;断定;vi.诊断;判断; treat:v.治疗;处理;招待;款待;n.款待;乐事;乐趣;
We started a childhood obesity initiative with the Heart Association in America. 我们曾和美国心脏协会合作,提出了一项减少儿童肥胖的倡议。
childhood:n.童年;幼年;孩童时期 obesity:n.肥大,肥胖; initiative:n.倡议;主动性;积极性;主动权;adj.起始的; Association:n.协会;关联;联想;交往;
We tried to do the same thing by negotiating industry-right deals with the soft drink and the snack food industry to cut the caloric and other dangerous content of food going to our children in the schools. 我们也尝试将同样的理念传达给那些饮料、零食的厂商, 通过协调磋商,来降低学校食物中 卡路里的含量以及其他不健康的物质。
negotiating:v.谈判;磋商;协商;商定;达成协议;(negotiate的现在分词) soft drink:n.软饮料(不含酒精); snack:n.点心;小吃;快餐;易办到的事;v.吃点心(或快餐、小吃); caloric:adj.热量的;卡的;n.热量; content:n.内容,目录;满足;容量;adj.满意的;vt.使满足;
We just reorganized the markets. 我们因此重新整顿了市场。
reorganized:v.重组(reorganize的过去分词);整顿;重新制定;adj.重组的;重新制定的;
And it occurred to me that in this whole non-governmental world, somebody needs to be thinking about organizing public goods markets. 我也意识到,在现今这个非政府性的世界里, 我们需要一些人,来想办法打开公共产品的市场。
organizing:v.组织;安排;处理;分配;管理;(organize的现在分词)
And that is now what we're trying to do, and working with this large cities group to fight climate change to negotiate huge, big, volume deals that will enable cities 而这正是我们当下所要做的事情。 通过和大城市中各组织的合作,来共同阻止气候变化, 开展谈判,敦促这些
enable:v.使能够;使有机会;使成为可能;使可行;
which generate 75 percent of the world's greenhouse gases to drastically and quickly reduce greenhouse gas emissions in a way that is good economics. 排放世界上百分之七十五温室气体的大城市 采取极端快速的手段,以一种从经济学的角度来看行得通的方式, 来减少温室气体的排放。
generate:v.产生;引起; drastically:adv.彻底地;激烈地; greenhouse gas:n.温室气体(尤指二氧化碳); emissions:n.(光、热、气等的)发出,排放;排放物;散发物;(emission的复数)
And this whole discussion as if it's some sort of economic burden , is a mystery to me. 而人们为什么会把这一切当做是某种经济负担 对我来讲是个不解的谜团。
burden:n.负担;责任;船的载货量;v.使负担;烦扰;装货于;
I think it's a bird's nest on the ground. 我觉得减少温室气体将会产生巨大的利益。
When Al Gore won his well-deserved Oscar for the " Inconvenient Truth" movie, I was thrilled , but I had urged him to make a second movie quickly. 当Al Gore（戈尔,克林期的美国副总统）的影片《难以忽视的真相》 众望所归地夺得奥斯卡时,我是无比兴奋的。 但我也督促他抓紧时间来拍摄另一部电影。
well-deserved:罪有应得的; Inconvenient:adj.不便的;打扰的; thrilled:adj.非常兴奋; v.使非常兴奋; (thrill的过去分词和过去式)
For those of you who saw "An Inconvenient Truth," 如果你看过《难以忽视的真相》,你应该知道
the most important slide in the Gore lecture is the last one, which shows here's where greenhouse gases are going if we don't do anything, here's where they could go. 戈尔的整个演讲中最重要的一张幻灯片是最后一张, 它展示了如果我们什么都不做的话,温室气体排放的走向（上升） 以及温室气体排放应该达到的走向（下降）。
lecture:n.演讲;讲座;讲课;谴责;v.开讲座;讲授;讲课;指责;告诫
And then there are six different categories of things we can do to change the trajectory . 我们一共可以做六项事情 来改变温室气体排放的走向。
categories:n.(人或事物的)类别,种类(category的复数) trajectory:n.[物]轨道,轨线;[航][军]弹道;
We need a movie on those six categories. 我们需要一部电影来详解这六项事情。
And all of you need to have it embedded in your brains and to organize yourselves around it. 而你们所有人都应该将其铭记于心, 并依据它组织管理自己。
embedded:adj.嵌入式的;植入的;内含的;v.嵌入(embed的过去式和过去分词形式);
So we're trying to do that. 所以这就是我们当前正在努力做的事情之一──
So organizing these markets is one thing we try to do. 建立这些公益市场。
Now we have taken on a second thing, and this gets to my wish. 而我们正在做的另一件事情是和我的愿望相关的。
It has been my experience in working in developing countries that while the headlines may all be -- the pessimistic headlines may say, well, we can't do this or the other thing because of corruption , 根据我以往在发展中国家工作的经验, 虽然报纸头条,至少那些悲观的报纸头条,总是说 我们无法做这个、不能做那个,因为腐败泛滥,
pessimistic:adj.悲观的,厌世的;悲观主义的; corruption:n.贪污,腐败;堕落;
I think incapacity is a far bigger problem in poor countries than corruption, and feeds corruption. 但我却觉得在贫穷国家,比腐败更严重的问题是无能, 无能滋养着腐败。
incapacity:n.无能力,无能;
We now have the money, given these low prices, to distribute 我们现在有足够的财力资源,将这些低价位的艾滋药物
distribute:v.分发;分配;分销;分散;
AIDS drugs all over the world to people we cannot presently reach. 分给世界上那些我们现今还无法接触到的人们。
presently:adv.(美)目前;不久;
Today these low prices are available in the 25 countries where we work, and in a total of 62 countries. 现如今,这些低价位药品可以在62个国家买到, 其中25个是我们工作的国家。
And about 550,000 people are getting the benefits of them. 大概有五十五万人因此而收益。
But the money is there to reach others. 但就算我们有这些财力来帮助人们,
The systems are not there to reach the people. 却没有相应的体制将这些利益传递给他们。
So what we have been trying to do, working first in Rwanda and then in Malawi and other places -- but I want to talk about Rwanda tonight -- is to develop a model for rural health care in a very poor area 对此,我们所做的尝试是── 先在卢旺达,随后在马拉维和其他地区工作, 但我今晚主要想谈谈卢旺达── 我们正尝试着发展一个在贫困地区可行的乡村医疗模型,
Malawi:n.马拉维(非洲国家); rural:adj.农村的,乡下的;田园的,有乡村风味的;
that can be used to deal with AIDS, TB, malaria, other infectious diseases , maternal and child health, and a whole range of health issues poor people are grappling with in the developing world, 用来解决艾滋、肺结核、疟疾、其他传染性疾病、 母子健康、以及其他一系列发展中国家的贫困人口 正努力应付的医疗问题。
infectious:adj.传染的;传染性的;易传染的; diseases:n.[医]病(disease的复数);[医]疾病;[植保]病害;疾病种类; maternal:adj.母亲的;母性的;母系的;母体遗传的; issues:n.重要议题;争论的问题;v.宣布;公布;发出;(issue的第三人称单数和复数) grappling:v.扭打;搏斗;努力设法解决;(grapple的现在分词)
that can first be scaled for the whole nation of Rwanda, and then will be a model that could literally be implemented in any other poor country in the world. 我们希望这个模式可以首先普及到卢旺达全国, 随后可以推广到 世界上每一个贫困的国家。
scaled:adj.有鳞的; v.刮去鳞片; literally:adv.按字面:字面上:确实地: implemented:v.使生效;贯彻;执行;实施;(implement的过去式和过去分词)
And the test is: one, will it do the job, will it develop -- provide high quality care? 而其所面临的考验则是:首先,这个模式能履行它的职责吗？ 能发展提供高质量的医疗保健吗？
And two, will it do it at a price that will enable the country to sustain a health care system without foreign donors after five to 10 years? 其次,这一切可以在一个低价的前提下完成吗？ 可以帮助贫困国家在五至十年后脱离国际援助, 建立一个自给自足的医疗体系吗？
donors:n.捐赠人(donor的复数);[电子]施主;
Because the longer I deal with these problems, the more convinced I am that we have to -- whether it's economics, health, education, whatever -- we have to build systems. 我和这些问题打交道的时间越长, 就越坚信:我们必须── 不管是经济、医疗、教育还是其他的方面── 我们都必须建立好的体制。
convinced:adj.坚信; v.使确信; (convince的过去分词和过去式)
And the absence of systems that function break the connection which got you all in this seat tonight. 而体制的欠缺 足以摧毁让你们今晚得以坐在这里的联系。
You think about whatever your life has been, however many obstacles you have faced in your life, at critical junctures you always knew there was a predictable connection between the effort you exerted and the result you achieved. 回头想想你的人生 以及你人生中所面临的种种挑战, 在人生中关键的分叉口,你总是知道 你的付出与你的收获之间 有着一种可以预知的联系。
obstacles:n.障碍;障碍物;阻碍;(obstacle的复数形式) 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; junctures:n.接缝;连接;接合; predictable:adj.可预言的; exerted:adj.外露的;
In a world with no systems, with chaos , everything becomes a guerilla struggle, and this predictability is not there. 而在一个没有系统的混乱世界里, 一切都将变成游击队般的挣扎, 所谓的预知性也自然是不复存在了。
chaos:n.混沌,混乱; guerilla:n.游击队;游击队员;adj.游击的; predictability:n.可预测性;可预言;
And it becomes almost impossible to save lives, educate kids, develop economies , whatever. 而拯救生命、教育儿童、发展经济 等等梦想都将因此而变得不可能。
economies:n.经济;经济结构;节约;(economy的复数)
The person, in my view, who has done the best job of this in the health care area, of building a system in a very poor area is Dr. Paul Farmer, who many of you know, has worked for now 20 years with his group, 在我看来, 在为贫困地区建造医疗保健这一领域 最为成功的人士就是 Paul Farmer （保罗·法默医师）。 你们中的很多人可能听说过他。在过往二十年里,
Partners in Health, primarily in Haiti where he started. 他和他的团队Partners in Health（健康伙伴）主要是在海地工作。
Haiti:n.海地;
But they've also worked in Russia, in Peru and other places around the world. 但他们也曾在其他地方工作过, 比如俄罗斯和秘鲁。
As poor as Haiti is, in the area where Farmer's clinic is active -- and they serve a catchment area far greater than the medical professionals they have would indicate they could serve -- since 1988, they have not lost one person to tuberculosis , not one. 尽管海地是一贫如洗——而且法默医师的诊所 所覆盖的治疗区域 要远远超过他们的医疗队伍所能承受的范围—— 尽管如此,自从1988年起,他们手下的病患中,没有一个人死于肺结核。没有一个人。
clinic:n.诊所;临床实习;(医院的)门诊部;门诊时间; catchment area:n.(学校的)招生地区;(医院等的)服务地区;汇水区;汇水面积; professionals:n.[管理]专业人员(professional的复数); indicate:v.表明;显示;象征;暗示; tuberculosis:n.肺结核;结核病;
And they've achieved a lot of other amazing health results. 除此之外,他们也取得了很多其他了不起的医疗成就。
So when we decided to work in Rwanda on trying to dramatically increase the income of the country and fight the AIDS problem, we wanted to build a healthcare network, 因此,当我们决定在卢旺达工作, 打算大幅度地增加这个国家的收入并且抗击艾滋所带来的问题时, 我们想到的是建立一个医疗保健体系,
dramatically:adv.戏剧地;引人注目地;adv.显著地,剧烈地; healthcare:n.医疗保健;健康护理,健康服务;卫生保健;
because it had been totally destroyed during the genocide in 1994, and the per capita income was still under a dollar a day. 因为卢旺达的医疗体系在1994年的种族屠杀中被彻底摧毁, 人均收入仍旧是每天不足一美元。
genocide:n.种族灭绝;灭绝整个种族的大屠杀; per capita:adj.每人的;人均的;
So I rang up, asked Paul Farmer if he would help. 所以我打电话给保罗·法默医师,问他是否可以帮助我。
Because it seemed to me if we could prove there was a model in Haiti and a model in Rwanda that we could then take all over the country, number one, it would be a wonderful thing for a country 因为当时在我看来,如果我们可以证实有这样的一个体系 既可以在海地落实也可以在卢旺达全国性地落实, 那么我们就可以, 其一,为这个在过往15年里遭遇了难以想象的磨难的国家
that has suffered as much as any on Earth in the last 15 years, and number two, we would have something that could then be adapted to any other poor country anywhere in the world. 做一件善事, 其二,我们将拥有一套可以应用在 世界上任何一个贫困国家的体系。
adapted:adj.适于…的; v.使适应,使适合; (adapt的过去分词和过去式)
And so we have set about doing that. 这就是我们想达到的效果。
Now, we started working together 18 months ago. 我们在18个月前开始合作。
And we're working in an area called Southern Kayonza, which is one of the poorest areas in Rwanda, with a group that originally includes about 400,000 people. 现在的工作重心是在Southern Kayonza, 卢旺达最贫困的地区之一, 人口大概是四十万。
originally:adv.原来;起初;
We're essentially implementing what Paul Farmer did in Haiti, where he develops and trains paid community health workers who are able to identify health problems, 我们基本上是把保罗·法默在海地的模式应用到了这里。 在海地,保罗发展训练了一批全职的社区医疗员工, 帮助寻找健康问题、
essentially:adv.本质上;本来; implementing:n.实施,执行;实现;v.贯彻,执行(implement的现在分词); community:n.社区;[生态]群落;共同体;团体; identify:v.识别:鉴定:确认:发现:
ensure that people who have AIDS or TB are properly diagnosed and take their medicine regularly , who work on bringing about health education, clean water and sanitation, 确保艾滋和肺结核患者能及时确诊 并且按时服药。 同时他们也带去了医疗教育、洁净用水和卫生设备,
ensure:vt.保证,确保;使安全; diagnosed:v.诊断(疾病);判断(问题的原因);(diagnose的过去分词和过去式) regularly:adv.经常地;有规律地;定期的
providing nutritional supplements and moving people up the chain of health care if they have problems of the severity that require it. 提供了营养补品,并帮助那些有严重问题的患者 寻求更专业的治疗。
nutritional:adj.营养的;滋养的; supplements:n.补充品;增补物;[昆]补脉(supplement的复数); severity:n.严重;严格;猛烈;
The procedures that make this work have been perfected, as I said , by Paul Farmer and his team in their work in rural Haiti over the last 20 years. 这一过程,就如我之前所提到的,已经被保罗和他的队伍 通过过去20年在海地乡间工作的经验 完善,并日趋完美。
procedures:n.程序;规程(procedure的复数); as I said:正如我所说的
Recently we did an evaluation of the first 18 months of our efforts in Rwanda. 最近,我们刚刚对过去18个月在卢旺达的努力工作进行了评估。
Recently:adv.最近;新近; evaluation:n.评价;[审计]评估;估价;求值;
And the results were so good that the Rwandan government has now agreed to adopt the model for the entire country, and has strongly supported and put the full resources of the government behind it. 评估的结果是如此的令人满意,以至于卢旺达的政府 已经同意在全国范围内实施这一体系, 并且会提供采用政府现有的全部资源,来提供必要的支持。
adopt:v.采取;接受;收养;正式通过; resources:n.[计][环境]资源; v.向…提供资金(resource的第三人称单数);
I'll tell you a little bit about our team because it's indicative of what we do. 为了能让你们更好地了解我们的工作,我打算向你们更详尽地介绍我们的团队。
indicative:adj.象征的;指示的;表示…的;n.陈述语气;陈述语气的动词形式;
We have about 500 people around the world working in our AIDS program, some of them for nothing -- just for transportation , room and board . 我们在全球范围内共有500名员工 为我们的艾滋方案工作。他们中的一些人完全是无偿服务, 只收取通勤和居住的费用。
transportation:n.运输;运输系统;运输工具;流放; room and board:食宿;
And then we have others working in these other related programs. 除此之外,我们还有为其他相关项目工作的人员。
Our business plan in Rwanda was put together under the leadership of Diana Noble , who is an unusually gifted woman, but not unusual in the type of people who have been willing to do this kind of work. 我们在卢旺达的工作计划 是在Diana Noble的领导下完成的。 她是一位不寻常的女士, 但对于做这份工作的人来讲,她又显得是那么寻常。
Noble:adj.高尚的;贵族的;惰性的;宏伟的;n.贵族; unusually:adv.非常;异乎寻常地;显著地; gifted:adj.有天赋的;有才华的;
She was the youngest partner at Schroder Ventures in London in her 20s. 在她20岁的时候她已经是伦敦Schroder Ventures投资公司最年轻的合伙人,
Ventures:n.合资企业(venture的复数); v.敢尝试,冒险一试(venture的第三人称单数);
She was CEO of a successful e-venture -- she started and built Reed Elsevier Ventures -- and at 45 she decided she wanted to do something different with her life. 她也是一项非常成功的电子商业的执行总裁—— Reed Elsevier Ventures就是由她创办的。 但是在她45岁的时候,她决定要做一些不一样的事情。
Reed:n.芦笛;[植]芦苇;芦苇杆;[乐]舌簧;
So she now works full-time on this for very little pay. 现如今,她为我们全职工作,却拿很少的薪水。
full-time:adj.专职的;全日制的;全部时间的;
She and her team of former business people have created a business plan that will enable us to scale this health system up for the whole country. 她和她之前的商业伙伴为我们创建了一个业务计划, 帮助我们把整个医疗体系发展到全国。
And it would be worthy of the kind of private equity work she used to do when she was making a lot more money for it. 而她为此所付出的努力,若放到当初, 完全可以为她赚到一大笔钱。
be worthy of:值得;配得上的; equity:n.公平,公正;衡平法;普通股;抵押资产的净值;
When we came to this rural area, 45 percent of the children under the age of five had stunted growth due to malnutrition . 当我们刚刚来到这个地区的时候,五岁以下的儿童有45% 因为营养不良而发育不健全。
under the age of:在年龄之下;16岁以下; stunted:adj.发育不良的; v.阻碍…发展(stunt的过去式及过去分词形式); malnutrition:n.营养失调,营养不良;
23 percent of them died before they reached the age of five. 23%在五岁之前夭折。
Mortality at birth was over two and a half percent. 初生婴儿的死亡率超过2.5%。
Mortality:n.死亡数,死亡率;必死性,必死的命运;
Over 15 percent of the deaths among adults and children occurred because of intestinal parasites and diarrhea from dirty water and inadequate sanitation, all entirely preventable and treatable . 超过15%的成人和儿童死亡是 脏水和不完善卫生设备引发的肠道寄生以及腹泻所造成的—— 完全可以预防和治愈。
intestinal:adj.肠的; parasites:n.[基医]寄生虫;[生物]寄生生物(parasite的复数); diarrhea:n.腹泻,痢疾; inadequate:adj.不充分的,不适当的; preventable:adj.可预防的;可阻止的;可防止的; treatable:adj.能治疗的;好对付的;能处理的;
Over 13 percent of the deaths were from respiratory illnesses -- again, all preventable and treatable. 13%的死亡是呼吸疾病造成的—— 同样是可以预防和治愈的。
respiratory:adj.呼吸的;
And not a single soul in this area was being treated for AIDS or tuberculosis. 在这个地区内,没有一个艾滋或者肺结核患者得到应有的治疗。
treated:v.以…态度对待;把…看作;(treat的过去分词和过去式)
Within the first 18 months, the following things happened: we went from zero to about 2,000 people being treated for AIDS. 而在我们开始的最初18个月里,如下的事情发生了: 艾滋病的治疗人数从0上升到了2000,
That's 80 percent of the people who need treatment in this area. 占这个地区需要治疗的人口的80%。
treatment:n.治疗;疗法;对待;处理;讨论;
Listen to this: less than four-tenths of one percent of those being treated stopped taking their medicine or otherwise defaulted on treatment. 不仅如此,少于千分之四的接受治疗的患者 因为停止服药或是其他原因而中止治疗,
defaulted:v.违约;不履行义务;默认;预设;预置;(default的过去式和过去分词)
That's lower than the figure in the United States. 这甚至低于美国的数据——
Less than three-tenths of one percent had to transfer to the more expensive second-line drugs. 千分之三不到 需要转而购买更加昂贵的高级药物。
transfer:n.转移;调任;调离;[体]转会球员;v.调任;调走;转学;转移; second-line:adj.第二线的;
400,000 pregnant women were brought into counseling and will give birth for the first time within an organized health care system. 四十万（口误:应该是四万）的怀孕妇女接受了辅导, 并将第一次在一个有组织的医疗体系下分娩。
pregnant:adj.怀孕的;富有意义的; counseling:n.咨询服务;v.建议;劝告;商讨;(counsel的现在分词形式)
That's about 43 percent of all the pregnancies . 大概是全部怀孕数量的43%。
pregnancies:n.怀孕;丰富,多产;意义深长;
About 40 percent of all the people -- I said 400,000. I meant 40,000. 大概40%——我前面说是四十万孕妇,应该是四万——
About 40 percent of all the people who need TB treatment are now getting it -- in just 18 months, up from zero when we started. 大概40%的肺结核患者正接收着治疗, 而就在18个月前,这个数字还是0。
43 percent of the children in need of an infant feeding program to prevent malnutrition and early death are now getting the food supplements they need to stay alive and to grow. 43%需要婴儿哺育计划来防止营养不良和早死的儿童 正接受他们所需要的食物补品 来帮助他们生存、生长。
infant:n.婴儿;幼儿;未成年人;adj.婴儿的;幼稚的;初期的;未成年的;
We've started the first malaria treatment programs they've ever had there. 我们也帮助他们建立了他们的第一个疟疾医治方案。
Patients admitted to a hospital that was destroyed during the genocide that we have renovated along with four other clinics , complete with solar power generators , good lab technology. 病患们被送往我们重新装修的在大屠杀中被摧毁的医院, 以及新建的四个拥有太阳能发电器 和完善的实验室设备的诊所。
Patients:n.接受治疗者,病人;(patient的复数) renovated:v.修复;翻新;重新粉刷;(renovate的过去式和过去分词) clinics:n.诊所(clinic的复数形式); generators:n.[电]发电机;[计]生成器(generator的复数);
We now are treating 325 people a month, despite the fact that almost 100 percent of the AIDS patients are now treated at home. 我们现在一个月治疗325个病人, 这还不算所有那些在家接受治疗的艾滋患者。
treating:v.以…态度对待;把…看作;处理;讨论;(treat的现在分词) despite:prep.尽管,不管;n.轻视;憎恨;侮辱;
And the most important thing is because we've implemented Paul Farmer's model, using community health workers, we estimate that this system could be put into place for all of Rwanda for between five and six percent of GDP, and that the government could sustain that without depending on foreign aid after five or six years. 但最重要的一点是, 我们采用了保罗的模式,通过社区医疗人员的努力, 我们估算这个系统仅需要5%到6%的全国生产总值 便可以应用到卢旺达全国的范围内。 卢旺达的政府也可以在五、六年后摆脱国际援助, 独立维持这一体系。
estimate:v.估计;估算;估价;n.估价;(对大小、数量、成本等的)估计;估计的成本;
And for those of you who understand healthcare economics you know that all wealthy countries spend between nine and 11 percent of GDP on health care, except for the United States, we spend 16 -- but that's a story for another day. 你们中那些懂得医疗经济的人 应该都知道所有的富裕国家都在医疗保健上 花费9%到11%的国内生产总值。美国除外,我们花费16%—— 不过我今天没时间来解释这个。
(Laughter) （笑声）
We're now working with Partners in Health and the Ministry of Health in Rwanda and our Foundation folks to scale this system up. 我们现在正和“健康伙伴”以及卢旺达的卫生部门还有我们的基金会人员合作 争取扩大这个系统。
Ministry:n.(政府的)部门;
We're also beginning to do this in Malawi and Lesotho. 我们也开始在马拉维和莱索托实施这一体制。
And we have similar projects in Tanzania, Mozambique, 我们在坦桑尼亚、莫桑比克、肯尼亚和埃塞俄比亚
Kenya and Ethiopia with other partners trying to achieve the same thing, to save as many lives as quickly as we can, but to do it in a systematic way that can be implemented nationwide and then with a model that can be implemented in any country in the world. 都有着类似计划,与其他伙伴合作,达成同样的梦想, 最快速地拯救尽可能多的生命, 但却是以一个极其系统的方式进行,以便在全国范围内 甚至是全世界的范围内得以实施。
Ethiopia:n.埃塞俄比亚; systematic:adj.系统的;体系的;有系统的;[图情]分类的;一贯的,惯常的;
We need initial upfront investment to train doctors, nurses, health administration and community health workers throughout the country, to set up the information technology , the solar energy, the water and sanitation, the transportation infrastructure . 我们需要先期的投资来培训医生、护士、 医疗管理人员以及全国范围内的社区保健人员, 来帮忙安排信息技术、太阳能、 用水、卫生保健以及运输系统。
initial:adj.最初的; n.(名字的)首字母; v.用姓名的首字母作标记(或签名)于; upfront:adj.预付的;在前面的;正直的,坦率的;adv.在前面;提前支付(工资); investment:n.投资;投入;封锁; throughout:adv.自始至终,到处;全部;prep.贯穿,遍及; information technology:n.信息技术; infrastructure:n.基础设施;公共建设;下部构造;
But over a five to 10-year period, we will take down the need for outside assistance and eventually it will be phased out. 但在五到十年之内的时间里, 我们将减缓对外界援助的需求 直到彻底摆脱国际救援。
eventually:adv.最后,终于; phased:v.分阶段进行;逐步做;(phase的过去分词和过去式)
My wish is that TED assist us in our work and help us to build a high-quality rural health system in a poor country, Rwanda, that can be a model for Africa, and indeed, for any poor country anywhere in the world. 我的愿景就是希望TED可以帮助我们的工作,帮我们 在卢旺达这样贫穷的国家建立起一个高质量的乡村医疗体系, 将它当作一个全非洲 甚至全世界任何贫穷国家都可以效仿的模型。
high-quality:adj.高质量的;
My belief is that this will help us to build a more integrated world with more partners and fewer terrorists, with more productive citizens and fewer haters , a place we'd all want our kids and our grandchildren to grow up in. 我相信这将有助我们建立起一个更加融合的世界, 更多的合作分子,更少的恐怖分子, 更多的生产,更少的仇恨, 一个我们希望可以托付给我们的子孙的生长环境。
productive:adj.能生产的;生产的,生产性的;多产的;富有成效的; haters:怀恨在心者(hater的名词复数);
It has been an honor for me, particularly to work in Rwanda where we also have a major economic development project in partnership with Sir Tom Hunter, the Scottish philanthropist , 这是我的荣幸,尤其是可以在卢旺达工作。 我们现在还在和苏格兰慈善家Sir Tom Hunter合作, 开展一个大型的经济计划。
particularly:adv.特别地,独特地;详细地,具体地;明确地,细致地; partnership:n.合伙;[经管]合伙企业;合作关系;合伙契约; philanthropist:n.慈善家,博爱主义者;乐善好施的人;
where last year we, using the same thing with AIDS drugs, cut the cost of fertilizer and the interest rates on microcredit loans by 30 percent and achieved three to four hundred percent increases in crop yields with the farmers. 就在去年,我们利用我们从艾滋药物那里学来的经验, 将化肥的费用以及小额信贷的利率锐减了30%, 帮助农民的农作物产量 提升了300%到400%。
fertilizer:n.[肥料]肥料;受精媒介物;促进发展者; microcredit:n.微型贷款;微额信贷; yields:n.生产量,投资效益(yield的复数形式); v.[经]生产;
These people have been through a lot and none of us, most of all me, helped them when they were on the verge of destroying each other. 这些人都经历了许多,而我们——尤其是我自己—— 却没能给予他们援助,阻止他们之间的互相残杀。
on the verge of:濒临于;接近于;
We're undoing that now, and they are so over it and so into their future. 我们现在正努力弥补这一切。而他们也已经摆脱了过去,畅想着未来。
We're doing this in an environmentally responsible way. 而我们也尽可能地以最环保的方式达成这一切。
environmentally:adv.有关环境方面; responsible:adj.负责的,可靠的;有责任的;
I'm doing my best to convince them not to run the electric grid to the 35 percent of the people that have no access, but to do it with clean energy, to have responsible reforestation projects. 我正尽全力的说服他们,不要将电网直接扯到那些 现在还用不上电的、35%的人口, 而是应该使用洁净能源,负责任地开始重新植树造林。
electric:n.供电;adj.电的;用电的;电动的;发电的; grid:n.网格;格子,栅格;输电网; reforestation:n.重新造林;
The Rwandans, interestingly enough have been quite good, Mr. Wilson in preserving their topsoil . 卢旺达人对他们土壤层的保护工作 其实是相当尽责的。
interestingly:adv.有趣地; preserving:n.保留,保存; topsoil:n.表层土;上层土;
There's a couple of guys from southern farming families -- the first thing I did when I went out to this place was to get down on my hands and knees and dig in the dirt and see what they'd done with it. 有一批从南部农民世家来的人—— 我到达那个地方所做的第一件事 就是弯下腰来,挖挖当地的土壤, 看看他们对其作了些什么。
dirt:n.污垢;尘土;下流话;
We have a chance here to prove that a country that almost slaughtered itself out of existence can practice reconciliation , reorganize itself, focus on tomorrow and provide comprehensive , quality health care with minimal outside help. 我们现在有这样的一个机会来证实 就算是一个曾经几乎自我摧毁的国家 也是可以从头再来、重新组织、聚焦未来、 依赖最少量的外界援助提供全面、高质量的医疗保健。
slaughtered:v.屠宰;宰杀;屠杀;杀戮;使惨败;(slaughter的过去分词和过去式) reconciliation:n.和解;调和;和谐;甘愿; comprehensive:adj.综合的;广泛的;有理解力的;n.综合学校;专业综合测验; minimal:adj.最低的;最小限度的;
I am grateful for this prize, and I will use it to that end. 我对这个大奖感激不尽,并将充分利用它来实现我上述的梦想。
We could use some more help to do this, but think of what it would mean if we could have a world-class health system in Rwanda -- in a country with less than one dollar a day per capita income, one that could save hundreds of millions of lives over the next decade if applied to every similarly situated country on Earth. 我们需要大家的帮助。 设想一下,这一切将意味着什么,如果我们可以将世界级的医疗体系 带到卢旺达这个人均收入低于每天一美元的国家, 利用这个体系拯救上千万的生命, 并将其在未来的十年里推广到世界上每一个类似的国家。
world-class:n.世界级;adj.世界级的; applied:adj.应用的;实用的;v.应用;使用;申请,请求;(apply的过去分词和过去式) similarly:adv.同样地;类似于; situated:adj.位于…的;处于…境遇的;v.使位于;使处于;(situate的过去分词和过去式)
It's worth a try and I believe it would succeed. 这值得我们的努力,而且我相信我们可以成功。
Thank you and God bless you. 谢谢你们。上帝保佑大家。
(Applause) （掌声）