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EricaFrenkel_2011X-_万能麻醉器_
I'm going to talk to you today about the design of medical technology for low resource settings. 今天我要谈的 是关于在低能源供给下的医疗技术设计
technology:n.技术;工艺;术语; resource:n.资源;资料;才智;财力;v.向…提供资金(或设备);
I study health systems in these countries. 我在这些国家学习医疗系统
And one of the major gaps in care, almost across the board , is access to safe surgery . 一个重大的医疗缺口 在很多国家都存在的 是安全手术通道
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); across the board:全面地,整体地; surgery:n.外科;外科手术;手术室;诊疗室;
Now one of the major bottlenecks that we've found that's sort of preventing both the access in the first place and the safety of those surgeries that do happen is anesthesia . 我们发现的一个影响手术进行 和手术安全 的重要医疗瓶颈 就是麻醉
bottlenecks:n.[包装]瓶颈(bottleneck的复数); in the first place:首先;起初; surgeries:n.外科手术(surgery复数); anesthesia:n.麻醉;麻木(等于anaesthesia);
And actually, it's the model that we expect to work for delivering anesthesia in these environments. 事实上,这个方案正是我 为手术能在如此环境下顺利进行 而致力开发的麻醉方式
Here we have a scene that you would find in any operating room across the U.S. or any other developed country. 这个场景是一个 在美国和其他发达国家的手术室里常见的景象
In the background there is a very sophisticated anesthesia machine. 背景是 一台非常精密的麻醉器
sophisticated:adj.复杂的;老练的;见多识广的;水平高的;
And this machine is able to enable surgery and save lives because it was designed with this environment in mind. 这个机器能让 手术顺利进行并挽救生命 因为它是按照此要求 设计出来的
enable:v.使能够;使有机会;使成为可能;使可行;
In order to operate, this machine needs a number of things that this hospital has to offer. 要操作这台机器 医院需要具备一系列条件
It needs an extremely well-trained anesthesiologist with years of training with complex machines to help her monitor the flows of the gas and keep her patients safe and anesthetized throughout the surgery. 需要一个接受过良好训练的麻醉师 有数年操作复杂机械的经历 来监控气体进出 保证病人的安全和 手术中的麻醉状态
extremely:adv.非常,极其;极端地; well-trained:adj.训练有素的;良好训练; anesthesiologist:n.麻醉学者(医师); complex:adj.复杂的;合成的;n.复合体;综合设施; patients:n.接受治疗者,病人;(patient的复数) anesthetized:vt.使麻醉(anaesthetize);使麻痹; throughout:adv.自始至终,到处;全部;prep.贯穿,遍及;
It's a delicate machine running on computer algorithms, and it needs special care, TLC, to keep it up and running, and it's going to break pretty easily. 这台精巧的机器会进行精密运算 需要特别护理,TLC,以保证其正常运行 而且它很容易出故障
delicate:adj.精致的,微妙的,脆弱的,熟练的,柔和的;
And when it does, it needs a team of biomedical engineers who understand its complexities , can fix it, can source the parts and keep it saving lives. 出故障的时候,需要一队能解决复杂问题的 生物医学工程师的小组 来修理,替换零件 让其继续挽救生命
biomedical:adj.生物医学的; complexities:n.复杂性(complexity的复数);错综复杂的事物;
It's a pretty expensive machine. 这是台很昂贵的机器
It needs a hospital whose budget can allow it to support one machine costing upwards of 50 or $100,000. 医院需要有 五万到十万美元的预算 来购置和维持运营一台机器
budget:n.预算,预算费;v.安排,预定;把…编入预算;adj.廉价的; upwards:adv.向上;在上部;向上游;
And perhaps most obviously, and perhaps most importantly -- and the path to concepts that we've heard about kind of illustrate this -- it needs infrastructure that can supply an uninterrupted source of electricity , of compressed oxygen and other medical supplies that are so critical to the functioning of this machine. 也许最明显的就是 或者说最重要的－ 我们所知的那些概念 也说明了这个问题－ 这个机器需要 能提供不间断电源 不间断供氧 还有其他医疗设备的基础设施 这些都对这个机器的运转 至关重要
illustrate:v.解释;加插图于;给(书等)做图表;表明…真实; infrastructure:n.基础设施;公共建设;下部构造; uninterrupted:adj.不间断的;连续的; electricity:n.电力;电流;强烈的紧张情绪; compressed:adj.(空气或气体)压缩的; v.(被)压紧; (compress的过去式和过去分词) 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;
In other words, this machine requires a lot of stuff that this hospital cannot offer. 也就是说,这台机器需要的许多东西 是这个医院所不能提供的
stuff:n.东西:物品:基本特征:v.填满:装满:标本:
This is the electrical supply for a hospital in rural Malawi . 这是马拉威一个乡下医院的 供电情况
electrical:adj.有关电的;电气科学的; rural:adj.农村的,乡下的;田园的,有乡村风味的; Malawi:n.马拉维(非洲国家);
In this hospital, there is one person qualified to deliver anesthesia, and she's qualified because she has 12, maybe 18 months of training in anesthesia. 这个医院里 有一个人有实施麻醉的资质 她具备资质的原因是 她接受过12或许18个月的 麻醉训练
qualified:adj.有资格的; v.合格; (qualify的过去分词和过去式)
In the hospital and in the entire region there's not a single biomedical engineer. 在这个医院和这整个区域 没有一个生物医学工程师
region:n.地区;范围;部位;
So when this machine breaks, the machines they have to work with break, they've got to try and figure it out, but most of the time, that's the end of the road. 所以机器一旦出故障 就得带着故障运行 他们得自己试着修理,但大多时候,故障就意味着没戏了
Those machines go the proverbial junkyard . 这些机器就进了垃圾堆
proverbial:adj.谚语的;众所周知的;谚语式的; junkyard:n.废品旧货栈;废物堆积场;旧汽车丢弃的地方;
And the price tag of the machine that I mentioned could represent maybe a quarter or a third of the annual operating budget for this hospital. 而我提到过这台机器的价钱 这可能是这个医院 一年预算的四分之一 或三分之一
price tag:n.价格标签; represent:v.代表;表现;描绘;回忆;再赠送; annual:n.年报;年鉴;年刊;adj.每年的;年度的;一年的;
And finally , I think you can see that infrastructure is not very strong. 最后我想你们了解了它的基础设施不佳
finally:adv.终于;最终;(用于列举)最后;彻底地;
This hospital is connected to a very weak power grid , one that goes down frequently . 这家医院接入的电网非常弱 经常停电
grid:n.网格;格子,栅格;输电网; frequently:adv.频繁地,经常地;时常,屡次;
So it runs frequently, the entire hospital, just on a generator . 这整个医院常常就是靠 一台发电机运作
generator:n.发电机;发生器;电力公司;
And you can imagine, the generator breaks down or runs out of fuel. 可以想象 发电机若是出了故障 或者燃料耗尽会如何
And the World Bank sees this and estimates that a hospital in this setting in a low-income country can expect up to 18 power outages per month. 世界银行借此估计 在一个低收入国家的此类条件下的医院 每个月大约有高达 18次断电
World Bank:n.世界银行(向处于困境需要资助的成员国贷款的国际机构); estimates:n.估计;估价;估计的成本;v.估价;估算(estimate的第三人称单数和复数) outages:n.储运损耗;中断供应;运行中断;
Similarly compressed oxygen and other medical supplies are really a luxury and can often be out of stock for months or even a year. 同样,压缩氧气和其他医疗设备 可以算是奢侈品了 常常数月甚至一年 都没有任何储备
Similarly:adv.同样地;类似于; luxury:n.奢侈,奢华;奢侈品;享受;adj.奢侈的; out of stock:adv.已脱销;
So it seems crazy, but the model that we have right now is taking those machines that were designed for that first environment that I showed you and donating or selling them to hospitals in this environment. 这个看上去挺疯狂,但我们现在做的事 就是把针对我最开始展示给你们的环境 设计出来的机器 捐赠或出售给 只有这样条件医院
donating:v.捐赠,赠送;(donate的现在分词)
It's not just inappropriate , it becomes really unsafe . 这不仅是不合适的 而且不安全
inappropriate:adj.不适当的;不相称的; unsafe:adj.不安全的;危险的;不安稳的;
One of our partners at Johns Hopkins was observing surgeries in Sierra Leone about a year ago. 我们一位在約翰·霍普金斯大学的合作者 一年前在塞拉利昂观察了 那里的手术
observing:adj.观察的;注意的;观察力敏锐的;v.观察;遵守(observe的现在分词); Sierra:n.(尤指西班牙和美洲的)锯齿状山脉; Leone:n.利昂(塞拉利昂货币单位);
And the first surgery of the day happened to be an obstetrical case. 第一例手术正好是产科手术
obstetrical:adj.产科的;助产的;
A woman came in, she needed an emergency C-section to save her life and the life of her baby. 一个妇女需要进行紧急剖腹产 来挽救她的孩子和自己的生命
emergency:n.紧急情况;突发事件;非常时刻;adj.紧急的;备用的; C-section:n.剖腹产;
And everything began pretty auspiciously. 开始一切顺利
The surgeon was on call and scrubbed in. 外科医生准备好了动手
surgeon:n.外科医生; scrubbed:adj.精制的,纯净的;v.擦洗;废止;揉搓(scrub的过去分词);
The nurse was there. 护士也在
She was able to anesthetize her quickly, and it was important because of the emergency nature of the situation. 能马上实施麻醉 因为是紧急情况所以这一切很重要
And everything began well until the power went out. 一切都很顺利 后来停电了
And now in the middle of this surgery, the surgeon is racing against the clock to finish his case, which he can do -- he's got a headlamp . 在手术进行过程中 外科医生正和争分夺秒完成手术 他能做到,有个头灯
against the clock:争分夺秒地;尽可能快地(跑或游); headlamp:n.照明灯;桅灯;车前灯;
But the nurse is literally running around a darkened operating theater trying to find anything she can use to anesthetize her patient, to keep her patient asleep. 但是护士就得 在黑漆漆的的手术室里四处搜寻 能麻醉她的病人的东西 让病人处于睡眠中
literally:adv.按字面:字面上:确实地: darkened:adj.变黑的,没有灯光的;
Because her machine doesn't work when there's no power. 因为没有电机器就不能运转
And now this routine surgery that many of you have probably experienced, and others are probably the product of, has now become a tragedy . 这样一个诸位都可能经历过 或者由此出生寻常手术 演变成了悲剧
tragedy:n.悲惨的事;不幸;灾难;悲剧作品;
And what's so frustrating is this is not a singular event; this happens across the developing world. 更让人难过的是这并不是个案 在整个发展中的世界都是这样
frustrating:adj.令人沮丧的;v.使沮丧;(frustrate的现在分词) singular:adj.单数的;单一的;非凡的;异常的;n.单数;
35 million surgeries are attempted every year without safe anesthesia. 每年有三千五百万例手术 是在没有安全麻醉的情况下实施
attempted:adj.未遂的;v.努力;尝试;试图;(attempt的过去分词和过去式)
My colleague , Dr. Paul Fenton, was living this reality. 我的同事,鲍尔?芬东医生 就处在这样的情况下
colleague:n.同事,同僚;
He was the chief of anesthesiology in a hospital in Malawi, a teaching hospital. 他是马拉威一家医院的 首席麻醉师,那是个教学医院
anesthesiology:n.麻醉学;
He went to work every day in an operating theater like this one, trying to deliver anesthesia and teach others how to do so using that same equipment that became so unreliable , and frankly unsafe, in his hospital. 他每天就得 去这样的医院上班 在医院里教导别人怎样实施麻醉 怎么使用这个器材 十分不可靠 不安全的设备
unreliable:adj.不可靠的;靠不住的;
And after umpteen surgeries and, you can imagine, really unspeakable tragedy, he just said, "That's it. I'm done. That's enough. 在无数手术之后 你可以想象,无数悲剧之后 他说:“我不干了,我受够了
umpteen:adj.无数的;很多的; unspeakable:adj.无法形容的;不能以言语表达的;坏透了的;
There has to be something better." 我得做点有用的东西。”
So he took a walk down the hall to where they threw all those machines that had just crapped out on them -- 他去了一趟 堆着扔掉的那些他抱怨过的机器的房间
crapped:v.拉屎;(crap的过去分词和过去式)
I think that's the scientific term -- and he just started tinkering . 我想这就这些机器的名称 他开始修补
scientific:adj.科学的,系统的; tinkering:v.(尤指不起作用地)小修补,小修理;(tinker的现在分词)
He took one part from here and another from there, and he tried to come up with a machine that would work in the reality that he was facing. 他从每个上面取一些 然后作出一个机器 能在他所处的环境里实用的
come up with:提出;想出;赶上;
And what he came up with was this guy, the prototype for the Universal Anesthesia Machine -- a machine that would work and anesthetize his patients no matter the circumstances that his hospital had to offer. 他就得到了这个东西 这就是万能麻醉器的原型 这个机器能在 任何条件下 工作,麻醉病人
prototype:n.原型;雏形;最初形态; Universal:adj.普遍的;全体的;全世界的;共同的; circumstances:n.情况;环境;情形;(circumstance的复数)
Here it is back at home at that same hospital, developed a little further, 12 years later, working on patients from pediatrics to geriatrics . 这还是在那家医院 12年后 有了改进 适用于各个年龄的病人
pediatrics:n.小儿科; geriatrics:n.老年病学;老年病人;
Now let me show you a little bit about how this machine works. 现在我来解释一下它的运作原理
Voila ! 哇！
Voila:int.(法)瞧;可不是;
Here she is. 这就是了
When you have electricity, everything in this machine begins in the base. 有电力供给时 一切是从基座开始工作
There's a built-in oxygen concentrator down there. 下面有一个内置的氧气集中器
built-in:adj.嵌入的;固定的;n.内置; concentrator:n.浓缩器;集中者;[冶]选矿厂;[电]集线器;
Now you've heard me mention oxygen a few times at this point. 你已经听我提到过几次氧气了
Essentially , to deliver anesthesia, you want as pure oxygen as possible, because eventually you're going to dilute it essentially with the gas. 基本上,要实施麻醉 就得尽可能地使用纯氧 因为你最终会用气体 来稀释
Essentially:adv.本质上;本来; eventually:adv.最后,终于; dilute:adj.稀释的;淡的;vt.稀释;冲淡;削弱;vi.变稀薄;变淡;
And the mixture that the patient inhales needs to be at least a certain percentage oxygen or else it can become dangerous. 最后患者吸入的混合气体 必须有一定比例的氧气 不然就会很危险
mixture:n.混合;结合体;混合物;集合体; inhales:vt.吸入;猛吃猛喝;vi.吸气; percentage:n.百分比;百分率;利润的分成;提成;
But so in here when there's electricity, the oxygen concentrator takes in room air. 但是当有电的时候 氧气集中器就采入室内空气
Now we know room air is gloriously free, it is abundant , and it's already 21 percent oxygen. 室内空气反正是免费的 而起取之不尽 并且含有21％的氧气
gloriously:adv.光荣地;辉煌地;壮观地,壮丽地; abundant:adj.丰富的;充裕的;盛产;
So all this concentrator does is take that room air in, filter it and send 95 percent pure oxygen up and across here where it mixes with the anesthetic agent . 集中器采入室内空气,过滤 输入95％的纯氧 经过这里 混合麻醉成分
filter:n.滤波器;过滤器;滤光器;滤声器;v.过滤;渗入;(用程序)筛选;缓行; mixes:n.混淆;调拌料(mix的复数);v.混合(mix的第三人称单数); anesthetic:adj.麻醉的;感觉缺失的;n.麻醉剂,麻药; agent:n.代理人,代理商;药剂;特工;v由…作中介;由…代理;adj.代理的;
Now before that mixture hits the patient's lungs, it's going to pass by here -- you can't see it, but there's an oxygen sensor here -- that's going to read out on this screen the percentage of oxygen being delivered. 在混合气体 进入病人肺部之前 会先经过这里 你看不到,这是个氧气传感器－ 能读出氧气含量 显示在屏幕上
sensor:n.传感器;
Now if you don't have power, or, God forbid , the power cuts out in the middle of surgery, this machine transitions automatically , without even having to touch it, to drawing in room air from this inlet . 没有电的时候 或者上帝不帮忙,手术中间断电了 这个机器不需要人工操作 就能自动切换模式 开始从这个口采入室内空气
forbid:v.禁止;不准;不允许;(正式)严禁; transitions:n.过渡,转变(transition的复数形式);转场效果;转换滤镜; automatically:adv.自动地;机械地;无意识地;adj.不经思索的; inlet:n.入口,进口;插入物;
Everything else is the same. 其他的都是一样的
The only difference is that now you're only working with 21 percent oxygen. 唯一的区别是 你用的只是21％氧气
Now that used to be a dangerous guessing game , because you only knew if you had given too little oxygen once something bad happened. 这曾是个比较危险拼运气的手术部分 因为通常是出事了你才知道供氧不足
guessing game:n.猜谜游戏;捉摸不定的局面;
But we've put a long-life battery backup on here. 但我们有一个超常寿命的电池
long-life:adj.经过延长保质期处理的(牛奶等); battery:n.[电]电池,蓄电池;n.[法]殴打;n.[军]炮台,炮位; backup:n.后援;增援;(文件等的)备份;adj.后补的;支持性的;伴奏的;
This is the only part that's battery backed up. 这是唯一一部分依靠电池的
But this gives control to the provider , whether there's power or not, because they can adjust the flow based on the percentage of oxygen they see that they're giving their patient. 但这能让麻醉师能 应对无论有电没电的情况 因为他们能按照屏幕上读取的 氧气比例来调节气流
provider:n.供应者;养家者; adjust:v.调整;调节;适应;习惯;
In both cases, whether you have power or not, sometimes the patient needs help breathing. 不论 是否有电 有时候病人需要协助呼吸
It's just a reality of anesthesia. The lungs can be paralyzed . 这是麻醉的现实情况 肺部有可能麻痹
paralyzed:adj.瘫痪的;麻痹的;v.使麻痹;使无力;使失去勇气(paralyze的过去分词);
And so we've just added this manual bellows . 所以我们加入了手动风箱
manual:n.说明书;指南;使用手册;adj.用手的;手工的;体力的;手动的; bellows:n.波纹管;风箱;皮老虎;
We've seen surgeries for three or four hours to ventilate the patient on this. 我们见过三到四小时的手术 用这个来保持病人呼吸
ventilate:vt.使通风;给…装通风设备;宣布;
So it's a straightforward machine. 所以这是个操作简明的机器
straightforward:adj.简单的;坦率的;明确的;径直的;adv.直截了当地;坦率地;
I shudder to say simple; it's straightforward. 我不想说它简单 而是操作简明
shudder:n.发抖;战栗;震动;vi.发抖;战栗;
And it's by design. 从设计层面上
And you do not need to be a highly trained, specialized anesthesiologist to use this machine, which is good because, in these rural district hospitals, you're not going to get that level of training. 而且你不必是一名 经过优秀训练的,具备专门技能的麻醉医师才能来操作 这一点很重要,因为位于乡下的医院 不可能具备这个训练水平人员
highly:adv.高度地;非常;非常赞许地; specialized:adj.专业的; v.专门研究(或从事); (specialize的过去式和过去分词)
It's also designed for the environment that it will be used in. 而且它也是按其使用环境来设计的
This is an incredibly rugged machine. 这是个不可思议地很粗糙的机器
incredibly:adv.难以置信地;非常地; rugged:adj.崎岖的;坚固的;高低不平的;粗糙的;
It has to stand up to the heat and the wear and tear that happens in hospitals in these rural districts. 它能承受 在乡下医院里 会出现的过热和磨损
stand up to:经得起;抵抗;勇敢地面对;
And so it's not going to break very easily, but if it does, virtually every piece in this machine can be swapped out and replaced with a hex wrench and a screwdriver . 也不容易出故障 但是如果出了故障,几乎每一个零件 都可以用个六角扳手和螺丝刀 卸下来换个新的
virtually:adv.事实上,几乎;实质上; swapped:交换;调换; wrench:n.扳手,扳钳; vt.扭伤; vi.扭伤; screwdriver:n.螺丝刀;
And finally, it's affordable . 最后,它价钱不贵
affordable:adj.负担得起的;
This machine comes in at an eighth of the cost of the conventional machine that I showed you earlier. 这个机器只有 之前展示的那个传统机器的 八分之一的价格
conventional:adj.符合习俗的,传统的;常见的;惯例的;
So in other words, what we have here is a machine that can enable surgery and save lives because it was designed for its environment, just like the first machine I showed you. 也就是说,这个机器 能保证手术进行挽救生命 因为它贴合环境实际的设计 用途就和我一开始展示的机器一样
But we're not content to stop there. 但是我们并不于此止步
content:n.内容,目录;满足;容量;adj.满意的;vt.使满足;
Is it working? 这个机器能用吗？
Is this the design that's going to work in place? 这个设计能管用吗？
Well we've seen good results so far. 目前为止结果还是很好的
This is in 13 hospitals in four countries, and since 2010, we've done well over 2,000 surgeries with no clinically adverse events. 这个装备已经在4个国家13个医院应用 从2010起 我们已经用它做了超过两千例手术 没有一起医疗事故
clinically:adv.临床地;门诊部地;不偏不倚;通过临床诊断; adverse:adj.不利的;相反的;敌对的(名词adverseness,副词adversely);
So we're thrilled . 我们乐坏了
thrilled:adj.非常兴奋; v.使非常兴奋; (thrill的过去分词和过去式)
This really seems like a cost-effective , scalable solution to a problem that's really pervasive . 这似乎是个经济又可推广的方案 来应对目前广泛存在的问题
cost-effective:adj.划算的;成本效益好的(等于cost-efficient); scalable:adj.可攀登的;可去鳞的;可称量的; solution:n.解决方案;溶液;溶解;解答; pervasive:adj.普遍的;到处渗透的;流行的;
But we still want to be sure that this is the most effective and safe device that we can be putting into hospitals. 但是我们仍需要确定这是 最有效和安全的设备 能在医院里使用
to be sure:诚然;的确;哎呀(表惊奇); device:n.装置;策略;图案;
So to do that we've launched a number of partnerships with NGOs and universities to gather data on the user interface , on the types of surgeries it's appropriate for and ways we can enhance the device itself. 所以我们为此和一些非政府组织及大学 合作 来收集使用者方面的资料 机器适宜操作的手术 以及增强设备的数据
launched:v.发射;发起;开展;开始;(launch的过去式和过去分词) partnerships:n.伙伴关系;合伙;(partnership的复数) interface:n.接口;人机界面;连接电路;v.连接; enhance:v.提高;增强;增进;
One of those partnerships is with Johns Hopkins just here in Baltimore . 我们的其中一个合作者 来自约翰?霍普金斯大学,正好也在巴尔的摩
Baltimore:n.巴尔的摩(美国一座港市);
They have a really cool anesthesia simulation lab out in Baltimore. 他们在巴尔的摩有一个非常棒的麻醉实验室
simulation:n.仿真;模拟;模仿;假装;
So we're taking this machine and recreating some of the operating theater crises that this machine might face in one of the hospitals that it's intended for, and in a contained, safe environment, evaluating its effectiveness . 我们带着机器 在一个受控的安全环境下 重现机器 在其原本设计环境下 可能遇到的紧急情况 来评估其有效性
recreating:v.再现;再创造;(recreate的现在分词) crises:n.危机,紧要关头;危险期(crisis的复数形式); intended:adj.预定的;计划的;v.打算;计划;想要;(intend的过去分词和过去式) evaluating:v.估计;评价;评估;(evaluate的现在分词) effectiveness:n.效力;
We're then able to compare the results from that study with real world experience, because we're putting two of these in hospitals that Johns Hopkins works with in Sierra Leone, including the hospital where that emergency C-section happened. 这样我们就能把研究结果 和实际经验进行比较 因为我们把两台机器投放到 约翰?霍普金斯大学在塞拉利昂的合作医院 包括紧急剖腹产的那家
compare:v.比较;对比;n.比较;
So I've talked a lot about anesthesia, and I tend to do that. 我谈了很多关于麻醉的内容,我总是这么做
I think it is incredibly fascinating and an important component of health. 我认为麻醉是医疗中 非常重要的一部分也是非常有意思的
fascinating:adj.极有吸引力的;迷人的;v.深深吸引;迷住;(fascinate的现在分词) component:n.成分;部件;组成部分;adj.构成的;
And it really seems peripheral , we never think about it, until we don't have access to it, and then it becomes a gatekeeper . 麻醉看上去是次要的,我们几乎想不到它 只要我们需要而得不到的时候 那时候麻醉就变成守门人了
peripheral:adj.外围的;次要的;(神经)末梢区域的;n.外部设备; gatekeeper:n.看门人;
Who gets surgery and who doesn't? 能不能有手术机会？
Who gets safe surgery and who doesn't? 能不能施行安全的手术？
But you know, it's just one of so many ways that design, appropriate design, can have an impact on health outcomes . 你知道 这只是无数设计中的一个 无数合适的设计中的一个 会对医疗结果产生影响
impact:n.影响;效果;碰撞;冲击力;v.挤入,压紧;撞击;对…产生影响; outcomes:n.结果;成果;后果;出路;(outcome的复数)
If more people in the health delivery space really working on some of these challenges in low-income countries could start their design process , their solution search, from outside of that proverbial box and inside of the hospital -- in other words, if we could design 如果更多工作在医疗现场的人 能面对低收入国家的这些挑战 开始设计 寻找方案 跳出惯性思维 面对实际状况 也就是说,如果我们
delivery:n.[贸易]交付;分娩;递送; process:v.处理;加工;列队行进;n.过程,进行;方法,adj.经过特殊加工(或处理)的;
for the environment that exists in so many parts of the world, rather than the one that we wished existed -- we might just save a lot of lives. 能够按照世界各地不同的环境 而不是我们希望的理想环境来设计的话 我们可以拯救很多生命
Thank you very much. 非常感谢
(Applause) （掌声）