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GailReed_2014P-_世界医生的摇篮在哪里_古巴。_
I want to tell you how 20,000 remarkable young people from over 100 countries ended up in Cuba and are transforming health in their communities . 我要告訴大家, 為什麼 2 萬個傑出的年輕人, 來自 100 多個國家, 當初會選擇去古巴, 而現在正在改善他們的社區衛生。
remarkable:adj.卓越的;非凡的;值得注意的; transforming:v.使改变形态;使改变外观(或性质);使改观;(transform的现在分词) communities:n.社区;社会;团体;共有(community的复数)
Ninety percent of them would never have left home at all if it weren't for a scholarship to study medicine in Cuba and a commitment to go back to places like the ones they'd come from — remote farmlands , mountains, ghettos — to become doctors for people like themselves, to walk the walk. 九成的這些年輕人本來永遠不會離開家鄉, 要不是獲得獎學金去古巴學醫, 而且立志回到那些 像他們生長背景的地方服務: 偏遠的農村、山區和貧民區。 成為醫生, 用行動實踐信念。
scholarship:n.奖学金;学问;学识;学术成就; commitment:n.承诺;投入;保证;许诺; remote:adj.偏远的;偏僻的;遥远的;久远的; farmlands:n.农田; ghettos:n.犹太社区(ghetto复数);
Havana 's Latin American Medical School: 哈瓦那拉丁美洲醫學院
Havana:n.哈瓦那(古巴城市);哈瓦那雪茄烟; Latin:adj.拉丁语的;用拉丁语写成的;n.拉丁语;
It's the largest medical school in the world, graduating 23,000 young doctors since its first class of 2005, with nearly 10,000 more in the pipeline . 是世界上最大的醫學院, 從 2005 年第一班畢業,至今已有 2 萬 3 千名畢業生, 還有大約 1 萬名在學。
in the pipeline:在准备中;在酝酿中;在进行中;
Its mission , to train physicians for the people who need them the most: the over one billion who have never seen a doctor, the people who live and die under every poverty line ever invented. 學校的宗旨是:為最需要醫生的人培訓醫生, 為世界上 10 多億從沒看過醫生的人。 這些人從出生到死亡, 一輩子生活在各種貧窮線水平之下。
mission:n.使命,任务;代表团;布道;v.派遣;向…传教; physicians:n.[内科]内科医生(physician的复数); 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);
Its students defy all norms . 這所醫學院的學生很特殊,
defy:vt.藐视;公然反抗;挑衅;使落空;n.挑战;对抗; norms:n.[标准]标准,规范;基准(norm复数形式);
They're the school's biggest risk and also its best bet . 他們是學校最大的風險, 也是最大的勝算,
bet:n.打赌;赌注;预计;估计;v.下赌注(于);用…打赌;敢说;八成儿;
They're recruited from the poorest,most broken places on our planet by a school that believes they can become not just the good but the excellent physicians their communities desperately need, that they will practice where most doctors don't, in places not only poor but oftentimes dangerous, carrying venom antidotes in their backpacks or navigating neighborhoods riddled by drugs, gangs and bullets , their home ground . 他們從世界上最窮的地區被招收進來。 學校相信他們不單可以成為好醫生, 最糟糕的是, 而且是他們社群迫切需要的卓越醫生。 他們也願意去多數醫生不去的地方, 這些地方不但貧窮, 甚至通常很危險。 醫療包裡要帶蛇毒解毒劑, 或是四處出診, 遊走在被毒品、黑幫、子彈摧殘得千瘡百孔的地區, 就是他們的家園。
recruited:v.招聘,雇佣;招募;(recruit的过去分词和过去式) desperately:adv.拼命地;绝望地;不顾一切地;极度地; oftentimes:adv.时常地; venom:n.毒液;恶意;vt.使有毒;放毒; antidotes:n.[药]解毒剂(antidote的复数);v.解毒(antidote的三单形式); backpacks:n.背包(backpack的复数);双肩背包; navigating:v.航行,操纵(navigate的现在分词形式);adj.航行的,航行中; riddled:adj.布满的;遍布的;到处是…的;v.使布满窟窿;(riddle的过去分词和过去式) gangs:n.帮派(gang的复数);v.成帮结伙;合伙行动(gang的三单形式); bullets:n.子弹;弹丸;(bullet的复数) home ground:n.主场场地;主队运动场;自己的家;熟悉的工作地方;
The hope is that they will help transform access to care, the health picture in impoverished areas, and even the way medicine itself is learned and practiced, 培訓的目的 是要透過這些醫生,就近提供社區醫療照護, 提升貧窮地區的衛生水準, 甚至顛覆醫學訓練和行醫的方式;
impoverished:adj.穷困的;用尽了的,无创造性的;v.使贫困(impoverish的过去分词);
and that they will become pioneers in our global reach for universal health coverage , surely a tall order . 這些醫生會成為醫療先鋒, 將衛生保健推到世界每一個角落, 任務真的非常艱鉅。
global:adj.全球的;总体的;球形的; universal:adj.普遍的;全体的;全世界的;共同的; coverage:n.覆盖,覆盖范围; a tall order:苛求;艰巨的任务;过高要求;
Two big storms and this notion of "walk the walk" 兩個大暴風,和「用行動實踐信念」的想法,
notion:n.观念;信念;理解;
prompted creation of ELAM back in 1998. 催生了哈瓦那拉丁美洲醫學院,
prompted:v.促使;导致;提示;给(演员)提词;(prompt的过去分词和过去式) creation:n.创造,创作;创作物,产物;
The Hurricanes Georges and Mitch had ripped through the Caribbean and Central America , leaving 30,000 dead and two and a half million homeless. 喬治和米奇兩個颶風 重襲加勒比海 和中美洲, 造成 3 萬人死亡, 250 萬人無家可歸。
Hurricanes:n.[气象]飓风(hurricane的复数); Mitch:vi.逃学; Caribbean:adj.加勒比海的;加勒比人的;加勒比语的;n.加勒比海; Central America:n.中美洲(包括危地马拉、伯利兹、洪都拉斯、萨尔瓦多、尼加拉瓜、哥斯达黎加以及巴拿马);
Hundreds of Cuban doctors volunteered for disaster response , but when they got there, they found a bigger disaster: whole communities with no healthcare , doors bolted shut on rural hospitals for l ack of staff, a nd ju st too many babies dying before their first birthday. 數以百計的古巴醫生自願去救災, 不過他們一到那裡, 卻發現更大的災難: 很多社區完全沒有醫療服務, 偏鄉的醫院都關閉了。 因為人手短缺。 有太多太多的嬰兒不到周歲就夭折。
Cuban:n.古巴人;古巴产雪茄;adj.古巴的; volunteered:v.自愿做;义务做;自愿参军;(volunteer的过去分词和过去式) disaster:n.灾难,灾祸;不幸; response:n.响应;反应;回答; healthcare:n.医疗保健;健康护理,健康服务;卫生保健;
What would happen when these Cuban doctors left? 這群古巴醫生離開以後,又會變成什麼樣呢？
New doctors were needed to make care sustainable , but where would they come from? 必須有醫生接手,繼續提供醫療, 但要去哪裡找醫生？
sustainable:adj.可以忍受的;足可支撑的;养得起的;可持续的;
Where would they train? 怎麼訓練？
In Havana, the campus of a former naval academy was turned over to the Cuban Health Ministry to become the Latin American Medical School, 後來,一所哈瓦那海事學院的舊校園, 由古巴衛生部接管, 改建成了拉丁美洲醫學院,
campus:n.(大学)校园;大学,大学生活;校园内的草地; naval:adj.海军的;军舰的; academy:n.学院;研究院;学会;专科院校; Ministry:n.(政府的)部门;
ELAM. 也就是 ELAM。
Tuition , room and board , and a small stipend were offered to hundreds of students from the countries hardest hit by the storms. 它提供學費、食宿,和小額生活津貼, 給數百名來自受災最重國家的學生。
Tuition:n.指导;(尤指大专院校的)学费; room and board:食宿; stipend:n.奖学金;固定薪金;定期津贴;养老金;
As a journalist in Havana, 我在哈瓦那當記者,
journalist:n.新闻工作者;报人;记日志者;
I watched the first 97 Nicaraguans arrive in March 1999, settling into dorms barely refurbished and helping their professors not only sweep out the classrooms but move in the desks and the chairs and the microscopes . 看著首批 97 位尼加拉瓜學生 在 1999 年 3 月來報到, 搬進了幾乎未整修的學校宿舍, 幫教授們一下清空教室、 一下又搬進課桌椅和顯微鏡。
settling:n.安置;固定;沉淀物;移居;v.解决;安居;(settle的现在分词) dorms:宿舍(dorm的名词复数); barely:adv.仅仅,勉强;几乎不;公开地;贫乏地; refurbished:v.翻新,刷新(refurbish的过去分词); microscopes:n.[光]显微镜(microscope的复数);
Over the next few years, governments throughout the Americas requested scholarships for their own students, and the Congressional Black Caucus asked for and received hundreds of scholarships for young people from the USA. 接下來的幾年, 美洲各國的政府 都來幫自己的學生申請獎學金。 美國國會黑人同盟 也申請並且獲得數百個獎學金名額, 提供給美國的年輕人。
throughout:adv.自始至终,到处;全部;prep.贯穿,遍及; scholarships:n.奖学金;学问;学术;学术研究;(scholarship的复数) Congressional:adj.国会的;会议的;议会的; Caucus:n.干部会议;核心会议;vi.召开干部会议;开核心会议;
Today, among the 23,000 are graduates from 83 countries in the Americas, Africa and Asia, and enrollment has grown to 123 nations. 至今 2 萬 3 千名校友, 總共來自 83 個國家, 遍佈美洲、非洲和亞洲, 新生的國籍也增加到 123 個國家,
enrollment:n.登记;入伍;
More than half the students are young women. 半數以上是年輕的女性,
They come from 100 ethnic groups, speak 50 different languages. 來自 100 個不同種族, 說 50 種不同的語言,
ethnic:adj.种族的;人种的;
WHO Director Margaret Chan said, "For once, if you are poor, female , or from an indigenous population, you have a distinct advantage , an ethic that makes this medical school unique ." WHO 總幹事陳馮富珍說過: 「終於,如果你是窮人、 或是原住民, 這些條件反而變成獨特的優勢, 這種價值觀使 ELAM 與眾不同。」
female:adj.女性的;雌性的;柔弱的,柔和的;n.女人;[动]雌性动物; indigenous:adj.本土的;土著的;国产的;固有的; distinct:adj.明显的;独特的;清楚的;有区别的; advantage:n.有利条件:优势:优点: ethic:n.伦理;道德规范;adj.伦理的;道德的(等于ethical); unique:adj.独特的,稀罕的;[数]唯一的;n.独一无二的人或物;
Luther Castillo comes from San Pedro de Tocamacho on the Atlantic coast of Honduras. 魯瑟．卡斯第羅來自托卡馬喬市的聖佩德羅, 位在洪都拉斯的大西洋岸。
Pedro:彼得牌戏(一种纸牌戏) Atlantic:adj.大西洋的;巨人阿特拉斯的;n.大西洋;
There's no running water, no electricity there, and to reach the village, you have to walk for hours or take your chances in a pickup truck like I did skirting the waves of the Atlantic. 這個村落沒有自來水、 沒有電力, 從鎮上到那裡還得走好幾個鐘頭, 或跟我一樣,碰運氣搭小貨車, 沿大西洋岸,趁著退潮行駛。
electricity:n.电力;电流;强烈的紧张情绪; pickup:n.收集,整理;小卡车;拾起;搭车者;偶然结识者;
Luther was one of 40 Tocamacho children who started grammar school , the sons and daughters of a black indigenous people known as the Garífuna, 20 percent of the Honduran population. 魯瑟是托市 40 個上過小學的孩子之一, 加利福納黑人原住民兒童, 這些原住民佔宏都拉斯兩成人口。
grammar school:n.(尤指旧时英国的)文法学校;
The nearest healthcare was fatal miles away. 離他們最近的醫院
fatal:adj.致命的;灾难性的;毁灭性的;导致失败的;
Luther had to walk three hours every day to middle school . 魯瑟每天得要走上 3 個小時, 才能到中學上課,
middle school:n.初中;(英国为9到13岁儿童所设的)中间学校;
Only 17 made that trip. 只有 17 個小孩能上中學,
Only five went on to high school, and only one to university: 只有 5 個繼續唸高中, 只有 1 個最後上了大學:
Luther, to ELAM, among the first crop of Garífuna graduates. 魯瑟來到了 ELAM 醫學院！ 成為第一批加利福納畢業生。
Just two Garífuna doctors had preceded them in all of Honduran history. 整個宏都拉斯歷史,之前只曾有過 2 個加利福納族醫生,
preceded:v.在…之前发生(或出现);先于;走在…前面;(precede的过去分词和过去式)
Now there are 69, thanks to ELAM. 現在有 69 個！
Big problems need big solutions, sparked by big ideas, imagination and audacity , but also solutions that work. 非常問題需要非常手段, 靠偉大的理想、想像力和膽識激發, 但手段也必須行得通。
sparked:v.点燃,发动(spark的过去式,过去分词);鼓舞; imagination:n.想象;想象力;创造力;想象的事物; audacity:n.大胆;厚颜无耻;
ELAM's faculty had no handy evidence base to guide them, so they learned the hard way, by doing and correcting course as they went. ELAM 沒有實證可行的現成課程, 所以大家必須辛苦地摸索學習, 邊學邊做,邊調整。
faculty:n.科,系;能力;全体教员; handy:adj.便利的;手边的,就近的;容易取得的;敏捷的; evidence:n.证据,证明;迹象;明显;v.证明;
Even the brightest students from these poor communities weren't academically prepared for six years of medical training, so a bridging course was set up in sciences. 這些貧窮地區,就算是最聰明的學生, 也沒能力立刻開始 6 年醫學訓練。 所以學校設計了科學銜接課程,
academically:adv.学术上;学业上;
Then came language: these were Mapuche, Quechuas, Guaraní, Garífuna, indigenous peoples who learned Spanish as a second language , or Haitians who spoke Creole . 再上語言課。 學生來自馬普切族、克丘亞族、瓜拉尼族、加里福納族 多為原住民, 學過西班牙語,成為第二語言; 也有說克里奧爾語的海地學生。
second language:n.第二语言; Haitians:n.海地人(Haitian的复数); Creole:n.克里奥尔人; adj.克里奥尔语的;
So Spanish became part of the pre-pre-med curriculum . 所以西班牙文成為 上醫學先修課程之前的先修課程。
curriculum:n.课程;总课程;
Even so, in Cuba, the music, the food, the smells, just about everything was different, so faculty became family, ELAM home. 即使如此,在古巴, 音樂、食物、氣味等等, 一切風情民俗都截然不同, 所以全校師生都變成一家人:「ELAM 之家」
Religions ranged from indigenous beliefs to Yoruba, Muslim and Christian evangelical . 宗教信仰多元:跨原住民信仰、 約魯巴信仰、穆斯林信仰、基督教福音教派,
evangelical:adj.福音的;福音派教会的;新教会的;n.福音派信徒;
Embracing diversity became a way of life. 擁抱多元成為生活的方式。
Embracing:n.拥抱;v.拥抱,包含;(embrace的现在分词) diversity:n.差异(性):多样性:多样化:
Why have so many countries asked for these scholarships? 為什麼會有這麼多國家的人 爭取這些獎學金呢？
First, they just don't have enough doctors, and where they do, their distribution is skewed against the poor, because our global health crisis is fed by a crisis in human resources . 第一:他們的國家沒有足夠的醫生, 就算夠醫生,也分佈不均,漠視窮鄉僻壤。 因為全球的衛生醫療危機, 是受人力資源短缺危機所致,
distribution:n.分布;分配;分发;分销; skewed:adj.歪斜的;曲解的; crisis:n.危机;危险期;决定性时刻;adj.危机的;用于处理危机的; human resources:n.人力资源;(公司的)人事部;
We are short four to seven million health workers just to meet basic needs, and the problem is everywhere. 光是基本醫療需求,就缺少 4 到 7 百萬名醫療人員, 世界各地都有這個問題。
Doctors are concentrated in the cities, where only half the world's people live, and within cities, not in the shantytowns or South L.A. 醫生都集中在都市, 而都市只占全球人口的半數。 而且醫生都集中在市內, 不在週邊的貧民區或南洛杉磯。
concentrated:adj.决心要做的; v.集中(注意力); (concentrate的过去式和过去分词) shantytowns:n.棚户区(shantytown的复数);
Here in the United States, where we have healthcare reform , we don't have the professionals we need. 在美國, 我們雖然有健保改革, 卻短缺醫療專業人員。
United:adj.联合的; v.联合,团结; (unite的过去分词和过去式) reform:v.改革;改进;改良;(使)悔改;n.改革;改良;改善; professionals:n.[管理]专业人员(professional的复数);
By 2020, we will be short 45,000 primary care physicians. 到 2020 年, 會少 4 萬 5 千名基層醫療醫師。
And we're also part of the problem. 我們也是造成問題的元凶之一:
The United States is the number one importer of doctors from developing countries. 美國是吸引全世界最多發展中國家醫師的國家,
importer:n.进口商;输入者;
The second reasons students flock to Cuba is the island's own health report card , relying on strong primary care. 第二個學生們搶進古巴的理由, 是這個小島本身的衛生水準, 基層醫療做得很好。
flock:v.聚集;群集;蜂拥;n.(羊或鸟)群;(尤指同类人的)一大群; report card:成绩单;工作报告; relying:v.依赖;信任;指望(rely的现在分词);
A commission from The Lancet rates Cuba among the best performing middle-income countries in health. 醫學權威《The Lancet》期刊的委員會 把古巴列為全球醫療衛生最佳的中收入國家之一。
commission:n.委员会;佣金;犯;委任;委任状;vt.委任;使服役;委托制作; Lancet:n.[外科]小刀,柳叶刀;尖顶窗;小枪; performing:adj.表演的;演奏的;v.做;执行;演出;运转(perform的现在分词) middle-income:adj.中等收入的;
Save the Children ranks Cuba the best country in Latin America to become a mother. 「救助兒童會」評選古巴為 最適合生小孩的拉丁美洲國家。
Latin America:n.拉丁美洲(以西班牙语或葡萄牙语为主要语言的美洲地区);
Cuba has similar life expectancy and lower infant mortality than the United States, with fewer disparities , while spending per person one 20th of what we do on health here in the USA. 古巴人的平均壽命跟美國人一樣長, 嬰兒死亡率比美國低, 且差距較少; 但是古巴花在醫療衛生的人均消費, 卻只有美國人的 1 / 20。
life expectancy:预期寿命; infant:n.婴儿;幼儿;未成年人;adj.婴儿的;幼稚的;初期的;未成年的; mortality:n.死亡数,死亡率;必死性,必死的命运; disparities:不一致(disparity的复数);
Academically, ELAM is tough, but 80 percent of its students graduate. ELAM 對課業要求很嚴格, 但學生畢業率達 80%。
The subjects are familiar — basic and clinical sciences — but there are major differences. 主修科目跟一般醫學院一樣: 基礎科學與臨床科學。 但是也有很大的不同:
familiar:adj.熟悉的;常见的;亲近的;n.常客;密友; clinical:adj.临床的;诊所的;
First, training has moved out of the ivory tower and into clinic classrooms and neighborhoods, the kinds of places most of these grads will practice. 首先,訓練走出了象牙塔, 進入診間教室和社區, 就是多數畢業生將來執業的地方,
ivory tower:n.象牙塔(指远离问题、脱离现实的小天地); grads:n.梯度;毕业生(grad的复数);分度;百分度(grad的复数);
Sure, they have lectures and hospital rotations too, but community-based learning starts on day one. 當然他們也有講座和醫院輪班, 但是社區實習從新生入學就開始了。
rotations:n.旋转;循环(rotation的复数); community-based:adj.社区的;以社区为基础的;
Second, students treat the whole patient , mind and body, in the context of their families, their communities and their culture. 其次,學生注重全人治療, 兼顧病人的生理和心理, 並且考量病人的家庭、社群, 和文化背景。
treat:v.治疗;处理;招待;款待;n.款待;乐事;乐趣; patient:adj.有耐心的,能容忍的;n.病人;患者; context:n.环境;上下文;来龙去脉;
Third, they learn public health: to assess their patients ' drinking water , housing, social and economic conditions. 第三,他們學習公共衛生, 評估病人的飲水、家居環境, 和社經條件。
assess:vt.评定;估价;对…征税; patients:n.接受治疗者,病人;(patient的复数) drinking water:n.饮用水; economic:adj.经济的,经济上的;经济学的;
Fourth, they are taught that a good patient interview and a thorough clinical exam provide most of the clues for diagnosis , saving costly technology for confirmation. 第四,他們學習到 仔細地問診 加上周全的臨床檢測, 可以深入了解病情,幫助診斷, 省下確診技術的昂貴費用。
interview:n.接见,采访;面试,面谈;v.采访;接见;对…进行面谈; thorough:adj.彻底的;十分的;周密的; clues:n.(调查,研究等的)线索;迹象;(故事的)关键情节;(clue的复数) diagnosis:n.诊断; costly:adj.昂贵的;代价高的; technology:n.技术;工艺;术语;
And finally , they're taught over and over again the importance of prevention , especially as chronic diseases cripple health systems worldwide . 最後,他們不斷被教育 預防的重要性, 尤其是現在慢性疾病 拖垮世界各國的衛生醫療。
finally:adv.终于;最终;(用于列举)最后;彻底地; over and over again:adv.一再地;反复不断地; prevention:n.预防;阻止;妨碍; especially:adv.尤其;特别;格外;十分; chronic:adj.慢性的;长期的;习惯性的; diseases:n.[医]病(disease的复数);[医]疾病;[植保]病害;疾病种类; cripple:vt.削弱;使跛;使残废;n.跛子;残废;adj.跛的;残废的; worldwide:adj.全世界的;adv.在世界各地;
Such an in-service learning also comes with a team approach , as much how to work in teams as how to lead them, with a dose of humility . 這種實作學習 也注重團隊精神, 學生們學習彼此合作, 也學習領導團隊, 並且保持謙遜的態度。
in-service:adj.在职的;在职期间进行的;不脱产的;全职的; approach:n.方法;路径;v.接近;建议;着手处理; dose:n.剂量;一剂,一服;v.服药;给药;给…服药; humility:n.谦卑,谦逊;
Upon graduation, these doctors share their knowledge with nurse's aids, midwives , community health workers, to help them become better at what they do, not to replace them, to work with shamans and traditional healers . 一畢業,這些新科醫生就開始 把知識分享給助理護士、助產士、 社區衛生工作者, 幫助他們更能勝任工作, 而不是取代他們, 也會跟巫醫和傳統治療工作者合作。
midwives:n.助产士; v.促成; shamans:n.萨满教巫医(Shaman的复数); traditional:传统的,惯例的, healers:n.医治者;治疗物(healer的复数);
ELAM's graduates: ELAM 的畢業生
Are they proving this audacious experiment right? 是否證明了這麼大膽的嘗試奏效？
audacious:adj.无畏的;鲁莽的;
Dozens of projects give us an inkling of what they're capable of doing. 從數十個計畫 可以窺知他們的能力。
inkling:n.暗示;略知;模糊概念;v.暗示(inkle的ing形式);略知;低声说出; capable:adj.能干的,能胜任的;有才华的;
Take the Garífuna grads. 像是加利福納的畢業生,
They not only went to work back home, but they organized their communities to build 不但回到家鄉工作, 還集結社區力量,
organized:adj.有组织的; v.组织; (organize的过去分词和过去式)
Honduras' first indigenous hospital. 蓋了宏都拉斯第一間原住民醫院。
With an architect's help, residents literally raised it from the ground up . 在一位建築師的幫助下, 居民們胼手胝足,憑空打造出一座醫院。
residents:n.居民;住院医生;房客;(resident的复数) literally:adv.按字面:字面上:确实地: from the ground up:从头开始;彻底;
The first patients walked through the doors in December 2007, and since then, the hospital has received nearly one million patient visits. 2007 年 12 月,收了首批病患 到現在,這間醫院收容過 將近 100 萬的求診人次,
And government is paying attention, upholding the hospital as a model of rural public health for Honduras. 而政府也很關注, 以這所醫院做為宏都拉斯 農村公共醫療的模範,
upholding:v.支持,维护(正义等);维持,确认;(uphold的现在分词)
ELAM's graduates are smart, strong and also dedicated . ELAM 的畢業生聰明、 堅強能幹,
dedicated:adj.献身的; v.把…奉献给; (dedicate的过去分词和过去式)
Haiti, January 2010. 2010 年 1 月海地地震,
The pain. 傷慟的悲劇:
People buried under 30 million tons of rubble . 人們被埋在 3 千萬噸的瓦礫碎片下,
rubble:n.碎石,碎砖;粗石堆;
Overwhelming . 悲痛難當！
Overwhelming:adj.势不可挡的; v.压倒; (overwhelm的现在分词)
Three hundred forty Cuban doctors were already on the ground long term. 340 個古巴醫生 已經長期駐地救治傷患。
More were on their way. Many more were needed. 還有很多醫生正在趕過來,但仍需要更多的醫生。
At ELAM, students worked round the clock to contact 2,000 graduates. 在 ELAM,學生們晝夜不停地 聯繫 2 千位畢業醫生。
round the clock:昼夜不停;整天整夜;昼夜不停地;夜以继日的;日夜不停地;连续一整天; contact:n.接触,联系;v.使接触,联系;
As a result , hundreds arrived in Haiti, 27 countries' worth, from Mali in the Sahara to St. Lucia, Bolivia, Chile and the USA. 結果,好幾百位醫生趕來海地, 總共來自 27 個國家, 聖露西亞、玻利維亞、智利、美國等國家,
As a result:结果;
They spoke easily to each other in Spanish and listened to their patients in Creole thanks to Haitian medical students flown in from ELAM in Cuba. 彼此用流利的西班牙語溝通, 也能了解病人用克里奧爾語描述病情, 幸好有這些海地學生, 從古巴 ELAM 醫學院及時飛過來。
Many stayed for months, even through the cholera epidemic . 很多人待了好幾個月, 甚至爆發霍亂疫情,仍堅守不離。
cholera:n.[内科]霍乱; epidemic:n.流行病;蔓延;adj.传染病;流行性的;
Hundreds of Haitian graduates had to pick up the pieces, overcome their own heartbreak , and then pick up the burden of building a new public health system for Haiti. 數百位海地的 ELAM 畢業生, 必須收拾殘局重建家園, 忍住自己的傷慟, 然後一肩扛起重擔, 為海地建立全新的公共衛生系統。
overcome:vt.克服;胜过;vi.克服;得胜; heartbreak:n.心碎;伤心事; burden:n.负担;责任;船的载货量;v.使负担;烦扰;装货于;
Today, with aid of organizations and governments from Norway to Cuba to Brazil , dozens of new health centers have been built, staffed, and in 35 cases, headed by ELAM graduates. 現在,有了世界組織和各國政府資助 包括挪威、古巴、巴西等國家, 已經蓋好數十所新衛生中心, 找好人手,其中 35 所,院長是 ELAM 畢業生。
organizations:n.组织,构造,有机体(organization的复数);组织机构; Brazil:n.巴西(拉丁美洲国家);
Yet the Haitian story also illustrates some of the bigger problems faced in many countries. 不過,海地事件 也暴露了很多國家面臨的更大問題。
illustrates:v.阐明;举例说明(illustrate的三单形式);给…加插图;
Take a look: 748 Haitian graduates by 2012, when cholera struck, nearly half working in the public health sector but one quarter unemployed , and 110 had left Haiti altogether. 我們來看一下: 截至 2012 年爆發霍亂時,共有 748 個海地畢業生, 其中近半數在公共衛生單位工作, 但是有 1/4 失業, 還有 110 人被迫出國找工作。
unemployed:adj.失业的;下岗的;n.(集合词)失业者;
So in the best case scenarios , these graduates are staffing and thus strengthening public health systems, where often they're the only doctors around. 最理想的情況是, 這些畢業生都能順利就業, 強化公共衛生體系, 到從未有過醫生的地方開業。
scenarios:n.情节;脚本;情景介绍(scenario的复数);
In the worst cases, there are simply not enough jobs in the public health sector, where most poor people are treated , not enough political will, not enough resources, not enough anything — just too many patients with no care. 最壞的情況,公共衛生體系根本沒有足夠的職缺, 而這些通常是窮人看病的地方; 政治決心不夠、資源不夠、 什麼東西都不夠, 只有太多缺乏醫療照護的病人。
treated:v.以…态度对待;把…看作;(treat的过去分词和过去式)
The grads face pressure from their families too, desperate to make ends meet , so when there are no public sector jobs, these new MDs decamp into private practice , or go abroad to send money home. ELAM 畢業生也有家庭壓力, 急需餵飽一家子。 所以如果公共衛生單位沒有職缺, 這些新手醫生轉到私人醫院, 有些人只好出國工作,
make ends meet:收支相抵;量入为出; public sector:n.公营部门;公共部门; decamp:vi.撤营;逃走;逃亡; private practice:n.私人开业;私人医生开业; abroad:adv.在国外;到海外;adj.往国外的;n.海外;异国;
Worst of all, in some countries, medical societies influence accreditation bodies not to honor the ELAM degree, fearful these grads will take their jobs or reduce their patient loads and income. 最糟糕的是, 醫學界會左右認證機關, 不讓其承認 ELAM 的學歷, 因為怕 ELAM 畢業生搶飯碗, 或是搶走病人,害他們收入減少。
influence:n.影响;势力;感化;有影响的人或事;v.影响;改变; accreditation:n.委派;信赖;鉴定合格; fearful:adj.可怕的;担心的;严重的;
It's not a question of competencies . 這非關能力問題。
competencies:n.能力(competency的复数);胜任特征;职业能力素质;
Here in the USA, the California Medical Board accredited the school after rigorous inspection , and the new physicians are making good on Cuba's big bet, passing their boards and accepted into highly respected residencies from New York to Chicago to New Mexico. 在美國,加州醫學委員會 經過嚴密審查後才認證這間學校, 這些 ELAM 畢業生表現優異, 不負醫學院的期望, 他們通過醫師資格考試, 進入信譽卓著的醫院擔任住院醫師, 從紐約、芝加哥到新墨西哥都有。
accredited:adj.官方认可的; v.把…归于; (accredit的过去分词和过去式) rigorous:adj.严格的,严厉的;严密的;严酷的; inspection:n.视察,检查; highly:adv.高度地;非常;非常赞许地; residencies:n.住处;住院医生实习期;
Two hundred strong, they're coming back to the United States energized , and also dissatisfied . 兩百名 ELAM 精兵回到美國,滿腔熱忱, 但也非常不滿。
energized:v.使充满热情; (energize的过去分词和过去式) dissatisfied:adj.不满意的; v.使不满(dissatisfy的过去式和过去分词);
As one grad put it, in Cuba, "We are trained to provide quality care with minimal resources, so when I see all the resources we have here, and you tell me that's not possible, 有一個畢業生說: 「在古巴,我們學到用最少的資源,提供最高品質的醫護, 所以當我看見美國醫院資源這麼多, 你們卻說做不到,
minimal:adj.最低的;最小限度的;
I know it's not true. 我知道事實不是這樣。
Not only have I seen it work, I've done the work." 我不止看過其他人辦到,
ELAM's graduates, some from right here in D.C. and Baltimore , have come from the poorest of the poor to offer health, education and a voice to their communities. ELAM 的畢業生, 有些正是來自華盛頓特區及巴爾的摩這裡, 是窮人裡的最窮, 他們想提供醫療服務、教育, 並為社區發聲。
Baltimore:n.巴尔的摩(美国一座港市);
They've done the heavy lifting. 他們突破萬難扛起重任,
Now we need to do our part to support the 23,000 and counting, foundations , residency directors, press, entrepreneurs , policymakers , people — need to step up. 現在輪到我們盡一份心力, 支持這 2 萬 3 千位年輕人, 基金會、住院醫師訓練負責人、媒體、 企業家、決策者和人民, 都必須挺身而出。
foundations:n.基础;地基;基金会;粉底;(foundations是foundation的复数) residency:n.住处;住院医生实习期; entrepreneurs:n.企业家;(entrepreneur的复数) policymakers:n.决策人;(policymaker的复数)
We need to do much more globally to give these new doctors the opportunity to prove their mettle . 全世界都必須做得更多, 給這些新科醫生機會, 證明自己的堅毅;
mettle:n.勇气;气质;耐力;
They need to be able to take their countries' licensing exams. 他們必須能夠 參加自己國家的證照考試,
licensing:v.批准;许可;(license的现在分词)
They need jobs in the public health sector or in nonprofit health centers to put their training and commitment to work. 他們需要工作機會, 或是非營利衛生中心, 貢獻所學和決心。
nonprofit:adj.非赢利的;不以赢利为目的的;
They need the chance to be the doctors their patients need. 他們需要機會 成為病人最需要的醫生。
To move forward, we may have to find our way back to that pediatrician who would knock on my family's door on the South Side of Chicago when I was a kid, who made house calls, who was a public servant. 要邁向未來, 我們可能必須先回到過去, 回到小時候那個熱心的小兒科醫師, 會來芝加哥南區敲我家的門, 會四處出診,探訪病人, 真正的服務人群。
pediatrician:n.儿科医师(等于pediatrist);
These aren't such new ideas of what medicine should be. 這些都不是醫學定位的新觀念,
What's new is the scaling up and the faces of the doctors themselves: an ELAM graduate is more likely to be a she than a he; 不同的只是把範圍擴大, 和這些生力軍的新面孔。 ELAM 畢業生裡, 多於男性。
scaling:n.缩放比例; v.剥落;
In the Amazon , Peru or Guatemala , an indigenous doctor; in the USA, a doctor of color who speaks fluent Spanish. 在亞馬遜、秘魯或瓜地馬拉, 醫生很可能是原住民; 在美國,醫生可能不是白人, 而且會說流利的西班牙語。
Amazon:亚马逊;古希腊女战士; Guatemala:n.危地马拉(拉丁美洲国家);危地马拉人; fluent:adj.流畅的,流利的;液态的;畅流的;
She is well trained, can be counted on, and shares the face and culture of her patients, and she deserves our support surely, because whether by subway, mule , or canoe , she is teaching us to walk the walk. 她們受過良好的訓練, 來自跟病人相同的種族與文化, 確實值得我們支持。 因為不論是坐地鐵、騾子或獨木舟, 她們都在啟發我們付諸行動。
deserves:v.值得;应得;应受;(deserve的第三人称单数) mule:n.骡子;越境运毒者;(室内使用的)拖鞋; canoe:n.独木舟;轻舟;vi.乘独木舟;vt.用独木舟运;
Thank you. (Applause) 謝謝！（觀眾掌聲）