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MitchellBesser_2010G-_母亲互助同抗艾滋_
I want you to take a trip with me. 我要你们和我一起去体验一段旅程.
Picture yourself driving down a small road in Africa, and as you drive along, you look off to the side, and this is what you see: you see a field of graves . 想象你们开着车 行驶在非洲的一条小路上, 行驶途中, 当你透过车窗,望向路旁, 这是你所看到的景象: 你看到一片坟墓.
graves:n.坟墓; adj.重大的; v.对(船底)作清洗并涂上沥青等涂料; v.庄重地; (grave的第三人称单数)
And you stop, and you get out of your car and you take a picture. 你停下来,走下车,将这一幕拍下.
And you go into the town, and you inquire , "What's going on here?" 然后你到了镇里, 问人们, 照片上这个地方发生了什么事情?
inquire:v.询问;打听;调查;(古)质问;
and people are initially reluctant to tell you. 大家一开始不愿意告诉你.
initially:adv.最初,首先;开头; reluctant:adj.不情愿的;勉强的;顽抗的;
And then someone says, "These are the recent AIDS deaths in our community ." 然后有人说, 这些是最近在我们这里因为艾滋病而死的人.
community:n.社区;[生态]群落;共同体;团体;
HIV isn't like other medical conditions; it's stigmatizing . 艾滋病不像别的病; 它让人觉得羞耻自卑.
HIV:n.艾滋病病毒; stigmatizing:vt.诬蔑;玷污;给…打上烙印;
People are reluctant to talk about it -- there's a fear associated with it. 人们不愿意谈及它. 它让人感到恐惧.
associated:adj.有关联的; v.联想; (associate的过去分词和过去式)
And I'm going to talk about HIV today, about the deaths, about the stigma. 而我今天将会谈及艾滋病, 谈及由它引起的死亡, 以及人们关于对艾滋病的这种羞耻心理.
It's a medical story, but more than that, it's a social story. 这不仅是一个医学上的问题, 也是一个社会问题.
This map depicts the global distribution of HIV. 这幅地图描绘了全球艾滋病的分布情况.
depicts:vt.描述;描画; global:adj.全球的;总体的;球形的; distribution:n.分布;分配;分发;分销;
And as you can see , 同时, 你们可以看见,
as you can see:正如你所看到的;你是知道的;
Africa has a disproportionate share of the infection . 非洲受感染比例大大超出平均水平.
disproportionate:adj.不成比例的;不成比例地; infection:n.感染;传染;(身体某部位的)感染;传染病;
There are 33 million people living with HIV in the world today. 今天全球有3300万 艾滋病带菌者.
Of these, two-thirds , 22 million are living in sub-Saharan Africa. 其中,三分之二, 也即2200万, 生活在撒哈拉以南非洲.
two-thirds:n.三分之二;三分之二的;三分之二地; sub-Saharan:撒哈拉以南地区;
There are 1.4 million pregnant women in low- and middle-income countries living with HIV and of these, 90 percent are in sub-Saharan Africa. 有140万怀孕的女性 带着艾滋病病毒生活在中低收入国家, 而其中的90% 就在撒哈拉以南的非洲.
pregnant:adj.怀孕的;富有意义的; middle-income:adj.中等收入的;
We talk about things in relative terms. 让我们通过对比来说明问题.
relative:adj.相对的;有关系的;成比例的;n.亲戚;相关物;[语]关系词;亲缘植物;
And I'm going to talk about annual pregnancies and HIV-positive mothers. 以每年怀孕 的带有艾滋病病毒的母亲为例.
annual:n.年报;年鉴;年刊;adj.每年的;年度的;一年的; pregnancies:n.怀孕;丰富,多产;意义深长;
The United States -- a large country -- each year, 7,000 mothers with HIV who give birth to a child. 在美国 -- 一个大国 -- 每年有七千带有艾滋病病毒的母亲 生下孩子.
United:adj.联合的; v.联合,团结; (unite的过去分词和过去式) give birth to:产生,造成;生孩子;
But you go to Rwanda -- a very small country -- 8,000 mothers with HIV who are pregnant. 但在卢旺达 -- 一个很小的国家 -- 每年就有8千个带有艾滋病病毒的母亲怀孕.
And then you go to Baragwanath Hospital, outside of Johannesburg in South Africa, and 8,000 HIV-positive pregnant women giving birth -- a hospital the same as a country. Baragwanath医院, 位于南非约翰内斯堡的远郊, 那儿每年有八千个携有艾滋病病毒的母亲 临产 -- 一个医院就抵过一个国家.
And to realize that this is just the tip of an iceberg that when you compare everything here to South Africa, it just pales, because in South Africa, each year 300,000 mothers with HIV give birth to children. 想一想这只是冰山一角, 因此, 当你拿这里所发生的一切 与南非相比, 都显得不值一提, 因为,在南非, 每年就有30万携带艾滋病病毒的母亲 临产.
the tip of an iceberg:冰山一角; compare:v.比较;对比;n.比较;
So we talk about PMTCT, and we refer to PMTCT, prevention of mother to child transmission . 当我们谈到PMTCT, 我们所说的PMTCT, 即防止母子垂直传染.
refer:v.参考;涉及;提到;查阅; prevention:n.预防;阻止;妨碍; transmission:n.传输;传染;播送;发射;广播;传动装置;
I think there's an assumption amongst most people in the public that if a mother is HIV-positive, she's going to infect her child. 我想大部分公众会认为 如果一个母亲是艾滋病带菌者, 那么, 她就会把这个病毒传染给她的孩子.
assumption:n.假定;设想;担任;采取; amongst:prep.在…之中;在…当中(等于among);
The reality is really, very different. 这与事实却相去甚远.
In resource-rich countries, with all the tests and treatment we currently have, less than two percent of babies are born HIV-positive -- 98 percent of babies are born HIV-negative. 在资源富足的国家, 在我们现有的检测和治疗条件下, 仅有不到2%的婴儿生下来后艾滋病病毒检测是呈阳性. 98%的婴儿在生下来的时候艾滋病病毒检测是阴性.
treatment:n.治疗;疗法;对待;处理;讨论; currently:adv.当前;一般地;
And yet, the reality in resource-poor countries, in the absence of tests and treatment, 40 percent -- 40 percent of children are infected -- 40 percent versus two percent -- an enormous difference. 但是, 现实是在资源稀缺的国家, 在缺乏检测和治疗条件下, 40%, 40% 的孩子生下来就被感染了艾滋病病毒 -- 40% 比 2% -- 是相当大的差距.
in the absence of:缺乏,不存在;无…时,缺少…时; infected:adj.带菌的; v.传染; (infect的过去分词和过去式) versus:prep.对;与...相对;对抗; enormous:adj.庞大的,巨大的;凶暴的,极恶的;
So these programs -- and I'm going to refer to PMTCT though my talk -- these prevention programs, simply, they're the tests and the drugs that we give to mothers to prevent them from infecting their babies, and also the medicines we give to mothers to keep them healthy and alive to raise their children. 而这些项目-- 我将在我的讲话里称之为PMTCT -- 这些预防项目, 简单的说, 是指为母亲们提供检测和药物 来防止她们将病毒传染给她们的孩子, 同时, 我们也为母亲们提供药品 以便她们能够健康地活着并带大她们的孩子.
infecting:v.传染;使携带病菌;使感染;(infect的现在分词)
So it's the test a mother gets when she comes in. 所以, 母亲们来到这里时会接受这样一个检测,
It's the drugs she receives to protect the baby that's inside the uterus and during delivery . 这是给她的药品 用来保护婴儿在子宫里和生产过程中不受感染
uterus:n.[解剖]子宫; delivery:n.[贸易]交付;分娩;递送;
It's the guidance she gets around infant feeding and safer sex. 这是她所接受的关于哺乳 和性生活的辅导
infant:n.婴儿;幼儿;未成年人;adj.婴儿的;幼稚的;初期的;未成年的;
It's an entire package of services, and it works. 这是这一整套的服务, 而它是行而有效的.
So in the United States, since the advent of treatment in the middle of the 1990s, there's been an 80-percent decline in the number of HIV-infected children. 所以在美国, 自从上个世纪90年代中在艾滋病治疗上取得进步以后, 就实现了80%的减幅, 在艾滋病带菌儿童的数目上.
advent:n.到来;出现;基督降临;基督降临节; decline:v.下降;衰退;减少;谢绝;n.下降;
Less than 100 babies are born with HIV each year in the United States and yet, still, over 400,000 children are born every year in the world today with HIV. 仅有不到100个婴儿是生下来就带着艾滋病病毒的, 每年, 在美国. 但是, 目前 每年全球仍然有超过40万儿童 生下来就是艾滋病带菌者.
What does that mean? 这意味着什么呢?
It means 1,100 children infected each day -- 1,100 children each day, infected with HIV. 这意味着每天有1,100个儿童受感染 -- 每天1,100个儿童感染艾滋病病毒.
And where do they come from? 他们来自哪里呢?
Well, less than one comes from the United States. 这个, 来自美国的少于一个.
One, on average, comes from Europe. 平均来自欧洲的有一个.
100 come from Asia and the Pacific. 100个来自亚太地区.
And each day, a thousand babies -- a thousand babies are born each day with HIV in Africa. 而每天, 就有一千个携带艾滋病病毒的婴儿, 一千个, 在非洲出生.
So again, I look at the globe here and the disproportionate share of HIV in Africa. 因此, 当我再看看这张全球分布图 能看到, 非洲在艾滋病带菌者分布上的高比例.
And let's look at another map. 让我们来看另外一幅地图.
And here, again, we see 在这里我们再次看到
Africa has a disproportionate share of the numbers of doctors. 非洲的医生数量远远低于平均水平.
That thin sliver you see here, that's Africa. 那薄薄的银色部分, 就是非洲了.
And it's the same with nurses. 护士的数量也一样.
The truth is sub-Saharan Africa has 24 percent of the global disease burden and yet only three percent of the world's health care workers. 事实是, 在撒哈拉以南非洲 占了全球24% 的疾病分布 但是,却仅有3%的医护人员在这里工作.
disease:n.病,[医]疾病;弊病;vt.传染;使…有病; burden:n.负担;责任;船的载货量;v.使负担;烦扰;装货于; health care:n.卫生保健;
That means doctors and nurses simply don't have the time to take care of patients . 这意味着医生和护士 根本就没有时间去照顾病人.
patients:n.接受治疗者,病人;(patient的复数)
A nurse in a busy clinic will see 50 to 100 patients in a day, which leaves her just minutes per patient -- minutes per patient. 在一个繁忙的诊所里, 一个护士 每天要看50 到100 个病人, 在每个病人身上她只能花几分钟 -- 几分钟.
clinic:n.诊所;临床实习;(医院的)门诊部;门诊时间;
And so when we look at these PMTCT programs, what does it mean? 所以, 当我们重新谈及PMTCT项目的时候, 这意味着什么呢？
Well, back in 2001, when there was just a simple test and a single dose of a drug, a nurse, in the course of her few minutes with a patient, would have to counsel for the HIV test, perform the HIV test, 在2001年的时候, 那个时候只有一个简单的测试 和一剂药 每个护士, 在跟一个病人相处的短短的几分钟里, 她要对这个病人做艾滋病病毒检测,
dose:n.剂量;一剂,一服;v.服药;给药;给…服药; in the course of:在…过程中;在…期间; counsel:n.劝告,忠告,建议;法律顾问;律师;vt.提供专业咨询;建议,劝告(做某事) perform:v.表演;执行;履行;演出;工作,运转(好/不好);
explain the results, dispense a single dose of the drug, Nevirapine , explain how to take it, discuss infant feeding options , reinforce infant feeding, and test the baby -- in minutes. 解释检测结果, 配一剂药- Nevirapine, 向病人说明如何用药, 跟她讨论如何更好地哺育婴儿,, 还要在这几分钟里对婴儿进行检测.
dispense:v.分配;分发;提供;配药; Nevirapine:n.奈韦拉平(一种治疗爱滋病的药物); options:n.选择; v.得到或获准进行选择; (option的三单形式) reinforce:vt.加强,加固; vi.求援; n.加强;
Well, fortunately since 2001, we've got new treatments , new tests, and we're far more successful, but we don't have any more nurses. 幸好, 从2001年以后, 我们有了新的治疗方法, 新的检测手段, 我们的工作取得了很大的进步, 但我们没有更多的护士.
fortunately:adv.幸运地; treatments:n.治疗;疗法;对待;处理;讨论;(treatment的复数)
And so these are the tests a nurse now has to do in those same few minutes. 而这些测试是 一个护士必须完成的 在同样的短短几分钟里.
It's not possible -- it doesn't work. 这样不行. 这是没有效果的.
And so we need to find better ways of providing care. 我们必须想出 更好的方法来护理这些病人.
This is a picture of a maternal health clinic in Africa -- mothers coming, pregnant and with their babies. 这个图显示了非洲的产妇健康诊所-- 母亲们怀着她们的婴儿来到这些诊所.
maternal:adj.母亲的;母性的;母系的;母体遗传的;
These women are here for care, but we know that just doing a test, just giving someone a drug, it's not enough. 这些女人是来接受医疗护理的, 但是我们知道, 只做一个检测, 只给她们一份药, 是不够的.
Meds don't equal medical care. 药品并不等于医疗护理.
Meds:n.药物:
Doctors and nurses, frankly, don't have the time or skills to tell people what to do in ways they understand. 坦白说, 医生和护士, 没有足够的时间和技巧 用人们能够明白的途径来告诉他们该怎么做.
I'm a doctor -- I tell people things to do, and I expect them to follow my guidance -- because I'm a doctor; I went to Harvard -- but the reality is, if I tell a patient, "You should have safer sex. 我是一个医生. 我告诉人们该做的事, 而我也期待他们根据我的指引去做 -- 因为我是一个医生, 我在哈佛读过书 -- 但实际上, 如果我跟一个病人说, 你应该有更安全的性生活.
Harvard:n.哈佛大学;哈佛大学学生;
You should always use a condom ," 你应该一直使用避孕套,
condom:n.避孕套;阴茎套;
and yet, in her relationship, she's not empowered -- what's going to happen? 这不起作用, 因为在她和异性的关系里, 她并没有这种权力 -- 那接下来会发生什么呢?
empowered:v.授权;给(某人)…的权力;(empower的过去分词和过去式)
If I tell her to take her medicines every day and yet, no one in the household knows about her illness, so it's just not going to work. 如果我让她每天吃药, 但是, 她的家里没有人知道她的病, 那 这根本就不会起作用.
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;
And so we need to do more, we need to do it differently, we need to do it in ways that are affordable and accessible and can be taken to scale , which means it can be done everywhere. 所以我们必须做更多, 我们必须采用不同的途径, 我们必须通过更实际的 更可行的的和更容易被推广的方式来做这些事情, 这意味着它在什么地方都能使用.
affordable:adj.负担得起的; accessible:adj.易接近的;可进入的;可理解的; 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;
So, I want to tell you a story -- 所以,我要告诉你们一个故事.
I want to take you on a little trip. 我要带你们经历一段短暂的旅程
Imagine yourself, if you can, you're a young woman in Africa, you're going to the hospital or clinic. 如果可以的话,你想象一下, 你是一个年轻的非洲女性, 你要去一个医院或诊所.
You go in for a test and you find out that you're pregnant, and you're delighted . 你去做一个检测, 然后, 你发现你怀孕了, 你很兴奋.
go in for:参加,从事;追求;赞成; delighted:adj.高兴的; v.使高兴; (delight的过去分词和过去式)
And then they give you another test and they tell you you're HIV-positive, and you're devastated . 但他们又让你做了另外一个测试, 然后告诉你, 你对艾滋病病毒呈阳性反应, 你绝望了.
devastated:adj.不安的,混乱的,震惊的; v.彻底破坏; (devastate的过去分词和过去式)
And the nurse takes you into a room, and she tells you about the tests and HIV and the medicines you can take and how to take care of yourself and your baby, and you hear none of it. 护士把你带到一个房间里, 她跟你解释这些检测的项目, 解释什么是艾滋病,并告诉你该吃什么药, 怎么来照顾你自己和你的孩子, 但是你什么都听不进去.
All you're hearing is, "I'm going to die, and my baby is going to die." 你能听见的是, 我要死了, 我的宝宝也要死了.
And then you're out on the street , and you don't know where to go. 然后你走到街上, 你不知道要去什么地方,
out on the street:无家可归;失业;
And you don't know who you can talk to, because the truth is, HIV is so stigmatizing that if you partner, your family, anyone in your home, you're likely to be thrown out without any means of support. 你也不知道能跟谁倾诉, 因为现实是,艾滋病是那么让人忌违 你的另一半,你的家人,家里任何一个人, 如果知道这件事的话, 你就很有可能会被赶出去 无依无靠.
And this -- this is the face and story of HIV in Africa today. 而这个, 这个就是 今天艾滋病病人在非洲的处境, 以及她们的故事.
But we're here to talk about possible solutions and some good news. 但我们接下来还要谈可能的解决方案 以及一些好消息.
And I want to change the story a little bit. 而我要把这个故事稍稍改动一下.
Take the same mother, and the nurse, after she gives her her test, takes her to a room. 还是那个母亲, 还是那个护士。护士在给那个母亲做完检测以后, 把她带到一个房间.
The door opens and there's a room full of mothers, mothers with babies, and they're sitting, and they're talking, they're listening. 房间的门打开, 房间里都是母亲,带着婴儿的母亲, 她们坐在那里,谈话和聆听.
They're drinking tea, they're having sandwiches. 她们在喝茶,她们在吃三文治.
And she goes inside, and woman comes up to her and says, "Welcome to mothers2mothers. 她走进去, 女人们都过来跟她说, 欢迎来到 mothers2mothers.
Have a seat. You're safe here. 请坐下来. 你在这里很安全.
We're all HIV-positive. 我们都是艾滋病带菌者.
You're going to be okay. You're going to live. 你不会有事的, 你会生存下去.
Your baby is going to be HIV-negative." 你的宝宝不会成为艾滋病带菌者.
We view mothers as a community's single greatest resource . 在我们的眼中,母亲们 是这里最宝贵的资源.
resource:n.资源;资料;才智;财力;v.向…提供资金(或设备);
Mothers take care of the children, take care of the home. 她们照顾孩子,照顾家.
So often the men are gone. 经常,男人们出去了.
They're working, or they're not part of the household. 他们在外面工作, 或者并不跟孩子的母亲住在一起.
Our organization , mothers2mothers, enlists women with HIV as care providers . 我们的组织, mothers2mothers, 招募带有艾滋病病毒的女性 来这里护理其他人。
organization:n.组织;机构;体制;团体; enlists:vi.支持;从军;应募;赞助;vt.使入伍;征募;谋取…的赞助或帮助; providers:n.供应者;提供者;供养人;(provider的复数)
We bring mothers who have HIV, who've been through these PMTCT programs in the very facilities , to come back and work side by side with doctors and nurses as part of the health care team. 我们让那些带有艾滋病病毒的母亲, 她们已经通过PMTCT项目 特定疗程的治疗, 让她们回来和医生护士并肩工作 成为医疗护理队伍的一分子.
facilities:n.设施;设备;特别装置;特色;场所;(facility的复数) side by side:adj.并肩的;并行的;
These mothers, we call them mentor mothers, are able to engage women who, just like themselves, pregnant with babies, have found out about being HIV-positive, who need support and education. 这些母亲们,我们称她们为母亲指导员, 她们能够帮助那些 就像她们自己一样, 怀着孩子, 但又被发现是艾滋病带菌者, 需要支持和相关知识辅导的母亲.
mentor:n.指导者,良师益友;vt.指导; engage:v.吸引,占用;使参加;雇佣;使订婚;预定;
And they support them around the diagnosis and educate them about how to take their medicines, how to take care of themselves, how to take care of their babies. 在诊疗的过程中, 她们提供的支持还包括: 教她们怎样用药, 如何照顾她们自己, 如何照顾她们的孩子.
diagnosis:n.诊断;
Consider: if you needed surgery , you would want the best possible technical surgeon , right? 试想一下: 如果你需要手术, 你会要技术最好的外科医生来帮你做手术, 对吧.
surgery:n.外科;外科手术;手术室;诊疗室; technical:adj.工艺的,科技的;技术上的;专门的; surgeon:n.外科医生;
But if you wanted to understand what that surgery would do to your life, you'd like to engage someone, someone who's had the procedure . 但是如果你想搞清楚 这个手术会对你的生活带来怎样的影响, 你该会希望能够与那些 做过这个手术的人沟通。
procedure:n.步骤;手术;(商业、法律或政治上的)程序;
Patients are experts on their own experience, and they can share that experience with others. 久病成医, 病人之间可以分享自己的经验.
This is the medical care that goes beyond just medicines. 这是仅仅靠吃药无法达到的医疗护理.
So the mothers who work for us, they come from the communities in which they work. 所以这些为我们工作的母亲, 她们来自于她们工作所在的地区.
communities:n.社区;社会;团体;共有(community的复数)
They're hired -- they're paid as professional members of the health care teams, just like doctors and nurses. 她们受雇成为职业医疗护理队伍的一员, 就像医生和护士一样.
professional:adj.专业的;职业的;职业性的;n.专业人员;职业运动员;
And we open bank accounts for them and they're paid directly into the accounts, because their money's protected; the men can't take it away from them. 我们为她们开了银行帐户, 她们的薪水是直接存到她们的帐户里, 这样她们的钱就是安全的; 男人们不能把这些钱从她们身上拿走.
directly:adv.直接地;立即;马上;正好地;坦率地;conj.一…就;
They go through two to three weeks of rigorous curriculum-based education, training. 她们会接受两到三周的 严格的课程式教育和训练.
rigorous:adj.严格的,严厉的;严密的;严酷的;
Now, doctors and nurses -- they too get trained. 现在, 医生和护士也会接受培训.
But so often, they only get trained once, so they're not aware of new medicines, new guidelines as they come out. 但是经常, 他们只受到一次培训, 所以他们并不了解最新的医药, 和最新出来的医疗指导
guidelines:n.指导方针;参考;
Our mentor mothers get trained every single year and retrained . 我们的母亲指导员们每年都要接受培训 和再培训.
retrained:vt.重新教育;再教育;vi.再训练;再教育;
And so doctors and nurses -- they look up to them as experts. 所以医生和护士, 他们把这些母亲指导员看成专家.
look up to:尊敬;
Imagine that: a woman, a former patient, being able to educate her doctor for the first time and educate the other patients that she's taking care of. 想象一下: 一个女人, 之前是病人, 现在却能够开始教她的医生 还有其他病人 -- 那些由她照顾的病人.
Our organization has three goals. 我们的组织有三个目标.
The first, to prevent mother-to-child transmission. 第一: 防止母子垂直传染.
The second: keep mothers healthy, keep mothers alive, keep the children alive -- no more orphans . 第二: 保持母亲健康, 让她们生存下去. 让孩子生存下去. 再也不让他们成为孤儿了.
orphans:n.孤儿(orphan的复数);v.成为孤儿(orphan的三单形式);
And the third, and maybe the most grand, is to find ways to empower women, enable them to fight the stigma and to live positive and productive lives with HIV. 第三, 或许是最高的目标, 就是给这些女性予力量, 让她们克服羞耻感, 积极向上、更好地活着, 即使她们是艾滋病患者.
enable:v.使能够;使有机会;使成为可能;使可行; positive:adj.积极的;[数]正的,[医][化学]阳性的;确定的;n.正数;[摄]正片; productive:adj.能生产的;生产的,生产性的;多产的;富有成效的;
So how do we do it? 那我们怎样做到这些呢?
Well, maybe the most important engagement is the one-to-one , seeing patients one-to-one , educating them, supporting them, explaining how they can take care of themselves. 也许最重要的尝试就是, 一对一的沟通, 一对一的看望病人, 教他们, 支持她们, 告诉她们如何去照顾自己.
engagement:n.婚约;约会;交战;诺言;n.参与度; one-to-one:adj.一对一的;一一对应的;
We go beyond that; we try to bring in the husbands, the partners. 我们所做的还不仅限于此. 我们尝试让丈夫们或者配偶们加入进来.
In Africa, it's very, very hard to engage men. 在非洲, 我们很难说动男人, 让他们参与进来.
Men are not frequently part of pregnancy care. 一般男人们都不是孕期护理的一分子.
frequently:adv.频繁地,经常地;时常,屡次; pregnancy:n.怀孕;丰富,多产;意义深长;
But in Rwanda, in one country, they've got a policy that a woman can't come for care unless she brings the father of the baby with her -- that's the rule. 但是在卢旺达, 就在这个国家, 他们制定了一个政策, 即, 一个女人单凭自身是无法获得这里的医疗护理, 除非, 她将孩子的父亲也一并带来. 这是规定.
policy:n.政策,方针;保险单;
And so the father and the mother, together, go through the counseling and the testing. 因此, 孩子的父亲和母亲将一起, 接受咨询辅导和疾病检测.
counseling:n.咨询服务;v.建议;劝告;商讨;(counsel的现在分词形式)
The father and the mother, together, they get the results. 同样, 孩子的父亲和母亲将一起面对检测结果.
And this is so important in breaking through the stigma. 这样做对于克服羞耻感是相当重要的一步.
Disclosure is so central to prevention. 披露病情对疾病防预是很关键的环节.
Disclosure:n.揭露;透露;公开;公开的事情;
How do you have safer sex, how do you use a condom regularly if there hasn't been disclosure? 你如何能拥有更安全的性生活, 如何能有规律地使用避孕套? 如果没有披露病情的话.
regularly:adv.经常地;有规律地;定期的
Disclosure is so important to treatment, because again, people need the support of family members and friends to take their medicines regularly. 公开病情对治疗是如此的重要, 因为, 同样的, 人们需要家人和朋友的支持 以帮助他们定期用药.
We also work in groups. 我们也通过团队的方式来完成这些工作.
Now the groups, it's not like me lecturing, but what happens is women, they come together -- under the support and guidance of our mentor mothers -- they come together, and they share their personal experiences. 现在, 这些团队,并这不像我在讲课一样, 而是, 女人们自己走到一起, 通过我们的母亲指导员的支持和引导 她们走到一起, 分享各自的经验.
personal:adj.个人的;身体的;亲自的;n.人事消息栏;人称代名词;
And it's through the sharing that people get tactics of how to take care of themselves, how to disclose how to take medicines. 正是通过这种交流, 人们学会如何照顾自己, 如何披露自己的病情, 如何用药.
tactics:n.战术:策略:手段:兵法(tactic的复数) disclose:vt.公开;揭露;
And then there's the community outreach , engaging women in their communities. 还能在当地起到示范效应, 鼓励当地的女性参与进来.
outreach:vt.超越,伸出; vi.拓广,延伸; n.延伸,拓广; adj.扩大服务的; engaging:adj.有趣的; v.吸引住(注意力、兴趣); (engage的现在分词)
If we can change the way households believe and think, we can change the way communities believe and think. 如果我们能够改变 每一户人家的所信和所想, 我们就能改变这个地区人们的所信和所想.
households:n.家庭;拆迁户;家户(household的复数);
And if we can change enough communities, we can change national attitudes . 如果我们能够改变足够多的区域, 我们就能改变整个国家的态度.
attitudes:n.态度,看法(attitude复数);
We can change national attitudes to women and national attitudes to HIV. 我们能够改变整个国家对女性的态度 以及他们对艾滋病病毒的态度.
The hardest barrier really is around stigma reduction . 其实最大的困难是减轻人们对艾滋病病毒的羞耻感.
barrier:n.屏障;障碍;障碍物;关口;v.用栅围住; reduction:n.减少;缩小;降低;减价;折扣;缩图;
We have the medicines, we have the tests, but how do you reduce the stigma? 我们有药品, 我们有疾病检测。 但是我们如何减轻人们的羞耻感呢?
And it's important about disclosure. 而这对病情能否披露又很重要.
So, a couple years ago, one of the mentor mothers came back, and she told me a story. 所以, 几年前, 有一个母亲指导员回来找我们, 她跟我讲了一个故事.
She had been asked by one of the clients to go to the home of the client, because the client wanted to tell the mother and her brothers and sisters about her HIV status , and she was afraid to go by herself. 她的一个病人请求她 到这个病人的家里, 因为这个病人要告诉她的母亲,兄弟和姐妹 她的艾滋病病情, 但她害怕一个人去.
clients:n.委托人;当事人;客户机;(client的复数) status:n.地位;状态;情形;重要身份;
And so the mentor mother went along with. 所以这个母亲指导员就跟着去了.
And the patient walked into the house and said to her mother and siblings , "I have something to tell you. I'm HIV-positive." 这病人走进屋子里 跟她的母亲和兄弟姐妹说: 我想告诉你们一些事. 我是艾滋病带菌者.
siblings:n.兄;弟;姐;妹;(sibling的复数)
And everybody was quiet. 这时, 每个人都很安静.
And then her oldest brother stood up and said, "I too have something to tell you. 随后, 她最大的哥哥站起来说: 我也有些事要告诉你们.
I'm HIV-positive. 我是艾滋病带菌者.
I've been afraid to tell everybody." 我一直不敢告诉大家.
And then this older sister stood up and said, "I too am living with the virus, and I've been ashamed ." 然后她的大姐站起来说, 我也带着这种病毒, 我一直觉得很羞耻.
ashamed:adj.惭愧;尴尬;因惭愧而不情愿;
And then her younger brother stood up and said, "I'm also positive. 然后比她年轻一些的弟弟也站起来说, 我也是呈阳性.
I thought you were going to throw me out of the family." 我以为你们会把我赶出这个家.
And you see where this is going. 你可以看出事情是如何发展的.
The last sister stood up and said, "I'm also positive. 最后一个妹妹站起来说, 我也是呈阳性的.
I thought you were going to hate me." 我以为你们都会讨厌我.
And there they were, all of them together for the first time being able to share this experience for the first time and to support each other for the first time. 就这样, 他们一家人终于 能够一起分享经验, 也首次能够彼此互相支持.
(Video) Female Narrator : Women come to us, and they are crying and scared. (视屏) 女声: 女人们来找我们, 她们都在哭,很害怕。
Female:adj.女性的;雌性的;柔弱的,柔和的;n.女人;[动]雌性动物; Narrator:n.讲述者;(电视节目中的)幕后解说员;旁白员;
I tell them my story, that I am HIV-positive, but my child is HIV-negative. 我告诉她们我的故事, 我是个艾滋病带菌者, 但是我的孩子没有染上艾滋病病毒.
I tell them, "You are going to make it, and you will raise a healthy baby." 我告诉她们, 你们都能够生存下去, 你们都会有一个健康的孩子.
I am proof that there is hope. 我自己就是证明, 证明希望是存在的.
proof:n.证据;证实;adj.能抵御;可防护;
Mitchell Besser: Remember the images I showed you of how few doctors and nurses there are in Africa. Mitchell Besser: 记住我给你们看的图像, 在非洲, 那里的医生和护士是多么稀缺.
images:n.印象;声誉;形象;画像;雕像;(image的第三人称单数和复数)
And it is a crisis in health care systems. 这是一个当地医疗护理系统所存在的危机.
crisis:n.危机;危险期;决定性时刻;adj.危机的;用于处理危机的;
Even as we have more tests and more drugs, we can't reach people; we don't have enough providers. 就算我们有更多的检测手段和药品, 我们也难以遍及这么多人; 我们没有足够的人手.
So we talk in terms of what we call task-shifting. 所以, 我们提及所谓的任务转移.
Task-shifting is traditionally when you take health care services from one provider and have another provider do it. 任务转移在传统上即 你在这个医疗服务提供者这里得到了 由另外一个人为你提供的医疗服务.
traditionally:adv.传统上;习惯上;传说上;
Typically , it's a doctor giving a job to a nurse. 比如,一个医生将工作交给一个护士去完成.
Typically:adv.代表性地;作为特色地;
And the issue in Africa is that there are fewer nurses, really than doctors, and so we need to find new paradigm for health care. 但在非洲, 问题是 那里的护士却比医生要少, 所以我们要找到新的方式来提供医疗服务.
issue:n.重要议题;争论的问题;v.宣布;公布;发出;发行; paradigm:n.范例;词形变化表;
How do you build a better health care system? 如何才能建立一个更好的医疗服务体系呢?
We've chosen to redefine the health care system as a doctor, a nurse and a mentor mother. 我们选择将医疗服务体系重新界定为 由医生,护士和母亲指导员组合在一起的体系.
redefine:vt.重新定义;
And so what nurses do is that they ask the mentor mothers to explain how to take the drugs, the side effects. 护士们所做的 就是安排母亲指导员, 去告诉病人 如何用药,有什么副作用.
They delegate education about infant feeding, family planning , safer sex, actions that nurses simple just don't have time for. 母亲指导员教病人喂养婴儿, 做生育计划, 并实现安全的性生活, 这些都是护士们没有时间去做的事.
delegate:n.代表; v.授(权); family planning:n.计划生育;家庭计划;
So we go back to the prevention of mother to child transmission. 现在我们回到防止母子传染这个话题上来.
The world is increasingly seeing these programs as the bridge to comprehensive maternal and child health. 人们越来越倾向于将这些项目看作是 通向实现母子全面健康的桥梁.
increasingly:adv.越来越多地;渐增地; comprehensive:adj.综合的;广泛的;有理解力的;n.综合学校;专业综合测验;
And our organization helps women across that bridge. 我们的组织则 帮助女性跨过这座桥梁.
The care doesn't stop when the baby's born -- we deal with the ongoing health of the mother and baby, ensuring that they live healthy, successful lives. 这些护理并不会因为婴儿的出生就停止. 我们继续关注母亲和婴儿的健康, 让他们过上健康、 美好的生活.
ongoing:n.发展; adj.持续存在的; ensuring:v.保证;确保;担保(ensure的现在分词);
Our organization works on three levels. 我们的组织在三个层面上工作.
The first, at the patient level -- mothers and babies keeping babies from getting HIV, keeping mothers healthy to raise them. 第一, 在病人层面上-- 着眼于母亲和孩子, 保护孩子, 不让他们感染艾滋病病毒, 让母亲能够健康地养育他们.
The second, communities -- empowering women. 第二, 社区层面 -- 鼓励女性, 给她们力量.
empowering:v.授权;给(某人)…的权力;增加(某人的)自主权;(empower的现在分词)
They become leaders within their communities. 让她们成为所在地区团体的领导.
They change the way communities think -- we need to change attitudes to HIV. 去改变当地人们的的看法. 我们需要改变人们对艾滋病病毒的态度.
We need to change attitudes to women in Africa. 我们需要改变非洲人们对女性的态度.
We have to do that. 我们必须做到这点.
And then rework the level of the health care systems, building stronger health care systems. 然后重新运作医疗服务体系, 在这个层面, 建立更健全的医疗保健系统.
rework:vt.重做;修订;
Our health care systems are broken. 我们的医疗服务体系存在诸多漏洞.
They're not going to work the way they're currently designed. 以现有的架构, 他们是难以起到作用的.
And so doctors and nurses who need to try to change people's behaviors don't have the skills, don't have the time -- our mentor mothers do. 因此,当医生和护士们, 当他们没有技巧, 也没有时间去帮助人们 改变相应行为时, 我们的母亲指导员们能做到这些.
And so in redefining the health care teams by bringing the mentor mothers in, we can do that. 所以,通过将母亲指导员引入医疗服务体系, 我们能做到这点.
redefining:v.改变…的本质(或界限);重新定义;使重新考虑;(redefine的现在分词)
I started the program in Capetown, South Africa back in 2001. 我在南非开普敦开始了这个项目, 在2001年时,
It was at that point, just the spark of an idea. 在那个时候, 这只是一个思想的火花.
spark:n.火花;电火花;火星;活力;v.引发;触发;冒火花;飞火星;
Referencing Steven Johnson's very lovely speech yesterday on where ideas come from, 想到Steven Johnson昨天所做的演讲 关于好主意的来源,
Referencing:v.参考;查阅;给(书等)附参考资料;(reference的现在分词)
I was in the shower at the time -- 当这个思想火花闪现时,我正在洗澡.
I was alone. 只有我一个人.
(Laughter) (笑声)
The program is now working in nine countries, we have 670 program sites , we're seeing about 230,000 women every month, we're employing 1,600 mentor mothers, and last year, they enrolled 300,000 HIV-positive pregnant women and mothers. 这个项目现正在九个国家推广. 我们有670个项目点. 我们每月接见大概23万 女性. 我们聘请1,600个母亲指导员. 去年,她们共照看了 30万个带有艾滋病病毒的孕妇和母亲.
sites:n.网站(site的复数);遗址,举办地点;v.使...位于(site的单三形式); enrolled:v.(使)加入;注册;登记;(enroll的过去分词和过去式)
That is 20 percent of the global HIV-positive pregnant women -- 20 percent of the world. 这占到了全球20%的 感染艾滋病病毒的怀孕妇女, 全世界的20%.
What's extraordinary is how simple the premise is. 不可思议的是它的基本构思是多么的简单.
extraordinary:adj.非凡的;特别的;离奇的;临时的;特派的; premise:n.前提;假定;v.假定;预述(条件等);引导(论述等);;
Mothers with HIV caring for mothers with HIV. 用带有艾滋病毒的母亲来照顾带有艾滋病毒的母亲.
Past patients taking care of present patients. 过去的病人来照顾现在的病人.
And empowerment through employment -- reducing stigma. 和通过雇佣关系来给予他们权威和力量, 减少忌讳和羞耻感.
empowerment:n.许可,授权; employment:n.使用;职业;雇用;
(Video) Female Narrator: There is hope, hope that one day we shall win this fight against HIV and AIDS. (视屏)女声: 我们希望, 希望有一天 我们能赢得这场 对抗艾滋病病毒和艾滋病的战斗.
Each person must know their HIV status. 每一个人都必须清楚 他们的艾滋病病毒感染情况.
Those who are HIV-negative must know how to stay negative . 那些不带有艾滋病菌的人 必须知道怎样让自己不感染上艾滋病病毒.
negative:adj.[数]负的;消极的;否定的;阴性的;n.否定;负数;[摄]底片;v.否定;拒绝;
Those who are HIV-infected must know how to take care of themselves. 那些受到艾滋病感染的人 必须知道怎样 来照顾他们自己.
HIV-positive pregnant women must get PMTCT services in order to have 带有艾滋病病毒的怀孕母亲 必须通过PMTCT治疗 以生出
HIV-negative babies. 不带艾滋病病毒的婴儿.
All of this is possible, if we each contribute to this fight. 所有这些都是有可能的, 如果我们每个人都投入这场战斗.
contribute to:有助于;捐献;
MB: Simple solutions to complex problems. MB: 用简单的方法来解决复杂的问题.
complex:adj.复杂的;合成的;n.复合体;综合设施;
Mothers caring for mothers. 母亲照顾母亲.
It's transformational . 这将带来伟大的变革.
transformational:adj.转换的;改变的;转换生成的;
Thank you. 谢谢你们.
(Applause) (鼓掌)