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SoniaShah_2013G-_我们仍然没有清除疟疾的三个原因_
So over the long course of human history, the infectious disease that's killed more humans than any other is malaria . 在漫长的人类历史中, 疟疾是 致死率最高的传染性疾病。
infectious:adj.传染的;传染性的;易传染的; disease:n.病,[医]疾病;弊病;vt.传染;使…有病; malaria:n.[内科]疟疾;瘴气;
It's carried in the bites of infected mosquitos , and it's probably our oldest scourge . 它由受感染的蚊子叮咬传播, 可能是人类最古老的灾难了。
infected:adj.带菌的; v.传染; (infect的过去分词和过去式) mosquitos:n.蚊子(mosquito的变形); scourge:vt.鞭打;蹂躏;严斥;痛斥;n.鞭;灾祸;鞭子;苦难的根源;
We may have had malaria since we evolved from the apes . 从人猿时代起疟疾可能就已经存在了。
evolved:v.(使)逐渐形成;进化;进化形成;(evolve的过去分词和过去式) apes:n.[脊椎]猿;猩猩;类人猿(ape的复数);v.模仿;仿效(ape的三单形式);
And to this day , malaria takes a huge toll on our species . 直至今天,疟疾已经夺去了许多许多人的生命。
to this day:至今; toll:n.伤亡人数; v.(缓慢而有规律地)敲(钟); (尤指)鸣(丧钟); species:n.[生物]物种;种类;
We've got 300 million cases a year and over half a million deaths. 每年有3亿人疟疾患者, 其中有超过50万人死亡,
Now this really makes no sense. 这真让人匪夷所思。
We've known how to cure malaria since the 1600s. 自17世纪起, 我们就已经知道如何治疗疟疾。
That's when Jesuit missionaries in Peru discovered the bark of the cinchona tree, and inside that bark was quinine , still an effective cure for malaria to this day. 耶稣会传教士在秘鲁 发现金鸡纳树的树皮。 金鸡纳树树皮中的奎宁可以治疗疟疾, 这种方法至今有效。
Jesuit:n.[天主]耶稣会会士;虚伪狡诈的人(等于jersuit); missionaries:n.传教士;工作人员(missionary的复数); bark:n.树皮; v.(狗)吠叫; cinchona:n.金鸡纳树皮;金鸡纳树; quinine:n.奎宁;金鸡纳碱; effective:adj.有效的,起作用的;实际的,实在的;给人深刻印象;
So we've known how to cure malaria for centuries. 所以,我们知道如何治疗疟疾已经有几个世纪的时间了。
We've known how to prevent malaria since 1897. 从1897年开始,我们就知道如何预防疟疾。
That's when the British army surgeon Ronald Ross discovered that it was mosquitos that carried malaria, not bad air or miasmas , as was previously thought. 那时英国军队外科医生罗纳德-罗斯 发现了是蚊子传染疟疾, 而不是之前认为的空气质量或雾霾问题
surgeon:n.外科医生; miasmas:n.瘴气;臭气;不良影响; previously:adv.先前;以前;
So malaria should be a relatively simple disease to solve, and yet to this day, hundreds of thousands of people are going to die from the bite of a mosquito. 所以,疟疾应该是一种容易攻克的疾病, 但直到今天,仍然有成千上万的人 因为被一只蚊子叮咬而丧命。
relatively:adv.相当程度上;相当地;相对地;
Why is that? 为什么呢？
This is a question that's personally intrigued me for a long time. 这是一个很长时间以来 一直在困惑我的一个问题。
personally:adv.个人;亲自;本人;就本人而言; intrigued:adj.感兴趣的; v.密谋; (intrigue的过去式和过去分词)
I grew up as the daughter of Indian immigrants visiting my cousins in India every summer, and because I had no immunity to the local malarias, 我来自一个印度移民家庭, 每年夏天,我会去印度看望我的表兄弟姐妹们, 因为我对当地的疟疾没有免疫力,
immigrants:n.移民(immigrant的复数); immunity:n.免疫力;豁免权;免除;
I was made to sleep under this hot, sweaty mosquito net every night while my cousins, they were allowed to sleep out on the terrace and have this nice, cool night breeze wafting over them. 每晚我不得不睡在那种非常闷热的蚊帐里, 但我的表兄弟姐妹们却可以被允许 在露台上睡觉, 在露台上睡觉,
sweaty:adj.出汗的;吃力的;使人出汗的; mosquito net:n.蚊帐; terrace:n.平台;梯田;阳台;v.使成梯田,使成阶地;使有平台屋顶;adj.(女服)叠层式的; breeze:n.微风;和风;轻而易举的事;v.轻盈而自信地走; wafting:v.(随风)飘荡;使飘荡;吹拂;(waft的现在分词)
And I really hated the mosquitos for that. 因为这个,我特别痛恨蚊子。
But at the same time , I come from a Jain family, and Jainism is a religion that espouses a very extreme form of nonviolence . 但与此同时,我也是来自一个耆那教的家庭, 耆那教是一个极其信奉 非暴力形式的宗教。
at the same time:同时;另一方面;与此同时; espouses:vt.支持;嫁娶;赞成;信奉; extreme:adj.极端的;极度的;偏激的;尽头的;n.极端;末端;最大程度;极端的事物; nonviolence:n.非暴力;非暴力事件;
So Jains are not supposed to eat meat. 所以,耆那教徒不吃肉。
supposed:adj.误信的;所谓的;v.认为;假设;设想;(suppose的过去分词和过去式)
We're not supposed to walk on grass, because you could, you know, inadvertently kill some insects when you walk on grass. 不能在草地上走, 因为那样的话 你无意中会杀死一些昆虫。
inadvertently:adj.非故意地,无心地;
We're certainly not supposed to swat mosquitos. 当然,我们也不能打蚊子。
So the fearsome power of this little insect was apparent to me from a very young age, and it's one reason why I spent five years as a journalist trying to understand, why has malaria been such a horrible scourge for all of us for so very long? 所以,这小小的昆虫所拥有的如此可怕的力量, 在我很小时候就令我印象深刻, 而这也是为什么我作为一名记者 花了五年时间去尝试了解 为什么疟疾会成为人类持续的灾难。
fearsome:adj.可怕的;害怕的;极大的; apparent:adj.显然的;表面上的; journalist:n.新闻工作者;报人;记日志者; horrible:可怕的,极讨厌的,
And I think there's three main reasons why. 我认为主要有三个原因,
Those three reasons add up to the fourth reason, which is probably the biggest reason of all. 这三个原因共同导致第四个原因, 而这第四个可能就是其中的主导因素。
The first reason is certainly scientific . 第一个原因是科学相关的。
scientific:adj.科学的,系统的;
This little parasite that causes malaria, it's probably one of the most complex and wily pathogens known to humankind . 这种引起疟疾的小小的病原寄生虫, 可能是人类已知的最复杂 最狡猾的病原体之一。
parasite:n.寄生虫;食客; complex:adj.复杂的;合成的;n.复合体;综合设施; wily:adj.狡猾的;诡计多端的; pathogens:n.[基医]病原体;病原菌;[基医]致病菌; humankind:n.人类(总称);
It lives half its life inside the cold-blooded mosquito and half its life inside the warm-blooded human. 它生命的一半时间生活在冷血动物――蚊子体内, 另一半生命则生活在恒温动物――人类体内。
cold-blooded:adj.[生理]冷血的;残酷的,无情的;怕冷的; warm-blooded:adj.(动物)温血的;热血的;恒温的;热情的;易兴奋的;
These two environments are totally different, but not only that , they're both utterly hostile . 这是两种完全不同的环境, 而且它们在两种环境下都是有害的。
only that:只是;要不是; utterly:adv.完全地;绝对地;全然地;彻底地,十足地; hostile:adj.敌意的; n.敌对分子;
So the insect is continually trying to fight off the parasite, and so is the human body continually trying to fight it off. 因此,昆虫不断试图击退寄生虫, 人类的身体也不断地尝试抵抗它。
continually:adv.不断地;频繁地;
This little creature survives under siege like that, but not only does it survive, it has thrived . 这种小小的生物体正是在这种围困下生存下来, 而且还在蓬勃发展。
creature:n.生物;动物;(具有某种特征的)人; siege:n.围攻;包围;围城;不断袭击;长期努力;vt.围攻;包围; thrived:v.兴盛,繁荣(thrive的过去式和过去分词形式);
It has spread. It has more ways to evade attack than we know. 它拥有超过我们想象的更多方法来逃避攻击,继而传播蔓延。
evade:vt.逃避;躲避;逃脱;回避;想不出
It's a shape-shifter , for one thing . 就某一方面而言,这是一种蜕变。
shape-shifter:变形人; for one thing:首先;一则;
Just as a caterpillar turns into a butterfly, the malaria parasite transforms itself like that seven times in its life cycle . 就像一条毛毛虫变成一只蝴蝶, 疟疾寄生虫在其生命中有7次 这样的蜕变。
caterpillar:n.[无脊椎]毛虫;履带车;adj.有履带装置的; transforms:v.[数][电]变换; n.语法转化规则; life cycle:n.生命周期;寿命(产品等从开发到使用完毕的一段时间);
And each of those life stages not only looks totally different from each other, they have totally different physiology . 各个生命阶段不只形态迥异, 而且都有完全不同的生理状态。
physiology:n.生理学;生理机能;
So say you came up with some great drug that worked against one stage of the parasite's life cycle. 所以,当你找到一种很强大的药物 来对抗这种疟疾寄生虫生命周期的某一个阶段,
It might do nothing at all to any of the other stages. 但对其他生命阶段可能完全无效。
It can hide in our bodies, undetected , unbeknownst to us, for days, for weeks, for months, for years, in some cases even decades. 它隐藏在我们的体内,不被发现, 瞒着我们,几天、几个星期、 几个月、几年,有时甚至是几十年。
undetected:adj.未被发现的;未检测到的; unbeknownst:adv.不知地;adj.不知的;
So the parasite is a very big scientific challenge to tackle , but so is the mosquito that carries the parasite. 所以这种疟疾寄生虫对科学研究而言形成巨大挑战, 携带疟疾寄生虫的蚊子也如此。
tackle:v.处理; n.用具;
Only about 12 species of mosquitos carry most of the world's malaria, and we know quite a bit about the kinds of watery habitats that they specialize in . 只有大约12种的蚊子 携带了世界上大部分的疟疾, 我们知道 它们擅长生活在有水的栖息地。
watery:adj.水的;淡的;湿的;松软的;有雨意的; habitats:n.[生态]栖息地;(动植物的)[经]产地(habitat的复数形式); specialize in:专门研究…;
So you might think, then, well, why don't we just avoid the places where the killer mosquitos live? Right? 所以,你可能会认为, 我们可以避开蚊子滋生的地方,对吧？
We could avoid the places where the killer grizzly bears live and we avoid the places where the killer crocodiles live. 我们可以不接近凶猛灰熊的住地 也可以远离凶悍鳄鱼的活动区域。
grizzly:adj.灰色的;n.灰熊; crocodiles:n.鳄类,鳄鱼(crocodile的复数形式);
But say you live in the tropics and you walk outside your hut one day and you leave some footprints in the soft dirt around your home. 但如果你生活在热带地区 某天你在自家的房屋外面走 脚印留在了 门口的泥土上。
tropics:n.热带地区; hut:n.小屋;木屋;[军事]临时营房;[美俚]牢房;v.(使)住临时营房[小屋]; footprints:n.脚印;足迹;空间量,面积;(通信卫星)覆盖区;(footprint的复数) dirt:n.污垢;尘土;下流话;
Or say your cow does, or say your pig does, and then, say, it rains, and that footprint fills up with a little bit of water. 又或是你的牛或猪在土中留下了一些蹄印, 然后,下雨了, 那些印记里积满了水。
That's it. You've created the perfect malarial mosquito habitat that's right outside your door. 就这样,你已经为那些疟疾蚊子 在你家门口打造了完美的栖息地。
malarial:adj.患疟疾的;毒气的;
So it's not easy for us to extricate ourselves from these insects. 所以说,我们要摆脱这些昆虫并不容易。
extricate:v.(使)摆脱;解救;救出;挣脱;
We kind of create places that they love to live just by living our own lives. 我们生活, 其实也在为它们创建合适的生活环境。
So there's a huge scientific challenge, but there's a huge economic challenge too. 所以,这对科学来说是个巨大挑战, 对于经济来说,也同样是一个巨大挑战。
economic:adj.经济的,经济上的;经济学的;
Malaria occurs in some of the poorest and most remote places on Earth, and there's a reason for that. 疟疾发生在地球上那些最贫穷的 和最偏僻的地方, 这是有原因的。
occurs:v.重现(occur的第三人称单数); remote:adj.偏远的;偏僻的;遥远的;久远的;
If you're poor, you're more likely to get malaria. 如果你很穷,你更有可能患上疟疾。
If you're poor, you're more likely to live in rudimentary housing on marginal land that's poorly drained . 因为你的贫穷使你更可能生活 在贫瘠偏远地区简陋的房屋中,那里的排水往往不好,
rudimentary:adj.基本的;初步的;退化的;残遗的;未发展的; marginal:adj.边缘的;临界的;末端的; drained:adj.精疲力竭; v.排空; (drain的过去分词和过去式)
These are places where mosquitos breed . 也正是是滋生蚊子的好地方。
breed:v.繁殖;孕育;培育(动植物);导致;以…方式教育;n.品种;
You're less likely to have door screens or window screens. 你不太可能有门或窗户的屏障。
You're less likely to have electricity and all the indoor activities that electricity makes possible, so you're outside more. 你不太可能有电 所有通过电力所产生的室内活动都不太可能有, 所以你会更多在户外待着,
electricity:n.电力;电流;强烈的紧张情绪; indoor:adj.(在)室内的;在户内进行的;在室内用的;
You're getting bitten by mosquitos more. 更多地被蚊子叮咬。
So poverty causes malaria, but what we also know now is that malaria itself causes poverty. 所以说贫穷导致疟疾。 但我们也知道 疟疾本身也会导致贫困。
poverty:n.贫困;困难;缺少;低劣;
For one thing, it strikes hardest during harvest season, so exactly when farmers need to be out in the fields collecting their crops, they're home sick with a fever. 一方面,疟疾爆发最严重的时间是在收获季节, 说以正当农民要在田地里收割庄稼的季节 他们经常会发烧生病在家。
But it also predisposes people to death from all other causes. 当然这也容易引起其它疾病 最终导致死亡。
predisposes:vt.预先处置;使…偏向于;
So this has happened historically . 所以,过去我们已经有能力
historically:adv.历史上地;从历史观点上说;
We've been able to take malaria out of a society. 将疟疾从人类社会中铲除。
Everything else stays the same, so we still have bad food, bad water, bad sanitation , all the things that make people sick. 但其他一切却仍保持不变, 我们的食品安全、饮用水安全以及公共卫生都没有改善 所有这些都会让人生病。
sanitation:n.[医]环境卫生;卫生设备;下水道设施;
But just if you take malaria out, deaths from everything else go down. 但是,只要你清除了疟疾, 其它因素致死的情况也会减少。
And the economist Jeff Sachs has actually quantified what this means for a society. 经济学家杰夫-萨克斯对这一问题导致的社会影响 进行过量化分析
quantified:adj.量化的,定量;v.被量化(quantify的过去分词);
What it means is, if you have malaria in your society, your economic growth is depressed by 1.3 percent every year, year after year after year, just this one disease alone. 这意味着,如果有疟疾存在, 社会经济增长 会因为这一种疾病 每年减少1.3%,
depressed:adj.沮丧的; v.使抑郁; (depress的过去式和过去分词) year after year:年复一年地;每年;
So this poses a huge economic challenge, because say you do come up with your great drug or your great vaccine -- how do you deliver it in a place where there's no roads, there's no infrastructure , 这必然带来巨大的经济挑战。 因为即便你有好的药品 或者强大的疫苗 但对于一个车都不通 没有基础设施
come up with:提出;想出;赶上; vaccine:n.疫苗;牛痘苗;adj.疫苗的;牛痘的; infrastructure:n.基础设施;公共建设;下部构造;
there's no electricity for refrigeration to keep things cold, there's no clinics , there's no clinicians to deliver these things where they're needed? 没有电力制冷来低温保存物品 没有诊所,也没有临床医生的地方, 你如何把它们发送到那里去？
refrigeration:n.制冷;冷藏;[热]冷却; clinics:n.诊所(clinic的复数形式); clinicians:临床医生(clinician的名词复数);
So there's a huge economic challenge in taming malaria. 所以,在制服疟疾时我们面临巨大的经济挑战。
taming:n.驯养;v.驯化;制服;改良(tame的ing形式);
But along with the scientific challenge and the economic challenge, there's also a cultural challenge, and this is probably the part about malaria that people don't like to talk about. 在面临科学和经济挑战时, 我们还面临文化方面的挑战, 这大概是疟疾 让人们常常讳莫如深的那个方面。
cultural:adj.与文化有关的;文化的;与艺术、文学、音乐等有关的;
And it's the paradox that the people who have the most malaria in the world tend to care about it the least. 悖论在于:世界上疟疾最多的地方, 也是疟疾最不受重视 最不被在乎的地方。
paradox:n.悖论,反论;似非而是的论点;自相矛盾的人或事;
This has been the finding of medical anthropologists again and again . 医学人类学家的发现已经一次次的证明过这一点。
anthropologists:[人类]人类学家; again and again:adv.再三地,反复地;
They ask people in malarious parts of the world, "What do you think about malaria?" 他们问世界上疟疾流行地区的人们, 你怎么看疟疾这件事?
malarious:adj.患疟疾的;疟的;
And they don't say, "It's a killer disease. We're scared of it." 他们不会说, 它是一种致命的疾病。我们害怕它。”
They say, "Malaria is a normal problem of life." 他们说, 疟疾是一个正常的生活问题 。
And that was certainly my personal experience. 那的确也是我的亲身经历。
When I told my relatives in India that I was writing a book about malaria, they kind of looked at me like 当我告诉我在印度的亲人们 我正在写一本关于疟疾的书 他们看我的眼神,
relatives:n.亲戚;亲属;同类事物;(relative的复数)
I told them I was writing a book about warts or something. 好像我写的是一本关于瘊子之类的书。
warts:[皮肤]疣;[皮肤]肉赘;
Like, why would you write about something so boring , so ordinary? You know? 仿佛在问,那么无聊的话题,你也写啊！？ 这太平常了,知道吗？
boring:adj.无聊的;令人厌烦的;n.钻孔;v.使厌烦;钻孔;(bore的现在分词)
And it's simple risk perception , really. 它真是一个简单的风险认知。
perception:n.感知;知觉;看法;洞察力;
A child in Malawi , for example, she might have 12 episodes of malaria before the age of two, but if she survives, she'll continue to get malaria throughout her life, but she's much less likely to die of it. 比如,有一个来自马拉维的小孩, 两岁之前就已经得过12次疟疾, 但是,如果她活下来了, 她的一生都将不停地患上疟疾, 但因此致死的可能性会越来越小。
Malawi:n.马拉维(非洲国家); episodes:n.一段经历;片段,插曲;一集;(episode的复数) throughout:adv.自始至终,到处;全部;prep.贯穿,遍及;
And so in her lived experience, malaria is something that comes and goes. 所以在她的生活里, 疟疾不过是为来来去去的访客。
And that's actually true for most of the world's malaria. 对于世界上大部分的疟疾来说的确是这样的。
Most of the world's malaria comes and goes on its own. 世界上大部分的疟疾都是自己来自己去。
It's just, there's so much malaria that this tiny fraction of cases that end in death add up to this big, huge number. 只是,疟疾病例如此之多 一起起致死的病例加起来, 也就累积成巨大的数字。
fraction:n.分数;小部分;小数;少量;
So I think people in malarious parts of the world must think of malaria the way those of us who live in the temperate world think of cold and flu. Right? 所以,我认为在世界上疟疾流行地区的人们 看待疟疾的态度 就和我们这些生活在温带地区的人们看待 感冒和流感一样。对吧？
temperate:adj.温和的;适度的;有节制的;
Cold and flu have a huge burden on our societies and on our own lives, but we don't really even take the most rudimentary precautions against it because we consider it normal to get cold and flu during cold and flu season. 感冒和流感对我们的社会和我们的生活 造成了巨大的负担, 但我们并不会 考虑采取一些哪怕是最基本的防范措施, 因为我们认为它们只不过是普通的疾病, 就像在感冒和流感季节中常见的感冒和流感一样。
burden:n.负担;责任;船的载货量;v.使负担;烦扰;装货于; precautions:n.防范;预防措施;预警(precaution的复数);
And so this poses a huge cultural challenge in taming malaria, because if people think it's normal to have malaria, then how do you get them to run to the doctor to get diagnosed , to pick up their prescription , to get it filled, to take the drugs, to put on the repellents , to tuck in the bed nets? 所以,这对驯服疟疾带来了巨大的文化挑战。 因为,如果人们认为患上疟疾是正常的, 那么,你怎么能让他们跑到医生那里 去治疗,开处方 拿药 用上驱蚊用品,躺到蚊帐中去呢？
diagnosed:v.诊断(疾病);判断(问题的原因);(diagnose的过去分词和过去式) prescription:n.处方;药方;医生开的药;开处方; repellents:驱虫剂;防水布;排斥力(repellent的复数); tuck:塞进,折叠,卷起; n.(衣服或织物的)褶;
This is a huge cultural challenge in taming this disease. 这的的确确是一个巨大的文化挑战。
So take all that together. 所以把这些因素都凑在一起,
We've got a disease. It's scientifically complicated , it's economically challenging to deal with, and it's one for which the people who stand to benefit the most care about it the least. 我们可以说, 疟疾在医学上很复杂,在经济上的挑战也不好处理, 那些最该关注此疾病的人们 却对它不加重视
scientifically:adv.系统地;合乎科学地;学问上; complicated:adj.复杂的;难懂的;v.使复杂化;(complicate的过去分词和过去式) economically:adv.经济地;在经济上;节俭地;
And that adds up to the biggest problem of all, which, of course, is the political problem. 这所有一切加总起来,就导致了最大问题, 当然,就是政治问题。
How do you get a political leader to do anything about a problem like this? 政治领导人要怎样 才能为这类问题做一些什么呢？
And the answer is, historically, you don't. 答案是,从历史上看,不能。
Most malarious societies throughout history have simply lived with the disease. 在整个历史上,大部分疟疾流行的社会 就是简单地和这种疾病共存。
So the main attacks on malaria have come from outside of malarious societies, from people who aren't constrained by these rather paralyzing politics . 所以疟疾面对的主要攻击来源于 外部社会因素, 来自于那些 不受制于此类瘫痪政治的人们。
constrained:adj.不自然的; v.约束; (constrain的过去分词和过去式) paralyzing:v.使瘫痪或麻痹;使惊愕;(paralyze的现在分词) politics:n.政治;钩心斗角;政治观点;v.(贬)从事政治活动;(politic的第三人称单数)
But this, I think, introduces a whole host of other kinds of difficulties. 但我觉得这一点必然会导致一系列各式各样的问题。
The first concerted attack against malaria started in the 1950s. 第一次针对疟疾的协力防治 开始于20世纪50年代,
It was the brainchild of the U.S. State Department . 耗费了美国国务院不少心血,
brainchild:n.脑力劳动的产物; State Department:n.(美国)国务院;
And this effort well understood the economic challenge. 在此期间也充分考虑了经济面临的挑战。
They knew they had to focus on cheap, easy-to-use tools, and they focused on DDT. 他们知道必须着眼于便宜、 便捷的工具, 所以着力使用了滴滴涕（译者注:DDT,一种杀虫剂）。
easy-to-use:adj.易用的;好用的;
They understood the cultural challenge. 他们也理解了文化面临的挑战。
In fact, their rather patronizing view was that people at risk of malaria shouldn't be asked to do anything at all. 事实上,当时的观点十分照顾病人,人们认为 不能向处于感染疟疾风险之中的人们提什么要求,
patronizing:adj.自认为高人一等的; v.摆出高人一等的派头; (patronize的现在分词)
Everything should be done to them and for them. 只要为他们采取一切可能采取的措施就行了。
But they greatly underestimated the scientific challenge. 但他们大大低估了科学所面临的挑战。
greatly:adv.很,大大地;非常; underestimated:v.低估;对…估计不足;轻视(underestimate的过去分词和过去式)
They had so much faith in their tools that they stopped doing malaria research. 他们对他们的工具如此有信心 以至于他们停止了对疟疾的研究,
faith:n.信心;信任;宗教信仰;
And so when those tools started to fail, and public opinion started to turn against those tools, they had no scientific expertise to figure out what to do. 因此,当这些工具失败的时候, 公众的舆论开始反对, 而他们没有专业的科学知识可以应对这些。
public opinion:n.舆论;民意; turn against:反对;背叛;(使)变成和…敌对; expertise:n.专门知识;专门技术;专家的意见;
The whole campaign crashed, malaria resurged back, but now it was even worse than before because it was corralled into the hardest-to-reach places in the most difficult-to-control forms. 整个运动残败,疟疾又死灰复燃、卷土重来了, 而且甚至比先前更猛烈 因为它已经以最难控制的形式, 抢占了我们最难接触到的地方。
corralled:把…赶入围栏;聚集(corral的过去式和过去分词);
One WHO official at the time actually called that whole campaign "one of the greatest mistakes ever made in public health." 那时一位世界卫生组织的官员称那整个运动是 在公共卫生领域所做犯过的最大错误之一 。
official:adj.官方的;正式的;公务的;n.官员;公务员;高级职员;
The latest effort to tame malaria started in the late 1990s. 1990年代后期,新一轮驯服疟疾的运动启动了,
tame:adj.养驯的;驯服的;平淡无奇的;枯燥乏味的;v.驯化;驯服;使易于控制;
It's similarly directed and financed primarily from outside of malarious societies. 它的指导和经济支持 仍然来源于疾病肆掠的社会之外。
similarly:adv.同样地;类似于; primarily:adv.首先;主要地,根本上;
Now this effort well understands the scientific challenge. 这次努力很好的理解了科学所面临的挑战,
They are doing tons of malaria research. 他们做了无数的疟疾研究。
And they understand the economic challenge too. 他们也很了解经济面临的挑战,
They're focusing on very cheap, very easy-to-use tools. 主要集中在便宜、易用的工具上。
But now, I think, the dilemma is the cultural challenge. 但是却遇上了文化方面的困境。
dilemma:n.困境;进退两难;两刀论法;
The centerpiece of the current effort is the bed net. 目前主要的努力是利用蚊帐,
centerpiece:n.中心装饰品;放在餐桌中央的摆饰;
It's treated with insecticides . 它是用杀虫剂处理过的。
treated:v.以…态度对待;把…看作;(treat的过去分词和过去式) insecticides:n.[农药]杀虫剂(insecticide的复数);
This thing has been distributed across the malarious world by the millions. 这个蚊帐已在疟疾流行地区 发放了数百万件。
distributed:adj.分布的;分散的;v.分发;分配;使分布(distribute的过去分词和过去式)
And when you think about the bed net, it's sort of a surgical intervention . 当你想到蚊帐时, 它就像某种外科手术。
surgical:adj.外科的;外科手术的; intervention:n.介入;调停;妨碍;
You know, it doesn't really have any value to a family with malaria except that it helps prevent malaria. 你知道,除了有助于防止疟疾外, 它对一个已经患上疟疾的家庭来说真的没有任何意义。
And yet we're asking people to use these nets every night. 我们还会要求人们
They have to sleep under them every night. 每晚都必须睡在蚊帐当中,
That's the only way they are effective. 这是唯一有效的途径。
And they have to do that even if the net blocks the breeze, even if they might have to get up in the middle of the night and relieve themselves, even if they might have to move all their furnishings to put this thing up, even if, you know, they might live in a round hut in which it's difficult to string up a square net. 他们不得不这样做 即便这些蚊帐挡住了风, 他们有可能不得不 在深夜起床透透气, 他们可能需要移动他们所有的家具 来把这东西挂起来, 而他们很可能住在一个圆形的小屋 很难挂起一个方形的蚊帐……
relieve:v.减轻;缓解;缓和;接替; furnishings:n.家具陈设;穿戴用品;(furnishing的复数) string:n.字符串; v.悬挂; adj.由弦乐器组成的;
Now that's no big deal if you're fighting a killer disease. 但所有这些麻烦,对于要与一种致命疾病抗争来说
I mean, these are minor inconveniences . 我觉得都微不足道。
minor:adj.未成年的; n.未成年人; vi.副修; inconveniences:n.不便;麻烦;vt.麻烦;打扰;
But that's not how people with malaria think of malaria. 而患上疟疾的人们也许不这样认为
So for them, the calculus must be quite different. 他们有着完全不同的逻辑。
calculus:n.[病理]结石;微积分学;
Imagine, for example, if a bunch of well-meaning Kenyans came up to those of us in the temperate world and said, "You know, you people have a lot of cold and flu. 想象一下,如果有一群好心的肯尼亚人 来到我们这些在温带世界生活的人面前,告诉我们说 你知道,你们有很多的感冒和流感。
a bunch of:一群;一束;一堆; well-meaning:adj.善意的;好心的;
We've designed this great, easy-to-use, cheap tool, we're going to give it to you for free. 我们设计出了这个伟大的、便利的、廉价的工具, 并愿意无偿送给你们。
It's called a face mask, and all you need to do is wear it every day during cold and flu season when you go to school and when you go to work." 并愿意无偿送给你们。 你们只需要 在感冒和流感季节来临时, 上班上学都戴着它。
Would we do that? 我们会这样做吗？
And I wonder if that's how people in the malarious world thought of those nets when they first received them? 我猜想那些生活在疟疾泛滥地区的人们 第一次收到蚊帐的时候, 就是这么看待那些蚊帐的吧？
I wonder if:我不知道是否…？;
Indeed, we know from studies that only 20 percent of the bed nets that were first distributed were actually used. 事实上,根据我们的调查 我们第一次派发的蚊帐中只有20% 被实际使用了,
And even that's probably an overestimate , because the same people who distributed the nets went back and asked the recipients , "Oh, did you use that net I gave you?" 甚至连这个数字也是高估的, 因为分发蚊帐的那人回访时 问那些受助人 哦,你使用我给你的蚊帐了吗?
overestimate:v.高估;n.过高的评估; recipients:n.收件人(recipient的复数);
Which is like your Aunt Jane asking you, "Oh, did you use that vase I gave you for Christmas?" 这就像你的姑妈Jane在问你, 嘿,我圣诞节送你的礼物用了没有？
So it's probably an overestimate. 所以它很可能是被高估了。
But that's not an insurmountable problem. 但这不是一个不能克服的问题。
insurmountable:adj.不能克服的;不能超越的;难以对付的;
We can do more education, we can try to convince these people to use the nets. 我们可以多做教育工作, 试着说服这些人使用蚊帐,
convince:v.使确信;使相信;说服,劝说;
And that's what happening now. 而我们现在就正在这么做。
We're throwing a lot more time and money into workshops and trainings and musicals and plays and school meetings, all these things to convince people to use the nets we gave you. 而我们现在就正在这么做。 进行讲习和培训,还通过音乐剧和戏剧, 通过学校会议, 所有这些努力都是为了说服人们 去使用我们送的蚊帐,
workshops:n.工作坊,[工业]车间;研习会,讲习班(workshop的复数形式); trainings:n.培训(training的复数);
And that might work. 这也许可能奏效。
But it takes time. It takes money. 只是需要时间和花钱,
It takes resources . It takes infrastructure. 需要资源和基础设施。
resources:n.[计][环境]资源; v.向…提供资金(resource的第三人称单数);
It takes all the things that that cheap, easy-to-use bed net was not supposed to be. 为了这便宜又简便的蚊帐 我们必须大费周折。
So it's difficult to attack malaria from inside malarious societies, but it's equally tricky when we try to attack it from outside of those societies. 所以,在疟疾流行的社会,与疟疾的斗争很困难。 但其实当我们试图从这些社会外部去攻击疟疾时, 也会遇到相同的阻碍。
tricky:adj.难办的;难对付的;狡猾的;诡计多端的;
We end up imposing our own priorities on the people of the malarious world. 最终,我们把关注的焦点 放在了世界上疟疾流行地区的人们身上。
imposing:adj.壮观的; v.推行,采用; (impose的现在分词) priorities:n.优先事项;优先权;重点;(priority的复数)
That's exactly what we did in the 1950s, and that effort backfired . 这正是我们在1950年代所做的, 而结果却是事与愿违。
backfired:v.产生事与愿违的不良(或危险)后果; (backfire的过去式和过去分词)
I would argue today, when we are distributing tools that we've designed and that don't necessarily make sense in people's lives, we run the risk of making the same mistake again. 今天,我想说的是, 我们分发我们设计的那些 不一定会有意义的工具时, 我们其实在再次冒风险犯同样的错误。
distributing:v.分发;分配;分销;使散开;使分布;分散;(distribute的现在分词) necessarily:adv.必要地;必定地,必然地; make sense:有意义;讲得通;言之有理;
That's not to say that malaria is unconquerable , because I think it is, but what if we attacked this disease according to the priorities of the people who lived with it? 这并不是说疟疾是不可战胜的, 我觉得它可以攻克, 只是在疾病攻关时 我们是不是应该优先考虑那些受疟疾困扰的人们？
unconquerable:adj.克服不了的;不可征服的;压制不了的; what if:如果…怎么办? according to:根据,据说;
Take the example of England and the United States. 举个英国和美国的例子。
United:adj.联合的; v.联合,团结; (unite的过去分词和过去式)
We had malaria in those countries for hundreds of years, and we got rid of it completely, not because we attacked malaria. We didn't. 数百年来,在这些国家中都有疟疾, 我们已经完全摆脱了它, 但不是因为我们攻克了疟疾,我们没有。
We attacked bad roads and bad houses and bad drainage and lack of electricity and rural poverty. 我们攻克的其实是破旧的道路和鄙陋的住房 不良的排水系统,不足的电力供应和贫困的农村经济,
drainage:n.排水;排水系统;污水;排水面积; rural:adj.农村的,乡下的;田园的,有乡村风味的;
We attacked the malarious way of life, and by doing that, we slowly built malaria out. 易感染疟疾的生活方式是我们攻击的目标。 通过这样做,我们慢慢地将疟疾驱赶出去。
Now attacking the malarious way of life, this is something -- these are things people care about today. 攻击与疟疾为伴的生活方式 才是今天人们所关心的。
And attacking the malarious way of life, it's not fast, it's not cheap, it's not easy, but I think it's the only lasting way forward. 攻击与疟疾为伴的生活方式 不是一种可以迅速见效、廉价或者容易的办法, 但却是可持续走下去的唯一选择。
Thank you so much. 非常感谢。
(Applause) 非常感谢。