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1、www.XiYuS锡育软件Thank you very much.(Applause)I want you to take a tripwith me.谢谢大家。（掌声）我要你们和我一起去体验一段旅程.1099500Picture yourself driving down a small road in Africa,and asyou drive along,you look off to the side,and this is what yousee: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
2、到的景象:你看到一片坟墓.00:15And you stop,and you get out of your car and you take apicture.你停下来,走下车,将这一幕拍下.00:26And you go into the town,and you inquire,Whats going onhere?然后你到了镇里,问人们,照片上这个地方发生了什么事情?00:28and people are initially reluctant to tell you.大家一开始不愿意告诉你.00:32And then someone says,These are the recent
3、 AIDS deaths inour 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.00:34HIV isnt like other medical conditions;its stigmatizing.艾滋病不像别的病;它让人觉得羞耻自卑.00:40People are reluctant to talk about it-theres a fearassociated with it.人们不愿意谈及它.它让人感到恐惧.00:44And Im going to talk about HIV today,about the deaths,about the stig
4、ma.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.00:49Its a medical story,but more than that,its a social story.这不仅是一个医学上的问题,也是一个社会问题.00:55This map depicts the global distribution of HIV.这幅地图描绘了全球艾滋病的分布情况.01:00initially:adv.最初，首先；开头 reluctant:adj.不情愿的；勉强的；顽抗的 stigmatizing:vt.诬蔑;玷污;给打上烙印stigma:n.植柱头;耻辱;污名;
5、烙印;特征 depicts:vt.描述;描画And as you can see,Africa has a disproportionate share ofthe infection.同时,你们可以看见,非洲受感染比例大大超出平均水平.01:03There are 33 million people living with HIV in the worldtoday.今天全球有3300万 艾滋病带菌者.01:07Of these,two-thirds,22 million are living in sub-SaharanAfrica.其中,三分之二,也即2200万,生活在撒哈拉以南非洲.0
6、1:11There are 1.4 million pregnant women in low-and middle-income countries living with HIV and of these,90 percent arein 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.01:17We talk about things in relative terms.让我们通过对比来说明问题.01:29And Im going to talk about annual pregnancies and H
7、IV-positive mothers.以每年怀孕 的带有艾滋病病毒的母亲为例.01:31The United States-a large country-each year,7,000mothers 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.01:35But you go to Rwanda-a very small country-8,000mothers 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.01:43And then
8、 you go to Baragwanath Hospital,outside ofJohannesburg in South Africa,and 8,000 HIV-positivepregnant women giving birth-a hospital the same as acountry.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.01:50as you can see:正如你所看到的;你是知道的 disproportionate:adj.不成比例的/不成比例地 two-thirds:n.三分之二/三
9、分之二的/三分之二地 middle-income:adj.中等收入的 pregnancies:n.怀孕;丰富,多产;意义深长 give birth to:产生,造成;生孩子 outside of:在的外面;超出的范围And to realize that this is just the tip of an iceberg that whenyou compare everything here to South Africa,it just pales,because in South Africa,each year 300,000 mothers with HIVgive birth t
10、o 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.02:03So we talk about PMTCT,and we refer to PMTCT,preventionof 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.02:20I think theres an assumption amongst most people in the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
11、染给她的孩TED演讲者：Mitchell Besser|米切尔.贝瑟演讲标题：Mitchell Besser:Mothers helping mothers fight HIV|母亲互助同抗艾滋内容概要：How can mothers with HIV avoid passing it to their kids?In South Africa,MitchellBesser tapped a new resource for healthcare:moms themselves.The program he started,mothers2mothers,trains new mothers
12、to educate and support other moms.在非洲撒哈拉以南地区,艾滋传染极为严重,而医生则比世界上任何其他地方都更为紧缺.在缺乏职业医疗人员的情况下,Mitchell Besser 通过招募他的病人来建立了mothers2mothers-这个非凡的由艾滋感染女性组成的互助组织正在改善和拯救着生命.I think theres an assumption amongst most people in thepublic that if a mother is HIV-positive,shes going to infecther child.菌者,那么,她就会把这个病
13、毒传染给她的孩子.02:25The reality is really,very different.这与事实却相去甚远.02:32In resource-rich countries,with all the tests and treatment wecurrently 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
14、时候艾滋病病毒检测是阴性.02:35And yet,the reality in resource-poor countries,in theabsence of tests and treatment,40 percent-40 percent ofchildren are infected-40 percent versus two percent-anenormous 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.02:46So these programs-and Im goi
15、ng to refer to PMTCTthough my talk-these prevention programs,simply,theyrethe tests and the drugs that we give to mothers to preventthem from infecting their babies,and also the medicines wegive to mothers to keep them healthy and alive to raise theirchildren.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
16、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.02:57pales:v.变苍白(pale的三单形式)/n.尖木桩(pale的复数)prevention:n.预防;阻止;妨碍 in the absence of:缺乏,不存在;无时,缺少时 infected:adj.被感染的/v.传染(infect的过去分词)versus:prep.对；与.相对；对抗 infecting:vt.感染,传染 alive to:意识到;对有敏感So its the test a mother gets when she comes in.所以
17、,母亲们来到这里时会接受这样一个检测,03:13Its the drugs she receives to protect the baby thats insidethe 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03:15Its the guidance she gets around infant feeding and safersex.这是她所接受的关于哺乳 和性生活的辅导03:20Its 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.03
18、:24So in the United States,since the advent of treatment in themiddle of the 1990s,theres been an 80-percent decline inthe 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.03:29Less than 100 babies are born with HIV each year in theUnited States and yet,still,ov
19、er 400,000 children are bornevery 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.03:38What does that mean?这意味着什么呢?03:51It means 1,100 children infected each day-1,100 childreneach 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.03:53And wh
20、ere do they come from?他们来自哪里呢?03:59Well,less than one comes from the United States.这个,来自美国的少于一个.04:01One,on average,comes from Europe.平均来自欧洲的有一个.04:05receives:n.受光面/v.接受,接收(receive的第三人称单数)uterus:n.解剖子宫 advent:n.到来；出现；基督降临；基督降临节100 come from Asia and the Pacific.100个来自亚太地区.04:09And each day,a thousan
21、d babies-a thousand babies areborn 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.04:13So again,I look at the globe here and the disproportionateshare 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.04:23And lets look at another map.让我们来看另外一幅地图.04:28And here,again,we see Africa has
22、a disproportionate shareof the numbers of doctors.在这里我们再次看到 非洲的医生数量远远低于平均水平.04:30That thin sliver you see here,thats Africa.那薄薄的银色部分,就是非洲了.04:35And its the same with nurses.护士的数量也一样.04:38The truth is sub-Saharan Africa has 24 percent of the globaldisease burden and yet only three percent of the worl
23、dshealth 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.04:41That means doctors and nurses simply dont have the time totake care of patients.这意味着医生和护士 根本就没有时间去照顾病人.04:50A nurse in a busy clinic will see 50 to 100 patients in a day,which leaves her just minutes per patient-minutes perpatie
24、nt.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.04:55And so when we look at these PMTCT programs,what does itmean?所以,当我们重新谈及PMTCT项目的时候,这意味着什么呢？05:03Well,back in 2001,when there was just a simple test and asingle dose of a drug,a nurse,in the course of her few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
25、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,05:06single dose of a drug,a nurse,in the course of her fewminutes with a patient,would have to counsel for the HIVtest,perform the HIV test,分钟里,她要对这个病人做艾滋病病毒检测,05:06sliver:n.梳毛,梳棉;裂片/vi.成为薄片;裂成小片/vt.使成薄片;使裂成小片 dose:n.剂量;一剂,一服/vi.服药/vt.给药;给服药 inthe course of:在过程中;在期间www.
26、XiYuS锡育软件explain the results,dispense a single dose of the drug,Nevirapine,explain how to take it,discuss infant feedingoptions,reinforce infant feeding,and test the baby-inminutes.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.05:18Well,fortunately since 2001,weve got new treatments
27、,newtests,and were far more successful,but we dont have anymore 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.05:27And so these are the tests a nurse now has to do in thosesame 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.05:35Its not possible-it doesnt work.这样不行.这是没有效果的.05:42And so we ne
28、ed 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.05:46This 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.05:53These women are here for care,but we know that just doing atest,just giving someone a drug,its
29、 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.05:59Meds dont equal medical care.药品并不等于医疗护理.06:08Doctors and nurses,frankly,dont have the time or skills totell 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.06:11dispense:vt.分配,分发;免除;执行/vi.免除,豁免 reinforce:vt.
30、加强,加固;强化;补充/vi.求援;得到增援;给予更多的支持/n.加强;加固物;加固材料 treatments:n.临床治疗(treatment的复数);处理 maternal:adj.母亲的;母性的;母系的;母体遗传的Meds:abbr.医学电子学与数据学会(MedicalElectronicsandDataSociety);加拿大海洋环境资料局Im a doctor-I tell people things to do,and I expect themto follow my guidance-because Im a doctor;I went toHarvard-but the re
31、ality is,if I tell a patient,You shouldhave 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.06:17You should always use a condom,你应该一直使用避孕套,06:28and yet,in her relationship,shes not empowered-whatsgoing 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?06:30If I t
32、ell her to take her medicines every day and yet,no one inthe household knows about her illness,so its just not goingto 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.06:35And so we need to do more,we need to do it differently,weneed to do it in ways that are affordable and accessible andcan be taken to
33、scale,which means it can be doneeverywhere.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.06:44So,I want to tell you a story-I want to take you on a littletrip.所以,我要告诉你们一个故事.我要带你们经历一段短暂的旅程06:56Imagine yourself,if you can,youre a young woman in Africa,youre going to the hospita
34、l 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.07:01You go in for a test and you find out that youre pregnant,and youre delighted.你去做一个检测,然后,你发现你怀孕了,你很兴奋.07:06condom:n.避孕套;阴茎套 empowered:adj.获得授权的;允许的/v.允许;授与权力(empower的过去式)affordable:adj.负担得起的 go in for:参加,从事;追求;赞成And then they give you another test
35、 and they tell you youreHIV-positive,and youre 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.07:10And the nurse takes you into a room,and she tells you aboutthe tests and HIV and the medicines you can take and how totake 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
36、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.07:15All youre hearing is,Im going to die,and my baby is goingto die.你能听见的是,我要死了,我的宝宝也要死了.07:25And then youre out on the street,and you dont knowwhere to go.然后你走到街上,你不知道要去什么地方,07:29And you dont know who you can talk to,because the truthis,HIV is so st
37、igmatizing that if you partner,your family,anyone in your home,youre likely to be thrown out withoutany 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.07:31And 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,And this-this is t
38、he face and story of HIV in Africa today.以及她们的故事.07:43But were here to talk about possible solutions and somegood news.但我们接下来还要谈可能的解决方案 以及一些好消息.07:48And I want to change the story a little bit.而我要把这个故事稍稍改动一下.07:53Take the same mother,and the nurse,after she gives her hertest,takes her to a room.还是那个
39、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.07:56devastated:adj.毁坏的;极为震惊的/v.毁坏;摧毁(devastate的过去式和过去分词)out on the street:无家可归;失业The door opens and theres a room full of mothers,motherswith babies,and theyre sitting,and theyre talking,theyrelistening.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.08:01Theyre drinking tea,t
40、heyre having sandwiches.她们在喝茶,她们在吃三文治.08:06And 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.08:09Have a seat.Youre safe here.请坐下来.你在这里很安全.08:13Were all HIV-positive.我们都是艾滋病带菌者.08:16Youre going to be okay.Youre going to live.你不会有事的,你
41、会生存下去.08:18Your baby is going to be HIV-negative.你的宝宝不会成为艾滋病带菌者.08:21We view mothers as a communitys single greatest resource.在我们的眼中,母亲们 是这里最宝贵的资源.08:26Mothers take care of the children,take care of the home.她们照顾孩子,照顾家.08:30So often the men are gone.经常,男人们出去了.08:33Theyre working,or theyre not part o
42、f the household.他们在外面工作,或者并不跟孩子的母亲住在一起.08:35Our organization,mothers2mothers,enlists women with HIVas 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。08:38We bring mothers who have HIV,whove been through thesePMTCT programs in the very facilities,to come back andwork side by side with doc
43、tors and nurses as part of thehealth 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.08:44sandwiches:n.食品三明治;夹在一起的东西(sandwich的复数)/v.把做成三明治;将夹在中间(sandwich的第三人称单数)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.供应商(provider的复数形式)facilities:n.设施;工具,设备 side by side:并肩;一
44、起;并排These mothers,we call them mentor mothers,are able toengage women who,just like themselves,pregnant withbabies,have found out about being HIV-positive,who needsupport 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.08:55And they support them around the diagnosi
45、s and educatethem about how to take their medicines,how to take care ofthemselves,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.09:07Consider:if you needed surgery,you would want the bestpossible 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.09:16But if
46、you wanted to understand what that surgery would doto your life,youd like to engage someone,someone whoshad 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。09:23Patients are experts on their own experience,and they canshare that experience with others.久病成医,病人之间可以分享自己的经验.09:31This is
47、the medical care that goes beyond just medicines.这是仅仅靠吃药无法达到的医疗护理.09:38So the mothers who work for us,they come from thecommunities 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.09:42Theyre hired-theyre paid as professional members of thehealth care teams,just like doctors and nurses.她们受雇成为职业医疗护理队伍
48、的一员,就像医生和护士一样.09:46mentor:n.指导者,良师益友/vt.指导 diagnosis:n.诊断And we open bank accounts for them and theyre paiddirectly into the accounts,because their moneys protected;the men cant 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.09:51They go through two to three weeks o
49、f 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.10:00Now,doctors and nurses-they too get trained.现在,医生和护士也会接受培训.10:05But so often,they only get trained once,so theyre not awareof 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10:08Our mento
50、r mothers get trained every single year andretrained.我们的母亲指导员们每年都要接受培训 和再培训.10:14And so doctors and nurses-they look up to them asexperts.所以医生和护士,他们把这些母亲指导员看成专家.10:18Imagine that:a woman,a former patient,being able toeducate her doctor for the first time and educate the otherpatients that shes takin