There's a shocking statistic I want to share with you. Latin America is home to only eight percent of the world’s population but one third of its homicides. This is especially extreme in the Northern Triangle countries of Honduras, Guatemala and El Salvador, where I'm from and where I live. Just imagine the impact that this kind of unrelenting violence can have on a person's health, productivity and well-being. Especially because we know that if we're exposed to violence, this can result in trauma. And when that happens, our brain's stress response actually shuts down core functions like problem solving, critical thinking and emotional regulation. And it elevates the ones that we need to protect ourselves and survive. So this makes it really hard to learn to make decisions and even maintain relationships. It can also increase our risks of lung and heart disease, diabetes, anxiety and depression. So imagine what this can mean for entire communities when almost everybody can be walking around with unaddressed stress and trauma. Then picture what can happen as individual and collective trauma collide. To make matters worse, we know that exposure to violence can lead to more violence. Research has shown that survivors of violence can be up to six times more likely to either be involved in violence or be revictimized. It's literally the definition of a vicious cycle.
我要告诉你们一个惊人的数据。 拉美的人口只占世界百分之八, 但凶杀案却占全世界的三分之一。 在北三角国家 即洪都拉斯、危地马拉、萨尔瓦, 凶杀问题极为严重, 那里正是我成长的地方。 试着想想这样无尽的暴力 对个人健康、 工作和幸福所造成的影响。 况且我们知道 我们所遭受的暴力会导致心理创伤。 当遭受暴力时, 我们大脑的应激反应 会停止其主要功能, 例如问题解决功能、批判性思考功能 以及情感调解功能。 暴力促使我们要学会保护我们自身 以及在暴力中存活。 所以学会做决定甚至是维持关系 都变得相当困难。 遭受暴力也会增加我们的患病风险 包括:心肺疾病、糖尿病, 焦虑和抑郁。 所以想象以下场景 对整个社区意味着什么, (场景)几乎所有人都被 无法消解的压力和创伤困扰。 当个人与集体的创伤冲突时, 事情又会怎样。 更糟糕的是, 遭受暴力会导致更多暴力的产生。 研究表明遭受过暴力的人 较之常人有六倍的可能性 会参与暴力行为或继续遭受暴力。 这恰恰就是一个恶性循环。
The good news is we know that we can interrupt this cycle by addressing the underlying trauma with better access to mental health care. The only problem is access to mental health care in these communities is virtually non-existent. So just to give you an idea, in the United States, there are about 270 mental health care workers for every 100,000 people. In Honduras, this drops to two. So we're left with this classic conundrum. We know how to help solve the problem, but we don't have the resources to do it. But what if we re-envision what or who these resources could be? I think we should, because there are ways to flood communities with access to mental health care. It’s already being done, and it’s working. And I want to tell you a little bit about how we're doing it at Glasswing.
好消息是我们能够打破这一循环, 只要我们提供更普及的精神健康干预 去解决潜在的创伤。 唯一的问题在于 想要在这些社区中获取精神卫生干预 是几乎不可能的。 所以我要告诉你的是 在美国, 每 10 万人享有约 270 名精神卫生 工作人员所提供的服务。 在洪都拉斯十万人只有两人提供服务。 所以我们被迫面临这个经典的难题。 我们知道如何解决这个问题, 但我们缺乏相应资源。 但如果我们重新设想 什么或谁能够被称为资源呢? 我认为我们本身就是资源, 因为有许多向社区提供 精神卫生服务的渠道。 这些渠道已经被打通 并且正在运转。 我想告诉你关于我们在 Glasswing 是如何运作的事情。
We're training thousands of existing government employees like teachers, nurses, doctors and police officers on trauma education and self-care. We're essentially trying to create a whole core of lay mental health workers who are already serving on the front lines and can therefore step in and buffer the impacts of violence and trauma on themselves and on the communities they serve. We've trained health care workers to be able to recognize the signs of trauma, to be able to help patients understand what they're experiencing and equip them with tools to cope or refer them if they need it. We've actually seen that trauma-informed violence prevention work in hospitals can reduce the likelihood of revictimization by up to 30 percent.
我们培训了 成千上万在职的公职人员, 例如教师、护士、医生和警察。 培训内容是创伤教育和自我照料。 我们致力于建立一个体系, 该体系以长期从事一线工作的 精神健康工作者为核心。 这样这个体系就能够 降低暴力和创伤带给他们自身及 所服务社区的负面影响。 我们的培训使得 精神卫生从业人员 能够识别精神创伤的特征, 帮助病人来理解 他们正在经历的病情, 并教会他们应对的方法 或在他们需要时给予帮助。 我们发现在医院中 进行创伤知情方面的暴力行为预防, 人们遭受暴力的可能性 会降低百分之三十。
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In schools, we know that if children and adolescents have access to a caring adult that can help them cope with stress, their grades improve, their conduct improves and their resilience. And in our work with police, 90 percent of the police we trained actually felt better able to regulate their emotions and to deal with anxiety and fear. Eighty percent even told us that they felt better equipped to help their peers.
在校园中, 我们了解到如果儿童和青少年 能够得到有爱心的成人的关爱 将会帮助他们应对压力, 提升成绩, 提高表现及增强适应力。 当我们与警察一同工作时, 我们所培训的警察中的 90% 感到他们确实能够更好地管理情绪, 能够应对焦虑和恐惧。 百分之八十的警察告诉我们 他们有了更好的方式 去帮助他们的同伴。
I want to share a story with you. Back in 2018, our Guatemala team was working in a community with really high rates of crime, violence and stigma. One of the schools we were working in is actually a school where kids ended up if they got expelled or if they got in trouble. So that's why Walter, a 17-year-old student, was really surprised and a little confused, when Eluvia, one of our trauma-informed school coordinators, showed up to recruit him and his friends to work at the local primary school. But Eluvia's from that community, and she knew that if she could empower a young man like Walter to become involved and become a school coordinator, she could not only transform his life but also the life of the kids he'd work with. So sure enough, a couple of weeks later, Walter was trained and leading a group of 20 little kids in a glee club. He loved it.
我将讲述一个故事。 在 2018 年,我们的一支队伍 在危地马拉的一个社区中工作, 那里充斥着犯罪、暴力和不光彩的事。 我们服务的众多学校中的一所 是一些被开除的孩子及犯事孩子 的最终去处, 所以这使得 17 岁的学生 Walter 感到诧异并有些不解, 当作为创伤知情校园协调者的 Eluvia 出现并招募他和他的朋友 在本地的小学工作。 Eluvia 来自于那个社区, 她深知如果她能够给 Walter 这样的年轻人赋权 使其参与并成为一名学校协调者的话, 她将不仅改变 Walter 的生活, 也会改变那些 Walter 服务的孩子的生活。 果然,几周后, Walter 接受了训练 并指导一个有 20 位小朋友的合唱团。 他很热爱这项工作。
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He loved it so much that he continued to show up every week for over two years.
他的热爱使他在未来两年多时间里 持续性地每周开展工作。
But one afternoon, one of Walter's neighbors ran into the school screaming that Walter had to get home because his sister had been shot and killed. Walter sprinted out. And as he described it to me, he felt his mind and body go numb. Then he felt his heart start to race and his chest fill with rage. He knew who had killed his sister. And he ran up to his room to get a gun. Let me pause there for a sec. Do you remember what I told you a minute ago, about how violence can lead to more violence? That could have been Walter. But it wasn't. Because he told me that when he pictured his mentor, Eluvia, and the little glee club kids finding out that their role model had killed someone, he put the gun down. And that, that right there --
但一天下午, Walter 的一位邻居冲进学校, 喊 Walter 得赶紧回家 因为她妹妹被枪杀了。 Walter 冲出学校。 他向我描述, 他先是精神呆滞肢体麻木。 而后他感觉他的心脏剧烈跳动, 他极其愤怒。 他知道是谁杀害了妹妹。 接着他跑进屋里拿了把枪。 让我稍稍停顿一下。 你是否还记得我一分钟之前所说的 关于暴力是如何导致更多暴力? 这本可能发生在 Walter 身上。 还好这没发生。 他对我说他想起了 他的引路人——Eluvia, 以及小合唱团里的孩子们, 他意识到因为有他们作为榜样 这才抚慰了他的暴戾, 他放下枪。 这就是……
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is where the cycle of violence stopped.
打破暴力行为恶性循环之关键所在。
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That's everything.
这就是整个故事。
I have other stories like Walter and Eluvia's. But to interrupt and to stop this epidemic of violence, we need thousands more. And there are great ways to do this that are replicable. We know that we can provide more health care in communities provided by regular people. I’m talking about community, and I’m talking about systems change at the same time. First, we train everybody in public schools, public hospitals, clinics and police precincts on trauma, education and self care so they can better take care of themselves and also those that they serve understand trauma and manage it. Then we train a subset as interventionists so they can deal with emergencies, providing crisis intervention and ongoing support. And then we train a subset of those interventionists as trainers so they can continue to train their peers and they can train other organizations so we can have a growing network of trauma-informed services in each community. The great thing is this model is scalable and it’s cost-effective, because we're working within public systems with people that are already there.
我还有像 Walter 和 Eluvia 的许多其他故事。 但要阻断暴力行为的发生, 我们还需要更多这样的故事。 有很多可以通用的好方法 能产生这种效果。 我们清楚我们能比常人 在社区中提供更多健康照料服务。 我这是在讲社区 及同时期的系统变化。 首先,我们对公立学校, 公立医院、诊所和派出所的 每个人进行培训, 培训精神创伤、 教育以及自我照料, 这样他们就能够更好地照料自己, 和那些能够理解精神创伤 且能够很好处理应对的人。 我们会接着把他们培训成为干预者, 这样他们就能应对紧急事件, 进行危机干预并持续提供支持了。 接着我们又会从干预者中 选出一部分成为培训讲师, 因而他们能够持续培训他们的同辈, 并且他们也能培训其他机构, 这样每个社区的创伤 知情服务网不断扩展。 这种模式的好处是 规模调整灵活且低耗高效, 因为我们培训针对的是 公职系统的人员。 我们知道暴力行为 在人群互动中产生,
So really, we know that violence happens between people, but so does healing. That's where it starts. So we know the power lies in people, in relationships, in a community healing itself.
但暴力行为也在 人群互动中得到抑制。 这就是我们的出发点。 所以我们知道治愈的力量存在于 个人、社区的交往互动中。
One of my favorite quotes by Viktor Frankl in “Man’s Search for Meaning” is: "Between stimulus and response, there is a space. In that space is our power to choose our response. And in our response lies our growth and our freedom." Our goal is to literally infiltrate the space in between violent stimulus and response, with mental health knowledge and skills so that communities can pave their own way to healing and resilience.
我最爱引用维克多·弗兰克尔的是 来自《活出意义来》的文字: “在刺激和反应之间,有一个空间。 在那个空间中, 我们有力量选择自己的反应。 而我们的反应展现了 我们的成长和自由。” 我们的目的就是通过 对暴力刺激与反应之间的空间, 采用精神卫生知识和方法 而逐步进行影响, 以达到社区能够 自愈及适应调节的效果。
Thank you so much.
非常感谢。
(Applause and cheers)
(掌声和喝彩)