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.
我想跟大家分享 一個驚人的統計數字。 拉丁美洲的人口只佔全世界的 8%, 自殺人數卻佔三分之一。 在北方三角國家中 這個情況特別嚴重, 包括宏都拉斯、瓜地馬拉, 及薩爾瓦多, 也是我的家鄉和居住地。 想像一下這種持續的暴力會如何影響 人的健康、 生產力,以及幸福感。 特別是因為我們知道, 如果我們暴露在暴力之下, 可能會造成創傷。 如果發生了, 我們的大腦對壓力的反應 會是關閉掉核心功能, 比如解決問題、 批判性思考,以及情緒調節。 並會提升我們保護自己 及生存所需要的功能。 所以就會讓我們很難學習 做決策,甚至維持關係。 也會讓我們更有可能得到心肺疾病、 糖尿病、 焦慮症,及憂鬱症。 想像一下這對於 整個社區的意涵是什麼, 幾乎每個人都有可能帶著 未處理的壓力和創傷到處走。 接著再想像,當個人和集體的 創傷發生碰撞時會如何。 火上加油的是, 我們知道暴露在暴力之下 會導致更多暴力。 有研究指出, 暴力倖存者再次涉入暴力 或再次受害的可能性是六倍之多。 這正是惡性循環的定義。
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.
好消息是我們知道 我們可以打破這個循環, 透過讓心理健康照護更容易取得, 來處理這背後的創傷。 唯一的問題是, 在這些社區想取得心理健康照護, 根本是不可能的。 讓各位有個概念: 在美國,每十萬人 就會有大約兩百七十名 心理健康照護工作者。 在宏都拉斯,只有兩名。 所以我們要面對的 是這個典型的難題。 我們知道如何協助解決問題, 但我們沒有資源來做。 但如果我們重新想像這些資源 可能是什麼或是誰呢? 我認為我們該這麼做, 因為有些方法可以讓社區 取得大量的心理健康照護。 已經上路了, 且行得通。 我想跟大家分享一下 在 Glasswing 是怎麼做的。
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.
我們在訓練數以千計的 既有政府員工,比如 老師、護理師、醫生, 以及警員, 提供他們創傷教育 及自我照護的訓練。 基本上,我們是試圖創造出 由外行心理健康工作者組成的基礎, 他們都已經在前線服務了, 因此能夠介入並緩衝 暴力及創傷的衝擊, 包括對於他們自身 及他們服務社區的衝擊。 我們訓練健康照護工作者 讓他們能辨識出創傷的徵兆, 能協助病人了解他們經歷的狀況, 並讓他們有工具可以處理, 或者需要時幫他們轉介。 我們實際上已在醫院裡 看到創傷知情的 暴力預防工作 能將再次受害的可能性減少 達 30% 之多。
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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.
在學校裡,我們知道如果孩童 和青少年能找到關心他們 並可協助他們處理壓力的成人, 他們的成績和行為會改善, 連韌性也會提升。 至於我們與警方的合作, 我們訓練的警員中有 90% 確實覺得更能夠調節 他們自己的情緒, 也更能處理焦慮及恐懼。 當中甚至有 80% 的人告訴我們, 他們覺得自己更能協助同儕。
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.
我想跟大家分享一個故事。 2018 年,我們的瓜地馬拉 團隊所協助的社區 有著極高的犯罪率、暴力,以及汙名。 和我們合作的其中 一間學校是專門收容 被退學或惹上麻煩的孩子。 那就是為什麼十七歲的學生華特 會感到很意外且有點困惑, 因為當時我們的創傷知情 學校協調員之一,伊露薇雅, 到那裡去招攬他和他的朋友 到當地的小學工作。 但伊露薇雅來自那個社區, 她知道如果她能讓像華特 這樣的年輕人有能力 去介入並成為學校協調員, 她能改變的不僅是他的人生, 還有他將來能協助的孩子。 果真,幾週後, 華特受了訓練, 並帶領一個二十名 小朋友組成的歡樂合唱團。 他愛這份工作。
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He loved it so much that he continued to show up every week for over two years.
他好愛這份工作, 所以他每週都出席, 持續了兩年以上。
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 --
但有天下午, 華特的一位鄰居 跑到學校,大叫著要華特得要回家, 因為他的姐姐被射殺了。 華特衝出去。 他向我描述的說法是 他覺得他的大腦和身體都麻木了。 接著他感到心跳加速, 滿腔怒火。 他知道是誰殺了他的姐姐。 他衝上他的房間去拿槍。 讓我在此暫停一下。 還記不記得我剛才告訴各位, 暴力會導致更多暴力? 那本來可能發生在華特身上, 但並沒有。 因為他告訴我,當他 想像他的導師伊露薇雅 以及歡樂合唱團的那些小朋友 發現他們的榜樣 殺了人, 他就把槍放下了。 就是在這個時點——(掌聲)
(Applause)
is where the cycle of violence stopped.
暴力循環被中斷了。
(Applause)
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That's everything.
那是最重要的。
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.
我還有其他像華特 及伊露薇雅的故事。 但若要打破和中斷這種暴力的流行, 我們還需要數千個這樣的故事。 且有些很好的做法是可以複製的。 我們知道我們可以在社區中 提供更多健康照護, 由一般人來提供。 我在談的是社區, 我在談的是體制改變, 同時要發生。 首先,我們訓練 公立學校中的每個人, 公立醫院、診所, 及警方轄區的每個人, 教他們創傷、教育,及自我照護。 讓他們能把自己及服務對象 都照顧得更好, 了解創傷並管理它。 接著我們訓練當中一些人 成為處理緊急狀況的介入者, 提供危機介入處理以及持續的支持。 接著我們再將一些介入者 訓練為培訓員, 讓他們能夠繼續訓練他們的同儕, 也能訓練其他組織, 擴大我們的網路,讓每個社區內 都有創傷知情服務, 很棒的是,這個模型的規模 有擴大空間且成本效益佳, 因為我們在公共體系內進行, 用的是本來就在體系內的人。 所以,
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.
確實,我們知道 人與人之間會發生暴力, 但也會發生療癒, 療癒正是從那裡開始。 所以我們知道力量 來自於人,來自於關係, 來自於能自我療癒的社區。
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.
維克多‧弗蘭克的《活出意義來》 當中有句話我很喜歡: 「在刺激與反應之間,有一個空間。 在那空間中的,是我們 選擇如何反應的力量。 而我們的成長與自由 就在我們的反應當中。」 我們的目標是要能真正滲入到 暴力刺激和反應的這個空間, 靠的是心理健康知識和技能, 這樣社區才能為自己鋪路, 邁向療癒和恢復力。
Thank you so much.
非常謝謝。
(Applause and cheers)
(掌聲及歡呼)