I want you to take a trip with me. 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. And you stop, and you get out of your car and you take a picture. And you go into the town, and you inquire, "What's going on here?" and people are initially reluctant to tell you. And then someone says, "These are the recent AIDS deaths in our community." HIV isn't like other medical conditions; it's stigmatizing. People are reluctant to talk about it -- there's a fear associated with it. And I'm going to talk about HIV today, about the deaths, about the stigma. It's a medical story, but more than that, it's a social story.
請各位與我一起 想像你們開著車 開在非洲的一條小路上 邊開邊注意到路邊的景象 你會發現到的是這個 一片墓地 然後你會停下來,下車,拍下照片 繼續往城鎮開 然後你會問:「這裡發生了什麼事?」 居民一開始會不願意回答你 之後有人會向你坦白 「這些是我們社區,最近因愛滋而死亡的人」 愛滋不像其他醫療疾病 得愛滋是種恥辱 人們不願意多談 提到愛滋就一陣惶恐 我今天要談的是,關於愛滋、 關於死亡、 關於恥辱的故事 這是關於醫療的故事,但更重要的,是關於人們的故事
This map depicts the global distribution of HIV. And as you can see, Africa has a disproportionate share of the infection. There are 33 million people living with HIV in the world today. Of these, two-thirds, 22 million are living in sub-Saharan Africa. 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. We talk about things in relative terms. And I'm going to talk about annual pregnancies and HIV-positive mothers. The United States -- a large country -- each year, 7,000 mothers with HIV who give birth to a child. But you go to Rwanda -- a very small country -- 8,000 mothers with HIV who are pregnant. 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. 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.
這張地圖是全球愛滋分布圖 各位可以看到 非洲的愛滋感染分佈極不相稱 現今有3300萬人 感染愛滋病 這當中有三分之二的人 2200萬人住在次撒哈拉非洲地區 現在有140萬個愛滋媽媽 來自於中低所得國家 其中有九成 就住在次撒哈拉非洲地區 我們用相對的例子說明 我要談的是每年的懷孕率 與愛滋媽媽 美國這麼大一個國家 每年有七千個愛滋媽媽 產下子女 但你看到盧安達,相對而言很小的國家 有8000個懷孕的愛滋媽媽 當你到巴拉瓜納醫院 就在(南非)約翰尼斯堡附近 醫院裡有約八千名懷孕的愛滋媽媽 等著生產 光一家醫院的數量就如此龐大 所以請了解,這只是冰山一角 和南非相比 南非的情形可是一片慘澹 因為在南非 每年有30萬個愛滋媽媽 懷孕生子
So we talk about PMTCT, and we refer to PMTCT, prevention of mother to child transmission. 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. The reality is really, very different. 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. 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. 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. So it's the test a mother gets when she comes in. It's the drugs she receives to protect the baby that's inside the uterus and during delivery. It's the guidance she gets around infant feeding and safer sex. It's an entire package of services, and it works.
所以我要談PMTCT PMTCT代表:母子垂直感染的預防計畫 大家對於愛滋的普遍看法是 當一名母親感染愛滋 她的孩子也會受感染 但事實並非如此 在資源豐富的國家 我們已經有許多的測試與療法 愛滋寶寶機率只有不到2% 98%的寶寶愛滋病毒會呈現陰性反應 然而在資源短缺國家 因為測試與治療的缺乏 愛滋寶寶的機率高達40% 40%與2%的差距 是非常驚人的 所以這些計畫 我接下來演講裡所說的PMTCT 這些預防計畫 簡單說,母親能接受檢查與藥物治療 來預防垂直感染 同時也必須服用藥物 讓母親們身體健康到能養育嬰兒 所以一開始的檢查很重要 她要服用的藥很重要 能讓肚裡的寶寶能健康發育到出生 嬰兒餵養的指導很重要 安全性行為也很重要 這是關於完善的服務 而且是有效的
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. 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. What does that mean? It means 1,100 children infected each day -- 1,100 children each day, infected with HIV. And where do they come from? Well, less than one comes from the United States. One, on average, comes from Europe. 100 come from Asia and the Pacific. And each day, a thousand babies -- a thousand babies are born each day with HIV in Africa.
在美國 1990年代中期,愛滋的治療出現後 在愛滋寶寶的數量上 已經降低80% 美國每年的愛滋寶寶數量 不到100個 然而世界上 每年還是有超過40萬名兒童 一出生就感染愛滋 這代表了什麼? 這代表每天就有1100個孩子受感染 每天有1100個孩子感染愛滋 這些寶寶從哪來? 不到一個是來自美國 平均歐洲有一個 剩下有一百個來自亞洲、太平洋地區 然而每一天 有一千個寶寶,一千個愛滋寶寶 在非洲出生
So again, I look at the globe here and the disproportionate share of HIV in Africa. And let's look at another map. And here, again, we see Africa has a disproportionate share of the numbers of doctors. That thin sliver you see here, that's Africa. And it's the same with nurses. 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. That means doctors and nurses simply don't have the time to take care of patients. 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. And so when we look at these PMTCT programs, what does it mean?
所以我們看看全球情況 在非洲,愛滋分布不均的情況 我們來看另一個地圖 可以再次看到 在非洲,醫生數量也是分佈不均 圖中那條銀色細線,就是非洲 護士也一樣 事實上,次撒哈拉非洲地區 包含了24%的 世界疾病數量 但醫療人員數量卻只有全世界的3% 這表示,這裡的醫生護士 根本沒有時間照顧好每個病人 較忙的診所裡,每天 每位護士要照看50到100位病人 一個病人只有幾分鐘時間 短短幾分鐘 當我們看看這些PMTCT計畫,代表了什麼?
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, 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. 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. And so these are the tests a nurse now has to do in those same few minutes. It's not possible -- it doesn't work. And so we need to find better ways of providing care.
我們先回到2001年 當時要做的檢查很簡單 藥也只有一顆 一位護士可以在幾分鐘內 提供病人愛滋病諮詢、檢查、 解釋檢查結果、發藥(因為只有一顆:Nevirapine)、 解釋服藥方式、討論嬰兒的服藥選擇、加強嬰兒餵食、 替嬰兒檢查,幾分鐘內就要完成 幸運的是,從2001以後 我們有了新治療、新測試 能更加成功地對抗愛滋了 但護士還是不夠多 這些測試是 現在的護士 短短幾分鐘內就要完成的 這根本不可能 根本辦不到 所以我們需要的是 提供更好的醫療照顧
This is a picture of a maternal health clinic in Africa -- mothers coming, pregnant and with their babies. These women are here for care, but we know that just doing a test, just giving someone a drug, it's not enough. Meds don't equal medical care. Doctors and nurses, frankly, don't have the time or skills to tell people what to do in ways they understand. 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. You should always use a condom," and yet, in her relationship, she's not empowered -- what's going to happen? 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. 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.
這照片是非洲一家婦產科診所 許多的母親來到這,有懷孕的、帶著孩子的 這些婦女來這裡接受照顧 我們都知道只做測試 給他們藥物吃 是不夠的 藥品不等於醫療照顧 老實說,醫生護士們 根本沒有時間、能力 去好好解釋給病人聽 我是個醫生,我給病人指示 希望他們能照我說的去做 因為我是個醫生,我哈佛畢業的 但事實上 如果跟病人說:「你要有安全的性行為」 「一定要用保險套」 但他們的社會裡,女人沒有權利 會發生什麼事? 如果我告訴她,每天按時服藥 但她家裡沒人知道她生病了又有什麼用 這是行不通的 所以我們必須做更多 必須換種方式 這方式要我們能夠負擔 能夠接觸到更多人 所以一定要到處都可行
So, I want to tell you a story -- I want to take you on a little trip. Imagine yourself, if you can, you're a young woman in Africa, you're going to the hospital or clinic. You go in for a test and you find out that you're pregnant, and you're delighted. And then they give you another test and they tell you you're HIV-positive, and you're devastated. 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. All you're hearing is, "I'm going to die, and my baby is going to die." And then you're out on the street, and you don't know where to go. 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. And this -- this is the face and story of HIV in Africa today.
我分享一個故事給各位 帶你們來趟旅行 想想你們自己 是非洲的一名年輕女性,來到醫院或診所 你來做檢查 你發現你懷孕了,很開心 但他們要你做另一項檢查 告訴你患有愛滋,你感到很絕望 然後護士帶你到另一個房間 她告訴你一些檢查方式、 和需要服用的愛滋藥物 教你如何照顧自己和寶寶 你完全聽不進去啊 你聽到的只有「我快死了」 「我的寶寶也會死」 然後你走出診所,沒有目標地晃 你不知道能向誰傾訴 因為事實上,染上愛滋是很恥辱的事 你的伴侶、家人知道後 很可能把你趕出家門 不給你任何支柱 這就是非洲今日 對於愛滋病的樣貌
But we're here to talk about possible solutions and some good news. And I want to change the story a little bit. Take the same mother, and the nurse, after she gives her her test, takes her to a room. 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. They're drinking tea, they're having sandwiches. And she goes inside, and woman comes up to her and says, "Welcome to mothers2mothers. Have a seat. You're safe here. We're all HIV-positive. You're going to be okay. You're going to live. Your baby is going to be HIV-negative."
今天要談的是可能的解決方式 和一些好消息 我想要換個故事說 一樣的母親、護士,在她做完檢查後 護士帶她到另一個房間 門一打開,裡面全是媽媽們,與她們的孩子 他們坐著聊天,彼此傾聽 他們喝著茶,吃著三明治 她走進去,這些女人們走向她,並說 「歡迎來到媽媽天地」 「請坐下吧,你很安全」 「我們都有愛滋」 「但我們都會沒事的,你不會死」 「妳的寶寶不會得愛滋的」
We view mothers as a community's single greatest resource. Mothers take care of the children, take care of the home. So often the men are gone. They're working, or they're not part of the household. Our organization, mothers2mothers, enlists women with HIV as care providers. 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. 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. 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. Consider: if you needed surgery, you would want the best possible technical surgeon, right? 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. Patients are experts on their own experience, and they can share that experience with others. This is the medical care that goes beyond just medicines.
我們將母親視為 社群裡最有力量的來源 母親們照顧幼小,照顧家園 男人常常不在家 因為他們需要工作,不管家裡的事 我們的組織「媽媽天地(mothers2mothers)」 讓那些愛滋媽媽 成為照護人員 我們請那些有愛滋的母親們來 因為她們也經歷過PMTCT計畫 熟悉設備 讓她們回來,與醫生護士們一起工作 就像醫療團隊的一份子 我們稱這些母親為心靈媽媽 她們能夠接觸其他女性 因為這些女人就像以前的她們一樣,身懷六甲 因為這些女人剛知道自己得了愛滋 需要支持與教育 心靈媽媽能給病患們連續的扶持 並教導他們如何服藥 如何照顧自己 如何照顧孩子 想想:如果你需要開刀 你會找最好的外科醫生,對吧 但如果你想了解 手術將造成的影響 你想找的會是 有過同樣手術的病人 病人他們自己疾病的專家 他們可以分享自己的經驗 這才是所謂藥品以外的醫療照顧
So the mothers who work for us, they come from the communities in which they work. They're hired -- they're paid as professional members of the health care teams, just like doctors and nurses. 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. They go through two to three weeks of rigorous curriculum-based education, training. Now, doctors and nurses -- they too get trained. But so often, they only get trained once, so they're not aware of new medicines, new guidelines as they come out. Our mentor mothers get trained every single year and retrained. And so doctors and nurses -- they look up to them as experts. 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.
這些替我們工作的母親們 都來自於自己的社區 我們雇用她們,支付與專業醫療人員般的薪水 就像醫生、護士 我們替他們開銀行帳戶 薪水直接匯入銀行 如此一來,能保護他們的所得 讓家中的男人拿不到 他們必須接受二到三週的 非常密集教育訓練 醫生護士們也接受訓練 但通常只有一次而已 所以對於新藥品、 新的指導原則都不了解 但心靈媽媽每年接受訓練 重新培訓 所以醫生護士們 都把他們當成專家看待 想像一下,過去也是病人的婦女 竟能夠教育她的醫生 教育其他病人 照顧其他病人
Our organization has three goals. The first, to prevent mother-to-child transmission. The second: keep mothers healthy, keep mothers alive, keep the children alive -- no more orphans. 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. So how do we do it? 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. We go beyond that; we try to bring in the husbands, the partners. In Africa, it's very, very hard to engage men. Men are not frequently part of pregnancy care. 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. And so the father and the mother, together, go through the counseling and the testing. The father and the mother, together, they get the results. And this is so important in breaking through the stigma.
我們的機構有三個目標 第一:預防母子垂直感染 第二:照顧母親的身體健康,讓媽媽們活下去 讓孩子們活下去 不再有孤兒 第三點,也是最重要的一點 就是找到能賦予女性們力量的方法 讓她們能打破既有的印象 雖患愛滋,但也能過著正向、有生產力的人生 我們怎麼做的? 我想,最重要的就是"參與" 就是一對一 一對一的醫療諮詢及照顧 教導他們如何照顧自己 我們所做的不只如此 我們找來她們的丈夫、伴侶 在非洲,要男性們一起參與是很困難的 男人們通常不參與懷孕保健 但在盧安達這地方 他們有個政策就是 婦女不能單獨尋求醫療照顧 一定要孩子的父親陪伴才行 這就是規定 所以爸媽兩人會一起 接受檢查與諮詢 爸媽兩人一起等待檢查報告 這是打破原始印象很重要的一件事
Disclosure is so central to prevention. How do you have safer sex, how do you use a condom regularly if there hasn't been disclosure? Disclosure is so important to treatment, because again, people need the support of family members and friends to take their medicines regularly. We also work in groups. 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. And it's through the sharing that people get tactics of how to take care of themselves, how to disclose how to take medicines. And then there's the community outreach, engaging women in their communities. If we can change the way households believe and think, we can change the way communities believe and think. And if we can change enough communities, we can change national attitudes. We can change national attitudes to women and national attitudes to HIV. The hardest barrier really is around stigma reduction. We have the medicines, we have the tests, but how do you reduce the stigma? And it's important about disclosure.
公開對於預防是很重要的 要怎麼進行安全性行為?要怎麼定期使用保險套? 這些都是透過公開做到的 公開對於治療也很重要 因為,病人們需要家人朋友的支持 才能乖乖按時服藥 我們也是以團體進行 在團體裡,講課的不是我 而是這些女人們,聚在一起 在心靈媽媽的協助及輔導下 她們來到這裡,分享彼此的經驗 透過分享 病患們學會怎麼照顧自己 怎麼對他人坦白、如何服藥 接下來還要擴展到整個社區 讓社區內的女人都一同參與 如果我們能改變一個家戶 的想法與信念 我們就能改變整個社群的想法信念 如果我們能改變整個社群 我們就能改變整個國家態度 就能改變整個國家對女人的態度 對愛滋病的態度 最難的隔閡就是既有印象的破除 我們有藥物,也有醫療檢查 但要如何破除既有印象? 這又回到公開的重要性了
So, a couple years ago, one of the mentor mothers came back, and she told me a story. 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. And so the mentor mother went along with. And the patient walked into the house and said to her mother and siblings, "I have something to tell you. I'm HIV-positive." And everybody was quiet. And then her oldest brother stood up and said, "I too have something to tell you. I'm HIV-positive. I've been afraid to tell everybody." And then this older sister stood up and said, "I too am living with the virus, and I've been ashamed." And then her younger brother stood up and said, "I'm also positive. I thought you were going to throw me out of the family." And you see where this is going. The last sister stood up and said, "I'm also positive. I thought you were going to hate me." 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.
幾年前,有位心靈媽媽回來後 告訴我個故事 她有個病人,要求她 陪她一起回家 因為那病人想告訴自己的家人 她患有愛滋 但她不敢一個人面對 所以心靈媽媽陪她一起去 那病人走近家中 對她的母親與手足說: 「我要告訴你們一件事,我有愛滋」 每個人都噤聲 然後他的大哥站起來說 「我也要告訴你們一件事」 「我也有愛滋」 「我一直不敢跟你們說」 然後她姐姐也站起來說 「我也有愛滋」 「一直怕丟臉不敢說」 同樣的,她弟弟也站起來說 「我也有愛滋」 「我怕你們知道後,會把我趕出家門」 你們應該猜到後續發展了 最後,妹妹站起來說「我也有愛滋」 「我怕你們會恨我」 就這樣,他們第一次面對彼此 第一次分享這個經驗 第一次給彼此支持
(Video) Female Narrator: Women come to us, and they are crying and scared. I tell them my story, that I am HIV-positive, but my child is HIV-negative. I tell them, "You are going to make it, and you will raise a healthy baby." I am proof that there is hope.
(影片) 許多女人來到這 哭喪著臉 我分享自己的故事 告訴她們,我也是愛滋病患 但我的孩子很健康 我告訴她們,「你們辦得到的」 「你可以扶養出健康的寶寶。」 我就是最好的證明
Mitchell Besser: Remember the images I showed you of how few doctors and nurses there are in Africa. And it is a crisis in health care systems. Even as we have more tests and more drugs, we can't reach people; we don't have enough providers. So we talk in terms of what we call task-shifting. Task-shifting is traditionally when you take health care services from one provider and have another provider do it. Typically, it's a doctor giving a job to a nurse. 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. How do you build a better health care system? We've chosen to redefine the health care system as a doctor, a nurse and a mentor mother. And so what nurses do is that they ask the mentor mothers to explain how to take the drugs, the side effects. They delegate education about infant feeding, family planning, safer sex, actions that nurses simple just don't have time for.
記得我今天給各位看的 非洲那極少數的醫生護士數量 他們醫療系統的大問題 就算我們有再多的藥品、檢查 我們還是沒辦法接觸到很多人,因為協助不夠多 所以我們講到任務轉換 任務轉換通常是 當你從某個提供照護者的身上,獲得服務 會是由另一個照護者幫助你 正常來講,是由醫生囑咐護士 但非洲的問題是 護士比醫生還少 所以健保來說,需要有新規範 要怎麼建立更好的健保制度? 我選擇去重新定義健保制度 新制度包含了醫生、護士,和心靈媽媽 所以護士們能請 心靈媽媽們向病人解釋 服藥方式、及其副作用 她們教育這些媽媽餵食嬰兒的方式、 家庭計劃、安全性行為 這些都是護士們沒有時間做的
So we go back to the prevention of mother to child transmission. The world is increasingly seeing these programs as the bridge to comprehensive maternal and child health. And our organization helps women across that bridge. 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.
我們回到最初討論的,母子垂直感染的預防 有越來越多人,將這類型的計畫 視為母子健康的全面性橋樑 而我們的組織 就是要幫助女性跨越橋樑 但醫療照顧不止於孩子出生而已 我們照顧母子後續的健康 確保他們都能 健康地活下去
Our organization works on three levels. The first, at the patient level -- mothers and babies keeping babies from getting HIV, keeping mothers healthy to raise them. The second, communities -- empowering women. They become leaders within their communities. They change the way communities think -- we need to change attitudes to HIV. We need to change attitudes to women in Africa. We have to do that. And then rework the level of the health care systems, building stronger health care systems. Our health care systems are broken. They're not going to work the way they're currently designed. 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. And so in redefining the health care teams by bringing the mentor mothers in, we can do that.
我們的組織有三個層面 第一:病患層面 照顧母子,避免孩子傳染上愛滋病毒 讓母親能健康地撫養小孩 第二:社群層面 賦予女性力量 讓她們成為自己社群的領導者 讓她們改變社群的思考方式 我們必須改變大家對愛滋的態度 我們必須改變大家對非洲女性的態度 我們必須做到這些 再來努力健保系統的部份 建立更強大的醫療體制 因為現有的體制已經無效 照現在制度是不可行的 所以那些醫生護士們 必須負責改變病人的行為 不過他們沒有能力,也沒時間 但心靈媽媽們有 藉由心靈媽媽的加入,重新組織的醫療團隊才健全 這我們做得到
I started the program in Capetown, South Africa back in 2001. It was at that point, just the spark of an idea. Referencing Steven Johnson's very lovely speech yesterday on where ideas come from, I was in the shower at the time -- I was alone. (Laughter) 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. That is 20 percent of the global HIV-positive pregnant women -- 20 percent of the world. What's extraordinary is how simple the premise is. Mothers with HIV caring for mothers with HIV. Past patients taking care of present patients. And empowerment through employment -- reducing stigma.
我們的計畫最早從(南非)開普敦開始的 2001年那時候 當時,只是個突想的點子 依據Steven Johnson昨天的演講 講述新點子是從哪裡來 我當時沖著澡 獨自一人 (笑聲) 我們的計畫已在九個國家實行 共有670個據點 每個月能照顧到 23萬名婦女 共僱用1600個心靈媽媽 去年,我們收了 30萬名愛滋媽媽 這佔了全球 愛滋媽媽的20% 全世界的20% 這麼簡單的主張,這麼驚人的成果 讓愛滋媽媽照顧愛滋媽媽 讓過去的病患照顧現在的病患 讓就業賦予她們能力 打破既有的看法
(Video) Female Narrator: There is hope, hope that one day we shall win this fight against HIV and AIDS. Each person must know their HIV status. Those who are HIV-negative must know how to stay negative. Those who are HIV-infected must know how to take care of themselves. HIV-positive pregnant women must get PMTCT services in order to have HIV-negative babies. All of this is possible, if we each contribute to this fight.
(影片) 希望是存在的 我希望有天 我們能贏得這場 對抗愛滋的戰爭 每個人都要知道 自己的愛滋病毒情況 那些愛滋病毒成陰性反應的人 要知道怎麼繼續保持陰性 已經感染愛滋病毒的人 一定要知道 如何照顧自己 感染愛滋的懷孕婦女 一定要加入PMTCT計畫 如此才能 生下健康的寶寶 這些是辦得到的 只要每個人都盡一己之力
MB: Simple solutions to complex problems. Mothers caring for mothers. It's transformational.
這個複雜問題的簡單解答就是 讓母親們相互照顧 這轉變是非常大的
Thank you.
謝謝各位
(Applause)
(掌聲)