The idea of eliminating poverty is a great goal. I don't think anyone in this room would disagree. What worries me is when politicians with money and charismatic rock stars --
“消除贫困”是一个伟大的目标。 我想在座各位都会赞同这点。 令我担心的是,当有钱的政客 和耀眼的摇滚明星们
(Laughter)
使用这样的词语时,
use the words, " ... it all just sounds so, so simple."
这个目标听上去太过于轻松容易了。
Now, I've got no bucket of money today and I've got no policy to release, and I certainly haven't got a guitar. I'll leave that to others. But I do have an idea, and that idea is called Housing for Health.
我今天来一没带一大笔钱, 二也没什么政策可以发布, 很明显我也没拎把吉他上来。 我把这些东西留给别人去用吧。 不过,我倒是带了一个想法, 一个叫做“健康住所”的想法。
Housing for Health works with poor people. It works in the places where they live, and the work is done to improve their health. Over the last 28 years, this tough, grinding, dirty work has been done by literally thousands of people around Australia and, more recently, overseas, and their work has proven that focused design can improve even the poorest living environments. It can improve health and it can play a part in reducing, if not eliminating, poverty.
“健康住所”与穷人一起工作。 在他们住的地方开展工作, 目的是改善他们的卫生健康。 过去的28年里, 全澳大利亚,还有最近在海外地区, 有实实在在成千上万的人 干完了这项又脏、又苦、又累的工作, 并且他们的工作证明了,有针对性的方案 可以改善哪怕是最恶劣的生活环境。 这项工作可以改善卫生健康,就算是不能消除贫困, 也可以起到减轻贫困的作用。
I'm going to start where the story began -- 1985, in Central Australia. A man called Yami Lester, an Aboriginal man, was running a health service. Eighty percent of what walked in the door, in terms of illness, was infectious disease -- third world, developing world infectious disease, caused by a poor living environment.
我来把这个故事从头讲起,1985年, 在澳大利亚中部。 有一位名叫亚米·莱斯特的土著男子, 当年正在提供医疗卫生服务。 他看过的百分之八十的病例, 都是传染性疾病—— 第三世界,或是发展中国家典型的、 因恶劣生活环境而引起的传染性疾病。
Yami assembled a team in Alice Springs. He got a medical doctor. He got an environmental health guy. And he hand-selected a team of local Aboriginal people to work on this project. Yami told us at that first meeting, "There's no money," -- always a good start -- " ... no money, you have six months, and I want you to start on a project --" which, in his language, he called "Uwankara Palyanku Kanyintjaku," which, translated, is "a plan to stop people getting sick" -- a profound brief. That was our task.
亚米在艾丽斯斯普林斯(澳大利亚中部城市)组建了一支团队。 其中有一名医生, 还有一名环境卫生人员。 他亲自挑选了一支由当地土著人组成的医疗团队 来开展这个项目。 亚米在起初的那次会议上告诉我们,他们没有资金。 真是光脚的不怕穿鞋的,有前途! 你有6个月的时间, 我让你去启动一个用他的土著语称为 “uwankara palyanku kanyintjaku”的项目, 翻译过来就是“不再有人生病计划”, 多么简练而深奥啊! 那就我们的任务。
First step, the medical doctor went away for about six months. And he worked on what were to become these nine health goals -- what were we aiming at? After six months of work, he came to my office and presented me with those nine words on a piece of paper.
第一步,那名医生走了 大概有半年时间, 他去进行研究调查,并得出 我们要认准的这九项卫生健康目标。 进行六个月的工作后,他来到我的办公室 递给我一张纸,上面写着这九个词。
[The 9 Healthy Living Practices: Washing, clothes, wastewater, nutrition, crowding, animals, dust, temperature, injury]
[九项健康居住做法:清洗、衣服、废水、营养、拥挤状况、动物+、灰尘、温度、损害] 我当时真的是无语了。
I was very unimpressed. Big ideas need big words, and preferably a lot of them. This didn't fit the bill. What I didn't see and what you can't see was that he'd assembled thousands of pages of local, national and international health research that filled out the picture as to why these were the health targets.
拜托! 表达伟大的想法要用些高阶词汇 并且要多多益善才对吧。 这玩意儿也太差劲了吧。 但是你我没看出来的是, 他搜集整理了数千页的 当地、国家和全球健康研究报告, 并从这些报告中提炼出来
The pictures that came a bit later had a very simple reason.
可以解释这些卫生健康目标的图片。
The Aboriginal people who were our bosses and the senior people were most commonly illiterate, so the story had to be told in pictures of what these goals were. We worked with the community, not telling them what was going to happen in a language they didn't understand.
我们很快拿到了这些图片, 使用图片的原因很简单。 我们的“老板们”(对“服务对象”打趣的说法)都是土著人 而且那些年长者大多都不识字, 所以我们必须用图片来传达信息 告诉他们这些目标。 我们要为这个社区服务, 就不可能用他们不懂的语言 去告诉他们将要发生的事情。
So we had the goals and each one of these goals -- and I won't go through them all -- puts at the center the person and their health issue, and it then connects them to the bits of the physical environment that are actually needed to keep their health good. And the highest priority, you see on the screen, is washing people once a day, particularly children.
好吧,我们有了这些目标— 我就不一一列举了—— 每个目标都是以“人”和他们的健康问题为中心的, 然后将这些目标 和为保持他们良好健康而切实需要的 那些物理环境因素相联系。 其中最重要的一点,请看大屏幕, 就是人人每天清洗一次,尤其是给儿童。
And I hope most of you are thinking, "What? That sounds simple."
你们可能会想, “啥?就这么简单?”
Now, I'm going to ask you all a very personal question. This morning before you came, who could have had a wash using a shower? I'm not going to ask if you had a shower, because I'm too polite. That's it.
好吧,我问诸位一个非常私人的问题。 今天早上出门前, 有谁可以冲澡? 其实我问的很委婉, 我没直接问你们有没有洗澡。(笑声)
(Laughter)
好吧,好吧。
All right, I think it's fair to say most people here could have had a shower this morning.
我觉得可以不含糊地说,在座大部分人 今天早上都有冲澡的条件。
I'm going to ask you to do some more work. I want you all to select one of the houses of the 25 houses you see on the screen. I want you to select one of them and note the position of that house and keep that in your head. Have you all got a house? I'm going to ask you to live there for a few months, so make sure you've got it right. It's in the northwest of Western Australia, very pleasant place.
现在我想请各位做件事 请各位在屏幕上的25所房子中, 选择一所。 请选好并留意 那所房子的位置 而且要记住它的位置。 选好了么?一定要选对哟, 因为我要让你在那儿住几个月。 这些房子位于西澳大利亚州的西北部,很不错的地方。 好了。我们来看看你房子里的淋浴器好不好使。
OK. Let's see if your shower in that house is working. I hear some "Aw!" and I hear some "Ah!"
我听到一些“哦~~~”还有一些“啊~~~”
If you get a green tick, your shower's working. You and your kids are fine. If you get a red cross, well, I've looked carefully around the room and it's not going to make much difference to this crew. Why? Because you're all too old. I know that's going to come as a shock to some of you, but you are. And before you get offended and leave, I've got to say that being too old, in this case, means that pretty much everyone in the room, I think, is over five years of age.
恭喜打绿钩的朋友们,你们的淋浴器可以正常使用。 你们和你们孩子会没事儿的。 不过打了红叉的朋友们么, 我得仔细检查检查那间浴室 这对在座各位其实不会有什么影响。 为什么呢?因为各位的年龄都太大了。 我知道有人可能会觉得诧异, 但各位的年龄的确太大。 各位准备愤然离席之前, 我得解释一下,我说的“年龄太大” 意思是,基本上在座的每一位, 都超过5岁了。
We're really concerned with kids naught to five. And why? Washing is the antidote to the sort of bugs, the common infectious diseases of the eyes, the ears, the chest and the skin that, if they occur in the first five years of life, permanently damage those organs. They leave a lifelong remnant. That means that by the age of five, you can't see as well for the rest of your life. You can't hear as well for the rest of your life. You can't breathe as well. You've lost a third of your lung capacity by the age of five. And even skin infection, which we originally thought wasn't that big a problem, mild skin infections naught to five give you a greatly increased chance of renal failure, needing dialysis at age 40. This is a big deal, so the ticks and crosses on the screen are actually critical for young kids.
而我们真正担心的是那些零到五岁的孩子。 为什么呢?因为清洗能够消灭那些 感染眼睛、耳朵、胸部和皮肤等 常见传染性疾病, 如果孩子在5岁之前染上这些疾病, 那些器官就会终身受损。 会贻害他们的终身。 也就是说,到五岁的时候, 你会失明,而且是终身失明。 你会失聪,而且是终身失聪。 你会呼吸困难。因为到5岁的时候, 你已经损失了三分之一的肺功能。 就连我们平时不在乎的肌肤感染 也会变成大问题, 五岁以前轻微的肌肤感染 将大大增加肾衰竭的几率, 你可能到40岁时就需要做透析了。 这可不是闹着玩儿的!所以屏幕上的这些钩钩叉叉 其实对小儿来说是至关重要的。
Those ticks and crosses represent the 7,800 houses we've looked at nationally around Australia, the same proportion. What you see on the screen -- 35 percent of those not-so-famous houses lived in by 50,000 indigenous people -- 35 percent had a working shower. Ten percent of those same 7,800 houses had safe electrical systems. And 58 percent of those houses had a working toilet. These are by a simple, standard test. In the case of the shower: does it have hot and cold water, two taps that work, a shower rose to get water onto your head or onto your body, and a drain that takes the water away? Not well-designed, not beautiful, not elegant -- just that they function. And the same tests for the electrical system and the toilets.
屏幕上这些钩钩和叉叉的比例, 和我们在澳大利亚全境调查过的7800所房子的比例, 相一致。 正如屏幕上所显示的 — 有50000土著人民 住在其中35%的不起眼的房子里, 35%的房子配有能用的淋浴器。 那7800所相同房子中, 10%配有安全供电系统, 58%的房子 有可用的厕所。 检测标准很简单: 就淋浴而言,有没有冷热水, 两个龙头是否正常工作, 淋浴喷头能否出水, 地漏能否正常排水? 无需考虑设计是否美观大方, 只要工作正常就行。 检测电力系统和厕所的标准也是这样的。
Housing for Health projects aren't about measuring failure -- they're actually about improving houses. We start on day one of every project. We've learned -- we don't make promises, we don't do reports. We arrive in the morning with tools, tons of equipment, trades, and we train up a local team on the first day to start work. By the evening of the first day, a few houses in that community are better than when we started in the morning.
“健康住所”的项目不是为考量故障。 这些项目其实是为改善住房条件。 我们在每个项目确定的头一天就开工——经验告诉我们, 光说不练假把式,用不着承诺,也用不着打报告。 我们一早带来各种工具和很多设备, 同时,我们在开工第一天训练一支当地团队 来开展工作。 到第一天夜幕降临的时候, 那个社区中的一些房子 相比我们早上开工的时候,已经有所改善。
That work continues for six to 12 months, until all the houses are improved and we've spent our budget of 7,500 dollars total per house. That's our average budget. At the end of six months to a year, we test every house again. It's very easy to spend money. It's very difficult to improve the function of all those parts of the house. And for a whole house, the nine healthy living practices, we test, check and fix 250 items in every house.
那项工作持续了半年到一年时间, 直到所有的房子都得以修善 每所房子总共花掉我们 7500美元的预算。 那是我们的平均预算。 在每个项目的最后,我们都会逐一复查每所房子。 想花钱很容易。 难的是改善一所房子里 所有那些部分的功能, 就一所房子而言,是指那九项健康居住做法, 我们测试、检查和维修每所房子的250项细节。
And these are the results we can get with our 7,500 dollars. We can get showers up to 86 percent working, we can get electrical systems up to 77 percent working and we can get 90 percent of toilets working in those 7,500 houses. (Applause)
这些是我们花费7500美元 所能实现的结果。 在那7500所房子中, 我们能让其中86%的淋浴器正常使用, 我们能让其中77%的电力系统正常运转, 我们能让其中90%的厕所正常使用。 谢谢。(掌声)
Thank you.
(Applause)
那就是我们团队的工作,他们真的很棒。
The teams do a great job, and that's their work.
I think there's an obvious question that I hope you're thinking about. Why do we have to do this work? Why are the houses in such poor condition? Seventy percent of the work we do is due to lack of routine maintenance -- the sort of things that happen in all our houses. Things wear out, should have been done by state government or local government, simply not done, the house doesn't work. Twenty-one percent of the things we fix are due to faulty construction -- literally things that are built upside down and back to front. They don't work, we have to fix them.
你们可能在想一个问题 一个很明显的问题。 我们干嘛非要做这项工作? 这些房子的条件为啥如此糟糕? 我们工作的70% 是修复因缺少常规维修而造成的故障, 那种在我们所有人家中都会发生的事儿。 什么东西坏了,不能用了,之类的。 州政府或当地政府本应做好这些事儿。 可惜他们没做,结果那些房子就出了问题。 我们工作的21% 是修复因施工问题造成的故障, 什么东西装反了,装倒了之类的。 这些东西出了问题,我们就得去修。
And if you've lived in Australia in the last 30 years, the final cause -- you will have heard always that indigenous people trash houses. It's one of the almost rock-solid pieces of evidence which I've never seen evidence for, that's always reeled out as "That's the problem with indigenous housing." Well, nine percent of what we spend is damage, misuse or abuse of any sort. We argue strongly that the people living in the house are simply not the problem. And we'll go a lot further than that; the people living in the house are actually a major part of the solution. Seventy-five percent of our national team in Australia -- over 75 at the minute -- are actually local, indigenous people from the communities we work in. They do all aspects of the work.
如果你在过去的30年里住在澳大利亚, 这最后一个原因——你一定早已耳闻 “土著人的垃圾住房”。 这似乎成为了铁一般的佐证, 虽然我从没亲眼见过, 这一伪证一直被认为是土著人住房问题的主要根源。 好吧,我们只有9%的工作是修复那些损坏、 误用、或滥用之类原因而造成的故障。 我们可以很明确说,住在房子的人 根本就不是问题所在。 不仅如此,我们更要说 住在房子里的人其实是 解决问题的主要力量。 我们在澳大利亚70%的团队成员 刚才这一百分比已经超过75%, 其实是当地的土著人民, 他们来自我们项目帮助过的社区。 所有方面的工作都是他们在干。
(Applause)
(掌声)
In 2010, for example, there were 831, all over Australia, and the Torres Strait Islands, all states, working to improve the houses where they and their families live, and that's an important thing.
比如,2010年, 在澳大利亚各州和托雷斯海峡诸岛, 我们有831人致力于改善 他们和他们家人所居住的房子, 这非常重要。
Our work's always had a focus on health. That's the key. The developing world bug, trachoma, causes blindness. It's a developing-world illness, and yet, the picture you see behind is in an Aboriginal community in the late 1990s, where 95 percent of school-aged kids had active trachoma in their eyes, doing damage.
我们的工作关注健康。这是关键。 发展中国家的沙眼病能够致盲。 这是一种发展中国家常见的疾病, 然而,这张图所显示的是 在上世纪90年代末的一个土著社区 其中,95%的学龄儿童患有活动性沙眼 损伤着他们的眼睛。
OK, what do we do? Well, first thing we do, we get showers working. Why? Because that flushes the bug out. We put washing facilities in the school as well, so kids can wash their faces many times during the day. We wash the bug out.
好吧,怎么办? 我们要做的第一件事,是让淋浴器工作正常。 为什么?因为淋浴可以洗掉眼睛里的病菌。 我们也在学校里安装了盥洗设施, 以保证孩子们可以每天洗上几次脸。 把病菌洗掉。
Second, the eye doctors tell us that dust scours the eye and lets the bug in quick. So what do we do? We call up the doctor of dust, and there is such a person. He was loaned to us by a mining company. He controls dust on mining company sites. And he came out and, within a day, it worked out that most dust in this community was within a meter of the ground, the wind-driven dust -- so he suggested making mounds to catch the dust before it went into the house area and affected the eyes of kids. So we used dirt to stop dust. We did it. He provided us dust monitors. We tested and we reduced the dust.
接着,眼科医生告诉我们灰尘会摩擦眼睛, 使得病菌很快地侵入眼内。怎么办? 我们找来一位灰尘医生,别不信,真有这样的医生。 一个采矿公司把他借调给我们。 他在那家公司的矿区中专职控制灰尘, 然后他来帮忙,花了不到一天的时间 发现这个社区里的大多数灰尘 集中漂浮在距离地面一米的范围内,属于风动灰尘, 于是他建议用造土堆的方法 来阻挡灰尘飘进居住区域 去影响孩子们的眼睛。 所以我们用土阻挡了粉尘。 我们做到了。他给了我们几个灰尘检测器。 我们检测后发现灰尘的确减少了。
Then we wanted to get rid of the bug generally. So how do we do that? Well, we call up the doctor of flies -- and, yes, there is a doctor of flies. As our Aboriginal mate said, "You white fellows ought to get out more."
然后我们要搞定那些病菌。 怎么办? 我们找来了一位苍蝇医生, 没错儿,真有干这行的医生。 就像我们土著哥们儿说的那样, “你们这帮白人应该多出去走走,长长见识。”
(Laughter)
(笑声)
And the doctor of flies very quickly determined that there was one fly that carried the bug. He could give school kids in this community the beautiful fly trap you see above in the slide. They could trap the flies, send them to him in Perth. When the bug was in the gut, he'd send back by return post some dung beetles. The dung beetles ate the camel dung, the flies died through lack of food, and trachoma dropped. And over the year, trachoma dropped radically in this place, and stayed low. We changed the environment, not just treated the eyes. And finally, you get a good eye.
然后这位苍蝇医生很快就找出了 携带那种病菌的苍蝇。 他给这个社区的学生们发放了 幻灯上显示的这种别致的捕蝇器。 学生们抓到苍蝇以后,将它们送回苍蝇医生在珀斯的研究室。 因为这些病菌生活在苍蝇的内脏中,于是苍蝇医生从珀斯 寄回来了一些屎壳郎虫。 这些屎壳郎给力地抢食苍蝇们的骆驼粪, 导致苍蝇们因为食物短缺而死亡, 沙眼病菌的也就减少了。 一年之后,当地的沙眼病菌 大幅减少,而且一直很少。 我们不仅仅治了眼病,还改变了环境。 最终,还你一双明亮的眼睛。
All these small health gains and small pieces of the puzzle make a big difference. The New South Wales Department of Health, that radical organization, did an independent trial over three years to look at 10 years of the work we've been doing in these sorts of projects in New South Wales. And they found a 40 percent reduction in hospital admissions for the illnesses that you could attribute to the poor environment -- a 40 percent reduction.
这些小小的健康成果 和健康难题中的那些小问题,产生了巨大的不同。 新南威尔士卫生部, 那个激进的组织, 用三年多时间做了一个独立的追踪调查 调查我们10年来 在新南威尔士地区所做的这类项目, 结果他们发现, 因恶劣环境而致病的入院人数 减少了40%。 40%啊朋友们!
(Applause)
(掌声)
Just to show that the principles we've used in Australia can be used in other places, I'm just going to go to one other place, and that's Nepal. And what a beautiful place to go. We were asked by a small village of 600 people to go in and make toilets where none existed. Health was poor. We went in with no grand plan, no grand promises of a great program, just the offer to build two toilets for two families. It was during the design of the first toilet that I went for lunch, invited by the family into their main room of the house. It was choking with smoke. People were cooking on their only fuel source, green timber. The smoke coming off that timber is choking, and in an enclosed house, you simply can't breathe. Later we found the leading cause of illness and death in this particular region is through respiratory failure.
我还想展示一下,我们把在澳大利亚的工作原理 应用到世界上其他地方, 我只展示其中的一个地方,就是尼泊尔, 多么美丽的地方! 那儿有一个600人的小村子, 请我们去解决当地没有厕所的问题。 那儿卫生条件很差。 我们去的时候,没有宏伟的计划,也没有对伟大方案 的庄严承诺,我们就是去 给两户人家修建两个厕所。 在我们设计第一个厕所的时候 我被请去那户人家吃午饭。 当我走到他们客厅的时候, 屋里浓烟滚滚。 人们正用他们的唯一燃料 — 生木材烧饭。 那股烟真是太呛了, 要是在一个密闭房间里,会熏死人的。 之后,我们发现当地居民最大的病因和死因 就是呼吸系统衰竭。
So all of a sudden, we had two problems. We were there originally to look at toilets and get human waste off the ground, that's fine. But all of a sudden now there was a second problem: How do we actually get the smoke down? So two problems, and design should be about more than one thing. Solution: Take human waste, take animal waste, put it into a chamber, out of that, extract biogas, methane gas. The gas gives three to four hours cooking a day -- clean, smokeless and free for the family.
于是一下子我们又多出了一个新问题。 我们本来是去察看厕所情况 解决随地大小便问题。这不难办。 但是一下子我们有了第二个问题。 我们怎样才能搞定这股浓烟?总共俩问题, 我们的设计方案就不能孤注一掷。 解决办法:把人畜粪便, 堆进一个小房间内,从而提取沼气, 就是甲烷气体。 这家人每天可以用这种洁净、无烟而且免费的气体, 烧3到4小时的饭。
(Applause)
(掌声)
I put it to you: is this eliminating poverty? And the answer from the Nepali team who's working at the minute would say, don't be ridiculous -- we have three million more toilets to build before we can even make a stab at that claim. And I don't pretend anything else.
我要问一个诸位:“这算不算消除贫困?” 正在工作的尼泊尔团队 估计会说:别逗了, 先把剩下的300万个厕所建好 再讨论这个问题吧。 我没有吹嘘。
But as we all sit here today, there are now over 100 toilets built in this village and a couple nearby. Well over 1,000 people use those toilets. Yami Lama, he's a young boy. He's got significantly less gut infection because he's now got toilets, and there isn't human waste on the ground. Kanji Maya, she's a mother, and a proud one. She's probably right now cooking lunch for her family on biogas, smokeless fuel. Her lungs have got better, and they'll get better as time increases, because she's not cooking in the same smoke. Surya takes the waste out of the biogas chamber when it's shed the gas, he puts it on his crops. He's trebled his crop income, more food for the family and more money for the family. And finally Bishnu, the leader of the team, has now understood that not only have we built toilets, we've also built a team, and that team is now working in two villages where they're training up the next two villages to keep the work expanding. And that, to me, is the key.
就在我们今天坐在这儿的时候, 这个村子和周边的二个村里 已经建好了100多个厕所。 有1000多人使用这些厕所。 有一位少年名叫雅美·喇嘛, 曾患有脏器感染。因为现在用上了厕所, 他的病症明显减轻了, 而且再也没人随地大小便了。 有位自豪的母亲名叫康吉玛雅。 她现在可能正在用无烟燃料— 沼气 为她的家人做饭。 她的肺现在好多了,而且今后会越来越好 因为她已经彻底告别浓烟。 苏尔亚将正在制造沼气的粪肥 施在他的庄稼上。 他的庄稼现在带给他原来三倍的收入, 带给一家人更多的粮食和更多的金钱。 还有比什努, 当地团队的带头人,现在明白了 我们不仅修建了厕所, 同时我们也培养了一支团队, 这支团队现在正在两个村子里干活 同时他们也在训练下两个村里的村民 不断扩展这项工作。
(Applause)
我觉得这才是关键。
People are not the problem.
(掌声)
We've never found that. The problem: poor living environment, poor housing and the bugs that do people harm. None of those are limited by geography, by skin color or by religion. None of them. The common link between all the work we've had to do is one thing, and that's poverty.
“人”不是问题所在。 我们向来都是这么认为的。 真正的问题出在:恶劣的居住环境, 糟糕的住房条件,还有各种损害人体健康的病原体。 所有这些问题都不受地域、 肤色或宗教信仰的限制。 串联着我们所有工作的是 两个字:贫穷。
Nelson Mandela said, in the mid-2000s, not too far from here, he said that like slavery and apartheid, "Poverty is not natural. It is man-made and can be overcome and eradicated by the actions of human beings." I want to end by saying it's been the actions of thousands of ordinary human beings doing -- I think -- extraordinary work, that have actually improved health, and, maybe only in a small way, reduced poverty.
纳尔逊·曼德拉在二十一世纪一十年代中叶, 那个并不遥远的过去,他曾说过, 就像奴隶制和种族隔离一样,“贫困现象不是自然的, 它是人为的,人类可以通过采取各种行动 来战胜和根除贫困现象。“ 最后,我想说的是 正是通过成千上万普通人的行动 和他们杰出的工作, 健康水平才真正得以提高, 而且,通过一点一滴的努力,减轻了贫困。
Thank you very much for your time.
感谢各位到场!
(Applause)
(掌声)