Let's talk dirty. A few years ago, oddly enough, I needed the bathroom, and I found one, a public bathroom, and I went into the stall, and I prepared to do what I'd done most of my life: use the toilet, flush the toilet, forget about the toilet. And for some reason that day, instead, I asked myself a question, and it was, where does this stuff go? And with that question, I found myself plunged into the world of sanitation -- there's more coming -- (Laughter) — sanitation, toilets and poop, and I have yet to emerge. And that's because it's such an enraging, yet engaging place to be.
我們來說點"髒話"吧 幾年前 奇怪的是 我需要去上廁所 我找到了一間公共廁所 我走進廁所間的時候 正要準備做我這一生常做的事 那就是方便後 沖水 再將一切拋諸腦後 不知道什麼原因 那天 我反而問了自己一個問題 那就是 這些東西會到哪裡? 這個問題使我陷入了-- 一個關於衛生的世界-- 後面還有呢 --(笑聲)-- 一個關於衛生、馬桶以及糞便的世界 而我至今還未浮上來 因為 那是個多麼令人激動 又令人著迷的世界
To go back to that toilet, it wasn't a particularly fancy toilet, it wasn't as nice as this one from the World Toilet Organization. That's the other WTO. (Laughter) But it had a lockable door, it had privacy, it had water, it had soap so I could wash my hands, and I did because I'm a woman, and we do that.
回到馬桶的故事 那個馬桶並沒有什麼特別之處 也沒有比 「世界馬桶組織」的馬桶來的好 簡稱也叫WTO的組織 (笑聲) 可是它有可鎖的門 有隱私 有水 它有肥皂可以讓我洗手 而我當然洗了 因為我是女人 我們都會洗
(Laughter) (Applause)
(笑聲)(掌聲)
But that day, when I asked that question, I learned something, and that was that I'd grown up thinking that a toilet like that was my right, when in fact it's a privilege. 2.5 billion people worldwide have no adequate toilet. They don't have a bucket or a box. Forty percent of the world with no adequate toilet. And they have to do what this little boy is doing by the side of the Mumbai Airport expressway, which is called open defecation, or poo-pooing in the open. And he does that every day, and every day, probably, that guy in the picture walks on by, because he sees that little boy, but he doesn't see him.
可是那天 我問了那個問題 我學到了件事: 一直以來 在我成長過程中 我以為使用馬桶是我的權利 可是其實那是一種特權 全世界有25億人沒有馬桶 他們沒有一個桶子或箱子 全世界有百分之四十的人沒有馬桶 他們只能像這個小男孩一樣 在孟買機場的高速公路邊 這被稱為隨地排便 或者叫做在戶外上大號 他每天都得這樣做 每一天 在照片上的男人可能 會路過 卻無動於衷 因為他雖然看到了小男孩 卻沒有真正看進眼底
But he should, because the problem with all that poop lying around is that poop carries passengers. Fifty communicable diseases like to travel in human shit. All those things, the eggs, the cysts, the bacteria, the viruses, all those can travel in one gram of human feces. How? Well, that little boy will not have washed his hands. He's barefoot. He'll run back into his house, and he will contaminate his drinking water and his food and his environment with whatever diseases he may be carrying by fecal particles that are on his fingers and feet. In what I call the flushed-and-plumbed world that most of us in this room are lucky to live in, the most common symptoms associated with those diseases, diarrhea, is now a bit of a joke. It's the runs, the Hershey squirts, the squits. Where I come from, we call it Delhi belly, as a legacy of empire. But if you search for a stock photo of diarrhea in a leading photo image agency, this is the picture that you come up with. (Laughter) Still not sure about the bikini. And here's another image of diarrhea. This is Marie Saylee, nine months old. You can't see her, because she's buried under that green grass in a little village in Liberia, because she died in three days from diarrhea -- the Hershey squirts, the runs, a joke. And that's her dad. But she wasn't alone that day, because 4,000 other children died of diarrhea, and they do every day. Diarrhea is the second biggest killer of children worldwide, and you've probably been asked to care about things like HIV/AIDS or T.B. or measles, but diarrhea kills more children than all those three things put together. It's a very potent weapon of mass destruction. And the cost to the world is immense: 260 billion dollars lost every year on the losses to poor sanitation. These are cholera beds in Haiti. You'll have heard of cholera, but we don't hear about diarrhea. It gets a fraction of the attention and funding given to any of those other diseases.
可是他應該要的 因為 這麼多糞便在地上所帶來的問題 就是糞便上載著一些"乘客" 50種傳染病喜歡以人的糞便來傳播 所有的東西 包括蛋、囊、 細菌、病毒 所有這些東西 都可以在一公克的人類糞便中傳播 怎麼會呢?因為那個男孩不可能洗手 他打著赤腳 跑回家去 他可能攜帶的疾病 會污染周邊的飲用水 、食物 以及環境 因為他的手指和腳上都有糞便物質 在這個我稱為「沖水就了事」的世界 我們大部分的人都很幸運可以在這生活 這些疾病中最常見的病症-- 腹瀉 -- 現今聽起來是個笑話 也稱為拉肚子、拉稀、澇屎 在我生長的地方 我們稱它為 "德里腹" 可是如果你在一家領先的照片圖像公司 搜尋腹瀉的照片 你會找到的是這張圖片 (笑聲) 我不太懂為什麼她要穿比基尼 這是另外一張關於腹瀉的照片 這是瑪麗賽里 九個月大 你看不到她 因為她被埋葬 在位於利比理亞小村莊的一片青草底下 因為她在三天內死於腹瀉-- 也就是所謂的拉肚子、拉稀 我們當笑話來看待的病 這是她的父親 可那天她並不是唯一的受害者 因為還有其他 4,000 位孩童也死於腹瀉 每天都如此 腹瀉是世界第二大兒童的殺手 而你們可能被灌輸要關注的是 一些像艾滋病、肺結核 或者麻疹的病 可是死於腹瀉的孩童 卻超過這其他三個疾病加起來的總數 這是一個非常嚴重的高規模毀滅性疾病 而世界要對此付出的代價非常龐大 每年惡劣衛生狀況帶來的虧損 逹2600億元 這是位於海地的霍亂專用病床 你們可能聽說過霍亂 卻沒聽說過腹瀉的問題 給予腹瀉的關注與資助只占 其他疾病的一小部份
But we know how to fix this. We know, because in the mid-19th century, wonderful Victorian engineers installed systems of sewers and wastewater treatment and the flush toilet, and disease dropped dramatically. Child mortality dropped by the most it had ever dropped in history. The flush toilet was voted the best medical advance of the last 200 years by the readers of the British Medical Journal, and they were choosing over the Pill, anesthesia, and surgery. It's a wonderful waste disposal device.
可是我們有解決辦法 我們知道,在19世紀中期 那些偉大的維多利亞工程師們 建造了下水道與廢水處理的系統 也建造了沖水馬桶,所以疾病大幅下降 當時兒童死亡率下降的幅度 是有史以來最大的 沖水馬桶被英國醫學雜誌讀者選為 兩百年以來最厲害的醫學進展 而他們要在藥丸、麻醉 以及 手術裡 做選擇 這是一個美妙的廢物處理設備
But I think that it's so good — it doesn't smell, we can put it in our house, we can lock it behind a door — and I think we've locked it out of conversation too. We don't have a neutral word for it. Poop's not particularly adequate. Shit offends people. Feces is too medical.
我覺得它真的很棒--不會臭 可以把它放在房子裡 把它鎖在門後面 可是同時我們也把它鎖在談話之外 對於糞便 我們沒有中性詞 “便便”並不非常適當 “屎”又會得罪人 “排泄物”又太醫學了
Because I can't explain otherwise, when I look at the figures, what's going on. We know how to solve diarrhea and sanitation, but if you look at the budgets of countries, developing and developed, you'll think there's something wrong with the math, because you'll expect absurdities like Pakistan spending 47 times more on its military than it does on water and sanitation, even though 150,000 children die of diarrhea in Pakistan every year. But then you look at that already minuscule water and sanitation budget, and 75 to 90 percent of it will go on clean water supply, which is great; we all need water. No one's going to refuse clean water. But the humble latrine, or flush toilet, reduces disease by twice as much as just putting in clean water. Think about it. That little boy who's running back into his house, he may have a nice, clean fresh water supply, but he's got dirty hands that he's going to contaminate his water supply with.
我沒有其他辦法可以解釋 當我看到這些數據代表了什麼 我們知道要如何解決 腹瀉與環境衛生的問題 可是如果你們看看這些國家的預算 不管是發展中國家還是已發展國家 你會覺得哪裏好像算錯了 因為你會預期一些荒謬的情況 像是 巴基斯坦花在軍事上的錢 比花在水源與環境衛生的錢高出47倍 儘管每年巴基斯坦會有 十五萬位孩童死於腹瀉 你再看看 那本來就極其微小的 水源與環境衛生預算 百分之75到90的預算會 花在乾淨的供水系統上 這是好事;我們都需要水 沒有人會抗拒乾淨的水源 可是公共廁所,或者沖水馬桶 所減少的疾病 是乾淨水源的兩倍 想想看 那位跑回家的小男孩 他可能擁有乾淨的水源 可是他的髒手會污染水源
And I think that the real waste of human waste is that we are wasting it as a resource and as an incredible trigger for development, because these are a few things that toilets and poop itself can do for us. So a toilet can put a girl back in school. Twenty-five percent of girls in India drop out of school because they have no adequate sanitation. They've been used to sitting through lessons for years and years holding it in. We've all done that, but they do it every day, and when they hit puberty and they start menstruating, it just gets too much. And I understand that. Who can blame them? So if you met an educationalist and said, "I can improve education attendance rates by 25 percent with just one simple thing," you'd make a lot of friends in education.
我認為在廢物處理上真正的浪費 就是我們浪費掉 把它轉化成資源的可能 也浪費掉把它轉化成 激起巨大發展的可能 因為馬桶以及糞便 能為我們達成很多事 馬桶可以使一個女孩回到學校 在印度 百分之25的女孩們放棄就學 因為她們沒有適當的衛生設施 多年以來 她們已經習慣 上課的時候要憋住 我們都做過,可是她們每天都如此 當她們進入青春期的時候開始有月經 對她們來說已經無法承受了 我能理解她們 誰能怪她們呢? 所以如果你對一個教育學者說 “我可以用一個簡單的方法” “將學校出席率提高百分之25” 你在教育界就會交到許多朋友
That's not the only thing it can do for you. Poop can cook your dinner. It's got nutrients in it. We ingest nutrients. We excrete nutrients as well. We don't keep them all. In Rwanda, they are now getting 75 percent of their cooking fuel in their prison system from the contents of prisoners' bowels. So these are a bunch of inmates in a prison in Butare. They're genocidal inmates, most of them, and they're stirring the contents of their own latrines, because if you put poop in a sealed environment, in a tank, pretty much like a stomach, then, pretty much like a stomach, it gives off gas, and you can cook with it. And you might think it's just good karma to see these guys stirring shit, but it's also good economic sense, because they're saving a million dollars a year. They're cutting down on deforestation, and they've found a fuel supply that is inexhaustible, infinite and free at the point of production.
這還不是全部 糞便可以使你飽餐一頓 糞便裡有營養素 我們吃進營養,同時也排出營養 我們不會留住所有的營養 在盧安達的監獄 百分之75的烹飪燃料 是來自囚犯腸道中的物質 這些犯人被囚禁在位於布塔雷的監獄 大部份的犯人都參與了種族滅絕的行動 他們在攪拌自己的排泄物 如果你把糞便放在密封的環境里, 譬如一個儲槽 就像胃一樣 所以呢 像胃一樣 會有氣體產生 而你可以運用氣體來烹飪 你可能覺得 這些人現在要攪拌自己的屎 是得到應有的報應 可這也是符合經濟概念的 因為他們一年可以省下一百萬元 他們減少了森林砍伐 也找到了一種用不完的、 無限的、免費生產的燃料來源
It's not just in the poor world that poop can save lives. Here's a woman who's about to get a dose of the brown stuff in those syringes, which is what you think it is, except not quite, because it's actually donated. There is now a new career path called stool donor. It's like the new sperm donor. Because she has been suffering from a superbug called C. diff, and it's resistant to antibiotics in many cases. She's been suffering for years. She gets a dose of healthy human feces, and the cure rate for this procedure is 94 percent. It's astonishing, but hardly anyone is still doing it. Maybe it's the ick factor. That's okay, because there's a team of research scientists in Canada who have now created a stool sample, a fake stool sample which is called RePOOPulate.
糞便並不只在貧窮國家挽救生命 這個女人正被 注射一劑棕色物體 這個物體跟你想的沒錯 可並不完全如此 因為它是被捐贈的 現在有一個新的職業道路叫做“糞便捐贈者” 就像最近流行的的“精液捐贈者” 因為她被一種超級病毒感染 叫做艱難酸菌 此病菌很多時候都對抗生素有抗藥性 她患病已經多年了 她只要一劑健康的人類糞便 這個程序的治癒率是百分之九十四 效果令人訝異 可是接受此程序的人寥寥無幾 可能覺得噁心吧 不過沒關係,因為加拿大有一組 研究科學家已經做出糞便的樣本-- 一個假的糞便樣本 叫做 RePOOPulate
So you'd be thinking by now, okay, the solution's simple, we give everyone a toilet. And this is where it gets really interesting, because it's not that simple, because we are not simple. So the really interesting, exciting work -- this is the engaging bit -- in sanitation is that we need to understand human psychology. We need to understand software as well as just giving someone hardware. They've found in many developing countries that governments have gone in and given out free latrines and gone back a few years later and found that they've got lots of new goat sheds or temples or spare rooms with their owners happily walking past them and going over to the open defecating ground.
你現在可能在想 好吧 解決辦法很簡單 我們給大家一個馬桶就好了 這就是有趣的地方 因為事情並不簡單,我們也沒那麼簡單 所以真正有趣又令人興奮的工作 -- 公共衛生的工作裡迷人的地方 就是我們需要了解人類心理學 我們需要了解"軟體" 也要了解直接給予"硬體"的問題 我們發現 很多發展中國家的政府 都有給予免費的公共廁所 可是幾年後卻發現 那裡多出了新的羊棚、神殿或空房 建築的主人還開開心心的路過那裡 走到開放排便地去上廁所
So the idea is to manipulate human emotion. It's been done for decades. The soap companies did it in the early 20th century. They tried selling soap as healthy. No one bought it. They tried selling it as sexy. Everyone bought it. In India now there's a campaign which persuades young brides not to marry into families that don't have a toilet. It's called "No Loo, No I Do." (Laughter) And in case you think that poster's just propaganda, here's Priyanka, 23 years old. I met her last October in India, and she grew up in a conservative environment. She grew up in a rural village in a poor area of India, and she was engaged at 14, and then at 21 or so, she moved into her in-law's house. And she was horrified to get there and find that they didn't have a toilet. She'd grown up with a latrine. It was no big deal, but it was a latrine. And the first night she was there, she was told that at 4 o'clock in the morning -- her mother-in-law got her up, told her to go outside and go and do it in the dark in the open. And she was scared. She was scared of drunks hanging around. She was scared of snakes. She was scared of rape. After three days, she did an unthinkable thing. She left. And if you know anything about rural India, you'll know that's an unspeakably courageous thing to do. But not just that. She got her toilet, and now she goes around all the other villages in India persuading other women to do the same thing. It's what I call social contagion, and it's really powerful and really exciting.
所以我們的主要理念是要操縱人們的情緒 此方法已經使用了好幾十年 在二十世紀初的時候 一些肥皂公司用過這個方法 他們試過用健康的角度推銷肥皂 但沒人要買 他們試過用性感的角度推銷肥皂 所有人都買了 目前在印度有一項活動 勸導准新娘們 不要嫁入沒有馬桶的家庭 此運動叫做 "沒馬桶,我就不願意" (笑聲) 假使你以為這個海報 只是一個宣傳手段 這位是普蘭卡,23歲 去年十月 我在印度認識她 她成長於一個保守的環境 一個位於印度極為貧困的農村地區 她14歲時訂婚,而在21歲左右 她住進了婆家 到了那裡 她震驚的發現 他們竟然沒有馬桶 她的成長時一直都有公共廁所 這沒什麼大不了 可是我們是在講廁所的問題 在那裡的第一天晚上 他們告訴她 凌晨四點的時候 婆婆就會叫她起床 讓她出去 摸黑在戶外上廁所 她非常害怕 怕有醉漢會在外面遊蕩 她也怕蛇 也害怕被強姦 三天後 她做出無法想像的事 她離開了 如果你對印度農村有任何的了解 那就會知道她做的事 需要多大的勇氣 不止如此 她有了自己的馬桶,還旅行到 其他印度農村 勸導其他女人也做同樣的事 我稱這個現象為"社會傳染力" 極為強大的力量 也使人非常興奮
Another version of this, another village in India near where Priyanka lives is this village, called Lakara, and about a year ago, it had no toilets whatsoever. Kids were dying of diarrhea and cholera. Some visitors came, using various behavioral change tricks like putting out a plate of food and a plate of shit and watching the flies go one to the other. Somehow, people who'd been thinking that what they were doing was not disgusting at all suddenly thought, "Oops." Not only that, but they were ingesting their neighbors' shit. That's what really made them change their behavior. So this woman, this boy's mother installed this latrine in a few hours. Her entire life, she'd been using the banana field behind, but she installed the latrine in a few hours. It cost nothing. It's going to save that boy's life.
另外一個例子,在另一個位於印度的鄉村 跟普蘭卡住的地方也很近 此鄉村叫樂卡拉,一年前左右 這地方完全沒有馬桶 許多孩童死於腹瀉和霍亂 有些人來到這 運用各種不同改變行為的技巧 像是把一盤食物與一盤屎放在外面 讓村民看到蒼蠅飛來飛去的情況 莫名其妙的,那些本來覺得 自己做的事並不噁心的人們 頓時領悟,“慘了” 也想到他們還間接吃進了鄰居的屎 這才是真正讓他們改變行為的原因 所以有個女人,就是這位男孩的母親 幾個小時內就安裝了廁所 她一生都在後面的香蕉園裡大小便 可她卻在幾個小時內安裝了廁所 這不需花錢,也會拯救這位男孩的生命
So when I get despondent about the state of sanitation, even though these are pretty exciting times because we've got the Bill and Melinda Gates Foundation reinventing the toilet, which is great, we've got Matt Damon going on bathroom strike, which is great for humanity, very bad for his colon. But there are things to worry about. It's the most off-track Millennium Development Goal. It's about 50 or so years off track. We're not going to meet targets, providing people with sanitation at this rate. So when I get sad about sanitation, I think of Japan, because Japan 70 years ago was a nation of people who used pit latrines and wiped with sticks, and now it's a nation of what are called Woshurettos, washlet toilets. They have in-built bidet nozzles for a lovely, hands-free cleaning experience, and they have various other features like a heated seat and an automatic lid-raising device which is known as the "marriage-saver." (Laughter)
所以當我對環境衛生的現狀感到沮喪 雖然也有令人興奮的時候 因為我們有比爾與梅琳達蓋茲基金會 他們徹底改造馬桶,這非常好 我們還有麥特戴蒙拒上廁所的抗議 這對全人類是件好事 對他的腸胃卻不太好 可是也有我們要擔心的事 這是目前最偏離軌道的 千禧年發展目標 此目標落後了差不多50年之久 我們不會達到預期目標 在這個情況下提供人們衛生設備 所以當我對環境衛生感到憂心 我會想到日本,因為70年前 日本是一個使用坑式廁所的國家 他們用樹枝擦屁股 現在日本是個我們稱之為“衛洗麗”的國家 也就是所謂的免治馬桶 它們有內裝式的淨身噴嘴讓你無需用手 就可以享受到美好的清潔體驗 同時也有其他不同的特點 像是加熱座椅以及 自動提高馬桶蓋裝置 也被稱之為“婚姻的救世主” (笑聲)
But most importantly, what they have done in Japan, which I find so inspirational, is they've brought the toilet out from behind the locked door. They've made it conversational. People go out and upgrade their toilet. They talk about it. They've sanitized it. I hope that we can do that. It's not a difficult thing to do. All we really need to do is look at this issue as the urgent, shameful issue that it is. And don't think that it's just in the poor world that things are wrong. Our sewers are crumbling. Things are going wrong here too. The solution to all of this is pretty easy. I'm going to make your lives easy this afternoon and just ask you to do one thing, and that's to go out, protest, speak about the unspeakable, and talk shit.
可最重要的,我覺得他們在日本 做的非常勵志的一點是 他們把馬桶的議題 從鎖上的門中帶了出來 他們將馬桶加入談話裡 人們會去升級改良自己的馬桶 他們會去談論馬桶 將此類的議題變得正常 我希望我們也可以這樣 這並不是困難的事 我們真正需要做的 就是看待這個議題 為一個非常急迫以及可恥的問題 而不要認為只有貧窮的國家才有問題 我們的污水系統搖搖欲墜 在這裏 事情正朝著不好的方向發展 解決方法其實非常簡單 今天下午 我就不為難你們了 我只要求你們做一件事 那就是走出去,去抗議 講出那些說不出口的事 也講些"髒話"
Thank you.
謝謝
(Applause)
(掌聲)