Listen to the sounds of why hearing matters to the Alaskan Native people.
聽見聲音對於阿拉斯加的 原住民而言很重要。
Hearing loss makes it hard to fish on the open water, hunt caribou and harvest berries, activities central to Alaskan Native culture. Hearing loss isn't unique to rural Alaska. It's global. The Global Burden of Disease Project estimates there are 1.1 billion people living with hearing loss worldwide. That's more people than the entire population here in sub-Saharan Africa. Over 80 percent are in low- and middle-income countries, and many have no access to hearing care.
聽力缺損會造成在開放水域捕魚、 獵殺北美馴鹿, 以及採收莓類變得更困難, 這些活動對於阿拉斯加 原住民文化而言都很重要。 並不是只有阿拉斯加農村的人 才有聽力缺損問題。 它是全球性的問題。 「全球性疾病負擔研究」 估計全世界有 11 億人 帶著聽力缺損在過生活。 這個數目比整個 撒哈拉以南非洲的人口還多。 這些人當中,超過 80% 都住在中低收入的國家, 許多人沒有辦法取得聽力照護。
The impact on people's lives is tremendous. Anuk is a three-year-old boy I treated in Alaska. Ear infections started when he was barely four months old. His parents brought him into clinic, worried he didn't say much compared to his brothers. Sure enough, many rounds of infections had resulted in hearing loss. Without treatment, Anuk's speech will continue to lag behind. He's more likely to do worse in school, have worse job prospects and experience social isolation.
他們的生活受到很大的衝擊。 阿努克是我在阿拉斯加 治療的一位三歲男孩。 當他才幾乎要四個月大時, 就開始出現耳朵感染。 他的父母帶他去診所, 擔心相對於他的兄弟, 他的話比較少,可能是有問題。 當然,許多次的感染 造成了聽力缺損。 在沒有治療的情況下, 阿努力的說話能力就會持續落後。 他在學校的表現很可能會比較差, 工作的前景也比較不好, 還有可能會經歷到社會孤立的狀況。
But it doesn't have to be this way. The World Health Organization estimates that half of all global hearing loss can be prevented. If Anuk's hearing loss is identified and treated promptly, his life and the opportunities he has as he grows up could look vastly different.
但不見得一定要如此。 世界衛生組織估計, 全球的聽力缺損中, 有一半是可預防的。 如果阿努克的聽力缺損 即時被發現和治療, 他在成長過成中的生活和機會 都會有很大的不同。
I'm an ear surgeon working with partners around the world on new pathways for hearing loss prevention. This solution comes from my collaboration with a tribal health organization called the Norton Sound Health Corporation. Hearing loss evaluation traditionally requires testing by an audiologist in a soundproof room, with a lot of permanent equipment. An ear surgeon then examines Anuk's ears under a microscope and decides a treatment plan. These resources simply aren't available in remote settings. In a state where 75 percent of communities aren't connected to a hospital by road, an expensive flight is required. To overcome these barriers, Alaska has developed a state-of-the-art telemedicine system that connects over 250 village health clinics with specialists who triage all types of health concerns. My colleagues have validated that ear-related telemedicine consults are equivalent to an in-person exam. In 2016, travel was prevented for 91 percent of patients receiving specialty telemedicine in the Norton Sound region. Telemedicine has saved over 18 million in travel costs in this single region over the past 15 years.
我是位耳外科醫生, 和全世界的夥伴合作, 想找到新的方式來預防聽力缺損。 這個解決方案是我和一個 部落的健康組織合作的結果, 這個組織叫諾頓灣健康公司。 傳統上,若要做聽力缺損的評估, 需要在一間隔音室中 由聽力師做測試, 裡面還要有許多固定式設備。 耳外科醫生接著會在顯微鏡下 檢視阿努克的耳朵, 判斷要用什麼治療計畫。 而偏遠的地方不可能有這些資源。 在這個州,75% 的社區和醫院間 沒有道路連結, 於是會需要昂貴的飛行費用。 為了要克服這些障礙, 阿拉斯加開發了 一個先進的遠程醫療系統, 連結超過 250 個村落健康診所, 並且配有將病人依各種健康問題 做快速分類的專家。 我同事已經驗證, 和耳朵相關的遠程醫療諮詢 和面對面的檢驗有相同的效果。 2016 諾頓灣地區 接受專業遠程醫療的病人, 91% 省去了親自跑一趟的麻煩。 光在這個區域,在過去 15 年間, 遠程醫療就協助省下了 1800 萬美金的旅費成本。
Our team is taking the power of telemedicine to a new level, through a project funded by the Patient-Centered Outcomes Research Institute. For the first time, we are merging telemedicine with mobile screening technology that extends the reach of expert triage beyond health care settings. This cell-based screen, developed in South Africa, costs over 10 times less than traditional equipment and does not require advanced training. If I were screening Anuk at school, sound-attenuating headphones and noise monitoring would take the place of a sound booth, and I would use a phone adapter instead of a microscope to examine his ears. In a matter of minutes, screening and images are done. We then apply Alaska telemedicine technology to transmit the data to specialists, who connect Anuk to the treatment he needs.
我們的團隊要讓 遠程醫療的力量再更上一層樓, 靠的就是一個由患者導向 醫療效果研究所資助的計畫。 這是第一次,我們將遠程醫療 與行動篩檢技術結合, 這種技術能將 專家所做的病人快速分類 延伸到健康照護環境以外的地方。 這種以細胞為基礎的篩檢 是在南非開發出來的, 它的成本不到 傳統設備的十分之一, 且不需要進階的訓練。 如果我在學校裡為阿努克做篩檢, 減噪耳機和噪音監控 就會取代隔音間, 我就會用手機轉接器而不是顯微鏡 來檢測他的耳朵。 只要幾分鐘的時間, 篩檢和影像就完成了。 接著,我們應用 阿拉斯加電視醫療技術 將資料傳輸給專家, 他們會將阿努克 和他所需要的治療做連結。
Our team is launching a randomized trial in 15 communities along the Bering Sea to study how well this intervention works. Our goal is to prevent childhood hearing loss across the state of Alaska. But the concept is bigger than a single state. The impact is global. Mobile telemedicine can revolutionize access to care.
我們的團隊在白令海 沿岸 15 個社區 開始進行隨機試驗, 來研究這種干預治療方式的效果。 我們的目標是要在阿拉斯加州 預防童年聽力缺損。 比如,在馬拉威,只有 2 位耳外科醫生和 11 位聽力師, 人口卻有 1700 萬人。
In Malawi, for example, there are only two ear surgeons and 11 audiologists for a population of 17 million. This technology could empower teachers and community health workers to provide access to care to children in places like Malawi. Scaling up globally could change children's lives who have never had access to hearing care before, using just the power of a cell phone.
這項技術能夠在馬拉威這類地方, 讓老師及社區健康工作者 有能力協助兒童取得照護。 若能擴及全球, 就能協助以前從來沒有辦法 取得聽力治療的兒童, 改善他們的生活, 只需要用一支手機的力量 就可以做到這點。 該是為可預防之聽力缺損 帶來改變的時候了。 阿努克和無數像他一樣的兒童 都要仰賴我們。 謝謝。
It's time to change the course of preventable hearing loss. Anuk and countless children like him are depending on us.
(掌聲)
Thank you.
(Applause)