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  • I'm the luckiest guy in the world.

    我是這世界上最幸運的人。

  • I got to see the last case of killer smallpox in the world.

    我有機會看到世界上最後一宗致命天花的案例。

  • I was in India this past year,

    去年我在印度

  • and I may have seen the last cases of polio in the world.

    可能也看到世上最後一宗小兒痲痹案例。

  • There's nothing that makes you feel more --

    沒有什麼比這感覺更好的:有這樣的福氣及榮耀

  • the blessing and the honor of working in a program like that --

    可以在這樣一個團隊中工作

  • than to know that something that horrible no longer exists.

    知道這麼恐怖的東西不復存在。

  • So I'm going to tell you --

    所以,我要說 (掌聲)

  • (Applause)

    所以,我要給你們看一些可怕的圖片。

  • so I'm going to show you some dirty pictures.

    看這些圖片很難熬,但你們應該抱以樂觀的態度

  • They are difficult to watch, but you should look at them with optimism,

    因為圖片恐怖的程度

  • because the horror of these pictures will be matched

    與知道它們不復存在所帶來的振奮感相當。

  • by the uplifting quality of knowing that they no longer exist.

    但我要先告訴你們一些我經歷的事。

  • But first, I'm going to tell you a little bit about my own journey.

    我的背景不完全像你們預期的

  • My background is not exactly the conventional medical education

    傳統醫學教育。

  • that you might expect.

    我在舊金山實習的時候,

  • When I was an intern in San Francisco,

    我聽說有一群美國原住民(美洲印第安人)

  • I heard about a group of Native Americans who had taken over Alcatraz Island,

    居住在惡魔島(Alcatraz Island),

  • and a Native American who wanted to give birth on that island,

    有一個印地安人在島上要生小孩,

  • and no other doctor wanted to go and help her give birth.

    但沒有醫生想去那裡幫她接生。

  • I went out to Alcatraz, and I lived on the island for several weeks.

    我去了惡魔島,在那住了幾個禮拜。

  • She gave birth; I caught the baby; I got off the island;

    她生了小孩,我接生了嬰兒,然後我離開那個島。

  • I landed in San Francisco;

    我回到舊金山,所有媒體都想要訪問我,

  • and all the press wanted to talk to me,

    因為在那兒的三個禮拜,讓我成為印地安問題的專家。

  • because my three weeks on the island made me an expert in Indian affairs.

    我上了每個電視節目。

  • (Laughter)

    有人看到我在節目上,打電話問我

  • I wound up on every television show.

    願不願意在一部電影中演個

  • Someone saw me on television; they called me up; and they asked me

    一群搭車由舊金山前往英國的搖滾樂星們

  • if I'd like to be in a movie and to play a young doctor

    的隨隊年輕醫生。我說:「好,我可以。」

  • for a bunch of rock and roll stars who were traveling in a bus ride

    所以我成為一部大爛片中的醫生,

  • from San Francisco to England.

    這部片叫「Medicine Ball Caravan」。

  • And I said, yes, I would do that,

    好,你知道在六零年代,

  • so I became the doctor in an absolutely awful movie

    你要不是在車上旅行; 就是根本不在車上。(摘錄Ken Kesey 的名言,指跟 Kesey 同陣線或不同)

  • called "Medicine Ball Caravan."

    我在車上。我太太和我,共37年,加入了車隊(指這事業)。

  • (Laughter)

    我們的車帶我們從舊金山到倫敦。

  • Now, you know from the '60s,

    我們在大西洋換了車。然後又換了兩次車

  • you're either on the bus or you're off the bus; I was on the bus.

    我們開過土耳其、伊朗、阿富汗、

  • My wife of 37 years and I joined the bus.

    穿過開伯爾山口進入巴基斯坦,就跟其他年輕醫生一樣。

  • Our bus ride took us from San Francisco to London,

    這是我們在開伯爾山口,那是我們的車。

  • then we switched buses at the big pond.

    我們在穿越開伯爾山口時遇到些困難,

  • We then got on two more buses

    但我們最後到了印度。

  • and we drove through Turkey and Iran, Afghanistan,

    然後,跟所有我們這輩的人一樣,

  • over the Khyber Pass into Pakistan, like every other young doctor.

    我們住在喜馬拉雅山脈的修道院內。

  • This is us at the Khyber Pass, and that's our bus.

    (笑聲)

  • We had some difficulty getting over the Khyber Pass.

    這是我們的駐院醫師實習訓練,

  • But we wound up in India.

    跟醫學院的學生所應受的駐院實習訓練一樣.

  • And then, like everyone else in our generation,

    我們跟一個很有智慧的人學習,叫Karoli Baba的古魯(印度教的導師),

  • we went to live in a Himalayan monastery.

    他告訴我們脫下袍子

  • (Laughter)

    穿上西裝

  • This is just like a residency program,

    去加入聯合國當個外交官

  • for those of you that are in medical school.

    為世界衛生組織工作。

  • (Laughter)

    他還不可思議的預測天花可以被消滅,

  • And we studied with a wise man, a guru named Karoli Baba,

    而這是上帝給人類的禮物,

  • who then told me to get rid of the dress,

    因為在這些科學家的努力下

  • put on a three-piece suit,

    這個預測成真了。這個小女孩是Rahima Banu,

  • go join the United Nations as a diplomat

    她是最後一宗致命天花的患者。

  • and work for the World Health Organization.

    這是一張世界委員會開的證明文件

  • And he made an outrageous prediction that smallpox would be eradicated,

    證明史上第一次消滅一種疾病。

  • and that this was God's gift to humanity,

    消滅天花最重要的是早發現、早行動。

  • because of the hard work of dedicated scientists.

    我要你們重複這個「早發現、早行動」

  • And that prediction came true.

    你們可以說嗎?

  • This little girl is Rahima Banu,

    觀眾:早發現、早行動。

  • and she was the last case of killer smallpox in the world.

    Larry Brilliant:天花是史上最嚴重的疾病。

  • And this document is the certificate that the global commission signed,

    它殺死的人比任何戰爭都多。

  • certifying the world to have eradicated the first disease in history.

    在上個世紀,有五億人死於天花。

  • The key to eradicating smallpox was early detection, early response.

    超過兩個--你已經在看Larry Page了,

  • I'm going to ask you to repeat that: early detection, early response.

    有些人看得很快。(笑聲)

  • Can you say that?

    在Larry Page和Sergey Brinn--

  • Audience: Early detection, early response.

    我和他們有些關係和最近的新組織--

  • Larry Brilliant: Smallpox was the worst disease in history.

    在他們出生那年,

  • It killed more people than all the wars in history.

    兩百萬人死於天花。

  • In the last century, it killed 500 million people.

    我們在1980年宣布天花被消滅了。

  • You're reading about Larry Page already.

    這是我在公衛上看過最重要的投影片,

  • Somebody reads very fast.

    因為它告訴你:就算你是最富有,最有強壯的人、

  • (Laughter)

    是世界上最有權的國王皇后(埃及法老照片:死於天花)

  • In the year that Larry Page and Sergey Brin --

    也沒辦法讓你不受害於天花。

  • with whom I have a certain affection and a new affiliation --

    無法否認, 我們大家在同一條船上.

  • in the year in which they were born,

    以一個最高統治者的角度來看天花

  • two million people died of smallpox.

    是錯誤的。

  • We declared smallpox eradicated in 1980.

    你應該以一個母親的角色

  • This is the most important slide that I've ever seen in public health,

    看他的孩子染病卻束手無策。

  • [Sovereigns killed by smallpox] because it shows you

    第一天、第二天、第三天、第四天、第五天、第六天。

  • to be the richest and the strongest,

    你是個母親而你正在看你的小孩,

  • and to be kings and queens of the world,

    在第六天,你看到膿包變硬。

  • did not protect you from dying of smallpox.

    第七天,你看到天花經典的臍狀疤。

  • Never can you doubt that we are all in this together.

    第八天。

  • But to see smallpox from the perspective of a sovereign

    高爾之前說世界上最常被拍照的、

  • is the wrong perspective.

    最常被印出來的圖片

  • You should see it from the perspective of a mother,

    是地球。但在1974年,

  • watching her child develop this disease and standing by helplessly.

    這張照片才是

  • Day one, day two, day three,

    曝光率最高的.

  • day four, day five, day six.

    因為我們為這張照片印了二十億張

  • You're a mother and you're watching your child,

    我們拿著它們挨家挨戶

  • and on day six, you see pustules that become hard.

    給人們看並問他們家中有沒有天花病患.

  • Day seven, they show the classic scars of smallpox umbilication.

    因為那是我們的監控系統。我們沒有Google、

  • Day eight.

    我們沒有網路爬蟲(自動化瀏覽網路)、我們沒有電腦。

  • And Al Gore said earlier

    到了第九天,你看這張圖片,你會驚駭。

  • that the most photographed image in the world,

    我看這張圖片而我會說:「感謝上帝」

  • the most printed image in the world,

    因為這代表了這只是普通的天花病例,

  • was that of the Earth.

    而我知道這個小孩會活下來。

  • But this was in 1974, and as of that moment,

    到了第十三天,傷口長滿疙瘩、他的眼皮還是腫脹,

  • this photograph was the photograph that was the most widely printed,

    但這個孩子沒有繼發性感染。

  • because we printed two billion copies of this photograph,

    到第二十天,雖然他會一生帶疤,但他會活下來。

  • and we took them hand to hand, door to door,

    還有其它種天花不是這樣的。

  • to show people and ask them if there was smallpox in their house,

    這是個融合性天花,

  • because that was our surveillance system.

    病人全身上下沒有任何一個地方有超過

  • We didn't have Google, we didn't have web crawlers,

    手指頭大小的完好肌膚。

  • we didn't have computers.

    扁平天花,得病者百分之百死亡。

  • By day nine -- you look at this picture and you're horrified;

    出血性天花,最殘忍的,

  • I look at this picture and I say, "Thank God,"

    易感染於懷孕女性。

  • because it's clear that this is only an ordinary case of smallpox,

    我看過大約五十個女人死亡,她們全都染了出血性天花。

  • and I know this child will live.

    我從來沒有看過一個出血性天花死亡者不是懷孕女性。

  • And by day 13, the lesions are scabbing, his eyelids are swollen,

    在1967年,WHO開始了一個不可思議的計畫

  • but you know this child has no other secondary infection.

    要消滅一個疾病。

  • And by day 20, while he will be scarred for life, he will live.

    在那年,34個國家有天花病例。

  • There are other kinds of smallpox that are not like that.

    到了1970年,只剩下18個國家。

  • This is confluent smallpox,

    1974年,只剩下五個國家。

  • in which there isn't a single place on the body where you could put a finger

    但在那年,天花在印度爆發。

  • and not be covered by lesions.

    印度也成為天花最後病例的所在地。

  • Flat smallpox, which killed 100 percent of people who got it.

    1974年,印度有六億人口。

  • And hemorrhagic smallpox, the most cruel of all,

    那時印度有21個語言區,

  • which had a predilection for pregnant women.

    就像是說有21個不同國家一樣。

  • I've probably had 50 women die.

    任何時間都有兩千萬人在路上, 在搭著車、火車、

  • They all had hemorrhagic smallpox.

    走路,有五十萬村莊、一億兩千萬戶人家,

  • I've never seen anybody die from it who wasn't a pregnant woman.

    但沒有任何人願意告訴我們:他們家裡有天花病人

  • In 1967, the WHO embarked on what was an outrageous program

    因為他們認為天花是女神Shitala Mata

  • to eradicate a disease.

    (降溫女神)的拜訪,

  • In that year, there were 34 countries affected with smallpox.

    當女神來訪的時候不該讓陌生人進家門。

  • By 1970, we were down to 18 countries.

    所以沒有任何匯報天花役疫情的意願。

  • 1974, we were down to five countries.

    不是只有印度有天花女神,

  • But in that year, smallpox exploded throughout India.

    這種"天花神"的迷信在全世界各地普遍存在的。

  • And India was the place where smallpox made its last stand.

    所以我們要如何消滅天花?大眾接種是沒有用的。

  • In 1974, India had a population of 600 million.

    你可以讓印度每個人都接種,

  • There are 21 linguistic states in India,

    但一年後又有兩千一百萬新生兒,

  • which is like saying 21 different countries.

    在當時等於加拿大的人口。

  • There are 20 million people on the road at any time,

    為每個人打疫苗是沒有用的。

  • in buses and trains, walking; 500,000 villages, 120 million households,

    你必須在同一時間找到全世界每一宗天花案例

  • and none of them wanted to report

    且在每個案例周圍建立防疫圈。

  • if they had a case of smallpox in their house,

    我們就是這麼做的。

  • because they thought that smallpox was the visitation of a deity,

    光在印度,我和我的十五萬好朋友們

  • Shitala Mata, the cooling mother,

    拿著同樣的照片在印度

  • and it was wrong to bring strangers into your house

    挨家挨戶拜訪。我們拜訪了超過一千萬家庭。

  • when the deity was in the house.

    在過程中,我學到一件重要的事情:

  • No incentive to report smallpox.

    我們每做一次門戶搜索,

  • It wasn't just India that had smallpox deities;

    天花病例的數目就突然高起來一次。

  • smallpox deities were prevalent all over the world.

    當我們沒有搜索時,我們有了疾病被消除的假象。

  • So, how we eradicated smallpox was --

    當我們搜索時,我們有疾病病例增加的假象。

  • max vaccination wouldn't work.

    一個監控系統是必須的,

  • You could vaccinate everybody in India,

    因為我們需要的是早發現,早行動。

  • but one year later there'd be 21 million new babies,

    所以我們一直找一直找,找到

  • which was then the population of Canada.

    印度的每一宗天花。我們提供獎勵。

  • It wouldn't do just to vaccinate everyone.

    然後我們提高獎勵。我們繼續提高獎勵。

  • You had to find every single case of smallpox in the world

    我們在每一棟房子牆上記錄到訪的日期(像計分表一樣)。

  • at the same time, and draw a circle of immunity around it.

    當我們一直這麼做時,天花病例的數目最後也降到零。

  • And that's what we did.

    在1980年,我們宣布天花不復存在。

  • In India alone, my 150,000 best friends and I went door to door,

    這是聯合國在伊拉克戰爭前最大的活動,

  • with that same picture,

    十五萬人來自世界各地

  • to every single house in India.

    及不同種族、不同宗教、不同國家的醫生們,

  • We made over one billion house calls.

    肩並肩,互相幫助而無紛爭,

  • And in the process, I learned something very important.

    完成一個讓世界更美好的任務。

  • Every time we did a house-to-house search,

    但天花是我們試著消滅的第四個疾病。

  • we had a spike in the number of reports of smallpox.

    我們之前失敗了三次。

  • When we didn't search, we had the illusion that there was no disease.

    在瘧疾、黃熱病和雅司(熱帶莓疹)病上我們都失敗了。

  • When we did search, we had the illusion that there was more disease.

    不過很快的,小兒痲痹也會被消滅的。

  • A surveillance system was necessary,

    消滅小兒痲痹的金鑰是:早發現,早行動。

  • because what we needed was early detection, early response.

    今年有可能是我們消滅小兒痲痹的一年,

  • So we searched and we searched,

    這就會是史上第二個被消滅的疾病。

  • and we found every case of smallpox in India.

    David Heymann, 如果你透過網路轉播看這場演講。

  • We had a reward. We raised the reward.

    David, 繼續努力。我們快要做到了,我們只剩下四個國家。

  • We continued to increase the reward.

    (掌聲)

  • We had a scorecard that we wrote on every house.

    我覺得我跟Hank Aaron(美國棒球球員)一樣, 會很快的被Barry Bonds(棒球球員)追上取代。

  • And as we did that,

    讓我們再把一個疾病從我們耽心的清單中移除。

  • the number of reported cases in the world dropped to zero.

    我才在印度參與消滅小兒痲痹的工作。

  • And in 1980, we declared the globe free of smallpox.

    小兒痲痹的監控系統是四百萬人挨家挨戶去尋找。

  • It was the largest campaign in United Nations history,

    那是我們的監控系統。

  • until the Iraq war.

    我們需要早發現,早行動。

  • 150,000 people from all over the world --

    失明,一樣的。發現失明的鑰匙是

  • doctors of every race, religion, culture and nation,

    做流行病學問卷並找出失明的原因,

  • who fought side by side, brothers and sisters,

    方能做出正確的反應。

  • with each other, not against each other,

    賽瓦基金會是由一群

  • in a common cause to make the world better.

    曾參與消滅天花的人組成的。

  • But smallpox was the fourth disease that was intended for eradication.

    這群人爬到了頂峰

  • We failed three other times.

    嘗了消滅一種疾病的成功滋味,

  • We failed against malaria, yellow fever and yaws.

    且想要再做一次。

  • But soon we may see polio eradicated.

    在過去的27年當中,賽瓦基金在十五個國家

  • But the key to eradicating polio is early detection, early response.

    已經幫兩百萬失明人士找回光明。

  • This may be the year we eradicate polio.

    賽瓦的開始是因為我們想要將

  • That will make it the second disease in history.

    監控系統和流行病學理論

  • And David Heymann, who's watching this on the webcast --

    用在其他人都不認為是

  • David, keep on going. We're close!

    公衛的問題:失明。

  • We're down to four countries.

    在這之前只被認為是個臨床疾病。

  • (Applause)

    1980年賈伯斯給我一台電腦,蘋果第十二號,

  • I feel like Hank Aaron.

    它現在還在加德滿都(尼泊爾首都)運作著。

  • Barry Bonds can replace me any time.

    我們應該把它拿來拍賣,為賽瓦籌得到更多錢。

  • Let's get another disease off the list of terrible things to worry about.

    我們做了史上第一個尼泊爾的健康問卷,

  • I was just in India working on the polio program.

    也是第一個全國性的失明問卷,

  • The polio surveillance program is four million people going door to door.

    而結果另我們吃驚。

  • That is the surveillance system.

    我們以為會得到的結果是:

  • But we need to have early detection, early response.

    青光眼和沙眼是造成失明主要的原因.

  • Blindness, the same thing.

    但我們驚訝的發現失明竟多數是由白內障造成的。

  • The key to discovering blindness is doing epidemiological surveys

    你不可能醫治或預防你不知道的東西。

  • and finding out the causes of blindness,

    在你們的TED包裹中有一片DVD「無限視覺」,

  • so you can mount the correct response.

    在講V醫生和Aravind眼科醫院。

  • The Seva Foundation was started by a group of alumni

    我希望你們能看一看。

  • of the Smallpox Eradication Programme,

    Aravind一開始是賽瓦的一個計畫,

  • who, having climbed the highest mountain,

    現在是世界上最大最好的眼科醫院。

  • tasted the elixir of the success of eradicating a disease,

    今年,這間醫院會在印度

  • wanted to do it again.

    塔米德邦為三十萬人恢復視力。

  • And over the last 27 years, Seva's programs in 15 countries

    (掌聲)

  • have given back sight to more than two million blind people.

    禽流感。我在這裡為這些恐怖的事情發言--

  • Seva got started because we wanted to apply these lessons

    這有可能是最遭的。

  • of surveillance and epidemiology

    防止或是減輕禽流感流行的鑰匙是

  • to something which nobody else was looking at as a public health issue:

    早發現、早行動。

  • blindness, which heretofore had been thought of only as a clinical disease.

    在未來的三年中,我們不會有疫苗或是

  • In 1980, Steve Jobs gave me that computer, which is Apple number 12,

    足夠的抗病毒素來對抗禽流感。

  • and it's still in Kathmandu, and it's still working,

    這是世界衛生組織將大流行病分級表。

  • and we ought to go get it and auction it off and make more money for Seva.

    我們現在在警戒區第三級,

  • And we conducted the first Nepal survey ever done for health,

    只有一些些的人傳人病例,

  • and the first nationwide blindness survey ever done,

    但沒有大量人傳人病例。

  • and we had astonishing results.

    當世界衛生組織宣布我們在第四級時,

  • Instead of finding out what we thought was the case --

    這不會像科特莉娜颶風只局部在一區。我們知道的世界將會停擺。

  • that blindness was caused mostly by glaucoma and trachoma --

    不會有任何飛機飛行。

  • we were astounded to find out

    你會願意搭乘一架有250個陌生人的飛機

  • that blindness was caused instead by cataract.

    有人正在咳嗽和擤鼻涕,而你知道其中幾個

  • You can't cure or prevent what you don't know is there.

    有可能帶有致人於死地的傳染病,

  • In your TED packages there's a DVD, "Infinite Vision,"

    而你沒有機會得到抗病毒素或疫苗嗎?

  • about Dr. V and the Aravind Eye Hospital.

    我在十月的時候對世界頂尖的流行病學家做了問卷。

  • I hope that you will take a look at it.

    我問他們,這些人是流感病學家和流感病毒專家,

  • Aravind, which started as a Seva project,

    我問他們你們也想問他們的問題。

  • is now the world's largest and best eye hospital.

    你覺得流感流行的可能性有多大?

  • This year, that one hospital will give back sight

    如果發生了,你覺得會有多嚴重?

  • to more than 300,000 people in Tamil Nadu, India.

    百分之十五認為在三年內會發生流感。