The idea of eliminating poverty is a great goal.

想要消滅貧窮是個偉大的目標

I don't think anyone in this room would disagree.

我想在座的各位都會同意

What worries me is when politicians with money

我擔心的是有錢的政治人物

and charismatic rock stars --

及充滿魅力的搖滾明星

(Laughter)

用這個字

use the words,

使這一切聽起來非常非常簡單

" ... it all just sounds so, so simple."

那麼，我今天沒有半毛錢

Now, I've got no bucket of money today

也沒有政策要公佈

and I've got no policy to release,

我當然也沒有吉他

and I certainly haven't got a guitar.

我把那些都留給別人去做

I'll leave that to others.

但我的確有個計畫

But I do have an idea,

這個計畫稱做健康的家

and that idea is called Housing for Health.

健康的家與窮人合作

Housing for Health works with poor people.

在他們住的地方實際運作

It works in the places where they live,

而計畫完成後能改善他們的健康

and the work is done to improve their health.

過去 28 年來

Over the last 28 years,

這份艱難、費力，又會弄得滿身污泥的工作

this tough, grinding, dirty work

已有上千人在澳洲親自完成

has been done by literally thousands of people around Australia

近期更拓展至海外

and, more recently, overseas,

他們的工作證明了 藉由量身訂作的設計

and their work has proven

即使是最貧窮的生活環境也能改善

that focused design can improve even the poorest living environments.

它能改善健康 而且雖還稱不上消滅

It can improve health

但至少在減少貧窮上也有功勞

and it can play a part in reducing, if not eliminating, poverty.

我要從 1985 年說起

I'm going to start where the story began --

故事從澳洲中部開始

1985, in Central Australia.

有一位叫亞米的原住民

A man called Yami Lester, an Aboriginal man,

那時候管理一間健康服務中心

was running a health service.

上門求診的人

Eighty percent of what walked in the door, in terms of illness,

有 80% 得的是傳染病

was infectious disease --

第三世界發展中國家的傳染病

third world, developing world infectious disease,

通常都是因為很糟的生活環境而引起

caused by a poor living environment.

亞米在愛麗斯泉組了一個團隊

Yami assembled a team in Alice Springs.

他找了位醫生

He got a medical doctor.

他找了位搞環境衛生的傢伙

He got an environmental health guy.

然後他親自從當地 原住民中挑出一群人

And he hand-selected a team of local Aboriginal people

參與這個計畫

to work on this project.

亞米在第一次會議上告訴我們 他們沒錢

Yami told us at that first meeting,

非常好的開始，沒錢

"There's no money," -- always a good start --

你有六個月的時間

" ... no money, you have six months,

我要你開始一項計畫

and I want you to start on a project --" which, in his language,

他的母語稱這計畫為 "uwankara palyanku kanyintjaku"

he called "Uwankara Palyanku Kanyintjaku,"

翻譯起來就是 「讓人不再生病的計畫」

which, translated, is "a plan to stop people getting sick" --

非常深遠的信念

a profound brief.

那就是我們的任務

That was our task.

第一步，那位醫生離開

First step, the medical doctor went away for about six months.

約六個月時間

And he worked on what were to become these nine health goals --

他做的研究後來變成了

what were we aiming at?

健康目標的項目 我們集中火力的目標

After six months of work, he came to my office

六個月後他回到我的辦公室

and presented me with those nine words on a piece of paper.

在一張紙上寫下那九個字 對我做簡報

[The 9 Healthy Living Practices: Washing, clothes, wastewater, nutrition, crowding,

『九項健康生活原則：洗澡、洗衣、 廢水、營養、擁擠、動物、粉塵、溫度、受傷。』

animals, dust, temperature, injury]

那時我極度不為所動

I was very unimpressed. Big ideas need big words,

搞什麼

and preferably a lot of them.

遠大的想法要配艱澀的文字

This didn't fit the bill.

最好還是一大堆

What I didn't see and what you can't see

這跟我所想的不合

was that he'd assembled thousands of pages

當時我沒看見 而你們在這也看不到的

of local, national and international health research

是他其實集結了數千頁

that filled out the picture as to why these were the health targets.

當地、全國及國際的健康研究

The pictures that came a bit later had a very simple reason.

然後填進圖片說明為什麼這些

The Aboriginal people who were our bosses and the senior people

是健康目標

were most commonly illiterate,

這些圖片晚一點才畫出來

so the story had to be told in pictures

理由很簡單

of what these goals were.

這些原住民是我們的老闆

We worked with the community,

而老一輩的人大多普遍是文盲

not telling them what was going to happen

所以一定要用圖片來告訴這些人

in a language they didn't understand.

我們的目標是什麼

So we had the goals and each one of these goals --

我們要與這個社群合作

and I won't go through them all --

不能用他們聽不懂的語言

puts at the center the person and their health issue,

來告訴他們要做什麼

and it then connects them

所以我們把目標，每一項目標

to the bits of the physical environment that are actually needed

──我不會在此一一詳述──

to keep their health good.

放在中心的是居民及其健康問題

And the highest priority, you see on the screen,

然後把這個中心目標

is washing people once a day, particularly children.

與實際的生活環境相連

And I hope most of you are thinking,

就是他們實際所需以維持健康的環境

"What? That sounds simple."

最優先的，你在螢幕上看到了

Now, I'm going to ask you all a very personal question.

是讓大家每天洗一次澡尤其是孩童

This morning before you came,

我很希望在座的各位會想

who could have had a wash using a shower?

「什麼？這太簡單了吧。」

I'm not going to ask if you had a shower, because I'm too polite.

那麼，我來問各位一個 非常私人的問題

That's it.

今天早上你們來之前

(Laughter)

誰可以用蓮蓬頭沖個澡的？

All right, I think it's fair to say

我不是要問你們是不是有洗澡

most people here could have had a shower this morning.

因為我很有禮貌，就是這樣 （笑聲）

I'm going to ask you to do some more work.

好，好

I want you all to select one of the houses

我想這麼說不為過，在座大部分的人

of the 25 houses you see on the screen.

今天早上都可以沖個澡

I want you to select one of them and note the position of that house

我還要再讓各位多做點事

and keep that in your head.

我要你們所有人 從螢幕上的 25 間房子裡

Have you all got a house?

選出一間

I'm going to ask you to live there for a few months,

我要你們從中選一間且注意一下

so make sure you've got it right.

那間房子的位置

It's in the northwest of Western Australia, very pleasant place.

然後記在腦子裡

OK. Let's see if your shower in that house is working.

都選好房子了嗎？我要請你們

I hear some "Aw!" and I hear some "Ah!"

在那裡住幾個月 所以你要確定你選了合意的房子

If you get a green tick, your shower's working.

這位於西澳的西北區 非常宜人的地方

You and your kids are fine.

好，來看看你選的房子 淋浴設備能不能用

If you get a red cross,

我聽到了一些「喔」還有「啊」

well, I've looked carefully around the room

如果你選的房子打了綠勾 你的淋浴設備能用

and it's not going to make much difference to this crew.

你和你的孩子會很好

Why? Because you're all too old.

如果你拿了個紅叉

I know that's going to come as a shock to some of you, but you are.

嗯，我已經仔細看過這廳裡的人

And before you get offended and leave,

對你們這群人其實也沒差

I've got to say that being too old,

為什麼？因為你們都太老了

in this case, means that pretty much everyone in the room, I think,

我知道這對在座某些人而言很震驚

is over five years of age.

但你真的太老了

We're really concerned with kids naught to five.

那麼在你覺得被冒犯而離座前

And why?

我要說一下所謂太老，在這是說

Washing is the antidote to the sort of bugs,

我想幾乎在座的每一位

the common infectious diseases of the eyes, the ears,

都超過五歲

the chest and the skin

我們非常注意零到五歲的孩子

that, if they occur in the first five years of life,

為什麼？洗澡是病菌感染的解毒劑

permanently damage those organs.

常見的感染型疾病，像眼睛、耳朵

They leave a lifelong remnant.

胸腔及皮膚等等

That means that by the age of five,

這些如果在生命的頭五年發生

you can't see as well for the rest of your life.

會對這些器官造成永久性傷害

You can't hear as well for the rest of your life.

這些疾病會殘留一輩子

You can't breathe as well.

也就是說到了五歲

You've lost a third of your lung capacity by the age of five.

你的視力一輩子都不會太好

And even skin infection,

你的聽力一輩子都不會太好

which we originally thought wasn't that big a problem,

你的呼吸也不會太好

mild skin infections naught to five give you

五歲的時候你會失去三分之一的肺活量

a greatly increased chance of renal failure,

甚至是皮膚感染，我們一開始覺得

needing dialysis at age 40.

這不是甚麼大問題

This is a big deal, so the ticks and crosses on the screen

零到五歲間，即使是輕微的皮膚感染

are actually critical for young kids.

也會大幅增加腎衰竭的機會

Those ticks and crosses represent the 7,800 houses

使你在四十歲時需要洗腎

we've looked at nationally around Australia,

這是大問題 所以這些螢幕上的綠勾紅叉

the same proportion.

對年幼的孩子其實非常關鍵

What you see on the screen --

這些綠勾紅叉的比例 與我們在整個澳洲

35 percent of those not-so-famous houses

所合作的 7,800 棟房子

lived in by 50,000 indigenous people --

比例相同

35 percent had a working shower.

你在螢幕上看到的──35% 的這些

Ten percent of those same 7,800 houses had safe electrical systems.

沒名氣的房子裡住著五萬名土著

And 58 percent of those houses had a working toilet.

35% 有可使用的淋浴設備

These are by a simple, standard test.

同樣這 7,800 間房子裡

In the case of the shower:

10% 有安全的電力系統

does it have hot and cold water, two taps that work,

58% 的房子

a shower rose to get water onto your head or onto your body,

有可使用的抽水馬桶

and a drain that takes the water away?

這些是用簡單的標準測試出來的

Not well-designed, not beautiful, not elegant --

在淋浴設備方面，有沒有熱水及冷水

just that they function.

兩種可用的水龍頭

And the same tests for the electrical system

有沒有蓮蓬頭把水送到你的頭上

and the toilets.

或身上？有沒有下水口排水？

Housing for Health projects aren't about measuring failure --

不看設計好不好 漂不漂亮，優不優雅 ——

they're actually about improving houses.

就只看功能如何

We start on day one of every project.

在看電力系統及馬桶時 也是同樣的測試法

We've learned -- we don't make promises, we don't do reports.

健康的家計畫 不是拿來測量失敗率的

We arrive in the morning with tools, tons of equipment, trades,

這些計畫是為了改善房屋而做的

and we train up a local team on the first day to start work.

我們從每個計畫的第一天開始

By the evening of the first day,

──我們學到不給承諾，不做報告

a few houses in that community are better than when we started in the morning.

我們早上拿著工具 還有多到不行的器材貨物到家裡

That work continues for six to 12 months,

我們在第一天就培訓了 一個由當地人組成的團隊

until all the houses are improved

來開始工作

and we've spent our budget of 7,500 dollars total per house.

第一天晚上那個社區就有

That's our average budget.

幾間房子變得比我們早上

At the end of six months to a year, we test every house again.

開始的時候更好了

It's very easy to spend money.

這樣的工作要持續六到十二個月

It's very difficult to improve

直到所有的房子都改善為止

the function of all those parts of the house.

我們花在每間房子的經費是

And for a whole house, the nine healthy living practices,

7,500 元

we test, check and fix 250 items in every house.

那是平均經費

And these are the results we can get with our 7,500 dollars.

在六個月到一年的計畫結束後 我們會再測試每一間房子

We can get showers up to 86 percent working,

要花錢很容易

we can get electrical systems up to 77 percent working

要改善房子裡的每一項功能

and we can get 90 percent of toilets working

卻非常困難

in those 7,500 houses.

對整間房子而言 為了推行這九項健康生活

(Applause)

我們要在每一間房屋裡 測試、檢查、修繕 250 個項目

Thank you.

以下是我們

(Applause)

花 7,500 元所得到的結果

The teams do a great job, and that's their work.

我們可以修好 86% 的淋浴設備

I think there's an obvious question

我們可以讓 77% 的電力設備恢復功能

that I hope you're thinking about.

也可以修好 90% 的抽水馬桶

Why do we have to do this work?

在這 7,500 間房子裡

Why are the houses in such poor condition?

謝謝（掌聲）

Seventy percent of the work we do is due to lack of routine maintenance --

這個團隊做得非常好 這些就是他們辛苦的結果

the sort of things that happen in all our houses.

我想有個明顯的問題

Things wear out, should have been done by state government or local government,

我希望你們能思考一下

simply not done, the house doesn't work.

為什麼我們要做這樣的事？

Twenty-one percent of the things we fix are due to faulty construction --

為什麼這些房子的狀況這麼糟？

literally things that are built upside down and back to front.

我們所做的工作之中的 70%

They don't work, we have to fix them.

是由於疏於日常保養

And if you've lived in Australia in the last 30 years, the final cause --

所有的房子都可看見這種情況

you will have heard always that indigenous people trash houses.

東西用壞了

It's one of the almost rock-solid pieces of evidence

這些都該由中央政府或地方政府來做

which I've never seen evidence for,

不做，這些房子就不堪用

that's always reeled out as "That's the problem with indigenous housing."

我們修的東西當中有 21%

Well, nine percent of what we spend is damage,

是因為錯誤安裝

misuse or abuse of any sort.

真的就是上下或前後裝顛倒

We argue strongly that the people living in the house

這些當然不能使用，我們要修理

are simply not the problem.

如果過去 30 年間你曾住在澳洲

And we'll go a lot further than that;

最後這項因素—— 你一定老是聽到人家這麼說

the people living in the house are actually a major part of the solution.

就是原住民不珍惜房子

Seventy-five percent of our national team in Australia --

這幾乎是堅不可攻的證據

over 75 at the minute --

但我從來沒看過有什麼證明

are actually local, indigenous people from the communities we work in.

總是不需要多想因為這些是原住民住房的問題

They do all aspects of the work.

我們修的房子裡有 9%

(Applause)

的確有損害、誤用或濫用的情況

In 2010, for example, there were 831,

但是對此我們強烈抗議，住在房子裡的人

all over Australia, and the Torres Strait Islands,

不是問題所在

all states, working to improve the houses where they and their families live,

我們還要更進一步說

and that's an important thing.

住在房子裡的那些人其實

Our work's always had a focus on health.

還是解決問題的主要推手

That's the key.

我們在澳洲的團隊有 75% 的人

The developing world bug, trachoma, causes blindness.

現在還超過 75%

It's a developing-world illness,

其實是當地人，土著

and yet, the picture you see behind

來自我們幫助的社區

is in an Aboriginal community in the late 1990s,

他們做各樣的工作

where 95 percent of school-aged kids had active trachoma

（掌聲）

in their eyes, doing damage.

舉個例，2010 年

OK, what do we do?

在全澳洲、托雷斯海峽群島，以及每一個州

Well, first thing we do, we get showers working.

共有 831 人參與改善

Why? Because that flushes the bug out.

他們自己和家人居住的房子

We put washing facilities in the school as well,

而那是很重要的事

so kids can wash their faces many times during the day.

我們的工作總是著重在健康，這是關鍵

We wash the bug out.

發展中國家的沙眼病菌會導致失明

Second, the eye doctors tell us that dust scours the eye

這是發展中國家的疾病

and lets the bug in quick.

但是你在我身後看到的這張照片

So what do we do?

是 1990 年代晚期的原住民社區

We call up the doctor of dust, and there is such a person.

那裡 95% 的學齡兒童患有沙眼

He was loaned to us by a mining company.

對眼睛造成損傷

He controls dust on mining company sites.

所以我們做了什麼？

And he came out and, within a day,

首先我們把淋浴設備搞定

it worked out that most dust in this community

為什麼？因為這會把病菌沖走

was within a meter of the ground, the wind-driven dust --

我們也在學校裡裝了洗滌設備

so he suggested making mounds to catch the dust

所以孩子們白天可以洗很多次臉

before it went into the house area and affected the eyes of kids.

我們把病菌洗掉

So we used dirt to stop dust.

第二，眼科醫師告訴我們 灰塵會磨擦眼睛

We did it. He provided us dust monitors.

使病菌更快附著 所以我們怎麼做？

We tested and we reduced the dust.

我們徵調了粉塵醫生 真的有這種人

Then we wanted to get rid of the bug generally.

我們從採礦公司借將

So how do we do that?

他在採礦場控制粉塵量