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  • Translator: Joseph Geni Reviewer: Morton Bast

    譯者: Regina Chu 審譯者: Marssi Draw

  • 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

  • Well, we call up the doctor of flies -- and, yes, there is a doctor of flies.

    所以他來了,而且在幾天內就奏效

  • As our Aboriginal mate said,

    這個社區的大部分灰塵

  • "You white fellows ought to get out more."

    都飄在距地表一公尺範圍內 風會帶來灰塵

  • (Laughter)

    所以他建議做些土牆擋住灰塵

  • And the doctor of flies very quickly determined

    讓灰塵吹不進居住區

  • that there was one fly that carried the bug.

    危害孩童的眼睛

  • He could give school kids in this community

    所以我們用土堆擋灰塵

  • the beautiful fly trap you see above in the slide.

    我們就這麼做了。他提供了粉塵計

  • They could trap the flies, send them to him in Perth.

    我們作測試減低粉塵量

  • When the bug was in the gut,

    然後我們還想大規模地消滅這種病菌

  • he'd send back by return post some dung beetles.

    所以我們要怎麼做?

  • The dung beetles ate the