1.It is interesting that in the United States, the most significant healthcare budget goes to cardiovascular disease care, whether it’s private or public.
在美国有个蛮有意思的现象 最重要的医疗预算 无论是私人捐助还是政府提供，都是拨给心血管疾病的
2.There’s no comparison at all.
其他的疾病根本无法比拟
3.In Africa — where it is a major killer — it is totally ignored.
而在非洲，心血管疾病是致死率最高的一种疾病，却被彻底忽略了
4.And that situation cannot be right. We must do something about it.
这种情况不应该存在，我们必须改变它
5.Health status of a nation parallels development of that nation.
一个国家的健康状况与发展水平是成正比的
6.17 million people die every year from heart disease.
每年有1700万人死于心脏病
7.32 million heart attacks and strokes occur.
3200万人死于突发心脏病和中风
8.Most of this is in developing countries, and the majority is in Africa.
这其中绝大多数生活在发展中国家，而且以非洲最多
9.85 percent of global disease burden for cardiovascular disease is in developing countries — not in the West — and yet 90 percent of the resources are in the West.
在发展中国家，85%的全球性疾病会加重心血管疾病 而西方国家没有这种情况 然而90%的医疗资源却集中在西方国家
10.Who is at risk? People like you.
哪些人属于危险人群？你们都是
11.It’s not just the Africans that should be concerned about that.
不仅仅非洲人民需要关注
12.All friends of Africa, that will have reason to be in Africa at some point in time, should be very concerned about this deplorable situation.
所有要在非洲驻扎一段时间的人 都应该关注这个糟糕的状况
13.Has anyone here wondered what will happen if you go back to your room at night and you start getting chest pains, shortness of breath, sweating?
你们是否有想过 如果某天晚上回卧室时 突然觉得胸闷气短、不停出汗，要怎么办
14.You’re having a heart attack. What are you going to do?
这可是心脏病突发，你们会怎么处理
15.Will you fly back to the US, Germany, Europe?
飞回美国，德国，欧洲？
16.No, you will die. 50 percent will die within 24 hours if not treated.
不能这样，这样会死人的。50%的人在病发后24小时内未经治疗就会死亡
17.This is what’s going on.
这就是事实
18.In a look at the map of the US — the graph here, 10 million people here, 10 million here.
看看这幅图 最开始的时候美国和尼日利亚同样都有1000万人口
19.By the time you get to 50, it’s almost no one left in Nigeria — life expectancy’s 47.
等你们50岁的时候，尼日利亚估计已经变成空城，人都死了 他们的预期寿命只有47岁
20.It’s not because some people don’t survive childhood illnesses — they do — but they do not survive after the time that they reach
不是因为小时候得病死了 而是因为当他们
21.about 45 years old and 50 years old.
到45岁至50岁这期间时撑不下去了
22.And those are the times they’re most productive.
但这才是他们产能最大的时期
23.Those are the times that they should be contributing to Africa’s development. But they’re not there.
他们本应该能 为非洲的发展贡献力量，可人却已经不在了
24.The best way to spiral into a cycle of poverty is to kill the parents.
父母去世是导致贫穷的最快方式
25.If you cannot secure the parents, you cannot grant the security of the African child.
如果不能保证父母的生命 那么孩子的生命也岌岌可危
26.What are the risk factors?
心脏病的诱因有哪些
27.It’s very well known. I’m not going to spend a lot of time on those.
众所周知，所以我就不多说了
28.These are just for information: hypertension, diabetes, obesity, lack of exercise. The usual suspects.
大概就是这些： 高血压，糖尿病，肥胖症，缺乏锻炼，这些都是最常见的诱因
29.Right here in Tanzania, 30 percent of individuals have hypertension.
在坦桑尼亚，30%的人有高血压
30.20 percent are getting treated.
其中20%在治疗中
31.Only less than 1 percent are adequately treated.
但只有不到1%的人经历过完整、彻底的治疗
32.If we can treat hypertension alone in Africa, we’ll save 250,000 lives a year. That’s quite significant!
如果仅治疗非洲人的高血压 每年就能挽回25万人的生命，这个数字很可观
33.Easy to treat. Look at the situation in Mauritius.
高血压其实蛮好治疗的。看看毛里求斯人民的处境
34.In eight short years — we’re here talking about HIV, malaria, which is all good.
在未来短短的8年内，艾滋病和疟疾 都不会造成什么重大影响
35.We cannot make the mistakes we’ve made with malaria and HIV.
请不要再重蹈我们对待艾滋病和疟疾的覆辙
36.In eight short years, non-communicable diseases will become the leading causes of death in Africa.
在未来短短的8年内，非传染性疾病 将会成为非洲大陆上的主要致死疾病
37.That is something to keep in mind. We can’t deal with it with situations like this.
我们必须牢记这一点，我们不能像这样对待病人
38.This is a typical African hospital. We can’t depend on the elites — they go to USA, Germany, UK for treatment. Unbelievable.
这是一所典型的非洲医院。我们不能指望那些精英 他们都离开非洲，前往美国，德国或者英国
39.You can’t depend on foreign aid alone.
也不能就指望他国援助
40.Here is the situation: countries are turning inwards.
现在的各个国家都自顾不暇
41.Post 9/11, [the] United States has had a lot of trouble to deal with their own internal issues.
就拿9/11来说，美国国内一片慌乱， 自然把精力都集中在国内事务上
42.So they spend their money trying to fix those problems.
以妥善解决这些问题
43.You can’t rightly — it’s not their responsibility, it is my responsibility. I have to take care of my own problems.
帮助非洲并不是他们的责任 但是我的责任，我要努力处理好这些问题
44.If they help, that’s good! But that is not my expectation.
如果他们能够提供帮助，那当然好，但这并不能达到我的期望
45.These worsening indices of healthcare or health studies in Africa demand a new look. We cannot keep on doing things the way we’ve always done them.
非洲越来越低的医疗保健指数和越来越少人关注的医疗研究状况 必须改变，我们不能一直 停滞不前
46.If they have not worked, we have to look for alternative solutions.
如果办法不奏效，我们必须找到其他有用的办法替代
47.I’m here to talk to you about solutions.
我要说的是解决方法，如何改善当前这个局面
48.This has been what has been a difficult sign to some of us.
这是令我们头疼的问题
49.Several years ago, we started thinking about it.
几年前，我们就开始研究这方面的问题
50.Everyone knows the problem. No one knows what the solutions are.
每个人都知道症结所在，但没人知道对症下药
51.We decided that we need to put our money where our mouth is.
我们决定要把钱花在刀刃上
52.Everyone is ready to throw in money in terms of free money aid to developing countries.
当有人免费援助发展中国家的时候 每个人都兴奋不已
53.Talk about sustainable investment! No one is interested.
.但说到持续投资，却没人回应
54.You can’t raise money.
这样是筹不到钱的
55.I have done businesses in healthcare in the United States — I live in Nashville, Tennessee, healthcare capital of America.
我在美国有从事医疗保健方面的业务 我住在田纳西州的纳什维尔，那里是美国医疗保健的中心
56.[It’s] very easy to raise money for healthcare ventures.
在那从事医疗保健的企业筹款是件是件很容易的事
57.But start telling them, you know, we’re going to try to do it in Nigeria — everyone runs away.
但如果告诉投资者 我们打算在尼日利亚开展这项业务，没人予以理睬
58.That is totally wrong. Those of you in the audience here, if you want to help Africa: invest money in sustainable development.
其实这种想法是完全错误的，现场的观众， 如果你们想要帮助非洲，就要持续投资
59.Let me lead you through a day in the life of the Heart Institute so you get a glimpse of what we do, and I’ll talk a little bit more about it.
我来带你们看看心脏研究所一天的运作情况 让你们了解我们所做的 然后我再说点有关这个
60.What we have done is to show that high quality healthcare, comparable to the best anywhere in the world, can be done in a developing-country environment.
我们在发展中国家建立了一所 足以媲美世界上顶级医疗保健中心的 高质量的医疗中心
61.We have 25 positions right now — all of them trained, board certified in the US, Canada or Britain.
这个中心现在设有25个岗位，每个上岗人员 都在美国、加拿大活英国经过培训，并取得证书
62.We have every modality that can be done in Vanderbilt, Cleveland Clinic — everywhere in the US — and we do it for about 10 percent of the cost
我们拥有范德毕特大学, 克利夫兰诊所，甚至是美国其他所有的地方都能做的模态分析系统 但我们的收费只有
63.that you will need to do those things in the United States.
美国的十分之一
64.(Applause) Additionally, we have a policy that no one is ever turned away because of ability to pay.
（掌声） 另外，我们还有一个规定， 不能以支付能力为由将人拒之门外
65.We take care of everyone.
我们帮助所有需要帮助的人
66.(Applause) Whether you have one dollar, two dollars — it doesn’t matter.
（掌声） 你只有1美元或2美元，都没关系
67.And I will tell you how we’re able to do it.
让我告诉你们这一切是如何办到的
68.We make sure that we select our equipment properly.
确保选择正确的仪器
69.We go for modular units. Units that have multi-modality functions have modular components. Easy to repair, and because of that, we do not take things that are not durable and cannot last.
选择具有模块化单元的仪器。各个单元都能实现多模融合（不同成像方式的图像融合）, 含有模块化组件。易于修理，因此 我们选择的仪器都是耐用的
70.We emphasize training, and we make sure that this process is regenerative.
在我们这里，培训是重点 我们确保培训这一环节能够不断地传承下去，
71.Very soon we will all be dead and gone, but the problems will stay unless we have people taking over from where we stopped.
不久的将来，我们这一任将会老死离去，但除非 我们找到继任者，将我们的志愿继承发扬，否则问题依然存在
72.We made sure that we produced some things ourselves.
我们确保自产自用
73.We do not buy unit doses of radiopharmaceuticals.
不是从别处购买单位计量的放射性药物
74.We get the generators from the companies.
而是买来生产机器
75.We manufacture them in-house ourselves. That keeps the costs down.
进行内部生产，这样就降低了成本
76.So, for a radiopharmaceutical in the US — that you’ll get a unit dose for 250 dollars — when we’re finished manufacturing it in-house,
因此，在美国要花 250美元才能买到单位计量的放射性药物 在我们这边内部生产的
77.we come at a price of about two dollars.
只要花2美元
78.(Applause) We recognize that the only way to bridge the gap between the rich and poor countries is through education and technology.
（掌声） 我们意识到要缩短 富国和穷国的差距 必须通过教育和科技
79.All these problems we’re talking about — if we bring development, they will all disappear.
如果能够取得发展， 所有这些刚刚说到的问题都会迎刃而解
80.Technology is a great equalizer. How do we make it work?
科技起的作用举足轻重，我们又是如何利用科技的？
81.It’s been proved: self-care is cost effective.
事实证明：自我保健具有成本效益
82.It extends opportunity to the rural centers, and we can use expertise in a very smart way.
能够拓展农村市场的机会 通过巧妙地运用自我保健专业知识
83.This is the way our centers are set up.
我们建立了自己的医疗中心
84.We currently have three locations in the Caribbean, and we’re planning a fourth one.
目前我们在加勒比海有三家医疗中心 第四家的开业正在筹备中
85.And we have now decided to go into Africa.
并且我们决定要进军非洲
86.We will be doing the West African Heart Institute in Port Harcourt, Nigeria. That project will be starting within the next few months. We hope to open in 2008-09.
在尼日利亚的哈科特港 我们要建立西非心脏研究所，这个项目将在 接下来的几个月内启动，我们希望2008-09年就能正式投入运营
87.And we will do other centers.
我们还会继续筹划更多的研究中心
88.This model can be adapted to every disease process.
这个模式适用于每个疾病治疗流程
89.All the units, all the centers, are linked through a switched hub to a central server, and all the images are populated to review stations.
所有的环节，所有的研究中心， 通过交换式集线器连接到一个中央服务器上 所有的图像都能在视图站中看到
90.And we designed this telemedicine solution. It’s proprietary to us, and we are happy to share what we have learned with anyone who is interested in doing it. You can still be profitable.
我们设计了这个远程医疗方案，这是我们的专利 我们愿意跟其他人分享这一切 并同时使他们保持盈利
91.We make sure that the telemedicine platform gives access to expert medical specialists anywhere in the world, just by a click of the button.
只需点击鼠标 远程医疗系统就能 连接上世界各地的医学专家
92.I’ll lead you through to see how this happens.
现在我们看看这整套流程
93.This is at the Heart Institute. The doctors from anywhere can log in.
这是心脏研究所，世界各地的医生都能登录
94.I can call you in Switzerland and say, “Listen, go into our system.
我可以在瑞士打电话给你，“请登录我们的系统，
95.Look at Mrs. Jones. Look at the study, tell me what you think.”
看看琼斯太太的诊断图，告诉我们你的建议。”
96.They’ll give me that information, and we’ll make the care of the patient better.
医生们就会据此给出一些讯息 有了这些专家的讯息，病人的治疗就更有保障
97.The patient doesn’t have to travel.
病人们不需要长途跋涉
98.He doesn’t have to experience the anxiety of not knowing because of limited expertise.
不会因为缺乏专家意见 而焦躁不安
99.We also use [an] electronic medical record system.
我们还有一套电子病历系统
100.I’m happy to say that the things we have implemented — 80 percent of US practices do not have them and yet the technology is there.
我很自豪地告诉你们，在美国，80%的医疗手段中还没能采取 这些应用在研究中心的技术
101.But you know, they have that luxury.
但是美国人有条件
102.Because if you can’t get it in Nashville, you can travel to Birmingham, two hours away, and you’ll get it. If you can’t get it in Cleveland,
如果纳什维尔治不了，可以去伯明翰 只有两小时的路程而已；如果克利夫兰治不了，
103.you can go to Cincinnati. We don’t have that luxury, so we have to make it happen.
可以去辛辛那提，但非洲人民没有这种条件 因此我们只能通过科技来改变这种状况
104.When we do it, we will put the cost of care down.
同时降低看病的成本
105.And we’ll extend it to the rural centers and make it affordable.
我们要把业务拓展到农村地区，并且使当地人都能负担得起
106.And everyone will get the care they deserve.
每个人都能得到治疗
107.It cannot just be technology, we recognize that.
但我们意识到仅仅依靠科技是不够的
108.Prevention must be part of the solution — we emphasize that.
预防也是我们所强调的解决方案
109.But you know, you have to tell people what can be done.
但一定要是切合实际的
110.It’s not possible to tell people to do what is going to be expensive and they go home and can’t do it.
你可以跟病人说将要进行的治疗花费高昂 可这么说只能导致他们回家，因为负担不起
111.They need to be alive, they need to feed.
他们需要活命，需要养家糊口
112.We recommend exercise as the most effective, simple, easy thing to do.
我们推荐运动，因为运动是最有效、最简单的预防疾病的方法
113.We have had walks every year — every March, April.
每年的三月和四月是“行走月”
114.We form people into groups and make them go into challenges.
我们将病人分组，让他们互相竞赛
115.Which group loses the most weight, we give them prizes.
减重最多的那组将得到奖励
116.Which groups record more walking distance by pedometer, we give them prizes. We do this constantly.
通过计步器计算出的行走最多的那组 也会得到奖励，我们一直支持这项活动
117.We encourage them to bring children.
同时我们也鼓励病人带上孩子一起运动
118.That way we start exposing the children from very early on, on what these issues are. Because once they learn it, they will stay with it. In doing this we have created
从小就给孩子灌输 锻炼身体预防疾病的观念，一旦孩子们有了这种观念 他们就会坚持锻炼。通过开展这项活动
119.at least 100 skilled jobs in Jamaica alone, and these are physicians with expertise and special training.
仅在牙买加，我们就创造了至少100个技术类工作 这些医师经过特别培训，具有专业的医学知识
120.We have taken care of over 1,000 indigent patients that could have died, including four free pacemakers in patients with complete heart block. For those that understand cardiology,
我们挽回了1000多个十分贫困的病人的生命 包括为四个患有完全性心传导阻滞的病人 免费提供心脏起搏器。对于了解心脏病学的人来说
121.complete heart block means certain death.
完全性心传导阻滞意味着濒临死亡
122.If you don’t get this pacemaker, you will be dead.
如果没有心脏起搏器，病人将会死亡
123.So we are pleased with that.
能帮助病人我们觉得很欣慰
124.Indirectly, we have saved the government of Jamaica 5 million dollars from people that would have gone to Miami or Atlanta for care.
因为病人们无需飞到迈阿密活亚特兰大看病 我们间接替牙买加政府省了500万美元
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