演讲MP3+双语文稿:为什么要训练祖母治疗抑郁症
听力课堂TED音频栏目主要包括TED演讲的音频MP3及中英双语文稿，供各位英语爱好者学习使用。本文主要内容为演讲MP3+双语文稿:为什么要训练祖母治疗抑郁症，希望你会喜欢！
【演讲者及介绍】Dixon Chibanda
精神病学家，对人类大脑充满热情，他研究大脑如何影响我们的行为，以及我们如何做才能让每个人都开心。
【演讲主题】为什么要训练祖母治疗抑郁症
【中英文字幕】
Translated by Qikai Guo. Reviewed by Chan Yuxin
00:00
On a warm August morning in Harare, Farai, a 24-year-old mother of two, walks towards a park bench. She looks miserable and dejected. Now, on the park bench sits an 82-year-old woman, better known to the community as Grandmother Jack. Farai hands Grandmother Jack an envelope from the clinic nurse. Grandmother Jack invites Farai to sit down as she opens the envelope and reads. There's silence for three minutes or so as she reads. And after a long pause, Grandmother Jack takes a deep breath, looks at Farai and says, "I'm here for you. Would you like to share your story with me?"
在哈拉雷（津巴布韦首都） 8 月的一个温暖的早晨，范蕾，一位有两个孩子的 24 岁母亲 走向了公园的长凳。她看起来痛苦又沮丧。那条长凳上还坐着 一位 82 岁的老妇人，社区的人都亲切的叫她 杰克奶奶。范蕾递给杰克奶奶一个 从诊所护士那拿到的信封。杰克奶奶请范蕾坐下，在她打开信封并阅读时，有大概三分钟，两人都默不作声。过了一会儿，杰克奶奶深吸了一口气，看着范蕾说，“有我在呢。想和我说说你的故事吗？”
01:01
Farai begins, her eyes swelling with tears. She says, "Grandmother Jack, I'm HIV-positive. I've been living with HIV for the past four years. My husband left me a year ago. I have two kids under the age of five. I'm unemployed. I can hardly take care of my children."
范蕾开始了讲述，她的眼睛满含泪水。她说，“杰克奶奶，我的艾滋病检测结果呈阳性。过去四年来，我一直是艾滋病毒携带者。我的丈夫一年前离开我了。我有两个孩子，他们都还不到五岁。我还失业了，我几乎无力抚养我的孩子。
01:28
Tears are now flowing down her face. And in response, Grandmother Jack moves closer, puts her hand on Farai, and says, "Farai, it's OK to cry. You've been through a lot. Would you like to share more with me?"
这时眼泪不停地从她脸颊流下。作为回应，杰克奶奶坐近了一些，并且轻轻抚摸范雷，她说，“范雷，哭吧，没关系的。你经历了很多。你想和我再说说吗？”
01:47
And Farai continues. "In the last three weeks, I have had recurrent thoughts of killing myself, taking my two children with me. I can't take it anymore. The clinic nurse sent me to see you." There's an exchange between the two, which lasts about 30 minutes. And finally, Grandmother Jack says, "Farai, it seems to me that you have all the symptoms of kufungisisa."
接下来，范雷继续了讲述。“在过去的三周里，我经常想到自杀，带着我的两个孩子一起。我真的无法承受了。是诊所护士让我来见你的。” 在接下来的三十分钟里，她们互诉衷肠。最后，杰克奶奶说，“范雷。在我看来，你有 kufungisisa 的所有症状。”
02:25
The word "kufungisisa" opens up a floodgate of tears. So, kufungisisa is the local equivalent of depression in my country. It literally means "thinking too much." The World Health Organization estimates that more than 300 million people globally, today, suffer from depression, or what in my country we call kufungisisa. And the World Health Organization also tells us that every 40 seconds, someone somewhere in the world commits suicide because they are unhappy, largely due to depression or kufungisisa. And most of these deaths are occurring in low- and middle-income countries.
kufungisisa 这个词 让范蕾再也止不住泪水。事实上，在我的国家，kufungisisa 就相当于抑郁症。它的字面意思是 “想的太多”。根据世界卫生组织的估计，目前全球有 3 亿多人患有抑郁症，或者用我国的叫法，患上了 Kufungisisa。世界卫生组织也告诉我们，每 40 秒钟。世界的某个角落就会有人自杀，因为他们活得不快乐，主要是由于患有 抑郁症或 kufungisisa。大部分的自杀行为 都发生于中低收入的国家。
03:17
In fact, the World Health Organization goes as far as to say that when you look at the age group between 15 to 29, a leading cause of death now is actually suicide. But there are wider events that lead to depression and in some cases, suicide, such as abuse, conflict, violence, isolation, loneliness -- the list is endless. But one thing that we do know is that depression can be treated and suicides averted.
事实上，世界卫生组织甚至表明，年龄在 15 岁到 29 岁之间的群体中，目前主要的死因就是自杀。但导致抑郁症甚至自杀的原因 其实有很多，比如虐待，冲突，暴力，孤立，寂寞，等等。但我们知道的是，抑郁症是可治疗的，自杀也是可避免的。
03:54
But the problem is we just don't have enough psychiatrists or psychologists in the world to do the job. In most low- and middle-income countries, for instance, the ratio of psychiatrists to the population is something like one for every one and a half million people, which literally means that 90 percent of the people needing mental health services will not get it. In my country, there are 12 psychiatrists, and I'm one of them, for a population of approximately 14 million.
但问题是，世界上没有足够的 精神病学家或心理学家 来完成这项工作。比如在大多数中低收入的国家，精神科医生与总人口的比例 是 1 比 150 万。这个数字意味着 90％ 需要 心理健康服务的人群 无法得到应有的服务。在我的祖国，共有 12 位精神科医生，我就是其中之一，要为约 1400 万人口服务。
04:28
Now, let me just put that into context. One evening while I was at home, I get a call from the ER, or the emergency room, from a city which is some 200 kilometers away from where I live. And the ER doctor says, "One of your patients, someone you treated four months ago, has just taken an overdose, and they are in the ER department. Hemodynamically, they seem to be OK, but they will need neuropsychiatric evaluation." Now, I obviously can't get into my car in the middle of the night and drive 200 kilometers. So as best as we could, over the phone with the ER doctor, we come up with an assessment. We ensure that suicidal observations are in place. We ensure that we start reviewing the antidepressants that this patient has been taking, and we finally conclude that as soon as Erica -- that was her name, 26-year-old -- as soon as Erica is ready to be released from the ER, she should come directly to me with her mother, and I will evaluate and establish what can be done.
现在，我给大家讲个实际的例子。一天晚上，我在家休息，接到了一个 ER，也就是急诊室的 电话，那个城市和我住的地方 相距 200 公里。急诊室医生说，“你的一个病人，就是四个月前接受治疗的那个，现在服药过量，正在一个急诊科里。从血流动力上看没什么问题，但需要进行神经精神病方面的评估。” 但我当时显然不会在半夜驱车 200 公里到达现场。所以我当时能做的 就是和电话那头急诊室医生 进行了一个评估。我们确认自杀监管到位。我们确认我们检查了那个病人 一直服用的抗抑郁药物，最后我们得出结论，26 岁的爱瑞卡——那是她的名字—— 一旦爱瑞卡可以从急诊室出院，她应该和她母亲直接来我这里，然后我会评估她的精神状况，也会尽我所能来帮助她。
05:39
And we assumed that that would take about a week. A week passes. Three weeks pass. No Erica. And one day I get a call from Erica's mother, and she says, "Erica committed suicide three days ago. She hanged herself from the mango tree in the family garden." Now, almost like a knee-jerk reaction, I couldn't help but ask, "But why didn't you come to Harare, where I live? We had agreed that as soon as you're released from the ER, you will come to me." Her response was brief. "We didn't have the 15 dollars bus fare to come to Harare."
我们估计那要花大概一周。一周过去了，三周过去了，爱瑞卡没有来。一天我接到了爱瑞卡母亲的电话，她说，“爱瑞卡三天前自杀了。她在自家院子里的 芒果树上上吊了。” 那时候，就像膝跳反射一样，我忍不住问道，“但是你们为什么没来 我在哈拉雷的住处？ 我们都说好了，一旦爱瑞卡出院，你们就会过来。” 她的答案很简短，“我们付不起十五美元的巴士钱，去不了哈拉雷。”
06:28
Now, suicide is not an unusual event in the world of mental health. But there was something about Erica's death that struck me at the core of my very being. That statement from Erica's mother: "We didn't have 15 dollars bus fare to come to you," made me realize that it just wasn't going to work, me expecting people to come to me. And I got into this state of soul-searching, trying to really discover my role as a psychiatrist in Africa.
在精神健康领域，自杀很常见。但是爱瑞卡的死 却深深地震撼了我。爱瑞卡母亲的话： “我们付不起十五美元的 巴士钱去找你，” 让我明白了，让病人来找我，根本就行不通。我开始进行深刻的反思，想要探寻我作为非洲的 一名精神病学家的角色。
07:09
And after considerable consultation and soul-searching, talking to colleagues, friends and family, it suddenly dawned on me that actually, one the most reliable resources we have in Africa are grandmothers. Yes, grandmothers. And I thought, grandmothers are in every community. There are hundreds of them. And --
在经过一系列咨询和自我反思，以及和同事、朋友和家人的交流后，我突然之间明白了，实际上，在非洲，我们最可靠的资源 就是我们的奶奶们。没错，奶奶们。我认为，奶奶们无处不在。数量众多，而且——
07:37
(Laughter)
（笑声）
07:38
And they don't leave their communities in search of greener pastures.
而且也不会抛下我们 去追求更好的生活。
07:43
(Laughter)
（笑声）
07:45
See, the only time they leave is when they go to a greener pasture called heaven.
她们唯一离开的时候，是要去一个更好的地方，天堂。
07:49
(Laughter)
（笑声）
07:50
So I thought, how about training grandmothers in evidence-based talk therapy, which they can deliver on a bench? Empower them with the skills to listen, to show empathy, all of that rooted in cognitive behavioral therapy; empower them with the skills to provide behavior activation, activity scheduling; and support them using digital technology. You know, mobile phone technology. Pretty much everyone in Africa has a mobile phone today.
所以我想，何不训练一下奶奶们，让她们进行循证型的谈话治疗，在长凳上就能进行？ 让她们可以通过倾听他人 来表达同情心。这些都源于认知行为疗法； 可以让奶奶们提供行为激活，安排活动日程，并且让她们运用数码科技，就是移动电话技术。毕竟在非洲，现在几乎每个人都有手机。
08:26
So in 2006, I started my first group of grandmothers.
所以在 2006 年，我开创了我的第一个 奶奶团。
08:33
(Applause)
（掌声）
08:37
Thank you.
谢谢。
08:38
(Applause)
（掌声）
08:41
Today, there are hundreds of grandmothers who are working in more than 70 communities. And in the last year alone, more than 30,000 people received treatment on the Friendship Bench from a grandmother in a community in Zimbabwe.
现在，已经有数百位奶奶们 在超过 70 个社区中工作。仅在去年，就有超过三万人 在友情长凳上 接受了津巴布韦 某个社区的奶奶的治疗。
09:01
(Applause)
（掌声）
09:09
And recently, we published this work that is done by these grandmothers in the Journal of the American Medical Association. And --
最近，我们将 这些奶奶们完成的工作 发布在了美国医学会的期刊上。不仅如此——
09:18
(Applause)
（掌声）
09:20
And our results show that six months after receiving treatment from a grandmother, people were still symptom-free: no depression, suicidal ideation completely reduced. In fact, this clinical trial showed that grandmothers were more effective at treating depression than doctors and --
我们的数据表明，在经过一位奶奶 六个月的治疗后，人们的病症纷纷消失了： 也不再抑郁，自杀想法大大降低。这个临床试验表明，我们的奶奶们相比医生 要有效得多。
09:45
(Laughter)
（笑声）
09:46
(Applause)
（掌声）
09:54
And so, we're now working towards expanding this program. There are more than 600 million people currently aged above 65 in the world. And by the year 2050, there will be 1.5 billion people aged 65 and above. Imagine if we could create a global network of grandmothers in every major city in the world, who are trained in evidence-based talk therapy, supported through digital platforms, networked. And they will make a difference in communities. They will reduce the treatment gap for mental, neurological and substance-use disorders.
所以，我们现在正在致力于 扩大这个项目。全世界目前有 6 亿 65 岁以上的人。到了 2050 年，这个人数会增加到 15 亿。想像一下，如果我们 在全世界的所有主要城市 创造一个奶奶们的关系网络，她们都受过循证谈话治疗的训练，并由电子平台支持，通过网络工作。她们会在社区中起到显著的作用，减少精神，神经 和药物使用障碍方面的治疗缺口。
10:48
So, Farai had six sessions on the bench with Grandmother Jack. Today, Farai is employed. She has her two children at school. And as for Grandmother Jack, one morning in February, we expected her to see her 257th client on the bench. She didn't show up. She had gone to a greener pasture called heaven. But I believe that Grandmother Jack, from up there, she's cheering on all the other grandmothers -- the increasing number of grandmothers who are making a difference in the lives of thousands of people. And I'm sure she's in awe when she realizes that something that she helped to pioneer is now spreading to other countries, like Malawi, the island of Zanzibar and coming closer to home here in the Unites States in the city of New York. May her soul rest in peace.
范蕾在这张长凳上和杰克奶奶 进行了六个疗程的治疗。现在，范蕾有了工作，两个孩子也在上学。至于杰克奶奶，二月的一天早晨，我们以为 她会在长凳上治疗第 257 名病人，但她并没有出现。因为她去了一个更好的地方，天堂。但我相信杰克奶奶 一直以来都在天堂 鼓舞着其他的奶奶们—— 帮助着许多人的，队伍不断壮大的奶奶们。我也相信，当她知道她所倡导的精神 正在其他国家不断传播，比如马拉维，桑给巴尔岛，同时也将马上 影响到美国，就在纽约，我相信她一定会感到敬畏。愿她的灵魂安息。
12:00
Thank you.
谢谢。
12:01
(Applause)
（掌声）
12:04
(Cheering)
（欢呼）
12:06
(Applause)
（掌声）
