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  • These two Kenyan ladies were best friends

  • from neighboring villages,

  • but they'd stopped seeing each other, literally, for 10 years,

  • because both had gone blind from a curable condition called cataracts.

  • They hadn't been aware they'd been sat together for over an hour

  • when we offered them surgery at the nearest hospital.

  • Mama Jane, on the right, told me

  • her biggest fear was that she would poison her grandson,

  • whom she'd never seen,

  • because she couldn't see what she was cooking for him.

  • Her arms were covered in burns from cooking on a charcoal stove,

  • and she despaired that she was robbing her six-year-old grandson of his childhood

  • because he was effectively her eyes.

  • The effect of her blindness was going through the generations.

  • He wasn't able to go to school or break the cycle of poverty.

  • All of this, despite cost-effective solutions existing.

  • Cataract surgery can be done in under 10 minutes

  • for just a hundred dollars.

  • Four in every five people who are blind don't need to be;

  • curative or preventive treatments already exist.

  • Fortunately for Mama Jane and her friend,

  • a donor had provided treatment

  • so that we could take them to the nearest hospital

  • three hours away.

  • But in that very same clinic,

  • I met Theresa,

  • a shy young woman who couldn't look me in the eyes,

  • not because she couldn't see,

  • but the appearance of the growth on her eyes called pterygium

  • meant she'd lost her confidence,

  • and with it, her place in her community.

  • She had no prospects for marriage or children

  • and had been completely ostracized.

  • I knew how to treat her condition; it was pretty straightforward.

  • But we had strict instructions that the funds we had

  • were for people with cataracts.

  • What was I supposed to do?

  • Ignore her?

  • My wife and I managed to raise the funds to cover her treatment,

  • but situations like Theresa were common every day,

  • where people had the wrong diseases.

  • And by the "wrong diseases,"

  • I mean conditions for which funding hadn't been earmarked.

  • Earmarking may seem like smart business or smart philanthropy on paper,

  • but it doesn't make any sense when you're looking the person in the eye.

  • Yet, this is how we deliver health care to millions of people the world over.

  • I've been thinking about this problem for a very long time.

  • Things happened to me at the age of 12 that completely transformed my life.

  • My teachers insisted that I would go for an eye test.

  • I resisted it for as many years as I could

  • because as the only brown boy in the school,

  • I already felt like a chocolate chip in rice pudding,

  • and the idea of looking more different was not particularly appealing.

  • You see, I'd associated an eye test with wearing glasses

  • and looking different,

  • not with seeing differently.

  • When eventually I was persuaded to go,

  • the optometrist fitted me with the trial lenses

  • and was shocked at just how poor my sight was.

  • He sent me outside to report what I could see.

  • I remember looking up and seeing trees had leaves on them.

  • I had never known this.

  • Later that week, for the first time, I saw stars in the night sky.

  • It was breathtaking.

  • In fact, the entire trajectory of my life changed.

  • I went from a failing child at school who was constantly told I was lazy

  • and not paying attention

  • to suddenly being a child with opportunity and potential.

  • But I soon realized that this opportunity was not universal.

  • That same summer, in Egypt,

  • the home where my parents are originally from,

  • I was with children that looked a lot more like me

  • but couldn't have been more different.

  • What separated us was opportunity.

  • How is it that I had this life and they had theirs?

  • It still makes no sense to me.

  • How is it we've --

  • in a world where glasses, that completely changed my life

  • have been around for 700 years,

  • yet two and a half billion people still can't access them.

  • This deep sense of injustice drove me to become a doctor,

  • eventually an eye surgeon,

  • and in 2012, my wife and I packed our bags and moved to Kenya

  • to try and give something back.

  • We started by setting up a hundred eye clinics

  • across the Great Rift Valley,

  • where we met people like Mama Jane and Theresa.

  • We founded a new organization called Peek Vision,

  • a social enterprise where we built smartphone technology

  • that makes it possible for people in the community

  • to find people in their homes,

  • the most vulnerable groups who are being missed,

  • and created new tools that made it easier to diagnose them

  • and connect them to services.

  • Inspired by the challenges I'd had as a child,

  • we equipped teachers, 25 of them, with smartphones

  • to screen children in schools.

  • Our first program resulted in 21,000 children

  • being screened in just nine days.

  • That same program was replicated to reach 200,000 children,

  • covering the entire district.

  • Soon we were able to repeat this in six new programs

  • in different countries.

  • But now, I was faced with the very same problems I had with Theresa

  • of earmarked funds,

  • but now as an organization.

  • People wanted to fund specific projects

  • or particular diseases

  • or subsets of the population.

  • But it didn't make sense,

  • because what we needed to do was build an incredible team

  • who could create the systems that would change the lives

  • of millions of people, whatever their needs were.

  • But it didn't work that way.

  • Soon, we were able to align ourselves with partners who understood,

  • because I understand the challenge.

  • Ultimately, you need to trust where your money's going,

  • and that trust usually manifests through the requirement

  • to create detailed plans -- lots of paperwork.

  • But what happens if the dynamic needs of people

  • don't fit with the plan that you created,

  • and your funding is dependent on delivering the plan?

  • You end up with a choice:

  • Do you serve the plan, the funder,

  • or do you serve the need?

  • This is not a choice we should have to make,

  • because ultimately, we can only serve one master.

  • The measure of our humanity

  • is how we serve the most vulnerable amongst us.

  • Currently, the system is not working, and too many people are being left behind.

  • We've been fortunate to find incredible supporters and partners,

  • which led to a new program in Botswana,

  • in which every single schoolchild is being screened and treated

  • by the end of 2021,

  • meaning an entire generation of children

  • will have the opportunity that good vision affords.

  • But this took years of work.

  • It took multiple feasibility studies,

  • engaging different partners and stakeholders,

  • business cases, economic analyses,

  • to persuade the government to eventually come on board.

  • But they're now leading and funding this in their own national budget.

  • But we did not have the resources to do this.

  • Our visionary funders and partners came alongside us,

  • and the key ingredients were we were aligned on mission,

  • on the why we were doing it.

  • We agreed on the outcome, what had to be done.

  • But critically, they were flexible and gave us autonomy

  • to work out how we got there,

  • giving us the space to be creative, ambitious and take risk.

  • What if all health care looked like this?

  • What would it mean for all the social causes we're trying to solve?

  • Business knows this.

  • By taking a long-term, ambitious view

  • and giving people the autonomy to be creative

  • to solve our world's biggest challenges,

  • we've disrupted entire industries.

  • Look at Amazon, Google.

  • Surely, we need the same level of ambition

  • if we're going to serve the most vulnerable in our societies.

  • As a planet, we've set a target,

  • the Sustainable Development Goals,

  • yet we're spending less than half the amount on tackling the global goals

  • than we are on conflict resolution,

  • which mostly arises from the very inequalities we're not serving.

  • It's time for change.

  • It's not just common sense as well -- it makes business sense.

  • Our work in Botswana showed

  • for a modest investment, the economy would gain 1.3 billion dollars

  • over the lifetime of the children.

  • That was 150 times return on investment.

  • But part of the problem is that value is generated in the future,

  • but we need the money now to deliver it.

  • Turns out, this is not a new problem.

  • Banks have been solving it for centuries.

  • Simply put, it's called financing.

  • If you want to buy a house

  • but you can't afford to pay for it up front,

  • the bank financiers, you see, can realize that future value now.

  • In other words, you can live in the house straightaway.

  • But what if you couldn't?

  • What if you had to wait until you'd raised all of the money to move into the house,

  • and you were kept homeless whilst trying to save the money

  • to get there in the first place?

  • You'd end up in an impossible cycle, never able to get there,

  • yet that's this very same bind we've put on ourselves.

  • Inspired by the change in Botswana

  • and by the visionary support of our funders and partners,

  • we've come together -- two world-leading banks,

  • for-profit and private, not-for-profit organizations,

  • foundations and philanthropists --

  • to launch the Vision Catalyst Fund,

  • a fund which will have trust built in by design.

  • It will make funding available now

  • to the organizations that can serve the need of the most vulnerable.

  • It will ensure that those organizations can work together in partnership,

  • rather than competing for limited funds,

  • serving the priority needs of an entire population,

  • whatever they are,

  • so that ultimately the individuals affected

  • can receive the care that they deserve.

  • And as we've shown,

  • it doesn't make just a health and social difference,

  • it creates huge economic benefit.

  • This benefit in itself will create sustainability

  • to perpetuate a virtuous, catalytic cycle of improvement and change.

  • Because when we do this,

  • the individual needs of people like myself can be met.

  • And this coalition has come together this year

  • to make a commitment with 53 heads of government,

  • who have now committed to take action

  • towards achieving access to quality eye care for all.

  • We've had incredible commitments

  • of 200 million pairs of glasses to the fund

  • and millions of dollars,

  • so that the dynamic and individual needs of people --

  • like my own issues that I had as child,

  • and like Theresa, who just required simple surgery --

  • can be met.

  • For Theresa, it meant her place back in society,

  • now with her own family and children.

  • And for Mama Jane, it wasn't just restoring her sight,

  • it meant the opportunity to restore hope,

  • to restore joy

  • and to restore dignity.

  • (Music)

  • Thank you.

  • (Applause)

These two Kenyan ladies were best friends

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B1 INT US TED theresa serve jane people eye

【TED】Andrew Bastawrous: A new way to fund health care for the most vulnerable (A new way to fund health care for the most vulnerable | Andrew Bastawrous)

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    林宜悉   posted on 2018/10/01
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