| Recorded at | June 06, 2007 |
|---|---|
| Event | TEDGlobal 2007 |
| Duration (min:sec) | 14:05 |
| Video Type | TED Stage Talk |
| Words per minute | 192.14 fast |
| Readability (FK) | 71.47 very easy |
| Speaker | Seyi Oyesola |
| Country | Nigeria |
| Occupation | physician |
| Description | Nigerian doctor |
Official TED page for this talk
Synopsis
Dr. Seyi Oyesola takes a searing look at health care in underdeveloped countries. His photo tour of a Nigerian teaching hospital -- all low-tech hacks and donated supplies -- drives home the challenge of doing basic health care there.
| 1 | 00:18 | Just to put everything in context, | ||
| 2 | 00:20 | and to kind of give you a background to where I'm coming from, | ||
| 3 | 00:24 | so that a lot of the things I'm going to say, | ||
| 4 | 00:26 | and the things I'm going to do -- | ||
| 5 | 00:29 | or things I'm going to tell you I've done -- | ||
| 6 | 00:31 | you will understand exactly why and how I got motivated to be where I am. | ||
| 7 | 00:38 | I graduated high school in Cleveland, Ohio, 1975. | ||
| 8 | 00:42 | And just like my parents did when they finished studying abroad, we went back home. | ||
| 9 | 00:48 | Finished university education, got a medical degree, 1986. | ||
| 10 | 00:53 | And by the time I was an intern house officer, | ||
| 11 | 00:57 | I could barely afford to maintain my mother's 13-year-old car -- | ||
| 12 | 01:02 | and I was a paid doctor. | ||
| 13 | 01:06 | This brings us to why a lot of us, who are professionals, | ||
| 14 | 01:10 | are now, as they say, in diaspora. | ||
| 15 | 01:14 | Now, are we going to make that a permanent thing, | ||
| 16 | 01:17 | where we all get trained, and we leave, and we don't go back? | ||
| 17 | 01:24 | Perhaps not, I should certainly hope not -- | ||
| 18 | 01:27 | because that is not my vision. | ||
| 19 | 01:31 | All right, for good measure, that's where Nigeria is on the African map, | ||
| 20 | 01:37 | and just there is the Delta region that I'm sure everybody's heard of. | ||
| 21 | 01:42 | People getting kidnapped, where the oil comes from, | ||
| 22 | 01:46 | the oil that sometimes I think has driven us all crazy in Nigeria. | ||
| 23 | 01:51 | But, critical poverty: this slide is from a presentation I gave | ||
| 24 | 01:54 | not that long ago. Gapminder.org tells the story of the gap | ||
| 25 | 02:00 | between Africa and the rest of the world in terms of health care. | ||
| 26 | 02:04 | Very interesting. | ||
| 27 | 02:07 | How many people do you think are on that taxi? | ||
| 28 | 02:11 | And believe it or not, that is a taxi in Nigeria. | ||
| 29 | 02:14 | And the capital -- well, what used to be the capital of Nigeria -- Lagos, | ||
| 30 | 02:17 | that's a taxi, and you have police on them. | ||
| 31 | 02:20 | So, tell me, how many policemen do you think are on this taxi? And now? Three. | ||
| 32 | 02:28 | So, when these kind of people -- and, believe me, it's not just the police | ||
| 33 | 02:33 | that use these taxis in Lagos. We all do. I've been on one of these, | ||
| 34 | 02:38 | and I didn't have a helmet, either. | ||
| 35 | 02:41 | And it just reminds me of the thought of what happens when one of us | ||
| 36 | 02:49 | on a taxi like this falls off, has an accident and needs a hospital. | ||
| 37 | 02:55 | Believe it or not, some of us do survive. | ||
| 38 | 02:59 | Some of us do survive malaria; we do survive AIDS. | ||
| 39 | 03:03 | And like I tell my family, and my wife reminds me every time, | ||
| 40 | 03:07 | "You're risking your life, you know, every time you go to that country." | ||
| 41 | 03:11 | And she's right. Every time you go there, | ||
| 42 | 03:14 | you know that if you actually need critical care -- | ||
| 43 | 03:19 | critical care of any sort -- if you have an accident -- | ||
| 44 | 03:22 | of which there are many, there are accidents everywhere -- | ||
| 45 | 03:26 | where do they go? | ||
| 46 | 03:29 | Where do they go when they need help for this kind of stuff? | ||
| 47 | 03:34 | I'm not saying instead of, I'm saying as well as, | ||
| 48 | 03:37 | AIDS, TB, malaria, typhoid -- the list goes on. | ||
| 49 | 03:43 | I'm saying, where do they go when they're like me? | ||
| 50 | 03:47 | When I go back home -- and I do all kinds of things, | ||
| 51 | 03:50 | I teach, I train -- but I catch one of these things, | ||
| 52 | 03:54 | or I'm chronically ill with one of those, where do they go? | ||
| 53 | 04:00 | What's the economic impact when one of them dies or becomes disabled? | ||
| 54 | 04:06 | I think it's quite significant. This is where they go. | ||
| 55 | 04:10 | These are not old pictures and these are not from some downtrodden -- | ||
| 56 | 04:14 | this is a major hospital. In fact, it's from a major teaching hospital in Nigeria. | ||
| 57 | 04:20 | Now that is less than a year old, in an operating room. | ||
| 58 | 04:25 | That's sterilizing equipment in Nigeria. | ||
| 59 | 04:28 | You remember all that oil? | ||
| 60 | 04:30 | Yes, I'm sorry if it upsets some of you, but | ||
| 61 | 04:34 | I think you need to see this. That's the floor, OK? | ||
| 62 | 04:38 | You can say some of this is education. | ||
| 63 | 04:40 | You can say it's hygiene. I'm not pleading poverty. | ||
| 64 | 04:44 | I'm saying we need more than just, you know, vaccination, | ||
| 65 | 04:50 | malaria, AIDS, because I want to be treated | ||
| 66 | 04:53 | in a proper hospital if something happens to me out there. | ||
| 67 | 04:56 | In fact, when I start running around saying, | ||
| 68 | 04:58 | "Hey, boys and girls, you're cardiologists in the U.S., | ||
| 69 | 05:01 | can you come home with me and do a mission?" | ||
| 70 | 05:04 | I want them to think, "Well there's some hope." | ||
| 71 | 05:06 | Now, have a look at that. That's the anesthesiology machine. | ||
| 72 | 05:09 | And that's my specialty, right? | ||
| 73 | 05:11 | Anesthesiology and critical care -- look at that bag. | ||
| 74 | 05:15 | It's been taped with tape that we even stopped using in the U.K. | ||
| 75 | 05:19 | And believe me, these are current pictures. | ||
| 76 | 05:22 | Now, if something like this, which has happened in the U.K., | ||
| 77 | 05:27 | that's where they go. This is the intensive care unit in which I work. | ||
| 78 | 05:32 | All right, this is a slide from a talk I gave | ||
| 79 | 05:37 | about intensive care units in Nigeria, | ||
| 80 | 05:41 | and jokingly we refer to it as "Expensive Scare." | ||
| 81 | 05:46 | Because it's scary and it's expensive, but we need to have it, OK? | ||
| 82 | 05:54 | So, these are the problems. | ||
| 83 | 05:57 | There are no prizes for telling us what the problems are, are there? | ||
| 84 | 06:01 | I think we all know. And several speakers before | ||
| 85 | 06:04 | and speakers after me are going to tell us even more problems. | ||
| 86 | 06:08 | These are a few of them. So, what did I do? | ||
| 87 | 06:12 | There we go -- we're going on a mission. | ||
| 88 | 06:15 | We're going to do some open-heart surgery. I was the only Brit, | ||
| 89 | 06:19 | on a team of about nine American cardiac surgeons, | ||
| 90 | 06:24 | cardiac nurse, intensive care nurse. | ||
| 91 | 06:26 | We all went out and did a mission and we've done three of them so far. | ||
| 92 | 06:31 | Just so you know, I do believe in missions, I do believe in aid | ||
| 93 | 06:35 | and I do believe in charity. They have their place, | ||
| 94 | 06:38 | but where do they go for those things we talked about earlier? | ||
| 95 | 06:43 | Because it's not everyone that's going to benefit from a mission. | ||
| 96 | 06:48 | Health is wealth, in the words of Hans Rosling. | ||
| 97 | 06:51 | You get wealthier faster if you are healthy first. | ||
| 98 | 06:57 | So, here we are, mission. Big trouble. | ||
| 99 | 07:01 | Open-heart surgery in Nigeria -- big trouble. | ||
| 100 | 07:04 | That's Mike, Mike comes out from Mississippi. | ||
| 101 | 07:07 | Does he look like he's happy? | ||
| 102 | 07:09 | It took us two days just to organize the place, but hey, | ||
| 103 | 07:13 | you know, we worked on it. Does he look happy? | ||
| 104 | 07:18 | Yes, that's the medical advice the committee chairman says, | ||
| 105 | 07:20 | "Yes, I told you, you weren't going to be able to, | ||
| 106 | 07:22 | you can't do this, I just know it." | ||
| 107 | 07:24 | Look, that's the technician we had. So yes, you go on, all right? | ||
| 108 | 07:29 | (Laughter) | ||
| 109 | 07:30 | I got him to come with me -- anesthesia tech -- come with me from the U.K. | ||
| 110 | 07:34 | Yes, let's just go work this thing out. | ||
| 111 | 07:38 | See, that's one of the problems we have in Nigeria and in Africa generally. | ||
| 112 | 07:42 | We get a lot of donated equipment. | ||
| 113 | 07:44 | Equipment that's obsolete, equipment that doesn't quite work, | ||
| 114 | 07:47 | or it works and you can't fix it. And there's nothing wrong with that, | ||
| 115 | 07:51 | so long as we use it and we move on. | ||
| 116 | 07:54 | But we had problems with it. We had severe problems there. | ||
| 117 | 07:56 | He had to get on the phone. This guy was always on the phone. | ||
| 118 | 07:59 | So what we going to do now? | ||
| 119 | 08:01 | It looks like all these Americans are here and | ||
| 120 | 08:03 | yes, one Brit, and he's not going to do anything -- | ||
| 121 | 08:07 | he thinks he's British actually, and he's actually Nigerian, | ||
| 122 | 08:09 | I just thought about that. | ||
| 123 | 08:11 | We eventually got it working, is the truth, | ||
| 124 | 08:13 | but it was one of these. Even older than the one you saw. | ||
| 125 | 08:17 | The reason I have this picture here, this X-ray, | ||
| 126 | 08:20 | it's just to tell you where and how we were viewing X-rays. | ||
| 127 | 08:26 | Do you figure where that is? It was on a window. | ||
| 128 | 08:29 | I mean, what's an X-ray viewing box? Please. | ||
| 129 | 08:34 | Well, nowadays everything's on PAX anyway. | ||
| 130 | 08:37 | You look at your X-rays on a screen and you do stuff with them, | ||
| 131 | 08:41 | you email them. But we were still using X-rays, | ||
| 132 | 08:43 | but we didn't even have a viewing box! | ||
| 133 | 08:45 | And we were doing open-heart surgery. | ||
| 134 | 08:47 | OK, I know it's not AIDS, I know it's not malaria, | ||
| 135 | 08:49 | but we still need this stuff. Oh yeah, echo -- | ||
| 136 | 08:53 | this was just to get the children ready and the adults ready. | ||
| 137 | 08:57 | People still believe in Voodoo. Heart disease, | ||
| 138 | 09:00 | VSD, hole in the heart, tetralogies. | ||
| 139 | 09:04 | You still get people who believe in it and they came. | ||
| 140 | 09:07 | At 67 percent oxygen saturation, the normal is about 97. | ||
| 141 | 09:12 | Her condition, open-heart surgery that as she required, | ||
| 142 | 09:15 | would have been treated when she was a child. | ||
| 143 | 09:18 | We had to do these for adults. So, we did succeed and we still do. | ||
| 144 | 09:22 | We've done three. We're planning another one in July | ||
| 145 | 09:25 | in the north of the country. So, we certainly still do open-heart, | ||
| 146 | 09:29 | but you can see the contrast between everything that was shipped in -- | ||
| 147 | 09:34 | we ship everything, instruments. We had explosions | ||
| 148 | 09:38 | because the kit was designed and installed by people who weren't used to it. | ||
| 149 | 09:45 | The oxygen tanks didn't quite work right. | ||
| 150 | 09:47 | But how many did we do the first one? 12. | ||
| 151 | 09:51 | We did 12 open-heart surgical patients successfully. | ||
| 152 | 09:55 | Here is our very first patient, out of intensive care, | ||
| 153 | 09:59 | and just watch that chair, all right? | ||
| 154 | 10:02 | This is what I mean about appropriate technology. | ||
| 155 | 10:06 | That's what he was doing, propping up the bed because the bed simply didn't work. | ||
| 156 | 10:12 | Have you seen one of those before? | ||
| 157 | 10:15 | No? Yes? Doesn't matter, it worked. | ||
| 158 | 10:18 | I'm sure you've all seen or heard this before: | ||
| 159 | 10:20 | "We, the willing, have been doing so much with so little for so long -- | ||
| 160 | 10:24 | (Applause) | ||
| 161 | 10:25 | -- we are now qualified to do anything with nothing." | ||
| 162 | 10:29 | (Applause) | ||
| 163 | 10:32 | Thank you. Sustainable Solutions -- this was my first company. | ||
| 164 | 10:37 | This one's sole aim is to provide the very things that I think are missing. | ||
| 165 | 10:42 | So, we put my hand in my pocket and say, "Guys, let's just buy stuff. | ||
| 166 | 10:46 | Let's go set up a company that teaches people, educates them, | ||
| 167 | 10:50 | gives them the tools they need to keep going." | ||
| 168 | 10:53 | And that's a perfect example of one. | ||
| 169 | 10:55 | Usually when you buy a ventilator in a hospital, | ||
| 170 | 10:57 | you buy a different one for children, | ||
| 171 | 11:00 | you buy a different one for transport. This one will do everything, | ||
| 172 | 11:03 | and it will do it at half the price and doesn't need compressed air. | ||
| 173 | 11:05 | If you're in America and you don't know about this one, we do, | ||
| 174 | 11:08 | because we make it our duty to find out | ||
| 175 | 11:11 | what's appropriate technology for Africa -- what's appropriately priced, | ||
| 176 | 11:16 | does the job, and we move on. Anesthesia machine: | ||
| 177 | 11:20 | multi-parameter monitor, operating lights, suction. | ||
| 178 | 11:23 | This little unit here -- remember your little 12-volt plug in the car, | ||
| 179 | 11:27 | that charges your, whatever, Game Boy, telephone? | ||
| 180 | 11:31 | That's exactly how the outlets are designed. | ||
| 181 | 11:34 | Yes, it will take a solar panel. Yes a solar panel will charge it. | ||
| 182 | 11:38 | But if you've got mains as well, it will charge the batteries in there. | ||
| 183 | 11:43 | And guess what? We have a little pedal charger too, just in case. | ||
| 184 | 11:47 | And guess what, if it all fails, | ||
| 185 | 11:49 | if you can find a car that's still got a live battery | ||
| 186 | 11:52 | and you stick it in, it will still work. Then you can customize it. | ||
| 187 | 11:57 | Is it dental surgery you want? General surgery you want? | ||
| 188 | 12:00 | Decide which instruments, stock it up with consumables. | ||
| 189 | 12:06 | And currently we're working on oxygen -- oxygen delivery on-site. | ||
| 190 | 12:15 | The technology for oxygen delivery is not new. | ||
| 191 | 12:24 | Oxygen concentrators are very old technology. What is new, | ||
| 192 | 12:29 | and what we will have in a few months, I hope, | ||
| 193 | 12:31 | is that ability to use this same renewable energy system | ||
| 194 | 12:34 | to provide and produce oxygen on site. Zeolite -- it's not new -- | ||
| 195 | 12:41 | zeolite removes nitrogen from air and nitrogen is 78 percent of air. | ||
| 196 | 12:48 | If you take nitrogen out, what's left? Oxygen, pretty much. | ||
| 197 | 12:53 | So that's not new. What we're doing is applying this technology to it. | ||
| 198 | 12:57 | These are the basic features of my device, or our device. | ||
| 199 | 13:01 | This is what makes it so special. | ||
| 200 | 13:03 | Apart from the awards it's won, | ||
| 201 | 13:05 | it's portable and it's certified. It's registered, the MHRA -- | ||
| 202 | 13:09 | and the CE mark, for those who don't know, for Europe, is the equivalent | ||
| 203 | 13:12 | of the FDA in the U.S. | ||
| 204 | 13:16 | If you compare it with what's on the market, price-wise, | ||
| 205 | 13:20 | size-wise, ease of use, complexity ... | ||
| 206 | 13:25 | This picture was taken last year. | ||
| 207 | 13:27 | These are members of my graduating class, 1986. | ||
| 208 | 13:31 | It was in this gentleman's house in the Potomac, | ||
| 209 | 13:33 | for those of you who are familiar with Maryland. | ||
| 210 | 13:37 | There are too many of us outside and everybody, | ||
| 211 | 13:41 | just to borrow a bit from Hans -- Hans Rosling, he's my guy -- | ||
| 212 | 13:47 | if the size of the text represents what gets the most attention, | ||
| 213 | 13:52 | it's the problems. But what we really need are African solutions | ||
| 214 | 13:57 | that are appropriate for Africa -- looking at the culture, | ||
| 215 | 14:00 | looking at the people, looking at how much money they've got. | ||
| 216 | 14:04 | African people, because they will do it with a passion, I hope. | ||
| 217 | 14:09 | And lots and lots of that little bit down there, sacrifice. | ||
| 218 | 14:13 | You have to do it. Africans have to do it, | ||
| 219 | 14:16 | in conjunction with everyone else. | ||
| 220 | 14:18 | Thank you. | ||
| 221 | 14:20 | (Applause) |