in the middle of the night,

有一個警察在深夜裡巡邏，

and he comes across a guy under a street lamp

他遇到一個人在路燈下

who's looking at the ground and moving from side to side,

一邊盯著地面看一邊來回走

and the cop asks him what he's doing.

警察問他在做什麼。

The guys says he's looking for his keys.

那人說他正在找他的鑰匙。

So the cop takes his time and looks over

所以警察也花時間幫他找

and kind of makes a little matrix and looks

並且做了一些小記號，

for about two, three minutes. No keys.

大概花了兩、 三分鐘。 還是沒找到鑰匙。

The cop says, "Are you sure? Hey buddy,

警察說，"嘿，朋友，你確定你的鑰匙

are you sure you lost your keys here?"

丟在這裡了嗎？”

And the guy says, "No, no, actually I lost them

這個人說 “不，不，其實我把它們丟在了

down at the other end of the street,

這條街的另一邊，

but the light is better here."

但是這裡的光更亮。”

There's a concept that people talk about nowadays

現如今，人們談論著一個概念叫大數據，

called big data, and what they're talking about

他們談論的是

is all of the information that we're generating

我們通過網際網路互動時

through our interaction with and over the Internet,

我們生成的所有資訊，

everything from Facebook and Twitter

所有東西，從臉書、推特

to music downloads, movies, streaming, all this kind of stuff,

到音樂下載、 電影、 串流媒體 所有這類的東西，

the live streaming of TED.

TED 的直播。

And the folks who work with big data, for them,

對於那些處理大數據的人們來說，

they talk about that their biggest problem is

他們談論的最大問題是

we have so much information,

我們有太多的資訊，

the biggest problem is, how do we organize all that information?

我們面對的最大問題是， 我們如何整理所有的資訊？

I can tell you that working in global health,

我告訴你，在全球健康領域工作，

that is not our biggest problem.

這不是我們最大的問題。

Because for us, even though the light

因為對我們來說，

is better on the Internet,

即使網路上的燈更亮，

the data that would help us solve the problems

即使網上的數據能幫我們解決一些問題

we're trying to solve is not actually present on the Internet.

但我們試圖去解決的問題 實際上卻並不存在於網路上。

So we don't know, for example, how many people

所以我們不知道，

right now are being affected by disasters

例如，有多少人正在遭受災難

or by conflict situations.

或陷入戰爭囹圄之中。

We don't know for really basically any of the clinics

我們不知道發展中國家的診所裡

in the developing world, which ones have medicines

哪些有藥品，

and which ones don't.

哪些沒有藥品。

We have no idea of what the supply chain is for those clinics.

我們完全不知道這些診所的供應鏈是怎樣的。

We don't know -- and this is really amazing to me --

我們不知道——這真得讓我很吃驚——

we don't know how many children were born,

我們不知道有多少孩子出生，

or how many children there are in Bolivia

或有多少兒童在玻利維亞

or Botswana or Bhutan.

博茨瓦納或不丹。

We don't know how many kids died last week

我們不知道在任何這些國家裡，

in any of those countries.

上星期有多少孩子死去。

We don't know the needs of the elderly, the mentally ill.

我們不知道老年人和精神病患者的需要。

For all of these different critically important problems

對於所有這些不同的卻非常重要的問題

or critically important areas that we want to solve problems in,

或我們想要解決問題的非常重要的領域，

we basically know nothing at all.

我們基本上一無所知。

And part of the reason why we don't know anything at all

造成我們一無所知的部分原因

is that the information technology systems

是我們在全球健康組織工作時，

that we use in global health to find the data

用來查找資料，解決問題的資訊技術系統

to solve these problems is what you see here.

就是您在這裡看到的。

And this is about a 5,000-year-old technology.

這是一個大約有五千年歷史的技術。

Some of you may have used it before.

你們有些人此前可能用過。

It's kind of on its way out now, but we still use it

它現在已經過時了，

for 99 percent of our stuff.

但我們 99% 的工作都使用它。

This is a paper form, and what you're looking at

這是紙質表單，

is a paper form in the hand of a Ministry of Health nurse

你正在看的是健康部護士 手中的一張紙質表單

in Indonesia who is tramping out across the countryside

她正徒步穿行在印度尼西亞的鄉下，

in Indonesia on, I'm sure, a very hot and humid day,

在印尼，我確信，那是個十分炎熱和潮濕的一天，

and she is going to be knocking on thousands of doors

她要在幾週或幾個月內

over a period of weeks or months,

去敲千家萬戶的門

knocking on the doors and saying, "Excuse me,

邊敲門邊說，"打擾了，

we'd like to ask you some questions.

我們想問你一些問題。

Do you have any children? Were your children vaccinated?"

你有孩子嗎？你的孩子接種疫苗了嗎?"

Because the only way we can actually find out

因為讓我們可以找出

how many children were vaccinated in the country of Indonesia,

在印尼有多少兒童接種了疫苗

what percentage were vaccinated, is actually not

和他們接種了疫苗的百分比的唯一方法，

on the Internet but by going out and knocking on doors,

其實不在網際網路上， 而是通過走出去，敲那些門，

sometimes tens of thousands of doors.

有時需要敲千千萬萬的門。

Sometimes it takes months to even years

有時需要幾個月甚至幾年

to do something like this.

去做這樣的事情。

You know, a census of Indonesia

你知道，印尼的人口普查

would probably take two years to accomplish.

可能會兩年才能完成。

And the problem, of course, with all of this is that

當然，這其中的問題

with all those paper forms — and I'm telling you

在於所有那些紙質表單——我要告訴你

we have paper forms for every possible thing.

我們什麼事情都有紙質表單。

We have paper forms for vaccination surveys.

我們有接種疫苗調查的紙質表單。

We have paper forms to track people who come into clinics.

我們用紙質表單來跟蹤到診所來的人。

We have paper forms to track drug supplies,

我們用紙質表單來跟蹤藥品供應、

blood supplies, all these different paper forms

血液供應，所有這些不同的紙質表單

for many different topics,

有許多不同的主題，

they all have a single common endpoint,

他們都有一個共同終結點，

and the common endpoint looks something like this.

那個共同的終結點看起來就像這樣。

And what we're looking at here is a truckful o' data.

我們現在看到的是一卡車的數據。

This is the data from a single vaccination coverage survey

這只是一個疫苗接種覆蓋範圍的調查資料

in a single district in the country of Zambia

僅僅是尚比亞鄉下的一個地區而已

from a few years ago that I participated in.

它們來自於前幾年我參加的一次調查。

The only thing anyone was trying to find out

我們唯一想找到的是

is what percentage of Zambian children are vaccinated,

尚比亞兒童接種疫苗的百分比，

and this is the data, collected on paper over weeks

這是在數週內收集到紙上的數據資料，

from a single district, which is something like a county

僅僅是一個地區，

in the United States.

有點像我們在美國的一個郡。

You can imagine that, for the entire country of Zambia,

你可以想像，整個國家的尚比亞，

answering just that single question

回答只是這一個問題

looks something like this.

看起來這樣的。

Truck after truck after truck

一車一車又一車

filled with stack after stack after stack of data.

裝滿一堆一堆又一堆的數據資料。

And what makes it even worse is that

並且更糟糕的是，

that's just the beginning,

這只是開始，

because once you've collected all that data,

因為一旦你收集了所有的資料，

of course someone's going to have to --

當然有一些人必須要去——

some unfortunate person is going to have to type that into a computer.

有些不幸的人必須要把它們輸入到電腦上。

When I was a graduate student, I actually was

當我是研究生的時候，

that unfortunate person sometimes.

實際上我有時就是那不幸的人。

I can tell you, I often wasn't really paying attention.

我可以告訴你，我那時經常分心。

I probably made a lot of mistakes when I did it

我大概做了很多錯誤的輸入，

that no one ever discovered, so data quality goes down.

沒有人會發現，所以數據資料的品質會下降。

But eventually that data hopefully gets typed into a computer,

但是最終希望那些數據被輸入到了電腦上，

and someone can begin to analyze it,

那樣有人就可以開始分析它們，

and once they have an analysis and a report,

一旦他們得出了一份分析和報告，

hopefully then you can take the results of that data collection

但願你能使用那些收集來的數據結果

and use it to vaccinate children better.

來更好地為孩子們接種疫苗。

Because if there's anything worse

因為如果在全球公共健康領域

in the field of global public health,

有任何更糟的事情發生，

I don't know what's worse than allowing children on this planet

我不知道世上有什麼比讓孩子們

to die of vaccine-preventable diseases,

死於原本疫苗可預防的疾病更糟糕的事情，

diseases for which the vaccine costs a dollar.

那些疾病的疫苗成本也就 1 美元。

And millions of children die of these diseases every year.

但是，每年有數百萬的兒童死於這些疾病。

And the fact is, millions is a gross estimate because

而且事實是，數百萬只是一個粗略的估計，

we don't really know how many kids die each year of this.

因為我們真的不知道 每年究竟有多少孩子死於這些疾病。

What makes it even more frustrating is that

讓人更加沮喪的是，

the data entry part, the part that I used to do as a grad student,

數據輸入的部分， 也就是我作為研究生時曾做過的工作，

can take sometimes six months.

有時會長達六個月之久。

Sometimes it can take two years to type that information

有時，可以用兩年時間把那些資訊輸入到電腦

into a computer, and sometimes, actually not infrequently,

有時，其實經常發生，

it actually never happens.

那些數據根本不會被輸入。

Now try and wrap your head around that for a second.

現在試著想一想這一點。

You just had teams of hundreds of people.

你只有一個幾百人的團隊。

They went out into the field to answer a particular question.

他們要去實地回答一個特定的問題。

You probably spent hundreds of thousands of dollars

你很可能花掉了成百上千美元

on fuel and photocopying and per diem,

在燃料、複印和每日生活開支上，

and then for some reason, momentum is lost

然後出於某些原因，比如沒了勁頭兒

or there's no money left,

或者沒錢了，

and all of that comes to nothing

所有這一切都落空了

because no one actually types it into the computer at all.

因為實際上根本沒人把數據輸入到電腦裡。

The process just stops. Happens all the time.

這個過程就中斷了。但這常常發生。

This is what we base our decisions on in global health:

這就是我們在在全球健康組織裡頭的決策基礎：

little data, old data, no data.

少數據，舊數據，沒數據。

So back in 1995, I began to think about ways

所以，我們再回到 1995 年，我開始思考

in which we could improve this process.

我們可以改善這一過程的方法。

Now 1995, obviously that was quite a long time ago.

1995 年，很明顯，那是很久以前了。

It kind of frightens me to think of how long ago that was.

想想那有多久以前真得讓我有點害怕。

The top movie of the year was

那年最精彩的電影是

"Die Hard with a Vengeance."

"終極警探3"。

As you can see, Bruce Willis had a lot more hair back then.

正如您所看到的， 布魯斯 · 威利斯那時還有很多頭髮。

I was working in the Centers for Disease Control,

我那時正在疾病控制中心工作，

and I had a lot more hair back then as well.

那時我也有很多頭髮。

But to me, the most significant thing that I saw in 1995

但對我來說，在1995年， 我看到的最有意義的事

was this.

是這個。

Hard for us to imagine, but in 1995,

我們很難想像，但是在1995 年，

this was the ultimate elite mobile device.

這是那時候最精英的移動裝置。

Right? It wasn't an iPhone. It wasn't a Galaxy phone.

對吧？這不是一部 iPhone， 也不是三星 Galaxy 手機。

It was a Palm Pilot.

它是個掌上電腦。

And when I saw the Palm Pilot for the first time, I thought,

當我第一次看到掌上電腦時，我想，

why can't we put the forms on these Palm Pilots

為什麼我們不能把那些表格放到掌上電腦上？

and go out into the field just carrying one Palm Pilot,

然後去實地調查時就只帶著一個掌上電腦，

which can hold the capacity of tens of thousands

可以容納成千上萬的紙質表單。

of paper forms? Why don't we try to do that?

我們為什麼不試著這樣做呢？

Because if we can do that, if we can actually just

因為如果我們能那麼做，

collect the data electronically, digitally,

我們實際上就可以電子化、數字化地收集數據，

from the very beginning,

從一開始，

we can just put a shortcut right through that whole process

我們就在整個過程中獲得了一個捷徑，

of typing,

就不用打字，

of having somebody type that stuff into the computer.

不用讓人把那些數據輸入電腦裡了。

We can skip straight to the analysis

我們可以直接進行分析，

and then straight to the use of the data to actually save lives.

然後直接用那些數據去實際地挽救生命了。

So that's actually what I began to do.

所以那就是我開始做的事。

Working at CDC, I began to travel to different programs

在疾病預防控制中心工作時， 我開始到全世界不同的部門

around the world and to train them in using Palm Pilots

並且培訓他們用掌上電腦

to do data collection instead of using paper.

收集數據，而不是用紙張。

And it actually worked great.

實際工作進展得很順利。

It worked exactly as well as anybody would have predicted.

它就像每個人預計得那樣運作良好。

What do you know? Digital data collection

你知道嗎？電子數據收集

is actually more efficient than collecting on paper.

實際上比用紙張收集高效很多。

While I was doing it, my business partner, Rose,

當我在做這件事的時候， 我的生意夥伴，蘿絲，

who's here with her husband, Matthew, here in the audience,

她和她的丈夫，馬修，就在觀眾席裡，

Rose was out doing similar stuff for the American Red Cross.

蘿絲也去美國紅十字會做了同樣的事情。

The problem was, after a few years of doing that,

問題是，在那幾年之後，

I realized I had done -- I had been to maybe

我意識到我已經完成了——我可能已經去了

six or seven programs, and I thought,

6 個或 7 個組織，我覺得，

you know, if I keep this up at this pace,

你知道，如果再以這種速度繼續下去，

over my whole career, maybe I'm going to go

我整個職業生涯，也許我要去

to maybe 20 or 30 programs.

也許 20 或 30 個組織。

But the problem is, 20 or 30 programs,

但問題是，20或30個組織，

like, training 20 or 30 programs to use this technology,

給 20 或 30 個組織培訓使用這種技術，

that is a tiny drop in the bucket.

這簡直就是杯水車薪。

The demand for this, the need for data to run better programs,

這種要讓數據更好運行的需求，

just within health, not to mention all of the other fields

僅僅是在健康領域，其他領域暫且不談，

in developing countries, is enormous.

在發展中國家，這需求是巨大的。

There are millions and millions and millions of programs,

有成千上萬難以計數的組織，

millions of clinics that need to track drugs,

數以百萬的診所需要跟蹤藥品情況，

millions of vaccine programs.

數以百萬的疫苗組織。

There are schools that need to track attendance.

有很多學校需要紀錄出勤率。

There are all these different things

有各種各樣這樣不同的事情，

for us to get the data that we need to do.

並且我意識到，

And I realized, if I kept up the way that I was doing,

如果我繼續以我以前的方式，

I was basically hardly going to make any impact

在我的職業生涯結束之前，

by the end of my career.

我基本上很難做出什麼影響。

And so I began to wrack my brain

於是，我開動腦筋

trying to think about, you know,

努力思考，

what was the process that I was doing,

我在做的過程是什麼樣的，

how was I training folks, and what were the bottlenecks

我怎麼培訓人們，我遇到的瓶頸是什麼

and what were the obstacles to doing it faster

更快速、更有效的阻礙？

and to doing it more efficiently?

我意識到——我確定了主要的阻礙。

And unfortunately, after thinking about this for some time,

不幸的是，在思考這一段時間以後

I realized -- I identified the main obstacle.

我意識到——我確定了主要的阻礙。

And the main obstacle, it turned out,

這個主要的阻礙出現了，

and this is a sad realization,

並且這個發現讓我很沮喪。

the main obstacle was me.

這個主要的障礙就是我本人。

So what do I mean by that?

這是什麼意思呢？

I had developed a process whereby

我已經開發了這樣一個過程

I was the center of the universe of this technology.

我是這項技術的中心。

If you wanted to use this technology, you had to get in touch with me.

如果您想要使用這項技術，你必須聯絡我。

That means you had to know I existed.

這意味著你必須知道我的存在。

Then you had to find the money to pay for me

然後你不得不拿出錢來付給我

to fly out to your country

飛到你的國家

and the money to pay for my hotel

拿錢來支付我的旅館

and my per diem and my daily rate.

和我的每日支出和日常開銷。

So you could be talking about 10,000 or 20,000 or 30,000 dollars

所以你可以說是 1 萬或 2 萬或 3 萬美元

if I actually had the time or it fit my schedule

如果我真的有時間 或著能把這件事提上日程

and I wasn't on vacation.

而且我沒有在度假。

The point is that anything, any system that depends

這個問題的關鍵在於任何事，任何系統

on a single human being or two or three or five human beings,

只要是依靠一兩個或三五個人，

it just doesn't scale.

它就不會成規模。

And this is a problem for which we need to scale

問題就是我們需要傳播

this technology and we need to scale it now.

這項技術，並且我們現在就需要擴大它的規模。

And so I began to think of ways in which I could basically

所以我開始想

take myself out of the picture.

能讓我把自己脫離出來的方法。