Myshkin Ingawale: A blood test without bleeding
講者：Myshkin Ingawale
2012年2月演講，2012年3月在TED 2012上線
翻譯：洪曉慧
編輯：朱學恆、洪曉慧
簡繁轉換：洪曉慧
後製：洪曉慧
字幕影片後制：謝旻均
關於這場演講
貧血在世上許多地方是導致分娩死亡的主要原因，而這完全是可以預防的。但標準測試方法具侵入性且過程緩慢。在這場詼諧且鼓舞人心的演講中，TED會員Myshkin Ingawale描述他和他的團隊經過32次嘗試後，製造出一台簡單、便攜式、低成本的設備，可在不侵入皮膚的情況下檢測貧血。
關於Myshkin Ingawale
Myshkin Ingawale是Biosense Technologies公司的共同創始人，這間公司開發出ToucHB這種便攜式非侵入性裝置來檢測貧血。
為什麼要聽他演講
Myshkin是Biosense Technologies這間印度醫療科技公司的共同創始人。Myshkin和他的團隊已開發出一種便攜式、手機大小的設備，以非侵入性，即不需使用針頭的方式來診斷及檢測貧血。這項技術根據光學原理運作，並能瞬間顯示結果。
Myshkin Ingawale的英語網上資料
Home: Biosense Technologies
[TED科技‧娛樂‧設計]
已有中譯字幕的TED影片目錄（繁體）（簡體）。請注意繁簡目錄是不一樣的。
Myshkin Ingawale 談非侵入式血液測試
我喜歡建造東西，我一向喜歡建造東西。在Biosense公司的研究團隊，我與醫生和工程師朋友共同發展了一個想法，開發出一項名叫ToucHB的技術，它可在不須針刺的情況下檢測血紅蛋白。我相信這將使醫療保健民主化，這兩個字的含義太深了，我不知道它們是什麼意思。
（笑聲）
事實上，在2009年，我對此更是一無所知，我完全不知道將會發生什麼事。事實上當時我正忙著完成博士學位，研究的是與此完全無關的領域－研究人們如何互動，資料提供者如何互動，維基百科上的文章如何形成，試著瞭解這個系統的資料品質如何。我也建造了某種被稱為「哥本哈根腳踏車輪」的東西，這只是一輛相當美麗的電動自行車，建造於麻省理工學院SENSEable城市實驗室。我很幸運能拜訪我的故鄉孟買－回那裡度假。
所以當時我計畫進行一趟公路之旅，拜訪了一個叫Parol的地方，大約距孟買北方兩小時車程。這是我朋友Abhishek Sen實習的地方，他是當地一位醫生，這是他本人的相片。（笑聲）所以Abhishek讓我等了一段時間，他當時在Parol接生嬰兒。我等著他，當他終於出現時，簡直是一臉慘白。他告訴我有兩個人死亡，母親和孩子都死了，原因是所謂的產後出血。他解釋說，這是指嚴重的內出血。真正讓我震驚的是，他說這完全是因為未診斷出的貧血。
現在，貧血－我是一位工程師，但連我都知道－貧血並不是致命的病症，這是一種早有已知療法的病症。我是指，葉酸、鐵劑是相當便宜且可控制貧血的療法。那麼，這位女性為什麼會死亡？我是指，這完全是可預防的。離那裡五分鐘車程，就有這所醫療中心，發放有醫療補助的鐵劑，所以這整件事發生的原因令我震驚不已，我知道必定有可預防的方法。
我媽媽是兒科醫生，所以我向她討教，她告訴我一般測試貧血的方法－採取血液樣本，將它放入一台叫做庫爾特計數器的儀器。這台儀器價值一萬美元，可以在孟買找到，我想這裡或這裡任何地方都有，歐洲和世上大部分城市也有，但在Parol沒有；此外，操作機器的那個女人－那個技術員，在Parol也沒有。
（笑聲）
這讓我震驚不已－我喜歡解決事情，我想解決這個問題。我找了一位朋友，一位工程師和另外三個醫生，Abhishek也加入了這個團隊－我們希望能解決這個問題。當我從這裡走下台時，世上已有10個人因為一個完全可預防的問題失去生命。
現在讓我帶你們回到Parol。你們看到的這位女性、這位護士，在印度被稱為希望工作者（ASHA worker），基本上她是一位鄉村衛生工作者，一位護士長，她是健康照護體系真正的中心，公共醫療服務由希望工作者執行，而非醫生。現在我們知道，我們必須設計她可以使用的東西，我們知道這台儀器必須擁有以下三項特性－它必須是某種不需使用針頭的東西，所以它適用於大眾，不會產生醫療廢棄物等問題；它必須足夠簡單，讓那位女性希望工作者得以使用；第三，它必須是某種能讓她放進工具包的東西，方便她攜帶到各鄉里間進行檢測。
我們認為我們可以製造出這種儀器，所以－我們這麼做了。（掌聲）但是－它無法運作。（笑聲）所以我們又製造了一台，我們試了32次。（笑聲）但我很高興告訴大家，去年我們又製造了一台－它可以運作，現在就在我的錢包裡。因此這是一台叫做ToucHB Quik的儀器，它的功用是測量血紅蛋白、血氧及脈搏。我將它套上我的手指，打開開關，大約過20秒，它的小螢幕上就會顯示我的血紅蛋白數值、血氧飽和度和心跳速率，這有助於希望工作者在醫療場所診斷貧血。
（掌聲）
我稍微解釋一下它是如何運作的。你或許可以看見這裡面有微弱的光，事實上其中包含三種光，三種波長的光。基本上，我們使光穿過組織，藉由光的傳輸量、散射量及吸收量，我們可以計算出血液中的血紅蛋白含量，這是根據某種稱之為光容積變化描繪法的原理。我們確實對像這樣的非侵入式技術在未來能有什麼突破相當感興趣，我在Pratesh的實習工作之一是建立一個行動裝置應用程式，它可將這所有的數據發送到任何地方。
我們正進行許多令人非常興奮的研究，我很想多告訴你們一點，但基本上，我相信我身後這張地圖－基本上就是所謂的貧血地圖，代表全球因貧血造成的死亡率。當然，你注意到其中有些熱點－像是南亞及非洲。我的商業計劃非常簡單，我打算將這種儀器出售給全球每一間診所。這是一個簡單的基礎商業計劃，當我於2020年完成這個計畫時，當世界衛生組織再次公佈數據時，貧血地圖將會變成這樣。
（掌聲）
謝謝。
（掌聲）
以下為系統擷取之英文原文
About this Talk
Anemia is a major -- and completely preventable -- cause of deaths in childbirth in many places around the world, but the standard test is invasive and slow. In this witty and inspiring talk, TED Fellow Myshkin Ingawale describes how (after 32 tries) he and his team created a simple, portable, low-cost device that can test for anemia without breaking the skin.
About the Speaker
Myshkin Ingawale is the co-founder of Biosense Technologies, which has built ToucHB, a portable, non-invasive device to test for anemia. Full bio »
Transcript
I like to build stuff. I've always liked to build stuff. My team at Biosense, a startup I co-founded with my doctor and engineer friends, has built a technology called ToucHB, which can do blood testing of hemoglobin without pricks, without needles. I believe this is going to democratize health care. They're two big words, I don't know what they mean.
(Laughter)
In fact, in 2009, I was even more clueless. I had absolutely no idea what was going to happen next. I was, in fact, busy trying to finish off my Ph.D., which was in a completely unrelated area of how people interact, contributors interact, how articles are formed in Wikipedia -- trying to figure out how quality emerges from the system. I was also building something called the Copenhagen Wheel, which is just a really beautiful, beautiful electric bike at a lab at MIT called SENSEable City Lab. I was lucky enough that I visited Mumbai, my house, back for a vacation.
So at that time I was planning a road trip. I visited a place called Parol about two hours north of Mumbai. This is a place where my friend, Abhishek Sen was interning. He's a doctor there. And that's his actual photograph. (Laughter) So Abhishek actually made me wait. He was out there in Parol delivering a baby. I was waiting, and when he did emerge, he was ashen-faced. He told me that there had been two deaths; the mother and child both had died. The reason, he told me, was something called post partum hemorrhage. He explained this meant severe internal bleeding. What was really shocking for me was that he said that this is entirely due to undiagnosed anemia.
Now anemia -- I'm an engineer, but even I knew -- that anemia is something which is not supposed to be fatal. It is something which probably the cure is known. I mean, folic acid, iron tablets -- very cheap, affordable cures exist to control anemia. So why was this woman dying? It was completely preventable. Five minutes away from there, I had the center, the medical center, which was distributing subsidized iron tablets. So the whole nature of this thing completely shocked me. And I knew that there had to be a way to prevent this.
My mom is a pediatrician, and I asked her. She told me that this is how you would typically test for anemia. Take a blood sample and run it through a machine called a Coulter counter. This is a $10,000 machine which was available in Mumbai. It's also available here or in any part, I guess, in Europe and most cities in the world. But this is not available in Parol. Also, that woman who was operating the machine, the technician, is not available in Parol.
(Laughter)
Now this struck me as -- I love to fix things. I wanted to fix this. I got a friend of mine, an engineer, and three other doctors -- Abhishek joined the team -- and we wanted to solve this problem. By the time I step down from here there will be 10 people who have lost their lives through a completely, completely preventable problem.
Now let me take you back to Parol. You saw the woman there, the nurse. In India this is called an ASHA worker. It's essentially a village health worker, a matron. She is really the center of the health care system. Public health care runs on the ASHA worker, not the doctor. Now we knew we had to design something which she could use. We knew it had to be these three things that the machine had to have. We knew it had to be something which had no needles, no pricking, so it would have adoption, it would not have medical waste, all those problems. It had to be simple enough for that woman ASHA worker to use. And thirdly, it had to be something which she could carry in her kit. She goes village to village doing screenings.
We thought we could build it, so we built it. (Applause) But, but it didn't work. (Laughter) So we built it again. And we did this 32 times. (Laughter) But I'm very excited to tell you that last year we did build it -- it works. And I have it here in my purse. So this is a machine called the ToucHB Quik. What it does is it measures my hemoglobin, oxygen and pulse rate. I put it on my finger, switch it on, and in about 20 seconds it'll give me, on the little screen here, a value of hemoglobin, oxygen saturation and heart rate. This will help ASHA workers diagnose anemia at the point of care.
(Applause)
I'll explain a little bit about how it works. You might have seen a little light inside of it. In fact, there are three lights in there, three wavelengths of light. And we essentially pass light right through the tissue, and from understanding how much of it is transmitted, how much of it is scattered and how much of it is absorbed, we can figure out how much hemoglobin is there in the blood. And this is something which is based on a principle called photoplethysmography. We are actually really very excited about what else non-invasive techniques like this will be able to crack in the future. One of the things which my intern here, Pratesh, built is a mobile application, which can now send all this data anywhere it wants to go.
There's a bunch of very exciting stuff which we are doing. I would love to tell you a little bit more about it. But fundamentally, what I believe is that the map behind of me is called basically the map of anemia. It's the death rates caused by anemia globally. You'll notice, of course, that there are hot spots -- South Asia, Africa. My business plan is very simple. I'm just going to sell these to every clinic in the world. That's a simple bottom-line business plan. And by the time I'm done, in 2020, when the WHO publishes the data again, this is going to be the map of anemia.
(Applause)
Thank you.
(Applause)
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