| : [♪ Μουσική Καλησπέρα, όλοι. Είναι ένα πραγματικό να είστε εδώ, ευχαριστούμε τον Τέντ και την εξαιρετική ομάδα που έχουν για να με συμμετέχουν. Πριν να σας πω κάποια σκέψη, πρέπει να σας πω το πρώτο σημείο, αφού το θέμα σήμερα είναι σημείο, πώς ήρθα εδώ στο TEDxPatras. Δύο εβδομάδες πριν ήρθα να δώσω μια μορφή σε έναν σχετικό συμμετέχωμα στην Αθήνα και πήγα από το συμμετέχωμα στον Βασιλί Σοφίας Αβένιο. Παίρνα το αυτοκίνητο και υπήρχαν δύο άντρες, ένας καθόταν στο σπίτι του αυτοκίνητος με την πόρτα ανοιχτή και ένας καθόταν έξω. Είχαν ταγγίδες όπως αυτά, αλλά δεν έκανε ταγγίδες. Είχαν δοκιμάσει με, είχαν δοκιμάσει, είχαν δοκιμάσει με χαλάρωτα, είχαν δοκιμάσει με χαλάρωτα και ξεκίνησα να περπατήσω πίσω στη στρατιώ. Και, ως κάποιος που γνωρίζω στη Νέα Υόρκη, είμαι πάντα σίγουρος ποιος είναι πίσω. Οπότε, αυτά τα δύο άντρες με ακολουθούν. Τώρα, αρχίζω να πιστεύω ότι έχω ένα τραπέζι με έναν κομπιούτρο. Αν τραπέζι το τραπέζι θα τους αγόρω, μπορεί να τους αγόρω, δεν θα είναι τόσο καλά. Αν τραπέζι το τραπέζι, θα μπορώ να τραπέζω το άλλο τραπέζι. Οπότε, σταματώ στον φως και λέω, κύριε Ζαούτης, και είπαν, ναι, και είπαν, γνωρίζουμε εσάς, γνωρίζουμε εσάς. Και είπαν, εντάξει, δεν γνωρίζω εσάς. Και είπαν, είχαμε σημασία και θέλουμε να σας εγγραφείτε στο TEDxPatras, γιατί είχαμε δει τη φωτογραφή σας και πήγατε στη στρατιώ και γνωρίζαμε εσάς. Και είπαν, εντάξει. Και είπαν, μπορούσαμε να σας εγγραφείτε ένα τραπέζι. Και είπαν, πού, και είπαν, μπορούσαμε να πάμε εκεί, στη στρατιώ. Και είπαν, εντάξει, μπορούσαμε να πάμε εκεί. Αυτός είναι ο τρόπος που έφτασα στο TEDxPatras σήμερα. Αυτός ήταν ο πρώτος στιγμός μου. Ευχαριστώ στους δυο άνθρωποι που δεν έφτασαν να μου αγόρω και να πάρουν το τραπέζι και να πάρουν το χρήμα μου. Είμαι λίγο εντυπωσιασμένος, γιατί είδαμε πολλούς τελικούς φιλοσοφούς, που μιλούσαν για πραγματικές ιστορίες της ζωής. Και θα σας δώσω κάποια πιο βασική ιστορία σήμερα. Θέλω να γνωρίζω, τι κόψει 3.000 ελληνικούς πολίτες ένα χρόνο. Εντυπωσιασμένοι σε ελληνικούς πολίτες. 3.000 ελληνικούς πολίτες ένα χρόνο. Και πολλοί, πολλοί περισσότεροι. Αλλά η Ελλάδα έχει συγκεκριμένως ένα σημαντικό πρόβλημα με το οποίο ονομάζουμε ελληνικούς πολίτες. Βγαίνετε στο νοσοκομείο, όπως είπε ο Θεοδότης, και βγαίνετε με διάφορες προβλήματα. Βγαίνετε στο νοσοκομείο, και βγαίνετε με διάφορες προβλήματα. Πιο σημαντικά, η περισσότερη από αυτές τις ελληνικούς πολίτες, και θα σας πω λίγο περισσότερα για αυτές, είναι δημιουργημένη από ελληνικούς πολίτες. Ελληνικούς πολίτες, στους οποίους οι ελληνικούς πολίτες που έχουμε σήμερα, δεν είναι πια εφαρμογημένοι. Είμαστε σχεδόν σχεδόν να ερμηνεύσουμε κάτι που ονομάζεται ελληνικός πολίτες. Ένα ελληνικό εποχή που θα μας παίρνει πριν την εποχή του World War II, πριν την εποχή του Φλεμμίνου να εξελίξει το πενεσίλαιο. Είμαστε σχεδόν έξω από ελληνικούς πολίτες. Η ΟΠΑ έχει σχεδόν εφαρμογημένη αντιβοίωσης και αντιβοίωσης αντιδρομών ως το 3ο στον κόσμο φρόντι. Στην υγεία, στην υγεία κοινωνικής. Οι βιολογικοί, εμείς, και ξέρω ότι είστε εκεί, θα σας σκοτώσουν λίγο, εμείς, οι άνθρωποι, είμαστε σχεδόν 37 ετσιόλια. Θέλω να σας αισθάνετε λίγο αγκά. Υπάρχουν σχεδόν 39 ετσιόλια σχεδόν μπακτεριακά σελίδια, μέσα από εσάς, και σε όλες τις ορυφές μας. Είμαστε περισσότερο μπακτεριακά από τα ανθρώπινα σχεδόν. Όταν εφαρμογείτε αυτά τα μπακτεριακά σχεδόν στις αντιβοίωσεις, είναι πολύ σκληρές από εμείς. Έχουμε εξελίξει για πέντε ετσιόλια. Οι μπακτεριακά εξελίξουν για ώρες και μέρες. Έχουν εξελίξει για να γίνουν δύσκολοι σε αντιβοίωσεις πολύ, πολύ γρήγορα. Είναι πολύ σκληρές από εμείς. Όσο περισσότερα χρησιμοποιούμε τα αντιβοίωσεις, και περισσότερα χρησιμοποιούμε τις αντιμετωπικές, επειδή εγώ εμφανίζομαι, είμαι φυσικός, τα περισσότερα παιδιά, 50% των αντιβοίωσεων, είναι αντιμετωπικές ή χρειαστικές. Έχουμε δημιουργήσει αυτό το πρόβλημα, και η Ελλάδα ειδικά έχει ένα πολύ μεγάλο πρόβλημα με αυτό. Και πολλοί άλλοι ευρωπαϊκές χώρες, βλέπω στον Ιταλία και στους φίλους εκεί, έχουν αυτό το πρόβλημα με την εξελίξη των αντιβοίωσεων. Η Ελλάδα έχει το highest rate of antibiotic consumption in the European Union. And the highest rate of antibiotic resistance in the European Union, and among many of the developed countries. So we have to think about how we're going to break this antibiotic habit. I mentioned earlier, I started off talking about infections that happen in the hospital, and I said most of these are antibiotic resistant. So let's take a step back, I want to tell you a little bit about these healthcare acquired infections, and why it's so important that we do something about them. So what are they? What happens, literally what happens when you go in the hospital? You go in the hospital and doctors, and I think I have some doctor colleagues here, place tubes in us, or in our relatives or our family members. Tubes that are needed to deliver medicines that could save our lives, tubes that help us breathe. Every time we breach the natural barrier, our skin, and put tubes in ourselves, we expose ourselves to the risk of getting an infection. Our natural state is not to have tubes in our bodies. So you increase the risk, and then if those tubes are not handled properly, and what do I mean handled properly? Hands and practices. What are the practices around the appropriate handling of those tubes? One gets an infection, especially when there are a lot of germs hanging around, which happens in hospitals. The other way you get healthcare acquired infections is by transmitting infections from one person to the other. You're laying in the hospital, and the person next door has a cold or has diarrhea. The physician doesn't wash their hand, or the nurse doesn't wash their hand, and all of a sudden, you came in for your broken leg, and now you have diarrhea and pneumonia. So just transmission of germs amongst us. And then finally, a surgical infection. So you go into the operating room, if best practices are not adhered to, you come out with an infection that complicates what should have been a very simple surgery. Which brings me to the next moments. The World Healthcare Organization has put out, there are five moments of hand hygiene. There are literally five moments. That's what the campaign is, the five moments of hand hygiene. How we should wash our hands appropriately. We, as healthcare professionals, cannot seem to wash our hands. I don't know what it is. Is it because it's so simple that we think it's ridiculous? But if you read the scientific literature, it is the most effective way to prevent infections. Why should we prevent them beyond the 3,000 deaths, like we needed another reason beyond 3,000 dead people a year in this country? It costs the Greek healthcare system 1.2 billion euro a year. So I want you to think about that for a minute. A country in the financial crisis that Greece is in right now pays 1.2 billion to manage these healthcare acquired infections. Many cynics will say that this is part of doing business. This is what happens if you go to a hospital. This is what happens. This is unavoidable. The most important thing to take away from all this is that about 70% of these infections are preventable. So this has happened across the world, preventable. There are countries that have gotten to zero infections in their hospitals. And I start off by saying hand hygiene, but there are other very simple basic practices that could be followed. But we Greeks don't like to follow rules. We don't like to follow guidelines. We don't like to follow algorithms. And hence we've created this very large problem that is preventable in terms of both lives lost and money saved for a system that could use that money for something else. My personal moment and why I'm here talking about this. I was sitting in my office at the University of Pennsylvania. I had been just promoted to professor at a reasonably young age. And I was thinking about what do I want to do? What do I want to do with my life? What's next? I wanted something beyond writing another research paper or presenting at another scientific meeting. And what I tell people is that I'm bipolar. I don't mean bipolar as in really mentally ill, although I may be. But that I'm half Greek, half American. And the Greek side of me started really pulling at me. And it was at the time of the financial crisis. And I said, what do I know how to do? I know how to do infectious diseases. This is what I've been trained to do in the States. This is what I could do. So how can I contribute and try to help in this time of crisis and at a time when the healthcare system was really feeling the burden of these hospital-acquired infections? My colleague Nikos talked about Nikos Kazantzakis, who's one of my favorite authors as well. And I thought about a report to Greco. And I thought, what do I want to report to Greco when I get to sort of the end of my career and my life? So I came to Greece and I started a non-governmental organization called CLIO, which is dedicated to preventing hospital-acquired infections, reducing antibiotic resistance and improving our use of antibiotics. And we got together a bunch of young people like yourselves who either didn't have jobs or wanted something more important to do. And we came together as an NGO that's been funded with help of the Stavros Niarchos Foundation, which has invested in this, what I think they perceive as important work. What do we do? We do a lot of really simple things. And I love the simplicity of what we're doing right now. First of all, we try to measure the problem. One of the things that was missing is, how big is the problem? How big is the problem in hospital A, hospital B, hospital C? And actually just measuring the problem sometimes helps because people start comparing themselves to each other and say, why do I have a bigger problem than you? Maybe I should do something better. Maybe I should try to improve myself. And then just like the research institute or the institute that's working on car injury, we implement interventions. Very simple interventions. How do we educate people on proper hand washing? How do we get and motivate them to wash their hands more frequently? And most of the interventions are, I hate to say, not, they don't require a lot of technology. The airline industry is the safest industry in the world. Do you know why? They use checklists. They use safety checklists. They don't leave it to the pilot to think about whether before takeoff or before landing they've created a safe environment for the plane to take off. In medicine now, we've begun to use these checklists as well. This is what I have to do as a doctor. I check all the boxes. Chances are my patient will do well. We as physicians in general don't like to be told what to do. We don't like to think that medicine is not magic and following a guideline or a checklist is something that we don't like to do. But we need to do more of it if we want to create a better environment in terms of patient safety and quality, specifically around infections, I would say even more broadly than that. The final moments, and I don't want to talk about negative moments, but I think you've heard some of these things and you probably know them. What I heard, the moments that I kept hearing things like, δεν μπορούμε να το κάνουμε. We can't do it. We can't do it here. You can't do this in Greece. Αυτές είναι αμερικανιές. They come from the United States. You can't do that here. This is impossible. Infections are part of doing business. And that hasn't seemed to stop this. I think we're still fighting this battle. And I encourage you to learn more about this problem because I think 3,000 dead people a year is pretty important. And if you can prevent those, what I would ask you as young people in the audience and others is just to raise awareness, read about this a little bit more, and also hold your physicians accountable. When you go to the doctor and they're going to give you an antibiotic, ask them, do I really need that antibiotic? Is it going to make me better? In Greece we have over-the-counter antibiotics where you can get it at the pharmacy, which is not the pattern in most other countries, at least most other developed countries. What do we know, we, as the lay public, in terms of what antibiotic we should get or whether we should get an antibiotic? And I also encourage you, if you're in a hospital, unfortunate enough to be in a hospital, whether it's you or your relatives or somebody else, hold your doctors accountable. Tell them to wash their hands before they do something to you. Tell them to wash their hands before they touch your yaya, your papu, your children, your mother or your father. And ask them, are they following best practices? What are the practices that you're following to keep me safe and to keep me from being one of those one in ten, one in ten, Greek citizens who enter a hospital, get a hospital-acquired infection? Finally, just on a personal note, when they asked me to give this talk, they told me that I have 18 minutes to give this talk, and it was a particularly difficult problem for me. I'm from Icaria. How many of you have been to Icaria? Good. What is the sense of time in Icaria? So when they told me 18 minutes, I said, so you mean 35, 40. Να το πάμε μία ορίτσα. There's no clocks in Greece. So this is very upsetting to me, to see a clock here that's ticking and saying that you need to move forward. Thank you very much. Υπότιτλοι AUTHORWAVE |
