[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:00.29,0:00:05.54,Default,,0000,0000,0000,,I'm a physician trained in infectious diseases,
Dialogue: 0,0:00:05.54,0:00:07.93,Default,,0000,0000,0000,,and following my training,
Dialogue: 0,0:00:07.93,0:00:10.85,Default,,0000,0000,0000,,I moved to Somalia
Dialogue: 0,0:00:10.85,0:00:12.90,Default,,0000,0000,0000,,from San Francisco.
Dialogue: 0,0:00:12.90,0:00:14.51,Default,,0000,0000,0000,,And my goodbye greeting
Dialogue: 0,0:00:14.51,0:00:16.37,Default,,0000,0000,0000,,from the chief of infectious diseases
Dialogue: 0,0:00:16.37,0:00:18.46,Default,,0000,0000,0000,,at San Francisco General was,
Dialogue: 0,0:00:18.46,0:00:22.14,Default,,0000,0000,0000,,"Gary, this is the biggest mistake you'll ever make."
Dialogue: 0,0:00:22.14,0:00:26.19,Default,,0000,0000,0000,,But I landed in a refugee situation
Dialogue: 0,0:00:26.19,0:00:30.27,Default,,0000,0000,0000,,that had a million refugees in 40 camps,
Dialogue: 0,0:00:30.27,0:00:32.79,Default,,0000,0000,0000,,and there were six of us doctors.
Dialogue: 0,0:00:32.79,0:00:35.11,Default,,0000,0000,0000,,There were many epidemics there.
Dialogue: 0,0:00:35.11,0:00:37.72,Default,,0000,0000,0000,,My responsibilities were largely related to
Dialogue: 0,0:00:37.72,0:00:39.46,Default,,0000,0000,0000,,tuberculosis,
Dialogue: 0,0:00:39.46,0:00:43.33,Default,,0000,0000,0000,,and then we got struck by an epidemic of cholera.
Dialogue: 0,0:00:43.33,0:00:45.39,Default,,0000,0000,0000,,So it was the spread of tuberculosis
Dialogue: 0,0:00:45.39,0:00:47.44,Default,,0000,0000,0000,,and the spread of cholera
Dialogue: 0,0:00:47.44,0:00:52.64,Default,,0000,0000,0000,,that I was responsible for inhibiting.
Dialogue: 0,0:00:52.64,0:00:55.28,Default,,0000,0000,0000,,And in order to do this work, we, of course,
Dialogue: 0,0:00:55.28,0:00:57.98,Default,,0000,0000,0000,,because of the limitation in health workers,
Dialogue: 0,0:00:57.98,0:01:01.75,Default,,0000,0000,0000,,had to recruit refugees to be a specialized
Dialogue: 0,0:01:01.75,0:01:04.51,Default,,0000,0000,0000,,new category of health worker.
Dialogue: 0,0:01:04.51,0:01:07.73,Default,,0000,0000,0000,,Following three years of work in Somalia,
Dialogue: 0,0:01:07.73,0:01:10.34,Default,,0000,0000,0000,,I got picked up by the World Health Organization,
Dialogue: 0,0:01:10.34,0:01:13.39,Default,,0000,0000,0000,,and got assigned to the epidemics of AIDS.
Dialogue: 0,0:01:13.39,0:01:16.26,Default,,0000,0000,0000,,My primary responsibility was Uganda,
Dialogue: 0,0:01:16.26,0:01:19.27,Default,,0000,0000,0000,,but also I worked in Rwanda and Burundi
Dialogue: 0,0:01:19.27,0:01:22.35,Default,,0000,0000,0000,,and Zaire, now Congo,
Dialogue: 0,0:01:22.35,0:01:25.92,Default,,0000,0000,0000,,Tanzania, Malawi, and several other countries.
Dialogue: 0,0:01:25.92,0:01:28.38,Default,,0000,0000,0000,,And my last assignment there was to run a unit
Dialogue: 0,0:01:28.38,0:01:30.27,Default,,0000,0000,0000,,called intervention development,
Dialogue: 0,0:01:30.27,0:01:33.98,Default,,0000,0000,0000,,which was responsible for designing interventions.
Dialogue: 0,0:01:33.98,0:01:36.96,Default,,0000,0000,0000,,After 10 years of working overseas,
Dialogue: 0,0:01:36.96,0:01:38.68,Default,,0000,0000,0000,,I was exhausted.
Dialogue: 0,0:01:38.68,0:01:40.88,Default,,0000,0000,0000,,I really had very little left.
Dialogue: 0,0:01:40.88,0:01:45.29,Default,,0000,0000,0000,,I had been traveling to one country after another.
Dialogue: 0,0:01:45.29,0:01:48.76,Default,,0000,0000,0000,,I was emotionally feeling very isolated.
Dialogue: 0,0:01:48.76,0:01:50.89,Default,,0000,0000,0000,,I wanted to come home.
Dialogue: 0,0:01:50.89,0:01:52.93,Default,,0000,0000,0000,,I'd seen a lot of death,
Dialogue: 0,0:01:52.93,0:01:55.88,Default,,0000,0000,0000,,in particular epidemic death,
Dialogue: 0,0:01:55.88,0:01:58.83,Default,,0000,0000,0000,,and epidemic death has a different feel to it.
Dialogue: 0,0:01:58.83,0:02:02.44,Default,,0000,0000,0000,,It's full of panic and fear,
Dialogue: 0,0:02:02.44,0:02:06.23,Default,,0000,0000,0000,,and I'd heard the women wailing and crying
Dialogue: 0,0:02:06.25,0:02:08.54,Default,,0000,0000,0000,,in the desert.
Dialogue: 0,0:02:08.54,0:02:10.93,Default,,0000,0000,0000,,And I wanted to come home and take a break
Dialogue: 0,0:02:10.93,0:02:13.97,Default,,0000,0000,0000,,and maybe start over.
Dialogue: 0,0:02:13.97,0:02:16.82,Default,,0000,0000,0000,,I was not aware of any epidemic problems
Dialogue: 0,0:02:16.82,0:02:18.46,Default,,0000,0000,0000,,in America.
Dialogue: 0,0:02:18.46,0:02:21.75,Default,,0000,0000,0000,,In fact, I wasn't aware of any problems in America.
Dialogue: 0,0:02:21.75,0:02:23.83,Default,,0000,0000,0000,,In fact -- seriously.
Dialogue: 0,0:02:23.83,0:02:26.67,Default,,0000,0000,0000,,And in fact I would visit friends of mine,
Dialogue: 0,0:02:26.67,0:02:29.76,Default,,0000,0000,0000,,and I noticed that they had water
Dialogue: 0,0:02:29.76,0:02:31.77,Default,,0000,0000,0000,,that came right into their homes.
Dialogue: 0,0:02:31.77,0:02:33.65,Default,,0000,0000,0000,,How many of you have such a situation?
Dialogue: 0,0:02:33.65,0:02:34.82,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:02:34.82,0:02:37.43,Default,,0000,0000,0000,,And some of them, many of them actually,
Dialogue: 0,0:02:37.43,0:02:39.54,Default,,0000,0000,0000,,had water that came into more than one room.
Dialogue: 0,0:02:39.54,0:02:42.79,Default,,0000,0000,0000,,And I noticed that they would move
Dialogue: 0,0:02:42.79,0:02:44.80,Default,,0000,0000,0000,,this little thermoregulatory device
Dialogue: 0,0:02:44.80,0:02:47.07,Default,,0000,0000,0000,,to change the temperature in their home
Dialogue: 0,0:02:47.07,0:02:49.92,Default,,0000,0000,0000,,by one degree or two degrees.
Dialogue: 0,0:02:49.92,0:02:51.60,Default,,0000,0000,0000,,And now I do that.
Dialogue: 0,0:02:51.60,0:02:55.86,Default,,0000,0000,0000,,And I really didn't know what I would do,
Dialogue: 0,0:02:55.86,0:02:58.40,Default,,0000,0000,0000,,but friends of mine began telling me
Dialogue: 0,0:02:58.40,0:03:02.38,Default,,0000,0000,0000,,about children shooting other children with guns.
Dialogue: 0,0:03:02.38,0:03:04.20,Default,,0000,0000,0000,,And I asked the question,
Dialogue: 0,0:03:04.20,0:03:06.15,Default,,0000,0000,0000,,what are you doing about it?
Dialogue: 0,0:03:06.15,0:03:08.26,Default,,0000,0000,0000,,What are you in America doing about it?
Dialogue: 0,0:03:08.26,0:03:10.67,Default,,0000,0000,0000,,And there were two essential explanations
Dialogue: 0,0:03:10.67,0:03:12.92,Default,,0000,0000,0000,,or ideas that were prevalent.
Dialogue: 0,0:03:12.92,0:03:14.98,Default,,0000,0000,0000,,And one was punishment.
Dialogue: 0,0:03:14.98,0:03:17.15,Default,,0000,0000,0000,,And this I had heard about before.
Dialogue: 0,0:03:17.15,0:03:19.79,Default,,0000,0000,0000,,We who had worked in behavior
Dialogue: 0,0:03:19.79,0:03:23.18,Default,,0000,0000,0000,,knew that punishment was something that was discussed
Dialogue: 0,0:03:23.18,0:03:26.01,Default,,0000,0000,0000,,but also that it was highly overvalued.
Dialogue: 0,0:03:26.01,0:03:28.36,Default,,0000,0000,0000,,It was not a main driver of behavior,
Dialogue: 0,0:03:28.36,0:03:32.25,Default,,0000,0000,0000,,nor was it a main driver of behavior change.
Dialogue: 0,0:03:32.25,0:03:34.30,Default,,0000,0000,0000,,And besides that, it reminded me
Dialogue: 0,0:03:34.30,0:03:36.80,Default,,0000,0000,0000,,of ancient epidemics
Dialogue: 0,0:03:36.80,0:03:39.87,Default,,0000,0000,0000,,that were previously completely misunderstood
Dialogue: 0,0:03:39.87,0:03:42.44,Default,,0000,0000,0000,,because the science hadn't been there before,
Dialogue: 0,0:03:42.44,0:03:44.83,Default,,0000,0000,0000,,epidemics of plague
Dialogue: 0,0:03:44.83,0:03:47.74,Default,,0000,0000,0000,,or typhus or leprosy,
Dialogue: 0,0:03:47.74,0:03:50.48,Default,,0000,0000,0000,,where the prevalent ideas were that there were
Dialogue: 0,0:03:50.48,0:03:54.12,Default,,0000,0000,0000,,bad people or bad humors or bad air,
Dialogue: 0,0:03:54.12,0:03:56.73,Default,,0000,0000,0000,,and widows were dragged around the moat,
Dialogue: 0,0:03:56.73,0:04:00.18,Default,,0000,0000,0000,,and dungeons were part of the solution.
Dialogue: 0,0:04:00.18,0:04:02.33,Default,,0000,0000,0000,,The other explanation or, in a way,
Dialogue: 0,0:04:02.33,0:04:04.10,Default,,0000,0000,0000,,the solution suggested,
Dialogue: 0,0:04:04.10,0:04:07.10,Default,,0000,0000,0000,,is please fix all of these things:
Dialogue: 0,0:04:07.10,0:04:10.44,Default,,0000,0000,0000,,the schools, the community, the homes, the families,
Dialogue: 0,0:04:10.44,0:04:11.96,Default,,0000,0000,0000,,everything.
Dialogue: 0,0:04:11.96,0:04:13.78,Default,,0000,0000,0000,,And I'd heard this before as well.
Dialogue: 0,0:04:13.78,0:04:16.51,Default,,0000,0000,0000,,I'd called this the "everything" theory,
Dialogue: 0,0:04:16.51,0:04:19.18,Default,,0000,0000,0000,,or EOE: Everything On Earth.
Dialogue: 0,0:04:19.18,0:04:20.79,Default,,0000,0000,0000,,But we'd also realized
Dialogue: 0,0:04:20.79,0:04:24.43,Default,,0000,0000,0000,,in treating other processes and problems
Dialogue: 0,0:04:24.43,0:04:27.34,Default,,0000,0000,0000,,that sometimes you don't need to treat everything.
Dialogue: 0,0:04:27.34,0:04:29.52,Default,,0000,0000,0000,,And so the sense that I had
Dialogue: 0,0:04:29.52,0:04:32.12,Default,,0000,0000,0000,,was there was a giant gap here.
Dialogue: 0,0:04:32.12,0:04:34.87,Default,,0000,0000,0000,,The problem of violence was stuck,
Dialogue: 0,0:04:34.87,0:04:37.14,Default,,0000,0000,0000,,and this has historically been the case
Dialogue: 0,0:04:37.14,0:04:38.30,Default,,0000,0000,0000,,in many other issues.
Dialogue: 0,0:04:38.30,0:04:39.88,Default,,0000,0000,0000,,Diarrheal diseases had been stuck.
Dialogue: 0,0:04:39.88,0:04:41.35,Default,,0000,0000,0000,,Malaria had been stuck.
Dialogue: 0,0:04:41.35,0:04:43.82,Default,,0000,0000,0000,,Frequently, a strategy has to be rethought.
Dialogue: 0,0:04:43.82,0:04:47.11,Default,,0000,0000,0000,,It's not as if I had any idea what it would look like,
Dialogue: 0,0:04:47.11,0:04:50.42,Default,,0000,0000,0000,,but there was a sense that we would have to do
Dialogue: 0,0:04:50.42,0:04:52.67,Default,,0000,0000,0000,,something with new categories of workers
Dialogue: 0,0:04:52.67,0:04:54.94,Default,,0000,0000,0000,,and something having to do with behavior change
Dialogue: 0,0:04:54.94,0:04:59.05,Default,,0000,0000,0000,,and something having to do with public education.
Dialogue: 0,0:04:59.05,0:05:01.12,Default,,0000,0000,0000,,But I began to ask questions
Dialogue: 0,0:05:01.12,0:05:03.66,Default,,0000,0000,0000,,and search out the usual things
Dialogue: 0,0:05:03.66,0:05:05.61,Default,,0000,0000,0000,,that I had been exploring before,
Dialogue: 0,0:05:05.61,0:05:07.14,Default,,0000,0000,0000,,like, what do the maps look like?
Dialogue: 0,0:05:07.14,0:05:08.59,Default,,0000,0000,0000,,What do the graphs look like?
Dialogue: 0,0:05:08.59,0:05:10.63,Default,,0000,0000,0000,,What does the data look like?
Dialogue: 0,0:05:10.63,0:05:13.02,Default,,0000,0000,0000,,And the maps of violence
Dialogue: 0,0:05:13.02,0:05:14.99,Default,,0000,0000,0000,,in most U.S. cities
Dialogue: 0,0:05:14.99,0:05:16.98,Default,,0000,0000,0000,,looked like this.
Dialogue: 0,0:05:16.98,0:05:18.64,Default,,0000,0000,0000,,There was clustering.
Dialogue: 0,0:05:18.64,0:05:21.98,Default,,0000,0000,0000,,This reminded me of clustering that we'd seen also
Dialogue: 0,0:05:21.98,0:05:23.72,Default,,0000,0000,0000,,in infectious epidemics,
Dialogue: 0,0:05:23.72,0:05:25.72,Default,,0000,0000,0000,,for example cholera.
Dialogue: 0,0:05:25.72,0:05:28.08,Default,,0000,0000,0000,,And then we looked at the maps,
Dialogue: 0,0:05:28.08,0:05:30.80,Default,,0000,0000,0000,,and the maps showed this typical wave
Dialogue: 0,0:05:30.80,0:05:32.59,Default,,0000,0000,0000,,upon wave upon wave,
Dialogue: 0,0:05:32.59,0:05:33.94,Default,,0000,0000,0000,,because all epidemics
Dialogue: 0,0:05:33.94,0:05:36.52,Default,,0000,0000,0000,,are combinations of many epidemics.
Dialogue: 0,0:05:36.52,0:05:39.62,Default,,0000,0000,0000,,And it also looked like infectious epidemics.
Dialogue: 0,0:05:39.62,0:05:41.24,Default,,0000,0000,0000,,And then we asked the question,
Dialogue: 0,0:05:41.24,0:05:44.78,Default,,0000,0000,0000,,well what really predicts a case of violence?
Dialogue: 0,0:05:44.78,0:05:47.02,Default,,0000,0000,0000,,And it turns out that the greatest predictor
Dialogue: 0,0:05:47.02,0:05:50.33,Default,,0000,0000,0000,,of a case of violence is a preceding case of violence.
Dialogue: 0,0:05:50.33,0:05:53.56,Default,,0000,0000,0000,,Which also sounds like, if there is a case of flu,
Dialogue: 0,0:05:53.56,0:05:56.46,Default,,0000,0000,0000,,someone gave someone a case of flu, or a cold,
Dialogue: 0,0:05:56.46,0:05:58.90,Default,,0000,0000,0000,,or the greatest risk factor of tuberculosis
Dialogue: 0,0:05:58.90,0:06:01.95,Default,,0000,0000,0000,,is having been exposed to tuberculosis.
Dialogue: 0,0:06:01.95,0:06:04.68,Default,,0000,0000,0000,,And so we see that violence is, in a way,
Dialogue: 0,0:06:04.68,0:06:07.84,Default,,0000,0000,0000,,behaving like a contagious disease.
Dialogue: 0,0:06:07.84,0:06:09.39,Default,,0000,0000,0000,,We're aware of this anyway
Dialogue: 0,0:06:09.39,0:06:11.33,Default,,0000,0000,0000,,even in our common experiences
Dialogue: 0,0:06:11.33,0:06:13.14,Default,,0000,0000,0000,,or our newspaper stories
Dialogue: 0,0:06:13.14,0:06:16.26,Default,,0000,0000,0000,,of the spread of violence from fights
Dialogue: 0,0:06:16.26,0:06:19.72,Default,,0000,0000,0000,,or in gang wars or in civil wars
Dialogue: 0,0:06:19.72,0:06:21.97,Default,,0000,0000,0000,,or even in genocides.
Dialogue: 0,0:06:21.97,0:06:24.54,Default,,0000,0000,0000,,And so there's good news about this, though,
Dialogue: 0,0:06:24.54,0:06:27.35,Default,,0000,0000,0000,,because there's a way to reverse epidemics,
Dialogue: 0,0:06:27.35,0:06:29.36,Default,,0000,0000,0000,,and there's really only three things that are done
Dialogue: 0,0:06:29.36,0:06:31.22,Default,,0000,0000,0000,,to reverse epidemics,
Dialogue: 0,0:06:31.22,0:06:33.86,Default,,0000,0000,0000,,and the first of it is interrupting transmission.
Dialogue: 0,0:06:33.86,0:06:35.79,Default,,0000,0000,0000,,In order to interrupt transmission,
Dialogue: 0,0:06:35.79,0:06:39.34,Default,,0000,0000,0000,,you need to detect and find first cases.
Dialogue: 0,0:06:39.34,0:06:42.35,Default,,0000,0000,0000,,In other words, for T.B. you have to find somebody
Dialogue: 0,0:06:42.35,0:06:45.60,Default,,0000,0000,0000,,who has active T.B. who is infecting other people.
Dialogue: 0,0:06:45.60,0:06:47.02,Default,,0000,0000,0000,,Make sense?
Dialogue: 0,0:06:47.02,0:06:49.28,Default,,0000,0000,0000,,And there's special workers for doing that.
Dialogue: 0,0:06:49.28,0:06:51.14,Default,,0000,0000,0000,,For this particular problem,
Dialogue: 0,0:06:51.14,0:06:53.46,Default,,0000,0000,0000,,we designed a new category of worker
Dialogue: 0,0:06:53.46,0:06:54.80,Default,,0000,0000,0000,,who, like a SARS worker
Dialogue: 0,0:06:54.80,0:06:56.66,Default,,0000,0000,0000,,or someone looking for bird flu,
Dialogue: 0,0:06:56.66,0:06:58.41,Default,,0000,0000,0000,,might find first cases.
Dialogue: 0,0:06:58.41,0:07:00.61,Default,,0000,0000,0000,,In this case, it's someone who's very angry
Dialogue: 0,0:07:00.61,0:07:02.36,Default,,0000,0000,0000,,because someone looked at his girlfriend
Dialogue: 0,0:07:02.36,0:07:04.15,Default,,0000,0000,0000,,or owes him money,
Dialogue: 0,0:07:04.15,0:07:06.62,Default,,0000,0000,0000,,and you can find workers and train them
Dialogue: 0,0:07:06.62,0:07:09.73,Default,,0000,0000,0000,,into these specialized categories.
Dialogue: 0,0:07:09.73,0:07:11.38,Default,,0000,0000,0000,,And the second thing to do, of course,
Dialogue: 0,0:07:11.38,0:07:12.88,Default,,0000,0000,0000,,is to prevent further spread,
Dialogue: 0,0:07:12.88,0:07:16.41,Default,,0000,0000,0000,,that means to find who else has been exposed,
Dialogue: 0,0:07:16.41,0:07:18.85,Default,,0000,0000,0000,,but may not be spreading so much right now
Dialogue: 0,0:07:18.85,0:07:21.38,Default,,0000,0000,0000,,like someone with a smaller case of T.B.,
Dialogue: 0,0:07:21.38,0:07:24.23,Default,,0000,0000,0000,,or someone who is just hanging out in the neighborhoods,
Dialogue: 0,0:07:24.23,0:07:25.86,Default,,0000,0000,0000,,but in the same group,
Dialogue: 0,0:07:25.86,0:07:28.15,Default,,0000,0000,0000,,and then they need to be, in a way,
Dialogue: 0,0:07:28.15,0:07:29.53,Default,,0000,0000,0000,,managed as well,
Dialogue: 0,0:07:29.53,0:07:32.88,Default,,0000,0000,0000,,particular to the specific disease process.
Dialogue: 0,0:07:32.88,0:07:35.93,Default,,0000,0000,0000,,And then the third part, the shifting the norms,
Dialogue: 0,0:07:35.93,0:07:39.23,Default,,0000,0000,0000,,and that means a whole bunch of community activities,
Dialogue: 0,0:07:39.23,0:07:41.57,Default,,0000,0000,0000,,remodeling, public education,
Dialogue: 0,0:07:41.57,0:07:43.71,Default,,0000,0000,0000,,and then you've got what you might call
Dialogue: 0,0:07:43.71,0:07:44.93,Default,,0000,0000,0000,,group immunity.
Dialogue: 0,0:07:44.93,0:07:46.82,Default,,0000,0000,0000,,And that combination of factors
Dialogue: 0,0:07:46.82,0:07:49.18,Default,,0000,0000,0000,,is how the AIDS epidemic in Uganda
Dialogue: 0,0:07:49.18,0:07:51.62,Default,,0000,0000,0000,,was very successfully reversed.
Dialogue: 0,0:07:51.62,0:07:54.45,Default,,0000,0000,0000,,And so what we decided to do in the year 2000
Dialogue: 0,0:07:54.45,0:07:56.37,Default,,0000,0000,0000,,is kind of put this together in a way
Dialogue: 0,0:07:56.37,0:07:58.90,Default,,0000,0000,0000,,by hiring in new categories of workers,
Dialogue: 0,0:07:58.90,0:08:01.47,Default,,0000,0000,0000,,the first being violence interruptors.
Dialogue: 0,0:08:01.47,0:08:04.13,Default,,0000,0000,0000,,And then we would put all of this into place
Dialogue: 0,0:08:04.13,0:08:05.57,Default,,0000,0000,0000,,in one neighborhood
Dialogue: 0,0:08:05.57,0:08:07.98,Default,,0000,0000,0000,,in what was the worst police district
Dialogue: 0,0:08:07.98,0:08:09.88,Default,,0000,0000,0000,,in the United States at the time.
Dialogue: 0,0:08:09.88,0:08:12.63,Default,,0000,0000,0000,,So violence interruptors hired from the same group,
Dialogue: 0,0:08:12.63,0:08:15.61,Default,,0000,0000,0000,,credibility, trust, access,
Dialogue: 0,0:08:15.61,0:08:18.23,Default,,0000,0000,0000,,just like the health workers in Somalia,
Dialogue: 0,0:08:18.23,0:08:20.50,Default,,0000,0000,0000,,but designed for a different category,
Dialogue: 0,0:08:20.50,0:08:22.47,Default,,0000,0000,0000,,and trained in persuasion,
Dialogue: 0,0:08:22.47,0:08:26.25,Default,,0000,0000,0000,,cooling people down, buying time, reframing.
Dialogue: 0,0:08:26.25,0:08:28.21,Default,,0000,0000,0000,,And then another category of worker,
Dialogue: 0,0:08:28.21,0:08:30.75,Default,,0000,0000,0000,,the outreach workers, to keep people
Dialogue: 0,0:08:30.75,0:08:34.12,Default,,0000,0000,0000,,in a way on therapy for six to 24 months.
Dialogue: 0,0:08:34.12,0:08:37.78,Default,,0000,0000,0000,,Just like T.B., but the object is behavior change.
Dialogue: 0,0:08:37.78,0:08:39.59,Default,,0000,0000,0000,,And then a bunch of community activities
Dialogue: 0,0:08:39.59,0:08:41.28,Default,,0000,0000,0000,,for changing norms.
Dialogue: 0,0:08:41.28,0:08:43.65,Default,,0000,0000,0000,,Now our first experiment of this
Dialogue: 0,0:08:43.65,0:08:46.33,Default,,0000,0000,0000,,resulted in a 67-percent drop
Dialogue: 0,0:08:46.33,0:08:47.80,Default,,0000,0000,0000,,in shootings and killings
Dialogue: 0,0:08:47.80,0:08:50.20,Default,,0000,0000,0000,,in the West Garfield neighborhood of Chicago.
Dialogue: 0,0:08:50.20,0:08:52.35,Default,,0000,0000,0000,,(Applause)
Dialogue: 0,0:08:52.35,0:08:53.71,Default,,0000,0000,0000,,And this was a beautiful thing
Dialogue: 0,0:08:53.71,0:08:55.32,Default,,0000,0000,0000,,for the neighborhood itself,
Dialogue: 0,0:08:55.32,0:08:58.22,Default,,0000,0000,0000,,first 50 or 60 days, then 90 days,
Dialogue: 0,0:08:58.22,0:08:59.99,Default,,0000,0000,0000,,and then there was unfortunately another shooting
Dialogue: 0,0:08:59.99,0:09:01.51,Default,,0000,0000,0000,,in another 90 days,
Dialogue: 0,0:09:01.51,0:09:03.95,Default,,0000,0000,0000,,and the moms were hanging out in the afternoon.
Dialogue: 0,0:09:03.95,0:09:06.35,Default,,0000,0000,0000,,They were using parks they weren't using before.
Dialogue: 0,0:09:06.35,0:09:08.49,Default,,0000,0000,0000,,The sun was out. Everybody was happy.
Dialogue: 0,0:09:08.49,0:09:11.68,Default,,0000,0000,0000,,But of course, the funders said, "Wait a second,
Dialogue: 0,0:09:11.68,0:09:13.00,Default,,0000,0000,0000,,do it again."
Dialogue: 0,0:09:13.00,0:09:16.32,Default,,0000,0000,0000,,And so we had to then, fortunately,
Dialogue: 0,0:09:16.32,0:09:19.08,Default,,0000,0000,0000,,get the funds to repeat this experience,
Dialogue: 0,0:09:19.08,0:09:21.09,Default,,0000,0000,0000,,and this is one of the next four neighborhoods
Dialogue: 0,0:09:21.09,0:09:24.11,Default,,0000,0000,0000,,that had a 45-percent drop in shootings and killings.
Dialogue: 0,0:09:24.11,0:09:26.89,Default,,0000,0000,0000,,And since that time, this has been replicated
Dialogue: 0,0:09:26.89,0:09:28.50,Default,,0000,0000,0000,,20 times.
Dialogue: 0,0:09:28.50,0:09:30.58,Default,,0000,0000,0000,,There have been independent evaluations
Dialogue: 0,0:09:30.58,0:09:32.53,Default,,0000,0000,0000,,supported by the Justice Department
Dialogue: 0,0:09:32.53,0:09:35.31,Default,,0000,0000,0000,,and by the CDC and performed by Johns Hopkins
Dialogue: 0,0:09:35.31,0:09:39.10,Default,,0000,0000,0000,,that have shown 30-to-50-percent and 40-to-70-percent
Dialogue: 0,0:09:39.10,0:09:41.21,Default,,0000,0000,0000,,reductions in shootings and killings
Dialogue: 0,0:09:41.21,0:09:43.13,Default,,0000,0000,0000,,using this new method.
Dialogue: 0,0:09:43.13,0:09:44.58,Default,,0000,0000,0000,,In fact, there have been three independent
Dialogue: 0,0:09:44.58,0:09:46.70,Default,,0000,0000,0000,,evaluations of this now.
Dialogue: 0,0:09:46.70,0:09:48.96,Default,,0000,0000,0000,,Now we've gotten a lot of attention as a result of this,
Dialogue: 0,0:09:48.96,0:09:51.15,Default,,0000,0000,0000,,including being featured on
Dialogue: 0,0:09:51.15,0:09:55.10,Default,,0000,0000,0000,,The New York Times' Sunday magazine cover story.
Dialogue: 0,0:09:55.10,0:09:57.89,Default,,0000,0000,0000,,The Economist in 2009
Dialogue: 0,0:09:57.89,0:10:00.11,Default,,0000,0000,0000,,said this is "the approach that will come to prominence."
Dialogue: 0,0:10:00.11,0:10:02.44,Default,,0000,0000,0000,,And even a movie was made around our work.
Dialogue: 0,0:10:02.44,0:10:03.61,Default,,0000,0000,0000,,[The Interrupters]
Dialogue: 0,0:10:03.61,0:10:06.12,Default,,0000,0000,0000,,However, not so fast,
Dialogue: 0,0:10:06.12,0:10:07.98,Default,,0000,0000,0000,,because a lot of people did not agree
Dialogue: 0,0:10:07.98,0:10:09.96,Default,,0000,0000,0000,,with this way of going about it.
Dialogue: 0,0:10:09.96,0:10:11.92,Default,,0000,0000,0000,,We got a lot of criticism,
Dialogue: 0,0:10:11.92,0:10:13.66,Default,,0000,0000,0000,,a lot of opposition,
Dialogue: 0,0:10:13.66,0:10:15.40,Default,,0000,0000,0000,,and a lot of opponents.
Dialogue: 0,0:10:15.40,0:10:18.25,Default,,0000,0000,0000,,In other words, what do you mean, health problem?
Dialogue: 0,0:10:18.25,0:10:20.83,Default,,0000,0000,0000,,What do you mean, epidemic?
Dialogue: 0,0:10:20.83,0:10:23.64,Default,,0000,0000,0000,,What do you mean, no bad guys?
Dialogue: 0,0:10:23.64,0:10:25.80,Default,,0000,0000,0000,,And there's whole industries designed
Dialogue: 0,0:10:25.80,0:10:28.75,Default,,0000,0000,0000,,for managing bad people.
Dialogue: 0,0:10:28.75,0:10:31.80,Default,,0000,0000,0000,,What do you mean, hiring people
Dialogue: 0,0:10:31.80,0:10:33.74,Default,,0000,0000,0000,,who have backgrounds?
Dialogue: 0,0:10:33.74,0:10:38.24,Default,,0000,0000,0000,,My business friends said,
Dialogue: 0,0:10:38.24,0:10:41.59,Default,,0000,0000,0000,,"Gary, you're being criticized tremendously.
Dialogue: 0,0:10:41.59,0:10:43.59,Default,,0000,0000,0000,,You must be doing something right."
Dialogue: 0,0:10:43.59,0:10:45.60,Default,,0000,0000,0000,,(Laughter)
Dialogue: 0,0:10:45.60,0:10:48.85,Default,,0000,0000,0000,,My musician friends added the word "dude."
Dialogue: 0,0:10:48.85,0:10:52.62,Default,,0000,0000,0000,,So anyway, additionally,
Dialogue: 0,0:10:52.62,0:10:54.45,Default,,0000,0000,0000,,there was still this problem,
Dialogue: 0,0:10:54.45,0:10:57.35,Default,,0000,0000,0000,,and we were getting highly criticized as well
Dialogue: 0,0:10:57.35,0:11:00.65,Default,,0000,0000,0000,,for not dealing with all of these other problems.
Dialogue: 0,0:11:00.65,0:11:03.78,Default,,0000,0000,0000,,Yet we were able to manage malaria
Dialogue: 0,0:11:03.78,0:11:06.53,Default,,0000,0000,0000,,and reduce HIV and reduce diarrheal diseases
Dialogue: 0,0:11:06.53,0:11:08.47,Default,,0000,0000,0000,,in places with awful economies
Dialogue: 0,0:11:08.47,0:11:10.29,Default,,0000,0000,0000,,without healing the economy.
Dialogue: 0,0:11:10.29,0:11:12.82,Default,,0000,0000,0000,,So what's actually happened is,
Dialogue: 0,0:11:12.82,0:11:15.27,Default,,0000,0000,0000,,although there is still some opposition,
Dialogue: 0,0:11:15.27,0:11:17.09,Default,,0000,0000,0000,,the movement is clearly growing.
Dialogue: 0,0:11:17.09,0:11:19.17,Default,,0000,0000,0000,,Many of the major cities in the U.S.,
Dialogue: 0,0:11:19.17,0:11:21.41,Default,,0000,0000,0000,,including New York City and Baltimore
Dialogue: 0,0:11:21.41,0:11:22.68,Default,,0000,0000,0000,,and Kansas City,
Dialogue: 0,0:11:22.68,0:11:24.61,Default,,0000,0000,0000,,their health departments are running this now.
Dialogue: 0,0:11:24.61,0:11:27.23,Default,,0000,0000,0000,,Chicago and New Orleans, the health departments
Dialogue: 0,0:11:27.23,0:11:29.76,Default,,0000,0000,0000,,are having a very large role in this.
Dialogue: 0,0:11:29.76,0:11:32.62,Default,,0000,0000,0000,,This is being embraced more by law enforcement
Dialogue: 0,0:11:32.62,0:11:34.60,Default,,0000,0000,0000,,than it had been years ago.
Dialogue: 0,0:11:34.60,0:11:36.65,Default,,0000,0000,0000,,Trauma centers and hospitals
Dialogue: 0,0:11:36.65,0:11:38.94,Default,,0000,0000,0000,,are doing their part in stepping up.
Dialogue: 0,0:11:38.94,0:11:40.84,Default,,0000,0000,0000,,And the U.S. Conference of Mayors
Dialogue: 0,0:11:40.84,0:11:43.43,Default,,0000,0000,0000,,has endorsed not only the approach
Dialogue: 0,0:11:43.43,0:11:45.72,Default,,0000,0000,0000,,but the specific model.
Dialogue: 0,0:11:45.72,0:11:48.97,Default,,0000,0000,0000,,Where there's really been uptake even faster
Dialogue: 0,0:11:48.97,0:11:50.97,Default,,0000,0000,0000,,is in the international environment,
Dialogue: 0,0:11:50.97,0:11:52.72,Default,,0000,0000,0000,,where there's a 55-percent drop
Dialogue: 0,0:11:52.72,0:11:55.15,Default,,0000,0000,0000,,in the first neighborhood in Puerto Rico,
Dialogue: 0,0:11:55.15,0:11:57.96,Default,,0000,0000,0000,,where interruptions are just beginning in Honduras,
Dialogue: 0,0:11:57.96,0:12:00.87,Default,,0000,0000,0000,,where the strategy has been applied in Kenya
Dialogue: 0,0:12:00.87,0:12:03.52,Default,,0000,0000,0000,,for the recent elections,
Dialogue: 0,0:12:03.52,0:12:06.69,Default,,0000,0000,0000,,and where there have been 500 interruptions in Iraq.
Dialogue: 0,0:12:06.69,0:12:09.96,Default,,0000,0000,0000,,So violence is responding as a disease
Dialogue: 0,0:12:09.96,0:12:12.23,Default,,0000,0000,0000,,even as it behaves as a disease.
Dialogue: 0,0:12:12.23,0:12:14.43,Default,,0000,0000,0000,,So the theory, in a way,
Dialogue: 0,0:12:14.43,0:12:18.60,Default,,0000,0000,0000,,is kind of being validated by the treatment.
Dialogue: 0,0:12:18.60,0:12:21.53,Default,,0000,0000,0000,,And recently, the Institute of Medicine
Dialogue: 0,0:12:21.53,0:12:23.67,Default,,0000,0000,0000,,came out with a workshop report
Dialogue: 0,0:12:23.67,0:12:25.53,Default,,0000,0000,0000,,which went through some of the data,
Dialogue: 0,0:12:25.53,0:12:27.08,Default,,0000,0000,0000,,including the neuroscience,
Dialogue: 0,0:12:27.08,0:12:31.40,Default,,0000,0000,0000,,on how this problem is really transmitted.
Dialogue: 0,0:12:31.40,0:12:34.31,Default,,0000,0000,0000,,So I think this is good news,
Dialogue: 0,0:12:34.31,0:12:36.17,Default,,0000,0000,0000,,because it allows us an opportunity
Dialogue: 0,0:12:36.17,0:12:37.73,Default,,0000,0000,0000,,to come out of the Middle Ages,
Dialogue: 0,0:12:37.73,0:12:40.77,Default,,0000,0000,0000,,which is where I feel this field has been.
Dialogue: 0,0:12:40.77,0:12:43.88,Default,,0000,0000,0000,,It gives us an opportunity to consider the possibility
Dialogue: 0,0:12:43.88,0:12:46.67,Default,,0000,0000,0000,,of replacing some of these prisons
Dialogue: 0,0:12:46.67,0:12:49.96,Default,,0000,0000,0000,,with playgrounds or parks,
Dialogue: 0,0:12:49.96,0:12:52.62,Default,,0000,0000,0000,,and to consider the possibility
Dialogue: 0,0:12:52.62,0:12:56.31,Default,,0000,0000,0000,,of converting our neighborhoods into neighborhoods,
Dialogue: 0,0:12:56.31,0:12:59.76,Default,,0000,0000,0000,,and to allow there to be a new strategy,
Dialogue: 0,0:12:59.76,0:13:03.62,Default,,0000,0000,0000,,a new set of methods, a new set of workers:
Dialogue: 0,0:13:03.62,0:13:07.04,Default,,0000,0000,0000,,science, in a way, replacing morality.
Dialogue: 0,0:13:07.04,0:13:09.42,Default,,0000,0000,0000,,And moving away from emotions
Dialogue: 0,0:13:09.42,0:13:12.61,Default,,0000,0000,0000,,is the most important part of the solution
Dialogue: 0,0:13:12.61,0:13:16.93,Default,,0000,0000,0000,,to science as a more important part of the solution.
Dialogue: 0,0:13:16.93,0:13:21.65,Default,,0000,0000,0000,,So I didn't mean to come up with this at all.
Dialogue: 0,0:13:21.65,0:13:24.15,Default,,0000,0000,0000,,It was a matter of,
Dialogue: 0,0:13:24.15,0:13:25.98,Default,,0000,0000,0000,,I wanted actually a break,
Dialogue: 0,0:13:25.98,0:13:30.10,Default,,0000,0000,0000,,and we looked at maps, we looked at graphs,
Dialogue: 0,0:13:30.10,0:13:31.73,Default,,0000,0000,0000,,we asked some questions
Dialogue: 0,0:13:31.73,0:13:34.93,Default,,0000,0000,0000,,and tried some tools
Dialogue: 0,0:13:34.93,0:13:37.49,Default,,0000,0000,0000,,that actually have been used many times before
Dialogue: 0,0:13:37.49,0:13:39.40,Default,,0000,0000,0000,,for other things.
Dialogue: 0,0:13:39.40,0:13:42.66,Default,,0000,0000,0000,,For myself, I tried to get away from
Dialogue: 0,0:13:42.66,0:13:44.40,Default,,0000,0000,0000,,infectious diseases,
Dialogue: 0,0:13:44.40,0:13:46.36,Default,,0000,0000,0000,,and I didn't.
Dialogue: 0,0:13:46.36,0:13:47.98,Default,,0000,0000,0000,,Thank you.
Dialogue: 0,0:13:47.98,0:13:51.27,Default,,0000,0000,0000,,(Applause)