模擬TOEFL iBT004 リスニング問題 - 公衆衛生の歴史

諸事情から日の目を見ることが（おそらく）なくなってしまった模擬TOEFL iBT問題の数々。それらをせっかくなので公開しようと思う。1年半前にはタイムリーだったが、時宜を得た内容ほど時の経過とともに陳腐化してしまう。以下、コロナ禍の最中に業務の一環として久しぶりに『 看護覚え書 』を読む機会があり、その中でナイチンゲールの公衆衛生に対する深い洞察に改めて感じ入った。そして彼女が赴いたのはクリミアで、そこはまさに2010年代にロシアがウクライナから奪い取った土地。さらに彼女の同時代人である手洗いの祖、センメルヴェイスと予防接種の祖、パスツールを組み合わせれば、内実のある、タイムリーなレクチャーが作れるのではないかと思い、会社（というか部長の）の業務命令として作ったのが以下である。Have fun!

Question 01
What is Florence Nightingale widely regarded as in the field of medical science?
(A) Founder of modern nursing
(B) Pioneering surgeon
(C) Military strategist
(D) Leading epidemiologist

Question 02
How did Florence Nightingale's hygiene practices impact the mortality rates among soldiers during the Crimean War?
(A) Eventually, the mortality rate increased drastically.
(B) Eventually, the mortality rate increased significantly.
(C) Eventually, the mortality rate decreased incredibly.
(D) Eventually, the mortality rate decreased temporarily.

Question 03
What was the primary reason for the high mortality rates among soldiers in the military barracks during the Crimean War?
(A) Lack of medical treatment
(B) Frequent battle stations
(C) Infectious diseases
(D) Poor living conditions

Question 04
What did Ignaz Semmelweis discover about preventing the spread of disease in hospitals?
(A) The importance of quarantine
(B) The significance of hand hygiene
(C) The role of vaccinations
(D) The need for sterilized surgical instruments

Question 05
Why did Ignaz Semmelweis face resistance and ridicule from the medical community?
(A) His ideas were too complex.
(B) He lacked proper evidence to support his claims.
(C) His ideas challenged established notions and practices.
(D) He did not communicate his findings effectively.

オーディオ・スクリプト

Listen to part of a discussion in a history of medical science class. 

Professor: Last week, we talked about the history of pandemics, specifically the 1918 flu pandemic and the most recent one, the COVID-19 pandemic. Today, we are going to discuss the contributions of two important figures in the field of public health: Florence Nightingale and Ignaz Semmelweis. 
Professor: Florence Nightingale was a British nurse. Well, to be more precise, she is widely regarded as the founder of modern nursing. During the Crimean War in the 1850s, she implemented strict hygiene and sanitation practices in the military hospital where she worked. As a result, there was a significant decrease in mortality rates among wounded soldiers. Her work in promoting hygiene and sanitation practices in nursing and healthcare systems has had a lasting impact.

Female Student: Umm, professor, would you be able to be more specific about how Nightingale's work affected the mortality rates among soldiers?

Professor: I was just about to do that, Linda. Nightingale's hygiene practices included regular cleaning of the hospital environment, improved ventilation, and clean bedding for patients. She also made sure that the soldiers received proper nutrition and hydration. Records had it that by implementing these practices, the mortality rate among the soldiers plummeted from 42% to 2%.

Male Student: Wow, that’s incredible. Um, professor, does that mean that most of the soldiers had died, not because of the wounds from battle, but because of the uncleanliness of the hospital?

Professor: Yes and no. Yes, infectious diseases were very common in the military barracks, and they really were sometimes fatal. But no, the first and foremost reason for the high death rates supported by many historians, including myself, is a mixture of  poor living conditions in which soldiers were placed. As a matter of fact, the highest mortality rate of 42% was recorded a while after Nightingale and her volunteer nurses arrived. Wounded soldiers received minimum medical treatment, and that was it. Hardly anyone helped them even eat. That’s why many of them were suffering from malnutrition. What Nightingale and her followers did first was to clean the toilets, because it was the job no one was officially assigned to do. That way, they made their way into the hospital, and they gradually began to attend to patients, most of whom were bed-bound. They helped them feed and go to the toilets, made sure that beds, sheets and floors were clean, and made day rounds and night rounds, too. Keep in mind that before Nightingale, making night rounds and providing nighttime care was not a common practice. I’m assuming that you all know that this earned her the alias of The Lady with the Lamp. Anyways, it is difficult to say which of these aids made the most contribution to the decrease in mortality rates, but again, yes. Uncleanliness was definitely one big culprit, if not the biggest. Does this answer your question, George? 

Male Student: Yes, of course.

Professor: OK? Now, let’s talk about Ignaz Semmelweis. Semmelweis was a Hungarian physician, who recognized the importance of hand hygiene in preventing the spread of disease. In the early 1840s, he noticed that maternal mortality rates were significantly higher in hospitals where physicians conducted autopsies and then delivered babies without washing their hands. By implementing a policy of hand washing with a chlorinated solution, he was able to reduce the mortality rate by 90%. However, his ideas were initially met with resistance and ridicule from the medical community at the time.
Female Student: Professor, I have a question. Why did the medical people in those days not accept Semmelweis’s ideas?

Professor: That's a fair question. Well, at the time, the medical community did not fully understand the importance of hand hygiene. Moreover, his ideas challenged the established practices of the medical profession, which made them difficult for some to accept. It was not until many years later that his contributions to the field were recognized.
Female Student: But why? Why was it that nobody listened to him? It’s unthinkable to not accept the importance of hand sanitation. 
Male Student: I was thinking the same thing. What made it so hard for the people back then to realize that keeping their hands clean is essential?
Professor: Well, what seems obvious today did not necessarily seem obvious a century ago. This is one such example. OK. So, Semmelweis was born in 1818, and Nightingale was born in 1820. So, they were contemporaries. Let’s bring in one more here. His name is Louis Pasteur. He was born in 1822. What did he do? George?

Male Student: Umm, to my understanding, he is best known for the discovery of sterilization. It is a more intense process than pasteurization. And pasteurization got its name from no other than Pasteur.  

Female Student: Professor, he also discovered the principle of vaccination. 

Professor: Perfect! Now, let’s remember. Pasteur published Germ Theory in 1861, and actually discovered germs the following year. But it was in the 1840s that Semmelweis was studying the cause of high death rates in specific hospitals. Also, the Crimean War was fought from 1853 to 1856. Nightingale was onto something. She seems to have presupposed the existence of microorganisms as a cause of infection, but she didn’t prove it herself. Fortunately, she wasn’t criticized. But Semmelweis was. He died in 1865, and soon after his death, Pasteur’s theory gained academic recognition that microorganisms were indeed the cause of infection. So, in a way, Nightingale and Semmelweis were a few decades ahead of their time. But they sure did lay the foundation for modern medical practices. The phrase “New Normal” was coined in 2020, during the Covid-19 pandemic. Handwashing certainly became a new normal. But what seemed to be new then was actually not new at all. As we discussed today, the policy of hand washing goes back about a hundred years. Having lived through the pandemic era, we can learn a few things from history. Learning about history helps reshape our knowledge, not of the past but of the present.   

正答

Question 01   (A)
Question 02   (C)
Question 03   (D)
Question 04   (B)
Question 05   (C)