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Hi, everyone again. Um Thank you for staying over. I'm very pleased to introduce Helen, please. She is the Gas Up Presidente and also winner of the Global Surgery Award. She's an S T three in general surgery in Oxford. Um So a big round of applause for Helen. Thanks for the introduction, Roberta. So, yeah, good to meet you all. Um I hope everyone's had a fantastic conference and very well done for making it through to. Now. You've all done very, very well. Um So as Roberta said, my name is Helen. I am an S T three in general surgery in Oxfordshire. Um And I'm also the Presidente of Gas Och, which if you don't know about it, it's the global anesthetics obstetrics and surgical collaborative. So it's a UK trainee based organization set up in 2015, really to encourage more trainees to engage in global um surgery, um and to become lifelong um leaders in that field. So it's an absolute pleasure to be invited to speak to you all today. Um, as the Asset Global Surgery Award winner from last year. And I'd love to tell you all about my trip. I'll try and compress it as much as I can. But also seeing as the theme of this conference is about reconnecting and inspiring, I'll do my best to inspire you all to think more globally about your work and give you some tips about how you can get involved. Um Let me see if I can write this click up. So I want you all to have a think whether whilst you're in medical school, there was a particular image or a particular picture from a lecture or a textbook which really sat with you and really resonated or inspired you. For me, it was this image which was shown in a lecture by someone who was involved in global surgery. Um I don't know if you've seen one of these before. It's a cardiogram from World Mapper and this particular cardiogram um has the surface area of each nation proportional to the number of working doctors in that country. And this really shocked me. Um I guess it's not that shocking to think about in a sense because sadly, we are so used to the awful um in a just inequalities and injustices in this world. But when you think that Africa is the second largest continent by surface area and population, and on this image is basically just a thin line, it really brings home the fact that there are gross inequalities in this world. Um So with this image sort of burning in my mind, um I decided to go through med school, making myself the most globally minded medic that I could. Now, many of you will be familiar with this paper. I hope if you're not pleased you go away and read it or at least the abstract. So in 2015, the Lancet commission came out on global Surgery and really brought together lots of people's work. You're already working in the field and also looked at the evidence at the time and what was needed going forward to make it more equal. Some of the key figures which have always stood out to me. Firstly, five billion people lack access to surgical care. 100 and 43 million operations are lacking globally. And in terms of personnel, there's a one million person deficit in terms of specialists in low middle income countries, in surgery, anesthetics, and obstetrics. For me, this highlights that this is absolutely essential for all of us to care about. When we think of global health. We think of the big hitters tuberculosis HIV, malaria. But actually this lancet commission highlights that more people die due to lack of access to surgical care than from tuberculosis, malaria and HIV annually. They say that global surgery is the neglected step child of global health and that it's an indivisible indispensable part of healthcare. All of us here, we want to be surgeons because we know it's important and it's important for all people. So I did my best through med school to get as much exposure to global health as I could in my particular of interest is Sub Saharan Africa. So, um in my, some of my first year of med school, I managed to get a small grant, got to Cameroon where I did a medical school placement. Um, two years later, I went to South Africa and did a placement in a pediatric unit there. And through the University of Oxford, I did my elective in Madagascar where I got to work in surgery with a grant from the War College of Surgeons of Edinburgh. And um as a foundation doctor, I managed to organize um academic foundation placement with the Global Health Research group up at the University of Leeds, which was funded by N H R and did research in wound care, which actually presented asset and uh also the World Health Organization in Geneva. So that's kind of some background about me. I then did course surgical training and thought. Well, unfortunately, it's gonna be really difficult to get out to Africa. Now we have these crazy hours and all these things we need to do. I need to try and prepare my portfolio to be a registrar, but I still felt that draw. And so I decided to take a year out of training. Um and lots of people advised me, oh, you need to be careful taking extra time out. It's a really difficult time to take time out or divide your portfolio score. Etcetera, etcetera. But I think if you're really passionate about something, sometimes you have to make sacrifices. And so I tried to be smart. I got a job with a team up in Leeds, uh the Institute of Emergency General Surgery and worked with them for six months and I was really up front with them and they were very, very supportive of me um, in getting as many things in my portfolio as I could, as much exposure as I could in those six months. Um to allow me to have six months working in Africa. And I'm really grateful to asset for supporting that. I wasn't entirely sure where I'd go and then a number of things help clarify that for me. Um So first of all, I started working with Frames, which is a group down in Brighton, the virtual reality in medicine and surgery group. They were mainly focused on UK trainees at the time, but I went forward to them and discussed the opportunity to take their work globally, which they were really interested in doing. I did a triathlon with a friend. I have no idea why I'm terrible at running. Um And she was raising money for Mingo Hospital in Uganda. And then I met the chair of friends of Mango um UK charity who said you should go and work in Kampala, um Mingo Hospital. So all of this kind of came together. And at the same time, I got more involved with gas sock and I applied to be their events rep which I got and we started uh various activities from that. So Uganda, I didn't know much about it. It's actually similar in surface area or geographical landmass to the UK. It's got a much smaller population. Um, it is a place where like many African countries. There's a very small number of doctor of surgeons as compared to here, there's currently 230 surgeons in Uganda and about 260 obstetricians. Most trainees are focused almost entirely on service provision and there's very little postgraduate training. Um The burden of disease is enormous and things like annual leave or study leave aren't even part of people's vocabulary. The hospital I went to um was very supportive. Um a good place to go as a trainee because I didn't want to go somewhere and be expected to do lots of work sort of autonomously. Um It's got 300 hospital beds and a number of different specialties. And it's also linked to a local school of medicine. It's a missionary hospital. I was actually the first hospital established in East Africa 125 years ago by a group of UK missionaries, but it's now very much led by Ugandans. So I went back to the letter that I submitted to asset to find out what I said I was going to do and see how similar it was to what I actually did um as with all things, things changed a bit. But these were my main objectives, firstly, getting clinical experience in a low middle income country setting. Secondly, developing a collaboration between the emergency general surgeon team that I've been working with in Leeds. And Mingo. Thirdly, Mingo was requesting to develop a laproscopic department which is still in progress. And fourthly, there was a real call for more postgraduate training and that's how I got the rims group involved. I'm just going to run through those very quickly. As you can tell, there's quite a lot to talk about in terms of the clinical experience. This was the team that I worked with and and the operating room was always full of people wanting to learn. And I also got opportunities to go and work inr oral settings as well in terms of the leads Mango collaboration. Our main first step was actually setting up a journal club. We really wanted something that was bidirectional learning and increasing academic capacity because it's very little exposure in there, um surgical, even medical training and there's a lack of critical appraisal skills. So people that were really keen to do that, we also talked about exchange site visits, elective opportunities and also the laproscopic training. So this is our first journal club, Gloria Melvin presented. It was absolutely fantastic and that's been going for a year now with a monthly journal club. We do it all online and there's a really good turnout of doctors in Uganda as well as in leeds who attend. And I was really excited to get a text from one of them the other day to say, Doctor Helen. Um we've got some great news. We've published our first case report because we're so inspired by what we've learned through Journal Club, so really proud of the team there to have taken their own initiative and take that on to a new level in terms of laproscopy development, lapresse, laproscopic services are still very limited in Uganda. Um I tried my hand at some D I Y the help of my dad and put together a basic lap box and we thought that we could start some training in Uganda. Sadly, both of the instruments broke straight away and I couldn't find any way to replace them. So that quickly came to a stop but, and we were able to do the site exchange visits. So two of the surgeons came over to the UK and we're able to see the lapse um center in Leeds and meet with the chair of the friends of Mango Charity as well as working closely with the E G S team and developing those relationships. And then towards the end of my visit, one of my bosses from Leeds came out to the, came out to Kampala. So did a site visit the other way around and actually brought lots of equipment with him and ran a simulation course which was far superior to my D I Y box that led him to be able to install those lap boxes with some funding um to set up the first lap simulation center at Mingo. And the plans are to try and use proximity for some remote Proctor ship. Um And that was a small gathering. Um I think that collaborations are really built on relationships. So that's one of the takeaways for me. And also unexpectedly, I became a trustee of the hospital. So just shows the importance of ongoing long term commitments and relationships when you're doing global surgery finally, and I would just mention this in terms of postgraduate training. And if you want to know more, please do see the poster that I submitted with with the rims team. Um We ran a virtual reality training conference in the UK and Kampala. So Rims is run by Jack Danda. He's really the pioneer of it and it uses categoric models CAD of Eric um procedures um videoing it in 360. And then um it could be watched by headset or on your phone. So we use cardboard headsets donated by medical realities um with smartphones. And we were able to deliver this course to rel surgeons. We also got the local university involved to actually have a virtual reality laboratory. And the program design was in Brighton. We managed to get funds to take 10 East African surgeons as scholars to come to Brighton have hands on experience. At the same time in Kampala, I ran a four day conference and we had over 70 delegates come and join us for virtual reality training. And then we live streamed it globally and we had over 1000 registrations of people all over the world who were linking in to learn. Obviously, it's a huge amount of work. A huge team who were involved with that. And I want to say a huge thanks to all of them. We presented it at the Association's of Surgeons of Uganda Conference in Kampala were on national television which got a huge number of registrations um coming in. Um And yeah, it's just a really fantastic event that people are really excited by the technology. I'll end by just letting you know how you can get involved. So obviously, I'm here on behalf of winning the prize, but also representing gas sock. And if you'd like to get involved in global surgery or, you know, others who are in anesthesia, obstetrics and a globally minded, there's lots of ways to get into. Our membership is free. We've got a newsletter, we've got our new Frugal Innovations course, which the QR Code will come up in a moment. We've got module one coming up shortly, the working groups you can get involved in and we're always interested in talking to people who are wanting to work abroad. That's the QR Code for our Frugal Innovations course, I'll also mention the I C I G S conference coming up in Kenya. For anyone who's got a real interest in surgical innovation. I'm happy to take any questions. I'm sure we've massively overrun, so probably not. But thank you once again to asset for helping me do the work that I've been doing. Thank you very much Helen for this presentation. Really inspiring a great way to end today. Any questions from the floor different, someone near the front who's got a question or comment into my life. Right. Oh, thank you so much.