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is and welcome, um, a very eminent person in our midst today on Doctor Ronnie Packer, who I would like to start and congratulate. She's the president elect off RC GI. She'll take off over the role in December, so we are all globally very proud of that. And I'm sure the's audience here was very much aware. But low belly, I think it's something that we need to mention. So she is a consultant obstetrician urogynecologist of the Cord and Health Services, and it just trust and honorary senior lecturer. The same George's University of London. She's being the vice president of global health at our See a GI since 2019. Onda Um, she's the past president of the International Urogynecologist so see a shin and leads the national obstetric in a little sphincter injury or C care bundle project on Daz, I said she has been elected, and she's a perfect male president of the college on. We are all very proud to be associated with you went to be hearing you now on, but we look forward to listening to you on safe childbirth, global health activities off the wrong college of obstetricians and gynecologists. Welcome runny. Uh, thank you so much. Thank you so much for that really kind introduction. I'm I'm deeply moved, but good morning to all a few. It's an absolute pleasure to be here today. I'm ashamed to say that is the first time I'm attending a blue conference and I don't know why. Don't ask me why, but I promise you I'll be here for the rest. So hold me to that Andrew and many congregations on this initiator I've been asked to talk about safety I'll birth and what the college does about it. But a shaky also told me that there are several people here who may not be familiar with what they are. Sergi is. So I'm going to tell you a little bit about the Royal College of Obstetricians and kind of collagenous on how safe childbirth is. His part is, at the core off everything that we do in the college. I'll then tell you about some of the initiatives that we have in the UK, which can be up scaled to any setting, be it high low or middle income settings. On last but not least, some of the activities that the college is involved in So the R. C O. J. Is a charitable organization on it works to improve women's health care across the world, both in the UK on outside. And I'm very sure that this is going to be one off. The focus is off the work that I'll be involved in. I wanted to be a global college. It is a global college because look at the distribution off our members. Now the BG I'd amongst you will have noticed that almost 50% off the membership off the are Sergi is outside the UK and it is our job to serve members and fellows globally on. We do this to education. We do this to policy. We do this to clinical quality. On also advocacy. We advocate not only for our members and fellows, but the women and girls that we serve. So this is the members are the This is the officers current office is These are the people who keep the engine going. Okay, Are we are led by any more issue is our president where abeley let I'm extremely proud to work with him. I'm proud to work with this group of officers and you can see our portfolios are white. So I deal with global health. We deal with education, clinical quality, work force, a big issue in this country and last but not least, membership. And I'm really proud to say that when we started in 2019, end of 2019, the first thing we looked at was our strategy goals, and we ensured that global health was included in every strategy goal. Off the are, see a GI, So it's part of everybody's business. You will also be surprised to look at this data. These are in Marcy Gee, exam A distribution now, as you all know, them ostriches really popular globally. It used to be paper based. People used to travel all over as examiners. Well, the pandemic hitters and we had to think outside the box. And now the exam is virtually part one part, too. Also part tree. But we're hoping to convert part three back to face to face because it just does not work that well. But we were in a situation. We had to continue business as usual. We had to continue doing the exam. We had a love where we didn't have any exams. people were writing to us and say What's happening over here, especially my international members and because this is a very important exam for them. So that was the silver lining to this doctor loud, wasn't it? But what I want you to look at Look at the candidates for part two here in January 2022 75% from outside the UK some off. You may be surprised to hear this and that's why I brought this data over here. The other thing we had to do is think about what we do with our courses. Are courses were mainly held in London in the our city buildings. Everybody had to travel there to attend are courses which are very high quality. Okay, they focused to a safe childbirth. So again we converted them to virtual. Many of them are hybrid now, and we have noticed that we have members and fellows on also non members and fellows attending Our courses were truly and that means our global out treat has increased. And I think this is This is really good. This is positive as technology improves will get better at this. It's not perfect on I must say to you that I love meeting people face to face. This is an absolute pleasure to be a and see people as an apple, A said. More than just on a screen. It gives you a really warm feeling on. If you're a person, person, person, kind of person, then you want to see people face to face. It's a really warm feeling, so thank you for inviting me here today. What else did we do again when the pandemic? Eight hours. And this was really tough for the officers because we all had great plans. I certainly had great plans for global health. Everything had to come to a standstill. We have to think outside the box business as usual stopped. But the main issue we had was the pandemic on how it was affecting women and girls, how it was affecting education, how it was affecting pregnant women. They waas no evidence out there. We really had to think as we were running as evidence was coming out pregnancy what happened in gynecological care gynecological services who are affected terribly there, the worse affected in this country and I know also globally because women's health is not prioritize and that's an issue. So we had guidance in very suspects education, pregnancy, gynecology, how we're going to rest your services. And this was our goal With 19 infection in pregnancy, Guidance worsen 15. It changed. It was dynamic. It's also had criticism, okay, because we were changing so rapidly. But we've also getting guidance for government. We needed to keep it all similar. We didn't want the government to say one thing. It did happen several times. We didn't want to say something different from them. We also needed to look at evidence. Evidence is important. We did not know much about this disease. So now they are in version 15 on. I hope it stops there, but I'm not so entirely sure. But really this was important. It was important for women. It was important for professionals. As you can see over here, the co bit hub was accessed by over six million people. Globally, our social media presence increased and if you look at Instagram, how much is it? 450% increase in access to instagram Now that's the kind of thing that people look at these days, especially mothers on. There was a lot of confusion about this. Wasn't people really wanted to know more pregnant women were frightened. I look at the access over there and this was not only in the UK, but the top 10 countries of a day. India, Saudi Arabia. It was globally important on what I want to say two and a pill A is that I think we should be working on guidelines at a similar Beanie collaboration. We need to work together. We all need to be giving the same messages on Really, that would help in several ways. One is we give the same message to women. They get the same message. It helps them but and does not cause confusion. But also we could use resources for something else as well, if we work together. So my plea is that we don't go and start making different guidances, different information. But we all work together on I hope this is something that we can achieve together. Yeah, Coming, Teo Information Leafless. Not one of the things we do very well is a green top guidelines which is access globally on. We need to work on adopting those for different settings. It's a global colleges. I said one size does not fit all. So how do we make this guidance that we spend so much money and time on relevant to different parts of the world? So we need to adopt those guidelines. But we also have some wonderful information. Leaflets on these leaflets are developed not by somebody just sitting in the college, but co produced with women co produced with charities not focused. They put up to information leaflets on Cesarean section over here, which are really important. There are lots of other guidance is on instrumental delivery assisted delivery. If you want to call it that but Cesarean section as well. These are simple there, well done. And why don't we all start using the same kind of information replace? Why do we have to reinvent the wheel? We also about looking at translation off these refill. It's so that they can be used globally. But you know, we in this country be also multicultural. We need to look at this as well. The consent advice on plants is Asian. Birth is being worked on. It's a very important card inside information from the college, and we're working hard on that on that's going to be converted into a video off patient information, and that's how we're hoping to move on on. That may be something that is going to be quite useful instead of people going and making another kind of information. If it maybe we should be using this information because a lot of effort goes into this. What else we do? Do we do well, We like to collaborate with others we know we cannot achieve. We do not have the skills to achieve good quality research. We need global partners. But in the UK, we work with the Tommy Center, along with the Royal College of Mid Wives. We as obstetricians do not want to just go and create something we need to work with a midriff reqally. So we have a very close bond with the Royal College of Mid Wives. In fact, the house in the same building as that on that's really going to improve the way we work with them. The Tommy's up is something that you may be familiar with, and it essentially aims for all pregnant women to receive the right here at the right time, no matter where they live. Okay, that's the Thomas up. It has been piloted in six centers. It's going to be up scared. In 26 a different centers, it aims to assess accurately assess a woman's risk off preterm birth. On also present dysfunction, it provides personalized care, so moving away from sick boxes on risk factors on also provides clinical decisions. Support to healthcare professionals so you don't have to remember. The 220 guidance is when you see a woman, for example, with preeclampsia. How wonderful to be able to put certain parameters and get guidance. This woman needs it, aspirin or whatever so can read. Then use the stool in lieu in middle income countries is what I think, and it may not be the same parameters, but some work needs to be done to ensure that it it suits that particular population. And where I was struck with this idea was when, two months ago I visited my hometown, which is in rural India, a little town called Chikoti, which nobody in India also has heard off on. We have our family farms over this. I went to the farm and I was talking with the person who does the farming. And I asked him about a, uh I was talking to him about some crops and I asked him, you know, this issue again, what does this disease on it. And he took out his iPhone and started looking at that. And I thought, Well, if in rural India Chikoti where you still have home buts, you have an iPhone. Hey, why can't we improve care over here using something like this? So we need to start thinking outside the box. Everybody has an iPhone, the people who work in our homes in India, for example. All of them have our iPhone on. That's wonderful that this is what we need to be using, um, quickly moving on to the next aspect is that ABC program, which is the avoiding brain Injuries for childbirth program. This is led by Tim Drink out essentially looking at INTERPOSITUM. Peter Surveillance and impacted people head on. This is being up scaled in this country, but they're looking at how you do. You safely delivered impacted fetal had a cesarean section, and they're using augmented reality, essentially enhancing the way a health care professional delivers a fetal head. You can actually see yourself doing this delivery with augmented reality, and I think this is the way forward. If you see TMJ caught in a corridor, he'll ensure that you do this. Okay, so be aware. If you see him at a mile run away. Otherwise you'll be practicing this. Another thing is about the basic a bundle. It's a project that I'm involved in very passionate about. Always. C stands for such a cane is finger injury, which includes stood and four degree tail. And we have a quality improvement program and this ah country consisting off four aspects providing antenatal information, manual pen ear protection, doing an episode to make correctly when indicated and also an examination. And this has been introduced in 16 centers in this country on, we have found a 20% reduction in O A C rate without an increase in sensation and episode to me, and I don't have time to discuss this. I can talk to you all day about this because it's my passion, but he had the papers you can refer to if you need. We have also asked mothers about the beauty of US healthcare professionals, and we have quantitative research so quickly are moving on to the global health activities that were involved in our international projects. There are several ongoing at present, if or you all know that every year 25 million unsafe abortion steak place mainly focused in sub Saharan Africa. So we have a project. They're essentially focusing on increasing healthcare professionals, capacity to address barriers to safe abortion and post abortion care on this is in Five sub Saharan countries were working with champions advocates in this country. We have 60 champions on along with them, we have co produced best practice guidance. We have focusing on advocacy and also research, and maybe we can talk about that in the question time. This is some resources that are useful on. This is important because safe contraception safe abortion leads to safe childbirth. There we have to e learning packages. We also have best practice. Papers on all of this are available on the college website now. Benign gynecological conditions much neglected because women don't die from this. It affects the quality of life. So we have a project known as essential gynecological skills. Ah, which essentially focuses on preventing gynecological conditions but simple conditions abnormal Mention breeding of normal. You trying, pleading, etcetera. Um, and if you look, this is a study that we have them were looked at the global of burden dizzy off disease in 2019 on found that the years off, too just to disability from benign conditions globally, especially in law in middle income countries, is higher than HIV AIDS, malaria, TB combined and this is important data. So we have modules. We are developing a master between US program who then we'll upscale. This not only two doctors, but healthcare professionals in Bangladesh. Our current project is in Bangladesh we are working in partnership with. I see DDR be on also the obs any gynie society off Bangladesh. I'm really excited about this. It's training low impact on getting high impact solutions. It's focusing on prevention so that you have a mother who safe to give birth. We also very good at advocacy. We educate for women in crisis areas. Also, for refugees who come to this country, the government was making them pay for for the healthcare. We are working with them to ensure that they don't have to pay for this on some work on FGM we have a project in Somalia land which has the highest matanov mortality rate. Again, we're working on looking at emergency gynecological skills in healthcare professionals in this area. But one area that I'm really proud off is the advocacy work that we're doing in secular thing. Support for sexual entry, Productive health off girls in overseas development on many off. You may know that this government in November 2020 reduce the idea or official development aid from 0.7% GDP to 0.5% on this equates to treat to four billion, which has a huge impact in learn middle income countries. It has affected many aspects of care, but just one example in interest of time. If you just look at family blooding, if you just look at family planning with funding which would be 218.9 million, 13,000 medical debts would be prevented. But with these cuts, you then have funding cuts off 132.4 million. You have 8000 more debts occurring due to this on. This is due to unintended pregnancies which could be prevented, but we now occur because of these cuts on this is something we really need to do something about. We need to speak for those women. So we are working with parliamentarians Were advocating the UK government to prioritize srh are funding in the international development budget. Are we also working with other medical colleges to advocate for a search of funding? We want to ensure that this doesn't get got any further. There is not a lot of hope. I must say, on if you see what happened in the, uh is happening in the government yesterday. I don't know where we're going, but we need to continue to be the voice of women into in middle income countries. We're we're also working with the members and pillows are strongest voice are members and fellows on. We're working with our trying to understand how this lack of funding is affecting people, and we're focusing on Bangladesh, Pakistan and Nigeria. So I hope in the last 15 20 minutes, I've kind of told you what the college does. I've told you the projects we have over here and also the projects were doing internationally on. But I hope that we develop some partnerships which would be fruitful for women and girls globally. Thank you so much for your kind of thing. Thank you very much. Runny for taking us through. What? The colleges on about what it does here for, um, the membership on for the patients That kid takes care off on what international project you have on what your vision is for the international, uh, partners. I'm strapped months again with, uh, the online platform. If there's any question, Nothing, Not yet. Okay. We can, uh, come here for a minute or so. Any questions? Uh, yes, Akilah. Thank you very much. Money for covering so much in 15 minutes time. I'm coming. More from the perspective off researchers and trainees here in UK. There are a lot off trainings today attending. So just want to know how we can involve office. And I need trainees who want to work in the proper health field whom we are separately engaging with them in the research side. But how can we actually have a tripartite partnership to promote a global health research? Yeah. So our Rosie Teesta will tell you that global help train is sat as a separate group before three years on, they did their own thing. But now they're involved in the global health. Ah, group off the college. So they involved in the Center for Global Health. So they're bringing them in. We can do much better. No doubt about it. Ah, but Rosie and Teesta do you'll feel a little bit more involved now, um, is rosy. Yeah, does he was a chair there on Be have tried to involve them. They come to our global board meeting on. But perhaps we need to think off away, off involving more people who are interested. But with your permission chair, can I get rosy to say different things that the global health trainees have been doing? Yeah, that's very briefly, right. Thanks, miss. Like, er, um it's so great to see you here. And we're so excited for the work the college is gonna do You undo your leadership in the next few years. I've been in the chair of the attorneys local health committee for the last few years. I will be stepping down shortly. Test is currently the vice chair. I'm and you're quite right. In the last few years, we've had the opportunity to come in more work closely with the global health board to get involved in there, making a Bush and safe program and contribute, as we have been for a long time, to some of the training programs that the college has been delivering, like a central and logical skills, and that's been really positive on. But I think it's a really bushel of us on the committee to see why do engagement across the whole training body, which I think is what shaky they was saying on one of the things I'm really excited about. The moment that we're launching very shortly is our peer to peer platform, which is part of the colleges network for helping people to connect with pears across the country. And we've got a part from set aside for trainings. You're interested in global health. Amber Wilson. He couldn't be here today has been taking the lead in setting that up on. I think that's gonna be a really positive resource for trainings to be able to engage with what the college is doing to talk to each other about what they're doing and to hopefully get more involved beyond what we've already been able to do. So thanks for the question on. Maybe you want to also tell them about the strategy more yes, and taste the lead on making a beautiful strategy training module, which has a very good starting point for trainings. You're interested in learning a little bit more about global health work and the kind of things we might need to be considering if we are training is thinking about being involved in research and wanting to take part, providing care in international settings. Okay, thank you very much for that aspect of the trainees. I think the way figure also has something for trainees. I think it's interesting that it's happening at this level also. So if there's a question, then we've got a comment from Kathryn. How Long line? Who says thank you very much for the presentation. It would be so great for the college to work with the WH show in promoting joint patient information resources in different languages on in pictorial form for women and girls with lower educational attainment in broad for 15% of our women, do not speak or read English as a first language, and it costs US 500 lbs per leaflet to get it translated. If we could have global resources in different languages, that would be wonderful and would save hospitals. Lots of money. Point taken s. So I think in the interest of time, we really close decision. Thank you very much for, uh, knee and the comments on DA, uh, we give her another round of applause.