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With that in mind, it's a great pleasure to invite Justice Hoffmeyer to come and speak to us for the first half hour or so. The justice Hoffmeyer has been a hero of mine ever since I started knobs and gynie in the in the nineties. He started out working in South Africa, the Holy Cross Mission Hospital in Trance Kind I, before specializing in option going on. Then he came to Oxford to study fetal physiology and 83 84 on, then went back to the head of obstetrics and gynecology, gynecology at the Coronation Hospital in the University of 40 s around in 88 2000 on then worked in Eastern Cape until 2020 and then in the last two years has moved to the University of Botswana. A lot of my connections with him come from our mutual interest in low cost innovations on. But, uh, just this is a huge role model because he's he set up things like the oral misoprostol solution which I I've been working on ever since on for labor induction. Delayed court tramping for preventing intraventricular hemorrhage in the in eights on also something which I don't know How many have you used? The posterior accident Sling traction for shoulder dystocia, this putting a small catheter and the posterior shoulder and liver in the posterior shoulder, which I think is under used nationally but is an important development bird. He's not stop there, and he is currently how it was a big randomized trial going on a moment off suction tampon on for treatment of postpartum hemorrhage and a reusable trade. So that's quite a knack. Ter to follow. Uh, he's now have maybe 400 peer review publications on works that moment in Botswana on Do Take the Opportunity, then to also assist his wife, Carol, with community development projects in your Eastern Cape. Three. The piece Comma Trust. So without any further ado, I'll ask Justice. I hope that he's there. Can we get him? Um, can we get a view of justice? Ah, now we're getting just switching. Okay, that's fine. So justices going to talk on Cesarean section births, the scale of the problem, the challenges and solutions, and we're going to have about half an hour, maybe speak around 20 minutes. Then we'll have a chance with questions for those of you online There's an online facility for typing in your questions, so we'll have questions from the room. But at the same time, we'll also be Who is that? Me? Thank you. Thank you. And then at the same time, where will have questions coming in online as well. So as justices speaking, feel free to type questions into the AP as we go. So now we'll see if we can link up with Botswana. He is There is just a matter of connecting the leg. No, that's right is traditional. And in the hybrid conference we had in Liverpool, which was the first time we tried to do, uh, a non line conference, that was September 2020 the last flow conference. It was really the i t, which was the most challenging. It was it was fantastic conference because suddenly we got so many. We got 1,000,000 people. Was it from around the world? Joining on Gwen? We did an analysis and there's a poster of it somewhere in there if you want to see all the feedback from the last conference and the on the number of people who joined but suddenly were reaching areas that ordinary conferences don't reach, you know way. Sit here in you know where the lucky ones who can afford to come. We can afford the travel. We got accommodation, but actually, these conferences often don't aren't able to connect with with people that the conference is actually all about. So we still recognize that there was an issue with, uh, getting connective itty on there. Certainly. People who even within country, where when I spoke to my colleagues in Uganda, actually getting connected in Uganda was okay from any, but really, you needed good WiFi and that wasn't available for everyone. So there was still a problem in in in local areas, but actually, suddenly to get 1000 people at a conference where additional you had had between 60 and 100 people coming was great. Um, And it also allowed us to, uh, have a top speakers from around the world, so that allows us to do that again. But of course, the risk is that the i t can go. So justice. Are you that? Hello, Justice. Can you hear us? Fantastic. You're so welcome to Birmingham. And thank you so much for joining us. I was just telling the audience here about how lucky we are to get toe have a hybrid conference so we could have people like yourself joining us by the magic of the Internet from Botswana. I'm assuming your inbox one there. Is that right? Yeah. Yeah, that would be great. Thank you. So I'll pass straight onto if I'm a justice. We we got a half a now our But we could maybe leave a bit of time for questions. So the stage is all yours and so many things. And thanks so much. Six girl in school. Okay, well, just the related. So is our goal. What? And see which is the only off? And if you want us to weigh mean, you don't really see peacefully. So that's good. The same thing with selected you is really related to see, weren't it? It is. It's at This is not really so. You wouldn't expect the same results. Very basic equipment. We were saying the same things are sitting as the decisions I do. How are you? Must wait. Wait, wait. And you said you were absolutely And provisions off long acting reversible contraception. I immediately off the first war stories off execution, say knowledge. Yeah, and even with a she or the original material event for this program like to speak to say this just avoiding unnecessary to be simple. Each lab operations Reaper it is. It's it's just a simple cyst And be sorry. Way is way too Operation Misleading is where this is. The other thing is, with these little bit infection with six to be less is when you use that this'll eating fruity check that this is This is way, way, way. And you'll be well, the the information yes he had is making off movies. I mean, you say you weigh, you have a mask that would use it So said he was operating with what? How the only always used to because the last three years in the last week also a different variations on a continuous and supported options with your assistant and the reason is found is in essence, saying six. So I didn't need that useful me is you know, your age ankles and in diversity of a super stuffed up the's. See, that's the thing away. Nice. So they were thinking of decision excluding and so what? Unfortunately, I said, I wish women with you every scene Spector's without We wish. Yeah, that's not study supported. The void exists Separation, separation and hard things on. These is much, much, much operations. I want off this off this section second space and has seen practice for the base. This is the way they they weigh possible. So you need to take a women's used and please saying they actually nothing else is way and waivers. Bridge six is typical patient's disease and using anything for me. Okay, way. Increase the Xanax, which has? Yeah. So what has I think it is? I say he's because this is so This is you know, so and couple of years I think off those days, always signs of being mildly is in this case, we see that I see 80. So he's sleepy things that professor these special and that these these scary that she's way wow just and specially needs to know about, you know and see and some your It's well, I it is on. It was great off on mobility in a seizure on in and save these breaks, it was substantially higher. Okay, some ways are interferences of the normal persists results. In the long run, it's in normal versus pieces. Oh, and so what? You really and the last few minutes weight is. I think she had Teo and ascending spaces. She say she reaches that the pressure. You just need that. And this is just a little ways. Probably for two. Is your weight here crazy places and exercise some more weight. So way wasn't supporting you may for someone at least hard experience, which is long and, you know, since August that reduces eggs. So avoidance is what I'm suggesting is improved. You in three months, they can and using one the penny off You ever tell you with the Sinuses? So what is it? Do you have a Sinus session and three Justice? Thank you so much for that tour de force summary of the state of the art and where we are on where we could potentially be going. Are you able to stay with us for a few minutes for some questions That okay? Do you have any questions in the room or any which have popped up? People see them online. You can see the chat and so maybe if you can, you tell me if there's any questions online. Okay. Any questions in the room? Yes, Yes. Can you introduce yourself When you when? When anyone speaks. Thank you for your stability. A local health America. You pee. But I have a past in gym. Barbara on motion beak. It's It's simply go to me because it just goes back 30 years I did twice one. I think one was for what? A tractable shoulder dystocia. Even snapping the clavicle didn't work, which always did work before the thing. That that's kind of it because we have in our heads up there was this quite common but certainly catastrophic infection post procedure that women basically became unstable in their pelvis. You had ruined her life. So how has the thinking evolved? And what can we do to minimize that catastrophic after effect? Okay, then is a shot stuff with existing separation on the synvisc units on what we use, see? And you said actually, the shoulders, it's amazing way actually has two assistants on because that actually pull this is on the exception and five and with extraction, this is a separate through the this's techniques. You last off. Okay. Thank you. Very much. I think we've got a question which has come in online. Yeah, it's a comment saying care in labor is indeed key. But so often a problem with the very disadvantageous staff to patient ratio is is an issue. One midwife looking after 5 to 10 women is not unusual. How can we better support women in labor when in these kind of difficult circumstances to say that? So it's these that you need to do more. So let me ask to stop Chase away that way, young woman. She's just need to move me something, just chasing the way. Yeah, and this way, Fantastic. Thank you very much. And thank you so much for joining us justice. It's It's fantastic to be able to link with you, if only for half an hour on. We appreciate all the work you've done over the years in generating these the's innovations and presenting the issues in such clearway. So Randall Laws justice theme