well thank you so much Dan it’s such a pleasure to be here I’m starting with a
pleasure to be here I’m starting with a
pleasure to be here I’m starting with a warning slot slide for all of you
warning slot slide for all of you
warning slot slide for all of you because I was asked by the producers to
because I was asked by the producers to
because I was asked by the producers to let you know that I’m sharing some
let you know that I’m sharing some
let you know that I’m sharing some graphic content and images because I
graphic content and images because I
graphic content and images because I think they’ll help you better understand
think they’ll help you better understand
think they’ll help you better understand the crisis that I’ll talk about today
the crisis that I’ll talk about today
the crisis that I’ll talk about today now while I’m an anesthesiologist I’m
now while I’m an anesthesiologist I’m
now while I’m an anesthesiologist I’m not planning to put you to sleep today
not planning to put you to sleep today
not planning to put you to sleep today in fact I desperately hope that I’m not
in fact I desperately hope that I’m not
in fact I desperately hope that I’m not going to put you to sleep today I want
going to put you to sleep today I want
going to put you to sleep today I want to wake you rather to a crisis that is
to wake you rather to a crisis that is
to wake you rather to a crisis that is the absence of anesthesia and ask you to
the absence of anesthesia and ask you to
the absence of anesthesia and ask you to care about five billion in need of safe
care about five billion in need of safe
care about five billion in need of safe anesthesia and surgery
anesthesia and surgery
anesthesia and surgery geography truly is destiny and for the
geography truly is destiny and for the
geography truly is destiny and for the populations on this map in yellow and
populations on this map in yellow and
populations on this map in yellow and orange their destiny has been to live
orange their destiny has been to live
orange their destiny has been to live without the essential part of healthcare
without the essential part of healthcare
without the essential part of healthcare anesthesia and surgery I’ve experienced
anesthesia and surgery I’ve experienced
anesthesia and surgery I’ve experienced this crisis in real time throughout my
this crisis in real time throughout my
this crisis in real time throughout my career and I’ve been changed by what
career and I’ve been changed by what
career and I’ve been changed by what I’ve witnessed I’ll never forget a
I’ve witnessed I’ll never forget a
I’ve witnessed I’ll never forget a mother that I met in northern Sri Lanka
mother that I met in northern Sri Lanka
mother that I met in northern Sri Lanka my experience is with her and her family
my experience is with her and her family
my experience is with her and her family changed the course of my career you see
changed the course of my career you see
changed the course of my career you see I was serving in northern Sri Lanka as
I was serving in northern Sri Lanka as
I was serving in northern Sri Lanka as part of a Doctors Without Borders
part of a Doctors Without Borders
part of a Doctors Without Borders surgical team serving behind the front
surgical team serving behind the front
surgical team serving behind the front lines of the war that had been going on
lines of the war that had been going on
lines of the war that had been going on for more than 20 years many of you will
for more than 20 years many of you will
for more than 20 years many of you will remember this crisis the southern
remember this crisis the southern
remember this crisis the southern Sinhalese army
Sinhalese army
Sinhalese army battling the north northern Tamil
battling the north northern Tamil
battling the north northern Tamil separatist the Tamil Tigers who were
separatist the Tamil Tigers who were
separatist the Tamil Tigers who were famous for the Black Tigers the young
famous for the Black Tigers the young
famous for the Black Tigers the young suicide bombers which terrorized the
suicide bombers which terrorized the
suicide bombers which terrorized the country throughout the conflict those
country throughout the conflict those
country throughout the conflict those Black Tigers Armagh more here in this
Black Tigers Armagh more here in this
Black Tigers Armagh more here in this memorial which was centered in the town
memorial which was centered in the town
memorial which was centered in the town where I lived as part of this team
where I lived as part of this team
where I lived as part of this team living in northern Sri Lanka was austere
living in northern Sri Lanka was austere
living in northern Sri Lanka was austere and for the civilians that lived here
and for the civilians that lived here
and for the civilians that lived here they lived without electricity without
they lived without electricity without
they lived without electricity without running water
running water
running water and without access to health care or
and without access to health care or
and without access to health care or basic medicines but somehow life
basic medicines but somehow life
basic medicines but somehow life continued babies were born children went
continued babies were born children went
continued babies were born children went to school and the Hindu temples
to school and the Hindu temples
to school and the Hindu temples continued to offer worship the hospital
continued to offer worship the hospital
continued to offer worship the hospital where we worked was also in an austere
where we worked was also in an austere
where we worked was also in an austere shape it had been bombed on many
shape it had been bombed on many
shape it had been bombed on many circumstances and the concrete walls
circumstances and the concrete walls
circumstances and the concrete walls were crumbling the roof was merely a
were crumbling the roof was merely a
were crumbling the roof was merely a piece of tin or in some places a tarp
piece of tin or in some places a tarp
piece of tin or in some places a tarp which blocked out the Sun and the rain
which blocked out the Sun and the rain
which blocked out the Sun and the rain at times but it was here that we offered
at times but it was here that we offered
at times but it was here that we offered surgery for the civilian population and
surgery for the civilian population and
surgery for the civilian population and sometimes for combatants we offered
sometimes for combatants we offered
sometimes for combatants we offered emergency surgery for landmine injuries
emergency surgery for landmine injuries
emergency surgery for landmine injuries and for motorcycle accidents for
and for motorcycle accidents for
and for motorcycle accidents for infections and almost on a daily basis
infections and almost on a daily basis
infections and almost on a daily basis we treated mothers pregnant women who
we treated mothers pregnant women who
we treated mothers pregnant women who had been laboring for days and days
had been laboring for days and days
had been laboring for days and days would arrive on bicycle asking for a
would arrive on bicycle asking for a
would arrive on bicycle asking for a surgery to take out the baby that was
surgery to take out the baby that was
surgery to take out the baby that was stuck inside our operating room was
stuck inside our operating room was
stuck inside our operating room was equally in bad condition the room had an
equally in bad condition the room had an
equally in bad condition the room had an open window with no screen and through
open window with no screen and through
open window with no screen and through this screen the dust and flies blew
this screen the dust and flies blew
this screen the dust and flies blew regularly we had limited access to
regularly we had limited access to
regularly we had limited access to equipment and to medicines we frequently
equipment and to medicines we frequently
equipment and to medicines we frequently ran out of oxygen out of pain medicine
ran out of oxygen out of pain medicine
ran out of oxygen out of pain medicine and out of life-saving medicines and so
and out of life-saving medicines and so
and out of life-saving medicines and so on the day that the mother arrived that
on the day that the mother arrived that
on the day that the mother arrived that I mentioned we were doing our work in
I mentioned we were doing our work in
I mentioned we were doing our work in the hospital and she arrived with her
the hospital and she arrived with her
the hospital and she arrived with her physician father asking us for a
physician father asking us for a
physician father asking us for a cesarean delivery to deliver her second
cesarean delivery to deliver her second
cesarean delivery to deliver her second child her father spoke English and
child her father spoke English and
child her father spoke English and explained that her first child had been
explained that her first child had been
explained that her first child had been delivered by cesarean section and
delivered by cesarean section and
delivered by cesarean section and therefore he knew that it would be safer
therefore he knew that it would be safer
therefore he knew that it would be safer for her to deliver in these
for her to deliver in these
for her to deliver in these circumstances again by cesarean delivery
circumstances again by cesarean delivery
circumstances again by cesarean delivery we were able to accommodate her the next
we were able to accommodate her the next
we were able to accommodate her the next day and so I provided for her a spinal
day and so I provided for her a spinal
day and so I provided for her a spinal anesthetic that made her numb from about
anesthetic that made her numb from about
anesthetic that made her numb from about her chest down and in no time a
her chest down and in no time a
her chest down and in no time a beautiful baby
beautiful baby
beautiful baby big boy was born and we were
big boy was born and we were
big boy was born and we were able to quickly close her incision and
able to quickly close her incision and
able to quickly close her incision and move her on to the recovery ward all was
move her on to the recovery ward all was
move her on to the recovery ward all was well but before we left the hospital
well but before we left the hospital
well but before we left the hospital that evening we were called back to the
that evening we were called back to the
that evening we were called back to the recovery ward because the nurses
recovery ward because the nurses
recovery ward because the nurses reported that this mother was in
reported that this mother was in
reported that this mother was in distress it was this room where we went
distress it was this room where we went
distress it was this room where we went only by then it was dark and so there
only by then it was dark and so there
only by then it was dark and so there were kerosene lanterns burning in the
were kerosene lanterns burning in the
were kerosene lanterns burning in the corners and I as I looked across the
corners and I as I looked across the
corners and I as I looked across the room I could see that this mother was
room I could see that this mother was
room I could see that this mother was sitting bolt upright in bed and she was
sitting bolt upright in bed and she was
sitting bolt upright in bed and she was leaning forward and clutching her chest
leaning forward and clutching her chest
leaning forward and clutching her chest she was surrounded by her family by all
she was surrounded by her family by all
she was surrounded by her family by all the nurses working that evening and by
the nurses working that evening and by
the nurses working that evening and by all the patients in the ward as well as
all the patients in the ward as well as
all the patients in the ward as well as I move closer I could see that she was
I move closer I could see that she was
I move closer I could see that she was really struggling to breathe and as I
really struggling to breathe and as I
really struggling to breathe and as I got closer still I could see that her
got closer still I could see that her
got closer still I could see that her coloring was gray I sat down next to her
coloring was gray I sat down next to her
coloring was gray I sat down next to her and I felt her pulse her pulse was
and I felt her pulse her pulse was
and I felt her pulse her pulse was racing I asked the nurses to bring the
racing I asked the nurses to bring the
racing I asked the nurses to bring the few emergency supplies and the oxygen
few emergency supplies and the oxygen
few emergency supplies and the oxygen that we had available in the operating
that we had available in the operating
that we had available in the operating room to me I listened to her lung fields
room to me I listened to her lung fields
room to me I listened to her lung fields with my stethoscope and although I had
with my stethoscope and although I had
with my stethoscope and although I had some ideas about what was going on I had
some ideas about what was going on I had
some ideas about what was going on I had none of the tests or the x-rays that I
none of the tests or the x-rays that I
none of the tests or the x-rays that I needed to make a good diagnosis so we
needed to make a good diagnosis so we
needed to make a good diagnosis so we had to move forward with treating her
had to move forward with treating her
had to move forward with treating her about the time that the oxygen and the
about the time that the oxygen and the
about the time that the oxygen and the resuscitation bag arrived she collapsed
resuscitation bag arrived she collapsed
resuscitation bag arrived she collapsed and stopped breathing we use the bag in
and stopped breathing we use the bag in
and stopped breathing we use the bag in the mask to breathe for her but her
the mask to breathe for her but her
the mask to breathe for her but her coloring didn’t get better I was feeling
coloring didn’t get better I was feeling
coloring didn’t get better I was feeling her pulse and I could feel that it was
her pulse and I could feel that it was
her pulse and I could feel that it was getting weaker and weaker I finally was
getting weaker and weaker I finally was
getting weaker and weaker I finally was able to take her blood pressure and her
able to take her blood pressure and her
able to take her blood pressure and her blood pressure was very low I asked for
blood pressure was very low I asked for
blood pressure was very low I asked for the life-saving medicine epinephrine
the life-saving medicine epinephrine
the life-saving medicine epinephrine that she so needed to help her hurt beat
that she so needed to help her hurt beat
that she so needed to help her hurt beat better but I was told by the nurses that
better but I was told by the nurses that
better but I was told by the nurses that we’d run out and so as we continued
we’d run out and so as we continued
we’d run out and so as we continued standing by about evaluating her her
standing by about evaluating her her
standing by about evaluating her her heart stopped
heart stopped
heart stopped we didn’t have anything to shock her
we didn’t have anything to shock her
we didn’t have anything to shock her heart back into action nor did we have a
heart back into action nor did we have a
heart back into action nor did we have a breathing machine to breathe for her
breathing machine to breathe for her
breathing machine to breathe for her overnight
overnight
overnight so he started chest compressions because
so he started chest compressions because
so he started chest compressions because she was young and healthy and we hoped
she was young and healthy and we hoped
she was young and healthy and we hoped that it would restart her heart and I
that it would restart her heart and I
that it would restart her heart and I don’t know if we were there for minutes
don’t know if we were there for minutes
don’t know if we were there for minutes or for an hour but sometime in that
or for an hour but sometime in that
or for an hour but sometime in that process her physician father stepped up
process her physician father stepped up
process her physician father stepped up behind me and he put his hand on my
behind me and he put his hand on my
behind me and he put his hand on my shoulder and he whispered we have to
shoulder and he whispered we have to
shoulder and he whispered we have to stop we have to let her go I wish I
stop we have to let her go I wish I
stop we have to let her go I wish I could tell you that this was a rare
could tell you that this was a rare
could tell you that this was a rare event but in the countries I’m telling
event but in the countries I’m telling
event but in the countries I’m telling you about today it’s not only common but
you about today it’s not only common but
you about today it’s not only common but it happens every day because of a lack
it happens every day because of a lack
it happens every day because of a lack of access to the things we need but more
of access to the things we need but more
of access to the things we need but more importantly to a generalized at lack of
importantly to a generalized at lack of
importantly to a generalized at lack of access to anesthesia and surgery in fact
access to anesthesia and surgery in fact
access to anesthesia and surgery in fact five billion people lack access to
five billion people lack access to
five billion people lack access to anesthesia and surgery in the world
anesthesia and surgery in the world
anesthesia and surgery in the world today and while this number is
today and while this number is
today and while this number is extraordinary I have to tell you that
extraordinary I have to tell you that
extraordinary I have to tell you that it’s based in science The Lancet
it’s based in science The Lancet
it’s based in science The Lancet Commission on global surgery published
Commission on global surgery published
Commission on global surgery published this report on April in April of 2015
this report on April in April of 2015
this report on April in April of 2015 and this report was life-changing
and this report was life-changing
and this report was life-changing because for finally we could quantify
because for finally we could quantify
because for finally we could quantify the problem and therefore we could move
the problem and therefore we could move
the problem and therefore we could move forward with the solutions now many of
forward with the solutions now many of
forward with the solutions now many of you may be asking yourself how is that
you may be asking yourself how is that
you may be asking yourself how is that even possible
even possible
even possible how could two-thirds of the world lack
how could two-thirds of the world lack
how could two-thirds of the world lack access to this basic health care well
access to this basic health care well
access to this basic health care well I’m here to tell you that the problem
I’m here to tell you that the problem
I’m here to tell you that the problem started long ago in in these countries
started long ago in in these countries
started long ago in in these countries that you see on the map in orange and
that you see on the map in orange and
that you see on the map in orange and yellow because they were plagued
yellow because they were plagued
yellow because they were plagued literally by life-threatening infectious
literally by life-threatening infectious
literally by life-threatening infectious diseases as well as by other
diseases as well as by other
diseases as well as by other humanitarian crises including droughts
humanitarian crises including droughts
humanitarian crises including droughts famine and conflict and these things
famine and conflict and these things
famine and conflict and these things combined consumed all the healthcare
combined consumed all the healthcare
combined consumed all the healthcare resources and there was no money or
resources and there was no money or
resources and there was no money or resource for anything more but somewhere
resource for anything more but somewhere
resource for anything more but somewhere in the middle 90s these things begin to
in the middle 90s these things begin to
in the middle 90s these things begin to change
change
change infectious diseases had better treatment
infectious diseases had better treatment
infectious diseases had better treatment and prevention including HIV some
and prevention including HIV some
and prevention including HIV some droughts ended people were fed and
droughts ended people were fed and
droughts ended people were fed and conflicts resolved and therefore disease
conflicts resolved and therefore disease
conflicts resolved and therefore disease started to look a whole lot more like it
started to look a whole lot more like it
started to look a whole lot more like it looks here in the United States trauma
looks here in the United States trauma
looks here in the United States trauma became more common cancer was more
became more common cancer was more
became more common cancer was more common and heart disease is now
common and heart disease is now
common and heart disease is now everywhere but none of the resources
everywhere but none of the resources
everywhere but none of the resources were available to begin treating these
were available to begin treating these
were available to begin treating these problems as they appeared so imagine
problems as they appeared so imagine
problems as they appeared so imagine with me if you can being in a terrible
with me if you can being in a terrible
with me if you can being in a terrible car accident and having a badly badly
car accident and having a badly badly
car accident and having a badly badly broken leg but no one there to fix it or
broken leg but no one there to fix it or
broken leg but no one there to fix it or no one to give you pain medicine for
no one to give you pain medicine for
no one to give you pain medicine for your pain or imagine having a heart
your pain or imagine having a heart
your pain or imagine having a heart attack without the critical resources to
attack without the critical resources to
attack without the critical resources to save your life or to have a cancer that
save your life or to have a cancer that
save your life or to have a cancer that hasn’t been diagnosed and you’ve had it
hasn’t been diagnosed and you’ve had it
hasn’t been diagnosed and you’ve had it for so long that you now have tumors in
for so long that you now have tumors in
for so long that you now have tumors in both breasts and throughout your body
both breasts and throughout your body
both breasts and throughout your body like this woman who we met and she died
like this woman who we met and she died
like this woman who we met and she died only three months later or this
only three months later or this
only three months later or this gentleman who years ago had two very
gentleman who years ago had two very
gentleman who years ago had two very very small hernias which would have been
very small hernias which would have been
very small hernias which would have been fixed in a matter of minutes by a quick
fixed in a matter of minutes by a quick
fixed in a matter of minutes by a quick surgery but he had no access to that and
surgery but he had no access to that and
surgery but he had no access to that and so his hernias grew larger and larger
so his hernias grew larger and larger
so his hernias grew larger and larger and his pain and immobility increased
and his pain and immobility increased
and his pain and immobility increased until finally he could no longer work or
until finally he could no longer work or
until finally he could no longer work or provide for his family
provide for his family
provide for his family in fact the backlog on surgeries is so
in fact the backlog on surgeries is so
in fact the backlog on surgeries is so big than a hundred and forty three
big than a hundred and forty three
big than a hundred and forty three million cases are needed every year just
million cases are needed every year just
million cases are needed every year just to begin to catch up and tragedy further
to begin to catch up and tragedy further
to begin to catch up and tragedy further is that 16 million deaths occur every
is that 16 million deaths occur every
is that 16 million deaths occur every year because of the lack of access to
year because of the lack of access to
year because of the lack of access to safe anesthesia and surgery and most of
safe anesthesia and surgery and most of
safe anesthesia and surgery and most of these are preventable I hope I’ve made
these are preventable I hope I’ve made
these are preventable I hope I’ve made you come to the realization that
you come to the realization that
you come to the realization that anesthesiology is
anesthesiology is
anesthesiology is central to the solution for this problem
central to the solution for this problem
central to the solution for this problem and in fact anesthesiology is essential
and in fact anesthesiology is essential
and in fact anesthesiology is essential to health care and integral to health
to health care and integral to health
to health care and integral to health living without anesthesiology is painful
living without anesthesiology is painful
living without anesthesiology is painful and life-threatening and so how does
and life-threatening and so how does
and life-threatening and so how does that look on the ground in those
that look on the ground in those
that look on the ground in those countries that I showed you in orange
countries that I showed you in orange
countries that I showed you in orange and yellow well I’ll give you three
and yellow well I’ll give you three
and yellow well I’ll give you three examples in Ethiopia there are 22
examples in Ethiopia there are 22
examples in Ethiopia there are 22 anesthesiologists for 90 million people
anesthesiologists for 90 million people
anesthesiologists for 90 million people in Rwanda there are 13 anesthesiologists
in Rwanda there are 13 anesthesiologists
in Rwanda there are 13 anesthesiologists for 11 million and Sierra Leone has only
for 11 million and Sierra Leone has only
for 11 million and Sierra Leone has only one remaining anesthesiologists for 6
one remaining anesthesiologists for 6
one remaining anesthesiologists for 6 million people
million people
million people well how many anesthesiologist do you
well how many anesthesiologist do you
well how many anesthesiologist do you need how many do we have here in the US
need how many do we have here in the US
need how many do we have here in the US well I can tell you that we have
well I can tell you that we have
well I can tell you that we have approximately one anesthesiologist for
approximately one anesthesiologist for
approximately one anesthesiologist for every 10,000 people in the US which
every 10,000 people in the US which
every 10,000 people in the US which amounts to about 60,000
amounts to about 60,000
amounts to about 60,000 anesthesiologists and all that’s more in
anesthesiologists and all that’s more in
anesthesiologists and all that’s more in this country than for all 80 countries
this country than for all 80 countries
this country than for all 80 countries that I showed you on the map and so
that I showed you on the map and so
that I showed you on the map and so let’s talk about the solutions because
let’s talk about the solutions because
let’s talk about the solutions because there’s so much good news here for us
there’s so much good news here for us
there’s so much good news here for us now
now
now five integrated solutions exist which
five integrated solutions exist which
five integrated solutions exist which will lead to the scaling up of safe
will lead to the scaling up of safe
will lead to the scaling up of safe anesthesia and surgery and provide for
anesthesia and surgery and provide for
anesthesia and surgery and provide for these diseases I’ve described to you
these diseases I’ve described to you
these diseases I’ve described to you data collection and analysis is much
data collection and analysis is much
data collection and analysis is much needed to ensure we know where the
needed to ensure we know where the
needed to ensure we know where the problems are and what is specifically
problems are and what is specifically
problems are and what is specifically needed education and training has to
needed education and training has to
needed education and training has to happen for the many doctors nurses and
happen for the many doctors nurses and
happen for the many doctors nurses and technicians that we need to improve
technicians that we need to improve
technicians that we need to improve access and to improve patient safety
access and to improve patient safety
access and to improve patient safety innovation for new equipment that is
innovation for new equipment that is
innovation for new equipment that is cost effective and technology
cost effective and technology
cost effective and technology appropriate and is so needed in all
appropriate and is so needed in all
appropriate and is so needed in all these operating rooms around the world
these operating rooms around the world
these operating rooms around the world and permanent access to medicines that
and permanent access to medicines that
and permanent access to medicines that are in chronic need in many of these
are in chronic need in many of these
are in chronic need in many of these countries oxygen antibiotics pain
countries oxygen antibiotics pain
countries oxygen antibiotics pain medicines and life life-saving medicines
medicines and life life-saving medicines
medicines and life life-saving medicines as well and the most important solution
as well and the most important solution
as well and the most important solution is
is
is that of government government has to
that of government government has to
that of government government has to invest in this process and sustain it or
invest in this process and sustain it or
invest in this process and sustain it or these solutions will not amount to a
these solutions will not amount to a
these solutions will not amount to a permanent fix and this may be the most
permanent fix and this may be the most
permanent fix and this may be the most difficult part of the solution grouping
difficult part of the solution grouping
difficult part of the solution grouping because as you might have guessed this
because as you might have guessed this
because as you might have guessed this is going to be expensive
is going to be expensive
is going to be expensive in fact The Lancet Commission on global
in fact The Lancet Commission on global
in fact The Lancet Commission on global surgery estimates that it will cost
surgery estimates that it will cost
surgery estimates that it will cost three hundred and fifty billion dollars
three hundred and fifty billion dollars
three hundred and fifty billion dollars to scale up to safe anesthesia and
to scale up to safe anesthesia and
to scale up to safe anesthesia and surgery but more important is that it
surgery but more important is that it
surgery but more important is that it will cost twelve trillion dollars in
will cost twelve trillion dollars in
will cost twelve trillion dollars in lost GDP if we don’t do this today I
lost GDP if we don’t do this today I
lost GDP if we don’t do this today I hope you’ll agree with me that this has
hope you’ll agree with me that this has
hope you’ll agree with me that this has to happen these important events have
to happen these important events have
to happen these important events have already occurred making this feasible
already occurred making this feasible
already occurred making this feasible and we’re well on our way to the scale
and we’re well on our way to the scale
and we’re well on our way to the scale up I believe that we are well on our way
up I believe that we are well on our way
up I believe that we are well on our way to more anesthesia more surgery and to
to more anesthesia more surgery and to
to more anesthesia more surgery and to many lives saved my colleagues and I are
many lives saved my colleagues and I are
many lives saved my colleagues and I are working with our partners on the ground
working with our partners on the ground
working with our partners on the ground to help them make sure that this is a
to help them make sure that this is a
to help them make sure that this is a reality we continue with advocacy we
reality we continue with advocacy we
reality we continue with advocacy we continue to engage new partners in
continue to engage new partners in
continue to engage new partners in pharmaceutical companies and medical
pharmaceutical companies and medical
pharmaceutical companies and medical industry and we encourage others already
industry and we encourage others already
industry and we encourage others already on the ground to take at this effort
on the ground to take at this effort
on the ground to take at this effort this is the global surgery era I
this is the global surgery era I
this is the global surgery era I continue to experience this crisis in
continue to experience this crisis in
continue to experience this crisis in real time and I’m impressed by the
real time and I’m impressed by the
real time and I’m impressed by the changes that I’m seeing I’m inspired by
changes that I’m seeing I’m inspired by
changes that I’m seeing I’m inspired by my partners on the ground like dr. jean
my partners on the ground like dr. jean
my partners on the ground like dr. jean who was the last remaining
who was the last remaining
who was the last remaining anesthesiologist in rwanda she is still
anesthesiologist in rwanda she is still
anesthesiologist in rwanda she is still there today teaching and educating
there today teaching and educating
there today teaching and educating providing advocacy for patient safety
providing advocacy for patient safety
providing advocacy for patient safety and for anesthesia around the country
and for anesthesia around the country
and for anesthesia around the country and it’s because of her and many like
and it’s because of her and many like
and it’s because of her and many like her that I continue to work for the five
her that I continue to work for the five
her that I continue to work for the five billion in need of safe anesthesia thank
billion in need of safe anesthesia thank
billion in need of safe anesthesia thank you very much
you very much
you very much [Applause]
[Applause]
[Applause] you
”
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