 So good morning or good afternoon depending on where you are and thank you for the introduction sassy so. As you mentioned I'm the head of public and community engagement at the Oxford University clinical research unit in Vietnam and in particular based in Ho Chi Minh City. So in the context of strengthening patient experiences and patient outcomes. I want to share an example of how we've worked to support healthcare workers as they do this as they support patients. And I'm going to give an example from a project called beyond the hospital that we conducted in a hospital in Ho Chi Minh City about five years ago. So the rationale for this project was an observation from our CNS that central nervous system. Research team that the patients who had recovered from an infection were actually often left with very severe sequelae and disabilities and then had poor long term outcome. And so although they they had recovered they although they had recovered from the infection, they were not well. And so what we wanted to do through this project was to understand the patient's needs better understand how we could support healthcare workers to better support the patients and together to develop a discharge pack discharge process and with with the aim of improving outcomes. So the flow of the project was we had a qualitative research phase and then the data used from this went on to inform the development of resource packages DVDs and some films and I'll tell you a little bit more about some of these methods but that's just a flow of the project that was took about two years. So the methods we in you, we used included sort of standard interviews and focus group, focus groups, not only with the patients but also with carers and families because in the Vietnamese setting much of the day to day care, a feeding and changing of sheets, etc happens by the carers in the hospitals, not by the health staff, so they were important stakeholder group for us to involve. But then we also use some participatory methods, which is what I would like to share in this talk and So firstly, just some of the data or findings from the interviews with patients and their carers. And it showed a huge number of challenges that they faced I mean not surprising not surprisingly, including the financial burden, the ongoing ongoing physical challenges mental health challenges and the concern that they would be a burden on the family. What came clear through these interviews was that the challenges didn't stop when they left hospital in fact sometimes they even got bigger and one one patient said it was like the hidden iceberg under the sea was that the picture that they used of going home and what else became clear was that there was a lack of support when they left hospital and that they felt very unprepared carers felt unprepared to take these often severely disabled patients home. To get overwhelmed by this slide. It's just to show you that that through the interviews with the healthcare workers also showed a huge range of challenges and stresses from them on their jobs. In the department, we felt that we were in a place to, to help them with these two, two aspects of their work that on communications where often dealing with anxious anxious patients or carers, or answering hard, breaking bad news answering questions dealing with violent patients and then going on to manage their own in own emotions and the, this is the area that we then have have worked with them. As one participant said to us 90% of the complaints coming from patients and carers were related to the communication that they had had with a doctor or with a healthcare worker. In response to these needs of the patients and these needs from the healthcare workers, we went on to conduct a number of activities with the healthcare workers, these included workshops such as working on empathy physiotherapy training because physiotherapy isn't routinely done on the wards, and then these more participatory events, such as the photo exhibition so this was a photo exhibition, a photo sorry a photo project that we conducted with patients and their family members and we asked them on return home to take photos of aspects of their life that proved challenging and to take photos of things in their life that helped them overcome these challenges what was it that kept them going what with the successes and together with the patients and their carers. They created posters with with captions of their life post post discharge their life beyond the hospital. And at the end of this small project we held an exhibition in the hospital where we invited a couple of these patients back and we invited the healthcare workers to come and look at the posters. And it was, it was a surprisingly moving experience and what we realized is that for many of the healthcare workers, particularly those on the intensive care units. They rarely had closure with patients they saw them very ill, some of these, one of the women in these photos had been in a coma for five months. When she came out of the coma, she was then moved to another ward and and the doctors who had been caring for her, never saw her up walking, and then to meet her again or to see photos of her on a beach with her family and with children was deeply moving. The only thing that came out of this photo exhibition is that healthcare workers as as is so nicely expressed in this quote. Realize that the extent of the challenges that patients were facing as they left hospital and realize that they, there was very little to support them in terms of discharge planning or resources. And then the second sort of participatory method that we used with them is participatory theater and this is based on a theater the theater of oppressed, which was developed by Augustus but while he was an active a Brazilian activist and an artist in the 1970s. And our aim and using this sort of role play in theater was to help healthcare workers understand patients experiences and to have increased empathy for them. So we partnered with a professional theater company. We drafted a script very closely based to based on the interview data. We cross checked the script with healthcare workers. There was some disagreement they, they felt it was too negative. One or two of them felt it was too negative. So we had a we had a series of reviews and developing the script together and this was actually, I've highlighted this here that it was actually a very long process. And I feel that in reflection that the quality of the script was hugely important in how much we got out of or the healthcare workers got out of the role play after that. And based on based on particular challenges that the patients and their families had identified the script had three had three stages admission to hospital during treatment and diagnosis and discussion of diagnosis and then discharged or pre discharge. So the play was put on by professional actors for two groups of about 70 or 80 doctors and nurses and we had intended to have two shows the first one for senior doctors and the second for the junior doctors and nurses because we had assumed that the junior doctors perhaps would feel less able to take part in less able to speak out if they had their seniors there but what happened in the end is because of timings. It was a complete mix. And in in line with this method of of the forum theater or participatory theater the audience is invited to stop the performance at any point and suggest an alternative way of dealing with the role playing the scene or dealing with the situation. If they're willing, they're then invited to come up and reenact a scene from their own perspective. So, on reflection, we, we really didn't know how this would, how this would go whether the doctors would would appreciate this type of role play. Overall, there was a very strong positive response to, to these workshops, the mix of the doctors didn't seem to matter in fact some of the junior doctors said they found it really helpful hearing how a senior doctor would have enacted that scene. They, there was a number of people participated. And in the feedback at the end over 90% said that they felt more empathy and that they, that they would like to have more of these sessions and they identified issues that they felt would be really helpful to try out scenarios in this sort of safe air at safe zone, and such as explaining sensitive issues dealing with conflict. And this photo here. The, the, the lady in the white coat she's actually the vice head of the hospital and she came up to reenact as a doctor, a scene that she felt could have been acted in a different way. So, the project, the project team we had a number of people on the projects. And I want to acknowledge the help it was led by Annabel audio and, and Dantana who's social scientist, and a number of other people we had a lot of input from from doctors themselves, and an advisory board including to disabled members but what I really wanted to highlight here is that we had a very strong support from the hospital directors themselves, and this has gone on to mean that there's been a much sort of much bigger impact than we had first imagined would be possible and the hospital has gone to establish a social work department and ongoing communication training for healthcare workers. And then from our, from our side in the engagement department, we have. We have really worked on developing resources for healthcare workers and then in partnership with Moana who's going to speak about this in a minute. And sassy and others at Camry and the global health network. We have created a website called the connect website and this is a website that's that specifically aimed at supporting field workers and healthcare workers, kind of the people who are on the front line. So I would encourage you. If you are a health worker or a field worker to look at this site. Please give us feedback and please use it. So that that's it from me and I would like to stop sharing and hand over to Moana.