 So our next presenter is visiting from Indonesia from the University of Kajamata which is about an hour away from Jakarta, the capital of Indonesia, Dr. Dhani. He's a neuro-ophthalmologist there at the University of Kajamata and he's gonna be presenting on a project that has interested him because he's particularly interested in medical education and outreach. So this is a project where he went out and met with local farmers to educate them about pesticide use and the ocular disorders that are encountered with certain pesticide use. Thank you. Good morning everyone. My name is Dhani. Actually it's weird because in Indonesia it's common people have a single name so my name is Wydian Danna but you can call me Dhani, that's my nickname. I come from Indonesia and this is our study and our services in the community. So it's about pesticide exposure and ocular disorder in Nga Blak Village Central Java Indonesia. So I come from Indonesia. It's a 29 hours flight with full transit so it's quite far from Utah. This is the situation in Nga Blak Village. It's a very nice village in the high light. So the weather is nice. It's not so cold like here. We have no snow in Indonesia. So still people have vegetables, they plant vegetables and also tobacco in this village. So most of them are farmers. They work as a farmer and this farmer has a habit that really makes us care about their healthy status. It's about using pesticide without protection. So they're unprotected because they have lack of safety equipment. There's no Google, there's no idea how to protect their self in the village. And they use semi-modern tools so they have mechanical spray tools to use to spray this pesticide to the plants. And they consider about the cost also because it's quite expensive to buy Google hand gloves and the coat for the protection. So this is why we think this farmer never uses that kind of protection when spraying the pesticide. If we read the literature we can see that ideally, ideally they use this kind of protection. But usually our farmers, they only see the wind. So when they saw that the wind direction is go that way, they spray this way. So it's very traditional, but they use that kind of technique almost every day in that village. We can see that the pesticide actually able to penetrate our body through the skins and this is the area that really gets influenced by this pesticide. Especially the Kanita area is 100% penetrated, which is very dangerous in this area and also in this area in the head. So this is the reality in Ngambla village. They use this kind of protection only for the sun. They're not even thinking that this is also protection for the pesticide, but they use it for the sun. But actually the ideal protection should be like this. So in the village of pesticide, it can penetrate from the skin, the eyes, inhalation, and ingestion. So the publication before, they said that they have effect of the pesticide. It can be depression, neurological deficit, diabetes, respiratory disease, and also cancer. So we formed a team to go to this village. So in this Ngambla project, actually it's a multi-year project, you know, starting this project. It's combined research and health services to the community. And the aim of this project to educate farmers protecting their self when using pesticide, to collect the data about neuro-ophthalmological disorders and possibly image related to this exposure. So the team consists of dermatologists, neurologists, and also ophthalmologists for this first year. The methods we give training to the cater and the communities conducting a free observation, giving free personal protective equipment and eyeglass, and also free medical exam and medicine, and also free cataract and the gym surgery. So we take the data from this free medical exam. The participant for our first medical exam, we have like 280 persons visit our camps, and we have 164 male and 117 female farmers. And we have this in the age, most of them between 18 to 16 years old, and some of them above 60, and there's only minor number for below 18. For the vital sign in general examination is normal, most of them. For the past medical history, we got that, but not many of them feel the questionnaire. So we only have this kind of data that some of them have hyper-cholesterol, some of them have diabetes, and some of them have hypertension, according to their answer in the questionnaire. But only one person, two person had this kind of hypertension through hetero-minus cerebral inspection. For the habits, we see that this smoking habit, only minor number filled the questionnaire, but I'm sure that some of them have this habit. And coffee, drinking coffee, some of them, most of them have this habit, analysis used, and also other medication. For the peripheral protest that we got from the data until now, we see that from this result that 20 of them have abnormal blood glucose, uric acid, you can see that it's quite big number, and cholesterol also 37 in the number of the patient that have this cholesterol high. So about the exposure itself, we can see that most of them using this pesticide, one or twice per week, and some of them more than twice, some of them less than once. For the onset using this pesticide, you can see that more than 10 years most of them, so 88 farmers use this pesticide, spray with that kind of unprotected equipment, is more than 10 years, is 88 farmers, and some of them is below five years, and you can see this data. So it's quite long exposure. So this is the pesticide they have in general, and you can see from this pesticide, and we see the ingredients and the content, and the demolish is the most dangerous item. It's 18 grams per liter, adequate evidence of clinical science of central nervous system toxicity. So this agent is very dangerous, but the other is not so dangerous. From the eye examination, you can see the data below, but the palpabra, conjunctiva, cornea, camara, acrylentaria, iris, RAPD, and vitreous that we saw from this patient that we saw that less than 1% eye abnormality occurred from this patient. So it's not a big number, but we're not sure actually. We would like to gain more data about this. It's all abnormality. So it's still raw data. So we will see again the exposed, we're related with the issue or not. So we're still not sure about this. But the visibility, some of them have a problem with the visibility, but actually this number, actually, because they are early people, so they need a reading glass. And the lenses, you see, this is 7.2% abnormality. This one is for the refractive error, actually. So because this team is not, not all of them is ophthalmology, so they write like this. For the easy error and contrast examination, we can see that 1.6 abnormality for the easy error and around 9.4 abnormality for the contrast test. For the eye disease that we can diagnose from this patient, we can see that we get 7 cataracts in that moment, and we already give like a social program for this cataract surgery. We have one conjunctivitis, one exotropia, so it's small number, one glaucoma, one hypertensive, retinopathy, and it means that refractive error. But there are two patients, and this will be two patients with high myob, one patient. So actually this number is not so high. So we can see that in the literature that a long-term ocular exposure to pesticide can affect the conjunctiva, cornea, iris, lens, retina, and the optic nerve result. So the Kachamada initiative now, we try to implement this project. It's actually a three-year project. We implement this research. We develop this flip chart. We give them protection for the community. We try to educate people that it's dangerous to use this pesticide without protection. We try to get some cheap protection for them, for example, this good and face mask and also Google, and also they can use actually raincoat to protect their recipes. The raincoat is not so expensive actually. Thank you very much. This is my presentation.