 My name is Colonel Katherine Graff of the Joint Military Operations Department here at the Naval War College. I'm an Army logistician with 22 years of service. I have the distinct privilege of moderating today's second panel. The focus of this panel is military environments, challenges, and issues. This topic addresses the National Action Plan, objective of national integration and institutionalization, its purposes to contemplate the links between women's rights and participation and national security engagements in order to facilitate smarter decision-making in conflict and post-conflict situations. As you can see, this panel includes five distinguished members. The rules of engagement are similar as the first panel. I will briefly introduce each panel member right before they speak, attempt to keep them on time and facilitate a 15-minute question and answer period after they've all completed speaking. Our first panelist is Dr. Joshua Goldstein. Dr. Goldstein is Professor Emeritus of International Relations, American University, Research Scholar, University of Massachusetts, and Non-Resident Sadat Senior Fellow, CIDCM, University of Maryland. Dr. Goldstein is an interdisciplinary scholar of war, peace, and international relations, and author of Winning the War on War, The Decline of Armed Conflict Worldwide, which won the Conflict Research Society's Book of the Year award in 2013. Please join me in welcoming Dr. Joshua Goldstein. Thank you. I'm going to speak about the history of women in combat in 15 minutes, so I'll try to talk fast. I wanted to thank Professor Raum and the others who have organized this conference and given us the chance to talk about these interesting topics. War is probably the most gendered of human activities outside of childbirth and lactation, and throughout history, it's safe to say 99% of the combatants in war have been males, so it's a striking gender divide. And in today's uniformed state armies, about 20 million people, 97% male. In the designated combat forces worldwide, several million people, over 99% male, and as we heard, peacekeeping forces also 97% male. So this is a long-standing pattern. And I want to ask why it is that women so rarely participate in combat. What happens when they do participate? And can we explain when and where women do participate historically? Because luckily, there have been so many wars in history that even that 1% gives us a lot of experiences to sample from. So let me start out talking about the physical gender differences that are kind of obvious. And this is the big point I want to make in this talk. We talk about men are one way and women are the other way. I've already heard it several times today. As someone who lives out in the tail end of a lot of bell curves myself, these gender differences are almost always of this quality that the average of the two gender groups differs. But in fact, there's a lot of variation within men and a lot within women. Some men are even interested in gender, but most aren't, and so forth. So variation within the groups, the bell curves overlap. Let me just give you a few examples of this. Things that might be useful for fighting wars historically, being bigger, stronger, faster, and so forth. So lifting capacity, upper body strength, is one of the biggest areas of gender difference. These data are out of date. I think you'd have more overlap now. But even back in 1982, in the US Army, some women had more upper body strength than some men in the Army. And I'm going to go quick here. Height has a little bit more overlap. I've met women taller than me, but not very many of them. Speed, less difference, still an average difference. But if you stood at the finish line of the New York Marathon and watched the people come across the first 30 or 40 would be men, then comes a woman, then it's all mixed for the next 10, 20,000 people. Here's a measure of harm avoidance. In this case, what might be useful is to be on the left here. That is, not to avoid harm too much if you need to fight a war. And you see that men are more accepting of risk, but not very much. Mostly overlap in those two curves. And we get to verbal ability, also very useful in fighting wars. And in this case, actually, the curves are shifted the other way. So women are higher on the curve, but again, mostly overlap. So these are the type of differences that we find empirically. Now, two hypotheses that we can draw out of this about when women should participate if these gender differences are behind their exclusion from combat. One, when a society is mobilizing more of its population into a military effort, kind of people's war, then you should find you're sampling into the middle of these bell curves, and you should find more women mixed in. Assuming the society wants to feel the best military force that it can, which is usually an imperative for most societies, historically. And so, if you will, the GI Joe Vietnam, sort of we're drafting everybody type war, that's where you should have some women participating in the force for maximum effect. But when you get into the elite combat, very small number of warriors, such as GI Joe Extreme here, then you would be sampling way out in the tail of the men's curve, and there are going to be very few women out there. Second effect is, as technology develops, it mitigates these gender differences. So you're kind of bringing the two bell curves together, if you will. The first time this happened in a big way in ancient warfare was the use of horses, and we know that women can ride horses as well as men, because in the Olympic events, it's the one category that's gender integrated. And even Ramsay's himself here cuts a kind of a fem figure, if I will. This is not all about upper body strength anymore. It's control of the horse. It's accuracy with the bow and so forth. Then we bring in firearms later in history. This should be another big break at which women would get involved. Women can shoot just as well as men, and in fact, in World War II, the Navy was using women to train the men how to shoot. But they weren't allowed to go out and shoot those guns themselves, even though clearly they were perfectly good at it. Then we get into industrialized war and technological war, aviation, and so forth, and here these kind of brute upper body strength differences become far less important. And in fact, the designer of aircraft would rather have this smaller average woman than the larger average man, because more space in the cockpit for navigation, weaponry, less weight, and smaller distance from heart to brain. So here you should find great opportunity for women to become involved. Okay, what's happened historically, and I'm going to go very fast here. Starting in ancient times, well, this is what didn't happen. The battle of the Amazons, as imagined by Greek men, that there were societies in which the entire army was made up of women, the entire society was made up of women. There's no historical evidence this kind of thing ever existed, although our own imaginations still kind of go wild about imagining these women fighters and their possible role. What did exist was evidence of societies in which some women participated in fighting, and these were at the same time as the ancient Greeks, the Surimation tombs in which women have been dug up, buried with implements of war with them. And this has been taken as evidence that Amazons existed, not exactly. But about 15% of the women had these war implements with them, and about 90% of men. So still weighted towards the men, but with some women involved. These were raiding societies, riding horses, constantly at war. So there was a high mobilization. And then, as I mentioned, horses coming into the picture, they were fighting on horseback. So two factors that could lead to women's participation, and indeed, you find that tail of the women's curve, plus most of the men's curve. And that's how they got an effective fighting force. Okay, skipping forward, I just jumped through several categories in which women have participated in fighting. In many wars, women have dressed up as men and gone off to fight, usually in small numbers, often unknown, buried in mass graves, or go back home undiscovered at the end of the war. And this is one of those anecdotal evidences, but you keep coming across that they fought effectively, that when their gender was discovered, they were, oh, but she fought really well. And particularly brave and keeping your wits about you in combat. Those seem to be themes that I come back to again and again. Many fought in the Civil War, and there have been a couple of books out recently about women fighters in the Civil War. Occasionally, a woman fights out in the open as a female with male forces. This was the case of Lozan who fought with Geronimo's forces. And you usually hear the story there that, well, women never participate. This is what they said about these Geronimo's band, too. Women never participate in war. And you say, well, what about Lozan? Oh, well, she was a really good fighter, or she really shoots straight. Or as the commandant at the Russian Naval Academy said, when they let their first woman in, a single woman can't destroy the entire Russian Navy. It's sort of like it's an exceptional case. It doesn't really upset gender norms. And yet it's proof that some women have gone into fighting roles they can do so very effectively and increase the military potential of their society. The main place we found women fighting historically is in irregular forces, especially guerrilla warfare, the resistance in World War II, the Tamil Tigers had about a third of the combatants were women. Actually, some of my least favorite groups, recent terrorist groups that have been using women as suicide bombers. And in these cases, women have proven effective at blowing themselves up or at fighting on the battlefield, some of the Latin American, the FARC. And so forth, also have used women in these roles. And they've been effective. These are cases that do fit this mobilization hypothesis because it tends to be the irregular forces, the militias, and especially home defense militias, such as in Vietnam, Vietnamese, Viet Cong forces during that war, have tended to integrate women more into fighting roles, whereas the regular uniformed forces less so. Now, in the uniformed forces, first of all, kind of a side note, but women have historically been able to command men in battle. And there's a lovely book about warrior queens in ancient times. These trunk sisters were driving out the Chinese from Vietnam. That's an old theme. And will men follow the commands of women who are leading them? Yes, historically, they can. But at the actual level of participants, soldiers in an army, it's much rarer to find women integrated in large numbers into uniformed forces. Now, the Dahomeh Kingdom is the exception to this. And it's a very odd case because it's very important, but sort of a unique case historically. In the 19th century in West Africa, the Dahomeh Kingdom was a society constantly at war. They would go war on their neighbors, capture slaves, bring them to the port, trade them to Europeans for guns, and take the guns and go back to war again. So here's the mobilization hypothesis at work. The whole society living on war. And at some point, for reasons, there's also a couple of good books on this case, so I won't go into details, and I don't have time. At some point, the king realized that he could put women into the forces, and they would be more effective militarily. So here was a standing army for about a century, long time, with about a third women in the forces. They trained like the men. They were separate from the men in their own wing of the army, but they trained the same. They fought the same, same muskets, same ability to cut off heads, and they were shock troops. They turned the tide of battle in more than one case, and very effective in enhancing the military strength of their society, the Dahomeh Kingdom. Now, why wasn't this innovation picked up by other societies who saw that it worked? I don't know, I don't have a good answer to that. But in fact, it wasn't. And eventually, they were overrun by the French, although they were the preeminent military power in West Africa at that time, before the French finally put them down. And then we have to skip all the way forward to the Soviet Union in World War II to find another case of a regular, uniformed army integrating large numbers of women. The Soviet Union, another society, completely mobilized for war, and they integrated women as notably frontline nurses who were armed and were fighting on the frontline, but were also nursing. And one of the main things they did, which has come up in recent years in the American debate, is drag wounded men off the battlefield. Would a woman have the strength to drag the wounded man off the battlefield? It used to be this kind of clincher line about why women can't be in combat. Well, they did it in the Soviet Union, and lots of it. Women were also trained in a special school as snipers, hundreds of them, and that's pretty cold-blooded killing, sniping, and they were completely effective in doing that. And then, of course, as aviators, they had a fighter group and a bomber group. These were the so-called night witches. They were in these combustible biplanes, and they'd go out at night, they could never have survived in the day, and set up a forward base, fly a racetrack pattern over the German lines, and they'd have to slip slide in with their engines off to avoid the spotlights and the machine guns, and then try to get out of there alive. Very effective, absolutely as good as any male pilot. So that was the Soviet Union in World War II. Now, in recent years, we do have one case of uniformed women in a regular army, the Eritrean Army. They started as a guerrilla force, and so the usual plenty of women in there because it's an irregular army, then they became independent, became a regular army, and then they went right back to war again, and so then you had large numbers of women in the infantry, in trench warfare, and again fought very well in that case. And again, a case where the society's very mobilized for war. I need to add that there are societies who are completely dominated by war, mobilized to the max, and don't use women. So I haven't answered these puzzles really entirely. All right, you know the story of US women's integration recent years, so I'm not gonna really spend time on it. But the pattern that's typical of NATO countries and countries around the world now is the one that the United States has also followed, first women into combat aviation. You remember maybe the story of Kim Campbell and her warthog in Iraq, but I don't have time to tell it. And then into naval combat, then the kind of ground forces, but starting with military police, which we all know is this big loophole in the combat exclusion. And then these recent programs, the INS program in Iraq and the FETS in Afghanistan that have used women as women, sort of in this particular way, and there's lots to say about those programs, but I think others will probably talk about them better than I can. Let me just add a little story here about how unusual it is that we have 15% women in the US military that were using women in these new combat roles, and that of course we've now lifted the combat exclusion rule. This is one of the, I guess it's three women who have made it through the Marine combat training course so far. I was in Norway a couple of years ago talking with their military, and they were very cute really, like what's all this gender stuff about and what are we supposed to do about it? And I said, the Swedes know all about it, but we Norwegians don't understand it and we're getting this pressure from our civilian leaders that we have to do something about gender. As this is a room about 150 officers, almost all men, and so I was trying to use my good language and talk about force protection and operational effectiveness, and that seemed to be going over really well, but then they said that they were getting the pressure from politicians down and that the United States seemed to have been developing this from out in the field up, which I think is quite true. These programs like Lioness that were not conceived of by some political leader as some way to promote women's rights, this was just, we're out in the field, we're not, things aren't going so well, we need to innovate, which has been a major point of the US military down through the years, a strength. So I told the Norwegians like, all you have to do is just get a couple thousand people together, send them over to Afghanistan, you'll be big heroes in the United States, and you'll learn all about gender relations and how to bubble up knowledge from below, and then there was this kind of polite little laughter from the room and I guess the Norwegians still have not sent us their 2,000 people, but my request was in. Anyway, my point about that is that this is something very new historically and we can't call it an experiment, it's way past that stage, but it's a new development to have women in combat roles. We know that women can fight from the historical experience I just told you, but now we're learning it in a new way, kind of bubbling up from out in the field, and my sense is we haven't quite integrated it back home and in the powers that be and that's kind of our next task. So I'm gonna stop there, hopefully not too far over time, thanks. Thank you, Dr. Goldstein. Okay, our second panelist is Dr. Lauren McKenzie. Dr. McKenzie is an associate professor of cross-cultural communication at the United States Air Force, Culture and Language Center in Montgomery, Alabama. She received her MA and PhD in communication from the University of Massachusetts and has taught international intercultural competence courses throughout the Department of Defense over the last five years. Dr. McKenzie's research centers around the verbal, perilinguistic and nonverbal components that comprise the communication of respect across cultures. Ladies and gentlemen, Dr. Lauren McKenzie. I'm very pleased to be here today on behalf of the Air Force, Culture and Language Center, whose mission it is to help airmen of all ranks become more cross-culturally competent. We have a very robust center filled with civilians and active duty Air Force. We have retirees, we have contractors, we've got 35 people and all of us are devoted to help airmen become more cross-culturally competent. We see ourselves as a one-stop shop for all things language and culture. We in fact even have five faculty members who all look at an exam and culture from different intellectual lenses. So we have a cultural geographer, we have a variety of anthropologists, we have organizational communication scholars, I do intercultural communication. It was very exciting to be part of that effort and we teach throughout the Air Force all different levels of PME. So that's the context, that's where I'm coming from. We offer a variety of culture education products. We offer things like culture-specific field guides to dozens of countries around the world. We offer one-click maps, we offer videos that bring culture to life for airmen. And we also offer, as you can see on your far right, some online courses, specifically my course, which is the Introduction to Cross-Cultural Communication Course. One of the predictors as we all know of intercultural competence is the ability to communicate respectfully in circumstances of cultural complexity. And I have created a course that speaks specifically to that need. As we all know, an increasingly effective means for changing mindsets in regards to women and culture and respect is to offer free education. And I'm here today to reinforce the power of distance education, distance learning, to get our message across. And I want to make the argument that my course serves as a model in the Department of Defense for teaching culture education online. And I will support that claim throughout the next 10 minutes or so and talk about some of my programmatic research, looking specifically at Wiki contributions from female airmen about their avowed identities and how they've either aligned or not aligned with their ascribed identities. Also, just a little bit of background about my class here. So it's currently in its sixth iteration. It's graduated a 1,500 students today. It's offered by the Community College of the Air Force, which I think is really exciting. When you enlist in the Air Force, you are automatically enrolled in the Community College of the Air Force and guaranteed an associate's degree if you fulfill your duty. So I think that's really great and forward-thinking of the Air Force to offer that to their airmen. It's a three-credit, 14-week, introductory-level course. And it's, like I said, it's free. It's accessible. So if we want to get our message across, I think this is a really powerful way to do it. It is, of course, the biggest challenge for me when I was developing this several years ago was I had to make it self-paced. And I had always enjoyed the luxury of having face-to-face interactions with my students and bringing culture alive and communication alive in residents, you know, face-to-face. And, you know, when I thought about doing this online, I was like, oh, not another online class, right? We've all sat through those mandatory PowerPoints and online trainings. And I really just wanted to make this something different. And so that was my task that I set out to do back in 2009 when I first started. And so this course introduces the concepts and skills associated with cross-cultural communication. But each lesson, and there's 12 lessons, focuses specifically on the communication of respect across cultures in the different ways we can get at that, whether it be non-verbally, perilinguistically, verbally, through interaction, management, through listening, et cetera. And that's what the course is about. Before I get into some of the research, just a few snapshots, I mean, in some senses, the course isn't different than any that you would take in the DOD, for instance, or in any civilian university. I offer a 10 to 15 minute introductory video at the beginning of each lesson that just kind of puts this particular skill that I'm introducing into context and how it lines up with the objectives of the course. And then, of course, every single lesson after my video segues into sort of a Hollywood-style video. This is an excerpt, say, from the Hurt Locker. And you might remember the instance when the American soldier points the gun at the Iraqi's head and then in the background, you hear the other soldier saying, well, if he wasn't an insurgent before, he is now. And so I try to take instances of videos and Hollywood-style videos and, again, bringing the content alive for students. Of course, we have a variety of readings, an academic and a military-centered reading for each class. And, of course, it is free to all students. I mean, this is where the course, I think, sort of sets itself apart and how some of the data that I've been able to collect, I think it's really useful programmatically. So I have an interactive Wiki option. So, again, when you're talking about a class that is open to, say, 300 students at a time, or even up to 1,000 at some times, right, how can you get them to connect with one another? So the Wiki is just kind of a collaborative document, just like everyone knows what Wikipedia is. But I strategically place prompts in each of the lessons that ask students to contribute what they've learned in the course thus far to their lived experiences, as men, as women, as airmen, professionally overseas or at home in their neighborhood or in their own marriages. We don't have to go overseas and deploy to experience culture, right? We all know that in our own tables, right? So, for instance, this one asks, provide an example you've witnessed of effective but not appropriate or appropriate but not effective communication, because we know that competence is defined as effective and appropriate communication. And so the students, I get typically about 900 contributions per iteration of the course. So I am swimming in data, which is really exciting. And then, the exciting thing is not only can students contribute their own, their own experiences, their own, they can contribute their own stories, they can look at each other's and they can contribute to those, like in any discussion board. But then what I do with them is that I review them at the end of each semester and I turn them into situational judgment tests. So the course began with my vision of how I would teach communication and respect to airmen. But it's ended up now, when it's six iteration, it's more airmen's voices than my own. So I take these instances, these experiences of cultural complexity and frustration that they've had, whether it be in their flight and their unit or overseas, whatever, I turn them into stories and teachable moments. So this one is on just an airman that was a PCS, PCS or stationed in Aviano, Italy and his landlord, whenever you'd see one, would slap them on the cheek. And he just didn't know what to make every thought. So what I do is I create distractors, of course, along, like any multiple choice test. But the situational judgment test is a bit different in the sense that the students then get, they sort of taken down the road to show the consequence of their decisions. So they can look up every single answer and they can see why it is the best choice or why it's not in an explanation. So I'm constantly creating these situational judgment tests that are, again, from the words of our airmen. Okay, so let's bring this back to intercultural competence. And in this course, I introduced the key skills associated with intercultural competence and, like I said, specifically the communication of respect. I look at competence as being achieved when one's avowed identity. So how I see myself, how I want to be recognized, aligns with ascribed identity, which is how others see me, right? So what we want, what we want to achieve in intercultural competence is the alignment of avowed and ascribed identity, right? But how is this enacted in conversation? So you saw my title was the interpersonal behaviors that shape avowed and ascribed identities of female airmen. So which interpersonal behaviors say are predictors of respectful communication across cultures? And in my class, I introduce one framework that speaks to this question. So again, I don't look just saying at just verbal communication or just nonverbal. But as it's been shown in research the past couple of decades and in this idea of the communication of respect is that often it isn't a single instance of perceived disrespect that damages a relationship, but rather a constellation of interactional features that damages a relationship. And what I mean by, and I'm borrowing from the words of Benjamin Bailey, who I studied with at University of Massachusetts, a constellation of interactional features looks something like this. It looks like it's verbal communication. It's nonverbal, it's perillinguistic. It's this idea of interaction management, right? And taken together, right? How can this lead to avowed and ascribed identity being misaligned? So with this in mind, I created a prompt for the students in one of the lessons on identity and narrative. And I asked them to describe an instance in their career in which they're avowed identity, how they see themselves as a man or a woman did not align with their ascribe identity, how they were viewed by others in their own perception as a male or female. And so what I got and what I'm looking at and we'll describe in just a second, we're about 400 wiki contributions and this is over just the past two iterations. This is not the entire course. This is just a small sampling. And about 26% was female. That's an average in my class, 26% female and that's a bit higher than the female representation in the Air Force overall, which is that 18% as of two days ago. Okay, so I asked them to think about this and then I collected all of the different contributions and I looked specifically at 90 contributions by female airmen and I subjected the data, the wiki contributions to what's called semantic network analysis. And that's a little bit different than your sort of typical content analysis in the sense that it not only looks at frequency of words, so what words are they using most to talk about how they see themselves, but it looks at the relationship between the most frequently used words, if that makes sense. And so what I came up with was this example, this is just one of what I might call opposing dialectics. This idea that women, female airmen for instance, are seeing themselves as strong, but men aren't calling them weak, they're just perceived as not strong. They see themselves as friendly, but they're often referred to as chatty, right? And the bottom one, which is who's most frequently, is that they see themselves as Air Force and others see them as Chair Force, right? So really excellent quote unquote at building PowerPoint presentations and balancing budgets, not so excellent downrange, right? So I think this is sort of revealing of what some of our female airmen are experiencing, right? This is their avatar identity and seeing as it sort of is opposing in how they are ascribed by others. And as the saying goes, sometimes the opposite of a truth isn't a lie, but another truth. And so what we're seeing here are two truths. Bringing it back to the communication of respect, respect in an interaction is other oriented, other oriented. This implies that an individual is considered competent to the extent to which others in the interaction are attended to appropriately, if that makes sense. So if we wanna know how women want to be seen, say in the Air Force, for example, we have to look at this seriously and specifically. So what they're saying is that they are receiving appraisal respect. They are tolerated, right? They're looking at a vertical relationship here. How they wish to be seen is more recognition respect, right? And this is process-focused, occurs in interaction. It's also known in the literature as horizontal respect. And I think this is really important because if we're thinking about empowering women, I think it's really important to articulate, right? For them to articulate how they are recognized and how they would like to be recognized. I think this is extremely important to moving forward in the intercultural competence education of our total force. Because as we know, when it comes to things like, as Ms. Sonia talked about with population, right? Sometimes we may not be talking about the same thing, even if we're looking at the same thing. And I think that's a really important point to underscore here, and we're talking about respect and we're talking about the avowed identities of our female airmen. I think this is an extremely important point to drive home. In conclusion, building partnerships and building rapport begins with effective and appropriate communication of respect across cultures. And this course is one step in that direction. You can find the publications for myself and my colleagues at our website. We're at culture.af.mil. Again, this is just the beginning of the research that's been ongoing for a while now. I'll have a publication that speaks to some of what I've talked about today. Comes out in February and it will be linked here to our website. I just wanted to say thank you so much for your time. I'm so pleased to be here. And I'd love it if you had a chance to email me. I'm at lauren.makenzie at us.af.mil. I'd love to keep the conversation going. So thank you. Thank you, Dr. McKenzie. Okay, our third panelist is Colonel Ellen Herring. Colonel Herring is a senior fellow with Women in International Security where she directs the Combat Integration Initiative project. Her research and work focuses on women and gender in the military but she is presently completing a PhD at Georgetown University. She is a regular university guest lecturer and has been invited to address members of Congress. Ladies and gentlemen, Colonel Ellen Herring. Well, that was a hard act to follow, two hard acts I have to say. And I would also say that Dr. Goldstein kind of stole a little bit of my thunder here. So I'm going to modify what I was going to talk about because I was going to talk about things like physical standards and he's already said it all pretty much there. So I'm going to kind of backtrack and talk about practice. Practice within the military and practice within your own institution. And a lot of what we've been talking about so far, I think, has been really kind of theory-based, some degree of practice, but it's a lot of practice, at least from the first panel, was kind of overseas, looking at overseas. I'm going to look internally at ourselves, the U.S. military specifically because I jumped off a cliff in May of 2012 when I became a plaintiff in the lawsuit that challenged the combat exclusion policy. So with my co-plaintiff, Command Sergeant Major, Jane Baldwin, we filed a lawsuit against DOD. And that was a very, I still shake when I even mentioned that, believe it or not, in public that I went forward and did that. So in May we filed the lawsuit, then shortly thereafter, we talked to the ACLU and we helped the ACLU team develop their lawsuit because what I didn't realize is lawsuits don't really make the kind of institutional change that you hope they're going to make. There's a whole range of efforts that have to go on. When you're looking at changing organizations, institutions, cultures, and they take a long time and they take a lot of different pressure points. So the ACLU also in November, they filed the second lawsuit. It's called a companion suit. And then in January of this year, the Department of Defense lifted, and it was just as we were preparing legal arguments for our first day in court, that they lifted the exclusion. So I'm talking about this as a practitioner and I didn't jump into this thinking, oh, I'm gonna practice engaging in institutional change, but I've learned a lot of lessons along the way. And I tried to think about those lessons and record some of the lessons. And as we were kind of mobilizing a group or, well, actually after we filed the lawsuit, we began to hear from women all over the Department of Defense. They would email me out of the blue. They'd get my phone, not my phone, my email from the Global Directory. I got Facebook, or not Facebook, pardon me. Yeah, LinkedIn, I got all kinds of different contacts from women. So we thought, well, this isn't just, we've gotta do more about this. So we kind of mobilized a group of people to start applying pressure in other areas. And we had planned to have a conference in February of 2015, which we did have, but of course February 1st was right after we lived at the Combat Inclusion Policy. We had to kind of regroup. How are we gonna have this conference? What are we gonna talk about? Now the policy's lifted, but actually we had a lot to talk about. And one of the things I learned at that conference was from a Swedish Army officer who came, Dr. Robert Eggnell, who a few of you may know, and he said to us, he said, look, you've got to stop talking about this being a matter of equality. Take equality out of your lexicon. You've gotta talk about military effectiveness, operational effectiveness, military effectiveness, and you've gotta be able to articulate that and explain how changing the dynamics of the military is gonna make it a better military overall, that this is not gonna harm national security. In fact, we're hoping to improve exponentially our national security apparatus. So the next challenge was, okay, how do we say that? How do we write that? How do we make that something that people will accept? And I happened to be invited to write a paper for the Army and War College, which I did, so I decided I'm gonna tackle this military effectiveness. And so the paper is called, What Women Bring to the Fight. And what I essentially talked about is a couple of studies that I've read about, and I linked them to military effectiveness, which is collective intelligence. So teams are collectively more intelligent when they include more women. And in our case in the military, where you've got these vast organizations from the smallest squads to the joint staff, you have either no women, if you're talking about an infantry squad company, to the joint staff that still has a very fractional percentage of women. And the collective intelligence studies are pretty robust, they've been done at MIT, they've been done over multiple times over a period of years, and they consistently tell the same story. Collective intelligence is really linked to including more women in your groups. And it's not just women, it's a diverse group, it's a gender diverse group. The other study that I included in the article was, what the gender diversity studies, a number of them, but not gender, I'm sorry, diversity studies writ large, how diverse groups are collectively better decision-making groups. But then they really asked me to tackle the whole physical challenge issue and unit cohesion. So the two big arguments including women are still you're not as strong, and you will disrupt unit cohesion. And those are, well I think that the physical challenge, seeing we're already, just in the nine months since we lifted the Army, it's done a great job at doing some serious research on physical requirements for what it takes to do the different types of jobs. So MOS specific physical requirements, what do we need, they validated them through it, an extensive process with a number of research teams, and they're slowly but surely opening different MOSs as they develop the standards and make the training pipelines available to women. So I'm very encouraged by that. Then the other aspect though is the whole unit cohesion that somehow or another when women get into combat units that it's a, that's different. That is somehow or another, that's not like an MP unit or an engineer unit that somehow or another infantry or armor is so distinct and unique that we cannot include women because there's just this, the band of brothers effect, I often hear that. So I happened across, actually I didn't, a researcher, a French researcher said, well have you read the British study on women in combat? I hadn't, and she sent it. And it's the British in 2009 and 2010 were looking at considering including women in their combat forces. And they actually hired a defense contractor called the Berkshire Consultancy to go out and study this cohesion topic. Because now, you know, we've 10 years plus of war, we've had women engaged in combat many, many instances. And so they did this empirical study. It was both quantitative and qualitative. Two pieces of it took a year to do it where they analyzed units that engaged in combat, those that had no women, as well as those that included women. They used the US, we have a cohesion survey that we use. They used our survey, they surveyed the soldiers in all males, in all male units, then they compared them to male responses from mixed gender units that had engaged in combat and what did they find? I'm sure it's not any surprise to this room, but they found absolutely no difference in experienced cohesion for men in all male units who had engaged in combat and men in mixed gender units that had engaged in combat. What they did find, which I think was very interesting, was that women consistently and universally rated cohesion lower than men, yeah, across the board. So that was actually not surprising to me having been in the Army for a long time. I think we don't feel as welcome or as included, we don't feel as socially connected to the organizations that we're in, I think, as men do. So, but it was interesting to see this revealed pretty clearly in this study. So I think that's about all I wanna talk about, except I would like to end with one comment that I heard from the Ambassador this morning. She said, use your voice and power when you have it. And I really thought that that resonated for me because I didn't realize I was doing it at the time, but as a colonel, you actually have a little bit of gravitas maybe, maybe just a little bit. And so when you do something like step out and challenge your institution, some people sit up and listen, other people dismiss you, but many don't. But at a certain point in time, you have to be willing to stand up and challenge your institution, especially if you think that what you're doing is good overall for the institution, of course. And so I really liked her comment. Use your voice and power when you have it. So thank you. Thank you, Colin. Okay, our fourth panelist is Rear Admiral Thomas R. Coleson. Rear Admiral Coleson joined the Center for Excellence in Disaster Management and Humanitarian Assistance in September, 2010 as the Chief Operating Officer following a 38-year Navy career. He began in the Navy as a surface warfare officer conducting riverine salvage operations in Vietnam and served as a saturation dive officer. He received his Doctor of Medicine degree in 1979 from Indiana University School of Medicine. His most recent assignment was Deputy Surgeon General of the Navy, Deputy Chief Bureau of Medicine and Surgery. Ladies and gentlemen, please join me in welcoming Rear Admiral Coleson. Thank you very much, Mary. Thank you very much for putting this program on. And Keeley, thank you very much for getting me here yesterday. That was an effort. Right now, I'm actually at the Uniformed Services University of the Health Sciences, which has several schools. It has the Abearer School of Medicine, which is what it started with. It has the Graduate School of Nursing. We have Graduate School of Dentistry and also a program in healthcare administration that leads to a master's degree. We have several centers there, one of which is the Center for Disaster and Humanitarian Assistance Medicine, which is where I work right now. And I developed a very strong interest in military health engagement as a tool for opening doors with other countries. And that's basically why I'm here, but I want to talk a little bit, I was thinking really hard about what am I going to talk about up here, particularly with the Navy nurse, Al Schimpkis in the back, who's going to correct me on most things I bring up. But I wanted to talk about two things. One from the National Action Plan is making sure that female US military personnel to encourage and model gender integration and reach out to female and male populations and partner nations. Now that's something that the military medical departments have done for quite some time. And I'd like to relate some of our experiences with that, my impressions of that, and perhaps use that as a model of a microcosm of the rest of the military, which could perhaps look at our experience in the medical department and apply that perhaps with some other areas. The numbers of percentages of women in the military has been brought up of 15, 14, 18%. I don't have no idea what it is in military medicine, but it's a lot higher than that. And if you look at why is that, historically we had a lot of nurses, nurses tended to be women, we had a lot of doctors, doctors tended to be guys, but in the past 15, 20 years, nursing schools have admitted many more men and medicals and dental schools have admitted many more women and times are changing to the point where people really are fungible when it comes to their technical expertise. And I'll talk about that in a minute. So we've had in the medical departments of the military an opportunity to kind of live the dream of gender integration in a way that perhaps the rest of the military hasn't. And what I'd like to talk about initially is some flagging general officers that I've had the opportunity to work with, not so much to talk about their own stories, but to use them as reflective of people we have in the medical service. Rhonda Cornham, who's a retired Brigadier General from the Army. He's also a graduate of Ushu. She's a general surgeon, but in the First Gulf War, she was on a mission to retrieve some downed flyers. Her helicopter was shot down. Five of the eight people were killed on board and she survived but became a prisoner of war. And she's a very outspoken individual. I'll give some Rhonda Cornham quotes later which I will be sure that I read directly from what she said because it's always dangerous to quote Rhonda Cornham. But she is a very outspoken, very strong role model for men and women in the military. The first time I met her, she was the commanding officer of the Launstuhl Germany Hospital where all the casualties from Iraq and Afghanistan came back. And she was overseeing that process of bringing our casualties back from there. Elaine Wagner is currently the Navy Medicine East commander, a job that I had which is the commander of the Navy Hospital of Portsmouth, the Navy Medical Center of Portsmouth and all the hospitals in the east coast and the Mediterranean. She's a dentist and at one point in her career she commanded the Navy Combat Hospital in Kuwait on the Kuwait Iraq border at the outbreak of the war. The first Navy medicine flag officer, medical flag officer was Bonnie Potter who I also knew from our change of jobs once. She and another female Navy admiral, Kathy Martin changed jobs at Bethesda as a commanding officer of the Naval Medical Center at Bethesda when it was called that. The current Army Surgeon General is a nurse, Patty Horoho, Lieutenant General Horoho who has broken another glass ceiling if you wanna look at it in that regards of somebody besides a medical corps officer becoming the Surgeon General of the service. So in the medical department we have several examples of strong, extremely competent women leading. And the best example, and I get to talk about it because she's not here, which is great. She's coming tomorrow. My good friend Rocky Bono. And I really want you to read her bio because it talks a lot about who she is, but it also tells you what it takes to develop to where she's become. You don't get there because you're a woman. You don't get there because you're a medical person. You get there because you've done all the stuff she's done. And what she did was do a general surgery residency, a trauma fellowship, went to Portsmouth on staff and then led the clinical investigation department to see, oversees the research there. The animal use committee, which is a very ticklish thing to run on a Navy hospital, particularly when you're right across the river from PETA. We don't have that label in that building is where we keep the animals at Portsmouth. Then she became the intern advisor. So here is, at that point, I suppose Lieutenant Commander Bono as the advisor is a role model for the interns at a major medical center teaching program. She then goes on to deploy and becomes the chief of trauma on the pier in Saudi Arabia. Eventually goes on to command the Naval Hospital at Jacksonville, Florida, where she was the one who got to pick the folks we sent to Guantanamo Bay to do medical care down there. And we'll talk about that a little more in a minute. Did a couple other things and became the Pacific Command surgeon at which point she oversaw the health engagement for the entire Pacific and it's an extremely important role for our engagement in the pivot to the Pacific for the Pacific Command. Now, it took her 30 years to become a role model to become the first medical officer to go to the Chinese Military Medical School and give a lecture. So this female surgeon, trauma surgeon, medical corps officer, speaking to a Chinese medical school was mobbed after she spoke, asked her about this tomorrow. She was mobbed by a bunch of young female Chinese military physicians who wanna know how did she become a general? Now, if that's not being a role model, I can't help you. So I want you to read her bio because that's what it takes to get somebody in front of a medical school of a country that we're trying to engage with in peaceful ways and act as a role model. So enough about Rocky, she'll talk tomorrow. One of the things that we do in medicine, question for those of you that are in the line or around the line, a lot of you say, yeah, that's a real problem center of the medical guys or yeah, that's a real problem center of the chaplains. Did you ever wonder what our stresses are when we go out, the medical people in the chaplains? We deployed a lot of people from Portsmouth when I was there, to Iraq, to Afghanistan. We supported the medical unit down in Guantanamo Bay, taking care of the detainees, which is an extremely tense place to be. We really can't afford a mistake. And the last thing I would tell people going out the door is look, take good care of your patients and take good care of each other. And that last part really meant to say, look, nobody's gonna look after you except for you because you're the medical folks. And if you've got a problem, be it physical or mental, you're it, you're in the chaplain. So make sure that while you're taking excellent care of the trauma patients that come to you, that you look after each other because you're not gonna be mission effective to use your point if you don't. And if you want a little look into that world, excellent book by Heidi Kraft, Dr. Heidi Kraft, rule number two, is a book about her experience in a surgical unit in Iraq where she was the clinical psychologist that dealt with everybody's problems, the staffs, the patients, everybody's. And this really started out as an issue, and she'll talk about this. This is a book that she was kind of reading, writing to decompress, which turned into a book. She currently works at the Navy Health Research Center in San Diego, working with the Marines up at Camp Pendleton. So the name of the book, everybody remembers the movie and the TV series, M.A.S.H., right? Hawkeye is the hero in this book and Harry Potter, Henry Potter. That was the army, what can I say? Henry Potter was the CEO of the unit, and Henry was kind of the wise and old, experienced guy there. And Hawkeye came in, he came in to talk to Hawkeye and Henry tells him that when he went to school for commanding officers, he learned there were two rules of war. Rule number one is young men and women die, and rule number two is that doctors can't change rule number one. And that's something that the medical folks live with, and that's something we've faced with all the trauma patients that have come in for first responder care, to the surgical units, the launch stool, and back to our units. And it's very near and dear to us, and she really captures that. So the question that we were asking ourselves and that people were asking a lot of women involved in deployments around the military was what are the effects on our fungible assets, our people that we send, and what are the effects on men and women as they deploy, are they the same or are they different? And this comes down to the data question you asked. There's all kinds of opinions, and fortunately there is some hard data, and the data I would quote to you is by Amy Street and Don Bollett from the VA, the Veterans Association, I forget the name of the place, but the Veterans Group in Boston, which had two recent publications, that one of the Journal of General Internal Medicine in 2013 and another in the Journal of Adnormal Psychology in 2011, both bring the same point, and that is this, that amongst men and women, if you correct, if you control for two things that I'll bring up in a second that are leadership issues, one is sexual violence, and the other one is command climate. If you control for those two issues where people exposed to combat, the PTSD rates are the same, and the only difference between men and women is that men tend to use more alcohol than women, so command climate and sexual harassment, and the point that I was telling one of the professors here I was gonna stop the table about, that's a senior leadership issue, there's absolutely no place in the US military anywhere for that not to happen, and it needs to occur here, it needs to occur in OCS, it needs to occur in boot camp, and it needs to occur on a daily basis to take these policies that have been written about this and live it, and you don't live it by quoting the policy and you don't live it by taking, you need to take people to master to, whatever you call it in the army when you correct things, to NGAP for breaking these rules, but by using positive examples like Rocky will use, and we'll talk about it tomorrow, and other people will use about how to do your job, be part of a unit, and make sure you support each other, that's how you correct this, and it's a daily event that I would encourage the war college to, to make sure that you talk about it here. So enough of that, Sewabox. Health engagement. So, when I was asked to come up here, I was thinking, why do you want a doctor to come to a thing about women, and why do you want a guy, you know, what can I add to this? And, particularly, why do you want somebody that got involved in fighting in Vietnam in 1972, and then trying to open the door with Vietnam in about 2005 to talk with Vietnam again? When you're trying to talk to Vietnam, mill to mill, what's a safe topic? Well, you can talk about, you can't talk about flying combat aircraft, and you can't talk about using bayonets, but you can talk about preventing HIV, because HIV is a subject that affects every military in the world. It's something that affects young people between the ages of 18 and 24 and others, but 18 and 24 are largely males, who you recruit to do crazy things in your military to be very risk-taking, but you want them to be risk-averse when it comes to the things that will give you HIV. That's a safe topic. I can get up there as a US military uniform doctor and say, you know, here's the problems we were facing, here's how we addressed them. You've got an issue in the northern part of your country up in the Golden Triangle. Why don't we talk about how you're doing it? We can learn from you and back and forth. That kind of helped open the door. So health engagement is something that the military uses not as a feel-good thing, not as something that's a humanitarian venture, but something to support the strategy of the United States, the goal of the United States, and to help advance our issues around the world. Now, if we can do things that will help humanity, that's great, and that's why I asked Janet to come up because she can explain that a lot better than I can. But the issues is if you look at how does the United States project its power forward, we do it through the 3Ds. Diplomacy, which we've heard from the ambassadors, development, which we've heard from the USAID, and through defense, which occurs through the military. When the military started doing care for others besides ourselves, Dr. Goldstein said he wrote a paper in 1960s about how the army could use its medical care for good around the world, and he never got it published because he was told something along the line of, we fight wars, we don't do good stuff. Is that kind of a good paraphrase? Yeah, something like that in the 80s. Since then, soft power has taken on a whole new meaning. And then we heard, we the military heard from USAID saying, hey, what are you guys doing development for? We're out there supposed to make people develop health systems. We're out there supposed to make gender equality an issue. We're out there supposed to deal with AIDS issues through our contracts with PEPFAR. What are you guys doing in the development business? And he said, I don't know yet, we'll get back to you. And then the State Department called and said, we've trademarked the word diplomacy. That's a State Department word. You guys can't use that one. So we all got in the room and said, we better think of another word. So we use the term health engagement in the military. And that's a very good word to use because it gives you the opportunity to go work with other militaries, mainly to figure out how to talk to them about stuff. And when we think about what kinds of issues can we engage on, well, we can engage on lots of things, but why don't we look at the things that would help societies in general and see how militaries in other countries address those. So if you look at how the other parts of the world address these things, you come to the Millennium Development Goals, which the UN published in the 90s thinking about the turning of the century, figuring out how can the world develop in a rational way? What kind of goals can we put out there? So the funding agencies and so the development agencies will have something to work around that will help societies become more stable that can bring people together and will really address issues. And there were eight goals, three or four of which I think really apply here. Millennium Development Goal three has to do with eliminating gender disparity in primary and secondary education. So that's not a medical thing, but we'll come back to that. Goal four, help me, Janet, I just flipped the wrong page. Goal four has to do with under five mortality rate, child mortality. That's kind of a medical issue. Number goal five has to do with women's healthcare, improving maternal health, specifically maternal mortality, which is a medical issue, and universal access to reproductive health, okay? And a goal six has to do with three specific diseases, HIV, AIDS, malaria and tuberculosis around the world and other infectious diseases as a catch all. So if the development agencies are working on these, if we, the military folks are going to work with other militaries and we want topics to talk about, we're gonna talk about things like combat trauma care. Now that helps the military, but it also helps strengthen the health system of a country that needs surgical capability. And if you wanna talk about maternal health, one of the issues in many countries is that many birds go unattended by skilled birthing assistance. And in many countries, the ability to do surgery in provincial hospitals does not exist. There are civilian NGO organizations working on this. And if you can do surgery in a provincial hospital, you could do a C-section in a provincial hospital that will save lives during the birth process. So indirectly, we affect that one. More directly, if we look at child mortality, okay, now why do kids under five die and why do kids under one die in many countries? Infectious disease is a big one, rehydration, malaria. The military has overseas labs that are focusing directly on malaria, not so much because of child mortality, but because we send troops into malaria's areas around the world and we wanna protect ourselves. But the techniques and the capabilities overlap. There's another good area. Lastly, HIV, I'll approach that for a moment. Everybody knows about the PEPFAR program, the President's Emergency Program for HIV, AIDS Relief. There's a military piece of that called the DHAP program, the Defense HIV and AIDS program, which is run out of the Navy Health Research Center in San Diego. And what that does is work with militaries around the world for the same process that I was talking about in Vietnam. We wanted to talk about how to prevent HIV in foreign militaries. This is largely a program in Africa, as you might expect. And it works hand in hand with the PEPFAR program because militaries, if you look at most militaries, are mobile populations. Mobile populations tend to become HIV infected because of their proximity to the disease, because of the behavior when they're away from home, and they bring these diseases home. So there's a very close overlap. Same with malaria. In some countries, Indonesia and Burma, for example, the militaries will deploy from their home base into areas where malaria is endemic. They'll come home, the mosquitoes in that area don't know the difference. They bite that deployed service member and affect the family. So by affecting diseases in the military, we can overlap with what's going on in the civilian sector. We've been very successful with this and we've tried over the years, we, the military, have tried over the years to become more sympathetic to others in the business of looking out for disease around the world, specifically USAID. And the two people here today are from the USAID office of military affairs, is that correct? And that office, did that always exist or is that fairly new? 2005. So that's after the discussions between the DOD and USAID about how do we stay out of each other's way and how do we collaborate? And today, and most of the, yeah, it's ongoing, but we're way ahead of where we were a few years ago. And most embassies today, the DAT, the Defense IDSA and the OCD, the Office of Defense Cooperation and the USAID officer, at least the embassies I've been in are much more on the same page than were in the past when it comes to at least health engagement from the military and health processes from the civilian sector, the USAID overseas. So there's some thoughts. When Admiral Bono comes tomorrow, I really ask you to listen to her. I really ask you to challenge her on what she's done and how she got there and how she has become such a strong role model for women in military medicine. And you can ask the others that you see in your own services when you get there. Again, I think that for the rest of the services, I encourage you to look at the struggles we've had in medicine about how to get where we are at the way we have forward and what we found out about our own stresses. I promised to talk about Gitmon, I'll do that really briefly, and this comes back to fungibility. Taking care of detainees in Guantanamo Bay is not something you wanna read about in the New York Times. And you're gonna read about it in the New York Times if things go bad. So when it came just time to send somebody down there to do something for a detainee that was a medical issue, we found the best person we could find clinically to deal with that issue and then we kind of build a team around that person. So when we had to deal with things in the cardiothoracic surgery world, we picked the best cardiothoracic surgeon we had a proportionate, then we sent him down there, turned out he didn't need to do anything. When we had a neurosurgical issue come up down there, I picked the same doctor that operated on my back and I asked her to go down and see if she would be able to deal with this. So we just sent a message to the detainee, the best neurosurgeon we happen to have in the military on the East Coast is a woman whose name I won't bring up here since you're taping it. And she's gonna operate on that on you. And if that's okay with you, we'll do that. We substituted clinical capability for a little bit of cultural talents on that piece and I think you got better care because of it. So thank you very much for listening and thank you very much for letting me come up. Thank you, Admiral. Okay, our final panelist. Our final panelist is Ms. Janet Fleishman. Ms. Fleishman is an independent consultant on women's global health issues and is senior associated with the Global Health Policy Center of the Center for Strategic and International Studies where she focuses on women's global health and United States policy. She worked for Human Rights Watch for 20 years and is a frequent speaker on issues related to gender and HIV AIDS, women's global health and US policy and she has testified before both the Senate and House Africa subcommittees. Ms. Fleishman. Thank you all. And I'm going in quite a different direction than the rest of the panelists but I wanna thank you all because those were very interesting presentations but when the Admiral calls, you come. So that's why I'm here today and I appreciate the invitation. And I wanna look at this from a different perspective to look at why does it matter? Why do we need to address the needs of women and girls in humanitarian crises and conflict situations? What is the benefit of it and why is that important at this stage? And let me start out with a bit of an anecdote when I was in Zambia earlier this year and I was speaking to the First Lady of Zambia who is herself an obstetrician, gynecologist and a champion for women's health issues and she really articulated the importance of looking at women's broader women's health and empowerment for the benefit of the countries and in this case for the missions involved. And she said, quote, at the end of the day mothers and women make the difference. Whatever you do should be women-centered. It's the cornerstone for every country. And I think the reality is that over the past several years we've seen that US policy makers have also increasingly recognized that advancing women's global health and gender equality is in fact one of the most pressing challenges of the 21st century. There's a growing body of evidence that demonstrates that investments that focus primarily on women and girls and we're talking about maternal health services, voluntary family planning, access to HIV services, education for girls, economic empowerment for women, preventing and responding to gender-based violence. These are not only critical to improve health outcomes but they are actually producing substantial positive results in terms of poverty reduction, development and economic growth and that's why it matters to the US. We know that security is essential for long-term development to take place and that development is critical if security is gonna be sustained. So all of this gives you a sense of why even in this difficult budgetary environment as former Secretary of State Hillary Clinton used to say investing in women and girls is not only the right thing to do, it's the smart thing to do. Let me run through just a little bit of the data that supports this because I think it's important to realize we're not just asserting this but this is really shown to be critical as a key part of development. In the World Bank's 2012 development report, they said that gender equality is a core development objective in its own right but greater gender equality is also smart economics enhancing productivity and improving other development outcomes, including prospects for the next generation and for the quality of societal policies and institutions. And they came forth with some very compelling data about noting that if barriers that discriminate against women working in certain sectors and occupations were eliminated, labor productivity would be increased by some 25% in some countries. When you look at issues of violence against women and children, we see the strong ties between the experience of violence as a child and negative long-term consequences. There is an organization called Together for Girls that the US government participates in. They did surveys on violence against children in a series of countries and they've estimated that in the participating countries an estimated 30% of girls and 10% of boys had had an unwanted sexual experience before the age of 18 and that girls who experience abuse as children are up to twice as likely to be HIV positive in the future and boys are more likely to practice high-risk behaviors and are at high risk to become perpetrators as adults. The issue of family planning, voluntary family planning to reduce maternal and child deaths, it's extremely cost effective. The investments in voluntary family planning significantly improve maternal infant and child deaths and avert millions of unintended pregnancies and abortions. In fact, cutting maternal deaths by increased contraceptive use has cut maternal deaths by 40% in the past 20 years and if we were to meet the unmet need for family planning which is estimated to be over 220 million women, we could reduce maternal deaths by a further 30%. It's also one of the most cost effective investments a country can make. And finally on the issues of HIV and AIDS, we know that there's a disproportionate impact of HIV in many countries around the world particularly in Sub-Saharan Africa and that the US policy goals on reaching an AIDS-free generation will not be achieved unless we really target programs to meet the needs of women and girls. HIV is the leading cause of death and disease in women of reproductive age. In Sub-Saharan Africa, 60% of those living with HIV are female and young women between the ages of 15 and 24 are infected at rates on average three times higher than males their age. And PEPFAR itself has said that these many girls are forced into sexual activity in marriage at very young ages and are extraordinarily vulnerable to unintended pregnancy, HIV, sexual violence and exploitation. So that's just some context for you. Let's look for a minute at what does this mean for humanitarian crises for conflict situations for post-conflict situations. It's imperative that plans for humanitarian interventions are done with gender dynamics in mind before they start, not moving the goalposts later on. They has to be essential to the effort to protect civilians and to manage conflict and we've seen in conflict after conflict over the years how critical this is. Humanitarian crises, whether the armed conflicts such as we're seeing in Syria now or the Central African Republic or natural disasters like the Philippines now have a huge impact on women and girls and they present enormous challenges to address their needs. The reason that it's so critical to address their needs is that they are front and center in the response in these conflicts. Women and children represent some 75% of refugees and internally displaced persons, IDPs. They're highly vulnerable to violence and other abuses during emergencies and these abuses include forced displacement, targeting and punishing of women because of their own activism or the activism of their male relatives, the drive toward forced marriages and child marriages because of instability and lack of security for girls and young women, increases in domestic violence and sexual violence committed by both civilians and combatants, lack of access to food, shelter, healthcare, interruption of education and sexual exploitation and trafficking. In many zones of conflict around the world, women and girls are deliberately targeted and attacked often with impunity and forced displacement associated with crisis and conflict exposes them to particular risks of violence and exploitation. Violence against women as we know, especially sexual violence including rape, sexual assault, mutilation, forced prostitution and sexual slavery is increasingly recognized as a facet of recent conflicts from the Balkans to Rwanda where rape was actually a weapon of genocide. Sexual and gender-based violence in these situations of extreme conflict have become a deliberate tactic for purposes of humiliation, terror, societal destruction and ethnic cleansing. In other situations, sexual violence is opportunistic by both civilians and combatants and in places in post-conflict where war has come to an end. They are often plagued by the violence and insecurity, the lack of the rule of law, breakdown in what's left of health systems and these can contribute to also high rates of domestic and gender-based violence. Evidence shows that violence against women can be in fact a primary indicator of a nation's stability and security and its propensity for future internal conflict. So let's look quickly at some of the issues that are of primary importance, the question of reproductive health services and services to address and prevent gender-based violence. These are two areas that are always increasing in times of conflict. In the reproductive health services, we're talking about anti-natal care, assisted delivery, emergency obstetric care, all of these become unavailable. Access to family planning services, of course, become interrupted. Young people often are more vulnerable to HIV infection and sexual exploitation, unwanted pregnancy in perilous conditions because of the lack of access to family planning services. One of the things that needs to be therefore included is the minimum initial service package, MISP, for reproductive health in crisis situations. There's a package of services that's been well-defined and is really important to implement at the beginning of these crises. I think it's also important to note that there's been progress. The Department of Defense has dedicated staff for addressing gender considerations in certain instances, involving sexual assault prevention and response and combating trafficking in persons. AFRICOM has a working group on women, peace and security. The US Central Command has established some gender advisors, the Marine Corps female engagement teams, DOD's Defense International Institute of Legal Studies has been providing training to the Congolese military on preventing and prosecuting gender-based violence. We've noted the number of peacekeepers around the world and there are almost 2,500 female peacekeepers participating in peacekeeping operations around the world and the training that goes on for them and for their male counterparts is extremely important. And the military's involvement in HIV has become very important as it seeks to engage particularly with African militaries on HIV care and treatment and the broader civilian services that tend to be associated with that. The US military is also involved in helping to develop effective accountability and transitional justice mechanisms that address crimes against women and girls and other civilians. And this points to the importance of engaging not only broadly with civil society but specifically with women's groups in these countries. And as an outreach and gender specialist at AFRICOM put it, some people think it's just a feminist agenda but when people understand that it's about engaging over half the population to enhance human security, that's when the light bulbs start to go on. The US has also responded recently in terms of under Secretary of State John Kerry. In September he announced a new initiative called Safe from the Start. The program will allow the UN High Commissioner for Refugees, the ICRC and other humanitarian organizations to hire specialized staff and launch new programs to develop methods to protect women and girls at the outset of emergencies. We've seen however in the Philippines so far that we've got a long way to go. These, as much as we know that these things have to be put in place, we are still struggling to make this work. I wanted to say a few words also about the links between gender-based violence and HIV because there's, we often look at these as dual epidemics that both exert a destructive and disproportionate impact on women and girls. They are also mutually reinforcing epidemics. Gender-based, the threat of violence or violence itself often leads to HIV infection or complicates one's situation after being infected. It's also an area that's worth noting that's been of a lot of, there's been significant bipartisan consensus around the importance of looking at gender-based violence as one of the aspects that has to be looked at in terms of HIV. PEPFAR itself has launched a new initiative on gender-based violence and HIV, starting in three countries, Tanzania, Mozambique and DRC, to look at ways that both from the facility level and the community level, PEPFAR resources can be used to more effectively address HIV and GBV together. Violence, even PEPFAR recognizes, is a risk factor for HIV as well as a consequence of being HIV infected. Country studies show alarming levels of physical and sexual violence against women and girls and women who experience violence face four-fold higher risks of HIV and STIs. I think we should understand that there's, this is an important moment when there's been much more attention to the issues of women and girls and the U.S. policy agenda. The first term of the Obama administration really highlighted this, particularly with the, under the tenure of Secretary of State Hillary Clinton, and many new policies were brought, were designed to address these issues, particularly gender-based violence, but also as you know, the Women, Peace and Security and a range of other policy initiatives. Now the challenge is implementation. And I think we can look, take this moment, this new threshold of commitment, and say what are the next steps going forward. There are deep uncertainties in terms of the funding as we know, but I think the fact that there has been bipartisan consensus and some very important data out there about gender-based violence, about the importance of reproductive health, about the links with the importance of addressing women and girls in the context of HIV AIDS programs really is helping to move this further down the field. It's also critical to look at what is the level of country ownership of these issues on the ground. How are we reaching out to governments, to civil society? How are we investing in the capacity in the countries to address these issues? And the truth is we need to demonstrate success. We were talking about data before and what works, and we need to be able to show if you put these programs in place, what's the difference? What's the added value? We need to be documenting this and really proving the effectiveness or changing the designs and figuring out how best to reach women and girls and to engage them from the start in the design and implementation of these programs. If you're building a, if you have a refugee crisis and you don't involve the women and you put the latrine somewhere far off in the dark where there could be vulnerable to abuse or if they have to collect firewood far away or water, those are the kinds of situations where they're very vulnerable to abuse and exploitation. Where they, where feeding centers are located, the way education is structured. There's a whole range of ways that we've seen this time and time again and yet we still don't do it right. So we really need to learn the lessons of so many of these conflict situations and put these things in place from the start. This includes making sure that these issues of women and girls are central to intervention, planning and involving women in decision making about the design and implementation of these programs. It's about effective and appropriate security, creating safe spaces for women and girls in these situations. It's about building local capacity, particularly women leaders, women civil society organizations, women who are involved in leaders in their communities and refugee situations or others. It's about how we train security and police forces. How are they taught about women and girls? Are women recruited? Are there incentives to recruit them into police and security forces? Because in certain ways they're not fungible and a woman reaching out to women in communities, whether it's in Afghanistan or Liberia or anywhere, can be a very different kind of intervention than a male officer doing that. And obviously we have to use the best resources that we have available. And we have to implement what we have. We have to implement Security Council Resolution 1325, the National Plan on Peace and Security, the very important policies on gender-based violence, the minimum initial service package on reproductive health, and the broader gender policies that have been designed and promulgated by the first term of the Obama administration. So there's a lot to do, but I think there's been very important lessons learned, and this is a really important moment to move forward and actually implement what works. And I think in the end of the day, the military has a very interesting opportunity to make sure that we can be building on past US investments in these critical areas, that we look at this package of services, of maternal health, of family planning, of HIV, of gender-based violence, and work towards sustainability by strengthening these partnerships on the ground and leadership back in Washington. So, thank you. Thank you, Ms. Fletchman. So that concludes the second panel. The panel will happily entertain any questions.