 Thank you very much Tash, thank you very much to everyone, especially thanks to Carmen Martinez who is the one in charge of this presentation. So I'm going to present the innovation in mental health services in Colombia on behalf of MSF Ocuba. So then let's move to Colombia's map to see just quick about the context. So this is a Colombia map and those are the regions where MSF is working right now. This is the region where I'm going to present today. This is Buenaventura urban area. As we can see here this is close to the sea and that means that this is the main port of Colombia. 60% of the legal business is ongoing in through Buenaventura which means that for the mafia guys let's say this is quite interesting to be here in order to take the control and then it's quite tough to the population because they use severe heavy issues against the population like killing and this and that and especially sometimes they have very difficult restriction movements. So this is the reason why MSF is developing this kind of program here in Buenaventura. Okay this is some of the figures about also context in Buenaventura but then before that let's say that 90% of the population in Buenaventura are Afro-Colombian people. 60% of them are living in poverty online. So as we can see here we have 42% of them have been displaced and 48% are victims of the conflict. In Colombia this is a conflict ongoing and there are certain regions where the violence is becoming very high gear and increasing every day let's say like in Buenaventura. And this is another figure which is speaking about the context. We have from its its cage rate per 100 inhabitants is 41 which is the double compared with the national statistics. And just here just to speak a bit this is more about the MSF is getting information about the context and this one both these non-legal grounds. This one is quite tough. This is a national people who take these statistics and we bring these statistics for us. This is 19 cases but the 19 cases doesn't mean that they found 19 bodies. It means that they found 19 holes with one, two, three, four, five bodies or just pieces of bodies. So this is Buenaventura context. So why MSF is there because the violence but also people has very heavy restriction to movements by times. Okay so this is a Buenaventura game. What we are doing in Buenaventura we are providing a teleconceal therapeutic counseling through the cell phone and face-to-face sessions. So as we can see here this is A, B and C. What does it mean? It means that these are the physical rooms where MSF is providing the therapeutic as well face-to-face with psychologists and the call center is working in this area as well. So somebody is calling us the psychologist, they speak at the phone and they start either through the phone or referral the case through one of these places. We will speak later about when we referral cases to those three rooms. Something else to say that this area is one of the tougher ones so this is why we have this kind of signals that we promote the service through the radio but also our cars used to go here to promote as well the service. Which kind of service are we providing there? Mental health and psychosocial support and for the acute psychiatric cases we referral to the presciential ABC room with our doctors and also integrate medical care with the sexual violence cases so our doctors used to see and to treat patients as well in sexual violent cases. Okay so it's an innovative strategy for us. Why? Because MSF didn't develop this before and in the context it's also new. It's working 24 hours and all the days in a week by multidisciplinary team. I already mentioned psychology, social workers and medical doctors and is again teleconcelling via cell phone or face to face. Target population, people with emotional symptoms relating to the violence, sexual violence and acute psychiatric cases. Okay so what we want to answer is why I am here today. The strategy is trying to see if that new model is increases the more population especially when there is a movement restriction so if we have more people using that the cell phone let's say but also we are going to go in deep and analyze a bit more about the clinical outcomes. It's no matter only to have more people but it's also a matter of quality of the care. Okay so to answer the question about the access we will go with the data from February to December before the program started and after the program started but about the clinical outcomes we will be focused only from September to December. The results so in total is not here but in total we receive from September to December when the program started around 10,000 calls but we were able just to speak with 7,000 something but out of 7,451 we have to remove the technical problems and people who you know funny tolls or prank tolls or whatever so we will be focused just in the 43% remaining. Now target population from this 43% it was 23% who calling us target follow-ups is 36% but that follow-ups is not only to do the session with the psychologist in the phone it's also to ask for the address in the ABC rooms. Other service request is 12% what does it mean it means that has a medical organization people used to call us for medical checking so what is important for the psychologist is to do a proper assessment to see if that medical question is linked with psychosomatic complaint for example otherwise we keep the the session if no we refer to the medical service no to the national and no target calls is people who were having mental health complaints but that's mental health complaints is not relating with the violence not the sexual violence neither. Okay patients we have here 732 but we will be focused just in 565 because the rest where they knew the program through different strategies not through the radio so we will be focused just in 555 65 sorry and in the call we will keep in only 67% why because those 33% we will refer and that is important which are the criteria for us to refer to the physical room okay sexual violence because it's an emergency situation psychiatric acute cases somebody who perhaps is wanting to kill himself or want to kill another one and people who are scared to speak are also in the phone so they prefer to speak face to face so those are the more or less the three referral situations when we refer to the potential let's say then in the call so at the beginning we keep 378 but then later on we have to refer as well more or less almost half of them know by more or less the same reasons okay speaking about gender and age we have almost 70% of the population who call us female and most of them are more than 19 years old the diagnosis is just to say that the the diagnosis we follow the criteria about the DCMA 40 and R these are the psychologists who do do the diagnosis so I'm going I'm not going to spade speak about that because he's already there and clinical outcomes which is quite important also we closed from September to December 372 cases and okay here I have it okay so reason for ending treatment what does it mean it means that when we start the evaluation we do also a planned treatment with the with the client in order to achieve some some goals so if we achieve the goals we call successful treatment right now sometimes because the severe of the symptoms could be low symptoms or moderate it will be just a single consultation but also because people have to move or they say that you know I cannot come back or I can't call you back or whatever is the reason so we do also single consultation as well dropout means that the people who are not coming back anymore for us neither through the phone neither face to face but however we try to reach them how perhaps calling them perhaps asking to the family member and you know how is your peter and what's going on to see what's what is happening and then a patient referral we have here 29% most of them has been referred from the call center means that from the phone to the face to face 106 cases more or where referral now we have a big dropout no so people are not coming back anymore so this is one thing that we are going to speak a bit more now condition and exit means that how people if despite they don't come back how they finish the treatment perhaps we have here people who improve even they didn't come back for example from this successful treatment no so it didn't come back but they improve or from the dropout they didn't come back no so even we didn't close let's say in the agreement with the client sometimes they improve their symptoms using the scales rate okay so impossible to determine is almost 53% most of them are here right from those who are drop out are this figure okay so we have 258 claims who have been treating through the call center and 114 from the face to face just about speaking about the this unable to trace no we have that 81% has been treated through the call center 18% to face to face what does it mean it means that we are having very challenging in the call center about the dropout and about the improvement as well as we can see here no so the improvement is higher in the face to face is 68% in the call center is just 27% okay admissions this is to answer the question about this you know what the model is really trying more people no yeah having more people so the call center started in september and we want to compare before and after so before we were having 60 new clients per month and average and after the the new project started the new model started is 171 which means that it's really increasing on 186% so we are having more people with the new program conclusions so we are having this innovative model is helping the people for the access when they have moving restrictions and the call center is also another way to provide treatment for the population as well now clinical findings we have to analyze much better and go in deeply but keep in mind that this also a very new it was just four months which we are analyzing it's not to avoid the discussion but it's just to mention that okay even though we have to to keep in mind and to consider that we are having some challenge in the closure especially in the call center recommendation then the model could be in places where MSF is seen that population has restriction movements but but and this is very much important it's not only that people are not able to move has to be in a very safe place otherwise we put people at risk as well and perhaps they are not going to call you know if they feel that calling us is very tricky and very risky for them they are not calling us and the model is not going to work neither and we we already speak about the reasons behind dropout and we have to improve perhaps our protocols our skill has a psychologist in order to avoid a high right dropout in the call center I guess this is all