 You've heard from some of the experts what we need to do. But the biggest problem is the how we actually do it. Getting implementation has been particularly difficult. And from my point of view, if you want to know why we haven't done it, it's because we really haven't convinced the majority of health care professionals that this is something that they should do as part of their day-to-day work, not something special. So what we're going to do here is we're going to go to the experience of the learners. And Luis is going to help me with this. Because the other three couldn't be here, they're going to be on video. And I hope it'll work that we can get the stories. But I'm first going to start with Luis and ask him why he applied in the first case to do the program. Well, first of all, thank you for the invitation. I'm Luis Torres Torrija. I'm a physician and a quality improvement specialist in Mexico. And why apply? First, there are two moments that took me to this part of the fellowship. First, during my medical training, I was involved in a medical error that caused the death of a patient that was crashing for me. And I thought about quitting my dream to be a physician. Thankfully, I got the support. And I took my efforts to improve patient safety. The second moment was when I had the opportunity to work in one of the best hospitals in Mexico, that is Hospital Español. We aligned with the action of evidence-based practices. And we implemented it. And that's why we started with the collaboration also with the support of Javier Davila to really work in improving our processes. I saw the publication of the Patient Safety Movement Fellowship. And I didn't think I'd apply. And I was honored to be selected with four other excellent professionals, Evie, Samar, Liz, Carl, that he wasn't able to finish and me. That's great. Thanks. And now you know why. So let's go and see what Elizabeth Nyaga from Uganda has to say. So I can have it turned on, please. Hello, everyone. My name is Elizabeth Igaga. I'm in Uganda based in Kampala, Uganda, and an anesthesiologist by training. I'm one of the inaugural fellows of the Health Care Safety Fellowship with the Patient Safety Movement Foundation. Health care safety and patient safety are frequently overlooked and yet they are a highly important part of medical care. We have about 5 billion people worldwide who do not have access to safe surgery and safe anesthesia. So it is important that as a global community, we continue to focus on not only volume of surgery, but also on the quality and how safe surgery being provided is. So this fellowship for me helped me understand the different systems and the reasons why some of these interventions, one, are not paid attention to, but also are not working as well as we think they would. It put a lot of moving parts into perspective for me and also provided some pathways to solutions for the patient safety and health care safety problem that we have in my country. So that is Liz, who unfortunately couldn't be with us. Any comments on that? No, I completely agree. Like the question is why not we have more professionals training in patient safety? Why do not have health systems with incentives aligned with patient safety? And how they say local is global. And even though we are from different backgrounds from different cultures, we face similar problems. But also we face or we have the similar goals to improve the health being of our patients. So you also heard just before the break from Ted Ross that the biggest burden is in lower middle income countries. And the fellowship is targeting people from the lower middle income countries, even though we do have from upper income countries this year. But the main thing is to spread learning across the world. So let's see how we do it. And I'm just going to see if Samar's going to come up next. Oh, no, it's Abby first. What? Sorry. My name is Dr. O'Connion. I've become a public health physician and program manager by the state ministry of health here in Nigeria. It was a great opportunity to learn in the health care safety fellowship program over this period of one year to understand that medical error is one of the leading causes of death globally and also to learn that harm can be measured. And it gives us the understanding that whether our organizations are safe today and we can be reliable and be safe for health care tomorrow. Harm does not occur intentionally. So the health care provider is also a victim of harm. And providing leadership will provide safer care for all of us. Thank you. So Abby is a leader in Nigeria. And his main area was to try and improve reporting of safety events in his region, basically. And the key thing about what people learn is that some start from ground zero. They know nothing about patient safety. They learned about it. They wanted to learn when they applied. Others are more experienced when they come along. But the intent is to have a very broad view of patient safety rather than how do you respond to incidents to really take a proactive view of looking at how one can design health care systems. So for example, the next session, which is in 12 days' time on human factors, I think the human factors people are very happy to know that it's a core part of the program. And it's really trying to take things that are more complex and make them much easier and rather have a view that this is what we can do in an up-and-coming country, but say how can you apply this in a resource stretched and poor country in which you do not have the resources. You don't have the nurses to do everything you would like them to do. So you have to think out of the box to apply it very differently. Do you want to comment on it a bit quickly? Yeah, totally. Like the fellowship journey has been really enriching. We were empowered participating in webinars, in panels with experts. And even to be here sharing our experience about the fellowship. And if we can resume in three important aspects that we learn, we can say that the part of the knowledge and skills through the best practices, through the latest publications related to patient safety, how we work, how we discuss during the different sessions, the second point, the collaboration and networking. We are a multicultural group. And with that, we share the different situations that we have and the possible solutions. Also the faculties, we do not have like a student and professor background. It's more peer to peer because they also share the same vision. And they can give us their experience. And the first one, the leadership, the communication, and the empathy. And that we applied it through the project that we did through the fellowship that the faculty have been supporting with us. Step by step to make the proper changes that we want to do in our country and in our organization. So we're listening. Now the last person is Samar Hassan, who's from Jordan. And she works for an accreditation body. And she was really keen in seeing how antimicrobial stewardship was applied in her country. But here's her bit on learning. So we've learned by interact with discussions with experts around the world, by sharing experiences with our colleagues in the fellowship, by reading a lot of evidence-based and updated research, and also by applying the knowledge within the context of our countries. So a lot of what we do is, or how it works, is that there's a monthly meeting. In between the meetings, there's a set of reading that people have to do. And I update them so later. So I will be constantly updating what they have to read and what they have to learn. They are required now to provide reflections of what they've learned. So not what did you learn, but so what? What are you going to do about what you've learned, which is even more difficult for doctors and nurses to learn about really reflective practice. So they're learning about how to reflect and how to make a difference. And there are 12 sessions. I'm ably supported by a number of volunteers who, mainly from the US, who will lead the session. But the main learners are the learners. They lead the session, they have to, one of them will take the lead, summarize what's learned, and then apply it. And as you can see, we have Mexico, Jordan, Nigeria, and Uganda. Each have got a different background, different environments, and therefore they're learning from each other. The most important thing is that we're learning from them. So it's very humbling as someone from an upper-income country to learn at how people are solving the same kind of problems when they don't have resource. And whenever I work now in Ireland and the UK, and people say, we don't have enough resource, I say, come off it. You need to go to Sudan where I was last weekend. You can see what no resource really means. So this is something that's good learning. We really appreciate it. But that is the theory of them. Tell me about the group of the community, briefly as we come towards the group of the community that's developed. Well, it has been a really good group, and I can quote Liz of one of the reflections that we have during the different sessions that is that the more we learn about patient safety, the less we actually know. And I don't know if that makes sense, but the reality with the reflections, it opened our eyes about the complexity of the healthcare industry, about the different approaches that has been in place during these 20 years, really to rethink if that's what we need right now and to really change our ideas and paradigms about the healthcare where we're still thinking that we need perfect professionals for imperfect systems. So that kind of reflections is what we have. Normally these kind of sessions, we got more questions than answers, to be honest. But I think that's the first step and understanding all the different cultural, social and different backgrounds that we can have as a fellows. So as we come to the end, the final thoughts that Louise has just given you some, this fellowship program, this year we have four learners, one from the UK, that's Mel Woodfield, one from Brazil, Natalia Camargo, Manel Yunus from Iraq, and Frank Kitonga from Kenya. Just say another needed test. Seems quite popular to track the needed tests. But they are learning together and it's quite interesting this mix that we've got this year which is very different from the previous year. And we just put an advert out for next year which starts, which is out now and closes in July. The key thing about this from the Patient Safety Movement Foundation is that this is offered to the learners for free. So they just have to give time. I think that's the most cost, that's their cost, giving up their time. And it's actually becoming more time than we had previously because each year we learn and this is the second year of the program. And the idea is to build the future workforce in countries that require expertise in patient safety. So we would like your support, we'd like to advertise it but my last thing to do in the last minute or so is to give out the certificates and now Louise is going to take all four certificates. So we'll start with yours which I believe is the bottom one if I've got it right. So yeah, that's it. So here's your certificate Louise and congratulations on completing the program. Thank you. And of course it's lifelong learning because fellowship is if you know the Lord of the Rings and you go on a fellowship never ends. So it never ends. So all these fellows can join ongoing learning because even if they learn about human factors again next week and they heard about it last year they're never going to stop learning because it changes every time. So just to give the last two, this one on behalf of me is for Liz. So you can have to open them all up, everyone go. See if you can manage that. This is for Ebi. It's got a much longer name. Ebi Kapaie, if you're recording maybe it's easier. And the last one is DeSamal. So Louise, would you give them off to them? Thanks very much. And yeah, and so finally I'd just like to thank the Patient Safety Immune Foundation for this great idea and for agreeing to continue doing the fellowship program. There are not many of these that are available for people in lower middle-income countries. We often take these things for granted learning opportunities but this is something now that is one of the bonuses of COVID that online learning is much easier than before. So thanks very much. Thank you. Thank you so much.