 Thank you very much, Kiran. Can you hear me? Good. I like these microphones. Usually I'm so short I need a box, so this is great. First of all, what a pleasure to be here. One of the things that's not in my bio is that I owe a lot of what I am today to MSF. In 1999, as an obstetrician and gynecologist in private practice, I felt really useless. I felt that, you know, with all my skills and my knowledge, that there was a whole world out there and so much conflict that, you know, I wasn't doing enough. And so I actually turned around to many organizations in my country, Malaysia, and asked, you know, is there any way I can volunteer to be an obstetrician in Kosovo for six months? No one replied. And then I reached out to MSF in Australia and Hong Kong and they said, look, send us your CV and so forth. Well, I didn't join MSF but I started my own organization called Mercy Malaysia and led that for ten years. So you have always been my inspiration and so I just wanted to say thank you for that and I'm here today because you inspire me. So I also want to say that it's such a pleasure to deliver this keynote and when I was talking to Sarah about this and, you know, one of the things she said, please engage with us on community engagement and accountability. So let me start by, you know, what we might be thinking about today. Like some of you, I'm thinking about Ebola over the last few weeks and the situation in DRC. And, you know, while at the Federation, which is really a secretariat, I work in the secretariat that oversees 190 national societies all over the world and believe it or not, 165,000 branches and 17 million volunteers. So we've been making sure our volunteers on the ground have the training that's required to support community response. I can't help asking myself, have we learned the lessons of the Ebola crisis three years ago? Is there a widespread? If there is a widespread outbreak today, will we do a better job? And we must hope the answer is yes. One of the single biggest lessons that came out of the Ebola crisis in West Africa was the indisputably seminal role in humanitarian work of local community engagement. These days it seems you can't pick up a newspaper without reading about a vision of a localized response to humanitarian aid. A vision where local realities drive humanitarian work, not predetermined response frameworks dreamed up in New York or Geneva. A vision where humanitarian action is more effective because it is shaped by and responds to what is actually happening and not what outsiders like us might be thinking. But three years ago, there was limited genuine understanding of this. We all learned the hard way, MSF, the Red Cross, the UN, all responders. And the lesson was simple. If you do not take the time to understand the concerns of the people whose doors you knock on, you will probably get it wrong. And I was really encouraged by the discussions before lunch. And I think it's fantastic that you have anthropologists in MSF. And I think, you know, looking at, as a doctor myself, you know, one of the things we're trained to do is actually to listen. And I think this is a real advantage in the health profession. But do we listen enough? I ask myself that as a humanitarian, what changed? So let me tell you a little, a few stories about a small local village in Guinea Conakry during the Ebola crisis, the village of Dioman Coidu in Macenta. In 2014, in this village, a deadly disease was stalking terrified mothers, fathers, children, grandparents, 72 people were sick with Ebola virus. At least 200 others had been in contact with the sick people and could develop the disease. An information vacuum was overflowing with rumor and misinformation. Suspicion and lack of trust were rife. People were told Ebola had no cure. They were told not to touch deceased loved ones. They were told sick people should go to emergency treatment centers, but then families would never see them again. Villagers were saying that Ebola was sent through witchcraft or was manufactured by foreigners to kill Africans. Local people believed Red Cross volunteers were selling bodies, organs, and blood. We know how our lack of understanding of these very real perceptions were major failures of the response in Macenta. The village community refused to accept support from the Red Cross volunteers and attacked our volunteers who came to the village. Health buildings and ambulances were set on fire. Community resistance in Macenta, like in other regions, was a result of a top-down biomedical approach where foreign experts believed that they had the answers to a scientific challenge. The answers were obvious. It was just a matter of telling local people what they should do. Isolation, quarantine, cremation, safe burials were the marching orders coming from the humanitarian and aid community and governments supported by the military force. We all know now that this approach clashed violently with community practices, social norms, and traditional beliefs. And we know the results. The virus spread like wildfire across three West African countries, tragically killing 11,000 people and taking over a year to get under control. MSF, of course, played a key role in the response, saving lives and treating patients in emergency clinical units across the three affected countries. As did the Red Cross staff who worked with local community volunteers to help people bid farewell to their loved ones in ways that were both dignified and safe. The turning point in the Ebola response can be summed up in four words, equal partnerships with communities. It was not until the world recognized the concrete fact that humanitarian solutions ultimately start with and end with communities that we are able to together turn tide over the Ebola crisis in West Africa. Making sure community concerns drive humanitarian response is crucial, not just because it is the right thing to do, because it is the best thing to do for an effective response. For too long, the international humanitarian sector have believed we were the experts in humanitarian response. We had the answers. We held the purse strings. We dispensed the knowledge. Now we are finally learning that local people, the drivers, the systems that were mentioned earlier, practices and influences ultimately shape humanitarian need and response. Local people and communities have local knowledge, relationships and access to change the course of an outbreak or disaster. Community leadership ensures that humanitarian response is on the right track. Understanding the importance of community engagement is one important step. Generally making local communities equal partners in humanitarian response is the more difficult other. I would like to share with you five key principles for engaging communities as equal partners. These are principles that I have learned over many years working with communities and now honed in working with the Red Cross and Red Crescent movement. At the Red Cross, community engagement is in our DNA. Our volunteers and staff are part of local communities. They are in communities before, during and after crisis and emergencies. Our volunteers don't fly in and out. They are there for the long haul, working every day with local community members to co-develop and co-implement solutions to every day and unexpected challenges. These are principles generously shared with me by many friends, volunteers, local staff who have been my mentors. First, listen twice before you speak once. Whether it is in a meeting with local communities, working with faith-based leaders or a group of concerned parents, we must find ways to give people the chance to share their fears, views and opinions. And we must make sure that our response responds to those concerns. There is no point starting with a megaphone to dictate to people what we think they should be focused on or change in their lives. Besides being disrespectful, it just doesn't work. In Bangladesh, Sierra Leone and Burundi, for example, the Red Cross, Red Crescent has set up a helpline for people to call in and feedback to us on their needs and concerns. Dedicated lifelines paired up with volunteers' human interaction has helped tremendously in shaping our response effectively in times of emergencies. Second, start where they are, not where you are. We must learn to let issues, concerns and priorities of our local partners and communities drive their engagement, not our own agenda or expertise. Instead of walking into a community and telling someone what change we want to bring, we just need to take the time to find out what they need, what they know, and how they understand risks and vulnerabilities. Ask questions, listen to responses, let our partners and communities' priorities drive the agreed way forward. Be aware that there will always be local politics at play, so we may never really understand what is going on. Take that little village in Masanta during the Ebola outbreak. We told people that they needed to bring loved ones to the treatment centre. We told people that they were allowed to touch deceased loved ones. We didn't understand that because people thought Ebola was a curse and we had told them there was cure, there was absolutely no reason to go to the treatment centre. We didn't accept that any grieving parent will want to lovingly farewell a deceased child. It was only when we respectfully listened to local chiefs, traditional healers, headmen and religious leaders as the experts and agreed to join efforts that communities, volunteers and local leaders succeeded in turning that tide. It was not just a disease of agencies and doctors and medical people anymore. It was their disease and they had to fight to end it. Third, technology transforms. Technology has transformed humanitarian work. There are now more smartphones than there are human beings in the world. Information, some of us have too, don't we? The guilty ones are laughing. Information accurate or inaccurate can be shared instantly with millions of people with the press of the button. This has radically changed relationships and really changed humanitarian work, both in terms of supporting response and bringing new challenges. On the one hand, we can share life-saving information quickly, immediately and widely. And new technologies can help us better understand local concerns and monitor new developments. At the Federation, we have a knowledge sharing app, just to share with you, called virtualvolunteer.org that provides a platform for people migrating or considering migrating to get reliable information and advice about services. The information is shared from volunteers on the ground who are in direct contact with people who are migrating. Innovations like this can help to empower people and support informed decision-making. But misinformation and rumours can also spread quickly through technology and new forms of stigma, exploitation and extremism can also thrive. The dark web has become the province of people smugglers, human traffickers and other criminals. Four, technology can break and nothing beats face to face. As amazing as new technology is for connecting us and giving us new access to knowledge and information, it can break. I don't know about you, but my phone has been incredibly slow and I think it's part of the virus is going round the world. Especially in a disaster crisis setting, it can even break further. An over reliance on technology for humanitarian work can get in the way of being able to connect with local communities and truth be told, real challenges are always best addressed in person. Nothing beats sitting with people, looking them in the eye, letting them look at you and candidly, openly and respectfully developing a cause of action together. Technology has an essential role to play in supporting localisation through community engagement, but it can never be the whole story. And lastly, follow through. Put simply, keep to our promises. If we say we are going to do something, we must do it. If we don't think we can follow through on our commitments, we must say it openly. This is what transparent, honest communication means and it is the ABC of meaningful and successful community engagement. Earning trust is the key to any long lasting relationship we need to build with communities and indeed in our lives. These five principles should actually apply, it does apply after a disaster like in Haiti, but it can also apply to conflict situations. When a hurricane strikes, people need information as much as water, food, medicine, shelter. In conflict affected communities, people need to know what is happening around them, how to reconnect with loved ones and where to find help. In a conflict situation though, the local information environment can be highly politicised. Media can be targeted and or controlled by also opposing factions. In today's armed conflicts, the information space is increasingly contested and filled with rumours, misinformation, propaganda. The neutral independent impartial humanitarian action of societies has been key to delivering aid and services, including unbiased information. Unfortunately, community engagement is often poorly resourced in many of these conflict settings. It's not a priority. Improving that community engagement in emergencies is not only about pushing out instructions, it's about establishing a dialogue that should encompass asking, receiving and acting on information. Feedback loop mechanisms are essential to increase the speed, relevance and effectiveness of our action in emergencies. In 2015, my last job before joining the Federation was actually running the World Human Terrain Summit Secretariat. I know. I left after 18 months after having completed all the consultations. I really felt an honest voice needed to be out there talking to the 23,500 people that we consulted and many of them who affected people. And if you look back at the consultations, there was a fantastic article written by Irene that summarised what they called the report card. And there was a report card on the Middle East. And we really fared badly as an international community. There was so little trust. There was even, if you count as a report card between one to ten on a score, we failed in everything, including the perception of impartiality and neutrality. Three in four Syrian refugees in Jordan report that they had never been asked if they needed, if they get the help they needed. Nine in ten received assistance, but only three in ten found assistance helpful. Two in three people in South Sudan, Jordan and Afghanistan feel they have little or no influence on the aid they receive. People are not tired of being asked for their opinion and feedback. They're just tired of their questions not being answered. Their opinions not being taken seriously and their requests not being fulfilled by the aid response. This means that today we are still delivering aid that might be useless to the people that need it most. We must invest in planning, budgeting and resourcing community engagement in any humanitarian response from the get go. It cannot be left as an afterthought. At the International Federation of Red Cross and Red Crescent where I work, we strive every day to try to put these five principles into action. And believe me, it's difficult. Right now, we are running phone based surveys in Greece and Italy to capture migrants' perceptions or in West Africa to best understand beliefs and social cultural practices. In Asia Pacific, we are supporting volunteers to communicate and address local perceptions of diseases. In Tanzania and Bangladesh, we are running participatory video approaches to capture local voices and help us shape our operations and programming. We know that if we want to save lives and build stronger, more resilient communities, then we must work to put local communities in the driver's seat across all our humanitarian work. Our volunteers and local staff, many of whom have died in the course of action. We just lost another volunteer yesterday in Afghanistan who was out doing an immunization project. They are the real experts. The life changing local actors we strive to support. Through them, we can form partnerships with the local people who ultimately determine the success of our humanitarian work. So I'm going to end there and just say that this is a scientific research meeting and it's wonderful. I've been looking through the brochure and I like the fact you have an innovation day tomorrow. And I think that as an organization as MSF, you know, your way out there, your way ahead of everyone in terms of research, in terms of your thinking, in terms of, you know, your really, you know, cutting edge way of dealing with all the crisis and your rapid response, your independence, your fiery independence. But I think until and unless this knowledge and this research that you have, this wonderful skills that you have really meaning, mean so much to the local person in those villages or in those communities that are trapped in conflict. I think you really need to keep striving and pushing yourself because, you know, it really has, there is still a gap whether we like it or not. And even the best organizations, communities really don't perceive us as much as we think, you know, they do. And I think it's a job for every one of us and it calls for us to rethink the way we want. It calls for us to build partnerships that are unusual. And in your innovation, you know, discussions tomorrow, please, you know, remember about, it's not just about product innovation. What is the process? How do you get the paradigm? How do you get this mindset shift? How does innovation become a culture? And most importantly, how is it, how can it be as the lowest common denominator as possible, which is people. So thank you very much for this great honor to be speaking to you today. So thank you very much, Dr Mahmood, for that very thought provoking presentation there. I mean, I think that if you asked within MSF, do we think there is a point to community engagement? I think that everyone would agree there is, but we often struggle in the tensions of wanting to act rapidly and wanting to have impact. We struggle to find the time, we struggle to know how, and I think you've given us a set of principles, which we can all look at ourselves, we can look at our own practice and our own experience and think to ourselves to what extent have we been able to apply these sort of principles in our work. Now, I want to open the floor for questions to Dr Mahmood. So as before, please put up your hand, give your name and affiliation, and let's start. And if no one asks a question, I will. So, yeah, I think the first question over here. It's called Hi there, I'm Anne-Marie Peggam with MSF and also studying at SOAS here in London. My question is actually how you would suggest that we reconcile, particularly in Middle Eastern context and conflict settings that we've been working in more recently, community demands for highly technologically based interventions which have been common in these areas before the conflict started. How to reconcile that with clear needs on our side for evaluation for much more basic things like hygiene and appropriate circuits for surgical patients, which aren't necessarily appreciated by the communities and could contribute to the perception that we're not responding in the way that the community wants when we know and I think on a professional level in many of these contexts they know that basic things are important, but there is quite a demand for technology and how do I reconcile that? Do we have another question? Florian, up in the centre. Florian Westfall of MSF Germany, thanks very much for that thought provoking intervention. I think I have a similar question to the previous one, but slightly more simplistically. What do we do when communities are wrong? Because at the end of the day, I think in what you're saying there's an assumption that the community will self-correct, but we also know that communities are usually led by people and people who don't always necessarily have the interests of that community at heart, who may be driven by other factors. So how can we kind of safeguard to make sure that what we're trying to capture and what we are capturing really does reflect the interest of the community, especially of the weakest members of the community? We'll take a third question if there is one at this moment. Okay, yes, Carline. Hi, I'm Carline, I work in operations at MSF. I just to add a little bit to that, I guess, I'm just interested. I was part of the Ebola response. I think indeed, as Kieran already says, we all know that we need to engage with communities, we all know that we have to have a better dialogue. And I think we probably, although we got more aware of it, but we know this for a long time, I think we struggle to do that effectively. But then if I look at the Ebola, I was just wondering what you said about it only stopped when we properly started to engage in communities. Well, it sounds obvious. I was just wondering, how do we know? Because one of my, and this is not scientific, it was just my gut feeling, I had no clue, I still don't have a clue, was that I got the feeling that people got so scared. So because the desk was so real, that people got so scared that that's why they actually started to change behavior. So I just wonder in how far we actually did get it right at the end, because I'm not sure. I got the feeling that it was more the community sorting it out and that we played a role in that as humanitarian or as world or whatever, as Maddox. Great. Thank you very much. Dr. Mahmoud, if you would like to. All very easy questions. As you know, muscle hierarchy of need has changed, right? So internet connectivity is right in there and we can't help it. This is how society progress. And I think you shouldn't fear technology. That's my first kind of advice. And I think that, you know, look, you're not going to be able to please everyone. Let's face it. As a medical organization, you go into a war zone or you go into a conflict setting and they're real injuries. You have no time to ask too many questions because we know we take Hippocratic oaths. We get in there and we save lives, but in some of the other circumstances, we're talking about communicable diseases and other situations that community engagement becomes so important. Now, I think you we need to think how we turn it around. How do you use technology actually to actually influence people that maybe they're not asking the right questions? And also, I think very importantly, how does MSF and I'm sure you do it well, but you aren't doing everything. So to be absolutely clear from the outset, this is what we do as MSF. Anything other than that is not what we do. And that's part of accountability, holding yourself to what you are doing and, you know, ensuring that the highest quality of service is being given in those circumstances. So I think, you know, having those kind of difficult conversations. Now, one of the things we're doing at Federation, we have under my my division, we do futures and foresight. And it's really fascinating. And I hope I'm sure you're doing it as well, where we bring, you know, we have this black jellyfish, black elephant, black swan thing, right? What are the disruptors in society? What are disruptors in in how we see the future and how will that impact our organization? And technology is right in there. It is a disruptor that is going to disrupt continually. And, you know, but but asking ourselves then, where does our relevance come in as an organization and leverage on that technology? These are questions we are asking ourselves. So but I think that being absolutely clear what you you are as an organization and using technology to disseminate what actually people need. But don't forget that technology now is so different from it was before. You're talking now about, you know, people wanting cash much more than anything else. You have now Bitcoin, you have, you know, blockchains that can actually look at, you know, transparency and a lot of government. I have to be politically correct now. Some people don't like it because it actually you can you can actually reduce corruption. So so technology can disrupt corruption as well in a positive way. So so, you know, it's it's it's something we just have to embrace and being, as I said, again, being absolutely clear what it is and finding clever ways to influence communities on what they need. I mean, you and I know this. I mean, you you you watch television or you go to the social media and then you see a product. You don't really need it, but, you know, it's influenced you. How do we now use technology to influence affected people as well? That this is what's actually good for them. I think this is something we need to get the 20 year olds in a room and and ask them to help us. What do we do when communities are wrong? First of all, you know, we have to be very careful. How do we know they're wrong? And and until unless, you know, it's really blatantly obvious that what what they want is that bad for them. Then again, you know, using the power of influence. I think speaking from my own field experience, right, when I when I go into any situation, I've worked in a lot of conflict areas. I usually say to my staff, tell me, who are the five influences in this community? It's normally a midwife, a local priest or an Imam, you know, a teacher or somebody. These are your influences. Use them better and then, you know, try to influence the influences to to do that. And I think when communities are wrong and you as a as a credible organization, state category and document that this is against what is right, then no one's going to hold you accountable for that. Because as I said, you cannot you can only want to do the right thing. But sometimes you can't because different circumstances prevail. Ebola, well, yes, diseases have cycles and end of life of diseases. We all know that. Was it just basically the, you know, kind of. Evolution of Ebola that it ended at that time and not because we engage with communities. Well, I know that WHO itself has said to us, at least, that it was the safe and dignified burials that actually stopped, you know, to transmission quite drastically. It was when these these these people were influenced to allow their their loved ones to be taken away and buried in a dignified way that the pattern sort of coincided. It could be a pure coincidence. I think it's I can't tell you often whether there's any research on that. I have to go back to to my health team and ask them. But certainly this is what we've been hearing a lot. And does it matter that it's not the cause? It's still very important to give safe and dignified burials to to people who who are in those circumstances. You know, why why why is it an afterthought, you know, and and I think, you know, we just have to ask ourselves all the time. It doesn't have to be cause and effect. It's the right thing to do.