 To remind you, Eric and Isaac started out by showing how we could apply UAV technology, so their issue of access, the extreme environment in which they were operating. Jean-Yves explained how you can use technology to drive a paradigm shift with regards to borehole regeneration. So instead of just digging a new one, can we just repair the existing ones? And finally, Manu and Ivan both attacked the same problem, that this issue of shouting over the fence. I mean, it's ridiculous. In this modern day and age, that's how we have to communicate information and provided a technical solution to that, which we then found that they could apply to lots of other applications as well. I think it's interesting to note that all of the problems were expressed by field clinicians originally. And so it was people from the field, people like Brett that you saw in the video that Manu showed, who said, help, we've got this problem, we can't solve it at field level. I think it's been alluded to in your introduction, Arjen, but innovation happens in the field all the time, every day and by everyone, and particularly the national staff, a very innovative population. And if they can find a solution themselves, they're not going to call us, they're just going to get on with it. And so these were examples where they couldn't find a solution themselves and they called us and we did our best to respond and find a solution to respond to the problem with success, I think, in all cases. The second point I'd like to make is that they all collaborated with external actors. I think Taran, you mentioned, many people have mentioned the importance of this collaboration with academia, with corporate. And I think it's interesting to explore those relationships, which, for example, in the case of Manu, moved from a simple client service relationship where we purchased technology but now moved to a kind of consultancy relationship where we have the technology with the competence in-house and they offer a consultancy support. And I think the same is actually to be said across all of you. And so with that in mind, let's move on. Are there any questions? If there's one online, I'll take that straight away. Please go ahead. So just to acknowledge our online audience who are busy tweeting comments, and I quote, following the last few talks, I'm singing, ain't no mountain high enough, ain't no valley low enough, ain't no river wide enough. So thank you for your support. I have two questions. So the first one is from the deputy editor of the Lancet in infectious diseases who asks, with regards to the UAVs, what level of collaboration have you heard or do you see having in the future with corporations currently using this technology such as Amazon? Thank you. Thanks very much. Thank you. I think as Eric has already mentioned, we only started with Martinet because they are also interested in this kind of use of the UAVs. But since then we've actually had, people saw what we did on the internet and we've actually had people contacting us to say, hang on, we have this, we have this. So it's just a matter of trolling through all these proposals that are coming up and we see what is suitable to what we need in the field. We're still some ways off, but we'll collaborate with anybody who can come up with what we need in the field. The second question. The second question is from MSF Zimbabwe who directs this question to the presenter of the boreholes. Very context specific technology would indeed be much needed in Zimbabwe, well done. And is there a plan in the future to train more Watson officers on how to use this innovation? So will you be training? Are you running a workshop? Well, the thing is quite heavy to maintain alive this workshop because we have a high turnover with expat and we know that also when expats get the knowledge very often they leave MSF. So we have to start again and again. So it's heavy for us to maintain it. So that's the internal discussion that we have for the moment. Do we keep it internal with as heavy as it is and we have to start always, always? Or do we create an external service provider like I would say a technical interface that we could just call when we need and could be called by any humanitarian organization, for example. That's the discussion on the table for the moment. Okay, thank you very much. So there's a question. I'll take first the gentleman on the left with the orange jumper and then afterwards Maya. Thank you for all the practical example you have given this afternoon. Once upon a time was a map of the world with Terra incognita. This is where you are working today. You are working today on place of no legislation or no applied legislation on personal data management of the patient. Do you agree, don't you agree? But if you try to put the information on cloud in Lebanon or in Myanmar, it will not work like that. So don't you think we are just occupying in the name of emergency, in the name of technology where laws are not yet implemented or developed and that could be further a contradiction with what we do on patient's file. I don't speak about an X or a Y. I speak about even names we've seen on Lotus Notes program. I hope that the names were not existing stuff from Afghanistan. You see, all this issue of personal data, how do you see it in the future? Because for me, yeah, there is an issue of law and order. In ICAC we have this problem. We work on place of detention. We have personal data, place of detention. We have to use totally secured data. And you know very well that once in a while at the White House is somebody who is doing a paper, one or two more paper on the floor that is left behind. All this issue of having related data, not only on medical but on protection issue because all of us work in protection. How do you see that in the future? Thank you very much. I think it's a very good question. It touches on something that's been raised earlier by our colleague at the back. And I think it's also on the keynote speech as well, a question that was raised. Where are we going with this? This is a bulldozer. Watch out. Does anybody feel like offering a reply? Just out of here. Sure. First off, it's clear that we store personally identifiable information of patients in the NIH, in the health system here in Europe. So clearly there's some kind of standard that people can apply even where there is strong legislation and strong public opinion and where people have a strong enough voice to defend their privacy. So we actually look at those standards. In emergencies, sure, it's clear that the paper system that we were using is less confidential than we would expect in a normal health facility, starting with shouting over the fence, which by the way I would say is considerably less secure than transmitting it over the Wi-Fi. Quite a number more people can understand what you're saying when you're shouting over the fence than can hack into your Wi-Fi. That can be done as well. To some extent, there's a question of actually living in the real world and not saying, well, we have to put, you know, 48-bit encryption or 128-bit encryption on every transmission of the Wi-Fi within the Ebola Center and go, who are the potential people that might want to listen in? What are the risks and judge it? I mean, if you're talking about information of people in detention centers or HIV-positive people in Uganda, that's a completely different thing than an emergency malaria setting or an Ebola setting. So one has to live in the world and do some risk-benefit judgments. You can't hamstring yourself and be unable to do a response to help people. Sometimes, you know, the right to treatment has to be balanced with the right to privacy, which is not to say that we throw the baby out with the bath water and go, well, Africans don't need privacy anyway. No, not at all. We, for example, do not store stuff on the cloud when the local server is passworded. And there's probably one or two people in this room who, given sufficient time and motivation, could get that information. But not nearly so easily as they could by simply strolling in and grabbing the patient file, which is available to anybody who gets into the low-risk zone. So there's a question of progress and there's a question of proportionality and there's a question of judgment. And of course, in Myanmar or Lebanon where there's also the question of security and access, we have to judge it as well. So my answer is this is something that every agency and every project has to devote some thought space to. Yeah, I think there's another slightly obvious thing. I mean, apart from Dr. Isaac, who is a medical and has this ingrained in his blood, this patient protectionality, we are, to a large extent, non-medical people. So we have to learn this and we have to learn about ethics, medical ethics specifically. So that's a learning process and we're discovering today that even not blacking out people's names on presentations is an issue and I think you're very right to bring it up. And so that's something that we need to address as a community of medics working with non-medics to avoid going the wrong way. So we move to Maya. Sorry, I'm going to change the subject. Well, first of all, to Jean, why don't you train the national staff up if there's a big expat turnover? Thank you. I mean, we talk about innovation and scaling up and we're in Papua New Guinea for now, but my question is what is the perception and about the neutrality, the perception of MSF using drones, the blurring of the lines versus military and humanitarian organizations and how are we going to deal with this? Okay, thanks very much. So first to Jean-Yves, the first question was the question on did you train the national staff in the use of this technology and would you consider a handover to the national staff to further use the kit that you've developed and what are the issues or challenges around that? So in Niger, we have this workshop working for now for more than two years field activities. So we have one expatriate and the rest of the team are national staff. So they are well trained on how to use, how to handle all the tools and how to transform into Excel Graph. But then after, the issue is how do you interpret it? So it's also a profession to be a hydrogeologist. So that takes time and years and I'm sure that in Niger and everywhere you find nice people that will be after years well trained and independent. So we do that, yes. We try. Thanks very much. And did you address the question of drones and well, I've said it now. I shouldn't say the word drone, I should say unmanned aerial vehicle, even that itself is touchy. Perhaps you could explore, unpack this issue please, Eric. So yeah, technically it's, we're speaking about different technologies and for sure different perception. The UAVs we are using because the UAVs is in fact the commercial name for this kind of technology and drones are the military name. The difference is first of all that we, the communication we are passing through the authorities and through the local communities. We inform them, we are very clear with them and we show them why we use it and for which purpose and they can see it. So it's a different level of perception. After as you are raising, if we want to see between the military and the humanitarian world using this kind of technology, it's more or less the same question we are speaking about the confidentiality of patient fine. We have to think twice of why we want to deploy them. If you want to use the same technology tomorrow in Afghanistan, your chance of success are very close to zero. Based first by the military, we will shoot it down and the local population will shoot it down. So at the end of the day, it's really to think and that's one of the constraints of this deployment of this kind of technology is where we are able to use it and also it's clearly on the time of how we explain to the people why we are using that and how we are going to use it. So it's not the same thing and as we are, I should say, the difference that it's much smaller, it's obviously totally not dangerous and it's not at all the same kind of technology. Military one is much more an easier technology so it's really completely different system that we are using. Thank you very much. I just wanted to add a comment on the rebranding. I think there is a lot of work that needs to go into the rebranding of drones because they came to us through the military and we're just adapting the technology to what we do so we need to work on the naming of the drones as well. Already we've shifted to UAVs but probably we need to move a little bit, like for hours we could call it sputnik or something like that. But it's just that we need to think about this because people associate them with the military, that's for sure. The one that we used to film LW3 in Monrovia was in fact called an EB and so maybe there's another suggestion and so this comes up, but it's not the first time and it's going to be the last we've taken technology from the military. The modular field hospital is a classic example and we just ordered it in white instead of green but it's the same thing. Okay, we did a bit more than that but simplifying things somewhat three or four years at Vellum but you get the point. I think the technology is out there and the perceptions need to be considered, the ethics need to be considered. Thank you once again for raising this very important point but the solutions are there and so let's apply them and let's find solutions for our clinicians who are in need. So time for a couple more questions. I'll go firstly for the gentleman in the front in the blue shirt and secondly there was a hand raised in the middle and finally at the back, black shirt. Please introduce yourself. Hi, TJ Campbell, MSFUK. Great presentations all. I was specifically interested in asking about the relative numbers of people who used the tablet versus the PDA in the Ebola treatment areas and as part of the evaluation of what worked and what needs to be improved if you could give some insight in who looks at the outcome of these two technology units and maybe suggest best practices across MSF and other organizations like how that works and what happens next like who looks at that. Correct. So it's a very good question. I think a short answer if you want to menu our feedback board first. Well I can say that we had 80 patients registering the system and well during the pilot which was around three months and well the users were basically the clinicians going inside and we also got a really good feedback from data about the user friendliness of the tool. And well for the future I think what I was missing in this project is to be on the ground for more time or checking that everything is going well. Like I said, we need skilled people. We need a project management to make sure people continue to use it so they understand how to use it. It's very easy to use but they need that little encouragement anyway. To address the question Ivan and now what next? We've produced these solutions. Where do we scale up? How do we scale up? Who decides where to scale what? Do we choose? Do we not choose? How do we deal with that? I propose that in order to choose which system we adopt that Manuel and I should have a wrestling match. Okay. So we'll arrange that in the pub later on this evening so as if you want to join us. No, I think actually it's not time to choose yet. I think there are tremendous advantages of each approach and I would even say there are advantages to the approach that MSF Switzerland took with the scan pen. It's not time to throw out any of these innovations that we've worked on. I'm certainly interested in going in the direction of other pathologies. I think our system is probably somewhat more adapted to more complex situations where you might have conditional questions, for example, questions that'll come up only if you do a certain thing and we have a little more sort of text entry capacity. Whereas I would say if you're looking at something like a cholera, a simpler and more emergency type disease, I personally, even working for MSF UK and having developed this, I would be taking a very, very close look at Manuel's system. So what to do from here? Well, my answer there is let's see what the field needs. Voila. Listen to the clinicians. Thanks very much. And so we move to the question, Lika, could you reintroduce yourself? Mia? Yes, my name is Lika from OCB. I gave her an earlier presentation about learning and development system in Afghanistan. And I just, I don't have a question. I just want to give a quick remark about the first question I heard about the privacy of the data. Just to reassure you, what I showed you was a copy of the online tool and we reshuffled all the data. So what you saw was not the real names of the staff and not the real names of the projects. Plus the spots were protected. So rest assured that this was really privacy protected information that we showed you. Thank you. Thank you very much, Lika, for clearing that out for yourself. Oh, Karek? I, Estella, last round, I must have, I have a question. It's not really a question, but it kind of answers to what you were saying now. Why do you have to choose? Why not work together? I see both systems, the systems that you both presented and I've seen both of them, one in the field and one outside of the field. One is, would be very adaptable for hospital setting and the other one for an outreach setting, but they need to speak, to be able to speak for it to each other. Is that possible or is the competition so high that that's just never going to happen? It is possible, it is possible. No competition. It is possible that whatever competition there is is very friendly. Now, AIDS, there are technical challenges with making different systems speak to one another, but one of the things that we've invested a lot in both sides is, is databases, to have the data stored in, you know, professionally set up databases and once you have that, then a good part of that work is done. But I certainly think that all of these kinds of initiative should be as modular as possible so that if you don't like my tablet, fine, use the PDA, but my server might still be interesting for you. So there's bits of the... Definitely, yeah. Many? No, I agree with you. Well, for the GICSA out there, the database in OpenMRS and the one we used in our project is also, is MySQL. So they are the, kind of the same and it would be actually very easy to migrate data from one to another or even I could even envision at some point to move early on as it is today to an OpenMRS data model. So all of this is possible and it doesn't require that much effort. I think the main reason when I started the project, I also thought about OpenMRS, but I found it a bit too much complicated for what we wanted to achieve. So I went for a simpler solution which was going to be also, I thought, faster. So because it was an emergency, we wanted to be there as soon as possible to help our clinicians and he was right. He was faster. So that was a good choice. So you see, you begin to feel the healthy tension between the other. Not the tension. We did, we did slightly different things, both of which have different values. But we're talking. I agree totally. I mean, it's a complimentary solution. And we're going to go to the pub afterwards and talk more. So on that note, on that note of collaboration, I'd like to thank the presenters today and award them with the flip-flop of innovation. To remind you, never to wear flip-flops in the field and to encourage you to continue innovating. Thank you very much. Please keep to your chairs. So thank you very much for this presentation. I think it throws up exciting new opportunities, but also some questions related to those new opportunities. So thank you very much for highlighting the possibilities, as well as some of the questions that we'll face in the future as MSF and other humanitarian organizations. And thank you very much, Robyn, for presenting in the enthusiastic manner that you did. And you will get a chair afterwards. But in the pub. What I wanted to do is basically, before I hand over to Kiran, Dr. Kiran, who's going to give some thoughts on the day, I just wanted to make sure that I thank everyone who has been involved in this day. And in particular, I'm looking at my notes because I don't want to forget anyone. We've had fantastic speakers. We've had the chairs who have also equally fantastic. We've had delegates. We have the online audience who has been, and Kiran will tell a little bit more about the number and where they came from. The Royal Society of Medicine, the Digital and Logistics teams, of course the organizers and the editorial committee that has selected all the presentations and which was drawn from across the MSF movement. And then in particular, I wanted to thank the people on the field who have very often been at heart and at the beginning of the innovations and of the changes that we were seeing presented today. And a massive cheer and applause for the volunteers who have been here all day and who have been helpful and who have made this day a success. So a big cheer for all of those. This day has also been sponsored. I don't think corporate sponsored, but nonetheless we have had sponsored. We have the Longer School of Hygiene and Tropical Medicine. The Royal Society of Tropical Medicine and Hygiene, Biomed Central, Plos Medicine, Lancet, the Global Health, F1000, the Welcome Trust and they have all been very generous in their support towards making this day a possibility.