 It's a pleasure and an honor. So I'll be talking about assessing health care needs in an inaccessible conflict zone remote surveying in Southern Syria. So basically, we performed a health survey in the rebel health areas in Southern Syria remotely from Jordan. So briefly, first, the background, seven years of war have heavily affected the society here in Southern Syria. They were the first to be involved in the resistance against the government. So these years were characterized by heavy fighting, intense conflicts, like ISIS. There was different tribes and families involved. So it was a pretty mess, a bit of a mess still as you might have read in the news. So basically during these times, access to these areas is heavily compromised. So it was extremely difficult to get access to the affected populations in terms of food, livelihood, and of course, medical aid. So we've been trying during the war times as MSF to assist with medical aid, mostly war wounded. But since there is a de-escalation period, which is now over but started somewhere late 2017, this allowed us to look into doing a epidemiological study on the most important health care gaps and access to barriers to accessing health care. In this period, we're like, OK, we cannot really access this area, but still it would be of tremendous value to get this information, to see where are the health gaps. So I'm talking here about a model and the experience of a remote survey rather than the survey outcomes and objectives and so forth. Yeah, so briefly, the objective of the actual survey was to look into the health gaps and to the barriers of accessing health care, looking at things like prevalence of or wounded, NCDs, maternal care, child care vaccination, and so forth, and so on. So MSF, of course, has a lot of experience with remote work, monitoring support, but actual epidemiological studies is relatively new. So here you can see the remote context, basically. The yellow parts are the rebel health areas and, yeah, unaccessible. We picked the two southern governments of Kinetra and the western part of Dara, they're in the red circle, to conduct this study. So using our third party, I'll come back to that later, and our connections to local councils and population data from UNHR, UNACHA, we managed to inform ourselves on the population density in the areas where, at that moment in time, are the people. And we were able to inform ourselves to develop a two-stage cluster design. So briefly, here you can see where we performed the survey, the clusters, and inhabited areas on basis of all the population data we got. And here are, so there's a qualitative aspect to this study as well, I'll come back to it later. These are the medical facilities that we interviewed for triangulation of information. So very quickly, the war of violence follows a rhetoric pattern, so there's been a lot of skirmishes and shelling throughout also last year, even despite the escalation period. MSF has two hospitals that supports no staff, because it's too tricky, we cannot take the responsibility if actual MSF staff would be in the ground, no or extremely limited access to crossing the border. So yeah, we had truckloads of hospital equipment and drugs that we could ship every now and then over the border, but there's a extremely limited movement possible of humans, for instance, for training, but also something simple like computer tablets. So the model, yeah, so I think, again, the other most important is the triangulation of sources. You can imagine that if you get information of only a household survey in such a chaotic war zone situation, it's going to yield quite different results from what medical facilities or NGOs will tell you. So this is like backbone of the assessment or survey where we started early on developing a platform, a negotiation platform, basically talking to these parties and also looking to collaborations on important health aspects in the region. So second of all, of course, for the quantitative part, the survey itself, third party is, well, inevitably, you have to use it because, yeah, we had no actual access to the area. So yeah, so where do you start? OK, so we had some hospitals on the ground. We had our network, and you start building a kind of umbrella, like a third party, where you start recruiting people under that umbrella, trying to make sure you have small trainings, doing small other tasks, preparing the massaging before you can do a large operation like a household survey. Then, yeah, well, technology is extremely important for us to try to implement such a remote survey. So we've been using the same software as Gaston was just presenting, but then for a survey. So there are numerous advantages, of course, that high-quality data. You're able to use skip logic and constraints and nodes and all these things, which speeds up the work, which is obviously extremely important when shelling can happen at any moment. Yeah, also, by the way, it allows you to check the data on a daily basis. I will come back to that later. Make sure that you have feedback, mechanisms every day, supported hospitals. So yeah, well, obviously, we had the privilege to work with our three hospitals. And not only were they useful for recruiting our HR, basically, enumerators, the field workers for the survey, but they were also able to basically monitor our third party, not very formally, but it was an important way to create somehow a trust and bond. Bored across parties, yeah. So this is something. There was no actual access to Syria for, for instance, what is important for us is the computer tablets. So we were able to make a network from the very beginning on with some border cross parties, some more sketchy than others, some authorities, some not, and trying to make as many lines as possible to get your tablets into southern Syria. And the same is true for getting your enumerator once you have your third party installed into Jordan for an actual training on an degree of such an operation. So this is quite a complex process to follow. And yeah, well, communication lines obviously extremely important for remote work. So basically, with clear hierarchical structures, we had connections to the hospitals that were able to, as I mentioned earlier, look at the third party. We had one supervisor for two teams existing of two people that were constantly following them. They were also in one WhatsApp. So on a daily basis, they almost were in contact with them. And the same is true for the survey manager that was, again, reporting on supervisors. In this way, we had in all layers, as much as we could, a good idea of what was happening at feedback mechanisms. So here, the only pictures I could share is, of course, a little bit compromised. But so these are our teams. There was always one car following them in case of a security issue. But also, the supervisor was always close by, if there was an issue with a household, maybe it was a technical issue with a tablet, or something not clear with the questionnaire. So then the results. Yes, first of all, the triangulation that really paid off. This was something you not immediately think of with MSF. OK, you do one-off household survey and you go on with that information. I think, well, getting information from NGOs, medical facilities is extremely important to either verify your findings and to negotiate access to the border crossing. It's a very complex process. And you should start very early on identifying your network, making sure you make office visits. And you keep it warm. Third-party building, saying make sure it's like you make a very clear plan where you want to recruit people, make sure that you're able to provide them with something, make it trust month. And well, this is all in a protocol that will be also published online, so if you're interested. Obviously, like communication remote data, well, this helped us massively with technology in all contexts. This is possible. But yeah, a little bit solar panels these days should be possible to get involved with tablets. So then some other results, just to show you a bit of the actual results from the survey. So on the basis of the household survey, we found, so we asked the mothers, the children, vaccination booklets. We found, for instance, measles and pony that was quite well covered, whereas DTP and hepatitis B it wasn't well covered. Now we're asking medical facilities and NGOs, so what's exactly going on? Well, apparently there was an influx of vaccination from the muscus into these areas. But rounds of vaccination were erratic, and I accessed basically through these areas. It's very compromised. Then some other results, for instance, the NCDs. Well, you see one in three adults reported to have one NCD. What was your usual suspects? Hypertension, diabetes, cardiovascular disease. Yeah, so what you hear them in the medical facilities is that there is some medicine, basic drugs, but it's affordability for more secondary care, more complicated density care. It's not there. Specific drugs, like insulin, you have issues with excesses in the area. So cold chain is an extremely difficult story. Same as through for lab tests, often not available. All actors on the ground decided that tracking the patients was lacking, which basically compromises the quality of continued care. Premises of more injury, 4%. Much higher, of course, than in other areas. Shrapnel wounds, blasts, these kind of things. Fractures are often seen. Interestingly enough, most actors on the ground are agreeing that during the most struggles and skirmishes, this was well covered by NGOs. So and cost was an issue, but mostly it was covered by NGOs, the care for war trauma. Rehabilitation, different story. A lot of people are having physical disabilities, thinking about limbs, but also vision. And there was barely any availability of this type of care. But can we conclude? Model has proven to you relevant information on healthcare gaps. Using triangulation is very important to make a complete story, verify your data from one place to another. Technology is extremely important. This is something I can't emphasize more, but it speeds up the process, high data quality. Then investing in and communicating with a third party is essential. Well, I already explained that a bit. And then every context demands unit configuration. So obviously, this is something you can directly extrapolate to another area. That's it. Apparently. Thank you.