 Cymru i chi i gyf certhiol i chi. Thank you for inviting me. I will talk a bit about the work of my organisation, Medeuxen, Frontière, or Doctors Without Borders. I prefer less to talk about MSF and more about the people that we assist. Ultimately that is what it is all about. I will give you some insight into the work we have been doing on displacement and migration over the years. You're all well connected people in tune with what's going on in the world. You'll know that the levels of displacement and migration that we see today are affecting hundreds of millions of people across the globe and causing incredible levels of humanitarian need. First, just a little bit about MSF. MSF as an organisation has grown incredibly over the last ten years or so. We've started as a small, French, quite radical, sort of left-leaning organisation founded by doctors and really importantly by journalists. Today we're a massive global undertaking. We've got 41,000 staff across the world. We work in 70 countries and an income of one and a half billion euros. It kind of makes our eyes water when we think of where we came from. We're doing millions of medical consultations every year. They range from primary healthcare which is delivered by mobile clinics sometimes under a tree in the middle of South Sudan. We're treating drug-resistant infection in the middle of Central Asia and we're doing reconstructive surgery in the Middle East for war-wounded patients from Yemen, from Syria and elsewhere. We're working in complex and dangerous environments and our biggest programmes around the world are in Syria, Yemen, South Sudan and the Congo. We work on the basis of what we call humanitarian principles. Humanitarian principles are derived from international law. There are three principles that you see up here, neutrality, impartiality and independence. The deal is basically that if we stick to these principles as a humanitarian organisation then parties to a conflict give us access and they try their hardest to avoid doing us harm. The principle of impartiality means that we treat those who need it most. The principle of neutrality means that we don't take sides in a conflict and the principle of independence means that we remain independent from the political and economic agendas that are driving that conflict. Basically the idea is if we don't get in your way then you will leave us to get on with our job which is that of providing medical care to civilian populations stuck in violent and abusive situations. I'm talking very theoretically because of course war is a very messy business and rules in war they rarely apply. Despite what it says in international law we have to negotiate access in every single situation in which we work. Government ministers, armed commanders, they're rarely very interested in the finer details of international law. What they're interested in is what we can bring to a situation. The healthcare that we can provide to populations that are in areas which they control that paints them in a positive light that's not always a very comfortable situation for us to be in. They're also interested in what we do for the economy. We create jobs, we buy goods on the local market. At times it's in their interest to commit violence against us and over the decades of our existence we've had hospitals bombed, we've had cars ambushed and we've had clinics looted. Being a medic, being a humanitarian unfortunately it doesn't bring any guarantees in situations of war. But the violence against aid workers that is unfortunately only too regular these days horrific though it is, it mustn't overshadow the horrific violence that is metered out to civilian populations caught in conflict every single day of the year. MSF puts a priority on direct presence in crisis. We recruit our medical staff from around 60 countries around the world and we work with mixed teams so international staff and national staff working together. The concept is that that brings external eyes into a situation we bear witness to the events that are going on around us and where we can we use that witnessing to talk publicly about a situation. We don't know that talking publicly will always help but we definitely know that silence rarely brings relief to civilian populations in enduring conflict. We also have to prioritise that principle of impartiality responding to those who are in the greatest need mean that we need to rethink what that means all the time. We can be working in a protracted crisis but where the health situation is actually quite stable. We're treating HIV patients, we're treating TB patients because that's what the local health authorities can't cope with. Suddenly overnight the situation changes there's an outbreak of violence, people are displaced and their needs change as a result. What was a quite stable health situation very quickly turns into something much more unstable. People have been displaced, they're camped probably on land that's really not suitable for human habitation they're under kind of rudimentary shelter they've got no clean water very quickly diarrheal disease develops they have no access to food that weakens people mortality rates very quickly start to spiral. Who's in the greatest need then the HIV and TB patients that we've been treating for years that we know that without their medicines they'll die or the under fives, the pregnant women, the elderly who are the first to die in a situation of acute emergency. We have to make brutal and sometimes really painful decisions about reprioritisation but we're set up in order to do that. We have emergency teams who focus on acute health needs and they override the longer term concerns. So I've been in a project myself in Myanmar where the emergency team came in, the situation had changed the project that I had nurtured that I had loved that I had taken a year to build up all my relationships with the local authorities. They rode roughshod over all of that because the needs demanded it. They put immense pressure on the local authorities but the stakes merited it. They have a different skill set from those of us that work in longer term situations which has tended to be my experience but the key is knowing when the right time is to deploy that set of skills. MSF's very strong focus on emergency situations is enabled by the fact that we have a majority of private funding. Government income represents only about 2% in our global income. That means that we are the ones who decide where we want to go and when. We're not waiting for any government to make that decision for us. It also means that we can say no to funding and we often do particularly in times of conflict. Warring parties, they care about where the money comes from. They want to know that you're not being paid to work there by a hostile government. Soldiers ask us on checkpoints. MSF has been working in situations of displacement from its very beginning. Our first large scale refugee response was in Southeast Asia, Cambodians and Vietnamese refugees in Thailand. That was when we did our first boat operations providing medical care to Vietnamese boat people stranded off the coast of Malaysia. Little did we know that 45 years later we would be doing the same but much closer to Europe. Today we have boats in the Mediterranean conducting search and rescue activities. Over the last three years they have assisted 72,000 people who likely would have died at sea without those boats being on the water. In the 80s to the 90s the numbers of globally displaced increased exponentially driven by conflicts in Afghanistan, Somalia, Sudan, Rwanda and Congo. Tens of millions of people were displaced to camps many of which still exist today. For example, being Dadaab camp in Kenya home to quarter of a million Somalis have been there for the last 25 years. The numbers of displaced today it's said is at the highest level since World War II. The UN gives the number of 65 million globally displaced 22 million of which are refugees. Being a refugee means that they've crossed an international border. There are many more who are internally displaced but haven't crossed that international border and they're trapped in situations of conflict and violence. We don't know how many internally displaced there are in the world today. They're much more difficult to reach and it's impossible to count them but what we do know is that if you are internally displaced you are far more likely to die and you are far less likely to receive assistance. And I experienced this situation firsthand when I was working in this place the Afghan-Pakistani border back in 2002. Inside Pakistan there were 70,000 refugees they had had the fortune they were camped in a desert it wasn't a situation that you would wish on anybody but they had had the fortune to cross an international border and they had therefore the full kind of response of the international humanitarian community. They had food, they had water, they had good enough shelter, they had health care, entertainment for the kids. It was survival but they could survive. Three kilometres away inside Pakistan were 40,000 internally displaced. They had nothing. MSF was the only organisation that had managed to work in both places and it was a really salient lesson what it means for a displaced person to cross an international border. Today there are 240 million people on the move worldwide. Some of them are in the desperate circumstances I've described they're internally displaced. Others have managed to cross borders and they're languishing in refugee camps in Turkey, in Jordan or in Bangladesh. They don't know how long they will stay. They don't know if they will ever go home. If the humanitarian system has done its job they have enough assistance but they can't move, they're trapped in the camps and they definitely can't work. This is the life of an encamped refugee. And so to avoid that life there's many refugees that flee to the cities. They don't want registration. They live hand to mouth, precarious existence, blended in with the urban masses, extremely vulnerable. And then there are others. There are others that are moving because of economic crisis and stagnation. They're moving because of environmental degradation. They're moving because they want a decent education for their children. And really, who can blame them? Human mobility, it's a characteristic of our species. We've been doing it since the beginning of time. 500 years ago it was the European societies that were on the move. Today it's Asians, it's Africans, it's South Americans. And that mobility today is being met with institutionalised and structural state violence. And that state violence is expressed through detention, containment, deportation, criminalisation and deterrence. That state violence is directed at some of the most vulnerable people in the world. Moving heightens your vulnerability. Whether you're moving independently or you're in the hands of people smugglers, you're far more likely to suffer from violence and deprivation than if you're stable. The numbers are big. I think in the size of those numbers we tend to lose sight of the fact that they're underpinned by individuals. And every single one of those people on the move are in individual story. In July I went to visit our work in Libya. So MSF is working in Tripoli and Misrata. We're working in 10 or 12 of the migration detention centres that exist in the country. There are hundreds more. Don't let the media tell you that these are camps. These are detention centres. And in 20 years of working with MSF we've rarely seen such human misery. You have hundreds of men, women and children crowded into very, very small spaces. They're no better than cages. They can't lie down. But pawling sanitation. Not enough food. We're treating adult malnutrition. We're also treating injuries sustained from violence and torture. These are the detention centres sitting as a buffer zone to Europe's shores. The Libyan Coast Guard funded by European governments, including our own, is intercepting boats and sending people back into these conditions. While I was there, I met a young boy, a 12-year-old. He was from Mali. His parents had drowned. He was sitting on an upturned bucket in the middle of the detention centre, so he didn't even get up when the food arrived, the biscuit that they were given, about 11. Clearly a traumatised child. He was surrounded by adult men. It really was no place for a 12-year-old. I met a young man from Gambia. He proudly told me that he was a cook back at home. He'd been in that festering detention centre for over a year. He hadn't had a single visit from an embassy official in all that time. I asked him why he left in the first place. His eyes filled up with tears. He just said, why? Why? He was a young man. All his friends had left. He wanted an adventure. What young man hasn't wished for the same. All he wanted to do was to go home. But without any attention from the Gambian embassy, he's staying there indefinitely. Some of the people in these detention centres, they had no intention of coming to Europe. I met one young mother. She joined her husband in Libya. He'd been there for about eight years. She joined him four years ago. She had two very young children. She'd been picked up off the streets of Tripoli and thrown into this detention centre. She had no idea why she was there. She'd had one phone call to her husband in all that time. The detention system funded by Europe in Libya is operating on an industrial scale. It is exploitative, abusive, and we're paying for that. In an attempt to stem the flow of people to Europe, European governments are doing deals. They're doing deals with refugee and migrant producing countries. As an example, Eritrea. If you're Eritrean and you're lucky enough to make it to the UK, you have a 90% chance of your asylum claim being accepted, such as the nature of the regime in Eritrea. The UK is giving Eritrea aid money, aid money to reinforce its border. That makes it impossible for people to flee. Displacement and migration, it's not a new phenomenon. And it's one that's here to stay as the world develops. Everybody has access to a cheap smartphone. You're sitting in your refugee camp in Turkey. You're desertified region in the Lake Chad Basin. You're in Poveridge Village in Southern Mali. People can see that life is better elsewhere. In an attempt to stop them from leaving, European governments are putting money into source countries for refugees and migrations. It's definitely more palatable to the public than funding these kind of detention centres. The idea is job creation. But the lesson from history is that as countries develop, actually migration increases. Economists estimate that once income reaches a level of about $7,500 per capita, the numbers start to drop off. But for Mali, that's a couple of generations away. So this is really a generational issue that we are facing. Are we going to spend the next 50 years managing human mobility through barbed wire, through drownings, and through inhumane detention, all in the name of deterrents? Maybe there's another way. Now I'm afraid that I'm going to disappoint you. I'm not a migration expert. I or MSF, we don't have the solutions to what I think is one of the defining issues of our age, but we definitely see the humanitarian consequences of today's migration policies. Unlike our name might suggest, we're not advocating for open borders. We believe governments have a right. We know they have a right to manage migration. But what we believe is that just as when they wage war and they have an obligation to do so in a way that minimizes human suffering, so it is with migration. But today's policies, they seem designed to do just the opposite. So whilst I don't have the solutions here for you today, what I do know is that collaboration between ordinary people who care about the extent of the suffering that they see before them will help to counter it. Listening to some of the talks today, you're a group of people that have got a lot on your plate clearly trying to do the right thing. I came to you prepared with some practical examples of how you might be able to get involved if you felt that you were able to lend some support to this issue. I've been having conversations with business about communication means, about payment means, about identification and e-records. These are all things, these are all initiatives that could help to reduce people's vulnerability whilst they're on the move. You can see up there a picture of a backpack. We use that backpack in South Sudan. It's packed with medications such as anti-milarials. It has water purification tablets. Our teams move with people whilst they're travelling to try and cross an international border. We have other ideas like this, but we need people to partner with. Something closer to home, missing maps. MSF has an initiative where we're trying to map vast regions of the world, regions where displaced people have gathered, routes that the human traffickers take, that at the moment are unmapped. We have an app. You could help with missing maps. You could join a mapping party, or you could even host them in your business. It's not just about MSF. There's lots of other groups closer to home that are doing really good work and that need support such as the Docs Not Cops initiative, which is protesting against the government's attempt to try to use doctors as immigration officers. As an individual, you can complain to the media. You can complain to your MP. You can complain against the use of dehumanising language. The narrative of fear that's stoked by many of our politicians today. You can complain about the use of British aid money to fund Libyan coast guard that send people back into those detention centres. Listening to the last speaker, MSF isn't trying to save the world, but we are trying to effect change for individuals. There is one significant change that could make a real difference for many of the people on the move today, and that is increasing their access to safe and legal channels for migration or resettlement. Perhaps this is where business has got the most important role to play. Today we're in this vicious cycle. The UK's own policies are promoting the very illegal trade of people trafficking that they are trying to combat. There is no legal way for people to move, so therefore they choose illegal channels. We create a market. We're telling people to wait in the queue and we're deploying violent means to prevent them from trying to avoid it, but yet the reality is there's no queue for them to wait in. It's marginally better if you're a refugee. In 2016 Europe took about 20,000 resettled refugees, which is about 10% of those that are registered globally for resettlement. There are higher targets, but we'll see what happens with those. But if you're an unskilled non-EU national migrant, you have zero chance, and this is why people are risking their lives. We have to change this balance of incentives, and perhaps there's an opportunity as the UK looks to life outside the EU, and perhaps there's an opportunity for business to influence that. I often wonder where that 12-year-old boy is today. Let's call him Omar. We very quickly apply labels to people, you're a migrant, you're a refugee. He wasn't a refugee when he left Mali, but by the time he'd gone through that brutal journey, he'd been orphaned and he'd ended up in that detention centre, he was definitely somebody that qualified for international protection. He's very grey. We often have exchanges with the British government. They tell us that what they are looking for is legal and well-managed migration, and if that's really the case, we are going to have to accept is that we have to allow for a queue to be formed. Otherwise, all we have is barbed wire, walls, drownings, and many, many more Omars. Thank you.