Good evening to all that are watching us. We are in Ibex Hill at the residence of the former president, Zambia's sixth president, Dr. Edgar Chagwa Lungu. There have been developments this evening that we needed to speak to. I have come here, I have seen the former president and I thought I could speak to the issues that I have developed this evening. Last time we were here, there was a police raid. There was an attempt for the police to conduct a search at the premises of the former president who is protected by law, who is protected by Act 98 of the constitution. The constitution protects him from criminal proceedings and criminal prosecution. That's what Act 98 pledges. The police were here claiming that they wanted to do a search against the former face lady and we discussed this matter, how impractical that matter was. This evening there were various developments. There was a statement, a police official statement to state that all officers, I need to emphasize, the message said all officers have to be withdrawn, have been withdrawn from the residence of the former president. The former president is regulated by, like I said, by the constitution and by the former president's benefits act of 1993. The president is entitled to 24-hour security. So when we saw that message, we were all alarmed. You are aware, especially of the happenings that occurred last week. The minister of home affairs has issued a statement to Damwon TV where he insists that the former president still has security. The police spokesperson says there are seven officers that have been withdrawn for redeployment. Our position is very, very simple as a party. This is coordinated harassment against the former president, like they attempted to raid the residence. These officers they want to remove from here, the officers that came here accused these police officers of siding with the president because they thought because they are police officers here they would just open the doors and the gates illegally. The officers that were here were very professional. They said they needed to inform the president and they couldn't allow access to CID officers from Lusaka police headquarters that came. And we know that there were threats against these police officers that they will be removed and redeployed. And this is what we have seen today with that message. There are sessions going around that under the former president's benefits act, the president is only entitled to three police officers now. These are matters we will discuss later. What we can confirm is that this is a coordinated attack on the former president. And why withdraw police officers without coming to discuss with the owner of the office, former president Ed Galungu. If there is any courtesies, the secretary to cabinet should come here, he is the one that regulates and runs this office. Should come and inform the president of these changes that they wish to undertake. And I must emphasize that you just can't bring anyone in the personal space of the president. You can't get an ADC for the president. He chooses. You can't get his driver. The president has a say even if you wish to make those changes. So what occurred here again is the same coordinated harassment we are talking about the former president. And again he is coming from the top because the man at the top keeps on saying no. And we've seen a series of events against the former president. To our party members, I have seen the president and the former first lady they are well. Of course they are apprehensive about these developments. But our core as a party is to the secretary to cabinet to come here and announce to the president these changes that they wish to effect. We shouldn't learn them about them in the press. To colleagues, the young people here have taken it upon themselves to come and replace the police officers. And they are here. Now there is some kupela support, now there is some kupela security. Because everyone was alarmed that the police have been withdrawn. And even the withdrawal we insist the secretary to cabinet may even need to come with the IG and come and see the former president and discuss his matters. The entitlement to the president are constitutional. They are not doing him a favor. These are constitutional entitlement. You have to have saved as president to enjoy the benefits that he is enjoying. So they are not doing him a favor. These are constitutional entitlements. The pensions and benefits provided again are constitutional and by law. So they are not doing anyone a favor. But the cateces requires that they come here and discuss with the president. So let's continue to pray for the Zambia 6 president and his family. Let's continue to pray for their well-being and we hope that the Lord keeps him. The biggest security comes from Godai. Not Kuvantu. So we need someone who is a one that keeps their life. So with those few words, thank you very much from the residents of the former president to rush here just to understand what is happening and to confirm these assessions. So just again to reiterate before I go, there is official message from the police. You read it. It says, all police officers from the former president residents have been withdrawn. That's what the police message. Or, yes, thank you very much. Much of our youth have been active. Well, let me tell you my instructions at Tabasele. But I can take away. So thank you very much. So many points. Yes, in fact, we want to send also a message to our fellow youths that I think our duty is very clear. We've got a duty to safeguard the party, the patriotic front party and including our 60 public and president. So the message to my fellow youths is that let's mobilize ourselves tomorrow and come and say good morning to our former president so that he understand that he has his young youths that he had empowered and they are strong to protect him. Thank you very much. So like I was stating, the reason we are here is very simple. There were these very sad developments against the president's office and we thought we could come and find out what it was. And this continues a pattern, a clear pattern of harassment against the former president. There are many people saying, no, leave the president out of politics. Wushewa polisi that have actually invited a message. It is their action. They are the ones that wrote that later. And they've said, oh, police officers. The minister says, no, the president has security. Dan Mualews, police spokesperson says, no, we are just withdrawing some police officers for redeployment. So which one is it? The official message says all police officers and the two conflicting statements. So good night and God bless you. Thank you for coming and stay strong. Thank you. Thank you.


What we're going to do is just give you a ground level view of Murray, the person, his humor, warmth, his temperament. We all were personal acquaintances, everyone on the stage, with Murray Rothbard. And so what we'll do is we'll just give some impressions that we had of him as fellow academics and friends. I think we'll start with just talking about our first meeting with Murray. I'll start and then we can go along. And then other things we might address if we have time is what surprised you most about Murray. I have a story about that. And about how Murray was a real person who loved real things. He loved American culture. He didn't just love liberty in the abstract. He loved the fruits of liberty. He loved American movies. He loved certain kinds of American food, especially Pepsi and Wonder Bread, true. And he was in love with American culture. He didn't hold himself above it. He felt part of it and he was very proud of it. So when I first saw Murray at a libertarian conference in the early 1970s in New York City, and the person, the speaker that had come on before him was named Robert LaFave, who was a pretty well-known libertarian back then, and was also a pacifist. And he sort of gave a spiel about why you shouldn't defend yourself. Murray came up after him and gave a talk. And people wanted to know what Murray's views were of pacifism. So Murray said, well, if someone was coming at me with a mallet, I'd pull out a gun and I'd plug them. So I was very... But the first time I met him was at a New Jersey Libertarian Party convention. I was a vice president, unfortunately. I quickly learned to distance myself from the Libertarian Party. And I had him there as a speaker and he consented to come for $75 and this lousy chicken dinner that we provided him with. But so when we met, he was very interested in the fact that I was an economic student, a graduate student in economics. And he immediately started searching frantically for a pen. And he was sort of like an absent mind professor.  So I didn't think much of it. I didn't know if he was really going to do it, but he did. And so the next few days later on Monday, somebody, a student called me and said, you know, we'd like to have you join our reading group. So they sort of vetted me in advance. And a few weeks later, I guess I had passed the test and they asked me to... Murray called me up and asked me to come to his apartment. So I was very, very nervous. Another student drove me there. And so I was worried that he would be questioning me, grilling me about Austrian economics and libertarianism and see how little I really knew. And I was terrified. But we knocked on the door and he opened the door and he said, John, my boy, come on in. So he made me feel just like we were friends for years. Some of the discussion was very, very interesting that evening. And the evening extended to 2 or 3 a.m. We spoke about... He asked me about looters. What do I think? What do you do with looters? This was back in the 70s when that may have been a problem. And so he said, you know, his position was that if someone was looting your property, you could defend it up to... even up to deadly force, if need be. But that if the looter got your property and was running away, that you couldn't use deadly force, you had to call the cops. Even if there were the government cops, you had to call the cops. So I kind of piped up and I said, well, I think you have a right to defend your property and recover it and use force doing that. And if it means shooting a looter down after they've run running away, I would be in favor of that. So Murray said, oh, now that's a conversation that I'm willing to have. He always liked if you were more hardcore than he was. He loved that. Then the subject of what we would do with state property after a libertarian or successful libertarian revolution. So I suggested selling it, watching it off and giving the money, returning the money to the taxpayers. Murray dismissed that. He said, no, no, no, he says, you need the government to do that. And it would prolong the process. What you should do is get the private property back into the hands of the people right away. So it could be used efficiently. So then I suggested, well, what about giving the factories to the workers and these public schools to the teachers? I said, no, no, they don't deserve that. So I asked him, I said, what would you do? He says, well, he says, the property should go to the heroes of the libertarian revolution. And finally, I'll end this little anecdote about my first meeting with Murray. Across the street was kind of a seedy parking lot. Across the street from the second floor apartment. And yet it was a hot summer night, the window was opened. And there were some of the two parking attendants. One of them had a trumpet, and they were blowing on it. It was really dissonant and cacophonous, and it was just terrible. So it was really annoying Murray. He was getting visibly upset. So he finally, in the best New York accent, yelled out the window.  And then his wife, Joey, immediately came in and got him away from the window, shushed him, and then closed the window and brought a fan in. And so he was pacified. But David, do you want to talk about first meeting Murray, or right? Yeah. Well, I had read Murray Rothbard's book, Man Economy in State, when it came out. That was 1962. But I didn't get to meet Murray until 1979. And it was at a conference in June 1979 put on by the Cato Institute. And I got along with Murray very well, and I met his great friends, came some of my greatest friends, Ralph Rayco and Ronald Hamaway. And one thing I realized when I met them, they had a terrific sense of humor, especially when the three of them were together. Murray was always laughing. One story that comes to mind, Tom Woods was mentioning the revisionist movement after World War I. One of the great revisionist historians was Harry Elmer Barnes, whom Murray knew. And at one point Murray was going to be the editor of a fesshrift collection of essays in honor of a scholar. It was a gigantic fesshrift, later published under title, Harry Elmer Barnes' Learned Crusader. So Murray was going to be the editor. Now, usually a fesshrift is supposed to be a surprise for the scholar being honored. But Barnes found out about it and when contributors would send in essays. If there was anything critical of him in it, Barnes would insert something to the effect. Professor Barnes would probably reply in this way to the comment. So when Murray was telling me about this, he said, eh, he wrote his own fesshrift. Oh, then one thing about Murray was he had a tremendous intellectual curiosity with just constantly absorbed information. Quite some time ago, there was a lot of discussion about a problem, a math problem called the Monty Hall Paradox. And Murray called me up. It was quite late at night and he was going over this and he said, eh, why are you just beginning to dawn? He was figuring this out. When he would go into a bookstore, sometimes in New York, we'd go to the Strand bookstore, which was his favorite bookstore. He would just also Barnes and Noble sale annex. He could just go through books, every book on the shelf and give comments about it. And he would just, if you ask him about any book he'd read, he could immediately tell you what was in it and various what was on particular pages. I remember on one occasion after a talk, I said to him, oh, didn't Mises reply to Ludwig Lachmann's criticism of him on the Austrian theory of business cycle? Somebody said, eh, that's right, economic in 1943. So he really knew everything and he was, although he's mainly, of course, known as an economist and a historian, he was interested in, he had a very good knowledge of philosophy, especially Aristotelian and Thomistic philosophy. He studied that very closely and one thing you find in reading Rothbard, this is very, I think very important when you read Rothbard, he thought tremendously fast, so although he was a very clear writer, he very often will compress the arguments and you have to read each sentence to see why he's saying a particular thing that he was just saw the connections in between things much faster than really anybody else. In that way, he was similar to someone who, another famous libertarian philosopher, Bob Nozick, the two of them really didn't like each other at all, but in that way, they were very similar, they were extremely fast in argument, but Murray was the biggest influence on my political and economic views and he was the person who meant the most to me over many years and it was a great privilege in my life to know him. Thank you. I met Murray Rothbard in 1988, so in the spring of 1988, I was making plans to attend graduate school in economics that fall and I was already sort of an aspiring Austrian economist, I knew who sort of the big names were, I never met an Austrian economist, I didn't know if there were any still alive, but I happened to see a paper flyer on a bulletin board that said, Mises Institute, scholarships available and I was flabbergasted that someone had created an institute named for Ludwig von Mises and you have to remember this was pre-internet, so there was no Mises.org where you could go and learn all about it and the history and see who all the people were, but there was an address and so I wrote in an application letter and sent in a transcript or an essay, whatever was required to send it in the mail, figured well, that's probably the end of that. So then I get a letter back from someone at the institute saying we're interested in your application, we'd like to pursue it further. The next step in the interview process is for you to have a telephone interview with our Vice President for Academic Affairs, Murray Rothbard. So of course, as a very young person, I was kind of like Joe Salerno, I was completely terrified of what would take place during this interview and studied and had a script written out and everything and so finally it's arranged, he calls and he was, it was a lot of fun. I mean, he was warm and engaging and encouraging. He wasn't grilling me in any way. Before long I was talking about professors I'd had as an undergraduate and problems, the disagreements that I had with my professors and Murray's, wow, he's completely wrong because I'm like, I felt like I was one of the guys and so eventually I did get the scholarship and I was invited to attend what was then called the Advanced Summer Seminar in Austrian Economics at Stanford University, what later grew into Mises University and I went out in the summer of 1988. I remember going to the registration table. I never met any of these people. Right, I go to the registration table and there's Pat Barnett and she's, oh, you're Peter Klein, oh welcome, here's your name tag. She had a big cooler of beer at the registration table. So here's your name tag, you want a beer? And I said, these are my people. As you've probably heard and others have mentioned, Murray liked to have fun, he liked to go out, he was a night owl and so one of the great things about those early days is, 9, 10, 11 o'clock at night the adults are all sort of winding down but Murray was just ready to go and so he and the students, we would go out to, we would find a late night diner and we would shoot the breeze and tell stories till late into the night. Tom Woods mentioned that he met Murray in 1993 and I remember that, I was at Mises University that year as well and I remember going to some diner with Murray and Tom who I met that year. Although I noticed Tom doesn't describe 1993 as the year he met Peter Klein but we also had the responsibility of getting the kind of vodka that he liked and keeping it on ice during the conference so he could get it out when needed. One other thing I remember about those days is at some Mises conference being asked to pick up Murray at his hotel which was some distance from the venue and then deliver him to the venue and so I'd go, I'd pick him up and we're driving to the venue and he's just mile a minute telling stories and of course they're all hilarious. Now this was in the days before Google Maps and I really didn't know this area all that well and all of a sudden I realized I'm completely lost and Murray's oblivious to where we are. He's just going on with his stories and somehow eventually I made it to the venue like one minute before Murray's lecture was scheduled to begin and there's Pat out in the parking lot glaring at me with a death stare but I'd almost ruined the whole conference but somehow we made it work. When I was a PhD student I had the privilege of working with Murray as the managing editor for the Journal of Libertarian Studies for which Murray was at that time editor in chief and I've learned a lot more in subsequent years about how academic journals work and what the peer review process is all about. The scientific literature is supposed to be peer reviewed and that gives it this sign of approval and having submitted many papers to peer reviewed journals and been a peer reviewer for these journals and serving now as an editor of an academic journal and managing the peer review process. I know how complicated it can be and how seriously people take peer review. Well Murray had a more laissez-faire attitude towards peer review as the editor of the journal but just to give you a sense of the amazing breadth of his knowledge, which David and others have already mentioned, authors would submit a manuscript. The way it works with a typical journal, you submit a manuscript, you wait a few weeks, you get back anonymous peer reviews that will assess your argument and make suggestions for improvement or whatever. So authors would submit papers to the Journal of Libertarian Studies on a huge range of topics, not just on Austrian economic theory but on every topic under the sun, philosophy, history, cultural studies, science and so forth, and they would get back to these lengthy, multiple page, single spaced, referee reports, often destroying the entire thesis of the paper, a few carefully worded sentences and then here's 100 books and articles you need to read to really understand this topic. Well they were all written by Murray because I was the one behind the scenes who was like managing the flow of papers and I would send the manuscript to Murray and then this peer review that was as long as the manuscript itself would come back and he could do this, as others have mentioned, quickly and efficiently because the range of his knowledge was so broad. So like David, it was a tremendous privilege to know him and it was a huge loss of course when he passed away unexpectedly in 1995 and I'd like to say that in a lot of my own professional work I've tried to take ideas from Murray's, from his economics and try to spin them out and elaborate on them. My basic understanding of entrepreneurship comes from an article written by Murray for a conference published in 87 or 88, 89. No I'm sorry, 85 is when it was first published where he just in a few sentences lays out what I take to be the correct theory of entrepreneurship. Among contemporary Austrians, Murray is sometimes described as a polemicist or a great libertarian theoretician, political economist, but not as a great technical economist and I think that's completely wrong. I think his technical economics work, especially as displayed in Man Economy and State but also in many other books and articles, is really forms the core of our current understanding of Austrian economics and we're so fortunate to have his written legacy and we're also fortunate to have these great memories of him as a person, thank you. I think my own memories of Murray go back to that first meeting which took place either in 1987 or 1989. I suspect that the 1989 was the more accurate date for our first meeting. But I think from that time on I was very impressed as Peter said by the depth of Murray's knowledge and by something that he, a skill or talent that he showed that I have never found to the same degree in anyone else. We editors speak about people being writing machines. I've never met anybody who could write as much as Murray and write things that were coherent and eloquent like he would write a letter to me in the middle of the night, which went on for 10 pages, made up of perfectly constructed sentences and making very logical arguments and bringing to bear all kinds of historical data. And I find I was very, although I only knew him for four or five years and then sort of met him intermittently at conferences, we did have a steady correspondence. I think Joe Salerno referred to that and as I point out of my own memories of people who my, famous people whom I met called Encounters, came about 10 years ago, some of my books were clearly inspired by Murray. My book After Liberalism, which deals with the replacement of classical liberal ideas by social democracy in the 20th century is clearly influenced by Murray. And I think you can see the skeletal form of some of the ideas that went into that book in the correspondence that Murray sent me and in the exchange of opinions that we had over a period of four to five years. I think my position that social democracy is ultimately much more destructive for Western societies than communism definitely came from Murray. And you have to sort of go back and remember these things because they were late to works that I wrote back in the 1990s. But the fact is that I was influenced by Murray in ways that I was not even aware of at the time that I wrote these books. I think he may have picked up the reference to Karl Schmidt for my biography of Karl Schmidt, which we discussed in some of the correspondence. But his allusions to or his application of Schmidt is perfectly correct. Murray also had an interest in something that interests me, which is looking for where ideas come from, right? From where they arise. And of course his work on the history of economic thought goes back and looks at the Jesuit thinkers at the Salamanca School and says, this is where Austrian economics really has its foundation or its origin, not in the thinking of Adam Smith. Well, I'm sure that came from years of reflection and from reading other people. And in a more, I suppose, contemporary sense, he was interested in where neoconservatism came from, something which both of us detested quite profoundly, but he was interested in, I remember he was always, the first neoconservative was Sidney Hook. Then he said, I may have been wrong, it may have been Max Lerner. Well, very few people, I think, remember who Max Lerner was. He was sort of a social democratic journalist who later became a neocon. Not a very interesting or good journalist, but Murray believed that he found the origin of neoconservatism and then there was somebody else to whom he traced these ideas. I'm sure we can find multiple sources for these diabolical concepts, but only Murray would have taken time to look for the source, the ultimate source. And I think he pursued this with the same seriousness with which he looked for the origins of Austrian economics in 16th century Spain. He was very much interested in historical problems. A book of his which he gave me, maybe Lou Rockwell gave this to me, but I've looked at many times this study of the Great Depression. And it's a brilliant study. And from listening to Peter Klein, I discovered that Carl Manger was the one from whom he had taken some of these concepts about the higher orders and capitalism. And it was in the Volkswirtschafts layer of Manger, published in 1871. But those ideas were there and Murray applied this to his study of the Depression. And it's a very cogent study. I mean, it changed my thinking permanently about that crisis. There's one other thing I'd like to say, and this is in response to something that came earlier, it's not about revisionism, since I've always prided myself on being an historical revisionist. There are some things that liberals are able to sell us or the left is able to sell us, although their accounts are totally inconsistent. Like for many years of my life, in fact, most of my life, I was told by my liberal friends or liberal teachers that the CIA and the FBI are very bad institutions. And we have to be on guard against them.  And this is this, and we can't trust the government.  You listen to liberals today, they love the government. They love the secret service. They can't have enough of it. They can't use it to arrest enough people in this country. And it's sort of difficult to see exactly how that works. There's another point that was earlier made about which Ryan made about the, how liberals understand the 19th century or how the left understands the 19th century. Well, actually they have two conflicting understanding of capitalism. One of them is Marx's understanding. Marx did not glorify pre-capitalist society. Remember, he spoke about the idiocy of rural life and so forth. He had no, he thought capitalism was great. It just had to be replaced by socialism. He had no nostalgia for the past. Who were the ones who had the nostalgia for the past in the 19th century? Romantic conservatives, people like Thomas Carlisle in England hated the factories and it was the reactionary right that didn't like. The left, most of the left was very much in love with capitalism in its time, though it had to be replaced. Now there were two groups, there was two groups on the left that did not share this view. One of them were the anarchist who had some vague notion of a primitive matriarchal society, right? In which things were still good. And then we moved on to patriarchy and all these other problems. And of course you already have this in Jean-Jacques Housseau. The other group are the current climate alarmist, right? Because they hate capitalism. They hate industrialism and so forth. So it wasn't that people were living any more morally before because at least in the Western world we were all sexist and racist, right? And homophobes. But at least we didn't destroy the environment, right? It's the capitalist who are destroying the environment. But then only Western capitalist because China is an Indian capitalist, don't do anything bad, right? It's just the capitalist here who are bad. So I think with the exception, those two groups are the exception, but I think the general view of the left in the 19th century, including the socialist, was that capitalism did have its negative side. It caused us some temporary pain, but in the end we'd be better because we'd be able to move on toward industrial socialism. I think that is probably the more general view held by the left in the 19th century. Okay, thank you. Thank you. Okay. We could go on and on, but. Thank you.


I'd like to reiterate the value of this conference. It's in both the formal presentations and it's the opportunity for informal discussions and networking. Each year, I notice robust discussions after the sessions and in the hallways. I also notice some of this in the restaurant and the bar down the hallway, so I do note that. I urge all of us, whether we're regulators, licensees, international, the public, no matter what sessions or what location, to take the time at this conference to listen carefully, ask questions, and come away better informed with progress having been made. Now it is a great pleasure that I welcome our keynote speaker, Chairman Spinecky, to the stage. The Honorable Christine Spinecky was designated Chairman of the U.S. Nuclear Regulatory Commission by President Donald Trump on January 23rd of 2017. Last year, she was sworn in for her third term as a commissioner for a term ending on June 30th, 2022. She began her service on the commission in 2008. Chairman Spinecky has enjoyed a distinguished career as a nuclear engineer at the U.S. Department of Energy and as a policy advisor in the U.S. Senate, advancing policies and initiatives regarding national security, science, technology, energy, and the environment. She has served on a number of expert advisory panels and has twice received the presidential citation of the American Nuclear Society for her contributions to U.S. Nuclear Policy. Chairman Spinecky is a graduate of the University of Michigan, please join me in welcoming to the podium our Chairman, Christine Spinecky. Good morning, everyone. Thank you, Brian, for that introduction. How is everybody feeling this morning? Feeling good? This is really a large group of people. I'm very pleased to take part in this year's regulatory information conference and I extend my thanks to each of you for attending this session and also to those of you tuning into the webcast and there are a number of people who've said to me, I'm gonna be tuning into the webcast so I know you're out there. I wanna add my personal thanks and on behalf of the commission to all of the many NRC employees who make this conference possible, as Brian was noting, as I note each year, this is a tremendous undertaking and it's fueled by the hard work of our many NRC staff and the Rick volunteers who actually are here during the implementation of the conference and make everything run smoothly. Their hard work and dedication are a chief contributor to what makes this conference a success on the part of the U.S. NRC. I'd also like to acknowledge the presence of our important partners from both other federal agencies and state agencies within the United States as well as the many international colleagues who are joining us this week. The NRC's critical relationships with other governmental entities and collaboration on lessons learned with international counterparts facilitate the effective achievement of our mission. Thank you for taking the time to be here and in some cases for agreeing to be a presenter at one of the technical sessions this week. Finally, I would like to acknowledge my commission colleagues, Commissioner Sperin and Commissioner Burns. They are both fine individuals and good colleagues and I'm very, very grateful for that. Where we agree, we agree. Where we disagree, we disagree and we move past it quickly. And you don't have to agree on everything to with someone in order to like them and enjoy working with them. Now, most of us in this room know that to be true. Outside these doors, well, I'm not sure I can always vouch for that but I really thank my commission colleagues for the productivity of our working relationship. So thank you both and I look forward to your remarks later in the morning. So a big milestone is coming up for me later this month. I will hit the big one, oh, I will complete a decade's worth of service on this commission and that makes this my 10th RIC speech. So last week, I was meeting with our EDO Victor McCree and I said, in case you're wondering, Victor, when it is that the well on RIC speeches and creativity runs dry, the answer is the number 10 but at the end of the day, all of you will be the judge of that, not me. And as Brian has mentioned, the remarks of our executive director for operations, Vic McCree will follow mine with a presentation of various agency initiatives and I'm gonna leave him that broad terrain for him to cover as our executive director. As he has been mentioned, there are individuals who are, will be circulating in the aisles to collect your written questions. So if you pass your question cards down to them, they will bring them up the row to be collected and brought to Brian so he can be prepared to ask me the questions at the appropriate time. But we can't break a 10 year record. I decided maybe year 11 is an opportunity for reset but I worried that some ill fortune would befall me if I didn't begin by telling a bad joke. So, okay, is everybody ready to groan? In unison is best, it's the most, it's maximum effect if you all groan in unison so this is the joke. I tell you a chemistry joke but I'm not sure I'd get a reaction. There you go, okay, that's the joke. See, I didn't want you to miss the joke because it's a joke about telling a joke. So it's kind of like the mobius strip of jokes, if you know what that is. It turns back in on itself. Perhaps you'll laugh later when you circle back around to it. So, since I last addressed this conference, the NRC has continued to challenge itself to deliver our safety and security mission in an effective, efficient and agile manner. Our public outreach to and engagement with those we regulate, public policy makers and the broader range of interested stakeholders continues to provide valuable insights to inform and shape many ongoing NRC program changes and enhancements. These insights are continually factored into the agency's work. That said, at its heart, our central safety and security mission remains unchanged even as our methods and means to accomplish it may evolve. At this year's RIC you'll have the opportunity to hear from NRC staff and a diverse set of external presenters as they provide information and engage in dialogue with each other on panel sessions about a range of topics. One of the breakout sessions this afternoon has generated significant early interest from attendees. In fact, I think it might already be oversubscribed and that is the technical session that begins at 1.30 entitled Transformation at the NRC. In his remarks following mine, Vic McCree will discuss at a high level the NRC's transformation initiative that he has charted and that is currently underway. I'm gonna leave that topic for him to discuss. Instead, I decided to highlight an initiative that perhaps isn't as visible outside of the NRC and that is the NRC's Innovation Forum. In assessing the results of employee viewpoint surveys of recent years on the statement, my organization values innovation, the NRC staff thought that the low to moderate level of employee agreement with that statement presented an opportunity to bring greater focus, structure and agency wide attention to capturing the many employee innovations and suggestions that probably were out there but they weren't necessarily finding a home. Although a handful of NRC offices had something along these lines such as Region II's idea greenhouse, the communications agency wide were piecemeal and not all employees had access to the same opportunity. Not being content with this is the status quo and with the support from the EDO and other agency executives, a diverse cross section of employees from across NRC's programs, regions, subject matter disciplines and levels of experience came together to create the NRC Innovation Forum. They're bringing tremendous energy to the cause of innovation and are off to a promising start. Unlike transformation, ideas submitted to the Innovation Forum need not be grand. I confess to occasionally hopping on the NRC internal SharePoint webpage for the forum and browsing the log of recent suggestions, I discovered for instance that moving to electronic concurrence on documents continues to be a very popular cause here at NRC. I was wondering if there are any members of the Innovation Forum here today, I would ask you to raise your hands but if you're not in the room, I still wanna thank you for establishing this forum and for your dedication and your infectious energy to harnessing all the creativity that we as NRC employees know exist in our organization. More broadly, the NRC continues to endeavor to forecast our work with greater accuracy and identify changes to our resource needs in the current very dynamic nuclear environment. The agency is pursuing activities such as standardizing and centralizing support staff's functions for both headquarters and regional offices and establishing a common prioritization process to prepare the agency to evaluate emerging work more readily and to staff it more efficiently. We're also implementing an enhanced strategic workforce planning process to improve the training, agility, and utilization of our capable workforce. In our programmatic work, the NRC continues its pursuit of risk informed regulation through which we strive to put focus on those issues that are most important based on their safety significance. The NRC staff continues to evaluate and update key risk informed decision-making guidance, develop a graded approach for using risk information more fully in licensing reviews, enhance our communication of risk activities, and advance other risk informed initiatives across the agency. This includes steps to ensure uniform implementation of backfitting regulations, improve training and oversight leading to more consistent identification and treatment of potential backfitting issues. The conference breakout sessions will examine activities such as these in greater detail, as well as many others, as Brian has noted, such as cybersecurity, radiation protection, decommissioning, low level waste, digital instrumentation and control, and emergency preparedness. With this broad set of topical sessions, I hope each of you will find the time you spend here at this conference to be very productive. As I reflect on the many activities underway, if I had to describe my personal assessment of how NRC is doing in one sentence, it would be, I continue to be fully confident in our ability to fulfill our mission and yet never satisfied that we have perfected the means and methods of how we go about it. And that's okay. The NRC is not complacent.  Will we extract the right lessons and evolve in the right ways while staying ahead of the changing world around us? I don't think any organization knows that for sure. The proof will be in the doing. In my view, the staff's innovation and transformation efforts are central to charting the course to NRC's future. As a member of our commission and as an NRC old-timer, I actually filtered with the term OG or Old Guard of 10 years, I am fully committed to this process and to helping them be successful in any way that I can. The way I see it, the failure to adapt to change, standing still, if you will, is simply is not an option for this or any organization. Change is hard work, though, and I know that. So I look for inspiration where I can find it. Last fall, I was invited back to my alma mater, the University of Michigan. The visit coincided with homecoming weekend, which was fitting, I suppose. As I walked the engineering campus, I did a lot of thinking about the intervening nearly 30 years since I was a student there. My first thought was, where did all those years go? And that's a thought best not lingered over the passage of time. But since I needed to address some of the students and alumni, my thoughts turned to why I chose to become an engineer in the first place. And the truth is, I think engineering is beautiful. Engineers have been known to be much maligned as a personality type, if not a profession. So I decided that I wanted to dispel the notion in my remarks at the university that we cannot be poetic as engineers, but maybe not being as poetic myself as I would like to be. I was forced to turn to the words of others. I was helped in this by the author H.G. Wells. I was reading and I appreciate that some of you have said I always have worked in something about a book I'm reading into my remarks, so here goes. I was reading within the course of the last year what I found to be a really interesting history of the electrification of America, and it was entitled, Empires of Light, Edison, Tesla, Westinghouse, and the Race to Electrify the World. And it's written by a historian, not a technical individual. So I think that it had maybe a broader scope than other histories of this same topic. But I came across a quote from H.G. Wells. He was describing his visit in the year 1895 to the Niagara Falls Power Station, which was the first major hydroelectric facility in the United States. In describing what he saw, he wrote the following. These dynamos and turbines of the Niagara Falls Power Company impressed me far more profoundly than the Cave of the Winds are indeed, to my mind, greater and more beautiful than accidental eddying of air beside a downpour. They are will made visible, thought translated into easy and commanding things. They are clean, noiseless, starkly powerful. All the clatter of the early age of machinery is past and gone here. There is no smoke, no grit, no dirt at all. These are altogether noble masses of machinery, huge slumbering monsters, great sleeping tops that engineer irresistible forces in their sleep. All these great things are as silent, as wonderfully made as the heart in a living body, and stouter and stronger than that. I fell into a daydream of the coming power of men and how that power may be used by them. I think of those words every time I stand on a turban deck at a nuclear power plant, the people in this room work in and around the most powerful technology on planet Earth. On any given day, that keeps me both inspired and humble, and I hope it does you as well. I thank you for your kind attention and I'm happy to take any questions you have. Okay, Brian, what have we got? Go ahead. I have a selection, Chairman, so we'll get to them all. Chairman Sminneke, do you think the NRC will ever achieve being fully risk informed? Well, the question was made easy by the term fully because, well, I'm not trying to pick it apart, but I think, and I was asked last year about NRC's progress and journey towards risk informed regulation, and I think it really is that a journey, but I think over the course of time there can be a different pace of change that occurs, and it may be in my opinion that with the dynamic environment right now, NRC may stand at the threshold of maybe making more of a step change through the transformation work, maybe even through the internal innovation cradle that we've created inside the agency. I don't think progress always occurs at a consistent pace, and my tenure observation of NRC, I think that what's happening now is around maybe looking at, we've gathered a lot of information, have we added to our knowledge in a way that we have the time and space to take a fundamental stepping back, and really looking at targeting some areas where there could be a more transformational increase in our risk informed regulation, so I don't know that fully to me would imply that you wouldn't be continuing to gather risk insights, and if nothing else, as new technology is adopted you have to build a base of understanding and risk understanding and safety understanding of that technology, so I think we'll always be adding to that, and it comforts me that NRC does have such a continuous learning approach to its work that I think I can't envision a future NRC 30 or 40 years from now that wouldn't still be seeking out those risk understandings and insights and feeding them back into the process. I've got at least five questions on one subject. I give credit to some well-prepared individual who has a typed printout, came prepared with questions they put on cards, so that's a new one for me. You know, that's quite brilliant. I think that that's wonderful. At last years, all five of them are very similar.  We have seen very little significant movement this past year. Why not? Is digital INC still a top priority for the NRC? What is the commission doing to drive progress within the staff? A couple of the other questions talk about the safety improvements that they hope that they can leverage and that aspects of digital INC has been proven to reduce SCRAM initiators on non-safety-related systems, so questioning our progress. I think that I encourage the questioner and others, and I know there's broad interest in digital INC, please question the NRC staff presenters. I think that my assessment of the NRC staff is they're ready to have a vigorous dialogue on digital INC and have been having it in various fora where they engage outside of the NRC on this. I think in my first year on this commission in 2008, one of the things that I did was visit the nuclear navy in the US to talk about their success in adopting digital instrumentation and control technologies. That was 10 years ago, and I'm fairly confident in saying the following. If you were to ask any NRC subject matter expert or the NRC managers if they're content with the pace of issue resolution on digital INC, I'm fairly confident they would tell you that they are not personally satisfied with it. That being said, I think that there have been a lot of issues that have been brought to the fore, and I think that the notion, I think success on digital INC could actually be a precursor to other kind of risk informed approaches that could spread into other areas of the NRC's work. So it may be a reason why it is, we're taking the time to work through with some finality the digital INC questions because they may philosophically have connection to other modernized technology that we know will be coming our way, and we wanna be sure that as we approach digital INC, we set a path that is going to work in terms of a risk informed approach overall to new technologies that are similar to what the regulated community is engaging us on now. It does take a bit of a paradigm shift. I will admit that personally I view coming to some greater resolution on digital INC, I think that'll be a leading indicator of having NRC having confronted some tough issues on risk and being risk informed. And I will say that I also observed that NRC makes a broad acknowledgement that digital INC systems, in addition to being necessary to address obsolescence issues in the supply chain also offer safety advantages. And I think that NRC is very committed to moving through these issues so that those safety enhancements for operators can be, we can accomplish that in the United States. Yes, thank you Chairman. And I know at the transformation session this afternoon, digital INC will be one of the items brought up by Dan Dorman at the transformation session. And I do highlight, as the Chairman mentioned, session T8, progress and challenges in implementing digital INC in the nuclear industry. So NRR is prepared to answer more in-depth questions at that session. Chairman Svanicki, what do you worry about day-to-day versus year in and year out? I think one of the luxuries for the members of our commission is the tremendous technical depth in the agency that allows us day to day to proceed with an extremely high confidence. I know I do and I think this is true to all the members I've served with. You can go day to day with great confidence that should some event happen at an NRC regulated facility, we are going to be able to have the people and processes and capability to address that on behalf of the American people. So that is a luxury to know that day to day, just the basic operational issues are not something that I need to worry about because my confidence is so high in the quality of how we would respond to an event. Year to year is a different question though because that's about peering over the horizon and saying, for the time that I'm at NRC, am I contributing to putting in place the things that when I arrived, my predecessors were thoughtful enough so that certain things I didn't have to immediately take on and worry. It is, I don't favor the term leaving a legacy but I think all of us in our work say that I want that those who follow on after me will go. Well, I didn't know that Christine Savenneke but thank goodness she thought that this might be a problem 10 years from now and she at least started to encourage people to put something in place to address that. I think if year to year I worry about anything, it's kind of about NRC is an organization, all of us and the way the culture that we're creating, the way we're working with each other and are we creating a legacy as kind of an organic organization that is gonna make all of our successors gonna position them for success and so I think year to year I hope I'm being as thoughtful as my predecessors were. A couple related to that topic on timing and in the future, there's two questions. One individual says I've been in nuclear power 47 years. Where do you see nuclear power going in America the next 47 years? That's prophetic. And another question congratulating you on your 10 years at the NRC. Where do you see yourself 10 years from now? Okay, well I didn't think I'd be standing here today so it makes me humble about predictions. Isn't that supposed to be a fool's errand to make predictions? So this is really me and this is not coming from anybody else but I've been in, so I don't have 47 years in and around the nuclear profession but I do have the end of this year it'll be 28 years not counting my time in the educational system. So I've observed things from being in a more technology development environment at the Department of Energy, being in a kind of a pure raw policy making environment of the Congress and Capitol Hill and then coming here and seeing kind of exquisite high fidelity mission execution that I think and I offer that so sincerely as a compliment to NRC as an enduring organization. I think they should pride themselves on that but I know it's ego to feel like you stand in uniquely dynamic times but gosh it sure feels like that to me, it feels right now I don't know if it's just I've progressed through enough of my career that I have enough runway that I, enough runway still in front of me but enough in my rear view mirror that I, that was a horrible mixed metaphor, that I, you know I have some perspective and maybe a little bit of going forward runtime that it seems like the future of nuclear in the United States is gonna be determined by what happens and so this is a crazy thing I shouldn't say as chairman. I think it's gonna be determined by what happens in the next five to seven years and so depending on what happens in the next five to seven years I'd be able to answer that question about 47 years from now but I think that the paradigms all around large light water reactors, the program that we have in the US I think it's at a pivot point and if for the part of the mission we execute for the part of the mission that technology designers execute for those who support the whole nuclear enterprise I think unless there are some kind of experimentation some pilot, some modeling of new paradigms I'm not sure that the old models can carry us through the next 47 years and by that I say you know I think the whole business of nuclear by my observation has changed and therefore the fact that you can have a design certification review in front of the NRC for even a model milestone of four years or six years or eight years if you talk to the communities that are investing in the future of nuclear they're not gonna hold a business case together that long so I think that some of what you see here are innovation forum which is inward looking and those are the tweaks to the process the transformation initiative that you'll hear more about I think fundamentally that is NRC's recognition of the fact that we've got to examine maybe again not our core mission changing but some of the methods and modes through which we conduct it and so we're looking at it and you can if you want to you can fault NRC for a lot of things we're pretty persnickety we're very deliberate we're very thorough if that bothers people but we're not closed off I just you know that's one thing I think there's a lot of defensiveness in debates about policy and stuff going on right now this is the least defensive organization with which I have worked I think there is an authentic spirit of saying we don't have the answers and so when I engage policymakers I work hard to communicate how genuine that is on our part if we're not doing enough to prepare for advanced reactors here's what we are doing what do you see that's missing tell me and I will take it back and we will take it on board because we do that doesn't mean that our proposed approach to it would be the same as anybody else's but you can't fault this place for being thinking we have all the answers and being closed off I just if you see it tell me about it but I don't see it thank you chairman a couple questions on timing of items why isn't the commission completed its deliberations on the final 5046 Charlie rule that's been up there there seems to be a second question on votes by the commission it is a low level could you comment on that progress yes as everyone knows our commission under law has the potential to have turnover on new members and members leaving our commission so every year we confront this but we have not been at our full complement of five commissioners for some years now and now we've been at three commissioners for some period of time rulemaking is a very very important that some of the questions seems to go around the rulemaking votes and the rules that are in process at the agency we have regulations on the books that have not been revisited in 20 or 25 years so one of the reasons that I as a member of the commission as I've always taken rulemaking as one of the most sober important things I do is that upon completion of a final rule that rule might stay as a regulatory requirement for decades to come and not be revisited in the absence of a need to revisit it so getting it right is a lot more important than getting it done super quickly we use other instruments for safety or security issues that need to be addressed immediately we have many other authorities we can do immediately effective orders so rulemaking is about putting in place the things that are likely to be in place for a very long period of time the administrative procedure act under which we're required to develop those regulations in general is a process that takes I think three years if you do it quick five, six years is not unheard of for a regulation so where members of our commission need time to investigate issues around pending either a proposed rule or a draft final rule I know I approach that with care I've observed every other member of the commission I've served with over the years takes that as a very, very serious responsibility and I think there are a lot of benefits to rulemaking but haste is not a positive attribute now some may say something taking a couple of years is not hasty the other thing, the reason I mentioned the composition of the commission is that although we have the authority to move forward with three members having served on five member commissions I observe that we have the greatest confidence as a commission that each of the unique perspectives brought by a member of the commission adds value and completeness and thoroughness to our deliberation on the final product which again might be in place for some decades to come so where you see that action is fast or slow by our commission the tempo of our work is something that we work as a deliberative body of three, four or five to pace that and I'm very I've been blessed to serve on commissions that were a colleague needed more time to continue to work through issues we tend to respect that with each other again knowing that where the agency needs to act quickly rulemaking is not the means through which we do that. Thank you Chairman. This questioner has enjoyed your references to popular culture in the past what film or movie reference comes to mind when you think about your experience as chairman versus a commissioner? Oh gosh, so many answers. And I don't share everything that goes through my head those of you who work with me probably think do you ever have an unexpressed thought? You know it's interesting this has actually I do have a lot of cable channels that run movies all the time and so I tend to see my old favorites you know I'm folding laundry or something on the weekend so I have something on in the background and recently something's been brought back forward although it's a film from 1980 I think I remember I first saw it I was in high school but it so I'll get to this in a minute but Cole Miner's daughter I don't know if anyone's ever seen that my grandfather was an iron miner so although it's not quite as quippy to say iron miner's granddaughter but Cole Miner's daughter it's a really great movie and we have an international audience here I don't know if people know this film but it is based on an autobiography by the first lady of country music Ms. Loretta Lynn and one of the reasons the movie inspires is just I have a view I am a fan of popular culture but I think that women in the arts we look at them as being entertaining and everything but the truth is during certain periods of time in our history and maybe to today think about those women had to be entrepreneurs business women in addition to being tremendously creative brilliant artists so much and often I have to assume they had to do all this in an environment while caretaking maybe providing for their families or not being treated all that well all the time probably I think that's probably true but this is a story of the hard life that Loretta Lynn had and she goes on to be very very successful of course but she has a moment where the success and the stress traveling all the time trying to care for her family she has a rather epic meltdown on stage which I am not about to re-enact right now but and I'm not having a meltdown being chairman that's not the point of this story but they have a point in that meltdown and again she won the Academy Award for Best Actress if you have not watched it I recommend if you just look at the subtleties of Sissy Spacex's performance as Loretta she just embodied the woman and just the subtlety of how she portrayed such a big personality and she deserved it and she did all her own singing if my memory serves so it was just an amazing, amazing performance speaking of another woman in the arts but in that kind of stream of consciousness on stage this is finally answering this question she gets to a point, do her as in do little is you know kind of in the aisle and he's looking at her and he's seeing her kind of just collapse from exhaustion almost but she said you know I wanted to come out here and just tell something to all y'all good people she said do doesn't want me to say anything so she reminds me a little bit of myself because I'm like I shouldn't be saying this but I'm gonna say it anyway but she says her good friend was Patsy Klein she actually really admired Patsy Klein but she said so she's got this stream of consciousness and she goes Patsy's always saying now you got to run your own life so that's what I think of as chairman because and Mr. Burns knows this really well is that the pace of small items demanding your attention every single day so the core of what we do chairman, member of the commission all those core authorities are the same we have the same vote in the process but the number of items of maybe not the greatest significance but time sensitivity that demand your attention I think there's some sympathy for anyone in this room knows what it is to come into your office and feel like they just ran your whole day so sometimes I have to take a breath and say girl you got to run your own life so I've got to set my own priorities the other great thing and I don't do a great Kentucky accent but that was pretty darn good but the other thing she says to do later on cause he's always making this sound in his chest throughout the movie it was Tommy Lee Jones who also did a great job he might have been nominated but I don't think he got the Oscar for best supporting actor but she says I had to make sure I get this and she goes you sound like an old buyer growl and it's pretty good well you go listen to the movie though it's pretty good oh the other there's the other my case of my final great line from that movie is do little is talking about growing up I think he grew up in West Virginia anyway I just I love the culture of that part of America which I don't think we've honored as much Appalachia in that part of the country I mean some of our most authentic culture American pure American culture comes from that part of the United States but so do little this is the one line of his and I don't have his accent down as well but he goes honey there's three things you grew up in West Virginia you got three choices coal mine moonshine or move it on down the line very good Chairman St. Patrick's Day is coming up I don't know if you have an Irish accent in there but I won't ask that's that's my side of the family I do not okay Irish joke that's my side also if you know Chairman one last question a few of the and it's Vic we've saved some for you here but on innovation and transformation there were a couple related questions you know do you believe incremental change is enough in the current environment or is more needed it sounds like an NRC staffer had a question about young in my career at the NRC what can I do to drive change and modernize regular regulatory activities and another spin on that was should I as an NRC member encourage innovation and new technology is that my role in the NRC mission that's a great set of questions I think the first of those about incremental change versus step change I think that I've had remarks around that in some of the other answers that have given and in my remarks to say that I and I don't know and it will be NRC employees who decide what where the transformation initiative goes and things like that of course there will be ultimately I think proposals for the commission but taking on the hard work of seeing if there's transformation opportunity and achieving it that's gonna fall to many of the NRC staff that are probably here listening or back over at the office building making sure that everything is functioning well right now I think that the role of every person in any organization is to show up and not with don't withhold their best ideas I spent a lot of the early part of my career I know this is inconceivable based on sitting here even this morning but I was afraid to speak up because I just I felt the Shirley's as I call them surely there's somebody else in this room that knows better than me surely there's somebody you know there's people been here longer than me and they know better and I just at some point I realize that first of all the thing you're thinking that your lack of you know like my ideas probably not that good I shouldn't say it a lot of other people in that room are withholding their ideas as well and we're not gonna get there if that's our approach so I think it's everybody's job that's been my approach in my career once I had this point of understanding that I realized that I should toss my ideas out into the mix and I wanted to be part of creating the organization that I was showing up to every day so I think whether or not it enthuses you I bet you have something that is of value to somebody else if you put it forward and you know I think the pace of change is something that it will be uneven will continue to have an uneven pace of change but I'm excited for NRC's future just very sincerely and that doesn't mean that we don't have a lot of hard stuff to take on board and that you know we're doing equally well in every area but I stand here very optimistic as I said fully confident but never satisfied and that's where I am and I approach my work that way and I think both of those things can co-exist. Thank you Chairman Sminneken.


It's my pleasure to introduce Cynthia Pitter. Cynthia is a registered nurse and a midwife for over 20 years. She's a lecturer at the University of the West Indies School of Nursing in MONA. She holds a master in nursing science from the University of the West Indies and is doing doctoral studies at the Institute for Gender and Development Studies, where her research and publications are focusing on gender-based violence in pregnancy. Currently, she represents the Jamaica Midwives Association at the board level at the Nursing Council of Jamaica. She is an educator and a trustee for the Caribbean Regional Midwives Association and one of two coordinators for the Young Midwifery Leadership Program in the English-speaking Caribbean. Welcome, Cynthia. We're looking forward to your presentation. You have the microphone. Thank you, Cecilia. Good morning, everybody. It's morning in Jamaica, warm sunny Jamaica, happy International Day of the Midwives, and it's my privilege to be here. And I just want to say thank you to Linda for inviting me and thanks to all the Midwives around the world and in Jamaica in particular. Our national project that we are doing for the International Day of the Midwives in Jamaica is to pay our President, at the moment, at the largest maternity health facility in Jamaica. That's the Victoria Jubilee Hospital. She's been a characteristic call to all the women that are there, all the models, and she will make a presentation to the two first babies that were born this morning, and also she will be awarding the Midwife that has been working the longest at that institution. So like Cecilia said, I am from Jamaica, beautiful island of Jamaica, and we are known in the Caribbean, that's Jamaica in the pink where the hour is, and we are known around the world for our legend, Bob Marley, already an artist and I'm trying to navigate. Okay, we are very honored to tell you that we have the fastest woman in the world and also the fastest man, that is Jamaica is the home of the fastest woman and man in the world. Kingston is our capital and we are a resort country. As a matter of fact, we were around the third island in the world and the first in the Caribbean. This is my school where I work, the U.S. School of Nursing, and the teachers that you are seeing on your right is our president, Mrs. Vester. She visited us in January and she had a public lecture and that's the executive body of our Jamaica Midwife Association. We have over 300 direct entry midwives in Jamaica plus midwives who are also registered nurses. My focus today is to inform you, to talk with you about respectful maternity care. That's the other, our word, maternity services. Cynthia, can you speak a bit closer to your microphone so that you're louder? Okay, this project, I became interested in this project when I started reading about it and realized that USCID has done many work in other parts of the world on this topic. And then I started to see how can we do something about it in Jamaica. So my object is for today where I will look at some definition of terms and hopefully generate some discussions around the respectful care in maternity and also give an outline of the proposal that I'm working on in Jamaica. Respectful maternity care is not something new but it started to emerge. We started to coin the world in the 1970s and 1980s. It was brought to national or global attention in 1985 when Maine, along with Rosenfield, brought it to an international conference, the World Respectful Maternity Care. Since then we have had the safe motherhood in 1987 and also the international conference on population and development program action in 1994 as also initiated this concept. That was from the 1970s of until now. We are still having that problem because a meeting was held in Rwanda in just November 2015 and from that meeting we can say that we are still having the problem around the world. Out of that meeting, individuals were talking that we are teaching Midwest to good vaginal exams but not to be kind. They believe that respect maternity care is sometimes framed as a soft issue without the same urgency as emergency obstetric services but the consequences of mistreatment can be serious and far-reaching. The participants at that meeting agreed that more work is needed to achieve high-quality care that is both safe and respectful. WHO also has declared universal rights of all women as an essential component of quality care. Respectful care, I believe, is an essential component in achieving the maternal health goals of the Sustainable Development Goals for the 2030 agenda. It is an urgent priority. In defining the term respectful maternity care universal rights of childbearing defines it as an evidence-based practical model that focuses on the interpersonal interaction that a woman encounters during labor, the legal and postpartum. Emphasis is placed on the respect for women's basic human rights including respect for women's autonomy, dignity, feelings, choices and preference including choice of companionship wherever possible has proven to be effective in reducing maternal mortality rates. Disrespectful care, on the other hand, in childbirth is an interaction or facility conditions that local consensus seems to be humiliating or undignified and those interactions are conditions that are experienced as are intended to be humiliating or undignified. These definitions prove a platform for various groups to unite and challenge unaccepted social norms and poor health system practice. A growing body of anecdotal and research evidence are now pointing to a disturbing future of health workers such as Midwest. Disrespectful abuse and women and girls worldwide in maternal disturbance. Disrespectful care knows non-geographical boundaries and such is not confined to any particular class or institution. A study that was done in Tanzania shows that 19 to 28% there's a prevalence, shows that it's a health crisis, you know, and the study was prompted by the number of facilities of women attending facilities to give birth. They realized that there was a decline, so the study was done and it shows that women describe their abuse as non-confrontational. They resign once they're to abuse because they are being abused. They stay away from home, stay away and stay at home or they simply accept their abuse or they return home or bypass certain facilities or providers. Mayor Respondent described more assertive approach like the fathers on the other hand would request better care or they pay a bribe or lodge a complaint and in one case assaulted a provider. Also in Mexico, disrespectful care was documented. In Kenya, 20% of the women also reported disrespectful care. They found that the study that was done found that non-confrontational care was very pronounced, was very significant, non-dignified care, some women report neglect or abundance or non-consensual care are either physical abuse and some have to pay. They were detained because they did not pay their fees. A qualitative study was also done in South Africa where it found that negative interpersonal relationship with caregivers was one of the themes along with lack of information, neglect and abandonment and absence of labor companion. The patient provided a relationship and an antinatal care uptake at two referral hospitals in Malawi also documented disrespectful care. What are the types of this respectful care? Bros and Il reported that physical abuse, for example, sitting, rock-forcing legs apart, condom pressure for normal delivery, non-consented care, non-confrontational care, non-dignified care, discrimination-based and specific patient attributes, abandonment of care, detention and facilities. In another study done by Manawa, absenteeism or unavailability of providers, corruption, poor communication and willingness to accommodate traditional practices, authoritarian or frightening attitude was also documented. The question is asked, are midwives part of the problem? Skill-birth attendants such as midwives, behavior and attitude are critical components at its release, the best practice in maternity services. Health care providers are more likely to value and adopt professional caring behavior and to obtain skills and knowledge to practice respectful maternity care. Midwives usually work diligent, treat women with compassion and even use their own resources to assist women in the referral in case of life threatening. Emergency. The model that we use in midwives model of care has deep respect for normal skill-birth and the uniqueness of each child-bearing woman and her family. The model is characterized by caring, empathy, support, trust, confidence and all those positive words. As a matter of fact, the International Confederation of Midwives and the International Council for Nursing also mandated their constraints to protect the rights of their clients. The midwifery curriculum in many countries needs all of us threatening in the areas of human rights and respectful care. There are many documented stories and narratives that have implicated midwives and we can make reference to the White Ribbon Alliance. Also in Jamaica, we have our own. A lot of some women reported disrespect and abuse. So we can safely say that midwives are a part of the problem. There are other potential contributions to disrespect for care, however. For example, at the individual level, some women become normalized. They accept their views. They don't talk about it. Lack of community engagement and oversight, financial barriers, lack of autonomy and empowerment on the part of the women. In terms of laws and policies, lack of human rights in some countries, ethics, principles at the national level, lack of environmental, national laws and policies, lack of legal redress mechanisms and lack of regulatory bodies. In terms of governance and leadership, lack of that we are also lacking in that area. The service delivery in many of our practice areas, they are lack of standards and leadership, supervision for respect and non-abusing childhood. Lack of accountability. The provider, sometimes they have prejudiced, provided as the standard a result of training, provided demoralized shortness of human resources and poor professional development opportunity and provide a status and disrespect. What do we need to do? The literature in the United States when we look at the needs assessment speaks to women of color. That's what I found documented is usually women of color or immigrant women who would report disrespect and abuse which is often due to poverty and lack of health insurance. Their maternal rate at that time was 28 per 100,000 which is trending now I think it's on the 14th. All governments are legally obligated to protect respect and fulfill the care of women. We found that lack of information about sexual health discrimination in the healthcare system lack of access to sexual and reproductive healthcare and poor quality of sexual and reproductive health information and services. You heard Karleen just spoke about adolescents are also affected as studied down by Mary Stanton shows that refugees women are also affected it's usually women in low and middle income countries women age 20 to 29 years old women with more than one children. Women who are unemployed have limited education also are disrespectful, disrespected. The characteristics of the abuser lack of information about sexuality and sexual health discrimination in the healthcare system lack of access to sexual and reproductive healthcare. Poor quality of sexual and reproductive health information and services and of course overwork staff poorly paid and erratic schedule create a stressful environment that can underline the respectful care. Of course, respectful care would have impact. One woman's negative experience may be enough to dissuade her family, neighbors, or friends from giving birth in a facility or the day seeking care. It can also impact the maternal and mortality rate. Many patients feel difficult or ignore where the healthcare workers pay to feel demoralized. Disrespectful care is a recipe for dangerous delivery practice normalization of abuse by healthcare providers and health facilities and of course it can lead to barriers to countries achieving international goals. We have known data on the cost but I can just imagine when a woman complains and sometimes these cases would end up in the courts and they have to be compensated, it can be very costly. A study was done in the Caribbean in Domenica and Domenica they have a 98% of deliveries that are done by skilled workers it shows that there was overcrowding and there was understaffed and experienced staff uncomplicated labor and deliveries were over medical life, emergencies were not dealt with in a timely fashion and providers suffer from compassion fatigue, demoralized and overwork. Quality of care was lacking and the labor and birthing process was the worst. So we see we have that documented but we don't have a study done in Domenica so we want to look at the Domenica experience. Our maternal mortality rate at the moment is 89 per 100,000 live birds nationwide 96% of our birds are hospital and 90% of our birds are conducted by skilled attendants including women. Domenica like many other countries in recent times have several reports of abuse by healthcare workers including midwives. Mothers never return to a particular hospital after claims of inhumane treatment. Three women have declared that they would never give birth at that hospital again after they said they were abused and mistreated by doctors and nurses one reported that she became suicidal and had to sweet professional medicine.  I was slapped, laughed and I was in a note of consciousness and that doctor looked at me and said how can I sleep so I must have sleep after that. So some of these are just un-dotal notes that our women are experiencing. A 16 year old claimed that she bore twin recently at the hospital and alleged that one was stolen after birth. I must say that there is usually an investigation and the chief usually follows where they may but most times the publics are not informed being mistrust for the system. The theory that I've not yet coined any theory but the area that I want to look at is central to having any discussion and this is the kind of abuse there should be and how midwives are predominantly women treat other women especially vulnerable women such as those during the birthing process. Midwives are engaged in struggle to assert their professional and middle-class identity and in the process deploy violence against patients as a result of creating social system and maintaining fantasy of identity and power. We can look at patriarchy as one of the theory that we could use the theorem and to give it a theoretical framework on the proposal that I'm working on. So the aim of my study will be called an exploration of respect for maternity care in middle-class practice and I believe it's a conduit for achieving the maternal health for the 2030 agenda in Jamaica. In this study I hope to examine the level at which respectful midwifery is being practiced in maternity care in Jamaica. So I will explore the mother's perception of care received during childbirth because what a woman perceives as disrespectful probably is not so. We have to do an investigation and we also want to examine the midwives perception of care for women during labor. We'll be using a cross-sectional study design using mixed method approach. We are going through the ethical approval process at the moment and we hope to start in September and November. So for the mother's the quantitative aspect of the study we'll do a telephone survey using a questionnaire which was developed by the International Literature and for the midwives with your qualitative study where we do in-depth interview using a semi-structured interview guide. The women that will be included are mothers who were delivered by midwives during the month of September and November. Mothers who gave informed consent, mothers who were 80 and over. Midwives who have worked in the area and midwives who gave informed consent. We'll exclude mothers who are below 18 and mothers who have had zero infection. We'll also exclude midwives who are on a part-time basis and midwives of course who are only during those two months. So we'll be doing our study at two public facilities that offers maternity care in the Kingston metropolitan area based on a 75 million person living in that area. These two institutions are both teaching hospitals and therefore they're more like we open to accommodating research and using the finding. Both institutions of a midwifery program and midwives are rotated through the labor world every six months. Because we have to try the tools that we will be using. It's new so we'll be pre-testing the tool at another hospital which has similar patients and that serves similar populations. Sorry. I believe that this study is relevant to Jamaica because it will strengthen the practice of respectful maternity care in Jamaica. It will also educate models of their rights to be to respectful care inform the midwifery curriculum develop standard that is tool to measure the prevalence of disrespect and abuse in maternity care and also inform future intervention on respectful maternity care. This study will also support the systematic review being currently conducted by WHO in which they hope to identify all forms of disrespect and abuse experienced by women during childbirth in facilities where the way forward. What do we need to do? We need to create we need greater support from government and develop development partners for research and action and disrespect and abuse initiate support and sustain program designed to improve the quality of maternal healthcare with a strong focus on respectful care as an essential component of quality care. We also need to emphasize the rights of women to dignified, respectful healthcare throughout pregnancy and childbirth involve all stakeholders including women in effort to improve quality of care and eliminate disrespectful and abusive practice generate generate data related to respectful and disrespectful care practices and this will ensure some system of accountability and meaningful professional support are also required. The fundamental right for respect for high quality healthcare should extend beyond the perinatal period to accommodate women throughout their lives and development of a tool to measure women's perception of respectful maternal care in public health facilities. We need professional development opportunities and quality of improvement program for example free and in-service program for midwives who are already in the system and of course we need to adjust shortage. Very importantly we need to celebrate those midwives who have given selfish work so we need to recognize them even where the problem of abuse are uncovered and this picture shows last year in midwives of the point in part of Jamaica were celebrated. In summary, while respectful maternal care primarily emphasized the absence of this respect and abuse healthcare providers and other staff it also advocates positive and supportive staff attitude and behavior that increase women's satisfaction with her birth experience. The theme of the midwife, women and newborn the heart of midwifery this is where it's all stuck with us that midwives of the world continue to work hard every day to ensure women and newborns to see the quality care that we deserve. The end and I want to thank you for listening and Jamaica no problem. These are some of my references. Thank you. Any questions? Thank you so much Cynthia. You have a couple of questions. The first one is why did you exclude birthing mothers who were under 18 years old from your study? I did that specifically because in Jamaica we are very protective of our teenage mothers and they have to get a different types of consent. So at the moment we just want to focus on the adults and then in the future we hope to do that data so we can make a comparative data. And then Nicola is asking does anyone know when whose systematic review will be published? Yes. WHO has done a lot of work and you can Google it and you will get information. They mostly focus in South Africa, Uganda, Tanzania, Mexico. So there is the data out there from WHO already. Other questions for Cynthia? Remember to speak on the microphone. If you raise your hand I can open up your mic and you can speak instead of typing. We'd love to hear from you. Cynthia have you collected any of the data yet? We have not. We just have anecdotal notes. That's actually what I'm after. I'm after some of the expressions of others about the disrespect or the abuse that they were subject to. And anecdotal records, yes. And I've highlighted some. So those that are highlighted are the ones that was made public in the print media. Oh, Nicola is asking you to expand on what you have based your questionnaire on. The change project. I don't remember the mean of the acronym. So there are two projects that are supported by UNFPA and USAID. The change project and the traction project. They have done studies and what we have done was to modify their question here. For example, the studies that they have done, they have three tools. One that will observe the midwife well. He or she is giving cure. One that they will ask the patient about their perception of cure. And one that will ask midwives is her perception of cure. So the questionnaire focus on the nine types of abuse, like physical abuse, family giving support or physical need. And then I will turn it around and modify. They gave me permission to modify to ask the questions of the models. So if you base on the change project and the traction project that was done in other parts of the world, they have given me permission to use. And those, like I said, they are focusing on the types of abuse according to WHO and ICPD rights of the women in child care. So, Nicola is asking are you looking at issues of poor practice, medicalization, or only straightforward disrespect and abuse issues? And I think you've given us an idea about that. Yes, because we are focusing on midwives. We could do study to extent on health care providers, but at the moment we believe that midwives are predominantly women. And we believe that women are to be women, but we know that that is not so. So that's why we are focusing on midwives at this moment. As midwives, we want to let our voices heard in Jamaica. So we are embarking on a series of studies looking at other areas to get some attention or some traction in Jamaica in terms of creating our own knowledge. Cynthia, even before you collect data, do you have an idea once you've identified some systematic problems that might be creating disrespect and abuse? What you might use as some corrective actions? Yes. We start looking at the curriculum first. As all the midwives, we need to be a model for the younger midwives. We have annual symposium like a conference in Jamaica each year and Respect for Care is one of the topics that is presented each year. So we are working on it. And whenever issues should come up, we usually attend to those issues immediately. So we are working on a course straight-in on a super-visory and our leadership role in the practice area. Do we have any more questions for Cynthia? I'm sorry, I've just come back. Did you answer the question about what you based your questionnaire on? The questionnaire was based on other things that was done. We used their tools. So we have modified those tools for our cultural preference. And it's based on the types of abuse that are identified by the ICPD and the White Ribbon Alliance. Okay. Thank you very much. Okay. So I think we've run out of questions. So I think we have to say for coming today all the way from sunny Jamaica. I actually live in Scotland where we have sunshine today and I was sitting in the sun for a little while. Just to make the use of it, we don't get sun all that often. So that's a lovely presentation. Thank you very much. I'll just run through these final slides so everybody knows we do each session. Okay. So just a reminder for me to turn off the recording.