Welcome everybody, and thank you very much for joining us today. My name is Hind Kabawat, and I'm the Senior Program Officer for Syria here at USIP. As you know, USIP has been working for the Syrian Revolution from the beginning. And today we are working with leaders inside and outside Syria to empower them to be leaders in their community. And more and more, I hope we can see more activities like this. This meetings reinforce our support for the Syrian society, which is our main mandate. And of course, I'm rushing because there is no time to take a time to breathe, but today we are pleased to welcome you. To welcome the members of the Syrian Civil Defense or the White Helmet. We have some 600 volunteers known as a White Helmet, and they are organized volunteers who act as rescue workers in the areas like Aleppo and Idlib. They are unarmed and impartial. They operate on principles of solidarity and humanity. And this has laid out in the Geneva Convention. In the last six months, they have received more than 2,500 lives, so they deserve everything. Thank you. Because the barrel bombs fall, these courageous men, and also have lots of women, saved lives with their bare hands. As a quick administrative matter, I just want to ask you, if you want to Twitter, please do it hashtags USIP Syria or hashtags with Syria. I just want to thank the Syria campaign, our co-sponsor for this event, to facilitate this visit and making it happening. Really thank you very much. And thank you for taking, for all of you to take this afternoon to spend with us. To begin our conversation, I'd like to ask Anna Nolan, director of the Syria campaign, to offer a few welcome remarks. Anna is a Belfast-born campaigner with deep expertise working on a range of justice issues. Prior to joining Purpose, the organization was incubated the Syria campaign and a work on campaign innovation at Oxfam, it's in Great Britain. Prior to that, she was the campaign manager for the Robin Hood Tax campaign. She holds degrees from Glasgow School of Art and Reading University. Anna, please. Thank you. Thank you. So I just wanted to thank USIP, first of all, for hosting us today. They pulled the gallery event on incredibly short notice, so we really appreciate the hard work that your organization has put into this. The Syria campaign was found in April of this year, and the objective and mission of the Syria campaign is to bring the voices of the Syrian Revolution, the voices that want freedom, that want democracy, that want peace to an international audience, primarily in Europe and the United States. As part of this work, we've launched a campaign called the White Helmets. The White Helmets is a campaign that aims to bring the incredible work that the Syrian Civil Defence do to a wider audience and help facilitate their efforts to secure more funding for that work, but crucially to end the attacks that they have to respond to. These guys can only end the suffering, and it's up to us in the international community to drive, to end it, not just ease the suffering. So we're so privileged to have had the guys in town for the last 10 days, and to be able to share their work with you today. Thank you, Anne. To begin today's event, we will first hear from Dr. Samuel Attar of the Syrian American Medical Society. Before I introduce him, I just want to thank him because he's the cause of my first visit to Killis because of Sam's, they took me under their wings and taken me. So thank you, Samuel, in advance for this. So Dr. Attar is an orthopedic surgeon at Northwestern University, Fimberg School of Medicine. Dr. Attar is an active member of the Syrian American Medical Society called SAMS, participating in medical missions and advocacy initiatives. He has volunteered in Field Hospital in Aleppo with SAMS in August 2013. And also in April 2014. Most recently, he worked at the Syrian Jordanian border in July 2014. With Metsens en Frontierre. Dr. Attar, please. Thank you very much. Good afternoon, everyone. Skips to the end, sorry. I'm Sam Attar. I'm an orthopedic surgeon at Northwestern University, but I've also volunteered with the Syrian American Medical Society. I just want to say thanks to the USIP and also the Syria campaign and also the civil defenders. It's an honor to be in their presence today, an honor to be a part of this program. I'll speak briefly. I just want to lend some perspective, give some insight into what life is like on the ground. And I can really only speak to what I witnessed as a surgeon in Field Hospitals in Syria. I volunteered in August 2013 and in April of 2014. I took this picture on the way in. The population stacks buses and cars on top of each other because these buses serve as shields from sniper fire. So snipers in Aleppo unfortunately shoot everything. They shoot at children. They shoot at elderly. They shoot at animals. Again, I worked with the Syrian American Medical Society who got me in touch with the Aleppo City Medical Council, who's a group of local medical professionals in Aleppo with no political or military affiliation. On the way there, I pretty much took a flight to Gaziantep. I got picked up at the airport, got driven to the border, passed the refugee camps, and I got dropped off at the border. Once you pass that line, you're kind of on your own. You cry for help. There's not much there to help you out, except these guys, if you are getting in trouble. On the way in, I took pictures of the destruction. Nothing's really been spared. Homes, schools, hospitals, bakeries, bread lines, all have been attacked and destroyed. A lot of buildings have been gutted. You'll find roofs pancaked on top of roofs. And the hard part is imagining the people that were living there. These were civilians who were living there, families and mothers and fathers, brothers and sisters. This was a mosque that was destroyed. This is the Dar al-Shafat Hospital, which was destroyed in November of 2012, or received some media attention. This is where we slept. We all slept on the floor. We all lived in our scrubs. I only did this for two weeks, but doctors and nurses and volunteers in Syria have been doing this for two years. So we're only short, two-week volunteer stints for me. I just get it in packets. These guys have been living this life nonstop for the past couple of years. In August, we lived here. But unfortunately, the hospital I worked at got hit by a barrel bomb. So the top floor was destroyed, so everything got moved to the basement. So when I came back, we were all living in the basement. I was told not to go to the roof because occasionally shots would get fired at the rooftop. So nobody was allowed on the roof. And I tried to stay away from windows because bombs would land right outside the hospital, sometimes a few meters away. And shrapnel would blast into the windows. This was my colleague. He is an orthopedic surgeon. I can't show his face because even health care professionals in Syria are targeted just for helping the quote unquote other side, whatever that side tends to be. He had not yet seen his family. He's an orthopedic surgeon. He's my age. But he hadn't seen his family in nine months. He had a wife and three daughters who he sent to live in Lebanon when the fighting broke out. He stayed behind to help out. And the one thing he looked forward to every night was looking at photos of his three kids that his wife would text him. That was his one thing he did every night. In the emergency room, people ask me what I saw. So I have a lot of graphic pictures. We're not going to show them. But I saw horrifying things, brutal things. It's hard to describe them. This is just one example. A school was hit when I was there in August. And this child was with his best friend at the time when it was hit. The last thing he remembers was seeing his best friend explode in front of him. And we were pulling out bone fragments here from his back. And I wasn't sure where they were coming from, because they weren't his bones. He didn't have any fractures. And after talking to him, he realized they were the bone fragments of other people around him that were hit. And this is the last thing he remembers before his best friend disintegrate. This was a child who I treated. He lost both of his legs above the knee, in addition to most of his family when a missile struck his home. The day before I left Aleppo, he asked me to bring back prosthetic legs, because they didn't have any prosthets or prosthetics in Aleppo. And from his understanding, they're like a pair of sneakers.  We treated a lot of sniper injuries. Again, I said snipers shoot everyone. So I treated head injuries. Not just me. We treated head injuries. We treated arm injuries, leg injuries, abdominal injuries. This is a caliber bullet in a pediatric knee. This is a high caliber bullet in a femur of a 17-year-old that was crossing the street, trying to get some food for his family. Got shot in the femur. We were able to fix it with these nails that we brought in on our backpacks. This is a femoral nail, which you would use to treat anything here in the States if anybody was in a car accident or a gunshot here. The operating rooms are very spartan. There's not really that much to work with, but it's amazing what you can do with very little. When barrel bombs drop, those that survive end up with shrapnel in their extremities. So this is an x-ray of a pediatric forearm, of a baby forearm. So all of that white stuff outside of the bone, you see that's all shrapnel that's projected into the soft tissues. It's hard to get all of that out. It's hard to clean all of that out. This is a happy story. This is a child that was caught in an airstrike, and he was brought into the emergency room unresponsive. He was rescued, brought into the emergency room unresponsive, did not have a pulse. His thigh was blown open. He did not have a femoral artery. That was blown open. And his femur was fractured. But everyone worked together. Everyone was part of a team. The blood vessel was found. It was clamped. His bone was fixed with an external fixator. And then a vascular surgeon took a superficial vein from his other leg and created a new artery. And then that night he woke up. He told us his name. We found out who he was. We were able to call his dad. So that was a win, amidst all of that. One thing I noticed, too, is that everyone pointed to the sky. Everyone pointed to the sky because there was a palpable sense of dread. Anytime you saw these dots in the sky, these are helicopters. That's what they look like. These are all my pictures. Then you'd see dots drop from them. And you'd hope you weren't in the pathway of their destruction. This is what a lipo looks like as of April 2014. I never used to look like this. But these are civilian areas which have been gutted open. Most of it was a ghost town when I was there in April 2014 because people fled. This was a hospital that was destroyed the day after I arrived. The field hospitals are codenamed in Syria. So only the local population knows where they're located. But it was bombed the day after I arrived. I managed to make it over there a week later and just take some pictures of what was going on. Our emergency room was always overwhelmed. We were always working 12 to 24 hours a day, rarely slept. The lucky ones ended up just needing oxygen when they were pulled from the rubble. Some ended up with open fractures. This is an arm that was broken after a barrel bomb hit. And these kids, these three kids were at school when a barrel bomb hit them.  He's just hanging out there calmly.  His hand was saved. But once it eventually heals, it's going to be scarred for life and likely will disable him for life. And then lastly, there's no morgue. So when you work in these field hospitals, sometimes after a barrel bomb attack, there are so many people flooding through the hospital door, there's no place else to put them except on the same bed. If two or three people on the same bed, when you run out of room on the beds, you put them on the floor. When you ran out of operating rooms, there are only three operating rooms. And you have eight people that need operations. You end up doing operations in the hallway on stretchers or in the emergency room. This is a man who lost his home to a barrel bomb. And he also lost his wife. And he was so distraught over what had happened that he didn't want to leave his wife's side until she was taken to be buried. Speaking of targeting of health care personnel, the hospital that I worked at was hit on February 7, 2014 incapacitated to the point where they had to go down from three to two operating rooms. This is what one of them looked like after the fact. And then in June 2014, it was bombarded to the point where now it's incapacitated. So people ask me, what I witnessed, what I saw, that's pretty much what I witnessed. And when I saw them, people ask me, well, who are the good guys? Well, I can at least tell you I met a lot of good people. I met a lot of good people who I trusted. These are doctors from the Aleppo City Medical Council. Many of these doctors had a lot of money, and they could have left, but they chose to stay, sleep on the floor and take care of people. They all worked together. They all worked as a team. I'm still amazed that a child like this could have gone through the injuries that he has and still is able to smile like that. And I think it speaks volumes to the resilience not of just children, but also the Syrian people. This is a man who saw an elderly lady get shot by a sniper, and he went to save her life. He saved her life in the process. He got shot, but he saved her life. And he only ended up with a minor arm wound. And then lastly, I want to finish off with these guys. I talked about some good people. You guys might recognize some of your friends. The hospital I worked at was in Aleppo. And in April, one day, the White Helmets showed up to our hospital, because when they weren't busy saving lives, they decided to show up and donate blood. And so they all came together to donate blood. These two are getting a little bit woozy, as you can see.  This guy here was just getting started. That's why I look so happy. So that was it. I crossed the border, and you're back home. But again, there are a lot of bad things happening in Syria, but there are a lot of good things happening, too. There are good people who are trying to make a difference. They really are heroes. They don't plan on leaving. They're doing the best they can. And they need all the help they can get. And there are three of them here today with us. So thank you very much for your time, and for letting me talk to you about Syria. Thank you. Thank you, Dr. Samir, for reminding us all that there is lots of good people. And hope we know that all this destruction is the result of what the Assad regime is doing. So now I'd like to introduce our panelists, who are all members of the Syrian civil defense team, who I like really to give them a very warm welcome to be here with us. So our first panelist is Ra'id Saleh, who has served at the head of the Syrian civil defense in Idlib for the past year. Before the Syrian Revolution, Ra'id was a businessman who sold electrical equipment. Ra'id was appointed by the local and regional authorities at the head of civil defense in the western liberated areas, which mean he manages 360 members at 17 stations. In August alone, his team responded to over 70 bombings and saved 177 lives. And also our second panelist is Khalid Harrah, who is featured in the video. We're about to show you later. And he's a member of the Syrian civil defense team in Aleppo City. Just to let you know that I witnessed your work in Aleppo in Ramadan in 2013, and I'm so honored today to be here, because I know how much you did to the Syrian people. So before the revolution, he was a painter and decorator. And also he joined the Syrian civil defense volunteer nine months ago. So welcome. Third, we have Farouk Habib. He's the program manager from the Syrian civil defense. He was closely with Ra'id and Khalid and their team. Originally from Homs, my favorite city, because my grandmother from Homs. So you're going to get a very special treatment. He was one of the early leaders of the revolution there, and he will be translating for Khalid and Ra'id today. So to provide you also with some context about the work of the Syrian civil defense, we have a short video. We're going to show you the short videos that highlight some of their great work. So thank you. This is Ra'id. His voice became very loud. We listened to his voice, and it was very difficult. After we arrived here, the work became very sad. This is the age of two weeks, or more, at any moment, he will dry up or die. The time has come. Of course, this is not possible. It's very sad. This is a spirit. You can do it in a very dangerous way. This is the age of two weeks. He will dry up or die, or three or four times a week.  I told him to cut, cut, cut. I'm going to show the other movie. That's it. This is so inspiring. Thank you.  Thanks to you, of course. Khalid, would you like to tell us a little bit more about your experience and your work to the highlight of this video? If you can tell us more about this. Peace be upon you.  I'm a man defending the city of Aleppo. For a while, I was in the city of Aleppo to a specific place. I didn't have a long period of time. I was in the city of Aleppo in the morning. In the morning, from 6.30 to 8 in the morning. This was a period before the city of Aleppo. For a while, I was defending the city of Aleppo. Our city of Aleppo. This is the boy you saw in the video. He was our center general. Khalid speaks about the intensive sharing on Aleppo city and all the civilian neighborhoods in that area. They used to expect the regime's air strikes every morning between 6.30 to 8.30. The regime even started targeting systematically the centers of the civilian defendants themselves. This baby, who you see in the video, was targeted to him and his family in a civilian building very close to the civil defense center in Aleppo. Today, our center general is in the center of Aleppo. One of the centers of Aleppo is in the center of Aleppo. This is the boy you saw in the video. That Tuesday, I remember the regime air strikes targeted our neighborhood with five barrel bombs. One of them targeted our center and the other one targeted the civilian building where the family of that baby was. We went there trying to help the civilians who were under rubble and the locals in that area told us that there were three families living in that building and actually they were families of three brothers. We respect them and we respect them and we respect them and we respect them and we respect them and we respect them we rescued the first family the second family and we were searching to find the third family. It took almost seven hours from us to rescue the three families, and when we were collecting our equipment, trying to go back to our center, a mother came crying and asking for our help to go back and look for her two children. She has a daughter of Shukran Amin bin Ed, a year and a half, and a baby of 10 days old. We went back and it was very difficult for us. It was a miracle to hear the voice of that baby. And in the beginning we thought that it's the voice of the one and a half year old baby, not this one. We didn't have advanced equipment, we didn't have search cameras or sound sensors to detect where the people are under rubble, so we used very light and basic materials. It took from us 16 hours, and in the last hour we were able to know where the child was, and we opened a hole in the wall to pull it. This story is one of thousands of stories in Aleppo, and in this story we were able to rescue that baby, but his sister, the child of one year and a half, we found her dead. During those 16 hours we were not able to keep working for the whole period because the air strikes continued and the same airplanes were coming again, so we worked for an hour or two hours, then we received a warning that there will be another air strike, we escaped and we come back again. Khalid had said that there are a lot of impressive stories which were not filmed, and we are a lot of so many impressive stories which were not filmed, this is just one example, and he said that if they have proper equipment they will be able to rescue more people. Can you tell us more about the serious civil defence, how does it work, how does it operate in a daily basis, more details about the operation? Just referring to the introduction, Raed said that he was not appointed by the local authorities actually, he worked on the ground with his colleagues of volunteers, established the first centre and gradually they expanded their work and they built their organisation, they are not assigned by anyone. Of course they co-ordinated with the elected authorities in the liberated areas. We came out of the protests in the Syrian revolution in 2011, and then we went to Turkey, and our efforts in the protests, we worked in the protests for many years, and then with the liberation of small areas from the regime's hands, we returned to Syria in the beginning of 2012, and we started working in the Eghasi field, there were a lot of protests, we helped people, we established the protests in Turkey. We have been working now for a year and four months, actually, we started our activities in helping our people from the beginning in 2011 when we participated in the revolution and the peaceful demonstrations, then we escaped when the army invaded our areas, we escaped to Turkey, we lived in the camps and we started working on relief projects in the camps of refugees, then we went back to Syria to the liberated areas when the FSA liberated some areas in the north, and we started providing assistance for the people there. The shelling targeted everything in Syria at that time until now, and Ra'id and his colleagues were trying to rescue people after the airstrikes, but they discovered then that sometimes they cause damages because they are not well trained to do this work. Then they started communicating with other donors and organizations trying to get assistance to know how to do this work. We had 136 people working in the civil defense system, they are in the same management, the district has 20 employees, each company has 25 employees. We expanded our work. Gradually, we got training and we started opening center after center in Jussu Shuo, Ma'aret, Naaman, Bin Nish and other areas. And now we have an organization joining 356 volunteers in Idlib. In 17 centers, there are main centers and sub-centers, but all of them work under the umbrella of one day, the director. Of course, the number is different between 15 or 20 or 25 people. Today, we have three centers of training in Syria, one in Aleppo and two in Idlib. Now, we are currently doing training in new centers such as Lada'i and Hama. And today, thank God, after a year and four months, we have 1,050 people working in the city. 17 centers in Aleppo, 17 centers in Idlib. There are nine centers, they were opened in Hama, six centers in Lada'i. God willing, we will develop until we cover all the Syrian lands. I had explained how they got training first outside of Syria in Turkey. Then they started training others inside Syria. And now they have three training centers inside, two in Idlib Governorate and one in Aleppo Governorate. They are proud that now they have almost 1,050 volunteers working for the seven defense, of course, the Syrian Governorates in Syria. They have 17 centers in Idlib, 17 in Aleppo, nine in Hama and six in Latakia countryside. The daily average of air strikes on Idlib Governorate is 15 air strikes per day. The daily average of air strikes on Idlib Governorate is 15 air strikes per day. And sometimes this number increases, exceeds 100 air strikes per day on Idlib alone, especially when the regime loses in battles anywhere in Syria. It punishes civilians in other areas. And 23 days ago, in one day, the regime executed 125 air strikes. We have plans for the future. For example, we are working to get accreditation from the UN for the civil defense organization as a humanitarian organization working to help Syrians. We want to form special search and rescue teams from our Syrian civil defenders and send them to work to help people in other countries. And we are sure after the achievements we have achieved during the past a year and four months we will not stop or go back. We will continue and advance. Until 23rd of August, we have rescued 2,514 civilians from undervalued. Thank you. Thank you, Harit. This is so inspiring. I like when we talk about hope and about our goals, about the future. Because this is all about the Syrian revolution. Like one of the activists told me, we started as a revolution of dignity and freedom, but the Syrian regime turned into war and destruction like what you witness now in Aleppo. I like now to turn the question to you, my dear audience. We need some good questions. All of your questions are good, but we need to have some debate. We have some times we can have discussions. So please. We have the microphones here. Yes, please. If you would like to introduce yourself and if you have, if you want to address your question to somebody special or to all of them, that's fine too. Thank you. My name is Carrie Lajanes and I have a question about how the people that are working over there doing the rescue work take care of themselves from a psycho-emotional standpoint. This is very difficult work and I know a lot of people are lost to the cause because of that. Okay. Thank you. Thank you. Thank you. Khaled said that it's our humanitarian duty to try to help our people. At the end, we work in our neighborhoods, in our areas. Those casualties are actually our families, our relatives and our neighbors. And we are committed to work and rescue them. Khaled added that we can't lose hope. We feel all is optimistic and we continue. We remember, he gave an example. He remembers a long time ago when they established the first center, there was an air strike on a bazaar in Darkoosh and there were so many civilians killed at that moment. At that time, when he and his colleagues responded to that attack and they're trying to rescue people, they couldn't rescue anyone and they were just collecting corpse of dead bodies. At that time, they felt they were helpless. But then, when they got training and when they had good success stories, now that they remember those times and it's an incentive for them to continue because now they believe that they can do something and they have to continue. Hi, I'm Akbar Shahid Ahmed from the Huffington Post and thank you so much for being here. My question is on the flow of medical supplies. So this is really for all of you. How does the flow of supplies work for hospitals, for groups like the Civil Defence? And with that, how do you maintain the flow of supplies for your purposes when there are so many other groups that might want to take them for their own purposes? So that can mean any of the militias, any of the people fighting on the ground. How do you keep your supplies safe from that? I can only speak to my personal experience. Many of the supplies I brought in, I just brought in in my backpack. Many of the physicians with SAMs, a lot of the stuff they bring in, they just bring in undoubled bags and backpacks that they walk across the border. And a lot of the supplies just get delivered to local field hospitals by coordinating with local volunteers on the ground. I can't speak much beyond that. I can answer a little bit because we had a suitcase initiative. For the last two years we've been a personal initiative. We take suitcases of medicine. When we go to South Turkey or to Jordan, we take with us medicine. And we already had 55 suitcases and it's all personal initiative from American and Canadian friends. Yes, please. In principle we do humanitarian work. We are not affiliated to any political activities. And we are there to help people. So generally we are welcomed almost by everybody. And those armed groups at the end, they are sons of this land. They are Syrians. And most of them are cooperative. They facilitate our work and they don't cause any problems for us. It's said that because of their focus on the humanitarian work, they are allowed even to go and work in very dangerous places like the places which are under control of extremist groups. Because they know that those humanitarian activists work just to help people. Thank you. First and later, Mohammad. Yes, Tia. Hi, everyone. I'm Tia Rojda. I'm Syrian lawyer. I have arrived in the United States seven months ago. I knew Raed and his guys and the local council in Idlib. They actually did a great job with Mr. Abbas Ameen. He's the governor of the Idlib council. And my question, I have actually two questions. The first one for Raed and his guys. I will ask by Arabic. Maybe Abbas Ameen can translate it. Just a second. Thank you. This is the first question. Do you want to open any channel to build medical work in the form of institutions with the Syrian coalition and the Syrian National Council? Yes, thank you. Tia asked briefly two questions, first question to Raed. He asked Raed about the American airstrike on Kaffir Darian in Idlib countryside a few days ago, which caused civilian casualties including three children. And the other question to Sam's organization if it has been able to build institutional structures in coordination with the bodies of the Syrian opposition like the National Coalition and the Indian Council. There were three American strikes on Idlib governorate. Two airstrikes targeted al-Nusra camps and the group of Khurasan. And the third airstrike was on the village of Kaffir Darian and there were civilian victims. 13 civilian were killed. And that was a big mistake. And in principle it was a big mistake to target anything in Idlib governorate because everybody knows that there is no ISIS in Idlib. It's not my work to intervene in these issues and call for an intervention or not our help is to rescue people. In principle the people were angry against targeting civilian buildings in Idlib but actually all of them were supporting the airstrikes against ISIS. The targets were well selected because Idlib governorate itself suffered a lot because of ISIS and the FSA in Idlib was the start of the fight against ISIS before anyone else and people of Idlib believe that they lost so many FSA leaders killed by ISIS maybe more than those who were killed by the regime itself. I don't know the exact answer to the question and the logistics behind it but I can say that the Syrian American Medical Society supports healthcare and local healthcare professionals all throughout Syria so those areas inside government control as well as those areas outside of the government control. Mohammad please you have the microphone. Thank you. Thank you. Mohammad Ghanem the Syrian American Council. It has stated U.S. policy to support civil society initiatives like yours. Have you received U.S. assistance in your meetings here where you promised additional assistance and could you speak a little bit more what kind of equipment you need? The U.S. government has provided several projects on the way to support civil society in Aleppo and we started working with the U.S. for a month. We planned a project with them for 15 days. I think it will be a great opportunity for the U.S. to work with the U.S. and we planned a project with them for 15 days. We provide uniforms, bags, bags and these hand-held equipment. In addition, we have cooperation with one of the support organizations, the S.E.U. and we have a plan for a period of time to enter Syria during this week with a value of $6 million before the U.S. In our meetings here, we promised to provide $4.5 million for other organizations to enter the Syrian civil society. But there is an important point. The U.S. government is supporting the issue of organizations in the difficult times. It said they got some assistance from the U.S. government through Chemonex. They got uniforms and bags and they will receive through the S.E.U. some vehicles and trucks funded by a grant from the U.S. of $6 million. In our meetings during the past few days, we have been promised of receiving $4.5 million in terms of equipment and vehicles for the civil defense. But we informed the officials here that we need also to get funds to cover the operating expenses because those heavy equipment need fuel to run them and need spare parts. And we don't have other sources of income. We are volunteers and we can't cover the operating expenses to use those equipment provided by the U.S. government. My name is Namo Abdul. I'm a journalist with Rudaou News Network. I have a question to all of you. I'd like just to have your personal views about the airstrikes by the United States and its partners. Do you think, I mean, have those airstrikes made the situation more or less dire for the civilians? And also, have they raised hopes among the Syrians as the international community seems to be paying more attention at least maybe to a different enemy now than the enemy that you've been fighting against for over three years? Actually, it did both. It increased the suffering of the civilians at the same time. It gave some hope. People had some hope that if the United States and the coalition started targeting ISIS, they might go further and target the regime later. Or at least stop the airstrikes of the regime in order to prevent it from targeting civilians and blaming the Americans for it. And the suffering of the civilians increased because of the mistakes in targeting some areas like the siles, the grain sines of Manbij. And they targeted also the oil fields. The oil barrel cost us 10,000 Syrian pounds before the airstrikes. Now it cost 45,000 Syrian pounds and it's very difficult to find it. Will the American government compensate us or provide any alternative to get the fuel? And unfortunately there is no clear strategy and vision. And after targeting the grain stores now, we will face a problem because half of the population in the liberated areas get grains from them. So 4 million Syrians, civilians in the northern areas will not be able to get grain and have bread. And we are afraid if the Americans target the other grains in Idlib, we will not be able to find a solution. Maybe there were five or six fighters from ISIS there, but does it work to target that very strategic warehouse? You need to add something? Dr. Attar, what are some of the major shortcomings facing Syria's health infrastructure in responding to this crisis? I'd say everything basic about medicine is a shortcoming. A lot of the doctors have left, a lot of the nurses have left, pretty much every position in the healthcare field has fled, leaving a lot of inexperienced people, volunteers. We don't know much about medicine, but we're doing their best to help out. There are some areas that don't even have basic supplies like antibiotics, anesthesia. A lot of hospitals have been targeted or destroyed, and so a lot of makeshift hospitals have, makeshift hospitals with not very good storage capacity have arisen, so it's really a medical crisis for that reason. Just want to add, from the beginning of the revolution, the Syrian regime targeted the doctors, killing them or asking them to leave or in prison, and there is so many doctors died in prison by torture from the Syrian regime. So it was like a plan to have this situation where we are now. And it's not just war wounded. I share a lot of stories of amputations and disabilities, but those are just the wounded. We're not talking about people that have basic conditions like high blood pressure, diabetes, asthma, leukemia, cancer. If you had those conditions inside Syria and you didn't have access to a hospital or a healthcare clinic, things probably didn't end up well for you for those reasons. Good. Yes. Hi. I have two questions. Can you introduce yourself? My name is Mishalina and I'm a student with WII. And I have two questions for all the panelists. I was wondering, at what age can an individual train and work with the Syrian civil defense and are there female members in the Syrian civil defense? Thank you. Yes. We have females civil defenders working with us in Islam. And the age should be between 20 to 30 years for the new volunteers who want to join the organization. I'm glad that there is one. And for those who defect from the regime, the firefighters who worked for the regime fire department, they are received for us no matter what their age. So, for example, we have someone who is 60 years old. But they have experience and our strategy is to give a place for everyone who defect from the regime and join us. Any other questions? Bassem, please. Bassem from Syria. We need to translate this. It's just like asking Bassem what is the reaction, how these people have been wounded, their feelings, their reaction after this. We have hope in life that there is still something that we can live with. Honestly, we, all over the world, have been patient with the Syrian people for four years. But it is said that the people inside have been suffering from their daily life. Like when they are in the morning in America drinking a cup of coffee and talking about this story. It has become a normal thing. I don't know anything new about our daily life. But the people are patient and they are able to continue their lives. Now you can find the area where you live after half an hour or half an hour, you can find your daily life again. Because it is a civil defense. If you are working for the regime, there is no one to clean the road, it is better to clean the road. When we rescue a person, actually we give him a new life. And this gives us new hope to continue. Maybe the world is surprised how the Syrian people are still able to continue how we survive and how we tolerate all of this. But actually we pull to the whole world that we are committed and we will continue and we will never surrender. And now it is our daily life. Like when you wake up in the morning and take your Nescafe, it is for us we wake up and wait for the airstrike. And when it bonds any place after 30 minutes or one hour, you may see it is normal again and people went back to continue their life. People try to escape in the beginning and many of them left the country and went to the camps. A person will try to live in a camp for a while. But because of the mistreatment, many of them now they prefer to stay under one roof. And they try to escape. They try to escape. They try to escape. They try to escape. They try to escape. And many of them now they prefer to stay under bombing, under shelling inside and not to go outside of sea. So after the revolution, what do you want to do? This is what this time asks. Just a moment. And later, honey. In terms of international organizations, do they exist in Syria? And do they share international organizations and work with you? Thank you. Just a moment. Just a moment. His question is about, is there any international organization working on humanitarian issues? And are there any cooperation with you? Yes? First, regarding the UN organizations, like the WFP, the UNHCR, the UNICEF, until a month ago, we were not able to get anything from them. They worked only on the UNHCR, the UNHCR, the UNICEF, the UNHCR, the UNHCR, the UNHCR, the UNHCR, the UNHCR, the UNHCR, the UNHCR, the UNHCR, the UNHCR, they worked only on the regime areas, they coordinated with it, and they sent the airs to the regime areas, and most of them were sold there. A month ago, the UN Security Council issued a resolution to permit and authorize the cross-border operations. So now the UN organizations are authorized to channel assistance from the neighboring countries, crossing the opposition, crossing borders. The other part is the other countries' organizations, like the Self-Children or GOL, or... There are many organizations, they are not very well-preserved, they are working in liberated areas and they are providing services to the people who are present in the area. But the non-UN, non-governmental organizations, like Save the Children and other humanitarian organizations, they work in the liberated areas and they provide good services and assistance for the people. There is coordination between them. They coordinate with them, but in their type of activities, the search and rescue and firefighting, there is no other organization working in Syria. Thank you. Yes. Phil Schruyfer, retired international health care worker. Just to pin it down to the panel, what's your feeling about ISIL, the Islamic State people, the enemy of your enemy, your friend, or is life more complicated? That's my question.   Honestly, I am the enemy of every person. Who is your enemy? Anyone who kills an innocent civilian is my enemy. Hi, Martha Maratza with Crisis Action. You spoke about what you need from governments like equipment, funding. What can normal Americans do to help you and your organization? I don't know what you mean. But for ordinary people, what can you do to help them? What can you do to help them? To help you. Honestly, I am happy to help and I want to send a message to the people of the United States that there are people in Syria who are able to make the future of Syria the light and the light. Yes. We are not only talking about the people who are expected to be in Syria but we are also talking about the people who are used to living with each other. We are not only talking about the people who are expected to be in Syria but we are also talking about the people who are used to living with each other. The main assistance which you can provide to us is to send the message to your people telling them that there are good people in Syria who are working to build a new future. The reason is that all over the country, all over Syria and all over the people of Syria people have created organizations like Daesh and the Egyptian army who are following the religion and we know that in the Middle East all of us are weak in front of the religion so people have become the leaders of these games. The Syrian people are not extremist. Daesh brought them the extremist group to have a chance to work in Syria because of the ignorance and because the international community abandoned us, they didn't help us and those groups used religion to wash brains of the of the young men and used the religion to take them to war. Yes. A question for Dr. Sameer. Can you introduce yourself? Andrew Overton You mentioned that there's a lot of people with high blood pressure, cancer basic medical issues that we can treat here in a lot of countries. Are these people getting any treatment at all in Syria or I'm assuming their best hope is to get out of the country, but is there any treatment for these people in Syria? I think there are a lot of areas where you're just cut off and I personally don't know and I don't know if anyone really knows about those areas. But there are hundreds of thousands of people in besieged areas that have no access to food or medicine. I'm not sure what the care is like there. I can just say that at least in the hospital I was at I only saw people that were wounded with war injuries from bullets and shrapnel because when you're in that environment, when you're in an area that's constantly under daily sniper fire under daily shelling, daily bombardment you're really only going to go to the hospital if you're injured. That's about all I can say. Laya Reisner. I was wondering if you could explain the relationship between the civil defense units that you work with and the local councils and the provincial councils in Idlib and Aleppo and how that relationship has maybe changed over the last six to nine months. I'm not sure what the relationship is between the civil defense unit and the local council. The relationship is linked with the civil defense unit and the local council. There's a relationship of coordination between the management of the civil defense and the presidency of the head of the provincial council. So there is coordination and so provides a revolt from the provincial council and to the government. We try to get all the working organizations on the ground to coordinate with each other and be in the future under the umbrella of the interim government. I apologize if the question was already asked and answered, so if it is, feel free. But is there any attempt or idea within the civil defense forces to incorporate some sort of mental health or group therapy or anything like that for the civilians that are rescued? No, we don't do that, but we have a plan for every two or three months to support the children, to support the people from the dangers of the war and the mines that have been damaged by the regime and the nuclear bombs and the nuclear bombs. It's not actually till the moment we don't provide mental health care, but we do raising awareness campaigns to spread the message and raise awareness among the people and mainly the children to teach them how to deal with the unexploded bombs, for example, and the other materials of the war. Can you talk about the religious and sectarian makeup of your organizations and of the rescue forces? Actually, we don't focus that much on this. Syrian citizens can join the civil defense. There are no conditions based on any criteria related to sectarian or religious background. We are Muslims, but the first civil defense center, we opened it in a Christian village. Yes, honey. My name is Honey Syed from the Syrian Radio, and I'm honored to be with you today. From all the questions that I have asked you today, what do you think is the role of the media? Honestly, after the media campaign, we were asked to work in Syria. My name is Honey, I'm from Radio Suriyali, also Syrian citizen. And my question was from all the questions that they had received today. What do they think is the role of the media as Syrians? People outside know us more than we do, so we don't know. To be honest, the role of the media is very important in addressing public issues. It's the main message, but the media is genuine. Honestly, today I don't know anything about the media. I want to be able to spread the message of Islam. In the past, we didn't pay much attention for the media work. We focused on our work in rescuing people. And later on, when we met with the Syria campaign people, we were surprised to see that the world outside of Syria know maybe about our work, maybe more than what we know, because people follow us. But in general, I believe it's very important to focus on the media work. But at the same time, he said that there's lack of credibility now in the media outlets in general. And it's very difficult to get a credible piece of news. He wishes that the media agencies focus more on sending pure, honest humanitarian messages rather than implementing political agendas for other governments. Any other questions? Thank you. As you see, there are good people in the Syrian opposition. We have so many of the Syrian people, good people. You can trust. As Ra'id wants, Ra'id doesn't want to be a refugee. He wants to go back home. So in order to do this, we need a fly zone. This is what he wants, so nobody can bomb him and nobody can kill him while he's rescuing others. It's a very simple request. People, they just want to live, and they want to live in peace. As you see, Ra'id talked about there's no sectarians. The first center they open is in a Christian village. Not to say that I have relatives everywhere, but I have relatives in Yakubi. So thank you. With your bare hands, you saved lots of lives. And this means a lot for us. The Syrian people deserve lives, and they deserve to live. And having you all here, it's an evidence that we still have hope. You watched so many ugly footage, but we have Ra'id, and we have Khalid, and we have my cousin here, Faroo, from Homs. We have Dr. Sami, they're all doing great work here. And this is why USIP always welcome these voices. We want to build peace in the world, and this is our mandate. And we want Washington and the globe knows about what's happening in order for us to build a good future. This discussion today is a wonderful example of what USIP is doing for the world and for everybody. We are, inshallah, the voices for the people who has no voices. We're always welcoming you, and you made me so proud. I am proud Syrian today when I see you. And I can see we're going to have hope. And as you said, Ra'id, we're going to build Syria, right? And this is what we want to do.  We welcome you, and we welcome all of you here. And thank you again.


UNU-WIDER has for more than 30 years been associated with some of the most advanced thinking in development economics and the practice of development. Since 1985 the Institute has created a global network of thousands of researchers and policymakers and over the past decade we have implemented two work programs on finance, food and climate change and on transformation, inclusion and sustainability. The UNU-WIDER conference builds on about a decade of UNU-WIDER work. It takes stock of where we've been and thinks about where we're going next. Many of the values underpinning the sustainable development goals are under threat so we're going to be debating how we can put the world back on track to a better future. Conferences are great things. We can do a lot these days remotely but you just can't replace the face-to-face interactions. The research presented usually speaks to reality and ultimately policies and that's what I'm looking forward to. I work with about 50 colleagues around the world to deal with issues of social welfare. This is a great platform for researchers in the Northern South to share experiences about what has happened in their countries. If you want to hear from the leading figures in the field of development economics, share ideas and network then you should come to UNU-WIDER. So just being there and interacting with policymakers and academics leads to a great exchange of ideas and this is something that you can't get by just reading emails. The acronym WIDER was chosen to highlight that WIDER is meant to ask big questions about development. This is what we have indeed aimed to do in the last two work programs and this is why we have named the September conference Think Development, Think WIDER.


So this year's Nobel conference at Gustavus is addiction exploring the science and experience of an equal opportunity condition For over 50 years now. We've ridded the conference in science, but also examine the intersection of science and society As you can imagine, there's a long list of potential topics that encompass the traditional themes neuroscience medicine material science astronomy physics The world is a much different place now than it was in 1895 when Alfred Nobel left his fortune to sponsor the Nobel prizes The boundaries of the disciplines continue to blur and new disciplines have appeared Many of the problems we face are not easily defined by physics chemistry or physiology Addiction is one of these problems Addiction affects every one of us in some way But it can be really hard to define let alone understand on one hand Neuroscience continues to expand our understanding of the biochemical and physiological underpinnings But addiction seems to be more than just a brain disorder. It affects the whole person including their relationships with friends family and co-workers Their problems can cause problems for the community in which they live and the responses that these communities have in the form of laws and Political policies affect the addicted person to complete a feedback loop that could either provide help or further exacerbate the problems It's appropriate then that we should assemble speakers both in neuroscience and medical sociology To help us understand the nature of the problem It's important to ground the discussion in the human element. So moral philosophy should be represented, too and it's also important to include voices from addicts and And finally The conference presents a unique opportunity to bring together experts from various perspectives Experts who probably don't bump into each other that much on the lecture circuit To talk about how we can address addiction in light of what both the physical slash life sciences and social sciences have taught us The 51st Nobel conference will bring all of these elements together for what we think will be a particularly relevant and special conference It's now my pleasure to introduce the chair of the 51st Nobel conference on addiction Dr. Peg O'Connor Dr. O'Connor has a joint appointment with the Gustavus philosophy department and the gender women and sexuality studies program Dr. O'Connor scholarship has engaged issues of addiction and recovery. She was an AA Heckman Fellow at the Hazelden Foundation and one of her blogs Philosophy shaken not stirred appears on the psychology today website. The other appears on the rehabs.com website She has four pieces on addiction appearing in the New York Times and her book life on the rocks Finding meaning and addiction and recovery is currently in press Dr. O'Connor's scholarship is informed by her work with students and with the dean of students on drug and alcohol education programs So please welcome Dr. Peg O'Connor. I'm not going to stand behind the podium I'm going to be free-range peg and I invite any of you if you see me drifting off to one side Give me a gesture. I'm afraid I might fall off So I'm Peg O'Connor. I am trained in moral philosophy That's an important part of what I do and the other important part of me is that I myself am an alcoholic in recovery for a good long time and so this conference to me represents a Depersonal commitment and a professional commitment particularly as it relates to our location and to our student body because my Active alcoholism was during the time when I was a college student primarily and that makes me I think Very attentive to what's happening with our students and some of the changes that I've seen over time And as we think about how we might address that I want to start today by talking about our very cool poster I think this is one of the coolest Nobel posters that I have seen ever and If you look you will see in those little circles various kinds of substances or behaviors either that have been recognized by the American Psychiatric Association as Being addictive or are under the category of being investigated Are they addictive or others that haven't even reached that point yet? But many people would argue for the reality of them. So if you look closely, I I need to look at my screen here We have gambling gambling is a process addiction. That's recognized. I believe we have someone smoking I think that's a regular cigarette and not marijuana, but it could be We have sniffing cocaine. I think we're smoking some meth We have the internet The use of the internet right now is in the category of a behavior requiring further study Whether or not it will be included as a use disorder We have two people embraced in an intimate sort of way because many people are arguing that sex addiction Like gambling is a process addiction that that is real as well next to that I'm squinting. Maybe that's the marijuana is I don't have better vision than mine That's marijuana. Oh, and we have a kitty cat in the house. Hello kitty cat. That's appropriate. We have We have exercise many people argue that exercise can itself become addictive that something that is healthy and adaptive Can become maladaptive and then we also have Alcohol which is in some ways regard as a paradigm case of a use disorder and then we've got various kinds of pills Now if you also look closely, you'll see that all of these When to round they tie around and they tie a person in knots That what may be fun activities or the fun use of substances Over time becomes less fun and it becomes terribly Constricting and it ties a person up. It limits them They give themselves over to whatever these substances or processes are and do we have any students in a Latin class? Any classes this year? So the word addiction comes from the Latin verb a dickie.  Perhaps that a person bestows her agency her freedom over to these drugs or these substances Such that one is no longer free in a kind of way About the title of our conference Scott and I and others had some really interesting conversations about this addiction exploring the science and Experience of an equal opportunity condition the science has become the dominant paradigm for explaining what addiction is neuroscience brain science in particular The experience what is it like to suffer from an addiction? What is it like to experience perhaps what goes on in our brains? But then how does that manifest itself and our behaviors and our attitudes and in our life views? Equal opportunity condition it can happen to anyone no amount of Educational achievement no amount of money no amount of incredible Family love and security Inoculate someone against an addiction So the title really is meant to show the ways in which None of us is immune from the effects of addiction And that's not to say that all of us could be addicted But I'm sure if we were to do a survey here one of the things that we realized in framing this conference is that Everyone's life is touched by addiction if it's a family member if it's a friend if it's a co-worker If you're living in a dorm with someone so all of us have a stake in this question in this condition and figuring out what it is Now I'll move away from the podium. It makes me nervous behind there Historically addiction has been used or understood as a moral failure of some sort It's thought that addicts possessed a kind of weakness of will and we can go back to everyone's favorite philosopher Aristotle I warned you about that moral philosophy piece Aristotle who argued really that there are two kinds of weaknesses of will in Some people their appetites or desires completely take over everything So appetites and desires run awry. That's one kind of weakness of will Another kind of weakness of will is that we deliberate we have our rational capacity. We know what we should do But at the end we give into those appetites or those desires And what Aristotle talks about is each of us becomes who we are with respect to our moral character by what we do habitually and so when we think about addiction as a habit it Seems that some of us become addicts by what we do over and over and over and over again And for Aristotle that is a kind of moral failure. So we don't so much talk about weakness of will We talk now about a lack of willpower But it's the same sort of picture behind it that some people just are not exercising Their willpower to put the brakes on their use and because they don't do that They are therefore making some kind of choice and then responsibility attaches firmly to them And so we end up with really interesting accounts of Responsibility Attaching to a conception of free choice that it turns out may not be well founded or well grounded at all When we take a look at what happens in severe addiction with people's abilities to make good kinds of decisions The good news is that much of the moral disapproval about addiction is lifting in different ways I'm not going to say that it's now acceptable to be addicted to something but in many ways there seems to be both individually and more collectively a kind of compassion about addiction and That may have to do with our seeing populations becoming addicted that we never thought what someone like that could become Addicted one of the things we know is that addiction rates among the elderly is starting to increase a good deal Partly that has to do with prescription medications Partly that it has to do with increased alcohol use because perhaps many older people are living alone They're isolated. They're lonely in general people start to use for reasons And those reasons may be good and those Reasons and the use may make someone feel better for a while, but then go back to that graphic up there What feels really good over here doing it to this amount as you progressively do more and more and more Becomes more and more harmful, but then you're caught in a kind of feedback loop. We think about addiction actually that term doesn't appear in the Diagnostic and statistical manual edition five, which is really the Bible of the psychiatric association Instead we now talk about everything as a disorder. So we talk about substance use disorders And there are eight of them alcohol tobacco marijuana are the most common forms of them Stimulants sedatives Opioids hallucinogen and inhalants. Those are the eight categories. I think I hit eight. I wasn't counting on my fingers If I missed one I apologize The best numbers indicate that about 26 million US citizens are addicted the bulk alcohol Then tobacco and then marijuana 25 million people When you think about that number, it's rather mind-boggling and when you think about some of the related health concerns That arise with certain kinds of usages over time. It becomes even more frightening Now one of the two of the speakers that we have coming Eric and Denise Kandel Have done incredibly important work with respect to the brain Eric Kandel in particular a lot of his early work was about neurotransmitters and also about memory and Eric Kandel has now been working with his wife dr. Denise Kandel who is also one of our speakers About the molecular Basis for what Denise Kandel identified as the gateway drug hypothesis have people heard That that's the idea gateway is a word that doesn't maybe resonate with the younger crowd if I said on ramp Maybe that would get you there the idea that Young people or any people start using one type of drug and then whether by habit or now What Denise and Eric Kandel are looking at the molecular basis for it that those drugs in some ways prime the pump For the use of other kinds of drugs now. It's a fascinating hypothesis Here are some of the things we know Inhalants are used by young children what's included as inhalants shoe polish magic marker spray paint glue That you have kids 11 and 12 years old who are sniffing them And getting a high off them and now some might say if you've got that noted that that picture of habituation Well, you get used to looking for those sorts of highs or it's something fun to do with friends It's like hey, I've got a new can of spray paint What do you got the other thing that we see is that young kids are both smoking cigarettes Even though you're supposed to show an ID to get cigarettes, but you can get cigarettes anywhere and These new e-cigarettes that are packed full of nicotine are quite popular with the younger set And so one of the things that Denise and Eric Kandel in particular are looking for is the influence of nicotine as The gateway drug to future use Age of first use matters enormously When students or when children start using their substances, whatever they may be before they are 18 One in four stands a chance of becoming one in four becomes addicted. Let's put it that way when People start their substance use 21 or older. It's one out of 25 So those are really staggering numbers when you think about it And so when I think about it, I think about oh my gosh How are we enlisting elementary school teachers and counselors again to go back to the inhalant use to go back to the tobacco use How are we enlisting high school teachers and how and what are we doing here at a college that these are all crucial Questions so the science here is incredibly important. The science may help us to form some good educational programs Science isn't in crucial is a crucial component of our discussions about any kind of drug addiction and The the tale the explanation that's being given about how Drugs work in the brain. It seems that drugs work in one of three ways some of them will pose as a naturally occurring neuro transmitter and take the place of the naturally occurring Transmitter and act in exactly the same sort of way. So included in that would be Morphine morphine mimics naturally Occuring endorphins, which means those endorphins that occur naturally can't get there. They've been there's like a masquerade It's like fraud alert someone else is using your credit card some neurotransmitters Will block a natural or some drugs will block a naturally occurring neurotransmitter That's what happens with alcohol alcohol blocks glutamate glutamate is absolutely vital for memory for learning and Cognition so once again, that's when dr. Eric Kandel's work is vitally important here and some drugs augment They increase The naturally occurring transmitters so cocaine for dopamine that burst of pleasure and euphoria and Ecstasy for serotonin so last year at Wesleyan University, which is my alma mater There were Was it 11 or 12 students who overdosed on a bad batch of ecstasy and some I'd say there's no good Dose or good batch of ecstasy. It's an illegal drug so ecstasy Ecstasy when you have too much of it when you overload your body with serotonin the effects of ecstasy Include your blood pressure rises really suddenly Your heart rate accelerates really suddenly and your body temperature accelerates really Suddenly not to put too fine a point on it But when you overdose you're kind of cooking yourself from the inside out and that's a very graphic way of putting it But ecstasy is regarded as a party drug that there was a fair amount of it Available so we always at colleges need to pay attention to what are the illegal drugs that are floating around out there How do they intersect with? legal drugs, I mean even say nicotine or when you're of age with alcohol and How do we think about what the effects are of mixing all of them one of the ways that science has been talking about addiction? Is that the brain is hijacked and that's a very compelling image? The idea is that as I've just described these drugs go in and they mess with naturally occurring Neurotransmitters and receptors and they take over. I have read that the brain goes rogue I have read that the brain is commandeered It's been hijacked and I've been very critical of that analogy because it seems to take away Human agency in general it breaks down because when I get into my own car I don't understand myself to be hijacking my own car I understand myself to be driving my own car and there's always that question of a person has to take the drugs introduce the drugs into his or her system for all of that Neurochemical tsunami to get going so I've been very critical of that analogy Until I read about some of the drugs used to treat Parkinson's disease Parkinson's disease involves the People who have Parkinson's are no longer really able to produce their own Dopamine their own kind of it's it's it's part of the pleasure reward circuitry So these drugs were created that mimic Dopamine they mimic dopamine far too much though because what they found was that a Significant number of people taking these drugs one was I think re quip and one was Mara Mara pecs. I mean how they make up these names. I don't know People taking these drugs suddenly were engaging in compulsive gambling They were engaging in all kind of Cybersexual affairs and adultery. They were shopping and out-of-control kinds of ways and then when they stopped and the drugs exited their system their behavior Reverted to exactly where it was before but the fact their lives now were utterly decimated I Read about one man who lost his life savings and who had committed adultery and he gets off these drugs and his life is in a wreckage and that really did make me say I need to Reconsider what I believe about that hijacking analogy. It may be useful in some ways But it certainly has its limitations because if you run with that hijacking metaphor It becomes more difficult to talk about good robust notions of Responsibility how are addicts responsible for our addictions? And I'm really glad that one of our speakers is Owen Flanagan who's a moral philosopher at Duke And he has done a lot of work on shame That there seems to be a couple of kinds of shame at work with addiction and one is that there's a shame in Not using your rational capacity to make good decisions remember that weakness of will you've got rational capacity But then you always override it at the end that kind of shame that then gets built upon When you start to act in those kinds of ways You're not living up to be the kind of good moral person you want to be so that that shame Starts to multiply but what kinds of accounts can we generate for For responsibility and addiction and we always have to be very careful because always in that background as I said earlier Was the view that addicts are somehow moral failure? So how can we introduce moral responsibility without bringing a lot of that kind of baggage?  It's in a social world. It's in a world of economics It's in a world of politics. It's in a world of race all those sorts of things Where does environment fit into our analyses of addiction? And this is one of the reasons why we're so excited about this conference You can't talk about addiction and just make it be a property or condition of an individual It is a public health concern. It is a legal concern. It is a public policy concern It's all these kinds of concerns. So how do we talk about them? One of our speakers is Dr. Carl Hart who's written a wonderful book part memoir called high price and He was raised as an African-American in a very poor part of Miami and he talks about all the things that that he did He was dealing drugs and doing drugs and yet he didn't become an addict But yet many of his friends he knows did what was different there and one of his messages is that it's vitally important That we not get our causality backwards So for instance, it's often assumed that addiction Causes a whole host of social ills and Carl Hart is going to turn that upside down and say Those social ills those social considerations the fact that some people are fundamentally marginalized discriminated against reviled that those perhaps Give people reasons to drink and that addiction is actually a symptom of much larger social problems and social ills and That raises the really interesting question if we want to address addiction What ends of the stick do we grab? We can treat individuals. We can say well, you know Peg get into rehab 28 days of rehab and do this and do that or Or we could also look again at those social political economic Environments in which people have reasons Perhaps justified reasons to drink or to use That's why a multidisciplinary Focus when we talk about addiction about addiction is absolutely crucial Question of when we talk about treatment again to cease using whatever it is that she's using that may well be accurate However, there's really no set Understood shared understandings of what good effective treatment involves Does it involve abstinence or could it be? moderated well-managed use is that a possibility Does effective treatment involve considering we've got to treat certain kinds of social ills That's why sociology is incredibly important to any of the discussions that we have about addiction Talking about addicted populations again talking about those dynamics that are perhaps identity Deconferring where do we factor those into the mix? I'm gonna now move to my second and last PowerPoint slide. I don't like PowerPoint. Here it is So as I said Substance use disorder is the new term that we use and that it is on a spectrum It is progressive and the DSM 5 has come up with these 11 criteria That should be considered in a 12 month period There are four categories One asks is use somehow Becoming out of control Are you negotiating and bargaining with yourself to try to cut down? Do you make deals? Do you make promises? So the first category is about how much control do you have over your use? The second category is Your use getting in the way of important social roles or social functions that you have The third category is about risky use our bad things starting to happen to you is your health being affected other kinds of physical risks or hazards that you're finding yourself encountering because of your use and the fourth category pharmacological indicators in effect is it taking you is it taking more of the substance for you to reach a certain point of intoxication or highness or buzzedness and Do you experience withdrawal when you cut back or when do you stop using? So on the spectrum Meeting two to three criteria is considered a mild use disorder. So two to three of These 11 is a mild use disorder and this one up here is alcohol use but substitute in those different drugs Four to five is moderate. So you're starting to move down that spectrum six plus is Severe So now I'm going to raise that question again about treatment It seems that most of our treatment efforts have been geared towards that six plus on the extreme severe end There's very little in trying to hinder or stop or turn the bus around To move from a mild off the spectrum to move from a moderate back to mild There's very little work being done there It was incredibly important to us in structuring this conference that we raised these questions about treatment So our final Wednesday session is dedicated to the question What's effective? treatment What's working? What's not working and what might we need to do? differently as Our understandings of addiction become far more complex. We need far more complex and nuanced Understandings of treatment. We don't yet have them We need them No two addicts are identical Different addictions Manifest and present differently. So what may work to treat this addiction over here may not be an effective means for treating this addiction over here complicate the picture even more Of the 26 million who meet the diagnostic criteria for a substance use disorder Probably about 8 million of them also have a co-occurring mental disorder and that again raises a question. What do you treat first? What end of the stick? Do you grab first? Those are questions that are remarkably unsettled. They are undetermined So the discussion on that Wednesday afternoon session I think will be quite lively One other question that comes up about treatment So with respect to heroin is one of the worst drugs to try to get off The withdrawal is utterly terrible and sometimes heroin addiction is held up. You think it's just a brain disease Be a heroin addict and start going through withdrawal and you will find every part of your body Especially your bowels is really involved with it So what about drug replacement therapies? Suboxone and methadone are two drug replacement therapies for people with heroin addictions and those drugs in effect Stave off the effects of withdrawal without the high There are maintenance program That raises the question for many people. Are you shifting one drug and one addiction the illegal one? heroin For one that is yes medically supervised and hence not illegal But still you are dependent upon it in a kind of way And where do we take into account the voices of addicts who say? I don't want to be dependent on any kind of drug as a replacement therapy Versus those who say this is exactly what I need because it enables me to become a productive member of society Drug replacement therapies are the source of huge public health and public policy battles Because the perception is it's still some junkies looking to get drugs Legally by gaming the medical system and some of our panelists would talk about why we must Overcome that perception that that is incredibly important because that will keep people from getting help And there have been many concerns of people who go to clinics where it is dispensed that they believe they are the target of Police that's quite unjustified and quite unfair. I Want to end by bringing it right close back to Gustavus So one of the virtues of this conference is that we hope to create campus-wide discussion about drug and alcohol use and abuse and not just create Discussion, but maybe create some good educational programming raise awareness about alcohol and drug use on campus The best numbers indicate nationwide that 20 percent of college students Have an alcohol use disorder Now the majority of them are probably in the mild to the moderate, but we know that there is a significant number of Students who have already reached that six plus Educationally, what do we do there to help students try to back it off? Because it is true that many people are able to turn their use around that they can do that some of Us do it on our own others of us can't do it on our own. We need education That's important point one important point two Numbers also indicate that 40 percent of college students binge drink and that's the term that's used a lot when we talk about Alcohol use on college campuses. I don't particularly like that the definition of binge drinking for women over the course of two weeks How many drinks have you had in a two-hour sitting? And if it's four or more drinks in a two-hour setting that's considered a binge and for men It's five drinks over a two-hour setting How many times over the last two weeks? 40% I don't know how trustworthy that number is what we know is that a lot of athletes For example will not drink in season, but when they're out of season they will drink And so if you don't capture them then well, you're perhaps missing They are drinking in these problematic ways, but it won't show up Regardless of whether you want to talk about alcohol use disorders if you want to talk about binge drinking Imagine the numbers of that we can all do the math. Let's imagine we have 2,500 students 20% of 2,500 is 500 500 That's a lot We're going to complicate the picture even more Best numbers indicate that 17 so 1 7% of college students misuse prescription study aids that were prescribed for ADHD 17% of students misuse those study aids and by misuse We mean either they have a prescription But they take more of it in the belief if one pill works really well Three pills will work three times as well. That's bad math bad bad compounding or To misuse is to use someone else's prescription Here's the really interesting thing the major source For students to get these pills when they don't have their own prescription is other friends With friends like that. I mean, I just think about that tagline friends. Don't let friends drive drunk But friends do share their prescription study aids, which is a crime Which could lead to Significant legal consequences perhaps academic consequences perhaps life consequences Here's another thing we know Adderall is the most commonly prescribed prescription medication for ADHD of the students who misuse Adderall 90 90% also binge drink ADHD drugs dim one's perception of the effects of alcohol So if you're really wired up on the stimulant and you're drinking and you don't feel like you've got the buzz you want You drink so far Beyond it you could well drink to the point of alcohol poisoning and that's absolutely horrifying in frightening and Vi-vance for example Stays in your system for 13 hours. So you can still do everything right You can take your drug as prescribed and you think great I just I just nailed that bio exam and That's seven or eight hours later Vi-vance is in your system for up to 13 hours So your ability to perceive how much you're drinking and its effects has gone by So I want to close by bringing it back to Aristotle where we started with that weakness of will One of the really important things that Aristotle says in his moral philosophy is that friendship is the most important moral relationship that you can have with another person and I think Students want to be really good friends. They want to do good and right by their friends But it's also really hard if a friend says if I don't get an A on this test I may flunk out or if I don't if I don't maintain my GPA. I might lose my scholarship and so how do we Help students teach students about friendship and to really take seriously Future possible regret if you're the one who gives a friend a study aid that gets them in trouble or has life-harming consequences Your friends are Vital to your well-being they're vital to what Aristotle says Flourishing or success at living and I would love to see Gustavus Think about create some kind of educational programming. So then in effect We are equipping our students with the knowledge to make some good decisions about those drugs For their own benefit and for the benefit of the friends. That's one of the longer term Consequences I hope of this conference and I would ask all of you students to help make that happen as we think about where it might happen So I'm going to end. I would love to take questions Anything I'd love to hear from you. So, thank you. Let's see if a student has a question first I always favor the students first But if you want a faculty member to prime the pump, we can also do that. Yep prime the pump Our pop culture representations of addiction are fascinating. So just as an example If you came in right before we started I had Amy Winehouse singing ain't gonna rehab with the lyrics there and Earlier this afternoon. I ran into Phil Bryant in the English department. I said, oh, yeah I'm gonna crank up Amy Winehouse and he said well you could also crank up and then he listed all these different songs and artists that were singing about their addiction either glorifying it or You know making it seem like like total fun and I think certainly we see that with respect to alcohol Arthur is a tragic character now, and this yeah Dudley Moore. So you people have no idea who that is Although I think it was made into a bad remake with them I said British comedian was it Russell Brand? Okay, some students go like this. Yes, I Think one of the reasons why we're kind of horrified by that now is that he's an older drunk But the you never see sort of bad younger drunks are younger intoxicated because it's all fun It's like welcome to the party. I mean Animal House I think is a really interesting cultural production about what college life should be and the assumption that Drinking and getting smashed. That's just to write a passage. That's what we do all the time You see absolutely no negative consequences from that kind of party use Let's see. I mean what what might be other examples. I don't know students can help me out.   Nobody really gets hurt or anything like that. Yeah, American pie Here's another thing to think about that when we look at these cultural productions It's usually guys getting really really drunk and that that's okay And we see the same things think about the expression drink like a real man That expression has some meaning doesn't it? What does that mean drink like a real man the vast quantities but not of wine? spritzers either beer or Hard liquor that's drinking like a real man if I said well shit drinks like a real woman It might give me the expression what and also I think there's more Social disapproval for women who are really really drunk Then men and then of course we have to think about the consequences So yeah, all the movies you mentioned were guys getting drunk with no problems. Oh White guys primarily too did I mention that a lot of drugs are racially coated again Carl Hart will be really Wonderful talking about that. Is there really any difference between snorting cocaine and smoking cocaine perhaps not but boy The sentencing guidelines sure made it seem like it was there were significant differences Other questions Yes So do we look at all addictions say to caffeine or to sugar as bad Now here's a dodge Caffeine is not regarded as a substance. That's addictive although they do recognize caffeine intoxication and caffeine withdrawal and caffeine is now in the category of warranting further study to see if it might be and sugar is an interesting one because that connects to discussions about food addiction and there's been I Would say some really good research done About foods that are what they call hyper palatable so the lovely union of sugar fat and Sodium that's what makes it yummy so the laze potato chip commercial from well Hello, white-haired people from The 1960s bet you can't just have one That's what a lot of food companies are now betting on so there There's a very vocal group arguing for the inclusion of food addiction Now a complicated a little bit more some people have asked well aren't there positive addictions Some things that are addictive, but yet to positive end I'd say given the way that we use the word addiction now I would say no and What's gained by saying that something that you love to do that you do a lot of it is an addiction Because in general bad consequences haven't followed from it nor has social Disapprobation disapproval and it hasn't necessarily Created enough for the kinds of problems that you see on those criteria So there was one person who argued for positive addictions There was at least one person currently identified as me who argued against the coherence of that notion that I wouldn't want to Turn too many things into addiction and in part that was a response to things I kept hearing Oh, I'm really addicted to the new salsa at the co-op or I'm just addicted to those trashy tabloids But I'm the grocery store magazine it seemed to trivialize addiction in a way that that I found really worrisome I mean to try to say that these things belong into the same category as heroin or alcohol particularly when you get down to that severe end it seemed to trivialize it Imagine that will come up somehow and that too is a function of the way that addiction runs through all these different levels You know the public policy the the the legal dimensions of it the public health dimensions And I think marijuana is really interesting so 22 states have medical marijuana and how many have recreational is it? three or five Okay, some number between two and five where Once again, I'm going to come down to the importance of Education there's a perception that marijuana isn't addictive and it's not harmful good studies show that When younger people start using marijuana and I'm going to say in this case younger is anyone less than 25 years of age that because of the ways the brain is developing You're more susceptible to do more long-term damage when you smoke marijuana Then if you start after you're the age of 25, so I have stood up in my classroom and said, you know something wins I'm like well if you are going to smoke marijuana legally Please don't start until you're 25 Because it won't harm you as much and I think one of the reasons for the Misperception that marijuana isn't addictive is that you don't necessarily see the same kind of really bad behavior That follows if someone is totally jacked up on cocaine or somebody is really really drunk I mean when you're really really stoned You're just to not to get into brawls Whatever you might eat a lot that's not the same kind of problem and you know interesting questions too about Colorado hasn't figured how to measure some ones intoxication from marijuana when they're driving So that's a an issue that needs to be addressed. Yeah, I'll hold that up there as an issue But marijuana is addictive. It's dangerous Certain mental disorders as I said go along with certain kinds of drugs What goes along with marijuana is schizophrenia? There's this question of do some people self-medicate before they have a diagnosis Do other people have a diagnosis and then they want to medicate to with these illegal kinds of drugs Let's see which other ones go together alcohol and antipersonality disorder I believe it's cocaine with PTSD So you want to be careful do these drugs cause those mental disorders? I'm not prepared to say that Is it somehow part of the mix and we don't really know how and they could exacerbate? I'm gonna say that that's for sure. And so that's why you know at the college. We're worried about Marijuana uses on the rise in part because well, it might be legal here someday or it's already medicalized Well, that's a different kettle of fish from what you're buying and smoking somewhere else Let's be clear on that and mixing with alcohol mixing with these other drugs The students who misuse Adderall who are also binge drinking are also three times more likely to use marijuana So now maybe we've got the perfect storm Well, some people are claiming that Disordered eating and oftentimes they're gonna separate anorexia out from binge eating disorder Some people say binge eating disorder is really food addiction the idea that you just start eating and you can't stop or you're eating certain kinds of substances and binge eating disorder is right now lodged in the compulsive use disorders And I'm not sure that that's fully accurate because it locates the problem on the individual once again Rather than in the substances of what they're eating as Playing an important role in that Yes Sure, and that's always an interesting question too. I mean a lot of people who quit drinking for example are sugar fiends Because alcohol has so much sugar so you go to AA meetings and there might be cookies and cupcakes and candy being passed around While we're sipping coffee and while you know smoking is no longer allowed in most places You talk to certain generations of AAers and they'll talk about the blue haze Because people would be smoking and then that became the question Well, is it more important to treat this addiction first get that one under control and then let's take on this other one That may be a matter of personal choice It may be a matter of a medical decision that you need to make in consultation with your physician or other health care provider Or whomever else how about one more question. I know we're coming towards the end To two more maybe okay. We'll defer to a student. I'll start here and then we'll go over there That's a good question. There may be some Genetic predisposition But the question always becomes what triggers or sets off that predisposition to become something actual and That's where a lot of people are saying you need to pay attention to the environmental factors and again Environment going all the way down into the tiniest part of the brain What is working there such that some gene expression gets switched on or switched off So yes, the neuroscience will help us there But unless and until we pay attention to these other kinds of causal factors We'll still have a very incomplete picture. I think that certainly Eric Kandel might talk about that If anybody can he will and if it doesn't raise it one of the things I love about Nobel is that there's a full dedicated half an hour for questions from the audience that you Can submit on paper or I think you could Twitter it in or whatever the verb is to Twitter Conjugate that however get that question out so that we can answer it well, shall we say good enough and Hopefully see a lot of you at the Nobel conference either live or live streaming. It's all good So thanks for taking the time out today Order your tickets order your tickets. They're going fast


Why do pro gamers wear earbuds and headphones? In this video, I will explain why and compare them both. In short, headphones and earbuds locate the exact sound of where the noise is coming from. This is especially beneficial when it comes to hearing footsteps. You can hear footsteps through normal speakers, but unless they are really spread apart, you won't be able to detect right or left. In some earbuds and especially headphones, hearing footsteps up and down the floor is easier. The stereo audio in most gaming headphones makes it super easy to know because headphones surround your ear. They have speaker grills above, under, left, and right of the ear, letting you know more precisely where the noise is coming from. Pro gamers really benefit from this. Headphones also have a lot of features that they can help gaming like surround sound. This feature makes sounds more precise in locations. You can also set an equalizer which balances out the sound. So for example, this could help lower gunfire sounds and increase footstep sounds.  It mainly helps with subtle background noise like a lawnmower and less with someone shouting. So the main takeaway is that it makes sound more clearer and easier to detect where it's coming from. Now that we know the benefits of headphones and earbuds, let's talk about the difference between the two. Headphones are obviously more expensive and offer better audio in general. They have bigger drivers allowing for better quality and volume. Some have three or six drivers. Headphones are also really comfortable. I think it depends on which headphones you get, but you would have no problem playing with them a few hours straight. Although it would leave a mark on your hair, it's a good trade-off for the comfort. Earbuds just fit in your ear so it's not more or less comfortable. I would say it's great if you game for a while because it won't squeeze or tighten your head. Earbuds aren't as customizable as headphones. They don't have adjustable features and doesn't fit in every ear. You can change the height of headphones and the earcups, but it's impossible to change the earbuds sizing. Earbuds are also more portable. I think it works well with laptops and phones.  Performance we talked about before, but basically headphones win all the way. They have special audio, audio tweaking features, surround sound, better quality audio and so much more. But is it worth the money over earbuds? I would say yes, but it depends. If you're a casual gamer and you really don't mind earbuds, I think that they would be worth it. I used the Apple ones for my gaming PC and it had a small impact on the quality. Although the inverse of this of headphones is really noticeable, earbuds won't leave out the important sounds when gaming. If you're talking about music or YouTube, it's a different story. And quality might matter, but in gaming, it really doesn't matter that much. All you gotta do is hear the important sounds. The mics on the headphones are surprisingly good. All gaming headsets have an detachable or detachable mic, and it really levels up their value for headphones. Earbuds have small and lower quality mics, but they are still really usable. This is a big deal for most people. Your average earbuds are 10 to 20 dollars, but I would say the $30 range is the best value. Headphones on the other hand can go from $50 to $500, but I suggest spending $50 to $150. Anything above that for both headphones and earbuds have diminishing returns, and I personally don't think they're worth it. So I hope you know now why pro gamers use headphones and earbuds, and I hope that you find which type of audio device you like better.