Let me start by saying that the work that I do means that from time to time, my computer's inbox sort of receives images from different parts of the world that are mired in deep conflict. And last December I just happened to receive on this one day two images which were kind of particularly shocking for me and which kind of stood out and troubled me a little bit more than usual. Because last December Syria was in the middle of what was the coldest winter in a very long time and snow had been kind of dumped over the ruins of Syria's cities. And frost, if you like, had kind of enveloped these villages and these towns which had existed for centuries as part of that very unique Levantine amalgam of cultures and faiths and traditions. But which were now sort of torn apart by sectarianism and by civil war. And the first image which was taken from a ruined high-rise building was of the jagged kind of ruins of the city of Homs as viewed through the window of a resident there. This was once a bustling city, a multi-ethnic and multi-religious city, now absolutely a ruin. It looked to me, it looked like 1945 in Berlin if you want to kind of a reference point. The second image was of a child for about 18 months old wrapped in a simple blanket. A child whose family had been displaced by the civil war in Syria and who had actually frozen to death during the night. I think it was the first time we tracked the kind of how the complex development was. The first time I remember getting an image where we'd actually seen babies freeze to death during the night. And at the time it struck me and it strikes me still that there could hardly be a more damning indictment of the international community's abject failure to uphold its responsibility to protect the people of Syria than those two images. What do I mean by that? I mean three years have passed, more than 160,000 people have been killed since the Syrian conflict first began. We now have 2.9 million Syrian refugees in neighbouring countries while 6.5 million Syrians remain displaced inside the country. Ongoing fighting has now left 10.8 million Syrians in desperate need of humanitarian assistance. 4.7 million of whom are in inaccessible areas, which is a remarkable figure in and of itself, and 240,000 of whom are living and dying, starving in besieged areas. And I think most disturbing of all, of course, Syria's civil war continues to inspire perpetrators on both sides of that conflict or on all sides of that conflict to commit new and appalling mass atrocities. For reasons of brevity, I'm going to assume the general outlines of how the Arab Spring turned so cold and so deadly in Syria and no one to most people here, but suffice to say Syria has now ceased to be a political conflict with sectarian undertones and has become a fully-blown sectarian civil war conducted with the participation of some secular combatants. Syria's vulnerable minorities, especially Christians and Alawites, have largely stayed loyal to the regime of President Bashir al-Assad. The government has actively organized civilian militias, for example, from these communities, deployed them alongside other state forces and sent them to attack neighbouring Sunni communities that are presumed simply because of their religion and background to be disloyal. And while the government, it has to be said, still bears primary responsibility for the crimes against humanity and for the war crimes that are being perpetrated within the country. Some armed opposition groups are also committing war crimes, reprisals against minority communities, killing civilians and extradition execution of government soldiers are becoming common. In particular, ISIL or ISIS or IS, as we're now supposed to call it, poses an existential threat to vulnerable religious minorities across Syria and, of course, now in Iraq as well. Meanwhile, the country has been kind of divided, if you like, roughly into three rival fiefdoms. We have a kind of Kurdish statelet in the northeast of the country. We have a government-controlled strip running from Latakia down the western coast and down the southwest of the country, including, of course, Damascus. And we have also then an unstable kind of patchwork of land in the east controlled by various contending rebel groups, an area that makes up half the country, it should be said. So Syria has ceased to be a conflict where the government is simply murdering its own people. It has also become, in the words of the UN Secretary General, a proxy war with regional and international players arming one side or the other. So I believe very strongly that the UN Security Council's inability to uphold its responsibility to protect the Syrian people and hold perpetrators of mass atrocities to account has been perhaps the greatest single failure of the United Nations so far this century. But in order to contextualize that, I think we have to go over some ground about what the responsibility to protect is and what the responsibility to protect is not. The UN and the entire kind of system of international politics, as we know it, is, of course, built around the principle of sovereign equality. The idea that all states have a right to determine their own affairs within their own borders. And furthermore, they have a right to territorial integrity, of course, which is not to be invaded, which is enshrined in Article 2-7 of the UN Charter. However, it's an obvious and a bitter irony that the walls of national sovereignty, which were designed to protect small countries from conquest, have quite often been misused by governments who sometimes view sovereignty as a license to kill. And by the late 1990s, I think, this state of affairs was becoming morally and politically unsustainable. And it's therefore the case that having presided over what were probably two of the greatest failures in the history of UN peacekeeping. Rwanda in 1994 and then Srebrenica the following year in 1995, Kofi Annan was looking to make amends when he became Secretary General of the United Nations in 1997. And at the start of the new millennium in the year 2000, he posed, I think, the question very sharply and very directly when he said, if humanitarian intervention is indeed an unacceptable assault on sovereignty, then how should we respond to a Rwanda, to a Srebrenica, to gross and systematic violations of human rights that offend every precept of our common humanity? And it was really the prompting of Annan, which led to the Canadian government in 2001, funding the ISIS Commission led by Gareth Evans and Mohamed Sunnoun, which developed the concept of the responsibility to protect, widely known, of course, by its abbreviation of R2P. And the responsibility to protect, I think, is actually a very simple idea, and it's focused around, I think, four mass atrocity crimes and three operational pillars. The four crimes, which are, of course, legally defined in the Rome Statute of the International Criminal Court, the crimes of genocide, of war crimes, of crimes against humanity, ethnic cleansing is not in the Rome Statute, but it's another one of those four mass atrocity crimes. The three pillars being, and this is very much how R2P developed and operates, first of all, the primary responsibility of every state to protect its populations from those crimes. Secondarily, the responsibility of the international community not to turn its back, but to actually help and to assist a state that is challenged by conflict or is struggling to uphold that responsibility. And thirdly, and only in the most extreme cases, for coercive measures if a state is manifestly failing or manifestly unwilling to uphold that responsibility. And it was this idea, which was universally adopted, as was said at the 2005 UN World Summit, which happened to be the largest assembly of heads of state and government ever assembled in history. And I think at its core, though, the responsibility to protect is predicated on the notion that sovereignty entails responsibility, drawing very much on the ideas of Roberta Cohen and Francis Deng. And it seems to me that is the correct approach, because it takes the question of rights away from potential interveners and places of where it belongs, the right of vulnerable people, of vulnerable populations to protection. And so the underlying premise, I think, of the responsibility to protect is a fundamental rejection of both the politics of unilateral interference and also of the politics of institutionalized indifference when it comes to mass atrocity crimes in different parts of the world. So in the eight years that have passed since then, nine years, we have made genuine progress. I think R2P has played a very important role in framing the international community's response, for example, led by Kofi Annan to the crisis in Kenya in 2007, 2008, and informed very much the preventive approach adopted by the international community regarding the 2013 election in that country. It's played a decisive role in Cote d'Ivoire, in Libya in 2011. It continues to play a role in a range of situations where coercive military measures are not thankfully necessary. But the development of R2P is also being, quite honestly, clearly not without tragic disappointments and setbacks. And while Libya and Syria provided R2P's biggest challenges to date, there have also been very divisive debates around, for example, Sri Lanka and other situations. And I think after Libya, much of the debate around R2P tended to focus on the use of military force. But of course R2P is about much more than that, and running right through R2P, and I think at the heart and soul of R2P, is an absolute commitment to prevention. Prevention of an initial outbreak of a crisis, prevention of its escalation, and of course prevention of recurrence. And so for example it was with that in mind that in 2010 the governments of Australia, Costa Rica, Denmark and Ghana embarked upon the R2P focal points initiative. Basically an R2P focal point as a senior government official responsible for the promotion of mass atrocity prevention at the national level. And all together since September 2010 41 countries representing all over the global north and south have appointed a focal point. The network brings together states as diverse, for example as the Democratic Republic of the Congo and the United States of America. Guatemala and Cote d'Ivoire, Australia, Ireland has an R2P focal point very recently appointed, and Bosnia. The most recent additions to the network of the governments of Mozambique and South Korea. And it seems to me that such a network for prevention would have been quite inconceivable even a decade or so earlier. But to return to Syria what about when prevention fails? What about these tough cases? And I think Syria really is the toughest case because even with the Security Council deeply divided over Syria an action blocked by the vetoes of Russia and China are obviously individual states and regional organisations took action to uphold their responsibility to protect. And we should compare, I was just talking about this at lunch, but we should compare the response with 30 years ago in 1982 when the current President Assad's father killed somewhere between 20,000 and 30,000 people in the town of Hamar and no one so much as issued an angry press release in response to that situation in 1982. It was very much considered a domestic matter for the Syrian government. Compared to now, by March 2012, one year after the current conflict began, at least 49 countries and the Arab League had already diplomatically isolated the Syrian government and imposed targeted sanctions. Other parts of the UN system also lived up to their responsibilities. The Human Rights Council in Geneva, for example, has passed 12 resolutions regarding and condemning mass atrocity crimes in Syria and had established an international commission of inquiry which has very much tracked the nature of those crimes and I hope will one day be used for prosecutions. Similarly, the UN General Assembly has passed seven resolutions condemning atrocities in Syria. But unfortunately, of course, the Human Rights Council and the General Assembly, these are not binding under international law. And so the Civil War grinds on. And we will never know what might have happened had the Security Council sent a clear message to both the Assad government and to armed rebels in late 2011 that the international community was united in opposition to mass atrocities in Syria. What we do know for a fact is that the absence of timely and decisive action has sent a clear message to both the Assad government and armed rebels that they could continue to do these sorts of things. That the absence of timely and decisive action contributed to the sectarian civil war that now endangers the lives of millions of civilians across the Middle East. And I'll give you some evidence of that. First veto occurred in October of 2011. The second veto occurred in February of 2012. The killing rate in Syria increased from approximately 1000 people per month to approximately 5000 people per month during the second half of 2012 as the Civil War sort of metastasized for one of a better expression. Between February and November of 2012 the death toll soared from 5,400 people to 59,000 people during that period. And the patterns of violence also changed. And this is something that we attempted to track quite consciously at the Global Center. So with each failure of the Security Council to hold the Syrian government and others accountable for their actions, President Bashar al-Assad's forces in particular deployed more extreme force. So for example, although protests against the Syrian regime began in March of 2011, Assad's forces did not widely utilize helicopters to attack opposition areas until after the second veto in February of 2012. And even then they exercised some restraint. Following the third UN Security Council veto on the 19th of July 2012, the number of helicopter attacks dramatically increased afterwards. Moreover, just five days after the vote fixed wing aircraft were used for the very first time against residential areas. And during August the following month the regime conducted more than 110 airstrikes against opposition targets including more than 60 with fixed wing aircraft. So contrary to popular opinion, whether shooting protesters or dropping barrel bombs on residential areas or deploying chemical weapons on the battlefield, the Syrian government has always been attentive and responsive to what's happening at the UN Security Council in New York. So we've now had four vetoes as you probably know and in my opinion an unprecedented display of callous indifference to mass atrocities in Syria. And we've had two successful resolutions, one which enabled the destruction of Syria's chemical weapons and resolution 2139, which was supposed to enable humanitarian access but is yet to be implemented. And this is just one of the reasons why we and some of our civil society partners are working for example with the French government and with Lichtenstein and the ACT group at the UN to push for a code of conduct amongst the permanent members of the Security Council which includes voluntary restraint on the use of the veto in mass atrocity situations. We believe quite obviously that the permanent members of the council have a responsibility not to veto when faced with these most conscious shocking crimes and the issue of the veto will not go away now no matter how much some of the permanent members would like it to. To shift track a little bit, well I think the media have at times portrayed the inability of the Security Council to agree about Syria sometimes to be the result of a kind of alleged misuse of R2P in Libya. The real problem is actually a much deeper division between the permanent members of the Security Council regarding the contours of the entire international order in the 21st century. So Russian and Chinese hostility to action aimed at constraining the Syrian regime is linked to a strategic clash between the P2 that is to say Russia and China and the P3, the United States, the United Kingdom and France on a whole range of situations and thematic issues from Syria to Sudan and from the future of UN peacekeeping to the universality of human rights. It's also worth remembering I think that while sections of the media predicted that Libya and Syria were the graveyard of R2P as an international norm, the facts indicate otherwise. Just to give you one, I guess, example of that. In the five years prior to the Libyan intervention in 2011 the Security Council had only ever referenced R2P four times in resolutions, two with thematic resolutions to a country specific. Take out the Libya resolutions for a moment if we can, but in the three years that have passed the Security Council has referenced R2P in no less than 20 resolutions. And these resolutions concern the trade in small and light weapons. They include the issue of prevention of genocide and they also confront the threat of mass atrocities in places like Cote d'Ivoire, Yemen, Libya again, Mali, Sudan, South Sudan and Central African Republic. And it's also worth keeping in mind I think in that context that 8 out of 15 current UN peacekeeping operations have an R2P or protection of civilians mandate. So my point being of course that R2P is not just a kind of cute abbreviation or affectation to be debated by newspaper editorialists but that actually the responsibility to protect is saving lives right now in places like Central African Republic and in South Sudan. But let's get back more specifically to Syria. I'm conscious that today's talk is being hosted by an institution dedicated to understanding European affairs. And so it's worth saying that Western, including many European powers, observing the unmitigated horror that I've talked about engaged in a bit of a tepid debate during really 2012 and into 2013 about whether foreign government should militarily intervene in the Civil War. However, support I think for military intervention was never more than lukewarm even amongst those governments that were most implacably hostile to Assad. This is in part because I think the balance of consequences argument was a very powerful argument with regard to Syria. No one wants to incite a broader regional conflict and become embroiled in a sectarian civil war in the Middle East. We've had several Western countries have had some experience of that lately elsewhere in the region. That's not to mention the crucial fact in my opinion that such proposed military actions in the absence of a UN Security Council mandate would be clearly illegal under international law. And although R2P is primarily a preventive doctrine, it is intended to also focus any coercive action against atrocity perpetrators in a way that is both morally legitimate and legal, and I'd put emphasis on both of those legitimate and legal. And faced with a deadlocked Security Council and in the absence of any other seemingly viable diplomatic options, Western governments, including European governments, have also debated whether to at various times, whether to arm the Syrian rebels and if so which Syrian rebels do we arm or not. The fact that a number of these groups, especially ISIL, are committing war crimes and conducting sectarian reprisals against civilians has, I think, turned the nervousness of some Western backers of the opposition into a sort of moral panic. And as the list of documented war crimes by those groups has grown, there's now an acceptance, I think, including many of those in the West who have been most verbose in calling for Assad's overthrow, that more arms might only enable more atrocities. Although I've got to say the caveat there is that ISIL's recent military gains in neighboring Iraq might change that calculus a bit for some of these powers. So is there a way out of this mess? Is there a path forward or is it just a case of pessimism and bleakness? To state the obvious, there is no easy solution in Syria. But I think that there are definite proximate steps that the UN Security Council in particular can take to start to positively affect the situation. The first it appears to me, and the most obvious one, is the issue of humanitarian access. According to the UN, approximately 6.5 million Syrians, that's a quarter of the population by the way, are displaced inside the country. And so for literally millions of Syrians, the threat from cold, from disease, and from starvation is now as real as the threat of being shot or being bombed to death. The UN has estimated that, as I said earlier, that 10.8 million Syrians urgently need humanitarian assistance while circumstances for those 240,000 who are in besieged areas is beyond desperate. And in these areas, you know, we have to be very, very clear. In these areas, food is a weapon. It's being used as a weapon. Civilians are being held to ransom and literally starved to death. And it's imperative that the UN Security Council break the siege of Syria and implement Resolution 2139. And I think the international community should be doing all it can to put as much pressure as it can on all members of the Security Council to pass the humanitarian resolution, which is currently being debated and may go to the Council in the next week. The second priority is for the Security Council and especially its powerful five permanent members to use their influence to push for a real outcome that transcends the failed and farcical Geneva II peace talks. Because even though a Pacific outcome to this conflict seems fanciful, it's no more so than thinking that flooding Syria with arms is going to secure an outright military victory for either side or stabilize the region in any way. Genuine peace talks need to have as their departure point, of course, a recognition of the fact that the key regional powers, Iran, Saudi Arabia, Qatar, Turkey need to militarily disengage. And that a broader regional confrontation along sectarian lines or otherwise is in no one's strategic interest. It appears to me that that is not actually a kind of hand-ringing utopianism. It's actually a sober recognition that no one can win this civil war and that behind those regional powers, Russia and the United States need to become guarantors of any eventual peace agreement. Finally, there is the issue of accountability for four years of mass atrocity crimes in Syria. Because I believe very strongly that impunity has emboldened those on all sides who remain most resistant to a negotiated solution. In the absence of accountability for atrocities, there can be neither peace nor justice on the Levant. The Security Council needs to refer the Syrian situation to the International Criminal Court for Investigation and Prosecution and the Chief Prosecutor of the ICC, Fatou Ben-Souda, who I'm a big fan of and who once described the ICC as the legal arm of the responsibility to protect, has suggested also the possibility of some sort of mixed tribunal should be explored and I think that's something that's worth following up on. So let me just end because I know we won't have a more general discussion, but just if I could, some very quick final comments on Syria. I think it's worth reminding ourselves that we call them crimes against humanity for a reason. Mass atrocities that are occurring in Damascus or Raqqa or elsewhere in Syria today are not just crimes against the Syrian people. These are crimes against each and every one of us as human beings and they therefore demand an international response. And while the cruel truth is that there is no quick fix in Syria, that does not mean that the UN Security Council and that the international community has to choose between invasion and inaction if those are the only two options available to us. And I think that's as true now as it was when the conflict first began. More generally, this year is the 20th anniversary of the genocide in Rwanda, a country I've had the opportunity to work in several times. And with that terrible anniversary in mind, I think what UN Secretary General Ban Ki-moon's words regarding R2P are especially relevant. He said, I would far prefer the growing pains of an idea whose time has come to sterile debates about principles that are never put into practice. And with that in mind, I'm also reminded of something that Rafael Lemkin, the Polish Jewish refugee from the Nazis, who invented the word genocide actually and also was almost singularly responsible for the UN Convention on Prevention and Punishment of the Crime of Genocide. He was once interviewed and he was asked what his political goal in life was, and he said, to shorten the distance between the heart and the deed. That's a great quote, which is why I believe that when it comes to stopping mass atrocity crimes in the 21st century, I still strongly believe that responsibly to protect is still the best instrument we have to bridge the gap between the sort of noble aims of the UN and the imperfect cynical world of global governments. And while we've, I think, largely won the battle of ideas, we still need to struggle for the consistent and practical implementation of R2P whenever and wherever human beings are marked for death and mass atrocities are threatened. Thank you. Go Ramele Moraga.


Hello, everybody. Andrea here with Dental L Mobile Hygiene. So how does a mobile dental hygienist work? So like a lot of patients of mine, before they start seeing me, they don't really know what a mobile dental hygienist is, and they probably have not heard of one. I'm the only one in the area, as far as I know, that is offering mobile dental hygiene services.   So I provide dental hygiene examination, so I can check you and your children for any cavities. The only thing that I don't do is take x-rays, because x-rays aren't portable. I can't do that, unfortunately. So if I feel like you do need x-rays taken, because perhaps you have a larger cavity that I feel you would benefit from x-rays, then I would send you to your dental office, or I can help you find a dentist in your area. But everything else, any dental hygiene services, I can do portable. If you have any questions about that, let me know, and teeth whitening, I can do also. So how it pretty much works is before you book an appointment with me, I'm going to ask you to fill out a medical and dental history form. You can do that all online, super easy. That way I kind of know a little bit about you before I come to see you. You, your family, children, I can do everybody in the same day. So if it's you and your three kids, I can do everybody the same day. So I come into your home to perform dental hygiene services. I have everything that I need. You don't have to set up anything for me, just basically I need a space that's big enough for a portable patient chair.  I bring my own side tables, anything too. So none of that is necessary. So you don't really have to set up anything. And dental hygiene appointments typically take one hour per person. If it's children, then a teeth cleaning might take about 30 minutes per person. For me to set up everything, it might take 10 to 15 minutes for me to tear everything down. So once our appointment is done, I clean everything up and that takes about 15 minutes as well. That's it. So it's not too bad. If you have any questions about that, let me know. And I do also submit everything directly to your insurance company. So you don't have to deal with that either. So the day of your appointment, you will only owe the difference that is not covered. If you do not have insurance, then we can talk about a payment plan if necessary, that is absolutely fine by me. How I accept payment is another common question. Email money transfer is perfect. Cash is perfectly fine. Credit cards, anything is no problem. It's completely up to you. And yes, I do offer payment plans if needed, because it's more important for me for you to be able to have access to dental hygiene care. And that to me is important. And you do not have to wear a mask in your own home. So talking about COVID, the pandemic, any changes. So the only changes would be is that I do have a mask on at all times. So that is to protect me and that is to protect you. I'm going to ask you the date of your appointment if you have any symptoms. If you have a cough, anything like that, if you've been around somebody who has had COVID, or if you of course do have COVID yourself, I'm going to be asking you these questions.   But the nice thing about me coming into your own home is you're only exposed to me, essentially, you're not going to a dental office where you're exposed to 80 other patients who come in throughout the day. You are only exposed to me, that's it. And I'm only exposed to you and your family, which is nice. I'm not working in a dental office where I'm also exposed to 80 other people coming and going. I do not see patients who have tested positive for COVID. Certain COVID symptoms, though, we can talk about that. You know, if you're sneezing, have a runny nose, it could be allergies, I'm not going to worry about that. If you have no other symptoms, I'm not going to worry. If your child has a runny nose, I'm not going to worry about that because children have runny noses. I have a runny nose too sometimes because of my allergies. So if you're concerned with any symptoms and whether I can see you or not, we can talk about that, but that's not something I'm too worried about. But the other things, if you also have a cough, if you have a sore throat, you've been sick for a week, then we might have to reschedule our dental hygiene service, but we can definitely talk about that. I see patients every day, so I see patients during the week, I see patients on weekends, and I do see patients in the evenings as well. Of course, the weekends and the evening appointments do book up quickly, so I am booked at least a couple months in advance, but people do cancel. People do reschedule their appointment. I can absolutely keep you on a short notice list. That is no problem, especially these days, you guys. If somebody tests positive for COVID, I cannot see them. If their child in the same household tests positive for COVID, I cannot see them.  You will absolutely be seen sooner. So if you guys have any questions, though, please let me know a little bit about me. I have 17 years dental professional experience. I used to work in dental offices. I have had my own mobile dental hygiene practice for, since I would say late 2018. So I have been doing this now for a little while. I see kids, adults, seniors, anybody. I travel about one hour outside of St. Thomas. So if you're within that area, yes, I do come to you. Okay. There's any questions you guys, please just feel free to comment below or send me a message anytime. And thank you for watching this and let me know if you need anything. I look forward to meeting you soon. Thank you guys. Bye for now.


Hello, hello. My name is Kristi Estrovitz with the San Francisco Public Library here in San Francisco, California on the Roma-Tush land, on the unceded land of the Roma-Tush Aloni peoples. Wherever you're joining us from, we're glad you're with us for this very special Nature Boost with Kitty O'Mara and Louise Herrera. Nature Boost is a proud partnership with our library and our local national parks partners. That includes the Presidio Trust, the Golden Gate National Parks Conservancy, and the National Park Service. For the past five years, we've been teaming up to bring nature experiences to our community. This is look like, oh, shuttles, free field trips from our branches to our local national parks with guided hikes by rangers, ranger talks, insider libraries, story walks in the parks, and an ongoing series honoring the 50th anniversary of the occupation of Alcatraz and much more. With the onset of the pandemic, we had to do things a little differently, so we partnered up for an original programming virtual series to bring a weekly Nature Boost as part of our summer learning program. This was so well received that we decided to turn this into a monthly series bringing a live discussion or a virtual experience to a local national park and more to your screen. These programs like today are available on our YouTube channel anytime for your viewing. With that, I want to introduce our very special guest. Louise Herrera is our beloved and newly retired San Francisco Public Library City Librarian. He was at the helm at our agency when we began this partnership with our parks family. He currently serves as a board trustee with the Golden Gate National Parks Conservancy SF MoMA and is a leader with the American Library Association with the Future of Libraries Committee. He's all he was also appointed by President Obama to serve on the National Library Museum Board in 2012. As well the same year, he was honored by Library Journal's Librarian of the Year. He's going to be in conversation with Kitty O'Meara. She is the author made famous with her poem, and the people stayed home, which brought comfort to our screens, has been turned into, has been translated into dozens of languages, turned into a musical, is a viral hit. He's going to be joining us from her home at the Full Moon Cottage near Madison, Wisconsin. She's a former teacher, a chaplain, a spiritual director. She has her master's in servant leadership, and we are so thrilled that she is bringing her new book to us today. I want to share a quote, it's already receiving much praise. And this is from Oh, the Oprah Magazine. Kitty O'Meara is the poet laureate of the pandemic. The poem has become shorthand for silver linings perspective during the coronavirus outbreak, and the hope that something good can come out of this collective state of together and apart. Before I turn this over, I want to just acknowledge our partners that are with us today to make this possible, and invite you to our next Nature Boost, which is next week with Ranger Fatima. She's going to be sharing Aloni Games, the game of staves, with permission from her peer from the Aloni tribe. So I hope that you'll tune in for this. With that, it is my pleasure to turn it over to Louise and Kitty for their conversation. Thank you very much, Kristie. I'm delighted to be joining you, and Kitty, it's a pleasure to meet you. I want to start by letting you know we're telling you that I really, really enjoyed the book and the people stay home. You know, it started as a poem. Thank you very much. It started as a poem, and poems really tell a story, and they evolve from sort of personal experiences and reflecting a life. So can you tell us about how the story began, and what's behind the poem? Yes, I think I can share some of that with you, Louise.  A lot of the things I believe and have prayed for in my life and in the world, and they kind of were swirling around as my husband and I went into quarantine or lockdown in early March, the end of February, right around then. We are both lovers of the earth, and we had been noticing articles that were saying that even a few weeks in quarantine in Europe and other places in the world where the pandemic had already put people into quarantine and lockdown. The earth was cleaning up and clearing up. The sky was clearing. The air quality was improving. That hurtened me, and I thought as we went into quarantine with the panic, the fear, the anxiety, the worries that brought with it, we could look to these types of things and use the time to consider how when it was over, we could heal the earth more fully. I have said that I didn't think that quarantine was going to reverse climate change, but I thought that these visible signs would inspire us. I also thought that the time in quarantine could be used to do things I've dedicated a lot of my life to, which is art and learning and healing, the continual healing that humans do and that I as a chaplain and spiritual director have helped people do. So all of that was kind of swirling around and I sat down one afternoon and just wrote it. It wasn't a lot of intentional premeditated and edited writing. It was just kind of all of that coming out the way it chose to come out. And I posted it on Facebook and that night a friend of mine in Albuquerque said, oh, I like this. Can I repost it? And I say, yeah, sure. And that was that. It was no big deal. And then it became a big deal within a few days. It's amazing, isn't it? How it just goes viral and something that's powerful and moving can really make a difference. And I love what you say about the power of healing and learning and all these concepts sort of come together in this moment of crisis, right? Right. Go ahead. No, I agree. They do. A lot of things become relevant that perhaps we hadn't had the time to make them before. And you receive so much global attention. It's amazing.  She says that you offer, quote, wisdom that can help during the COVID-19 pandemic and beyond. She is challenging us to grow, to look inside, to listen deeply and to allow ourselves to think differently and ultimately to create new ways of living on the planet. Isn't it wonderful? What was it like to hear that kind of praise? Well, his was among the first and it was, I have to be honest and say initially it was overwhelming. My husband and I were sitting in our living room and he noticed that one of his former students had reposted it and we couldn't figure out how, what had happened. And within hours a friend was texting me that Deepak Chopra had made a video of the poem. So it all sort of cascaded at that point. And I think it was only in retrospect that I appreciated his insight into what I hoped my little words could do. And I have to be honest and say when I sat them down, I wasn't really sending them out into the world. I was just sharing them with a closed group of friends on Facebook so that they did go global and viral and touch people has been equally touching and humbling to me. Yeah, you're absolutely right, though, because it resonated with the human heart and it touched people. So, I mean, even though it's personal, there's that universality that really really went far and beyond, which is so exciting. Yeah, and I think one of the reasons is because the language is very simple. And I think that was one of the reasons that people around the world took it in and translated it into their own languages. I also think people are yearning for a lot of the things that the poem addresses. And, you know, it was sort of unconsciously I wrote it and unconsciously it was received and resonating. And so then within a few days, I restarted a blog that I had stopped a few years ago, and that was the first post that I restarted it with, and began to get these hundreds and hundreds and hundreds of comments. And one of them was from an editor at Traw Publishing, and she wanted to inquire whether I'd be interested in a children's book and I thought that was perfect having been a teacher and written things for children. So that's how the relationship started and the book is the co-creation of all those wonderful people and my own input. That's beautiful. So it went from that poem and all of a sudden there's that transition into the written word, the book, right? Yeah. Oh, that's wonderful. So would you indulge us in reading the book? Oh, I'd be happy. I'd be happy too. I'd love to show the cover because I think it's beautiful and I'm very proud of it. And I also want to, before we get too far, I want to say that there's a wonderful website. And the PeopleStayedHomeBook.com. And it's got a lot of information and a wonderful teacher's guide and I want to let people know that that's available. Great. Yeah. So I'd like to read it and share it with you. And the PeopleStayedHome. I just want to go back to the end pages. I was talking yesterday with your editor and I I love the end pages because there's a picture on each page that matches one on the other and they're not in the same places. So it's really fun, I think, for children, but I got to say I had a lot of fun too. Just matching them up. So it's sort of an activity you can do before and after reading the book that I think extends it, makes it fun. Yes. The dedication is to my husband Philip and I can't say enough good things about him. I love him to bits and pieces and he makes everything possible for me. So that's to whom the book is dedicated. And the PeopleStayedHome by Kitty O'Mara. It's illustrated by Stefano Di Cristofaro and Paul Pereira. And the PeopleStayedHome and they listened and read books and rested and exercised and made art and played games and learned new ways of being and were still and they listened more deeply. Some meditated, some prayed, some danced, some met their shadows and the people began to think differently and the people healed. In the absence of people living in ignorant, dangerous and heartless ways, the earth began to heal and when the danger passed and the people joined together again, they grieved their losses, made new choices and dream new images and created new ways to live and heal the earth fully. As they had been healed. That was lovely, Kitty. I love the pacing and the movement. It has this meditative quality about it. Now, this is your first printed book, correct? Yes. The friend in Albuquerque that I had mentioned earlier had published two of my children's books. They were sort of middle grade novels, just as e-books. And after a few years of very modest sales, we decided to just take them down and so we did.  That must have been exhilarating. It was wonderful. It was very exciting. Meeting with the people at Tra was a gift from the get-go. The co-creation of give and take among us was wonderful. It was life giving. And really I can only call it blessing because I did nothing to deserve this. And it has occupied all the months that we've been in lockdown with just delight and fun and adventure. And it's just been a complete gift. So you just piqued my curiosity. So the poem itself took how long to write? 20 minutes? Maybe? Not like the poems I post on my blog. Wow. And then the book itself from the concept to the actual time you got your hands on it was not too long, right? No. Well, it started in April pretty quickly. And I think I got a copy of my own maybe two weeks ago. So it was beautiful. Beautiful book. And first of all, the illustrations, they really complement the poem, right? And so tell us about your team, your illustrative team. Well, so I worked with Andrea Burnett on promotion. Andrea Gollin was the editor and a real helpmate to me. Stefano de Cristofaro and Jeff Quintana did the, Jeff I think would be called the art director and Stefano did the illustrations. And later a gentleman, Paul Pareta, also assisted with the illustrations. Ilona Oppenheimer is the owner of Traw Publishing, the manager, the publisher. I can't say enough good things about her and every single one of the people I mentioned. They were always upbeat. There was no, there was no ego. It was all sort of, yeah, let's create this and give and take and talk about how I see it, how they see it. And I think we agreed on a lot of things. I wanted just a rampant inclusivity. I wanted everyone that I could think of on earth to be represented and every age group and I wanted cats and dogs and plants and, you know, it was everything I hoped for. And I love, love, love, love this book. I love the illustrations. Well, it's a good collaboration is very evident. And the other thing that struck me was that it has this multinational multiculturalism embedded in there. And so, you know, we love that. And it definitely transcends any one community. So talk a little bit about that. You know, I know it's had that global connection. Yes. Well, yeah. So early on I was hearing from people. There were a lot of people from South America. And I think the rhythm perhaps appealed to them. I don't know. I barely speak Spanish. But there was something about the rhythm of this or the imagery that very much appealed to speakers of Spanish. But then I began to hear from a lot of Asian, a gentleman who was most interested in getting it translated into several African languages. Eastern European. You know, French and in a lot of Western Europe. And again, like I said, I think, I think we all knew things weren't going the way they could on our planet. Our gifts weren't being called forth to the degree they could be. Climate change could have been mitigated and could still be somewhat if we would pay attention to it. And I think the virus itself was a did not need to occur and certainly didn't need to spread. And I think we were feeling as a globe, a great frustration with with what inaction had brought. And I think we were also looking for hope. And my belief is not Polly Anna, although I always defend Polly Anna because she was sassy and spunky too. But but that, of course, we can do better. We can we can join our gifts and we can do better. We can do different. And and I think that's what I strongly want to advocate. And I think that's what spoke to a lot of people because they agree. They agree with me. I agree, Katie, and I speak Spanish and to me, it had that inclusivity, and it had a certain rhythm. And that was beautiful. And I know you've had people get in touch with you because they want to set music to it, whether it's jazz or talk about that. Well, yeah, a lot of composers, choral composers contacted me.  John Krigliano wanted to write a in aria for Renee Fleming. And, but a country Western singer from England created a beautiful piece. A lot of people wanted to create videos their own to go with the piece, and they did. It's all over my my website. I have a few posts that I tried to just dedicate to the people who shared with me. I know a lot of people didn't and because it's all over. You can find them on YouTube and Internet. And that's fine with me. That's beautiful. I will say that a kind of an interesting thing happened speaking again of Spanish speakers. There is a group called the Gabriel Eligria. I have to get all the words right. Gabriel Eligria, Afro Peruvian sextet.  They have been together for 15 years and gotten awards and recognition for their jazz. And Gabriel had tried to reach me and we have not great phone service, so I never got the message. And it came about two months later, one day I was out in the garden and I heard this plunk and all kinds of messages arrived that had been sent in the past couple months. And so I contacted him and he said, oh my gosh, we were just about to forget all about this. And they wanted to use the poem for a piece on their new album. And they wanted me to record it. So I said, okay, okay, and we did that. And then he said, and now would you record it in Spanish? And we'll put that the same piece but with Spanish at the end because the album is about social distancing. And we'd like those to be the beginning and end of the album. And I said, yeah, no, Gabriel really not my wheelhouse. But I thought, okay, I remembered all those people who had contacted me and what they told me about the way this poem touched them. And I thought, you know what, I owe them this. I'm going to give it a shot. And I did. And then Gabriel contacted me. He sent me a recording of himself reciting it. He sent me the word. I did it again. I did it again. And eventually we got a piece that worked for them. And so that for me was sort of a full circle from the beginning of the adventure because I had heard from so many people who speak Spanish as their first language. That's terrific. So let's switch gears a little bit.  And so that's called the full moon cottage in Madison or outside Madison, Wisconsin. What's your daily life like? And how has it changed in the life during the pandemic? Well, in prior years, I had been working a lot with a dog rescue. And prior to that, we had two Border Collie labs for 13 years and they had died and we had adopted a new dog, a rescue dog. And then I started working for this rescue. And now we have five. So we have five dogs and three cats and we're in lockdown. But we have about four acres here with a lot of gardens. And so with the space and the companionship and my husband and I are real good buddies. We talk a lot and share a lot and laugh a lot. So it hasn't been hard other than every other week trips to the grocery store because we live in a state and in a county in the state where mask wearing has not been always respected. And so the caseload is rather high where we are. So it's a little scary to head out to the grocery store. But other than that, and compared to many, many people on the globe, we have been very grateful for our experience during this time. I love hearing about the love of canines of dogs. My wife and I have three rescues. And it's kind of ironic because a minute you started reading the poem. It came over and nestled right next to me. And it was either your soothing words or something, but I just found that so, so cute. But that that's great. And you've got five, five dogs, five rescues and three cats. So that's, that's fantastic surrounded by love. Very much. And it does it keeps our days it kind of in routine in terms of you get up and you walk the dogs and you come in for a while and then you go out and play and then it's a little time for rest and then we go to the gardens and so our days have been very routinely filled and you know it's it's hard for me to find my writing time but because of fill up. I'm able to do that. Oh, that's great. Kitty one of my two of my passions libraries and parks. And I know Christie mentioned early on how we're just blessed in the Bay Area of having a wonderful partnership between parks and libraries for learning. And so they're community partners. And we really see that connection. Talk a little bit about nature and I know this book is all about healing and the planet. But you also enjoy a lot of walks. A lot of delving deep into nature. Can you tell us about what how that inspires you. And the party. Yeah, it's been a lifelong source of spiritual deep deep spiritual joy for me. I was raised Catholic I taught in Catholic school I attended Catholic school so the spirituality of the earth was sort of taught and shared to me all the time I was growing up and became extremely important to my spiritual journey. And I think it's also just who I was who my parents were as well, especially my father was a gardener and had grew up on the lake in Minnesota. And so it just was always very very important to me to recognize that nature isn't the thing that outside isn't a place that it's us that we are it. And the communion that exists between myself and my trees and my flowers and I say mine. Those that I walk among and live among and tend as best I can and who tend me in turn it's all very important to me. It's my church. Absolutely. Some of us sometimes you know we go out on a walk or make the time for that but we really take it for granted and don't stop and smell the roses as they say right. So, what would you, what hints would you give our audience, parents and children to really, really relish the moments and the time when they go out on nature trails and make sure that they're safe for surroundings. Yeah, well, I know that this is true of of county parks and state parks everywhere that a lot of times there are Rangers who will serve as guides. And it's a matter of checking into that online which is easy to do. Guided tours and walks can be so educational and they're often of course designed for families. And so they're age appropriate in what they teach but you learn about the plants you learn about the birds you learn about the co dependency and the evolution of say a given trail or a park over the span of the four seasons. I think that's invaluable. You can do the reading that you know there's so much available now online and videos and YouTube and just create your own nature walk and go out and see what you can learn. There are apps you can have on your phone that will identify also aspects of what you're seeing around you. It's limitless so much you can do and see and learn about and be respectful of as well it's it's not about taking elements of that away from its habitat, but seeing it in its habitat and respecting how it evolves and the interdependency of the species is really a little plug for what the national the Golden Gate National Parks Conservancy is doing with nature boost because it really believes that parks are healthy. They really add to the what they call the parks are X. It's a prescription for good health and more and more studies are proving that to be the case. They're working really hard to make parks accessible to folks that are in urban communities that perhaps don't have that at the ready. The library provides shuttles as we talked about sometimes to to go out and really experience nature, but even within your confines right talk a little bit about what you can do at home or experiencing nature. I know we talked about the virtual and some of those virtual tours. It's one thing. Well a walk around your neighborhood a walk in a park that's safe of course you know do your masking do your gloving and your social distancing but there's still a lot of programs it in my area that are open in parks for guiding yourself or guided tours that are provided. Walking around the block and noticing the trees, seeing if you can figure out what they are. You know planting a little garden. I did my first garden when I was eight it doesn't have to be a big plot of earth it can be a small little thing where you where you plant and tend and watch the cycle. You can have house plants and care for them. You can you know I mean it's pretty limitless. And I mean it's great outside families that do that can do that families that pray can pray outside families that just want to do a breath exercise outside I think, you know, learn about taking your pulse and do it before you go out and then go out and do your breathing and take your pulse again and see what it does for you as a human being to be one with it.  It's true. What a nature and and to really Heal thyself, right? Oh Yeah Fantastic, so as a child Um, were you an avid reader and you still my lord, you know what I did I made I made a list for you of my favorite books And it just it went on and on and on it went on and on and on favorite books It's just so hard to to say favorite in my life other than husband. I it's just really hard to say favorite, but you know We moved a lot my father's career it was a corporate kind of military thing where you just you moved a lot and Every time we moved we would find the church in school and then the library and Then we'd start our weekly trips to the library in our, you know, big arm loads of books So reading it was modeled in my home. There was always a New Yorker. There still is a New Yorker So I've always had a copy in the New Yorker. There's always been stacks of books in every home I've lived in starting with my parents and Books are things to be proud of and happy to own and to cherish and take care of and That we have public libraries.  You know, you know the love of books and going to your public library That's that's so great. And you know even during the time of pandemic libraries have stepped up and provided not only virtual Programs and resources, but they're making a difference. They're working very much all over the country To really be a resource During these challenging times. So we should be very proud of our Libraries and we should be very proud and and I want to thank you Luis for your life and dedication and the light That you and Christie and Michelle and and everyone have put in the world You are the wizards of my childhood and I am very very grateful to you Thank you so much. I love that term wizards. Yeah So what are you working on now? What's your next big project kitty? You know, I I want to bring this book out into the world and and do it justice it deserves that I write poetry all the time and Occasionally I post it on the blog and that poetry I do not write in 20 minutes It's it it takes work for me to get it the way I want it and even after I post it. I still Puts around with it on my own. So that's keeping me quite busy. I have ideas for books that I'm thinking about But I really want to just keep it simple So I was perusing the really round your blog and I absolutely loved it and you had a tribute to John Lewis and You also had Stories about I think you mentioned the angels and miracles and you have such a breadth of topics But the photography is phenomenal. So are you the photographer thinking? Yes, uh-huh I enjoyed that very much You know and I have friends Online and I mean in my social circle and one is a former student who are really Photographers I am an avid amateur photographer But I do enjoy it very much and a friend of mine who liked it many many years ago said, you know Why don't you start a blog and do your writing and use your photograph? So I did That's fantastic. So what's a preview of your next month's blog so we can have a scoop Well, I just posted a poem yesterday that took me quite a while to write I don't know if it's quite finished, but it was finished enough I'm one of those people that you know post it. It's you know, it's you're not The poet laureate of the universe post the poem get it out there and then you know You can always tinker so I did post one yesterday and it was about the years of walking on the trail And as I said to you earlier, it's kind of my church. So I Kind of kind of used a framework of a liturgy and I called it the liturgy of the trail so I'm really proud of that poem and it was about the walking with the dogs for 25 years on this trail and My hands on that one. I'm gonna look forward to reading that one Okay, thank you Yeah, and I don't really plan too far ahead other than that. I You know, I pay attention to what's happening outside what I've got good pictures of I Try not to get Too political and that's hard for me, but I I I try to think of Hospitality and offering people a place to Maybe ponder a few things, but but I try not to tell people how to ponder So Kenny right now, I mean you you're a former educator and a lot of Learning and teaching and you know parents I have to hand it to them. They are my heroes of that are Serving as you know teachers for kids that are are learning from home What would you what advice would you give parents that may be struggling with that the trend that transition? I know some have gone back to school, but some are still in a hybrid mode There's next Talk a little bit about that because I think that's an important issue facing our country in the world, I think so too and I don't want to In any way minimize what teachers do because I did it, but I also don't want parents to Have this fear that their children will be lacking in any way if they are loved if they are nourished with books and Attention if they're invited to pursue things that interest them and guided in those pursuits I think we will all be fine. This is an experience We're going through together and it can teach us a lot of things about life and living that a Year curriculum might not include so You know, I don't think there should be panic I do think there should be moments when everybody shuts down all the machines takes a breath Tells a story. I grew up in a family that told stories And I think that taught me a lot of things that I didn't learn in school And I had wonderful teachers, but I think there are things we can use this time To boost and Pad and enhance our learning All of us as as family members and people so I really would tell parents to please please don't Don't be sad About what your children are missing because they're also gaining an opportunity that is richer In in ways than what could have been planned and offered and you know confined to third grade fourth grade fifth grade I think be expansive be hopeful Let go of being hard on yourself Wonderful advice and the other thing that stood out for me was it's a it's a time for deep listening to one another right Yeah, that's very important to me as a chaplain and spiritual director and teacher and just who I am I think I'm talking a lot right now, but yes as you are modeling listening is Key to so much of what happens in deep listening that you know where you listen to the person's mood and you listen to their choice of words and you listen to the way their eyes move and their body is Held and their breathing occurs when you listen to all those things and you ask The questions that go deeper It listening can do a lot of heavy lifting in relationship That is so true. I'm a work in progress in terms of listening, but you learn so much more When you listen and you know learning from you Is part of this journey so that that's terrific the other thing and me from you Lewis Yeah, the other thing is to have children right in journal And put their experiences to paper Is that a good idea? That's an excellent idea. I think any student I had would tell you that miss. Oh Made us right Lord. She made us right. I I thought that was an extremely important part of education And so I taught from literature itself I taught from novels and poetry and myth and plays that I chose and selected and since I was Teaching sixth seventh and eighth grade. I could You know, I could choose themes and enhance them each of those three years and and Select novels and plays and poetry and everything that I thought went with it but then there was writing and writing and writing and writing and writing that went with all of that too and You know, it can be interesting It can be write a poem listen to this know you write a poem or listen to this beginning and you write an ending or In a paragraph, you know with a beginning middle and end so that you know We would call the you know a few paragraphs an essay. So they got the idea of how that worked Endless again possibilities of the ways we can write and be invited to write but I can't say enough about the power That that gives the child to master writing clearly and coherently and imaginatively And certainly there the reading connection is there I know when the library and the Golden Gate Parks Conservancy teamed up one of the ideas was to have these story trails story walks so that as you walk in the trails you would have pictures and story and So you would stop save at a moment, but also read the story and what a wonderful Connection and those have been oh, yeah extremely popular. Oh Yeah, you got it all there You got the words and the and the walking and the nature and the story and oh Lord that is perfect beautiful hmm, so kitty we're almost at the the end of our conversation, but I really wanted to Close by asking what advice you've received From your audiences and then you want to pass on to our audiences With your rich experiences You've given us what it what advice I've received I don't know that people have offered me a lot of advice They're sharing of their stories has taught me Again, how important it is to be open and authentic You know so indirectly I would say that that was advice that I took to heart. They've taught me again The value of humility The awesome awesome Gift of people listening to your words The the modesty and innocence and The truth with which they shared their their stories You know, I think sometimes as a writer Any writer will do this and I know I do too is you know, you try to fancy up things and That pairing down to the You know the green truth of things is so important and I think I have learned that again Well kitty you have been a gift to all of us and we so thank you for taking time to not only share your story but also To share the experience of this wonderful poem and now book that has resonated worldwide So, thank you. Thank you. Thank you. We look forward to much more in the future And I'm going to turn it back over to Christi estimates Christi. Thank you. Louise. Thank you. It's been just a joy Oh, I want to offer my thanks to both of you for this thoughtful conversation I feel I feel like I'm a renewed with hope right now for For our families for our community for our children Kitty congratulations on this new book. It is a gift to us all. Thank you so much and Louise Thank you for joining us today and leading this conversation Just a reminder That parks and public libraries are for everyone They're free and available and accessible and I hope that you visit your local library in your local parks as soon as possible Thank you all for joining us today and you can look for more public programming off the San Francisco Public Library YouTube page and Look forward to more nature boost with our partners with the Golden Gate National Parks Conservancy The Presidio Trust and the National Park Service. Thank you for joining us. Thank you for all your great work Thank you. Thank you


In this session, we will cover the following learning objectives. First, we want to describe the principles of data quality. Second, we want to identify the tools in DHIs2 for data quality. Third, we want to verify that data quality procedures are in place. Number four, we want to confirm the use of data quality tools in DHIs2. And finally, we want to verify that data use practices are in place and being used. So let's start with some data quality principles. The WHO has defined data quality in their data quality review guidelines. There are three separate guidelines that you see here and a link to them on the slide. These are a really good starting place to understand some of the foundational principles of data quality, conducting data quality reviews, and even using DHIs2 to enable data quality reviews. If you're conducting data quality reviews, let's talk a little bit about the frequency. So different programs, different countries at different levels will have different frequencies of data quality reviews. Typically what we see is a monthly data quality review is the most frequently done. This is often done at health facilities or at district level. So as new data comes in every month at the lowest levels, health facility and district level, they're checking the data that's just come in. Annual data quality reviews are often done at national level, maybe regional level. These are large events where multiple programs are reviewing all of their data over the course of the year. They're not getting into the level of granularity or detail that the monthly data quality reviews are happening at lower levels. These annual data quality reviews are really looking at annual trends. They're finding big outliers. They're reviewing just general data quality metrics across the entire country, across the entire year. And then different programs will have different periodic reviews. So programs that are only being conducted during the rainy season or during a certain outreach campaign may only do data quality reviews at the end of those campaigns or maybe during those actual campaigns, but they're done at an ad hoc way. There are different methods for doing data quality reviews. The first one is doing a data quality verification survey. A surveys go out and look at different sites. So in this case, maybe health facilities, community health workers, maybe different districts, and they're assessing the accuracy of the data compared with the facility registry or the actual hard copy that the facility has. So they're physically going and they're saying, do the data that's in DHIS2 is it matching what's actually been physically recorded on paper records? They're also assessing the availability of inputs. For example, guidelines, staff knowledge on data quality, different standard operating procedures and how they're being conducted at the various levels to see if they're being adhered to. They're also assessing use. And it's very important to assess the use of data. Again, we talked about previously during the data use session that data quality and data use are tied together. We cannot have high data use if we have poor data quality. And so it's important to look at how is the data being used in a routine way and maybe a day-to-day way. And that will give us some indication of is the data trusted? Is the data reliable? Do the people at the lowest levels feel that they can use it? What are they not using? Why are they not using it? Is it because of data quality issues? Is it because they don't trust the data? So looking at the use of the data, not just the data quality, is also very important when we're doing these data verification surveys. The final point to make here is often travel is required. This means that you can't necessarily go to all sites, all health facilities, all districts all the time. You may have to just do this at an ad hoc way. Maybe you go to certain sites or certain districts that had a historically struggle with data quality to do these verification surveys. But it is important to note that travel is required for these typically. The other method to note here is data desk reviews. So in this one, as the name applies, there is no travel required. You're sitting at a desk and what you're doing is you are looking at the routine data coming in. Usually this is done a monthly or more frequently. And you are interrogating that data using the whole host of DHIS-2 tools and functionalities available to you. So you are looking for outliers. You're looking for consistency over time, internal, external consistency, which are concepts we'll cover later in the presentation. And you're using DHIS-2 to drill down into specifically where the problems are. And then you're hopefully reaching out to the individuals that manage those facilities or responsible for entering that data to alert them that there is a problem that you have identified. The third methodology here is DHIS-2 data validation rules. And DHIS-2 has a functionality that we'll cover in more detail later in the presentation that allows you to check data against predefined logic or what we call validation rules. And these can be done at multiple points or at different frequencies. So DHIS-2 can be set up to run the validation rules while the user is actually entering the data. So if they enter a data point that violates a validation rule, for example, the validation rule says that treated cannot be more than tested for some certain disease. Malaria treated cannot be more than malaria tested. Then if they put in a value that's greater for malaria treated than it is for tested, then DHIS-2 automatically flag that and say, here's an issue. We've automatically detected a problem. So that's during data entry. Validation rules can also be run ad hocly by a user using the data quality app in DHIS-2. So they can go in, they can run a validation rule analysis and DHIS-2 will produce to them a list of all the validation rule notifications that have been triggered. The third option is to have this run automatically. So DHIS-2 can be configured using the scheduler application to run validation rules automatically. And the user can receive the notifications for this automatic scheduled jobs into their email or sent to them via an SMS message. So in this way, the validation rule notifications can come to you as opposed to the previous two steps, which I mentioned, the user has to go to it. So it's important to revisit quickly the virtuous data cycle. And here we want to reiterate the fact that data quality and data use are connected. We see that if we have high data quality, that enables high data use. And vice versa, if we have high data use, often we're seeing very high data quality. Now the question always becomes, where do I start? Do I try to force data use or do I try to force data quality? And can I get to high data quality and still have low data use? Or how do I kind of handle this situation? And so as we're talking about data quality, I think it's important to appreciate that both of these can be done at the same time. We can take steps to improve data quality. And as we improve data quality, we can also take measures to improve data use through, for example, adding new feedback mechanisms, sending more alerts and notifications. They typically go hand in hand. As we start to improve data quality, people will start to, the measures that we take to improve data quality, for example, adding more alerts and notifications, having people engage with the data more frequently to find the errors and fix them, they will inherently start to use the data more. What's the starting point for most countries? The first starting point is often start to work on improving data quality because we cannot have high data use if we have poor data quality. It's just not possible. So we have to make sure that the data quality is to a certain degree that people start to trust the data. But as we start to work on data quality, what we often see is that correspondingly, data use also naturally kind of increases. As you drag one up, the other follows quickly behind. But it's still important to appreciate that data quality and data use are connected together. You can't have a high one without the other. And if you have a poor data quality, you will have poor data use. But it is a little bit more pragmatic to start with improving data quality. And as we see data quality improvements, we will hopefully see corresponding data use improvements as well. The WHO recommends several core indicators for annual data quality reviews. For maternal health, they recommend anti-natal care one visits. For immunization, they recommend Pinta third dose. For HIV AIDS programs, they recommend patients currently receiving ART. For TB, they recommend TB notification rate. And for malaria, they recommend confirmed malaria cases. These indicators are almost universally found in all country HMIS systems. So now we're going to go through the key data quality metrics. And we're going to cover five different measures of data quality. The first one here that we're going to talk about is data set completeness and timeliness. This is the measure that people often refer to as reporting rates. And this is the received reports on time divided by the expected reports. And in this particular data quality metric is really geared more specifically to data that is entered routinely in aggregate form at health facility or other levels. So every month I am receiving a aggregated report from the health facility. And this is the measure of did I receive the number of reports at the time that I expected to receive them. And DHIS 2 defines an expected report, which is the denominator here. Again, it's received reports on time divided by the number of expected reports. So DHIS 2 defines the number of expected reports as the number of organizational units or health facilities that are assigned to the data set. And a data set again at DHIS 2 is the actual reporting form. So how many health facilities have I said in my system configuration should be reporting on this data? And then the measure is the percentage of those that sent in their reports on time of those that I have assigned to report on that data. We should have a targeted completeness and timeliness of about 90% or greater. And research has shown that if we have a reporting rate for completeness of less than 80%, then often our data is not reliable. If we have less than 80%, then we're missing a large enough portion of the data so that our global or national indicators are not really reliable. There's too much data missing to say that this is an accurate measure of the status of the country or health program or whatever it is that we're trying to measure. In most countries this is improving and in many countries it is actually very good. We see very good data set completeness and timeliness across most countries that are using DHIS 2 as their HMIS. Some of course better than others but in many countries we see that it has improved over the years and now it's at a very acceptable level. Here's an example of a simple month-to-month line graph showing the reporting rates of various data set or reporting forms. So you can see that there is an ANC reporting data set. There's a maternity data set at HMIS which is kind of the monthly probably aggregated data from the health facility. We have one from malaria. We have one from immunization. And you can see the reporting rates here for each. You can also see indicated here that the reporting rate for the ANC data set has been going down over the last few months. And so this would be an indication that there's some issue in our reporting rates. There's some issue in some of the health facilities reporting and this is a data quality issue that would have to be followed up on. Of course as I mentioned earlier if I see that my reporting rate is going down then that means I'm not getting all of the data in which means that maybe some of my indicators like for example ANC1 coverage in this case may become less accurate or will become less accurate because they're not being calculated based upon all of the data that should be coming in. Let's move on to the next one then. So this one is consistency over time. And so what we expect in most data within the HMIS is a year over year predictability. We expect the data to be relatively consistent year from year. So when we make this line chart as you see in the example here we see that each year the data is following a similar pattern or trend. If it's seasonal then we see a similar kind of rise and crest and fall again at the same time every year. If it's just not if it's non seasonal data then we expect to see kind of the same patterns within the data. We don't expect to see too much variation. Now of course many countries have growing populations so you could see the numbers increase every year just because the population base is increasing but that rate of increase would probably still be the same. So year over year we see a similar kind of slope to the data. And that's what you see here in this example. You see that the data from 2020, 2021 and 2022 is nearly identical over the 12 month period. Again you see in this example a big spike in 2020 right in November. See that it's very obvious and vision of an outlier. There are maybe some situations where this is reliable data. There's some context where you could have an actual spike maybe some kind of mass vaccination campaign or something like that. But more often than not this is an outlier. In doing these year over year chart as you're able to do in the WHO data quality app and in the data visualizer app as we'll talk about later. You are clearly able to see these outliers and measure this kind of year over year consistency. In most countries this has also been improving and in many countries it's very good. And with the WHO data quality app and the other data quality tools that we have in DHIs to many countries have been monitoring this for several years now. And we see that it has significantly improved. The next data quality metric is outlier detection. And we just saw an example of an outlier in the year over year. But we need to make sure that we understand that there are many different ways in DHIs to be able to capture outliers. And outliers can be very significant and throw off our national statistics in a really impactful way. And what we see here in this example is a scatter plot. And the scatter plot is able to be made in the data visualizer application. And we have applied an outlier analysis to this scatter plot. And we're actually using an outlier detection methodology called interquartile range here in this particular example. We also have Z score and modified Z score available in the data visualizer application. But using this methodology you can see that we are monitoring here malaria inpatient death under five and malaria inpatient death over five. And we plotted these two data items against one another. And you can see that the vast majority of the health facilities each point here representing a health facility fall within an expected range. And those are showing up here as green dots. And then using our interquartile range methodology we have plotted what we consider a high and low threshold. So you can see those are the gray lines that are kind of on the outside. And any health facility that is above or below those gray lines is showing up here as a red dot. So it's indicating to you that this is an outlier. Now equally important on this chart are these horizontal and vertical dotted lines that's saying one percent of total X values or one percent of total Y values. What are these saying? This is saying that these dots represent more than one percent of the total value of malaria inpatient death or malaria under five or malaria inpatient death over five. So if it is above the dotted line that's one percent total Y values or it's to the right of the one percent total X values.  So this is an indication on how severe the outliers are. And you can see the outlier that we have highlighted here for facility two ninety nine is showing that they had under five one hundred and eighty three malaria inpatient death and over five only thirty one. And it's clear that malaria inpatient death under five of one hundred and eighty three is a value that is well outside of the expected range. Now is it wrong? Maybe maybe not. But it is significant and it's so significant that it would be throwing off the national statistics just as one health facility. And it's definitely worth investigating. Here in this example we can see that you can use things like the data visualizer application with the scatter plots to quickly identify outliers when comparing two different variables together and gives you a good opportunity to follow up and investigate. In many countries this is still a challenge. Many countries are still facing issues with detecting outliers in a timely way and being able to address them. Most of the outliers that are existing are not significant. They're not throwing off national statistics. But it does happen occasionally like we saw in the last chart where you have a value that is way outside the expected range and it's throwing off national statistics. Now outliers are very, very easy to input as a health facility. You can imagine a scenario where a health facility worker mean to put it in one hundred and they accidentally put in ten thousand. They just hit a couple of extra zeros as they're putting the data in. It's a mistake that any of us could easily make. And there are multiple points at which that should be caught. It should be caught at the point of data entry. So DHIS2 has the functionality to send up alert while they're entering the data saying, hey, this is outside of an expected range. Are you sure this number is correct? But if it's not caught there for some reason, then it can be caught on a dashboard as we see here. It can also be caught in validation rules and all of these various steps we'll talk a little bit about later. The next data quality metric is external consistency. And this measure is looking at the degree to which data should agree with other data points. We know that there are common relationships between various data points. Some common examples of this are dropout rates or coverage rates. And here in the example, we see a very common dropout rate between PINTA1 dose and PINTA3 dose. We know that in nearly all situations, we expect to have more PINTA1 doses than we have PINTA3 doses. And that's just because over the course of immunization, unfortunately fewer people are completing the entire course of the immunizations. They're getting the first PINTA dose and then they don't continue to get two and three. Now, a dropout rate is measuring what percentage of patients are not getting PINTA3 dose that did get PINTA1. And so you can see that here. We have all of our districts and then we have the dropout rates. Now, if we have a high dropout rate, then that's a problem to address programmatically. That's indicating that we have an issue with people in that particular area completing their immunization. We expect the dropout rate to be low. We want it to be as low as we possibly get because that's indicating that the people who have got PINTA1 are also getting PINTA3. However, when we have a negative dropout rate, that's indicating that we have more PINTA3 doses than we have PINTA1 doses. Now, is this impossible? Well, no, not technically. It could happen, especially if we're doing some kind of cohort analysis where we have a very different cohort for PINTA3 than we did for PINTA1 or some other kind of drug that has more differentiated cohorts along its various treatment steps. By and large, most of the time, we would expect to almost always have more PINTA1 doses distributed than PINTA3 doses. When we have a negative dropout rate, that's indicating to us that we probably have an issue with either our PINTA1 dose count or our PINTA3 dose count. Either PINTA1 is too low or PINTA3 is too high and it needs to be investigated. These kinds of things, like when we see negative dropout rates, we know that it is technically possible in certain situations, but it's almost always a data quality problem. And here in this example, you see that we actually have three different districts that are reporting negative dropout rates. And that may indicate to us that, you know, if you're looking at this, if you're an immunization coordinator, it may make you question your entire data. Obviously, the data is not reliable, but now I question all the districts. And so this is something to keep in track and follow up on, monitor continuously these various dropout rates and other types of external consistency measures. In most countries, because we have been making these dashboards for a long time, these types of analytics, they're both on the standard DHI2 dashboards as well as the dashboards in the WHO data quality app, we see that it has been improving significantly. And so many countries are actually quite good at monitoring this now, but it does still happen. Again, data quality mistakes are very easy to put in the system. And so it's something to continuously follow up on. Our very last data quality metric is consistency or accuracy of population estimates. This one is specifically referring to the review of denominators, our population denominators that we use in our coverage calculations, or many of our high level national or even subnational impactor indicators or KPIs are population based. And in many countries, we see that population data that is coming from the census is unreliable. And here in this example, you can actually see that all of these coverage rates in this scorecard are over 100%. Well, except a few, some of them are the ones that you actually see showing up with red, green or yellow. These are not over 100%, but all the ones that don't have a color that are just like a red value, these are over 100%. Some of them are very high, some of them are nearly 200 or over 200%. How do we have coverage rates over 200%? Are we administering two treatments to every single person? Probably not. The reality of it is that the population denominator in many countries is very wrong. And that means that if we're calculating any kind of indicator based upon population, we're not getting information that we can trust that is reliable. And I think that this is probably one of the most significant challenges facing data use and data quality in countries that are using DHS2 as an HMIS. You know, DHS2 has no magical way of calculating population for you. It has to come from somewhere, but there are various approaches to using alternative or service-based population estimates, as well as other organizations like WorldPop, Grid3 that are able to do new population projections that could be more accurate. But at the end of the day, whether it's using alternative or service-based denominators or using new projections of population, we have got to start to figure out how we address population denominators. Because what most countries have is not usable, as you see in this example. And unless we start to correct it, then we're not going to see a significant improvement in data quality or data use, at least for these types of indicators that are population-based.


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Okay, move out. This is the largest state in the Union, a vast area of over half a million square miles bounded by the Arctic and Pacific Oceans. 99 years ago, it was called Seward's Folly after the Secretary of State who purchased it from Russia for $7 million. Then it was thought to be a valueless wilderness. Today, there is still much wilderness, but it is hardly valueless. Vast natural resources have been discovered beneath the great tracks of land. Fishing boats and freighters crowd the busy ports. Alaska is on the move, a vital and prosperous state. Everywhere there are signs of growth. Each year more people arrive, particularly in the spring when the snow and ice begin to melt. New industries are flourishing around the growing cities like Anchorage and Seward. The coming of spring also means that ships can reach the coastal ports which have been icebound during the long winter months. The China comes into Valdez, the first ship the townspeople have seen in over four months. The China brings work to the people who have come down to the long dock to unload. It is March 27th. Good Friday. Although it is late in the afternoon, two of the crewmen, Fred Newmare and Ernest Nelson, try to get some pictures with their 8mm camera. Suddenly the whole harbor of Valdez is sucked dry. Out in the Gulf of Alaska, the ocean bottom seems to sink. Upward 50 feet, sending a giant wave toward shore. Crosses the China high and then smashes it down where the dock had been. Somehow, Fred Newmare manages to hang on and keep his camera running for part of this incredible trip. The harbor of Valdez is a seething whirlpool. The dock splinters, then disappears into the earth. No one on it will survive. The longshoremen, their children, and the dogs have disappeared. It follows the tremor, builds to a tremendous force and sweeps with terrible speed in a 500-mile arc. The great wave sweeps along the shore, striking ships, towns and cities. Anchorage, Alaska's largest city, buildings collapse, streets and homes slip into the earth. The tanks explode, sending flames shooting into the sky. The clock stopped at 5.36 and 15 minutes later, there was silence. Alaska had just been struck by the worst earthquake ...


Hi there, welcome to the Participants of the Kitchen. My name is Fallen. And I'm Nicole. Today we're talking about sweet peppers. Or bell peppers. These are available almost all year round luckily thanks to Ontario Greenhouse Growers. A funny story is when I was young, I'm kind of dating myself here, but when I was young, you only really could buy green peppers. And when the red, yellow, and orange came out, my mum thought they were all sort of hot and spicy, so we should actually try them for years. I really recommend you try them all. They all are really sweet, quite delicious, and have a slightly different flavour profile. And actually, what's really handy about these is that you don't have to prepare them. You can just wash them, and the kids can eat them almost like an apple. To keep your peppers fresher longer, we recommend that you keep them in the original packaging and only wash them when you're ready to use. So did you know that you can enjoy peppers both raw and cooked? And don't let them go to waste at the end of the week if you still have a bunch. You can even freeze them. Just prepare them how you normally would and put them in a freezer bag and store them in the freezer. When you do defrost them, they are going to be a bit soft, so they're better in a cooked recipe opposed to a raw recipe. So peppers are really good for you. They're low in calories, they have zero fat, they're low in carbohydrates, but they're really nutrient-dense. They have tons of different vitamins. If you're really concerned about the nutritional value of them, we would encourage you to eat them raw because they are heat-sensitive. So you'll lose a little bit of that nutritional value when you cook them. Check out these recipes on our website, Produce Made Simple, using fresh Ontario greenhouse bell peppers, macaroni and cheese stuffed mini peppers, spaghetti with roasted red pepper sauce, rustic chicken cacciatore, and spicy roasted red pepper dip. Thank you so much for watching. Look out for more greenhouse tips coming soon. Thanks for watching and look out for our next video. Nice. There you go. That was good! Solid.