Alright, so hello everybody. Welcome to the Library and Writing Center Secondary Sources Workshop. We are really excited today to be talking about some of the resources available to you if you are needing some secondary sources. So first off, we're going to introduce ourselves. Hi, my name is Carissa Powell. I use she or her pronouns. I am a student success librarian and I do a couple of different things that I mostly work with first year composition students. My email is Carissa at utk.edu and you are free to email me about just about anything. Hi, everyone. My name is Grace Darrell. I also use she her pronouns. I am one of the online learning librarians here at UT libraries. And like Carissa, I also do a lot of the things, but my main job is kind of twofold. One is creating online learning materials and then another one is working with students. Again, like Carissa, my email is up on the slide. It's gtherall at utk.edu. Feel free to email me with any questions or anything you need help with. Feel free to reach out. Just to give you an overview of what we'll be doing today. Again, there's going to be about 30 minute presentation and then about 30 minutes of Q&A. During the presentation portion, we'd love to hear from you over chat if you have questions about anything. So this is what we're going to be doing today. So we'll be sharing. I'm going to share with you a little bit from how some of you felt about research and some stressful feelings, some like unknowns, not really sure what it might look like. We will be defining some terms for everybody, learning where to go for research, what that might look like, and what it might feel like. We'll then wrap up to make sure everyone knows how to get help from both the library and the writing center after today. So we wanted to start off with some definitions just because in libraries, we sometimes use words that librarians know what they mean, but it's not always evident what they mean. So we're just going to go over a couple of definitions for words that we're going to use today. Again, if you have questions about these, feel free to type a question in the chat. So the first thing we're going to talk about is what is a secondary source. I'm sure you've heard of the term primary source, and there was actually a workshop recently on primary sources that you can go look at as well. So a secondary source is basically just a resource that comments on, analyzes, summarizes, or interprets a primary source or other secondary sources. The goals of this are journal articles, literature reviews, book reviews, a documentary is another kind of secondary source, so a lot of different kinds of sources. And we're mostly going to focus on journal articles today, but there are a lot of different types of secondary sources. The next word we're going to talk about is a database. Again, probably a word that you've heard a lot about. If you haven't, that's okay, you will, you will hear a lot about them in your time. So a database essentially is a collection or index of different resources. And within the database, you might find full text of the resource, you might find just a citation of the resource, or sometimes you'll find an abstract, which is basically just a paragraph that summarizes what the resource is about. So a database can have all some, or just one of these resources within it. Examples are academic search complete, which is actually an example of when we're going to look at today. There are also databases like JSTOR or Web of Science. There are also databases that work specifically with different kinds of resources, like statistical data, or we have primary source databases. So databases are not just for secondary sources, but those are what we're going to focus on today. And then finally, our last word of the day is a research guide, something else we'll talk about and something else you might have heard of. And a research guide is essentially a collection of information to help with research in a specific context. That could be a specific discipline like English. That could be a specific class like first year composition. So there are different kinds of context that you might find a research guide in. Examples are we have like a primary resource, primary source research guide, we have a first year composition guide if you've looked at that at all. And then another example like that discipline specific would be like a psychology research guide, which just gives examples of kind of getting you started for research gives you sample databases journal articles books you might want to read things like that. So this is what it might look like if you are on our libraries homepage, which is lib.utk.edu, we're just going to walk you through what that looks like. And so, once you get to our homepage to access some of the research guides that grace was talking about. Amber has also put the link in the chat. If you're watching this on YouTube, the link is down below. Right here is where you would click for your research guide. So you can click there. And then get to a page that looks like this. You can both scroll through to look through some different subjects. So you could go down to English or math, what have you. You can also type in right here, what you're looking for. So if you know that you're in a first year composition course you could type that in and hit enter, which would then take you to a page that looks like this. This is a guide that was created specifically for students in English 101<PHONE_NUMBER>98. So this is a really great place for you to go to kind of get a one stop anything you might need. On this page, we'll have both secondary sources and primary sources depending on which one you're needing. So since we're talking about secondary sources today you might want to check out that secondary sources portion. It also has links to a lot of other things you might need for your assignment so definitely maybe bookmark this one I'm a little biased because it's my guide but there's also guides for any other class you might be in. The other place to go to get started looking for articles for your secondary sources is back on the library's homepage. So again, lib.utk.edu. I'm going to come over to I'm kind of in like the bottom left hand corner ish where I would say articles and databases, very aptly named. So if you click there you would then get to a page that looks like this. And this might be a little overwhelming there's a lot of links on this page. But I would break it down a couple different ways. We have most popular databases that are what it really means is they're good general getting started databases. We also have databases by subject so if you know you're doing something very subject specific you can click there. I would also recommend this general topics getting started page that is also really great. So there are a lot of different databases. I would maybe recommend not clicking on the complete list of databases it's going to be really overwhelming. And I would really much more recommend going through some of the more popular ones or the getting started topics. So we defined terms and Chris showed us where to go for when we start our secondary source research. So starting with the articles and databases page or starting with research guides. Those are really good places to start when you're looking for secondary sources. And now we're going to transition a little into what the research experience looks like so if you're just starting out. If you're wanting to find a basic secondary source or you're wanting to see what's out there. What is that actually going to look like in practice. So I'm pretending that we're starting from the articles and databases page which you just saw. And like Chris said there are lots of different options here for the type of database you want to use. But we're going to look at academic search complete that's over on the left hand side of the page. And this is like it like it says one of our more popular databases and it's interdisciplinary which means that there are a lot of different kinds of disciplines that are going to be represented in that database. So you'll find secondary sources from a range of subject areas not just like psychology or anthropology or business or something like that. So if we clicked on that this is what our page would look like. So this is what the page this first search page for academic search complete looks like it's just some blank boxes. If you've used a database before this will probably look familiar to you. It's also similar like if you use one search on the library's website. It's just a search box and that's generally how it starts so you would insert your keywords into those search boxes. You're welcome to put more than one word into that first box or you can kind of separate out your terms and put them into each individual box. And then you can see below there are some advanced search options we're not going to go over those today, but if you want to do some more advanced searching. If you want to be a little bit more specific if you have some more ways you want to narrow down your search. That's a good place to go for that. But we're just going to pretend that we did a basic search for coffee and roasting which will show up on our next slide.  And this is what the search results page looks like. This is pretty typical of most databases or anywhere that you would go to look for secondary sources. This is kind of what it's going to look like. So it'll have your keywords at the top so you can remember what you were searching for. And then it's got this big search results page. So over on the left side, there are different ways to refine your results. So if you need a peer reviewed secondary source from a journal article, or from a scholarly journal, you can limit just to that. That's an option. You can limit my publication date. If you scroll down on those filters, there are also other options. So again, that's kind of a good way to narrow down your search if you're needing something maybe a little bit more specific or if you have too many results to sift through and you want a smaller number. In the middle section there. That's where your main search results are going to be. And we'll look at one of those in just a second just to kind of show you what that looks like when you're looking for secondary sources. But as you can see all three of these are academic journal articles. The search results, it's going to give you the title and then it'll tell you the authors. Sometimes it might have a preview of the abstract, but these don't. It gives you all of that kind of basic citation information. So authors where it was published, the date, all of that good stuff. And then it also gives you some subjects so you can kind of maybe see what the article is going to be about. And if you see there's also a find text button underneath the subjects. That's going to tell you that you can click on that and it'll help you find the full text of the article. And then if you see over on the right side of the page. We have a chat box embedded into the database into a lot of our databases. So if you're on academic search complete, and you're looking for secondary sources and you're just hitting a wall or up evaluating a source or you're not sure what to look for next, you can actually just chat with us from the database and get help that way, which is really useful. So we're going to pretend we clicked on the first section, the first option. And this is what this is basically what a search result looks like. And so, you know, it's a secondary source because if you see in that source section it says it's from a journal which is food chemistry. It says document type article, and then it gives you the abstract which is again just a summary of what the source is. So this will look pretty similar again in a lot of the databases that you're searching whenever you're looking for a secondary source. So get familiar. This will look very familiar to you when you start actually doing research or if you've already started doing research, you should kind of recognize this page. Again, like I said, this is going to look similar for different databases that you search. So whether you choose another one of those article databases on that articles and databases page. Those databases will probably look very similar will have similar functionality. Also, if again, like I said, if you start maybe with one search on the library's website. It will also look similar to this. So kind of just giving you a feel for again what research is going to look like as you start researching and looking for those secondary sources. So now that we have talked about the process of what some of these terms are where to go what it might look like. I wanted to make sure we talked about what research might feel like. And these are all like feelings that I have felt when I do my own research. So you're not alone if you feel some of these feelings. So some of my first feelings I feel when I started a research project is that I'm kind of like, oh my gosh, what am I doing? Where do I go? I'm not sure where to get started.  And sometimes as I get into the research, maybe I'm just like, I'm not finding the things I thought I was going to find or the things that I'm looking for. And so lastly, sometimes I'm just like, oh, I wasn't expecting to see that. Like sometimes you find things you weren't expecting. So all of these emotions are completely part of the research process and I just want to validate if you feel any of those feelings. Hopefully there also be some positive feelings in there too, but it's definitely a roller coaster of emotions. So some of the things I talk about with students when we talk about feelings is that research really is this cyclical process. It's pretty rare that you will do one search and find the thing you're looking for. And so kind of just want to dispel that myth right now. You know, such thing as a ideal perfect search. And it's really normal if you come up with the most beautiful search string of keywords and synonyms and then get zero results. So I just want to kind of throw that out there that any of those things happen to you. It's really part of the research process. Some of the very smart people have felt that way before. And if you run into any of those walls, that's completely okay. It's part of the process. And that's part of what we in the library and folks in the writing center are here to support you on breaking through some of those walls. So I hope that you will lean on some of the resources and support you have available to you that if you really are just not having a breakthrough on either the writing or the research side of things that there's lots of people who would really love to help you out. That is my plug for our next workshop, which is next week, October 7. It's on what to do if you're in a research rut. So if you're here, or it's before October 7, and if you're feeling any of those feelings, we have another workshop next week that will kind of walk you through concrete steps of what to do to break through that research barrier. Yeah, please come next week. It's going to be going to be a great time. And also just as a reminder, I don't have this on the slide, but the previous recordings of the other workshops are on the library's YouTube channel and they're linked from the library website. So I don't know if Amber wants to wants to find that link or I can just pop it in is this is not a pretty link. But this is the playlist for the other workshops that we had. So there's one about introduction to the libraries. Power notes, which is a tool for organizing your research topic selection and kind of an introduction to searching and then last week was the primary source workshop. So those are all places for you to go to see other workshops if you would like to see and learn more about what was going on in those. These are the ways that you can get help from the library later on. You can always of course chat with us. There are librarians on the other end we're waiting to help you, and that's what we're there for us to help with research so if you're in a rut. If you are just getting started and don't really know where you want to go. If you need help developing your topic, whatever it is, we can help you with that. We have a form specifically for that, or you're welcome to email a librarian, it can be your subject librarian, it could be Carissa, it could be me. If you've got a librarian you already kind of know and want to work with. So you can always do a one on one appointment with us that way. And then the other way is just to look at research guides if you're just getting started like we mentioned before. No matter what subject you're looking at, no matter what class you're in, we probably have a research guide for you, and you can kind of start with those. That's another way that you can get help as you're first starting out with your research. And now we're going to let the writing center talk about how you can get help from them. Thanks. Hi I'm Kirsten Benson, I'm the director of the writing center and so many of the things that that have been discussed today are things that that we also can help you with. So we have a variety of links right here on this slide and I put our website link right there in the chat as well. So, especially that wall, you know that was mentioned that place where things get a little overwhelming and you're thinking like I can't find any sources or I don't know what to do with my sources or things like I'm really sure that I'm using my sources most effectively. Once I have found them. Those were all things that we definitely can help you along the way. A lot of students think that the only time to get help from the writing center is when you have the project done. So, just like as just like you can reach out to the, to the librarians, you know for help while you're in the process you also can reach out to us for help along the way and don't have to wait until you have that draft all already finished in fact we are always saying like get help sooner rather than waiting till the end. So all of the information about how to how to get help from us is on our website that writing center dot utk dot edu. And also in there, the link where we have our appointment scheduler and appointment portal and that's that utk my wc online calm. And that's something that you might want to bookmark because that's where you can go and actually make the appointment to work with us. And that could be a video based appointment like this. So it could be an appointment where if you have a completed draft and you want you a little bit of feedback you can you can get an email appointment that way so all of those are described on our website and on that wc online page. And off of the writing center page there's a link about how to make an attend appointments and it kind of gives you a step by step instruction for you know how to register for a free account on that wc online and then how to how to make the appointment how to show up for the appointment and everything and let's say that one of the main things also is and this is also in the chat there too. You can if you have any questions at all like, I'm not sure how to make an appointment or something like that. I had to do is email us writing center at utk dot edu and we try to be really prompt in responding to to student inquiries so lots of ways that you can reach out to us and get help on, you know, on things that you work and working on. All right. Thank you so much kirsten for that. And now this is the end we've reached the end of our workshop today. So, there is a session survey if you would like to fill that out. You can also fill that out and get proof of attendance if you need that for your classes. I've already said next Wednesday we're doing another workshop for when you hit a research right that will be really useful. I'm really looking forward to seeing what recommendations and what the discussion looks like because I hit research routes. So, really looking forward to that. And then again if you want to see the full schedule of our workshops you can find that on the website at that link there. And I think at this time. Thank you all so much for coming and spending some time with us today. And now I believe we're going to stop the recording and then move on into our Q&A period.


Transitional Justice here on a Monday. I'm Jay Fidel and this is Annie Linden. We'll talk about transitional justice In in Afghanistan where you may recall that we haven't done anything much to stop it And so there's a big question about what Annie Linden can or should do to investigate You know the atrocities Especially the gender atrocities that are going on in Afghanistan while we speak well welcome to the show Annie nice to have you here. Thank you so much for having me Jay So let's learn a little about you.  You probably speak four languages. Am I right? Yes, actually Yeah, I so I am originally from Finland where we also speak Swedish and Yeah, I've studied English since third grade and I've also I speak Spanish because I've lived in in Mexico and in Colombia and They yeah, they've been great experiences and I'm really grateful for the opportunities that I'm I admire you for that I'm actually envious. I'm envious of everyone in your generation who who goes beyond, you know And certainly anybody in PEJ goes beyond so tell us how you get connected with project expedite justice right here from Kona in Hawaii so I study my master's at the University of Amsterdam right now and Someone who is alumni of the same program that I'm doing now he works at PEJ and He got in contact with our program and they asked for Interns and I found I saw that they were looking for case management intern. That was like this looks like a good good opportunity to To dive into and also in African context because that's something that I haven't been Researching much yet because I've been more focused on Latin America or Middle East So it's been a great experience. Yeah So transitional justice war crimes war crime investigations Prosecutions atrocities war criminals all that it's a it's an interesting world It's a I must say just being an outsider and looking in it's a very exciting stimulating You know altruistic way to spend your time Why that? Why did you make that decision, honey? I I believe I've always been interested in in human rights and seeing how the world works and how the international system in itself works So in my in my undergraduate degree I did international relations in the UK and then I I From there. I I realized that I was very much into also the legal framework and how the laws Work in the international arena. So now that I'm doing international criminal law as my master's I I've gained a pretty cool how to say view on how international justice works and then Then into transitional justice I During my time in Colombia. I studied transitional justice And I had the opportunity to work with an indigenous community and their political participation supporting their process and It just it sparked me that I this is something that I want to do and work with communities and bettering the world and How to say it be a part of the Good well you you're part of something that I I have observed in Project expedite justice. It's a global phenomenon of sort of a new generation International generation Do you think your generation will actually make a difference? Oh? Absolutely Absolutely, I Think it's especially with Now that the age of social media and how we're more connected Through the internet. I think this has a massive impact on Not only on on my generation, but everyone can be everyone is connected So especially like with the Rise of technology and how the developments in in that area will have a massive impact on developing the laws and and mechanisms for For people to access justice as well and to gather evidence for Specific crimes and yeah So if I if I went around Europe, you know from east to west Exclude Russia for this discussion If I if I went around Europe, would I find people like you? There if I went around Latin America, particularly Colombia, would I find people like you there? I mean is this something which you can find? People who are a simpatico You know in the in these places I'm excluding the US because I I really don't think the US is in the same place Your generation the generation we're talking about it is mostly Europe Latin America, and I suppose Africa I mean of yeah, of course I have I think We are everywhere Okay, it's it's not just that the only in Europe or only in these these in that country people work for these things there I everywhere where I Gone and now where I've lived I connected with people who work in human rights and in the field of law and share the passion That that I I have as well. Mm-hmm. So do you think you'll be committed to this to your whole life? Oh Yeah, absolutely. Yeah, well good. I'm happy to hear that because you're doing you're doing our work for us, honey You are representing all of us To make a better world. So what what is your master's thesis about? My master's thesis is on image-based sexual violence in on conflict So color clearly known as revenge porn So basically when sexual violence happens in wartime when that is filmed and put online how we can How we can criminalize this act because once you put something online it stays there What does that mean it does it help to put it online to publicize it? What do you mean? Does it help the effort to stop? gender violence to put it online oh Oh, I Don't I don't believe that it I mean that is To to feel first of all to film that These crimes and then distribute it online. This is a sort of Re-victimizes the victim survivor Change the question honey the prosecutions the trials Convictions You know the punishments the deterrence the action that you are taking to stop Gender crimes Does that help if you put it online if you publicize it? I mean it is it works as evidence of course but as for the victims privacy it's not Not ideal Understand that we'd want to violate anybody's privacy, but we we want to make it known that this happens Yeah, of course, I believe I believe there is there are ways to to Raise awareness on this however on the on filming these acts is I don't think it's the right way to You know, I've asked a lot of people from PJ and people who involved in human rights whether they think that Through the efforts of PJ and other NGOs around the world There is a reduction of Violations of human rights going on our atrocities decreasing or are they increasing as we speak well I believe they're Excuse me atrocities, I think they keep happening like we might not Know about it, but yeah with the technology. Yeah, I we do We are more aware of them, but it is Difficult to say whether or not they are decreasing or increasing because a Trot atrocities will always happen That's I'd like to catch you on that atrocities are always happening, you know and gender atrocities are always happening from Time immemorial It's almost built into the human condition that there will be You know gender atrocities rape and abuse including marital abuse and so How can we how can we reduce that? It's my right to say that it's everywhere in the world In my right to say there's no place exempt and there's no body exempt. No society is exempt from this So that you can find really horrendous things taking place everywhere How in a larger sense, how can we stop that? First of all, I believe we we have to raise awareness and we need We need people to take this seriously because In history and with women's rights movements are Our fear has not been taken seriously and our our suffering has not been taken seriously And I I think we're seeing it. We're seeing a change In people's attitudes that hey, this is actually real So I I think we need yeah, we need to raise awareness and educate people and bring these atrocities into light So if the atrocities happen in the context of a war That makes them somehow more noticeable More important to to To advise the world about it. I mean and I didn't want to spend a whole lot of time on this but You know in Ukraine, mr. Putin's army seems to be doing You know a lot of rape Just as the Russian army did when it crossed Poland Back in the 1945-44-45. There was a lot of a lot of what do I call it gender crimes? That sounds like such a A an understated word gender crimes But and there's been a lot of literature about that And I you know, I know, you know How much notice should we take of what putin and putin's army is doing in terms of these Crimes of a rape. I Mean it is horrendous absolutely horrendous It's it's just something I believe People just have been shocked that it's happening in the context of Europe However, I do I do see a sense of People seem to put more importance on this because it happens in the context of Europe. However, where was all this talk? What's happening to Like everywhere else in the world It's like of course, it's important that we talk about of course It's important that we talk about Ukraine, but and I love the solidarity that people show in hosting hosting refugees and Showing just the support To Ukrainians Yeah Let's let's go to Afghanistan because that's what we should cover today I are you working specifically on Human rights violations on gender gender atrocities in Afghanistan What what drives PJ to be concerned about Afghanistan right now? So I PJ I've not worked specifically on Afghanistan but I I wrote my undergraduate thesis on The US intervention in Afghanistan post 9 11 and how this intervention was framed as a With the humanitarian rhetoric to save the Afghan woman from the Taliban so I'm My personal interest has been in the Middle East and Latin America as well, but for my thesis I wanted to focus on specifically on this gendered narrative and how This mask masculine military action was justified to save the victimized Afghan woman when When it was How to say when Bush was not known as a feminist Supporter, let's say like that So this is this is what sparked my interest. Why? Why was this intervention? Framed like this when the president wasn't even in Elected for his feminist stance whatsoever. So this counterterrorism Women's rights Rhetoric was and an interesting Coin so I wanted to investigate it more. Well, they ask you when the US, you know Took over in Afghanistan one one would assume that the American presence would not permit That kind of abuse that Taliban was engaging in before And they you know, they took the power away from the Taliban And they said you will you will now behave yourself visa be women women can go to school have reasonable lives Then you know, they they're they're elevated and we are going to work hard And I don't know whether we had the kind of success we hoped for Bush or no Bush But we did achieve some success there and women were elevated during the wasn't 20 years that we we were there and we may have failed in other ways and we certainly failed in Keeping the Taliban out of power But we did improve the lot for women Why why then Why then to the Taliban bring it right back again is It part of the culture is it part of the religion that when they come back And this is so interesting to me when they come back they come back as a military operation They come back with guns They take over in short shrift and there's all kinds of you know history we can talk about there But but you mentioned a moment ago that when you have this kind of What's the word this this this macho? Warlike You know weapon laden Violent or at least threat of violence takeover in Afghanistan. It brings Um The the gender abuse right back like a like a rubber band bang And it's all right back and and they promise us they you know, they make public statements to the world They're not going to do that, but we are clearly seeing the Taliban is right back where it was Why is that? Is that is that a matter of the the Afghan culture that just could happen? I believe that in the 2020 peace agreement between the US and the Taliban they They made quite a few mistakes with trusting that Taliban would do Everything that they promised and by by giving them Everything that they basically wanted Undermined the Afghan government itself, so I believe them The The peace process itself was Overall during during the the two decades it was I Believe the US and like the the West wanted Afghanistan to be Something that they imagine Afghanistan to be on paper But it doesn't exist so for The Western world going to another country, which is already multi-ethnic very polarized society and Telling them. Okay. This is what we think pieces. This is what we think human rights is. This is how women Should be in a society it It just doesn't work like that it's I believe it's it's quite naive to It's either like yeah naive to think that you can go into another country Do an intervention like that and then say that this is how you're going to be it's just of course the the state the country has their own culture and their own Differences and with the with the rhetoric on Including women in In politics like in paper, it's incredible, but how you go about it and nuts Familiarizing yourself enough about The local context and the tribal differences, especially in Afghanistan the tribal differences in the country are massive and the Loyalty between women is not gender based. It's more class based. It's more tribal based Ethnic based So when like of course they were Women were included in The in in politics and they're they got education and health care But I think it stems Or it boils down to the tribal differences in the country because there was already before this This Common this mistrust in in the government and As the country is polarized there are class differences. So when when you include some women in politics and Some women in this and that it's it's often the political elite But then then Other communities might feel that they are still marginalized and it's rather tokenistic innocence So could could the United States have done a better job in the 20 years to to raise women up to You know incorporate them into the society properly And could the United States have done a better job I think you're saying that it could have done a better job in the peace agreement To try to leave leave Afghanistan and in better condition vis-à-vis You know the status of women What what could we have done both during that 20-year period and the peace agreement? To avoid the result we are having now That's a great question I Would say I would say that the US should have included more of the ordinary Afghan voice in the in the peace talks and in in in the inclusion of Political participation in general Because there was this mistrust already before before 9-11 happened before the Invasion happened. There was Afghanistan was already polarized So I think including more ordinary people rather than the political elite and going and actually getting to know What the society was like and not how it's all to be So now we're not there anymore And we have very little to do with the place that I'm not I don't think we have diplomatic Connections with them we go through agency arrangements. We we don't have anybody on the ground at all And and but we hear through project expedite justice and other NGOs Human rights organizations that there are violations of women's rights And women's human rights in in Afghanistan So it strikes me that this is a very hard thing for us to do a to find out what's going on B to identify, you know, the people and the process is involved and and you know actually investigate and you know You know violations of those rights and prosecute those rights.  What can the United States do? What can Western Europe do? What can anybody do? And in order to in order to improve the lot of women In Afghanistan today where we're the violation of women's rights in Afghanistan on a central part of its government It's it's a core point of the way it is governed by the Taliban I mean, it's this this is what they do. What can we do to stop that? That is a good question. It's It is always I don't know. I think I I Often go back to like what we could have done and what we should have done but In the end does it does it help? No, no, we have to fashion a strategy now Yeah, we have to do what we can do. I mean it's Afghanistan is not the only place. There are other countries that have similar Problems and a question is how can you investigate war crimes that are behind a curtain that way?  You can't bring them to justice.  It's a way that the local government Enhances its own power. I would say as an outsider So what what can you do on it? Give me a a course of action Yeah, I I believe We have we have to keep pressuring governments and international organizations And instead of For example, the UN just condemning what's happening We're actually doing something So I believe it's NGOs like PJ and other organizations that Do the work and the power of so we should should not underestimate the power of social media and how we can put spread awareness and Do activism From our home directly Well, can people can women in Afghanistan and Kabul for example, can they report these crimes out on the internet? Is there a way to electronically communicate? What they would like to tell us and then we could of course raise Global awareness about that if we knew if we had that information Is there a way that information can get out of Afghanistan is getting out of Afghanistan? There are women's organizations in in Afghanistan. So yes Yeah the other thing I wanted to ask you about is you know other countries and of course project expedite justice and other NGOs do have a certain amount of leverage and Not only by information, but by sanctions By saying, you know, oh We could give you money. We could give you support of one kind or another or not and This happened right after the United States left, I don't know what happened, you know more recently, but If you want us to show you favor to support you to help you in one way or another or many ways We could and we will what you've got to stop doing this to women Was that successful could it be successful now I'm sorry If I said for example We have we have some of your frozen assets like Russia like the sanctions and we will turn that over to you We could give you aid we could give you Billions of dollars a we know we know your economy is on its back We know your children are starving. We could help you but we need commitment from you We need you to stop the atrocities Then we will help you. Has that been successful. Could it be successful as then is any country or organization done that To do that kind of transaction that kind of deal. I mean, yeah with late Taliban is now that they are empowered they do struggle with the Financial aspect of the economic aspects And It I Don't I'm not really sure How that would happen and Because in order to I don't know in order to do that they you would have to recognize them as well and and Getting into that sort of like a diplomatic Establish in deep that sort of diplomatic Relations would bring them legitimate legitimacy as well, but I I also think with these Talks that Taliban would Have with with other states is Taliban already also struggles with internal Power struggle and the leadership and I don't know how How they would like who would make the decision who Who would negotiate because there's already some Terrible in times within Them because some some branches of Taliban feel that they don't have enough power and then Some others make the decisions so then How would they even get to these Negotiations, but yeah, they Yeah, the age isn't it's an interesting question because they're the people are suffering and they They're they're in a economical crisis. You know, it could be they don't care They don't care about the people suffering They just you know, we we see that in other countries and there are some people in the United States feel that way It doesn't matter how the people are doing the important thing is to stay in power. It's the you know It's the mark of autocracy We don't we you know that I and I suspect there must be some of that Especially when you say that their government is not functioning very well But here's here's one last question and I realize that this is you know, political or geopolitical question As much as it is a human rights question, but it you know, the Taliban is Corrosive it's toxic the Taliban, you know has never been good at building a society They may you know provide some Some benefit to some people but only for an obviously manipulative reason In larger sense, they they can't run a government. They can't run a country They never have been able to do it and they're not able to do it now even though They ostensibly have the power to do it and they don't have the skill And they don't have the knowledge and their their people are not oriented to do that So the question I put to you is Is the Taliban With this war against women, that's what we have here A war against women is the Taliban sustainable Is it is it going to be able to stay in power or is it going to collapse? Ultimately as a way to govern afghanistan As it seems to me that that possibility logically Exists and it's one we ought to be watching. What do you think? I don't think they're sustainable Precisely because they have this power Internal power struggle just they they don't have this established hierarchy and they You you can't function as A state or an organization when there's too many people hungry for Power and wanting to be the ones to make decisions. So they don't have this internal cohesion. So I don't think They can survive but Yeah, I guess you never know Well, I think you know, it's interesting that you know pj Is concerned about afghanistan and we all are But what I think what is interesting and what is interesting in your work? Is that in a in a strange way afghanistan is an exemplar? It's a closed state It's a state at war with its own people It's a state with a with a culture that divides Um, it's a state that is probably in the long term not sustainable even in the intermediate term Um, and it's not the only one And I think it's a learning experience. Don't you know, it's a learning experience for us The ones who are looking at it and studying it and trying to figure out how to help those who are inside it You know the ordinary people men and women who want to lead a reasonable life in in today's world That we need to learn From the afghanistan experience So that we can apply those lessons to other countries That are similarly closed countries closed states with the revelations of human rights going on inside Uh, don't you agree? Isn't this part of the examination that that project expedite justice and other human rights? NGOs should be making to carry those lessons elsewhere Yeah, absolutely. Absolutely it's um history tends to repeat itself as We've seen now with afghanistan as well um But yes, I I hundred percent agree Well, thank you, honey, honey linden I've finished lady educated in england and living in amsterdam even as we speak Uh and concerned with human rights all over the world including Latin america, africa Europe and certainly in the middle east. Uh, thank you so much, annie. We really appreciate this discussion with you Thank you so much for having me Aloha Thank you so much for watching think tech hawaii If you like what we do, please like us and click the subscribe button on youtube and the follow button on vimeo You can also follow us on facebook instagram twitter and linked in and donate to us at thinktech hawaii dot com Mahalo


Hi, I'm Sandy Baird, and we are here today with what's going on in the world today, and there's a lot going on as always. I'm here today with Eric Añero, a colleague of mine, and a colleague of this city, and everything important that goes on in this city. Eric is from the Ivory Coast. He's now becoming a lawyer here, and he's doing many other civic activities. And there are two important events going on, and we'll start today with the summit on Africa that's being held in Washington. And before we go to a discussion of that, we will see a little video. So, right? Yep. Okay, thank you. African nations are in Washington, D.C. this week for a three-day Africa summit organized by the Biden administration. The U.S. Africa Leaders Summit comes as the United States is trying to counter the growing influence of China and Russia in Africa. On Monday, Biden's national security adviser, Jake Sullivan, revealed the United States is pledging $55 billion in economic health and security support for Africa over the next three years. Working closely with Congress, the U.S. will commit $55 billion to Africa over the course of the next three years across a wide range of sectors to tackle the core challenges of our time. These commitments build on the United States' longstanding leadership and partnership in development, economic growth, health and security in Africa over the past three decades. During the U.S. Africa Leaders Summit, President Biden's expected to express support for the African Union to join the G20 and to push for the United Nations Security Council to include a permanent member from Africa. Axios is also reporting Biden's planning his first trip as president to sub-Saharan Africa next year. The Washington summit comes as Africa faces numerous crises from the climate emergency to political instability. Over the past two years, there have been coups in Mali, Sudan, Burkina Faso and Guinea. U.S. trained officers led several of those coups. The foreign nations were not invited to the Washington summit. Neither was Eritrea or leaders from Western Sahara, which has been occupied by Morocco since the 1970s. One prominent African leader who will not be attending this week's summit is South African President Cyril Ramaphosa, who faces possible impeachment over corruption allegations. As the summit comes, as the U.S. continues to expand its military presence in Africa, President Biden recently sent U.S. troops back into Somalia, reversing an order by Donald Trump to withdraw troops. So what's going on? Well, you know... What is this African summit? It's gathering that, you know, Biden is organizing, President Biden is organizing in Washington. It's the second one after the first was organized by Obama. I think it's 2014. And so this summit, as, you know, the video was saying, comes because the U.S. is facing serious challenges. In Africa or everywhere, really? Everywhere. But Africa has become, if you've seen it, the epicenter of, you know, almost like all these new geopolitical confrontations between the West and, you know, Russia and China. I would say between the West and the Brex. Okay, so what are the Brex? There are, you know, Brazil, Russia, China, India and South Africa. So these are the emerging power that are challenging very much. So, you know, the domination of the Western world, meaning, you know... Domination of the capitalist world, too, in a lot of ways, right? Yes, but today is no longer like a divide between capitalism and because everybody seems to have found their way of doing free market, depending on, you know, your background. But what is more important is that these countries no longer will take a dictatorship from the West. Because, you know, after like India, for example, used to be a former colony from Great Britain, but today India doesn't have any complex and would like the British to treat with them as, you know, a power or at least a sovereign country. And India also has the means to reclaim that because like it's one of the largest populated countries, the economy is also booming.  And Russia also wants... Russia is a nuclear power and Russia doesn't want to be taken for a third world country. You have Brazil, which is a large economy. And you have South Africa, which is also one of the largest economies in China, not the largest economy of Africa. So these countries also have their agenda. They want to do business across the continent. They want to do business across the world. So they're refusing what we call in French a chasse-garde, a turf of, you know, these post-colonial powers, I mean, these colonial powers. For example, the French-speaking countries in Africa are still under the domination of Paris. And then... And the French... I wonder if we could go back to the map, if that's possible. But the French countries are in French West Africa, correct, mostly? Yeah, some of them will come to, you know, the Central, you have Madagascar, and they have ties with France. And so, from Dhaka to Madagascar, you have, like, a lot of countries that... That are French. And then in this region, in the West Africa region and Central Africa region, almost 14 plus countries share a currency that is being controlled by France. Meaning the economy, politics, everything is held by France. So this is why in Africa we're seeing a revolution that, if we don't pay attention, will take away France and all the allies amongst them, the U.S. The new generation. In other words, there's competition for the control, not really for the control, but at least for the loyalties of those countries. They're not so loyal to the old imperial powers, right? Yes, and then what appears as a way to grant loyalty to another power is not what we think here. The U.S. and the Western world are always seeing it as a competition, not as a legitimate need and expression of sovereignty. It looks like you Africans cannot even choose with whom you want to do. If you choose our enemy, then you're choosing wrong. Under these pretexts, they don't get it. They don't get that the new generation of internet, those who went to school no longer the colonial subjects that their parents were, want equality. Someone was telling me, can black lives matter only in the U.S. and not in Africa? How can we be in Africa, still colonial beings, and we have to deal with a power that is saying that black lives matter. Black lives matter only in America, not in Africa or in the black and brown world. This is it. So instead of creating these big summits where the same people, the same leaders that are being challenged by the new generation there, that are being seen as just beggars and lackeys of the colonial powers, instead of having them, this country should understand that there's a new paradigm over there. There's a new way of doing business. Which is? Which is? I mean, wait a minute. Can we go back? So this summit that's happening in Washington, what is the purpose of it? To give aid? What is it? Yeah, I mean, it's the same thing. You see that Africa is being approached by China and Russia. And they are. And they are. And then not in not only approach, but Russia is one of the major, you know, armed dealer, major military assistant, you know, assistant power and also doing business with Mali, Bokina Faso and all these countries. You have China. Russia is doing business. Yeah. China is one of the major investors in Africa. China is building roads. China is building infrastructure. They're doing business over there. Do they do? Do they arm those countries as well? China not into the armed business. That's more the 40 of Russia. But in any case, they're also looking for the influence over there. Do business. Even India is doing business. Even Turkey is doing business over there. So they don't. And then the Africans want to do business with everybody. They want to do business with everybody. But it's not possible. Why? Because, as I said, a lot of them are still prisoners of a past colonial system that prevent them to do freely. They move. So if they want to do that, they have to break away from France, for example. That's what Mali did. Mali did when recently? Recently. After Kudeta. Mali now is best buddies with Russia. Because Mali is looking for someone to protect them against the retaliation of France. And the retaliation of France, and there have been a lot of articles and studies. It's like agitating all these criminals in the desert, these so-called terrorists, to terrorize the countries over there so that they can turn to France to ask for help against these terrorists. And in return for this help, okay, France will dig into your soil and get all the gold over there and the minerals. So it's a new dawn. It's a new paradigm, which is not going to be about these summits only, but also creating avenues of people to people business. Cultural. The U.S. is like one of the... Used to be. I mean, it's still, you know, just a movie comes out of the U.S. just like a new economic theory or whatever comes out of the U.S. and already, you know, the world wants to take advantage of it. The U.S. is still as big soft power. Which means cultural. Cultural. That can be used. You know, how can you expect a generation that have read all your books to accept that you come as a lesson-giver? You know, when they know that you best friend with France, you are best friend with England, you are best friend with... Belgium. You know, Belgium? I mean... Well, explain that. Because, I mean, there's so many Americans, I believe, that don't know a thing about history and are really unaware a lot of the colonial past in Africa. They might know, Americans might know that the West, England and France and the United States were associated with the slave trade. But beyond that, I don't think that many Americans know about the whole history of those powers in Africa after slavery. Colonialism. Colonialism. Right. And past colonialism. Because the main... And that means the control of Africa by Western powers for their resources, largely, right? They see flags. They see African nations playing at the World Cup and thinking that these are real nations. These are real countries and dependent countries. Here we are. Okay. It's not true. Well, what is true? What is true is Africa, not only is still dominated by the colonial powers... Of France and England. Of France, England, England somehow through, you know... But the U.S. is an ally of this. Right. The U.S. has to maintain this division of Africa that took place at the Berlin conference that... And then yelts at the division of the world where, you know, superpowers, you know, kind of share the cake. Okay. This is my turf. This is your turf. So if I won't go to your turf, I will back you there as long as you back me there. I help you knock down China if you help me get, you know... Knock down Russia. Russia, you know. But that's unfortunately what's happening with Africa. And Africa is still being seen by the people of the Western world as an infant. That is only looking for food, clothing, and medications. And then under this pretext of, you know, health assistance, all this kind of experiments. Yeah. And dumping of drugs and all kind of chemical to Africa has taken place. They didn't monitor, right? So when the civil society wants to topple down these dictators, these lackeys that are holding the country back, then come these powers to help that. So it's impossible. It's impossible for that continent to be successful if all its resources are taken away to Europe. For example, Niger, Niger is here. And that's also French-speaking, right? Yeah, French-speaking. Niger produces uranium. But Niger doesn't even have power.  They produce uranium. All this uranium goes to France, produces electricity for France when people from Niger. Is that nuclear? Nuclear. Right. You got, like, Ivory Coast produces, like, the largest quantity of cacao for chocolate.  And these countries are still, you know, imposed to produce raw materials and ship them. You have... Not just the same in the English colonies as well or not?  But it's the same, it's the same, it's the same scheme. If it's not militarism, then comes the IMF and the World Bank. And what do they do? They impose, you know, all kinds of programs. Right. For example... Austerity. Austerity. To pay back credit cards that have been flooded into the country by, you know... Citibank. Yeah. And then it's... You can't go anywhere. You still be Africa. And then... So now the U.S. is changing maybe... I mean, so what is this summit then for? To sort of court the African countries or what? Yes, to court them. Right. But it comes also with a stake. Yeah, which is... Because right before this summit, there was a low pass... I mean, how do you call it? But, you know, basically a low pass by Congress or, you know, a bill saying that countries, all individuals that will be helping China's or, I mean, Russia's malign influence... Malign influence. ...in Africa will be punished. So, like, it's like still a friend from Africa told me, Baba Biden and the 49 robbers. Yeah. That's how they see it. 49, most of them illegitimate, you know, that are not legitimate, you know, leaders are in Washington to be court so that they can maybe, you know, help with, you know, with regard to containing the influence of China. Not everybody wants China to be the dominating me. I don't want it. I don't want, you know, Africa to go under again. I mean, any other power. What I wish for Africa is that, you know, they can do business equally with the rest of the world. But maybe one has to be very, you know, how do you say it? Circumstance. First of all. Yeah. So it's good that a summit like this happened. But it's like a competition because the same summit happened in Sochi in Russia. There's also a summit China-Africa. There's also maybe a summit India-Africa. So African leaders are like beggars that go from summit to summit where they've been given champagne and all this nice gift and maybe some stipends to attend this summit with blah, blah. And then at the end, it's like, you know, who will give more to this power but less to the people? So what happens at the end? I mean, so these African leaders, first of all, are they legit leaders? Also, they are not. Are not. What do you mean? I take the example of the president of the Ivory Coast. He's serving a third illegal mandate that have been, you know, condoned by France, the European Union and the U.S. Was he put into power by those countries? I mean, it was like after a post-electoral stalemate which had like the Western powers weighing very much for him to be in power. Okay, he got two terms and after the two terms he comes and then says he's going to do a third term because his successor that he has designated has died. So I need to be there because my successor, like if there were nobody in this country to take over. But this guy is still, how can he be at a conference like this? Okay, the Chinese are not asking anything when it comes to human rights or whatever. Okay, so be it. Then let's go do business equal to equal. And this is what this leader says too? These leaders, they don't have a say. Most of them are over there just because they're protected by at least the West. Because I don't put the U.S. as the major. Most of them, Africa is not the turf of the U.S., so to speak. At this point. At this point. The U.S. is there as an ally of these... France. France, and you know. But also the U.S. is there also to, you know... Get a foot in the door. Yeah, but still, I'd rather have the U.S. play its own cards in Africa rather than being an ally of people that have created hundreds of years, or at least dozens of years of resentment from the Africans. Remember a few years ago, I mean less than a century ago, or maybe a century ago, people were having their hand cuts in Congo. That was by the Belgians. Lumumba's tooth, one of the Prime Minister of Congo's... Patrice. Patrice Lumumba's tooth was given back to Congo, like you give like the tail of an animal. Because he was assassinated. He was assassinated. And his tooth was being kept by one of the guys... Psychedentification?  So how can you, if you don't do at least that... You don't do at least penance. If you don't at least repair that. It's almost an oxymoron to try to become a helper when you help those who are still... But that's not changing, right? It's not changing. And that patronizing attitude. But so if a government comes into power, even if it's a free election, that is more friendly with Russia or China, what does the United States do? And France. Ah, they'll put pressure on this because there's competition. Right, and the competition is about what? About resources. It's about resources, but also it's about influence. It's about pride, it's about everything. It's about everything. And even you see that at the World Cup. To the last World Cup, because we have just a few minutes to talk about it. Which is tomorrow at 2 o'clock, Morocco versus France. So most Americans don't know the deal. Morocco is a former colony of France, right? So for the people from Morocco, it's kind of... The people of the world from Africa. Yeah, opportunity to take the revenge. And then this is what is at play. And then just also to show that we are nations now, all part of the world that we have to respect each other. So no nation, even if these nations are midget, like in terms of economy, military... Compared to France. But they're still people. They still have pride.  And then so who do you want to... Look, I'm a French from Quebec. So I would probably favor the colonies. But it's interesting because Morocco is the first African country, first Arab country because Morocco is dual Arab. I know. And therefore Islamic mostly, right? So it's like for the Arab world, it's the first country that is going at this stage of the competition. And for the African continent, it's also one of theirs that is going at this stage. So the whole continent is behind them. The whole black and brown world is behind them. I don't know in this country though. But thank God it's... Oh, this country has a lot of friends from here that are from Morocco because it's a tour de force. They did something very incredible. Which was? Which was going all the way to that stage. So they... The first African, first Arab country. Yeah, they gained respect from the... And then they were able also to beat some of these powers that also put the American teams in trouble. So, yes, but that's what we want. Thank God it's not like through a conflict, military conflict. Yeah, I'd rather have a soccer match, wouldn't you?  Hard to dominate you basically because you've got gold. Yeah. Because you've got coltons. Because you helped me fight the Russian. I helped you fight the Chechens and so to speak. So I like that idea of the summit in Washington. I hope that, you know... What did Trump... Trump didn't have such a thing, right? Trump was clear from the beginning. Trump wanted only America. And even you would be surprised. In Africa, people used to like Trump. I know. Because at least he was not coming to mingle in our people. Mass with your people. People were like, okay, these are whatever whole countries I don't get there. This is your business. But because the US, for example, is pledging $55 billion for Africa. But for what? I don't know. I'm going to ask you.  Or for businesses or what is it for? I mean, it's for security. In other words, is that the military? Military. It's also for climate change. What does that mean? I mean, it's like maybe we'll help you fight climate change. But Africa needs more than that. Africa needs to have access to education, access to democracy, the rule of law. And most of the systems over there are not in favor of that. So no matter how much money you put in these countries in Africa, you won't have a good result. It's like the same way we're pouring money into Ukraine. Where this money goes? God knows. Nobody knows. I mean, I hope he helps. Goes into guns. I hope he helps. But we need to redefine our relationship as countries around the world. We need to be tough together. Not only one country that wants the other countries to work in such a manner. No, we all have to sit down. The U.S. also is pledging to give to Africa a seat at the G20 summit, which is the 20 most important economies in the world. But Africa is there for what? As a prosperous economy or just a beggar? Well, you tell me. You tell us. Because to be there, you have to earn that. So again, we want the African Union to have a seat there or to have African countries have a seat at the Security Council. How about dismantling the Security Council and making it a general assembly? I know. So Africa will be there just for that little school. Brother? You get to sit there and then you say yes to everything? Yes. Well, no, you don't say yes to Russia and China. Only to the West. So the new generation in Africa doesn't want that. And they all want Morocco to win. They want Morocco to win. But I like the team of France. They're very good, though. And they're the same people. Yes. If you look at the... Let's look at those pictures. If you look at the team of Morocco and that of France... It's the same. It's almost the same. Right. Because France now has a lot of black and brown people within France, right? Yes. We call it even the team of France. It's like the same way they had these soldiers from Africa who went to fight the World War... Right. Right. Right. On behalf of France. Right. Or on behalf of Britain. Britain. Right. In World War I. It's unfortunate. But anyway, thank you very much. Oh, my pleasure. But we'll have to be back and talk about the results. Yeah. Correct? Especially of the soccer match. Right. Okay. And then we'll see what this summit in Washington... Right. ...will give birth to... It's about time, though, that the U.S. is paying attention, right? Yes. I mean, me, I would like the U.S. to use one of their best resources. Culture. Culture. Mm-hmm. And the African... The new Americans from Africa that are here thriving that could be the new economic ambassadors. Thank you. To Africa. Yes, why not? Okay. All right. See you later. Thank you.


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Felly, mae'n meddwl i'ch gweithio floraeus yn gweld ddechrau. Floraeus yn ffordd o'r cyffredinol yw 30 gadw, yn ymgyrch yn ymgyrch. Mae'n cyffredinol i gael ei ffordd ac yn ymgyrch â'r cyffredinol yw'r cyffredinol sy'n gweithio'r ffordd o'r cyffredinol i'w gweithio'r gweithiau. Florence is the lead obstetrician for perinatal mental health and has a joint clinic with the perinatal mental health colleagues. She's also the link consultant for the trust's home birth team and has a joint clinic with their consultant midwife. Florence is also a member of her local maternity voices partnership. She has co-founded hashtag mat EXP with Jill Phillips, a grassroots movement of women, families and staff caring for them working together to improve maternity services. The workshops have been a tremendous success being used by more than 50 maternity services and still being used today. Florence is also a clinical representative on the RCOG women's network and has her own podcast called the OBS pod. Florence, I don't know if you're able to turn your camera on and we'll turn ours off and then I'll give you presenter role. Hello, can you see me? We can. Welcome. Perfect. Thank you very, very much for the introduction. I'm just going to shut my blind because I'm going to be a bit stripy otherwise. You've got rain. I've got a bit of sun. So I'm very excited to be here. And I'm going to talk about collaborative working and I'm just going to give you some ideas the sorts of things that I do in my day to day work and the midwives I work with do. And I'm very happy to be interrupted and ask questions as we go along. If there's something that you want me to expand on, just put it in the chat and hopefully Ali and Leticia can just draw my attention to it. So a little bit about who I am. So I've been working in obstetrics and gynaecology in the NHS in the UK for about 30 years now. And actually, when I became a consultant, I decided to subspecialise just in obstetrics, which at the time was relatively unusual. But maternity care had always been my absolute passion. Labour ward was where I felt happy. It was my happy place and I really wanted to focus on that and improving maternity care. Along the way, I had two daughters of my own and I had very different birth experiences in terms of experience but identical birth experiences in terms of clinical outcome. So with both my daughters, I had an emergency cesarean for what people would describe as failure to progress. This made me realise even more than I had before how the language we use, the way we talk to women, the way women experience their birth and the care they're given has a massive impact. Because although on paper, my births were identical, to me, they were very, very different. One was a very negative experience and the other a very positive experience. So, as Allie mentioned, I've done lots of work on trying to improve women's experience of maternity care. And in lockdown, I decided to start a podcast to try and demystify the role of the obstetrician, make us a bit less scary, a bit more approachable, and to try and let midwives and pregnant women using maternity services kind of understand our thinking and a bit about us and what it's like to be us. One thing always leads to another with me and I ended up giving a TEDx NHS talk in August of last year, which is called Birth Should Be Special, about the idea that a birth experience is a woman's unique experience. And given I work in a high income country, women are often only having maybe two, three children in their lifetime. And those experiences are the profound moment for them when their child is born and that stays with them forever. And that's not to say if you have more children, it's less important, absolutely not. But we need to understand that birth is a pivotal moment in that woman's life. And indeed, I heard some time ago some recollections of women. It was interviews taken in a hospice at the end of life. And one of the key things that women wanted to recount about their lives was their birth experience. So it's important to the day they die. In my job, I'm teaching, training and supporting not only junior doctor colleagues, but also midwives, student midwives. And in their turn over the course of my career, midwives have taught me an immense amount. I'm sometimes labelled an honorary midwife and I'm really proud of that title. And so when it was suggested to me, I might like to come and talk at Virtual International Day of the Midwife. I absolutely jumped at the chance. So why am I here? I'm here because I strongly believe in midwifery. So access to a midwife and good midwifery care is crucial to outcomes for mothers and babies. We know the evidence is absolutely abundant. But midwives are only part of the system, as it's sometimes called. A maternity service is composed of all sorts of other health professionals. And it's important that we work together if we're truly going to put a woman at the centre of the care we give. As professionals, how do we make that happen? If that midwife is that key contact, that key continuity, hopefully, and key person, then midwives are advocating for women as well as caring for women. And how we interact as obstetricians, anesthetists, nursing staff and other health professionals can have an impact on that relationship and support of that relationship. So I'm here to share my ideas and improve collaboration, hopefully provide some ideas about respectful, safe women-centred care, wherever in the world you are, and hopefully make some connections. It's exciting to see people from across the world. And I'm interested that there's quite a few people from the United States because that's quite a different sort of maternity care provision. So I'm going to explore four basic things. I'm going to talk about relationships, leadership, information and communication. So before I start, I'm going to talk a little bit in relationships about teamwork. Who do you see as part of your team? I did some work on experience in the operating theatre and I took Jill Phillips, who I collaborate with, who's not a medical professional, to look around the operating theatre. And it was really fascinating because the sister-in-charge of operating theatres very proudly displayed this beautiful display of staff photographs. And when we looked at the photographs, we noticed there were nursing staff and operating department assistants, but there were no anesthetists and no surgeons. And we asked her, this is the operating theatre, where are the anesthetists and surgeons? They're not up on your board, surely they're part of your team. And she said, no, they're not part of our team, they're just visitors. So thinking about who actually belongs in your team, who do you see as being in your team is an interesting question because what you might think of as your team might be completely different from what other people think of as your team. So I'd like you to say, if you can, by taking the poll, which I'm going to give you, who do you think might be part of your team when you're on duty? I'm just giving it a moment. So we've got 15 responses to see if anyone else wants to do it. So when I'm on duty, I definitely feel it's the whole team. So I've been on Labour Ward today and I'm working with my colleagues, anesthetists, midwives, nurses, midwife in charge, students, a whole range of different people, pediatricians. So I'm going to publish the results. So we've got most people saying that every member of staff on duty, they consider to be part of their team, which is heartening. We've got a few who feel one or two that are just the midwives or just other junior people. And that picture I put up about flattening the hierarchy is really important. How approachable are the other people on duty? Do you feel able to go and talk to other people? So sometimes we work alongside people, but we may not be a genuine team. Do we actually really work together? Professor Michael West has done a lot of work on teamwork and he talks about su day teams where people aren't actually working as a team and really coming together, understanding each other, having a common purpose, a shared goal and then reviewing things. But they just happen to be people that are working together. It's a bit like when you have toddlers at a play group and they're kind of playing, but they're playing alongside each other rather than with each other. So do we really get to know each other? Some suggestions and things I've participated in to try and get to know and understand my colleagues a bit better are rather than a randomized controlled trial, a randomized coffee trial. So that could be that you put your names in a hat and you pull someone else out that works on your team and you just go and have a coffee together or have lunch together or just meet up and have a chat together. It could be that you decide to do that with a specific person that you perhaps work with but occasionally but don't know very much about. How do you get to know another human being as a person, understanding the whole of them, not just their work or their grade? What's going on for them? What are they interested in? What do they feel is important in their day-to-day work? So trying to get to actually know each other and I've done this both within the maternity unit but also we've done it across maternity units. So an initiative a few years ago was to have a randomized coffee trial of people interested in Matex improving maternity experience across the UK and we matched people up so that actually someone who was working in perhaps Devon could talk to someone who was working in Scotland for half an hour and now with the advent of Teams and Zoom and these virtual platforms it's really easy so you could have a randomized coffee trial with someone on the other side of the world doesn't necessarily have to be someone in your team but getting to know your team and understanding their roles. Another way of looking at people's roles and understanding what they really do is shadowing. So our admin team are really critical in improving continuity of care and making sure a woman sees the same midwife throughout her pregnancy and hopefully also being looked after by that same team in Labour. So they have a really critical role but how much do we understand about what they do and how much do they understand about what we do? So one of our admin team who works in the maternity back office and organizes all the appointments and sits on reception came to shadow me on Labour wards so that she could understand what the final outcome is and what that woman's experience of birth is and I went and I shadowed her in the office and understood the complexity of how to get the woman an appointment at a time that she could go to that was with the correct midwife in the correct place so that she would get continuity of care and sat on reception to see the sorts of worries women come in with, what appointments might need adjusting do they need interpreting services and all sorts of things that I haven't thought about. One of our consultant obstetricians had one of the home birth midwives come in and shadow her on Labour ward because she was very used to looking after uncomplicated births and women laboring physiologically at home but didn't have a lot of experience of women in an obstetric environment and one of our consultant obstetricians shadowed one of our theatre runners so we may do a case, do a cesarean perhaps walk out of theatre but do we know what the runners are doing to tidy up after us clean the theatre, sterilize things make sure the equipment goes back to be re-sterilized, account correct the floor mopped and then all the equipment, where does it all live and what do we need to do to prepare for the next case so understanding the crucial role that we each play in the team and how that team comes together and starting to try and get to know the rest of your team a bit helps build understanding so coming back to roles and responsibilities I'm a consultant what does that actually mean? well if you go back to the origin of the word consult the definition is to get information or advice from a person or book etc with specialist knowledge on a particular subject so that doesn't mean I have to do absolutely everything but it means I can be consulted so what does this mean in practice? I am the link consultant so many of the women under my care will never meet me I don't necessarily need to meet them I work closely with a number of midwifery teams and we can decide who needs to see me who can see them and how best to make sure that that woman gets the right care from the right professional within the team the picture I've put up is actually the perinatal mental health team so we've got specialist midwives that you can see on the left and myself and then on the right we've got psychiatric and psychiatric mental health nursing support so we will see women in a joint clinic but it might be that they need to see the specialist mental health midwife it might be that they need to see the psychiatrist or they might need to see me and the psychiatrist and we'll have a lot of conversations going on behind the scenes perhaps emails back and forth or sharing information on our electronic record or they'll come and say to me this woman does actually need to be seen by you I'm seeing her today but actually this problem is cropped up can you see her? so a consultant is a critical part of the team but doesn't have to see every single woman we can delegate and share out tasks depending on what the relevant expertise is and this works with a number of teams that I work with not just the perinatal mental health team the other key team that I work with is the perinatal mental health team the other key team that I am part of is the home birth team what does an obstetrician have to do with home birth you might say home birth is uncomplicated pregnancy and birth at home it's nothing to do with an obstetrician but actually being the support behind the scenes being there when a woman perhaps develops a complication or even just a slight deviation or change in her risk factors that means maybe she needs a little bit of obstetric input sometimes the midwives will email me or contact me or the women will come and see me for an appointment for us to discuss is home birth still a sensible option maybe it is maybe it isn't strictly speaking according to guidance but balancing up the risks and discussing things together we can come up with an approach that's individualised for that woman maybe it means having a bit of extra treatment available at home or explaining to her she's got a slightly higher chance of being transferred in in labour so there's a lot one can do as a consultant to support the midwives and a lot of those women having a home birth I will never see but I'm there if something crops up and it's important to have that relationship of trust so I've worked with the team for a long time I know the midwives are extremely experienced in home birth so when I'm talking to a woman about the chance of complications or problems at home I'm very confident that I know that that team are very experienced and I will tell her if the team say that you need to come in then you need to come in you will need to be transferred and you need to listen to that team because they're very competent someone had their hand up Just from Linda you tell her the advantages of home birth too Oh absolutely yes and often so a lot of the women that are asking for something that's a little bit more out of guidance shall we say I will often say to them actually yes I think you're quite right that home birth actually could be a really good option for you for example I wouldn't necessarily encourage a vaginal birth after cesarean at home but actually for some of the women that have had intervention and you think they didn't have an obstructed labour there isn't a reason maybe they've had a cesarean for breach birth for breach presentation then actually if they go into spontaneous labour being away from our doctors could actually increase their chance of a successful it's about balancing up the risks because we know that the outcomes are better for midwifery led care and home birth and because I've got that trust with the team and I know they're used to doing home vaginal birth after cesarean I know that if anything starts to deviate from normal that they're going to recommend the woman comes in and have a low threshold so I can say yes I can't officially recommend this but I can understand the pros and cons and why and yes there could be some benefits of this and the same with perhaps a woman who's got a normally grained baby but she's gestational diabetes but well controlled on diet officially she shouldn't be having a home birth but actually we can have a rational conversation about risks if your baby's not macrosamic and your blood sugar control is good and your labour starts spontaneously so we can have sensible conversations because yes there's a lot of benefit so I want to think a little bit about hierarchy now so I showed that slide with the midwife at the bottom and the doctor at the top and this idea of hierarchy and that's really important within relationships how flat or guess high would be the opposite is the hierarchy so I want you to just take this poll now and tell me how easy you feel it is to raise questions or concerns at work so I don't know if you're aware of the each baby counts work from the RCOG and one of the things they looked at was the fact that when there's a CTG concern how easy is it for people to escalate and can they escalate clearly and a lot of problems come about with decision making because people don't escalate or feel apprehensive about escalating and this is a really important safety question going back to what I said about getting to know your team if you know your team then you're much more likely to feel safe letting the midwife in charge know or letting the doctor know that you're worried about things so I'm interested to see here that there's a bit of a mixture and that actually a third of people on the call are feeling sometimes they feel a bit apprehensive about raising concerns and that is a worry and it's difficult to get a good culture where it's very easy to escalate and I'm going to talk a little bit about some of the things that may make that easier so one example is what we've done with fetal monitoring training so as I mentioned fetal heart monitoring can be a big issue in terms of escalation and risk of action not being taken or people not feeling happy to escalate and at my trust we are all educated to the same level so we all midwives, junior doctors, consultants senior team we all do the identical fetal monitoring training I do apologise my dog has just arrived we all do the same fetal monitoring training we're all identically trained we all go to the same master class once a year three or four hours of mandatory training we all take a competency assessment we all do the same one we're all marked in the same way and therefore we have a common language and shared understanding and everyone can recognise an act so rather than the old system where it might be that the junior midwife in the room would escalate the midwife in charge and then she might tell one of the junior doctors and then the junior doctor might tell the consultant and then a decision might be made everyone has the same understanding so I can have a midwife come and say to me Florence there's a chronic hypoxia there's a lady with chronic hypoxia or Florence there's a lady with subacute hypoxia on her CTG and I don't need to go and check I mean obviously I will go and see the women so I will check but I immediately know what I need to do and that midwife will immediately tell me this woman needs delivery this woman, this baby is in trouble so that need for escalation is taken away because everybody's on the same level everyone's got a shared understanding and everyone's view is respected I've also started as Allie mentioned in her introduction doing a joint clinic so doing a joint clinic with my consultant midwife colleague we found that a lot of women who were slightly having alternative care plans were having to come and see her and then come and see myself and there was a lot of duplication of appointments and it wasn't very helpful and we decided to bring things together so that we see the women usually once and then we can have some email back and forth or I might follow her up if needed but we will then make a written care plan and share with her via email it will go on our computer system at the hospital so that everyone is aware of what the care is that we're hoping to provide but it just means that we're not giving inconsistent advice it isn't that the midwives are saying one thing and the doctors are saying another thing and the pediatricians are saying another thing we can just bring everything together into one appointment and that's been really helpful and recently it was just so lovely to receive this feedback from a woman and hear how much she felt that having that joint appointment had really helped her then I wanted to talk a bit about leadership so I want to know where you're working and it's interesting we've got lots of people from the States because I think my understanding is a lot of women give birth in anithotomy in the States so let's take this poll how do most women giving birth vaginally so this is excluding cesareans give birth in what position just giving a bit of a time warning Florence it's 22 so we've got about 5-10 minutes ok I'm going too slowly aren't I ok in that case I'm going to publish this poll that's not as bad as I thought it was going to be actually so we've got 50% in whatever position they want so in this country it's around 20-25% depending on the year that give birth in anithotomy regardless of whether it's an assisted vaginal birth which is really quite worrying and this led me to do the anithotomy challenge which was trying to put myself in that women's position because as I mentioned I'd had emergency cesareans so I wanted to understand what it was like in anithotomy and I did a anithotomy challenge for NHS Change Day and if you look on Twitter at hashtag anithotomy challenge you'll find lots of different people have followed suit and done really interesting reflections with their teams on what it feels like, how vulnerable and exposed even though I was wearing clothes building understanding of what it's like as that woman as people come in and out of the door or come and talk to you between your legs what that actually feels like and how difficult that is and I've done this with student midwives and I've done this with midwives and I've done it with doctors and I'll practice development midwives do it with all our new starters now so that they get from the beginning and also sense of ok if I put a sheet and cover her up and give her a bit more bit less exposure a bit more modesty that makes a small difference, if I put her in anithotomy for the minimum possible time that makes a small difference and this week I've been really gratified to see some people doing the anithotomy challenge in Southampton, Isle of Wight and I'm really sorry for maternal mental health awareness week. It's also important how you role model and I try and role model quite a personalised caesarian experience so giving the baby direct to mum if baby can come on your chest with a vaginal birth, why can't it for a caesarian birth you can just pass the baby across the drape for skin to skin with the umbilical cord intact while you're waiting for optimal cord clamping of course with the uterus open I can't leave the umbilical cord waiting for white sadly although sometimes I can because sometimes the whole placenta is delivered and I can pass baby placenta the whole shebang to the midwife to sort it out. I put on here about different anaesthetics because I've also had issues where both parents are excluded from the birth of their child because the woman is having a general anaesthetic. We don't generally have partners in theatre at that point and I have on occasion managed to bring the partner into theatre to see the baby born even though the woman is under a general anaesthetic because why should that baby arrive completely surrounded by strangers How good are you at discussing names or do you talk about women as diagnoses so we've got people mostly using a woman's name which is great you know some of us get into bad habits and I do it myself sometimes where it's the placenta previa or room 24 and that's really bad we need to remember these are women we need to remember these are human beings and I usually on the wardrobe go into a room and say hello my name is Florence and I will say hello Latisha hello Allie whatever their name is address them by name and it helps implant them in my mind as that person as a specific person rather than a diagnosis or the same with the staff it's important to consider that your fellow staff you know are not just we have a real bad habit of talking about the peed as in the peed attrition rather than using their name their people and they deserve to be known by name language is really important I mentioned my births were failure to progress the use of failure is very negative and also using language women can't understand like IOL that means induction of labour to me but to an ophthalmologist means intraocular lens so not only can it cause confusion but women don't understand what we're talking about so we need to be transparent and clear with the language we use knowledge is power so it's really important to give women good information if we're going to hope to give them good women centre care and we're very much trying to treat women autonomously we're moving away from this paternalistic idea of medicine where I tell you what you should do because I'm the doctor I give you information on which you can then make your decision is the way forward so that's why I started my podcast and it was partly from maternity staff to try and help them understand the things that I'm thinking about but also to try and get my thoughts out to pregnant women and often the midwives will recommend to a woman a particular episode related to whatever problem they have in pregnancy and I try and signpost to nice guidance or RCOG guidance so that there's some good quality information because let's face it these days women they may use the internet they look stuff up so at least then they get some good standardised quality but also I try and be open and honest and discuss the fact that some things we're not very clear what the evidence is we're making recommendations but how good quality is that evidence so to bring it to an end and I'm sorry for rushing through things a little bit I think what I'd like to leave you with is that anyone can make a difference these are just my thoughts and ideas there are little things that you might be able to change in your day to day work with the team that you work with that might help you collaborate a bit better with the rest of your team with your obstetricians or anesthes or fellow midwives so there are little things that each and every one of us can do that don't cost anything using a woman's name and introducing yourself properly or thinking about minimising the time in lithotomy or having a coffee with one of the team doesn't cost anything but it may improve things improve your teamwork improve your culture and ultimately improve things for the women and babies under your care thank you thank you Florence I'm sure you've inspired a lot of us to build that relationship in our team with the neonatal doctors the obstetricians, the midwives, the team leaders and really have that openness and mutual respect of each other an agreement in the chat regarding some of your suggestions every maternity unit needs a Florence can you clone yourself Florence an amazing comment actually from Laetitia where every woman every woman in Ghana gives birth in lithotomy and Linda who was a midwife in England and lives in Scotland now has seen a woman giving birth in lithotomy which astounds me Linda that's amazing I don't know if anybody does have any questions we are running very short of time our massive facilitator Halima has already pasted some links but I'm just going to repeat them there again and I'm just going to grab presenter just to remind myself just a quick one Florence yes everything we are discussing is how to improve the experience of the woman's birth but in other parts of the world for example where I am we are still holding on to making sure that every woman goes home safe so that is where emphasis is on emphasis is not on how we write a good story about the woman's experience even in the classrooms the way we teach students and all that and not emphasise it on the birth experience how nice it was and all those things so in an era like this where we are promoting writing a good birth experience how do we incorporate this into our old primitive ways of doing things yes so this is a common thing in terms of people thinking that we just need to focus on the safety and when I started doing this work people were saying no that is just fluff we need to focus on the safety but there is a lot of correlation between safety and experience so listening to women really listening to them and understanding what they are telling you and what is happening to them is critical for safety and communicating with them properly is crucial for safety so I think sometimes people think well we have to do the safety first but actually the two come together so being able to raise concerns a woman being able to tell you what she is feeling and then for her to be listened to and not women talk about not being believed in the UK and I can't imagine that that is necessarily different in other parts of the world so people not listening not believing them when they talk about what symptoms is not moving or they have bled and people saying it wasn't that much so I think my advice would be communication and listening is a critical component of that safety I don't know if that answers your question I think it is fine Thank you Florence I think we all need more time with you because we haven't had much for questions and I think there's a thirst for that but I'm sure people can head to your OBS pod and get some more insights into the work that you do and a big big thank you from the VIDM for presenting today