Hey y'all, what's up? My name is Sonali. Welcome to a new vlog We're in New York City and this is going to be the last New York City vlog because today is our second to last day So sad about it, but I'm very happy that it's going to be a beautiful sunny blue sky day Even though it's gonna be I think maybe the coldest day that we've experienced here But we are headed uptown today to meet my friend Laura and Antonio for brunch And then we're just gonna do like a whole uptown day because I don't think we've been There for very long at least. I was hoping I would learn the area is really well by the end of the trip but The end of the trip is pretty much here and I still have no idea where everything is but we haven't been to Central Park So we're definitely going to do that today. I'm sad. It's our last day together We'll see each other again tomorrow We just had breakfast at And I literally think I had the best lunch just my life because it was chala bread so good and now We're at the meh. We're being our gossip girl selves because we're in the upper east side today And we're just gonna do a bunch of uptown things Where are we going next? We're going to... What's your rating? Okay, the matcha was like really bad It was like so bitter and I asked for extra sweet So super bitter and super sweet at the same time and it was just like not good. I literally have to throw it like halfway Empty and I usually always finish my matcha. So very sad about that Definitely should have gotten a chai, but vibes were cute and now going to a sports bar We got to watch our Jags play fun fact I was born in Jacksonville weren't you? Oh, yeah Was it Antonio? Yeah Duval So we're gonna basically me and Laura want to take a break just like stop walking so you're like Antonio We can just go watch your game if you want. Oh My gosh, they're all so cute They're so cute I'm an ornament heaven Was this a cat? I Said that we need a Yorkie ornament Maybe when we have a house, we'll have a whole mini tree just for Yorkie ornaments So we have to get this one I take that. That's cute. Oh my howling. I like this one. I like it. Okay. I think this is so pretty I picked it up and of course it says Made in India. That's like the second time it's happened. We're in H&M home I saw like a really pretty bug and it literally was from India. I think I'm like like subconsciously Like just attached to these cut like in more Indian designs, but it's really pretty. I kind of wish it was gold though Because my name means gold. This is the only ornament that I've been like kind of attached to I think it's just like so stunning I would be a little scared to travel with it, but Guess how much it is? It's $60 $60 which I get it like it's stunning, but still I cannot just buy from one of it. That's insane deciding between these two 35 this one is 25 what do you think right? I think I like this one It feels a little bit more how we're gonna travel with that. What feels a little bit more suitable to travel Yeah, but that's like Fold it up there You should get a bold one to be sort of trouble with your crafty brains No, they're gonna pack it. These are so cute, but they're so expensive like thousand five hundred One day these will be in my house We're back at Laura's apartment. I had to say Biden my my niece My granddaughter Laura's gonna put her ornaments on the tree Wait, I don't even know what you got. I can't remember what you did. I already put one It's freaking me out. Did you get to I don't know. I literally have on my hand Maybe check this Time to pray to st. Anthony this one's my little Chanel bag. I saw though Wait That's cute. Oh Very cute. Don't you take these off though? Probably the tags. Yeah Wait, where's our ornament from college or a little guy? Sonali painted its face literally gold Why do we do that? Oh, yeah, I literally have gold foil didn't I?  Or have you just been collecting over the years or what? Yeah This one's like burgdor The rest are all target. Oh, this is this is burgdor. This is Macy's this is like a random NYC like tourist shop Okay, oh the Christmas tree. Yeah, that's cute. Yeah And like the best like these are all target. I love these. Oh, oh, I like that one I even know where to put it. Oh, this is also perfect. I love the disco ball That was like such a thing last year. Yeah. Well, I feel like it's still a thing. Yeah We're headed out and we're getting some Thai food I'm so excited. I was actually kind of craving fried rice and she said they have it there But also green curry sounds good. No Tom cassoop. Have you ever had that? It's like the coconut Um, I don't think I would like that. I don't really like coconut and like yeah, it's really weird Oh, Ryan doesn't like coconut either. But he likes cassoop. Yeah I'll show it to you again now. I never know what's always actually laughing or crying Yeah, I know what they're not. I can't tell. Yeah, it's really hard to tell with you. Oh really? Thanks. I only want to FaceTime. I'm like...  Yeah. Okay. Well, what does that work? Oh, damn. She's working the morning snoring. That's a good... You have to go watch like White Lid is. And Lady. Yeah, so take her out again. Make her feel loved after Dixie girl does. Poor girl. I really want to go shopping because I feel like there's so many stores in Soho that we didn't do and I'm also not gonna wear as many layers this time because when we went I had so many layers on I was like getting so hot and That did not make me want to try on anything So I didn't really end up getting much and I really want to get a pair of jeans before I leave here I'm going to a rooftop bar tonight I made these reservations like a couple weeks ago and then I'll look cosy tonight So I'm very excited about that. This morning. I'm meeting my friend Mia and I think she's downstairs So I have to go. I'm also returning my fashion pass package today. I'm with Mia We just dropped off my FedEx package Got that out of the way and now we're going to Little cupcake bake shop. You can't really see it. What do you get here? I get the vegan chocolate chip cookie. It's the best. I I'm not a vegan lover and it's the best chocolate chip cookie ever It's like not too sweet. Yeah, I'm gonna eat it with a coffee. Oh my god. I'm obsessed with it But their cheesecake is also so good. Really everything in there is good, but The vegan chocolate chip cookie for sure.  Yeah, you really can't mess that up a lot. I feel like you make your matcha yourself Yeah, I feel like once you start making yourself you can't get it. Because you can like perfect it up. Yeah, that's so true What would you get? I got the gingerbread oat milk latte. This place has like every zero demand Yeah, and they always like switch it out for like the season Yeah And so I always come to try a new one. It's really great for eating cheese. I can't choose anything I was asking Mia. What's the best denim she has? Seven for all mankind Live and die by it. So everything that they hone is stretchy, but comfortable and it just fits right Like I can't explain it if you have to buy a jean that is like worth the money Because like jeans like go in and out of style so much. Yeah, you have to buy a jean that's kind of expensive But worth the money. Oh, yeah, and I'm totally fine with like investing in denim because I wear them Yeah, every single day. You don't have to wash it that much. Yeah. Yeah. Yeah Right, so we're going here other people said made well, but Made well maybe for like if you're six foot tall and have no curves Wait, that's honestly. Yeah, that's honestly probably true. You have to ask people who have similar body types. So true. So true Yeah, yeah, okay height. Yes matters more than anything. Agreed. So Send me prayers. We're going in a lot of the stores weren't open So it didn't get to go into something for all mankind. That means we have to go back to Soho But I went home for a little bit Ryan was working and now we're going to get more food. Also an update on the cookie It was actually really freaking good. It was pretty small not very cheap But I would get it again 100% it was like this banana chocolate chip oatmeal thing Honestly, I'm gonna look up the recipe when I get home because they were just like a really good breakfast Kind of cookie, you know Very young, but I'm ready for a hearty breakfast today And hopefully it doesn't weigh me down because sometimes like I get enough food coma If I have like a heavy meal, but I need to find me a pair of jeans.  We have the rooftop reservation at four and it's already like 12 So I feel like we don't have that much time today, which sucks There's still so much I want to do, but I guess that means I just have to come back We got a french toast with cream cheese, and it was really good very soft and thick There was a lot of cream cheese I'd like scrape it off, but then I got the russo, which honestly, I think I fucked up on my order I think I could have just like customized it. What do you think? I didn't like hers mine was about a nine So what's the French toast? Yeah Yeah, mine was like an onion bagel I Like didn't know which big one again. There was just like too many options There was literally like a hundred tubs of different cream. She's it's I've never seen that. I don't like so It was definitely an experience tomorrow our flights at 1145. So I think we should probably leave our hotel at like 830 so maybe we can get up early And get some bagels again I can do it right Unfortunately, there was no Joe's jeans store and I went into seven for all mankind But I really just did not like any of the styles or the colors. So I was very sad But I did like the material of those jeans They were pretty stretchy and comfortable, but I literally found the perfect pair of jeans on Joe's jeans site and I was so excited to go try them on and get them but There was a storefront like on the maps But then when I googled it it didn't even show up and there was literally no storefront So I was like very confused, but it's okay I think I'm gonna order them online and just try them on at home because that looks like the only option But I just got ready for dinner and drinks. It's our last night. So we're going to The newest like cool rooftop here in New York. I'm not really sure how to pronounce it But it's stunning and we haven't been to a rooftop yet It's gonna be perfect because it's right at 4 and I think Sunset's at 4 30 And then we're gonna make our way over to a restaurant called Moko for some omakase Right, can you give us a tour of New York? That's the Chrysler building back there. Wait, where Chrysler? Yeah It's a really bright thing. I'm square. Yeah Chelsea, okay Sorry if I'm shaking guys my hand is Well, I have my whole body's freezing What are all those buildings over there? Chelsea, I don't know. Okay. No one no one takes us seriously because we don't really know but what is down there? Lower man, I'm at World Street Center. Every time I see one of these buildings I think it's like the tipton this rooftop bar is super cool. They have like This outdoor area. I believe on both sides so you can see like kind of both views we just got kicked out because You can only get the table for I believe it was like 90 minutes, which honestly, I thought was gonna be like a really long time, but I Fell asleep apparently. I think that cocktail had something like Very calming in it. Like I was like what why do I feel so chill right now? I think the whole day. I was just kind of like a little anxious because I Was like trying to fit all this stuff in the day Which I feel like we didn't even get through half of what we wanted to do today But like I said that means I just have to come back Which I'm totally fine with because now I have friends in the city and and There's just always stuff to do. I feel like here. I just stepped in dog pit and my new freaking new balances Love that for me One we've ever been to sushi bar ATX is just really expensive It's like $5 for what was it 15 courses that it went by so fast How means now rate it like 10 out of 10. I was like, yeah, I mean don't judge us This is a food blog as you can see We are going to get my morning bakery So got to get it for me. So really took the Taxi three times and totals this whole trip and then we were tomorrow. I guess back to the airport Yeah, but to a hand to almost every time, but it's just so nice to have like good public transportation You just put it in Google Maps and it literally tells you like where to walk how long When the train's coming Is the West Village and I was just looking on the map and they have like Kerry branch on department starred on like Apple Maps, which is very interesting But this is such a vibe. I'm kind of sad that we didn't spend more time out here in the daylight because there's like cute shops around here and We're eating what? Magnolia bakery on the bench What do we give Magnolia? Everyone says I look like I'm in pain whenever I take a bite Which is honestly true. I am in pain because I know what's gonna happen later I'm already foreshadowing the pain What do we give Magnolia bakery this is the worst part which first one yet really I'm sad a lot of you decide that the cake's really good, okay? Oh You know No I don't want the icing That's like not even cream cheese, right? No, that croaker cake that my dad got was really good.  We got like a small. Oh, why don't I change the color? Okay No, we got a small and there was just like a lot of wafers in there I feel like heavy on the wafers Not so heavy on the pudding, you know and Anyways, no, babe I feel like we tried so many like I don't like iconic famous foods on our Little new york city vacation And you know what a lot of them were disappointing.  It's the next morning. We are all Packed up. Well, I'm not packed up. Ryan's packed up I'm currently working on it trying to stuff everything in my little suitcases But ryan is out getting us bagels for the last time I feel like I just had to like redo it the combination of all the things on a bagel. It just like wasn't the best Um, so we're gonna try again today. Our flight is at 1145. It's currently 835 so we're gonna head to the airport pretty soon Um, but I wanted to end the vlog here and I hope you guys enjoyed all these new york city vlogs I love Having these memories online and just for me to look back at um all my travels and honestly my whole life Because I film week in my life vlogs in austin where I live So if you guys are not already subscribed definitely do so and I already made an instagram highlight of everything We did so if you guys want even more recs definitely go check that out You can buy me on instagram and tiktok at so underscore gnarly without the g and I will see you guys in my next vlog. Bye


Somebody told me you can dunk, man. Who? So, one of the biggest mistakes I made during my dunk journey.  So if a lot of you are trying to dunk for the first time, that was a really good example. Where you at? Right here. Where you at? What's good, guys? I'm here at next level basketball. It's a tough rim. I'm exhausted. Four hours of sleep. Take you through a little bit of my training. Welcome to my channel. This is my dunk journey, and along the way, when I help you achieve your dunk goal, so let's go. It's got a baby one. All right, so I'm dealing with this hamstring injury, really pushing it with dead lifts last week. Kinda took the week super light, not really feeling that great off it. So today I'm just doing some light jumps, getting a feel for me. One thing I love about jumping is that it shreds me up. It really gets my body so much blood flow that even if once a week, even if I'm not really pushing myself that hard, I like to get that feel of jumping to keep that rust out. Another thing I'm noticing today is when I push really hard, I'm like really loading up. I'm taking off slower and I feel strong, but if I just go for it and just kinda go a little quicker, I'm taking off effortlessly. So just play with it, have fun, see how your body's doing. Oh yeah! So one of the biggest mistakes I made during my dunk journey was just doing this. Just doing one angle, one toss, one type of dunk. So my mental energy's there. I didn't get the first part of my sleep cycle because we have a circadian rhythm and I'm learning and why we sleep. Talk about that on my podcast. But yeah, my body feels super tired, don't feel bouncy, but I feel like I just wanna get that good blood flow if it gets sweating. Oh! So if a lot of you are trying to dunk for the first time, that was a really good example because I'm just simply not jumping high enough. And I know that feeling of when I was that high I thought I could dunk because my whole hand hit the rim and I got the ball over the rim. But a lot of times, one of the biggest mistakes I see is that people thinking they can dunk and they're saying, why do I keep missing? Why do I keep missing? But they really just have to get a little higher to stay on top of the ball. First 10 foot dunk in 2020. All of these rims are half an inch short to a couple inches short, but I like to measure to the fraction of an inch. This is definitely 10. I haven't dunked in at least maybe four or five months on a legit rim. So let's see if I can get my first one on the bad day. Ah! Oh, there it is. Oh, I'm gonna break the wall. My sand ain't seen you in a minute.  Where are you at? Right here. Where are you at? They call me telly. Guys, you can dunk, man. I'm not buying it. This guy.


My environmental justice research was primarily on communities, looking at the spatial distribution of demographics, pollution sites, landfills, and so forth. And so, many of my students also did our environmental justice work on communities. I was invited to participate in a proposal by the Executive Director of the Duwamish River Cleanup Coalition, who at the time was BJ Cummings, and she was looking for another partner to propose to the Environmental Protection Agency, who had a competition called Collaborative Problem Solving for Environmental Justice. And I was enthusiastically joined that group, and the reason I wasn't enthusiastic because of the topic that we had to grapple with, but the fact that this was really the first time I was going to be able to work with the community. And so I began to make that kind of transition from just outreach and informing to collaborating with and shared leadership. And so that was a great opportunity. That started in 2014. And many of my students also got involved, graduate and undergraduate students. And that transition is also an important part of what I teach about environmental justice, is typically an environmental or policy analyst is doing outreach and informing. They're not facilitating and they're not educating, right? They're sharing their expertise. And I mean, ultimately, I leave that up to the students where they're going to find themselves professionally and where they're comfortable with. But I've certainly moved towards the shared leadership. And now even the there's a continuum of community engagement that, you know, you just have the outreach on one side of the continuum, but then on the other side, the deepest kind of community engagement is when it's community driven. And so that is where I've recently progressed, I think, now myself professionally and some of my students because the research that we're doing is very much because of concerns of a community. Research challenge happens to be noise pollution. There's a lot of noise pollution, especially with the traffic from the airport in Seattle and the newer flight path takes lots of planes over Beacon Hill at very low altitude, sometimes 1,200, 1,300 feet. And those planes are every two minutes, every three minutes. We were invited to join the newest collaborative problem solving grant with the Beacon Hill Environmental Health Coalition. And instead of looking at chemical and toxic pollution, we're focusing on noise pollution. You just don't have the kind of noise pollution anywhere else in Seattle because these are communities that are fighting another kind of environmental injustice. You know, getting out in communities, burden with an injustice is critical, but you just can't go do that, understanding a really broad and historical context of the injustice that you're working on in not just individual terms, but also institutional terms. Never do social justice work on communities, do social justice work with communities. The theory kind of gets left sometimes at the door or on the street for good reason, and it's about getting out there and collaborating. And I think the other key part of that is going in with an attitude to serve, but also more importantly to learn and listen. As academics, we are so accustomed to talking and others listening to us, right? Because of our students in our classes, that's normally what kind of happens. But I think to do this kind of work, you're the student you have to take on that mindset of not just serving, but learning, and listening is so critical to that. Really important for me as an individual going into the communities in South Seattle for the first time was to ask the question, what kinds of environmental injustices are you experiencing? And then just listening. Never interjecting, never clarifying some thing they said that wasn't quite right, just listening. And I think that's been a real key to making the collaborations successful that I've been involved with.


I'll talk about anisechoria and I'll give a terrorist presentation as well because she's not here right now. So when we think about anisechoria and pathology we think about anisechoria first, whether the anisechoria is greater in bright light or anisechoria greater in dim light. So and I'll go over all of these but in bright light the pathologic pupil is usually is the dilated one and some of our differential includes an ADs, a third nerve, a palsy, pharmacologic medriasis and direct damage to the iris sphincter. In these situations in dim light the anisechoria decreases so they look more equal. In anisechoria that increases in dim light some of the differential includes Horner's syndrome and pharmacologic myosis. At least in this review they also say physiologic anisechoria. This is a very important chart from the BCSC which I'll go over little by little but again for anisechoria that is same in dim and bright light it's usually physiologic anisechoria. I'll talk first about this pathway anisechoria greater in bright light before I talk about the last part. So a couple of points for physiologic anisechoria. The difference in the pupil area size is usually anywhere from 0.4 to 1 millimeter. Greater than 1 millimeter we have to think about probably not physiological anisechoria. In this first pathway that we see anisechoria greater in bright light we first ask whether there is iris damage. And if there is an iris damage we can probably see it anatomically. So the first question is iris anatomy normal. If it's not then you know there's iris damage. One thing that we can get tested on as well is that it does not respond to pylocarpine and mimics pharmacologic medriosis as well but that's why we always look first. The other couple of things other signs of its sphincter damage by notches in the pupillary margin or transillumination defects near the sphincter muscle. Next is pharmacologic medriosis. There's no response to light and near stimulation. 1% or 2% will not constrict pupils that are pharmacologically dilated. For example we can have even segmental iris policy there's a good movie and novel about this and it is not super sensitive to either the 0.1 pylocarpine or the 1% or even the 2% and that's how we would diagnose pharmacologic medriosis. Some of the sympathomimetics include cocaine epinephrine and phenylpherin. Some of the parasympatholytics are the atropine tropicomide and scopolamine and we have to think about adrenergic medriosis as well but in here what we can get tested on is that accommodation is not impaired in these. The next in line is adrenergic medriosis. For adetonic pupils we really don't understand what's the path of physiology but people think about the damage of the ciliary ganglion and we've studies have shown that there's reduced ganglion cells. Let me tell you a little bit about the natural history of adetonic pupil and the acute face it is both pupils are poorly reactive to light and accommodation. For the next few months there is still light dissociation but constriction could be a little better but the redilation phase is still slow. This can be caused by several things including surgery, trauma, infection, inflammation or ischemia. This is associated with several systemic diseases including diabetes, chronic alcoholism, neurosophilus, amyloidosis, sarcoid, miller fissure, and charco maritouth. After we rule out all of these things the adiopathic tonic pupil is adi's pupil. The epidemiology is usually 70% of people are women and in their mid-age 20 to 50 years old. It's usually unilateral in 80% but there could be bilateral cases. The Holmes ad syndrome is basically an adi tonic with diminished deep tendon reflexes as well as orthostatic hypertension. And then finally you know to diagnose this 80% have cholinergic denervation super sensitivity to low pilocarpine and so the bigger pupil which is the 80s pupil will become the smaller pupil but we have to wait 45 to 60 minutes. The last thing I'm going to talk about is the third nerve palsy. Third nerve palsy as most of you probably already know is almost always accompanied by ptosis and limited ocular motility. We have to think about an aneurysm at the junction of the internal carotid and posterior communicating arteries. So I think those are the highlights. The next part is anisecoria greater in dim light. So for mechanical anisecoria as well again we can have previous trauma or inflammation that would lead to posterior synechia preventing dilation. We can have pharmacologic meiosis. One of the things is one of the meiotic agents is pilocarpine. So we always have to think about that. The next is Horner syndrome. So the symptoms of Horner syndrome include ipsilateral meiosis, facial anhydrosis and ptosis. The ptosis is because there's denervation of both tarsal muscles which result in a basically a narrow paupupril fissure. Anhydrosis we really don't test clinically but physiologically we get anhydrosis of the ipsilateral face from first or second order lesions. In third order lesions it usually spares the lower face and has anhydrosis in the ipsilateral forehead.  This is just a picture. So for Horner syndrome just always remember that the lesion is always ipsilateral. So the first order neuron is thought to be coming from somewhere in the hypothalamus. It goes down anywhere from C7 to T2 here in the cilia spinal center of budge wallar. The second order neuron goes up kind of comes around and then synapses in the superior cervical ganglion and the third order neurons goes up. Testing for Horner syndrome is very important to know. The first test is a cocaine. This blocks re-uptake of norepinephrine release at the synaptic nerve terminals. It would cause usually pupillary dilation, eyelid retraction, and conjunctival blanching of the unaffected eye. But in the affected eye there is no effect. And so post-cocaine anisocorea of greater than one millimeter is still diagnostic of the Horner's. Just remember for cocaine after you give it there's no change in anisocorea. The other test for Horner's is aproclonidine. This is an alpha one adrenergic agonist which dilates the pupil sympathetically, especially in denervated eyes like a Horner syndrome. In the unaffected eye it has no effect. But in the affected eye there's dilation. So compared to cocaine just remember that anisocorea reverses with aproclonidine testing. The last test for Horner's that we usually don't do in clinic is hydroxyamphetamine. And this basically tries to localize where the lesion is either the first second neurons or presynaptic neurons or the third order neurons. So again this enhances the release of the presynaptic norepinephrine from an intact third order. So in the unaffected eye it causes the eye to dilate because it has normal third order neuron. In the affected eye if the first or second order neurons are affected it'll cause it to dilate. But if it's a third order neuron problem there is no change. Some of the causes of Horner's syndrome anatomically first order could be vascular problems, tumors, demyelination. I can also show other brain symptoms including ataxia, nystagmus and hemisensory defect. For second order neurons problems we can have pancoast tumors, mediastinal lesions, thyroid mass, thoracic aortic aneurysms and brachal plexus trauma. We can have associated symptoms of arm pain, you know for shoulder stuff, cough, hemoptysis, swelling of neck. And then finally for third order neurons it's a carotid artery dissection. This is what we need to think about cluster headache, cavernous sinus lesions, and associated symptoms include numbness and cranial nerve 5 and double vision. With the apoconidine the other thing to look for is the ptosis resolution as well, so not just the anisocorrhea being affected by that so that's a helpful binding.  That is your like classic classic cavernous sinus so you need to kind of put it away in your mind when you see a six and a Horner's you have to look there. And the last thing that Tara wanted to mention is the Horner's imaging so for central processes and MRI of the brain and upper cervical cord for the pre-ganglionic we have to look at CT chest and MRI of the neck and for postganglionic again MRI of the brain and MRI of the head. And then just the last thing is a think of an internal carotid artery dissection with the painful Horner's syndrome. That's it.


Is there any life after death and what's the right age for sannyasana? The words sannyas or brahmacharya means to be in the path of the divine. When is the right age? I think that should be the first thing that you do in your life. When is the right age to get married? That is subject to social situations and above all, these thoughts come to you because till you were 10, 11, 12, 13 also maybe you were okay. After that, suddenly this chemical cocktail of hormones got into your system. Now you looked, suddenly everybody looks different. Once it so happened, Shankaran Pillai went to a party and when he came out of the party, he told his wife, you know, alcohol makes you look so beautiful. The wife said, well, I didn't have a drop. No, not you, me. So, a little bit of hormone entered your system and suddenly everything started looking different. After this hormone leaves your system, then you look back at your life and see, did I do all these things? Before they came also it looked like that. After it's gone also it looked like that, that in between period when you're being spiked from inside, suddenly everything looks different. Very few human beings are capable of keeping this spiking aside and look at life the way it is and then enjoy the spiking only to the extent it's needed. All others are driven by it. They shape their lives around it. So sanyas means just this, that you are not shaping your life around a temporary influence of chemicals on your system. It's a little bit of inebriation, you know? Suddenly everything looks different. So when should I go beyond these things? Sanyas is not a process of suppression or denial. It's a process of transcendence. When should you transcend? As quickly as possible. Yes? When should you suppress? Never. Because suppression is not a solution. Transcendence is a solution. Transcendence is not only a solution, it is way beyond that. It is beyond the problem. So whenever we are trapped in our limitations, somewhere we start thinking, this limitation is the only reality. This limitation is not the only reality. You remember a time when there was no sexuality and there was no talk about going beyond as a child, isn't it so? Yes? So this is an in-between phase.  Nature just wants to reproduce. If it doesn't drive you, you wouldn't do it. All the pain involved in delivering a child, but still we are overpopulated. That wouldn't happen if there wasn't enough drive from inside. You're spiked from inside, sabotaged from inside. Once your hormones hijacked your intelligence, after that wherever you look you see only that. It takes a certain level of awareness and capability to look beyond that. This is not a denial, but being able to see beyond that. Once you see beyond that, you understand the limitations of what this is. What is limited should be handled in limited way. You don't have to invest your whole life on it, isn't it? Yes? A small aspect of your life should only get that much attention. If that spreads through your consciousness, then that will become a crippling life. So sannyas is a realization of this. And when you have the ability to transcend, yes. So now you also want to know what happens after death. I think some things you know best only by experience. Just like marriage. You know it only best by experience. Somebody else tells you a million things, it's not true, isn't it? It's your experience. So this has always been the vain. This has always been the line that people have been taking. If anybody appears in front of you who happens to be a guru or claims to be one, immediately the first thing you ask is, what is life? What is death? See what you're asking is, I want you to understand, decipher your question down a little more and see what is it that you're asking. You're asking what is the nature of my life, isn't it so? When you ask what is death, where will I go? You want to know what is the nature of this? What will happen beyond this body? So you're asking, who am I? I'm asking, why are you asking me? See if you go on the street and ask somebody, who are you? All right. If you go on the street and ask somebody, who am I? You get instantly arrested. This happened in the Cincinnati airport. People were standing in a queue to check in at the check-in counter. One man comes, jumps the whole line and just goes straight to the lady behind the counter and she says, sir, please go stand in the line. Everybody's in the line. He says, no, no, no, I'm in a hurry. Please check me in. She said, everybody's in a hurry. Please stand in the line. Then he raised his voice and said, do you know who I am? The lady promptly picked up the microphone and she said, there is a man here who doesn't know who he is, can somebody help him? Can somebody help him? You are alive right now. If you want to know what this is, this is where you should look, not somewhere else. So unfortunately you're with me.  You want to hear this bull from me? They would have told you all these things. Now, don't think I'm confusing you because I don't have to make such effort. You're already confused. Do I have to make any effort in that direction? I don't have to make any direction. You are thoroughly confused, isn't it?  Yes? Confusion is a little better state than idiotic conclusions that you have made. Conclusion means death. Confusion means still a possibility. Yes or no? Confusion means still a possibility. You're still looking. Conclusion is death. You're finished.  I am atman. You're finished. So what happens, death? We'll find out in some time. Right now, what's happening now?  Let's find out what's happening now. There is something inside here which can make a piece of bread into a human being. We must find out what's happening now. If you understand, if you experience what's happening now, beyond the physicality of who you are, even after the body is done, still you know what's happening. If you're unable to know it now, how will you know what's after death? So if you're looking for spirituality for soulies or for entertainment, you just came to the wrong place. I'm not an entertainer. Nor am I a solace peddler.  Not an answer.  I have no answers for any damn questions you ask. If the question is true, if the question is genuine, if the pain of ignorance is tearing you apart, if the pain of not knowing is truly bothering you, then I can give you a method. I can give you a way to find a solution. But I have no answers because all answers are just stories which will either solace you or entertain you.


Health Emergency Operations Centers serve as central command centers for managing, coordinating, and responding to public health emergencies. San Dusha, like the rest of the region, is highly susceptible and has been impacted by a range of natural disasters. Over the past three decades, the eastern Caribbean countries have experienced approximately 61 disasters affecting over 500,000 people and resulting in a cost exceeding US$12.4 million. While countries may have the experience and capacity to respond to these emergencies, addressing health crises and natural disasters is a growing concern. As a result, it has become necessary for countries to review their decision-making processes and ensure there are clear procedures in place regardless of the type of disasters. Hence the reason for the Health Emergency Operations Centers training, which was conducted from June 26 to June 28, 2023. Having well-defined procedures facilitate the coordination and collaboration of the various stakeholders given the multidisciplinary collaboration that are necessary to respond to events such as hurricanes and other disasters. San Dusha has faced several emergencies that requires a coordinated response and therefore you have the experiences to pull from in moving forward in strengthening your health you will see. Paho, according to Ms. Malcolm, was pleased to collaborate with the Ministry of Health, Wellness and Elderly Affairs, who has recognized the need to continue to build capacity to manage its health emergency operation centers. The training was aimed at assessing, identifying and analyzing existing coordination and decision-making processes that are employed during the Health Emergency Cycle in San Dusha. Today, we gather here with a common objective to protect the health of all people and for this reason, Paho especially thanks the Ministry of Health in convening this training. We at Paho are committed to working with the Ministry of Health and other stakeholders to ensure that we build a resilient health system ensuring that we protect all persons including those vulnerable to these events. Permanent Secretary in the Ministry of Health, Wellness and Elderly Affairs, Ms. Jenny Daniel, stated that the training was timely in light of the recent cyclonic activities in the region. It is in recognition of this vital role of HEOCs in safeguarding the health sector state of readiness that we at the Ministry of Health, Wellness and Elderly Affairs, in collaboration with the Pan American Health Organization, as organized this training seminar here today. It is anticipated that this training will equip the internal stakeholders with the knowledge and capacity to respond to emergencies which may occur from time to time. Ms. Daniel said while the training on health emergency operation centers provided an opportunity for learning new concepts. It also served as a refresher in some aspects. From the Communications Unit of the Ministry of Health, Wellness and Elderly Affairs, Julia Tepita reporting.


Hello, YouTube! Alright, I'm driving. Just dropped off Dunkirk, the movie, into Redbox. If you haven't seen Dunkirk, you could pass, actually. Compared to yesterday's movie review in the vlog, go check that out. The greatest showman. Amazing movie. Dunkirk was a little slow, and I thought it was a Spielberg film, but it was not. It's a Christopher Nolan directed, and I usually love Nolan films, but he didn't quite nail it. It was just a little slow overall, and the acting was there, but it just was... I felt like the plot development, I was kind of lost. Character development was not there. It just was not there in the Dunkirk film, and maybe that's what he was going for, but I didn't enjoy it. So, you can pass on seeing Dunkirk, but definitely go see the greatest showman. Go check out True Love of the Nights movie review up there, up the right-hand corner. Okay, I am heading downtown to pick up some items. Yes, some items. I'm excited. Get excited. Delicious dinner, True Love. The boys are asleep. True Love is resting. She's pregnant. My wife is pregnant. She's carrying another human being inside of her. She's resting. Her back is hurting her a little bit. Hopefully, that starts feeling better soon. So, I'm out here in the man cave, recording another video for you in the shed. This is my shed in case you're new. Welcome. The Apple Watch. The saga of the Apple Watch continues. Listen, I'm not trying to rip anybody off. I'm really not. But I am trying to win. I'm a winner. I'm a competitor. I don't shy away from a little competition in this world. You hear me? So, I need an Apple Watch. I want an Apple Watch, mostly for running. I'm a big runner. I do a lot of big long, long, long runs. We're out in the mountains for three, four, five, six hours. And there are moments when I want silence out in the mountains. And there are moments where you're trudging along and you're like, wait a minute, this is kind of hard. I need something to pick me up. So, I want an Apple Watch to listen to podcasts. So, I have a lot of favorite podcasts out there. And I don't want to carry my phone. I want to just wear a watch, cut down on weight. So, I've been looking for a watch for, let's see, the last two months. And I've already purchased one Apple Watch, flipped it for $40 profit three hours later. Today, I bought this Apple Watch, series one, 42 millimeters for $100. $100 from a fella in downtown Denver. But I told myself, if I can double my money, if I can double my money today, today, I will sell this watch. I double my money. I'm more than double my money in six hours. So, I bought it for $100. I won't tell you what I sold it for, but let's just say I more than doubled my money in six hours. And I'm a little excited, as you can tell. Not only did I get a free Apple Watch today, I consider it free because I made a profit. The gentleman who sold me this Apple Watch is an employee at Great Dubai, a brewing company in downtown Denver, Colorado. So, he's like, wait a minute, you can't leave here without some free beer. I mean, this guy, God love him. Oh my goodness, he hooked me up with Kraft beer. I mean, this one right here, the Strawberry and Rhubarb. It's a sour ale, which I actually kind of like sour, especially in the summertime. He gave this to me. I mean, this is like an $8 bottle right here of beer. So, I got hooked up with some free beer, a free Apple Watch, in quotes, and I'm happy about it. So, anyway, that's my story for today. I earned it today. I earned it today. Don't mind if I do. Ibernationale English Style Old Ale, brewed and canned by Great Dubai Brewing Company, Denver, Colorado.


had a very, hopefully delicious dinner or lunch, I should say. Many of you might be recovering from that. So we're going to really try and make sure that we keep this discussion as exciting and riveting as possible and keep you entertained. I'm really glad to be able to moderate the session only because we have a very distinguished panel of discussants or panelists. To my left, we have the Minister of Health from China, Minister Chen Zhu. Welcome. To his left, to my left, and to your right, we have Kim Stratton, who I want to make sure I get this right, is the group country manager and head of external communications for Novartis in Switzerland. To her left, we have Minister Mohammed Ali Pate, I hope I pronounced that correctly, from the state of Nigeria. To his left, we have Rachel Duan, who is the head, the CEO of GE China. I hope I got your designation correct there. And last but certainly not least, we have Desmond Theo, who is the head of Phillips for the Greater China Region. Welcome to you all. First of all, I'd like to kind of put this topic in, or the topic of our afternoon. This is exploring how emerging markets can make their health systems more sustainable. That's the topic. And to put that topic in context, I wanted to share with you a statistic that I'm sure many of you may be quite familiar with. Just a few years ago, the OECD, the Organization of Economic or Economically Developed Countries, I always get that acronym wrong, but in any case, they reported that health expenditures in these mostly European countries, America, Canada, and Japan were skyrocketing and had, in fact, increased significantly over the previous decade or so. Back in 2007, the health expenditure of the United States was approximately 16% of their GDP, which has since then risen to about 18% and is projected to rise to almost a quarter, 25% of their GDP by the year 2040, something which is clearly not sustainable by any government. We also have observed historically that a lot of the emphasis in health care in the developed world has focused on treatment, therapy, cure, hospital-based care, and not necessarily on health itself or on prevention. And this is something that hopefully will get a chance to explore this afternoon, to really get a sense of what objectives or what initiatives our panelists think should be taken to ensure that those mistakes or those hard lessons that have been learned from the developed world are not repeated in the emerging world, in the developing world, where we can create better systems of health, both in terms of delivery, in terms of outcomes, so that society can thrive. So I'm going to start off with a question for the minister from China, which is clearly we've seen China's incredible economic progress. Has there been concomitant or associated progress in the health care system here in China? If not, what can be done to really accelerate the development and improvement and enhancement of the Chinese health care system? And how might it differ from the way that we've seen health systems evolve in the developed world? Thank you, moderator. Thank you, moderator. Thank you, moderators, ladies and gentlemen. I think we should guess the ladies that are joining us. It is my great honor and privilege to be invited to the world platform and lead the new champions this year. But the moderator has just asked a central question. I would like to briefly answer the question of the three aspects regarding the health care reform and economic development in China. First of all, China's policy is launching the new health care reform in March 2009 in the March 2009, the Chinese central government has decided to jointly issue the opinions on deepening the health care reform. It is marking the launching of the new ground health reform. The overall goal is to establish and improve the basic health care system covering urban and rural residences and provide secure, effective, convenient, and affordable health care services to all. Over the past three years, the Chinese government has held the principle that the basic health care system should be provided to all as public goods and no efforts to push forward five reform priorities. So far, I can proudly tell you that we have fulfilled all the tests that were in this round of health care reform. Now I would like to share with you the progress we have achieved in the first phase of the reform. First of all, the national health indicators keep improving. Some figures to be shared here at our internal mortality rate has dropped from 26.1 to 34.2 in every 100,000 mothers compared to 2008. And infant mortality rate fell from 14.9 per 1,000 to 12.1. So this is our new contribution for that aspect. Secondly, the basic health insurance system has taken shape. We can say that China now has the largest basic health safety net in the world, especially we have established the new rural cooperative medical scheme. This is already taking a good shape. Thirdly, the allocation and utilization health resources have been optimized. More public funds are directed to grassroots health care institutions, rural health and public health. With that, we're seeing a narrowing gap of health development and health level between city and rural areas. Last but not least, health financing structure has become more reasonable. Health equity has been improved. The rate of out-of-pocket expenditure to the total health expenditure has declined from 40.4% in 2007 to 34.9% in 2011. Actually, we have carried out the health care reform in full recognition of our current social economic development status and the public nature of health care. Holding high the principles of providing basic health care services, strengthening facilities and facilities at grassroots level, and building up mechanisms in health systems. We believe that the basic health services are the indispensable means to safeguard the health needs of the entire population, especially the low-income groups. The government must stand ready to provide and deliver basic health services and maintain its public nature when it comes to the non-basic health care services. I think they are complementary to the basic health care and can meet diversified health needs, where market and non-governmental capital claim a leading role. In my view, the basic and non-basic health care services are closely linked with the development of economy and public funding. The package and the benefits of basic health care services will be expanded constantly. Secondly, as one of the main goals of economic development, health is also vital for the economic growth. Apart from contributing to economic development by protecting the labor force, health industry is part of the economic development itself. Study shows that human capital contributes as high as over 70% to economic development in developed countries, while the proportion is only about 35% in China. So much more can be done in China to increase the role of human capital to economic development. According to the trends in recent years, traditional health industries such as medical care, biomedicine, and health industry, health insurance are developing rapidly, while elderly care, medical tourism, and other emerging health industries are just beginning to flourish. Globally, health has become a significant sector in a number of developed countries. Statistics indicate that health industry is one of the largest industries in the United States according to statistics. It is estimated that China needs to hire another 12 million health professionals according to the international health service provider population ratio. So here you can see that health industry can drive other industries, offer jobs, and stimulate consumption. It not only protects people's health and improves human capital, but also contributes to economic growth and upgrades its structure. I firmly believe that health will be a new growth engine for our future economy. Health development will provide a very rare and invaluable opportunities for China's economic and social development. And in 2010, the total health expenditure as economy grows will count more in GDP, and health industries will also contribute more to national economic development. In 2010, the average ratio of total health expenditure to GDP was 6.2% in low-income countries, while it stood at 8.1% in high-income countries. To name just a few, it is 11.9% and 11.6% in Germany and 9.6% in UK. Among the BRICS countries, it was 9% and 8.9% for Brazil and India, respectively. It was only 5.1% for China. That says we still have a long way to go for the total health expenditure growth in China. That being said, I would like to offer the following views for your considerations. First, China has an opening economy, and the policy for health industry is even more open and transparent. As health administrators in China say to you that we welcome private and foreign enterprises to participate in health industries. Recently, the Ministry of Health of China promulgated the notice on facilitating the development of non-public health institutions by regional health planning and organizational setting for health institutions. This notice clearly states that social capital shall be given more access to the development of health care institutions and non-public health facilities shall enjoy more development opportunities so that non-government and foreign investors will be attracted to set up and run health care facilities here. Our goal is that by 2015, non-public health care facilities should account for 20% in terms of health and in terms of hospital beds and services delivered. Secondly, while satisfying high-end health needs, attentions should also be paid to provide quality and low-cost and extensive health products that can meet more demands of different population groups. I am saying that the quality of many ways to provide primary health care, one option for government service from non-public health care facilities, I say this to, are foreign businesses here in China. Thirdly, our grassroots health care institutions would have to catch up in its technology offering. We can expect going forward, the further promotion of the health care reform would definitely stimulate the development of medical device industries. Fourthly, there is still much room for commercial health care health issues and schemes to meet people's diverse health needs. And apart from the basic health insurance schemes provided by the government, diverse and personalized health needs can be met by commercial health insurance teams. Fifthly, there is a huge development potential for emerging health industries with the ever-growing aging population in China. The demand of long-term care, rehabilitation, psychological care, and other elderly health care services are on the rise. On the other hand, China has abundant natural resources of health care springs, et cetera, with low-cost health care services and human resources. We have a lot to offer. These are enabling factors. Dear friends, as Mr. Paul Holzer, famous American economy has predicted, health industry will become the new wellness revolution following the IT industry to be the fifth wave of revolutions. We sincerely hope and welcome social capital, including foreign capital, Chinese, and health development. Here, I would like to especially appeal to domestic social capital to participate in this emerging market. Chinese government will also provide full support to the development of health industries. Currently in China, the National Economic County is estimated by categories of food industry. So the added value of health and health-related industries are not that accurate. The Chinese government will utilize satellite accounting systems to calculate GDP of health industries so as to precisely reflect the contribution of health and health-related industries to the entire social economy. This will also provide more information, evidence, on the provisions and consumption of health care services. We will also trade more nurses, nutritionists, psychologists, and other health professionals in order to meet the needs of the rapid development of the health industry. I'm confident that with our joint efforts, we are able to achieve healthy and sustained development of the health industry in China, and our people can access to more and better health services. Thank you. Thank you. Thank you, Minister, for that very comprehensive analysis of the Chinese health care system and the positive role that the private sector can play in this regard. I'm sure some of your comments must be music to the ears of some of our colleagues in the audience. One statement that you made, which I think was very important, and I want to touch upon this and hopefully get additional feedback, is that health is a source of economic wealth. And Kim, just in the Speaker's Room, just prior to the beginning of the session, you said that we, or you suggested that we should change the name of the World Economic Forum and rename it the World Health Forum. Can you elaborate on that, please? So often when we're talking with Ministers of Health and we also have to talk with the Ministers of Finance in order to support the Ministers of Health, people see health and the investment in health as a cost rather than the fact that a healthy nation leads to an economically prosperous nation. And it's interesting. I think it's our duty to sort of turn it around so that people see that it's a great investment. And what other sectors or ministries do you think or would you suggest that the Minister of Health engage to enable a wider understanding that in fact health can be a great source of economic strength? Well, I think one of the things, we've started up in Novartis. So Novartis, as you know, is a very traditional pharmaceutical company. We have, although we have a broad portfolio, so we have the prevention on the vaccine side, which is very geared. You know, if you look at the health economics, innovation of MCD products all the way through to quality generics and also consumer health products. But one of the things that we're really looking at at the moment is we've set up a small group looking at healthcare systems. Because when we were introducing new products, people see this as a cost. And so rather than just focus on the cost of the pill or the cost of the tablet, we wanted to see what was the effect of different systems had on patient outcomes. So we've done a number of studies, primarily focusing on the MCDs, on chronic respiratory cardiovascular diabetes and some cancer. And we've looked at different healthcare systems around the world. And I think one of the things, actually you were saying in the speaker's kind of room was that actually spending more money doesn't actually mean that you're going to get better outcomes. And that's what we've seen when we've looked at the studies. It's not just about pouring more money in that will actually get you better outcomes. In fact, there is a law of diminishing return. But likewise, a good patient outcome does not necessarily mean that it has to be the most expensive option either. And what we want to look at in order to support the ministers of health, because we realize that they have quite a difficult time with the finance ministers, is to actually take the discussion and the debate sort of much broader than just the cost of the tablet and to sort of say, can we build or can we re-engineer a different healthcare system that gives you better patient outcomes, but not necessarily at a bigger price tag. And in the emerging markets, for example, we have a great opportunity to kind of redesign the way that we deliver healthcare. Excellent. Minister Pate, given that you have a significant demographic dividend in Nigeria, you have a young, vibrant population, what are some of the tools or strategies you think that Nigeria should adopt to achieve better health outcomes while being more cost effective? Thank you. I think, before I answer that, on this issue of health within the context of economic development, in Nigeria, human development is a key pillar of our transformation agenda. And within that, the health sector is within the economic management team, so which makes it easy for the intersectional linkages to be met. In the context of health, as you said, we have a very youthful population, which is fast growing. Other parts of the world have an aging population, in fact, are shrinking, but that's also affecting the health systems. Overall, I will say that the paradigm that is currently prevailing in our health system globally in rich and poor countries is almost unsustainable if you look at what is coming into the future, because with aging, you have non-communicable diseases, even in our countries who are developing at the moment. So in that context, the way to go in my own view is actually to focus on basic services. So in Nigeria, we now have a vision of saving one million lives from now until 2015 as a way of catalyzing a movement or that transformation in the health system. And we do that through four pillars. One is basic services to ensure immunization is available, maternal and child health services are available, the access, universal access in terms of the health insurance and all the aspects, diarrheal diseases and basic things that actually save lives actually are delivered. Secondly, focus on prevention. Non-communicable diseases would be late in getting a tobacco bill. That's another aspect. Mental health has drifted off the agenda because there are no global champions for mental health, yet millions of people are suffering from mental health and it affects their quality of life and their productivity. Third element is quality of care. Even advanced economies, piling more money in the health system doesn't assure you the quality of care that you need actually. So we need to start thinking about that and that's one pillar in terms of our initiative. And then finally, unlocking the health sector market potential which brings me back to the intersectoral linkages. When you look at the health sector market potential in many African countries, there's a tremendous potential in the private sector like the minister said in China, but there are policy constraints, there are regulatory constraints and there are access to capital constraints. So how do we unleash that potential that exists in the private sector? But you cannot do it sitting in the ministry of health. So we took it to the economy management team and by walking within the context of the economy management team, to start to address those underlying fiscal policy issues that may constrain the growth of the sector or dealing with the cross-cutting regulatory barriers or access to capital to unleash the private sector potential so that it can provide high quality services, generate employment and contribute to our GDP. That's the way we're approaching it. Smart approach. Question for Rachel and for Desmond. Both of your companies are global pioneers and leaders in medical imaging, medical technology, et cetera. Do you think there is a need to change that paradigm from medical technology to patient, not to even patient, but to public technology? In other words, devices or tools that would enhance wellness or prevention of early progression of disease, early detection progression of disease. Can you comment on what strategies both of your companies have developed to try and promote wellness? Absolutely. First of all, I think if we talk about a sustainable health system, the first of all, what we're talking about is the sustainable health care, the most important thing is that everybody can have the basic health services and at the same time, we should also be able to improve the health of the general public and to present to people our company about the affordability and accessibility of medical services. This is especially so in the country side where we're at risk of limited resources. At the same time, China has a transitional period globalization, urbanization, aging problem. So these are punching challenges that the health of the general public has pointed just now in the year 2000 and 2009 we initiated another round of medical health reform. The most important thing is for us to set up a better health care mechanism. So we are big from a suitable company and we are one important link in the whole system. So we have also adjusted our own policies. So we have already set up our policy that is health innovation which can be summarized in the following. That is to improve the quality in order that everybody can enjoy a better health system. And I think this is in line with the policy of the central government. G.E. Medical first came to China in 1970. Nine. Now with the last 30 years of work we have already established our own group in great China. However it seems that we are still confined in the first 30s rather than the second 30s. And that is why we have established a new strategy so that we can have our own trust on the one hand we focus on the high end and also on the policy of innovation. At the same time we are also going to lead kind of society. We also emphasize the input in things so we are going to strengthen our R&D in order that we can develop a product so that data for the future needs of the rural area in China. So at present, 90% of the product aimed at the country side. Second, we have the products and these products must be delivered to the second and third tiers of the big country. So we have a huge sales team which are now working in the rural area and the third thing is the innovation of our business and service models. The innovations are very important so we are trying to actually develop a product especially the service of products. So they don't last for the future of our production. Our investment is to double I am very happy to share with you about this time and this is and I would like to share with you what piece of good news. So we are going to start our new factory which produces a new product. We are going to present the equipment so this is another new beginning of our business. So to conclude on the one hand we are going to grasp which level we are going to do the country side to be sure in order that we can discover and satisfy the need of the product, which is basically the one country side. And in this process we have two things I would like to emphasize. So the first thing I want to talk about is innovation I think one is innovation I myself I myself I was born in China but in most of my lifetime I am the big city of the country side so if we think about the market so we might find that even in the food and health areas there will be five to six different set of limitations so different modes market, supply, each satisfaction, we need to have different resources to our business. So we need to really plug into the same type, we must earn the differences between different set of limitations. So the other thing to do is to satisfy as I mentioned just now, and co-operative innovation is in the mood in the past. So in the past, we've just been working to the product. So we had developed how we are changing our strategy now. At the beginning of the development of the new medicine, so we get all the stakeholders involved. So this is what we're pushing to the way for us to understand the market action. So, and also in this room, so we can do better products. In addition to this, we are also doing what we call the reversed inflation. So in the past, we've had what they did. American agist and then we produce it in China in order to reduce the cost. Now, this is not the only thing on the one hand we need to keep the cost competitive. And at the same time, we also need to satisfy the need of the local people. And therefore, now, it is not right to force to copy everything from the United States. And therefore, it is important to first identify the real Chinese people. And to use the magic, so we need to buy the Chinese market. So quite a lot of the CT equipment is now being produced in China. And they're exported to other Southeast Asian countries. So this is what we call the reversed innovation. And to emphasize here is cooperation. Corporations who deed offer great support. Always one thing is off to where it is. And another, and ours is off to where action is. So doctors and it takes a lot of time first to nurture a generation of really good doctors. So we need to have some innovation in order to find new ways to educate new doctors. So we cooperate with others. Now, so we are cooperating with others. So we have already signed an agreement with our partners. So that we can conduct a training program for about 5,000 doctors in the future. And in the coming two years, we're going to select about five places in order to launch some of the new projects in the medical service. For example, how to have a mammal. So it grants training for the women at the countryside side at the early stage. So these are the important things that we have to do so far. Very good afternoon to each and every one of you. Well, first of all, on behalf of Philips, let me thank the World Economic Forum for giving us this opportunity. And also to Mr. Chen and the Ministry of Health that's been working with us for many years in China in collaborations with many of the programs. And I'll talk about one of the programs a little bit later. With regard to sustainable health, and when we talk about Philips and sustainable health area, we always talk about well-being, the health and well-being of our people and our individuals and also as communities. Since the 70s, Philips has been involved with many of the stakeholders around the world, with many universities, institutions, governments, Ministry of Health with regards to this topic alone. And earlier we just discussing about innovation and what we call about in Philips meaningful innovations. When we talk about new products bringing to China, and particularly like Mr. Chen said earlier, how do we provide that into the rural and rural communities? And one example I would like to share is with regards to our early detection in breast cancer.  And in China it's also an issue. And particularly in breast cancer, if you look at the incidence of breast cancer in women, in Caucasian women they peak around 65 to 75 years old, whereas in Chinese women there's two peaks actually between 45 to 55, and then another one between 65 to 75. So working together with Ministry of Health to work on the early detection is absolutely critical, absolutely important. So Philips with the meaningful innovation brought in the ultrasound technology that can be brought into the rural areas. We train physicians with our equipment and also our technology support, but we also work together with the China Medical Association, with their doctors, to train close to almost 10,000 doctors in the rural areas with early detection of breast cancer. And the last couple of years we've actually screened close to a million women. This is very, very significant. So those type of examples that I believe industries like us can help together, work together with countries, with governments, and enable us to bring more meaningful innovations into the market and help the population. And once that further is in the future, as Minister Pate said, in the prevention side. And hopefully that way we work towards early detection and we can work into the prevention side. Thank you. Great, thanks for that. Kim, one given Minister Chen's comments earlier about the perceived shortage or the need to fill, I think it was 12,000 professionals or health professionals that will be needed. Is there an opportunity to change the paradigm? 12 million. 12 million. 12 million. 12 million. 12 million. Wow, 12 million. Right. I missed 3-0. That's a magnitude. And now I know I'm in China. Welcome to China. Welcome to China. The scale is impressive. So given the need for this clearly very, very large population of health professionals, is there an opportunity to actually change the paradigm away from prescribers and physicians to health promoters, especially given the need in the rural areas and the scarcity or death of quality health services? And if so, what other venues should we explore, not just in China, but in other emerging countries for the delivery of health and wellness education that is focused on prevention? Okay, I don't know how we can help with 12 million, but I can maybe talk to you about a couple of pilots and a couple of programs that we've started up in Novartis. One, if I pick up firstly on the point of health care professionals, we've got two programs. One, a Rogia Parava, which we're conducting in India, and also another program that we're conducting in Xinjiang here in China. And basically what the programs look at is using community health workers and local educators to help actually educate school children, to help educate families, even health care professionals from school right into the health centers themselves, and also to take health care professionals from bigger cities out into the rural villages. And we're also combining this, for example, in our program in India with some sort of social marketing, because there's a lot of illiteracy as you can imagine in these areas. We take actually unemployed actors and we train them in certain disease areas so that they can act out how to know if you've got the first signs of, for example, tuberculosis or other diseases, and therefore help then triage them to these health care professionals that we've actually helped to bring out into these local communities. And this is all part of our kind of social kind of citizenship, if you like, corporate citizenship program and social programs in India and in China. And then sort of leveraging on from that, we've got another program in, primarily in Africa, which is called SMS for Life. And we've kind of coupled up with the telecoms industry. So, again, looking at this sort of Rachel's comment about cooperative innovation. We had a real problem there. We produce coartum, which is really the kind of gold standard, if you like, for malaria treatment. And it is really life-saving treatment. People should not die from malaria. And we were having a problem with the fact that there'd be a rainfall, that you'd have a kind of influx or an outbreak of malaria in a remote village. The mothers would take their children to the health centre. Quite often they would have to walk many miles. They would get to the health centre and there would be no life-saving treatment. So we were really worked with, again, the local health care professionals with their own personal phones. And now we have a system where they text in their inventory at the end of the week and then we make sure that they've always got inventory in these remote outposts in these health centres. So that, you know, if the mums can get their babies to these health centres, we know that there's going to be life-saving treatment. So there's another, I think, example of kind of innovation in terms of technology and kind of also using health care professionals to help with distribution of products as well. So if I heard you correctly, I'm hearing you suggest that Ministry of Culture, perhaps the Beijing Opera, could play a role in this. The Ministry of Culture, the Ministry of Transport in terms of getting patients from rural areas to facilities or to points where they can actually access care and maybe the Ministry of Information Technology or Ministry of Communications could play a positive, supportive role. Absolutely. I mean, you know, it has to be said that without the Ministers of Health in these situations, we would not have been able to make these programmes happen. But we had to do an awful lot of work as well with the other ministries to actually make sure that we were well supported. Minister Pate, can you share with us some of, maybe some of the models or of prevention in health education that are occurring or have been introduced in Nigeria, in other venues such as schools or in non-traditional health venues? Yes, I think a classical example has to do with immunisation. A few years ago we had people resisting immunisation, cost-effective public health intervention. Now, using networks of community leaders, traditional leaders, women leaders, for instance the Federation of Muslim Women's Association of Nigeria, were able to get to remote rural areas for them to speak to mothers, convince them with important health messages for their children. Now, that's a veritable opportunity for other health interventions. Oftentimes, our issues for maternal health is lack of awareness of the importance of skilled mother tenders. So getting that information out there, using community-based networks and partnering with local government institutions, with traditional institutions, with all civil society organisations at the grassroots, I think is the way to go in terms of conveying the messages. But there are other elements in nutrition. The role of the Ministry of Agriculture. We're working with the Ministry of Agriculture to see how we can scale up the community management of acumen of nutrition. As a driver, that's an underlying reason for a large proportion of our morbidity and mortality among children. So that's a very critical part. Education sector, of course, the communication sector, the mobile which Kim mentioned, we also need to work with that. Talk about economic policies, sugar policy, for instance. When you're developing, therefore, a country for growth, what does it imply for non-communicable diseases? I mean, those interactions are not strictly speaking within the confines of the health sector. So in our own case, we're opportune to be part of the economic management team, and therefore we have got linkages. And it's a lot easier, I believe, than if we had been outside that space when economic policy has been developed. Minister Chen, earlier we were speaking about patient empowerment or people empowerment. And we're here in the People's Republic of China. What can the Ministry of Health do to empower the people at an early stage to make intelligent decisions about their diet, about their lifestyle, about encouraging their children to exercise and to play, about designing cities and so that people are encouraged to lead active, healthy lifestyles? Chinese government's healthcare policies since the establishment of New China has already focused on disease prevention as well as to cover rural areas. But now we tend to focus equal importance between traditional Chinese medicine and Western medicine, and to encourage the whole society to take part of it, part of the responsibility of being healthy. Because health is definitely everyone's responsibility. Since 1952, we already had a campaign about the hygiene in our environment in order to avoid transmittable disease or epidemics as Chinese cities are being further developed. We are also faced with great challenges of aging population. And that's why there are also challenges of chronic disease. So in the past, we tend to focus on epidemic disease. Now we are mobilizing the whole society, adopting similar campaign and structure to give enough importance on chronic disease of aging population. That is definitely one priority. Recently, Chinese government has been promoting a concept around healthy city. Originally, we simply say a very clean city. But now we tend to focus on healthy cities. And by doing that, we hope we can switch from focus to chronic disease, including enhancing our regulations of ban smoking in public areas. And also to encourage our citizens to reduce their intake of salt, as we all know in China many, the second death factor in China is stroke. And a lot of it was contributed by our high intake of salt. Diabetes is definitely also another poor killer in China. Originally, it was only affecting probably less than 1% of our population, but now it's been quickly expanded to 9% covering some younger generations. Well, diabetes patients are now amounted to 100 million patients already, not including some diabetic patients that have been able, that do not need any medication. So that was 140 million. We have won a lot of Olympic medals, but nevertheless the purpose of encouraging people to be more athletic is to encourage people to exercise more to stay healthy. So we have some advantage in mobilizing our people and citizens very quickly if we want to, because we have that system in China to allow the Chinese government to quickly mobileize people. I would have to say among developing countries, so we probably are at the forefront by 2010, our average longevity is about 74.8 years old, and in Tianjin, the average longevity is 81.45 years old. It's actually higher than many developed countries. The life experiences of many cities in China is definitely pretty good in Shanghai and Beijing. Like I said, China is only spending 5.1% of our GDP in healthcare, and many cities, they are not even at that level, that national leverage. I believe we definitely have room to further improve this. We have seen good results so far. In addition, there is one technology I would like to focus on is information technology. Recently, IT technology has been regarded as a very important aspect of our healthcare reform. Our electronic patient records have been able to cover 60% of our rural populations. Even doctors in rural areas are using computers to record patients' medical history. We definitely have good infrastructure for this system, however, we still have to step up in terms of our medical experts, so more sophisticated and experienced medical doctors are still needed in China. The situation of hiring more medical doctors in towns and villages are still not their idea. We hope by expending our input into medical schools in China, we eventually will be able to send more medical doctors to the rural areas. This is probably one way to meet the gap of the number of health professionals we meet in country-wide. In terms of job employment, we definitely have the ability to train more health for professionals such as nutritionists and psychologists, such as psychiatrists, et cetera. Ideally, we would like to have one nutritionist and one psychologist per 2,000 or 3,000 Chinese physicians. For that alone, we can create a lot of jobs for medical professionals. Thank you. It's exciting to hear that there seems to be emerging evidence that you may be able to leapfrog by leveraging technology, to leapfrog and achieve significant health outcomes and not be encumbered or burdened by some of the infrastructural challenges that other countries have, especially by deploying and leveraging information technology. Very quickly, Rachel and Desmond, before we open the floor, how are your companies leveraging IT and ICT information communications technology to enable that leapfrogging? Well, a lot. I'm sure a lot of you are more familiar with IT related medical devices, but actually we have four business units. One business unit is on ICT, medical ICT. Last year, we established a joint venture with Microsoft to offer a specific and dedicated ICT requirements that ICT requires from medical industries in many countries around the world, in China in particular. I see opportunities in the following areas. First, in large hospitals, it is important how they can enhance their efficiencies. Using more ICT, their efficiency can be dramatically improved. If you go to large and famous hospitals in China, you will see the whole lobby is packed with patients, and that crowdness can be alleviated to some extent if medical doctors can always get first-hand medical information and records as soon as possible. Secondly, through medical ICT, we will be able to allow remote areas lacking medical doctors to stay connected and linked with doctors in cities. That is what we call remote diagnosis. This is a concept that has already been widely discussed, but for example, this idea can also be further expanded into maintenance or repairing of medical devices because sometimes if a machine is broken in the city, you can send a technician, this broken machine is out there in Wudu-Muji in Xinjiang, then for me to send a technician to fix that medical device is going to take me one day and travel only. And that's why the diagnosis is not only for patient, but also diagnosis and repair maintenance that require for remote medical devices. Thirdly, the overall ICT or informatization broadly in the towns and the villages that will eventually cover each province and each city. This will require the government and the patient in the hospital to be quickly synced up when each piece of medical information and records is being collected. So I think this has much to do with how the system is going to be designed. A lot of hospitals are very eager in creating their designs in their ideal system, but the question would arise from how eventually these grand concepts can be further promoted. Earlier, Minister Chen mentioned about health education and fully supported about that, especially as you all know, children are our future. In Phillips, we take corporate social responsibility very, very seriously, and we have the support called Simply Healthy at School where around the world, we work with teachers and school districts and we will work with also the local folks and go and teach students about healthy lives, about clean air, about clean water. And at the same time, of course, we will upgrade their lights and some of the IT part. We will spend about five days in that community with our volunteers, actually employees of Phillips and also volunteers around. So actually to tell the truth, next month, just after the October holidays, I'll be going into Yunnan with about 15 of my colleagues. I will be working for five days in this particular school to help them educate the children about awareness about healthy living, the food, stuff like that. And as earlier, Minister Chen said about early prevention and in diabetes, to choose the right food, clean water, clean air, et cetera, et cetera. If any of you guys want to join me, you're very welcome to, but it's a tough five days. But it is wonderful. I think also felt that entire companies on the move to provide help also in the community and around the world. And that's not only in China, it's around the world that we're doing that. Great, that's illuminating thought. Okay, so I'm going to turn the floor over to all of you and I invite you to ask questions and please keep them short. Please make sure that their questions are not long statements. And we'll start off in the third row, fourth row right there, please. Let's get a mic over to you. If you can just stand up, just introduce yourself, your affiliation, and really a nice discussion on very important topic. I'm Afta Mahmoud from Pakistan. I would like to ask two questions. One is, you know, in developing countries most of the population is living in rural areas and sub-urban areas. And we also know that most of the diseases can be prevented. So there is a great need of awareness in rural areas and sub-urban areas. The other important thing is screening. Just like if we take the example of hepatitis there are 350 million people infected with hepatitis E. 170 million people are infected with hepatitis E. Sorry Afta, could you ask the question? I just want to mention that if we screen the population it will be very less costly. And if we go to prevent the disease and if we go for the treatment it's very, very expensive. So what measures the government sector and the private sector is taking for the awareness and for screening process? Thank you. Okay, so let's direct this question to Minister Pate. Could you just reflect on what Nigeria is doing too? Yes, I think it's issue of prevention. It's one issue which has not been very well localised in the contemporary health systems. We focus on treatment, on cure, on hospitals. Sanitation, hand washing, basic things, nutrition. Those efforts have been neglected. In the context of our country in Nigeria we're mobilising and from a coalition across public and private sector using traditional institutions, public institutions and governments at all levels of course to different degrees to reach those remote areas because the areas that you've mentioned are ones that are most difficult to reach and yet will have the highest payoffs if we're able to reach them with those life-saving interventions. And here technology will play a major role in terms of telephones. We've got almost 100 million Nigerians with mobile telephones. So how do we innovate in using technology to reach those remote areas with information? I think those are the kinds of things that we need to do going forward in order to reach those populations and focus on prevention. Good. Again, if you could just keep the questions short. Gentlemen in the front. Thank you very much. One question to Minister Zhu. So at present we have already started insurance against major diseases. I would like to know what are the future measures and how long it might take for us to implement the policy. Ladies and gentlemen, it is true that we have issued a document on the insurance against catastrophic major diseases. We think the framework of new rural cooperative scheme we started the insurance against major diseases such as leukemia, especially among the young kids and recently eight major diseases have been included in it including the breast cancer and and at present, cardiovascular diseases have also been included. So in recent months, we have been working on how to get the right funding to get enough funding. However, funding is not a main problem. What I'm more concerned about is the medical services we can provide. So for example, those who need special medical services, we must go to a complete hospital each week. And this is very difficult for some of the remote areas. So from now on, this will be covered by insurance in Jiangxi province. This medical services has been provided for everyone. So if you want to provide adequate medical services across the country, it is still difficult, but I hope that in the future, all these major diseases can be insured against and can be treated effectively. Thank you. Thank you. We've had a robust discussion. We have time for just one more question. If you could direct your, let us know who your question is directed to. And I'd also ask my panelists, if you, the respondent, if you could just keep your comments to less than a minute, because I know we're over time, but please go ahead. The gentleman who's been furiously waving his hand in the back. Okay. I speak in Chinese. A question to Mr. Zhu, I'm from Nature Conservancy. So we are protecting the areas of a biodiversity. The Hencun Mountain is rich in biodiversity. And at the same time, so there are abundant herbal resources in that area, which can cure cancer. So I would like to ask whether the Ministry of Health can take any measures in these areas in order to help the preservation of these herbal resources. And we know that in some areas and also in the South African countries and South American countries, they have very abundant herbal resources. This is a very good point. As a matter of fact, the Ministry of Health and State Administration of Forestry are making joint efforts in order to protect the areas abundant with natural biological herbal resources. And we are also promoting the artificial planting of these herbs in order that we can have more production of these herbs. And I think to do it well, we need to have the cooperation between different ministries and different governmental agencies. Thank you. Thank you for the translator for accelerating that translation. Wow, she's really good. Okay, so I'm going to throw out a challenge to each of you. I'll leave you with a challenge and that is under 30 seconds, if each one of you can tell me what commitment you are willing to make that you're representing your state or your company that will accelerate the sustainability of health systems, either in your company or in your state. Let's start off with the Minister. Under 30 seconds. I want to establish a system that everybody can benefit from health systems. So this is the responsibility of the government of the responsibility of the government and we will achieve the goal. Thank you. I think for no artist, we'd have to say that we'd say true to innovation and true to the passion for patients. We're focusing on preventing all preventable causes of morbidity and mortality among women, children, and everyone. Excellent. So yesterday, Premier Wynne, Wynne mentioned and confidence. Confidence. That. That's the confidence. And different state orders should take their own responsibility to do. And also particularly like Dr. Chen mentioned earlier, regards to cervical cancer, digital call post-copy, which is another area of meaningful innovation that we want to bring to the channel. Excellent. I just want to apologize very quickly. We have a reporter, a rapporteur in the audience, who's Anne Clymer Eiting. She's the CEO of Mid-Marx. Anne, if you could just very quickly stand up. I just wanted to acknowledge you. Thank you, Anne. And please join me in thanking all of the panelists. I think their comments were very enlightening. No pun intending to Phillips. An enlightening experience indeed. I think we've had some very interesting comments and thoughts shared in terms of what the states, especially in the emerging markets, what China, what Nigeria are thinking in terms of how they can accelerate the improvement and enhancement of the wellness of their populations. And again, in learning from some of the lessons learned from the developed world and what the private sector can do in this regard to catalyze that acceleration. So thank you. Please join me in thanking the panelists.