THINK WE'RE READY TO BEGIN.

ACCORDING TO THAT CLOCK IT'S

2:06 THOUGH YOBILITY THAT, IT'S

AT LEAST TWO O'CLOCK.

AS WE KNOW THE TV AND AUDIO IS

SO GOOD IT -- THIS LECTURE CAN

BE HEARD EVERYWHERE.

THE AUDIENCE IS BIGGER THAN THIS

AUDITORIUM.‡O%–

PARTICULARLY DELIGHTED THAT

DR. BURKLE IS GOING TO ADDRESS

USN'T TOPIC INCLUDING DISASTERS

AND I HOPE DISASTER INFORMATION

MANAGEMENT.

HE TOOK THE TIME TO MEET ON

MONDAY, ON THAT VERY TOPIC AN WE

WERE ALL VERY INTERESTED IN

HEARING FROM HIM.

I SHOULD SAY MANY THE WAY OF

TRADITIONAL INTRODUCTION, HE'S

GRADUATE OF ST. MICHAEL'S

COLLEGE AND THEN THE UNIVERSITY

OF VERMONT COLLEGE OF MEDICINE.

OF COURSE IS CV IS SO INCREDIBLY

STENSIVE I COULD WASTE TIME

RECITING DEGREES AND

APPOINTMENTS AND

ACCOMPLISHMENTS.

BUT THEY DO INCLUDE A BOOK ON

DISASTER MEDICINE.

AND HE'S GIVEN A GREAT DEAL OF

THOUGHT TO THE RELATIONSHIP OF

ESSENTIALLY THE POLITICAL PEOPLE

THAT DOCTORS, SCIENTISTS AND

NEEDS OF THE WORLD.

SO I'M SURE WE'LL HAVE A VERY

GOOD TALK FROM HIM.

HE HAS ACHIEVED A EPITOME OF

CURRICULUM VITAENESS IN THAT HE

CAN HONESTLY CLAIM TO A HARVARD

DEGREE AND YALE EDUCATION.

THAT'S PRETTY GOOD.

HE ALSO ARRANGED SOMETHING I HAD

GREATLY BENEFITED FROM, NAMELY

HE HAS MULTIPLE OFFICES SO IT

MUST BE ENORMOUSLY DIFFICULT TO

FIND YOU.

I I CAN IMAGINE SOMEBODY SHOWING

UP IN HAWAII SAYING I WOULD LIKE

THE TO SEE THE PROFESSOR OF

SURGERY AND ADJUNCT PROFESSOR OF

MEDICINE DR. BURKLE ONLY TO BE

TOLD GEE, YOU HAVE TO GO TO

HARVARD.

DR. BAR STON IN THE HUMANITARIAN

INITIATIVE SCAL OF PUBLIC

HEALTH, I COULD PICTURE SOMEONE

SAYING I ALREADY WENT THERE BUT

THEY TOLD ME YOU HAVE TO GO TO

WASHINGTON D.C. WHERE HE'S IN

THE CENTER FOR INTERNATIONAL

SCHOLARS.

I THINK YOU REALLY WORKED YOUR

LIFE ON YOUR CV AND PR

STRRDNARILY SKILLFULLY AND I

VERY MUCH LOOK FORWARD TO

HEARING FROM YOU ON THE TOPIC OF

DISASTER MEDICINE.

[APPLAUSE]

>> CAN YOU HEAR ME OKAY?

GOOD.

THANK YOU, DR. LINDEBERG FOR

THAT KIND INTRODUCTION.

I WOULD LIKE TO THANK THE NLM,

CERTAINLY MEDICAL LIBRARIAN'S

ASSOCIATION BUT SPECIFICALLY THE

DISASTER INFORMATION MANAGEMENT

RESEARCH SENOR FOR -- SENOR FOR

THIS -- CENTER FOR THIS HONOR

AND OPPORTUNITY TO SPEAK TO YOU.

I'M GOING TO START OFF HONESTLY

WITH AN APOLOGY.

BECAUSE MY TALK I HOPE YOU'LL

WALK AWAY WITH SOME INFORMATION

THAT YOU DID NOT HAVE BEFORE

IT'S NOT THAT UPLIFTING I HAVE

TO TELL YOU IN TERMS OF TOPICS

BUT IT IS ALL QUITE ACCURATE,

TRUE AS CAN BE AND I THINK

UPDATED.

SO WE'LL SEE WHAT HAPPENS.

I'M GOING TO TRY AND WHETHER

THERE WILL BE TIMES I WILL TALK

ABOUT THE POTENTIAL FOR MORE

INFORMATION, MANAGEMENT,

ESPECIALLY THE IMMUNITY LEVEL

BECAUSE WE'RE MOVING MORE TO

COMMUNITY LEVEL IN TERMS OF

WORLDWIDE IN TERMS OF HANDLING

MAJOR CRISES.

BUT ALSO EWE NEED TO UNDERSTAND

-- YOU NEED TO UNDERSTAND THAT

THE COMMUNITIES NEED INFORMATION

IN ORDER TO DO WHAT THEY NEED TO

DO AND WE HAVEN'T CRACKED THAT

CODE JUST YET.

SO I HAVE A NUMBER OF THINGS BUT

ALL COMING TOGETHER.

I'M TALKING MORE ABOUT MAJOR

CRISES AS WE GO ALONG.

THE THEME REALLY IS INCREASINGLY

ALL DOMESTIC DISASTERS ARE UNDER

THE INFLUENCE OF INTEGRATED

GLOBAL CHANGES AND FORCES.

PEOPLE HAVEN'T THOUGHT THAT WAY

FOR A LONG TIME.

EN NINO WHICH STARTED IN THE

SOUTHERN PART OF THE SOUTH

PACIFIC HAD AN AFFECT ON THE

FREQUENCY OF TORNADOES AND THE

AMOUNT OF RAIN AND WATER AND

FLOODING THAT WE HAVE HAD IN THE

SOUTH.

AND CENTRAL PART OF THE UNITED

STATES.

SO THERE IS AN INTEGRATION.

WE CERTAINLY NOW WITH THE

WARMING OF THE OCEANS HAVE SEEN

BACTERIA, UNFORTUNATELY GENUS

WHICH CONTAINS CHOLERA, MOVING

NORTH SO CHOLERA QUITE HONESTLY

HAS BEEN SEEN FOR THE FIRST TIME

IN SCANDINAVIAN COUNTRIES.

BUT ALSO FOR THOSE WHO REMEMBER

CHER NOBLE.

PEOPLE WERE CONCERNED ABOUT THE

FALL OUT AND GETTING INTO THE

COW'S MILK IN FINLAND AND ALSO

ALASKA AND THINGS LIKE THAT, BUT

QUITE HONESTLY THE WHOLE NUCLEAR

PLANT ISSUES THERE WASN'T MUCH

CONSIDERATION WITH INDIVIDUAL

COUNTRIES AT THAT TIME.

AS A MATTER OF FACT IT WAS

BRUSHED OFF THAT THE RUSSIANS

DIDN'T KNOW WHAT THEY WERE

DOING.

THEY JUST MESSED THINGS UP AND

THEIR PLANTS WERE NOT VERY GOOD

IN CHERNOBYL.

YOU NEED TO KNOW THE SAME MODEL

IN CHERNOBYL IS THE ONLY MODEL

THAT EXISTS AND STILL EXISTS IN

RUSSIA TODAY.

IT HAD NOTHING TO DO WITH THAT

AT ALL.

LOOK WHAT HAPPENED WITH

FUKISHIMA.

ALMOST IMMEDIATELY COUNTRIES

BEGAN TO REASSESS THE NUCLEAR

THREATS.

UNFORT NOTLY WE DO NOT HAVE,

THAT'S ONE OF THE PROBLEM, ANY

STRATEGIC PLAN FOR NUCLEAR

THREATS GLOBALLY.

SPEAK ABOUT THAT LATER.

BUT BECAUSE OF FUKASHIMA, THEY

SHT DOWN, THEY HAD 5 PLANTS,

THEY SHUT THEM ALL DOWN EXCEPT

ONE, THAT WAS CLOSED TWO DAYS

AGO.

AND YOU CAN READ ABOUT IT

ACTUALLY IN THE LATEST ISSUE OF

NATURE WHERE THEY REASSESSED HOW

HIGH WITH THE EARTHQUAKE THE

TSUNAMI WILL BE SO ALL THE EAST

COAST ONES, THEY SAID IT'S MUCH

HIGHER THAN WE THOUGHT.

BUT GERMANY, ITALY, SWITZERLAND,

SWEDEN, BELGIUM ARE CLOSING DOWN

ALL THEIR NUCLEAR PLANTS.

SO IT'S MADE QUITE AN IMPACT AND

WE'LL SEE THEY'RE GOING TO RELY

ON -- GRANTED SOME PART OF OUR

WHAT WE'RE PAYING AT THE GAS

PRICES IS BECAUSE OF ENERGY

BUYING MORE BUT THE WHOLE ISSUE

IS THIS IS GOING TO BE QUIT A

DAUNTING ISSUE.

IN THE FUTURE.

NOW, EVERYTHING THAT I TALK

ABOUT, THERE IS A COMMON THREAD.

THAT YOU NEED TO KNOW.

SO THINK ABOUT THAT AS WE JUMP

FROM ONE TO THE OTHER.

ALL THESE CRISES PRODUCE MAJOR

PUBLIC HEALTH EMERGENCIES.

SO THEY AFFECT WATER AND

SANITATION, SHELTER, FOOD,

ENERGY AND ALL THE REST OF THE

STUFF.

BUT THERE'S ALSO COMES AT A VERY

INCONVENIENT TIME BECAUSE THE

ENTIRE WORLD PUBLIC HEALTH

INFRASTRUCTURE AND SOCIAL

PROTECTIONS PUBLIC HEALTH

PROVIDES THE TO CITIZENS IS IN

TREMENDOUS DECLINE.

THEY HAVEN'T BEEN MAINTAINED A

LOT HAS BEEN LOST OR DESTROYED

DURING WAR, THAT YOU'LL SEE.

AND IT'S EVEN IN THE UNITED

STATES.

WE'RE WAITING TO IMPROVE THE

INFRASTRUCTURE.

BUT JUST IN THE WASHINGTON AREA,

YOU CAN GO, THIS WAS MARSH LAND

THAT WAS ESSENTIALLY GIVEN TO

DEVELOP THE CAPITAL HERE.

FLOOD PLAINS BUT THE PIPING WERE

THE AQUIFERS PUT IN IN THE

1800s STILL REMAIN.

SO THERE'S SIMPLE THINGS LIKE

THAT THAT AFFECT EVERY STATE IN

THE UNION.

THE IMPORTANT THING TOO IS, WE

FOCUS IN ON THE EVENT AND DIRECT

CAUSES, DEATHS, INJURIES.

IN THESE SITUATIONS THAT WE'RE

GOING TO TALK ABOUT REALLY

PRODUCE MORE INDIRECT EFFECTS

OVER A PERIOD OF TIME SO OVER A

PERIOD OF TIME WE HAVE MORE

DEATH AND ILLNESS FROM THE

INDIRECT EFFECTS AND THE

OUTSTRIP THOSE NUMBERS WITH THE

DIRECT EFFECT.

SOLUTIONS ARE REALLY NOT UP TO

ANY INDIVIDUAL NATION STATES.

THEY ARE GLOBAL.

WILL BE GLOBAL.

AND INCREASINGLY COMMUNITY BASE

WHICH I'LL TALK ABOUT THAT HAS

STRONG IMPLICATIONS FOR MLA'S

FUTURE WHEN WE -- AND WE TALKED

A LITTLE BIT ABOUT THAT THE

OTHER DAY.

I DID ATTEND, THAT WAS REALLY

THE ONLY HEALTH PERSON TWO WEEKS

AGO IN COUNCIL AN FOASH RETIONS,

UNTIL 2020.

WHAT I WAS STRUCK WITH IS THE

FACT THAT, SO THESE WERE

GOVERNMENT AGENCIES, TELEVISION

AGENCY BUT THEIR INTENT WAS

OKAY, HOW DOES THE UNITED STATES

CONTROL THIS?

I LISTENED TO THIS FOR A WHILE,

I JUST HAD TO INTERRUPT AND I

SAID YOU KNOW, THE U.S. IF

YOU'RE GOING TO THINK ABOUT

DOING THIS IS ONE NATION, THAT'S

NOT THE WAY, THESE ARE GLOBAL

INITIATIVES AND YOU HAVE TO GET

USED TO WORKING WITH PEOPLE THAT

-- AND AGENCIES THAT YOU HAVEN'T

DONE IN THE PAST.

LET'S FIRST LOOK AT COON FLICT,

THAT HAS PREOKAY I -- CONFLICT

BECAUSE THAT'S PREOCCUPIED US

THE LAST THREE DECADES.

S THAT STUDY, IT IS IN PRESS

THAT WILL BE PUBLISHED BUT YOU

CAN SEE HERE POPULATIONS AS

EXPOSEDDED TO WAR AND VIOLENCE,

AND PRETTY MUCH THEY MERIT EACH

OTHER, THE NUMBERS OF PEOPLE WHO

DIED AND THE NUMBERS OF

POPULATIONS IN MILLIONS WHO WERE

EXPOSED TO CONFLICT.

THEN WE BEGAN TO SEE SPLIT.

AS A MATTER OF FACT NOW WE HAVE

THE LOWEST NUMBER EVER, INCLUDES

ALL 20th CENTURY TOO.

OF DECLARED WARS.

NEVER BEEN SOLO.

BUT WE HAVE THE HIGHEST NUMBER

ALMOST 400 MILLION OF

POPULATIONS EXPOSED TO CONFLICT.

NOW, WE HAVE DECLARATIONS OF

PEACE AND AGREEMENTS AND THINGS

LIKE THAT, BUT THAT'S GREAT FOR

THE DIP MATS, I WAS A DIP MAT

FOR A PERIOD OF TIME BUT THAT'S

NOT NECESSARILY MAKE THE

POPULATION HAPPY.

SO INCREASINGLY WE HAVE MORE

PEOPLE WHO ARE STILL LIVING IN

CONFLICT THOUGH THE WAR QUOTE

UNQUOTE HAS BEEN OVER.

THIS IS DIFFERENT.

DIRECT AND INDIRECT DEATHS.

YOU NEED TO KNOW HERE THE BLUE

LINE IS THE DIRECT DEATHS.

SHOCK AND AWE AND WHAT YOU HEAR

ABOUT FROM VIOLENCE, WHAT YOU

HEAR IN THE PRESS, VERY SEXY

LIKE THAT'S ALL THAT'S HAPPENING

BUT USUALLY, REASON WHY IN

PUBLIC HEALTH WE STUDY CONFLICT

IS THAT IT'S IMPORTANT FOR US.

WE SEE WHAT HAPPENS WHEN THE

PUBLIC HEALTH SYSTEM IS

DESTROYED AND HOW LONG IT TAKES

FOR THE EMERGENCE OF DISEASE AND

THINGS LIKE THAT.

I WAS THE FIRST AMERICAN TO GO

INTO BAGHDAD AFTER THE 2003 WAR

BECAUSE I WAS THE INTERIM

MINISTER OF HEALTH BUT I WAS

ALSO THE FIRST AMERICAN TO GO

INTO BAGHDAD ALONG WITH TWO

SWISS AND A LIBYAN TO NEGOTIATE

FOR THE CURDS.

SADDAM WAS THOUGHT TO BE DEAD AT

THE TIME AND WE WERE TRYING TO

GET THE CURDS BACK INTO THEIR

HOMES BECAUSE THEY HAD FLED WAY

UP IN THE MOUNTAINS, IF YOU

REMEMBER.

BUT THE INTERESTING THING IS

BAGHDAD AT THE TIME HAD NOT HAD

A CASE O CHOLERA IN OVER 20

YEARS.

THE ELECTRICAL GRIDS THAT RUNS

EVERYTHING, WATER, SANITATION

WERE DESTROYED IN THE WAR.

AND WHEN YOU REMOVE THAT

INFRASTRUCT'
 THAT VITAL

INFRASTRUCTURE, TAKE THE LID OFF

IT, WITHIN TEN DAYS THEY STARTED

TO HAVE CASES OF CHOLERA IN

BAGHDAD ALONE.

SO IT'S ALWAYS THERE.

BUT OUR PUBLIC HEALTH SYSTEM

REALLY PUT A LID ON THESE

THINGS.

SO THAT BEGINS TO START GOING UP

HOPE YOU CAN SEE THIS, 70 TO 90%

IN A PERIOD OF TIME OF DEATHS

AND ILLNESSES ARE PREVENTABLE TO

THIS, NOT RELATED TO VIOLENCE.

WE DON'T HEAR ABOUT IT.

THAT DOES NOT COME BACK TO THE

BASELINE FOR OVER A DECADE.

WHO ARE THESE PEOPLE?

THEY'RE USUALLY WOMEN, CHILDREN,

A LOT OF PSYCHOSOCIAL AND

DEPRESSION ISSUES AND THINGS

LIKE THAT.

THAT'S WHAT WE SEE.

WHEN THE SHOOTING STOPS THE

DONORS LEAVE, THE NGOs LEAVE

AND WE HAVE MORE EXPOSED

POPULATION THAN EVER.

THIS IS PART OF THAT ORIGINAL

STUDY BUT WE LOOKED AT THE POST

CONFLICT POST WAR PLACES AFTER

FIVE YEARS ANS ARE AFTER TEN

YEARS.

THIS GOES BACK TO WORLD WAR II

SO THE LIGHT AREA IS WHERE

THERE'S NO CONFLICT REMAINING

BUT AFTER WORLD WAR II ALL THE

WEAPONS WERE REMOVED, PEOPLE

EAGER TO GET BACK, GET BACK TO A

NORMAL LIFE, AS WE COME ALONG IN

MODERN TIMES THE DARKER THE

LEVEL HERE, THE MORE THE

INTENSITY IS OF THE VIOLENCE.

WHAT WE'RE SEEING NOW AFTER TEN

YEARS STILL A POPULATION YOU USE

TEN QUALITATIVE AND QUALITATIVE

INDICES BUT WE ASKED THE

POPULATION DO YOU FEEL LIKE

YOU'RE SECURE.

A LOT OF THEM DO NOT.

THIS EXPLAINS WHY THE MARSHALL

PLAN WHICH WE WERE ALL THOSE OF

US MINUTE TEARS -- MINISTERS HAD

TO READ AND THAT WAS THE PLAN

THE MARSHALL PLAN WAS GOING TO

BE REBORN BUT IT WAS IMPOSSIBLE

TO DO IN IRAQ AND IMPOSSIBLE IN

AFGHANISTAN.

A LOT OF US KNEW THIS FROM THE

BEGINNING.

BUT CAN YOU READ THAT ALL RIGHT?

THE DIFFERENCE BETWEEN

POPULATIONS AT WAR AN POST

CONFLICT REALLY GETTING BLURRED

BY THIS LEVEL OF LOW INTENSITY

CONFLICT.

THE RESOURCE BASE, WE'RE TAKING

PUBLIC HEALTH INFRASTRUCTURE YOU

TURN THE FAUCET ON, FLUSH THE

TOILET IS 10% OF WHAT IT WAS

BEFORE THE WAR, THERE'S NO ONE

THERE NOW, OH, YEAH, WE'LL FIX

IT.

WEAPONRY AND INTIMIDATION IN

AFRICA REMAINS.

THE ECOSYSTEM IS UNRESTORED.

WE NOW HAVE WARFARE ECOLOGISTS

WHO GO IN TO TRY TO BRING THE

ECOSYSTEM BACK.

WE'LL TALK MORE ABOUT THAT.

INFECTIOUS DISEASES ARE RAM PAN

BUT NOT MONITORED BECAUSE NOBODY

CAN DO THE SURVEILLANCE SO THAT

EXPLAINS WHY 47% OF THE

COUNTRIES RETURN TO CONFLICT

WITHIN TEN YEARS.

IF WE'RE TALKING AFRICAN

COUNTRIES IT'S UP TO 60%.

SO THIS IS REALLY THE EPITOME OF

WHAT WE CALL PUBLIC HEALTH

EMERGENCY.

ALSO CONVENTIONAL WARFARE WHEN

CROSS BORDERS, THE WAR IS OVER

TERRITORY, RESOURCES, THINGS

LIKE THAT.

WE HAVE THE LOWEST NUMBER OF

DECLARED WARS.

UNCONVENTIONAL WARFARE.

SO WE LOOK AT IRAQ, AFGHANISTAN,

OTHER PLACES, THE INTERESTING

THING IS PRIMARILY THE MILITARY

FOCUSED IN ON UNCONVENTIONAL

WARFARE THEMSELVES AND THEIR

DEALINGS WITH TERRORIST

INSURGENTS, WHATEVER.

THERE ARE THREE COMPONENTS IN

THIS VIN DIAGRAM.

FIRST IF WE TAKE IRAQ IT WAS NOT

UNTIL ABOUT 2007 PEOPLE BEGAN

TOKER WORRY ABOUT HOUR PERVASIVE

THE INSECURITY WAS AND HOW MANY

CIVILIANS WERE DYING.

THIS IS A PAPER I WROTE FOR THE

LANSETT ALL PRODUCE

UNCONVENTIONAL WARFARE ISSUES

PRODUCE CATASTROPHIC WARFARE

EMERGENCIES SO IRAQ HAD FAIRLY

GOOD INFANT MORTALITY RATES,

UNDERAGE FIVE MORTALITY RATES,

THESE ARE THINGS WE MEASURE AND

COME OUT IN WHO.

THEY WERE PROBABLY THE BEST IN

THE MIDDLE EAST.

WITHIN A SHORT PERIOD TIME THE

INFANT MORTALITY RATE WAS AMONG

THE FOUR WORST IN THE WORLD

ALONG WITH AFGHANISTAN, SIERRE

LEON AND LIBERIA.

WAR DOES THAT.

THE INTERESTING ALSO I MENTION

2007 BECAUSE DETERIORATED AND

STILL QUITE BAD AND

INFRASTRUCTURE STILL ISd

REPAIRED.

WHEN THEY HAD THE SURGE WHICH

MCCAIN SAID MY IDEA AND

EVERYTHING, YOU NEED TO KNOW THE

NGO RIGHT FROM THE BEGINNING

THIS IS WHAT YOU HAVE TO DO.

YOU HAVE TO GO TO THE

COMMUNITIES AND YOU HAVE TO

PROTECT THEM.

QUITE HONESTLY THE PLAN WAS

FIRST TO LEAVE IRAQ IN THREE

MONTHS BUT THEN WHEN I WENT UP

THE FIRST TO GO UP, THE OTHER

UP, THEY SAID WE'LL BE OUT IN

THREE WEEKS.

RUMS FIELD SAID.

SURPRISE.

SO THEY WERE NOT PLANNED FOR

THIS.

BUT IT TOOK THEM THAT LONG AND

IT WAS ACTUALLY ADVISED BY OTHER

PEOPLE, NOT BY THE POLITICSES.

EVOLVING CHANGES PORTRAY --

PETRAS SAID A LITTLE MORE THAN A

YEAR AGO OCCUPYING A NATION AND

DOING NATION BUILDING AS AN

ANSWER TO COUNTER-TERRORISM

DOESN'T WORK.

AT THE SAME TIME WHEN HE SAID

THIS HE SAID WE NEED TO KNOW

MORE ABOUT THE CULTURE OF

AFGHANISTAN.

I WAS IN THE VIETNAM WAR IN '68,

WE DIDN'T UNDERSTAND THE CULTURE

OF VIETNAM, WE DON'T UNDERSTAND

-- DIDN'T UNDERSTAND THE CULTURE

OF IRAQ.

WE CAN'T DO THESE THINGS UNLESS

YOU UNDERSTAND THE CULTURE.

CERTAINLY WIDESPREAD

DISSATISFACTION HAS ARISEN FROM

THE DOOR NORS.

WITH A ROLE OF POLITICS IN THE

MILITARY IN AID.

THE UNFORTUNATE THING IS MY

GENERATION TOOK TIME AND

ATTENTION TO BE SURE WE WERE

NEUTRAL, IMPARTIAL, WE WERE

INDEPENDENT.

WHO, WHETHER THE INTERNATIONAL

COMMUNITY OF RED CROSS,

WHATEVER.

HEALTH IS ABSORBED, PULLED IN BY

THE MILITARY.

ALL OF A SUDDEN WE'RE PULLED IN

AS A HARD POWER.

EVERYBODY WAS DOING HEALTH

INCLUDING THE MILITARY.

THE MILITARY U.S., WE SPEAK THE

SAME LANGUAGE, SAME COLOR SKIN,

WE BELONG TO THEM.

WE NEED TO KNOW THAT.

WE LOST UNFORTUNATELY OUR

AUTONOMY AND INDEPENDENCE AS

EFFECTIVE SOFT POWER, HEALTH

HAS.

SO WE MUST MOVE AND DONORS

DEPARTMENT OF INTERNATIONAL

DEVELOPMENT COMPARABLE TO YOU

SAID IN LONDON WE'RE NOT GOING

TO DO ANY MORE SHORT TERM FEEL

GOOD RINNING HEARTS AND MINDS

BUT RETURN TO LONG TERM ROOD

CAUSE ISSUES.

THEY'RE SUPPORTING THE SECURITY

THINGS.

YOU NEED TO ALSO UNDERSTAND THAT

ALL OF THE AID PROJECTS, THIS IS

PRETTY MUCH IN MOST OF THE

MIDDLE EAST AN AFRICA, EVERY

YEAR WE HAVE DOUBLED THE NUMBER

OF PROGRAMS, PROJECTS THAT

COLLAPSED OR SUSPENDED BECAUSE

STAFF, SECURITY PROBLEMS, OR

THERE'S DANGER TO THE STAFF.

THE 270 IN 2010, 270 AID WORKERS

SUFFERED FROM DELIBERATE

VIOLENCE TO THEM.

90 WERE KIDNAPPED.

WE DON'T HEAR ABOUT THAT, MORE

IS PEACE CIEPER, THE FIFTH

OCCUPATION MORE DEADLY

OCCUPATION AFTER LOGGERS AND

DEEP SEA FISHERMEN AND PILOTS

AND THINGS LIKE THAT.

BUT AMONG OCCUPATIONS WERE THE

HIGHEST OF THOSE WHO WERE TH

KILLEDQWe BY DELIBERATE VIOLENCE.

BUT WHAT IT'S COME TO IS THAT

COUNTRIES NOW, WANT THE

RESOURCES WE DON'T WANT YOU.

WHAT THEY THINK MIGHT BE

SIMPLISTIC BUT WHAT THEY HAVE

SEEN AN LEARN FROM PATTERNS IS

WE COME IN WITH SOME AID, BUT

THAT LEADS TO THEN IN A SHORT

PERIOD OF TIME THE MILITARY

COMING IN IN MORE -- AND MORE

VIOLENCE SO THEY PUT IT THAT

WAY.

ALL THE NGOs EXCEPT THE

ISLAMIC ONES WERE REMOVED FROM

SOMALIA.

AND I'M ON THE BOARD OF

DIRECTORS OF INTERNATIONAL

RESCUE COMMITTEE WHICH IS THE

LARGEST NGO FOR REFUGEES BUT

OVER 15% OF THE PROJECTS ARE

MANAGED REMOTELY FROM OUTSIDE

THE COUNTRY.

BECAUSE IT'S SO DANGEROUS.

P H THE JOURNALISTS HAVE GOTTEN

TO IT TOO, THIS IS TR THE

LANSETT, AND THEY WOULD TAKE A

PICTURE OF THIS GIRL AND

CONFIRMATION DRESS WHICH WHAT

THEY USUALLY HAVE AN PEOPLE SAY

THEY DON'T UNDERSTAND WHAT'S

GOING OUT THERE.

THEY OPENED THEIR LENS SO IT'S

NOT JUST SEEING THIS GIRL WHICH

IS SORT OF A CONTRADICTION,

WHITE AND PURE THE DRESS BUT

LOOK WHERE SHE COMES FROM.

THERE ARE OTHER THINGS HERE TOO.

SOME OF THE THINGS WE LEARN WHEN

WE'RE HUMANITARIANS YOU GET INTO

A VILLAGE OR REFUGEE CAMP, IF

EXROW SEE THE ANIMALS ARE TIED

TO THE TENT THEN YOU KNOW PEOPLE

HAVE ENOUGH FOOD FOR THEMSELVES

AND THE ANIMALS.

BUT IF THEY'RE LET GO THEY HAVE

TO TAKE CARE OF THEMSELVES.

SAME THING HERE SO THIS IS IS

WAY IT LOOKS SO THEY HAVE TO

HAVE AN OBLIGATION TO EDUCATE

GET THE TRUE INFORMATION OUT OF

THERE.

THEY TALK ABOUT RAPID

UNSUSTAINABLE URBANIZATION.

YOU NEED TO KNOW URBANIZATION IS

WONDERFUL.

IT PROVIDES ABOUT 90 -- 92%

ECONOMIES OF MOST COUNTRIES.

IT ONLY EXISTS WHEN THE PUBLIC

HEALTH INFRASTRUCTURE CAN MEET

DEMANDS OF THE POPULATION.

IN WATER, SANITATION, SHELTER,

WHAT HAVE YOU.

BUT TO HAVE GOOD URBANIZATION

YOU HAVE TO BRING SUPPLIES LIKE

FOOD, SOMETIMES THE WATER

CERTAINLY TAPPED IN.

THAT'S WHAT HAPPENED TO MOST

CITIES YOU HEARD ABOUT AND

CERTAINLY THE ONES YOU LIVE

HERE.

BUT RAPID UNSUSTAINABLE

URBANIZATION IS WHEN THE

POPULATION EXCEEDS THE THE

ABILITY OF THE PUBLIC HEALTH

INFRASTRUCTURE AND SOCIAL

PROTECTIONS TO PROTECT THAT

POPULATION.

THAT IS HAPPENING RATHER

RAPIDLY.

YOU NEED TO -- JUST GO BACK HERE

BUT EARLY DAYS WE JUST COUNTED

REFUGEES, WE HAD ABOUT

53 MILLION.

WE DIDN'T THINK ABOUT PEOPLE

INTERMLY DISPLACED.

AS A MATTER OF FACT UNDER

INTERNATIONAL LAW WHEN YOU'RE A

REFUGEE THE UN HIGH COMMANDER

HAS A HIGH RESPONSIBILITY BUT

IT'S THE HOST NATION THOUGH THE

HOST NATION WAS TRYING THE KILL

YOU, HOST NATION HAS THE

RESPONSIBILITY FOR INTERNALLY

DISPLACED.

BUT AFTER 9/11 LESS PEOPLE HAVE

BEEN REFUGEES TO CERTAINLY

EUROPE AND NORTH AMERICA.

BUT ALSO WITH REMEMBER WHEN I

SAID THOSE PEOPLE THAT THEN

REMAINED IN THOSE LEVELS OF

VIOLENCE EXPOSURE.

THEY MOVE.

THEY MAY GO TO THE CITY,

SOMEPLACE REGIONALLY SO THE

SETTLEMENTS AROUND NAIROBE WHICH

ARE MASSIVE, NOT SURE HOW MANY

ARE THERE BUT IT'S OVER 470,000,

THEY COME FROM 8 COUNTRIES

SURROUNDING THAT PARTICULAR AREA

SO YOU SEE THE MIDDLE LINE HAS

INCREASE SOD WE'RE DEEMING WITH

LOWEST LEVEL OF RES GEES AN THIS

IS -- REFUGEES.

NOW WE'RE DEALING WITH

INTERNALLY DISPLACED

POPULATIONS.

THIS IS A NEW CHALLENGE FOR US

ALL.

WE FEEL MAJOR 21st CENTURY

CRISIS IS RAPID UNSUSTAINABLE

URBANIZATION.

WHERE DO THESE PEOPLE COME FROM?

COST CONFLICT POPULATION, SUDAN,

A LOT OF PLACES IN AFRICA,

PUBLIC HEALTH RESOURCES THAT ARE

UP THERE.

SO THEY COME TO THE CITIES.

CLIMATE CHANGE AND BIODIVERSITY,

VERY, VERY COMMON.

CRISIS, WE'LL TALK AB NOSE

DETAIL.

ESCAPING THE -- ABOUT THOSE IN

DETAIL.

ESCAPING THE CONFLICT

POPULATIONCH AFGHANISTAN IS 98%

AGRICULTURAL, RURAL BUT SLOWLY

BECOMING AN URBANIZED COUNTRY.

IN KABUL THERE'S 320,000

INTERNALLY DISPLAYED THAT WERE

IN RURAL AREAS BUT NOW IN THE

CITY.

THEY HAVE NO POLITICAL VOICE,

THEY'RE BEING MOVED AROUND, HAVE

NO WATER, SANITATION AND NO GOOD

DEMOGRAPHICS HOW BAD THE

SITUATION, HOW MANY PEOPLE ARE

DYING, WHAT ARE THEY DYING OF,

THINGS LIKE THAT.

CERTAIN CERTAINLY THE RULE

ECONOMIES HAVE FAILED, HUMAN

SECURITY, TERRIBLE.

YOU GO TO LAGOS WHO IS THE

TYPICAL PERSON WHO ENDS UP

THERE, IT'S A SINGLE OR WIDOWED

FEMALE WITH 3 TO 5 CHILDREN

LOOKING FOR SOME KIND OF

SECURITY.

USING USUALLY A HISTORY OF BEING

RAPED AND ENDS UP HOPING THAT

THEY MAY GET A JOB, MANY OF THEM

AS YOU WELL KNOW TURN TO

PROSTITUTION JUST TO GET ENOUGH

MONEY ON THE TABLE, FOOD ON THE

TABLE FOR THEIR KIDS.

SO IT'S A BAD SITUATION.

THIS IS MUMBAI, YOU CAN SEE THE

ADVANCED DRAMATIC HERE AND

SURROUNDING MUMBAI IS ONE OF THE

LARGEST POPULATIONS OF

INTERNALLY DISPLACED.

THESE ARE CONTRADICTIONS WE SEE.

IF INDEED IN THE UNITED STATES,

PEOPLE OF THE DEVELOPED WORLD

ARE SQUATTER, PEEP WELL CALL

HOPELESS.

IN THESE COUNTRIES 78% OF THE

POPULATION ARE SQUATTERS OR

HOMELESS.

67 PEST% OF THE PEOPLE INTO

MUMBAI ARE MIGRANTS.

THEY'RE UP TO 350 NEW FAMILIES

EVERY SINGLE DAY THAT MOVE IN.

THESE PEOPLE LOST ESSENTIALLY TO

ANY KIND OF DATA COLLECTION IN

TERMS OF WHAT THEY DO, HOW WE

NEED TO PROTECT THEM.

AFRICA, PEOPLE ESCAPING TO THE

CITIES HAVE ESCAPED WITH ALL THE

WEAPONS THAT HAVE BEEN IN THREE

DECADES OF WAR.

CENTERS ARE.

IT'S BIG, BIG BUSINESS.

THE POLICE ARE CORRUPT, THEY'RE

PREDATORY GANGS, IT'S HEAVILY

VIOLENT AND A HORRIBLE

SITUATION.

IN ASIA THEY HAVE HAD AN

ECONOMIC BASE BUT PEOPLE HAVE

COME IN BUT THEY MOVE TO

DISASTER PRONE AREAS.

INTERCOASTALLY BUT VIOLENCE IS

NOT NECESSARILY A PROBLEM IN THE

ASIAN SITUATION.

SO THEY'RE DIFFERENT BUT ALL

BECOMING MEGA CITIES.

THE OTHER THING IS RECOGNIZE

NORMAL URBAN POPULATION GROWTH

GOES UP HERE BUT THOSE ENTERING

EXTREME POVERTY, SAY MAKING $2 A

DAY, THEY MAY GO TO THE CITIES

AND MAKE $4 A DAY FOR THEIR

FAMILY OF FOUR BUT THEY DON'T

GET OUT OF EXTREME POVERTY.

THAT'S ACTUALLY WHAT HAPPENS

DURING THE INDUSTRIAL REVOLUTION

WHEN MANY PEOPLE WENT INTO THE

CITIES IN THE 1850s.

THEY NEVER REALLY DID GET OUT OF

POVERTY.

SO WE HAVE, EVEN THOUGH NOBODY

IS OUT THERE DOING GOOD

DEMOGRAPHICS LIKE WE DID IN

REFUGEE CAMPS AND ALL THE REST,

BUT WE DO KNOW THE HIGHEST

WORLDWIDE UNDER AGE 5 INFANT

MORTALITY RATE, MATERNAL

MORTALITY RATE ARE COMING FROM

THESE UNSUSTAINABLE URBAN

CENTERS.

IF I HAD GIVEN YOU A TEST AND

ASKED WHERE DO YOU THINK MOST OF

THE PEOPLE, CHILDREN ARE DYING

AND ONE WAS CHECK OFF RURAL

AFRICA, THAT'S IT, NOT ANY MORE.

RURAL AFRICA MOVED TO URBANIZED

SETTINGS.

SO WE HAVE AT LEAST A BILLION

PEOPLE WITHOUT A POLITICAL

VOICE, HOW MANY OF YOU HAVE EVER

HEARD THE SPHERE STANDARDS.

THESE ARE STANDARDS WE HAVE TO

KEEP TO.

THROUGH SET UP REFUGEE CAMPS.

ONE LATRINE FOR 20 PEOPLE HAVE

TO BE WITHIN 50-METERS OF WHERE

THEY ARE, SO MANY SPACES BETWEEN

PEOPLE AND SHELTERS AN WHATEVER.

THEY DON'T EVEN COUNT.

THEY HAVE BEEN SO EXCEEDED.

SO JUST AS ONE EXAMPLE OF

LATRINES IS ONE, FOR EVERY 200

TO 300 PEOPLE.

BUT THEY MAY HAVE TO WALK UP TO

A MILE AND PAY A FEE, PAY A FEE

IN KABUL TO DO IT BECAUSE

SOMEBODY OWNS THAT.

WOMEN DO NOT GO TO THE TOILET AT

NIGHT.

ALL HAVE RAPE EM EPIDEMICS

BECAUSE OF THAT.

SO SPHERE STANDARDS ARE

ABSOLUTELY USELESS.

THE OTHER THING IS WE HAVE NO

REAL INTERNATIONAL PRESENCE FROM

THE USUAL NGOs.

WHAT THEY SEE IS THIS IS JUST

TOTALLY DAUNTING.

WHERE DO YOU START?

WITH HAITI AND THEN THE PAKISTAN

FLOODING OCCURRING DURING THAT

TIME, WE EXPENDED ALL THE TENTS

VAIL TO BELIEVE THE HUMANITARIAN

COMMUNITY.

THINK ABOUT IT, THERE'S JUST NOT

THAT MUCH INFRASTRUCTURE THAT

THESE NGOs HAVE.

SANITATION IS IGNORED,

INFECTIOUS DISEASES ARE RAMPANT.

WE HAVE LARGE POPULATIONS,

CITIES OF 30 MILLION, BUT IT'S

REALLY DENSITY MORE THAN -- MORE

RITCAL THAN POPULATION NUMBERS.

NOW, DENSITY WE START COUNTING

CITIES DENSITY ABOUT 2,000

PEOPLE PER SQUARE KILOMETER.

MUMBAI AVERAGES 30,000 PEOPLE

PER SQUARE KILOMETER.

SOME AREAS THERE'S A MILLION

PEOPLE PER SQUARE KILOMETER.

SO YOU HAVE AN INFECTIOUS

DISEASE BELIEVE ME YOU SPREAD IT

TO EVERYBODY WITHIN

MILLISECONDS.

WE HAVE NEVER HAD ANYTHING QUITE

LIKE THIS.

SO LOOK AT THE COUNTRIES WITH

THE TOP 400 URBAN POPULATIONS WE

HAVE SOME IN NORTH AMERICA.

DON'T WE?

WE HAVE THEM IN THE CARIBBEAN.

YOU CAN SEE SOUTHEAST ASIA ANDTY

BET THAT WE HAVE A LOT.

THAT'S IMPORTANT BUT SOME CITIES

ARE REALLY -- ARE DOING WELL BUT

YOU HAVE TO GO TO THE DENSITY SO

YOU CAN SEE HERE IN SOUTHEAST

ASIA ESPECIALLY THERE, THAT'S

WHERE WE HAVE THE PROBLEMS WE'RE

TALKING ABOUT SO DENSITY IS MUCH

MORE IMPORTANT THAN POPULATION

PER SE.

I CUT MY TEETH ON HUMANITARIAN

WORK IN CHINA.

ACTUALLY STARTED GOING THERE A

45 YEARS AGO.

WHEN I WEPT THERE I WAS TREATING

MALNUTRITION AN POVERTY.

80% WERE SUFFERING FROM

MALNUTRITION SO I TAUGHT THEM

HOW TO TREAT THEIR PEOPLE, I

TREATED PEOPLE, I LOVE THE OLD

CHINA, LOVE CHINESE, I DON'T

LIKE MODERN CHINA.

WE'LL TALK ABOUT THAT.

BUT THERE WERE 40 MAJOR CITIES

AT THE TIME, BEIJING YOU'LL SEE

AN OCCASIONAL CAR.

AS THE POPULATION HAS BURGEONED,

THEY'VE GONE AHEAD AND BUILT NEW

CITIES SEEKING PUBLIC HEALTH

INFRASTRUCTURE LIKE WATER.

PLACES TO HANDLE SANITATION.

THEY NOW HAVE OVER 600 CITIESCH

WHEN I WAS THERE ABOUT 6 TO 7

YEARS AGO I SPOKE AT SHANGHAI,

THEN THEY WANTED TO DRIVE ME ON

THEIR NEW HIGHWAYS TO THIS OTHER

CITY TO GIVE -- TURNED OFF THE

ROAD AND THERE WAS A GUARD AND

GUY SAW THE OFFICIAL SO THEY

OPENED UP AND WENT IN AND IN

FRONT OF US ALL, THEY GOT

NERVOUS AS CAN BE BECAUSE THEY

HAD AN AMERICAN IN THE CAR BUZZ

THERE WAS MASSIVE, MASSIVE CITY

TOTALLY WHITE, NOT A SINGLE

PERSON AROUND LIKE A NEUTRON

BOMB HIT, THEY DON'T DESTROY

BUILDINGS BUT THEY KILL ALL THE

PEOPLE.

STORES, SCHOOLS, HOUSING.

EVERYTHING BUT NOBODY AROUND.

WE FINALLY GOUT OUT THEY SAID

OVER DINNER, WHAT DID WE SEE?

THAT WAS A CITY -- AND ABOUT

THREE MONTHS LATER 5 MILLION

PEOPLE WHO MOVED THERE.

SO THEY FOLLOW THE WATER WHICH

AS YOU KNOW IS IN THE ABILITY TO

HAVE FOOD WHICH IS UNSUSTAINABLE

IN CHINA.

HERE WHAT THEY DECIDED TO DO IS

BUILD THE FIRST -- OR LARGEST

MEGA CITY, NOT TO BE ON THE

RECORDS, BUT ALL THESE IN THE

NORTH OF HONG KONG, IF YOU

REMEMBER THAT.

SO THEY HAVE TAKEN ALL THESE

CITIES VERY LARGE AND PULL THEM

TOGETHER AS ONE MAJOR CITY,

LARGEST ONE.

42 MILLION TOTAL SIZE OF VERMONT

AND NEW JERSEY COMBINED.

BUT THE REASON BEING IS THAT ALL

THESE DIFFERENT CITIES HAVE

THEIR OWN PUBLIC HEALTH

INFRASTRUCTURE AND

TRANSPORTATION.

THEY MAKE IT ONE BIG CITY THAT

CAN CONTROL IT BETTER.

BECAUSE THEY CAN'T FORM NEW

CITIES ANY MORE.

THIS IS THE PROCESS THEY HAVE

BEEN DOING.

THIS IS THE REASON THEY ALSO

NEED TO AND WILL, THIS IS WHY

THEY WANTED TO BUILDING A DAM IN

MIRAMAR PLANNING TO GO THERE.

THEY MAY INVADE THAILAND,

VIETNAM.

WE'LL TALK ABOUT THAT.

BUT THIS IS THE WAY THE PEARL

RIVER DELTA LOOKS BUT USUALLY

SKY SCRAPERS BUT THIS IS AS

CLEAN AS THE AIR GETS, IT'S

PRETTY BAD.

THEN THERE'S ALL THESE AREAS

HERE, AND THIS IS THE LAND USE.

HEAT TRAPS ARE UP TO 3-DEGREES

BUT RID OF ALL GRASSY AREAS SO

THIS PARTICULAR AREA IT WAS 300%

INCREASE AND LAND LOSS WITHIN

ONE YEAR WITH ASPHALT AND

CONCRETE.

WHATO
 HAPPENS IS IN ALL THESE

MAJOR CITIES HAD THEIR OWN

CLIMATE ALL BIG CITIES ARE

CONTROLLING THEIR OWN CLIMATES.

DETRIMENTALLY SAME THING HERE,

THE FIRST ISLAND IN THE

DISAPPEAR.

BUT (INDISCERNIBLE) AND ALL

PACIFIC ISLANDS HAD TO BECOME

URBANIZED.

THINK ABOUT THAT.

ROMANTICALLY YOU DON'T WANT TO

HEAR THAT.

BUT THEY HAVE ALL PULLEDDED INTO

CENTRAL LOCATIONS.

THEY HAVE NONCOMMUNICABLE

DISEASE SO THEY'RE GETTING

OBESE, TYPE 2 DIABETES,

PSYCHOSOCIAL AND DEPRESSION

PROBLEMS, THINGS LIKE THAT.

CARABOS IS TRYING TO GET ALL

THEIR PEOPLE TO ONE PLACE.

TRYING TO GET AN ISLAND IN NEW

ZEALAND, THEY ARE TAKE THEM,

ABOUT TAKING ABOUT 1,000 PEEP TO

BE TRAINED AS NURSES THEN WHEN

THEY GE TRAINED AND GET A JOB

THEY'LL BRING THE FAMILY IN.

BUT NOW THEY'RE LOOKING TO GET

100,000 MAYBE TO FIJI.

THE MALDO I HAVES, THE PRESIDENT

WANTS THE PEOPLE EVERY COUNTRY

IN THE WORLD TO TAKE SOME OF

THEIR PEOPLE BUT THERE IS SUCH A

THING AS CLIMATE CHANGE.

BUT EVEN IF THERE'S LEGAL THINGS

IF A COUNTRY DISAPPEARS,

CARABOS, MALDIVES ARE COUNTRIES

ONE OF 194.

WHEN IT DISAPPEARS DOES THAT

MEAN THE NATION DISAPPEAR?

THERE'S INTERESTING ISSUES THAT

WE HAVE NEVER BEEN FACED WITH.

THAT IS GOING TO DISAPPEAR.

VERY SOON.

WE HAVE BEEN MAKING A LOT OF

DECISIONS BASED ON THE

POPULATION BACK IN THE 1990s

WHICH TOLD US SOMETHING WE SAID

OH, OKAY, WE CAN BUY THIS.

80% OF THE BOTTOM BILLION OF

POVERTY WERE LOCATED IN STABLE

COUNTRIES LIKE TANZANIA BUT ALSO

CONFLICT ONES LIKE CARGO AND

BARENDI AND THEN ANDREW SUMNER

COMES ALONG WITH MORE CURRENT

DATA PULL TO FIND OUT WHERE THE

BOTTOM BILLION IN POVERTY IS

LIVING.

AND THIS WAS 93%, 72% BUT LOOK

AT THE CHANGE, MAJORITY OF

POVERTY RIDDEN PEOPLE ARE IN THE

MIDDLE INCOME STABLE COUNTRY,

MIDDLE INCOME FRAGILE AFFECTED

STATES LIKE NIGERIA AND PAKISTAN

BUT INDIA, CHINA AND INDONESIA,

SOMETHING WE HAVEN SEEN BEFORE.

SO THIS IS CHANGING HOW WE'RE

PLANNING ON AID AND THE NBGs

AND THE REST OF THE STUFF.

ALSO INFANT IMMUNIZATIONS.

REAL EFFORTS TO GET KIDS

VACCINATED FOR ALL THE

PREVENTABLE DISEASES, THE

DPDs, THOSE OF YOU THAT HAVE

KIDS.

BUT YEAH, WE ALWAYS THINK IT'S

THE LOW INCOME COUNTRIES THAT

HAVE THE LOWEST RATE.

THIS IS WHERE OUR PROGRAMS ARE.

BUT NOW WE'RE FINDING THE

HIGHEST RATES WHERE THEY'RE NOT

GETTING VACCINATION ARE IN THOSE

COUNTRIES INDONESIA, CHINA AND

INDIA.

SO TOTALLY DIFFERENT.

BOTTOM DIVERSITY CRISES,

SCIENTISTS WILL TELL YOU THIS IS

OUR MAJOR CRISIS.

WE HAVE JUST SO MANY BIODIVERSE

AREAS, I'LL SHOW YOU A PICTURE

OF THEM.

BUT BELIEVE IT OR NOT, THIS IS

WHERE MOST OF OUR VASCULAR

PLANTS AND VERTEBRA LIVED.

THEY ARE THE BIOLOGICAL OXYGEN

OF THE WORLD, WHERE WE GET FOOD

FROM.

THIS IS PROVIDES US WITH

FRESHWATER.

THIS IS WHERE WE GET A BALANCE

OF INFECTIOUS DIEZS OR BACTERIA

VIRUS, AND BECAUSE WE ALL HAVE

IT AND WE'RE EXPOSED TO IT.

THIS BALANCE TO PREVENT INVASIVE

DISEASES FROM OCCURRING OCCURS

IN THIS BIODIVERSE AREA BECAUSE

IT'S THERE TO ENSURE THE

STABILITY IN MANY AREAS IN THE

WORLD.

BIODIVERSITY HOT SPOTS OCCUR

WHEN THE HABITAT OF VASCULAR

PLANT ARE GREATER THAN 1500 OR

70% OF THE ORIGINAL HABITAT IS

LOST.

HIGH BIODIVERSITY IS A MAJOR

SIGNIFICANT SAFEGUARD AGAINST

INFECTIOUS DISEASE.

BIODI VRS AREAS BEING LOST IN

CHINA, BET YOUR LIFE.

RIGHT NOW CHINA CONTRIBUTES 40%

OF ALL THE NEW AND RE-EMERGING

INFECTIOUS DISEASES IN THE

WORLD.

ACCORDING TO UN REPORT THAT WILL

GO UP TO 80% BY 2030.

REMEMBER AVIAN—7! INFLUENZA, THAT'S

WHERE A LARGE NUMBER OF PEOPLE

DENSITY WISE LIVE WITH A HIGH

NUMBER OF DENSE WATER FOUL

CHICKENS AN THOSE THAT ARE

VECTORS FOR THESE KINDS OF

DISEASES.

THE OTHER THING IS 80% OF THE

CONFLICTS THAT WE HAVE HAD IN

THE WORLD OCCURRED IN 23 OF THE

34.

WE ONLY HAVE 34 MAJOR BIODIVERSE

AREAS IN THE WORLD.

SO WHEN WE HAVE WARS IT GETS RID

OF BIODIVERSITY.

SO I DON'T KNOW HOW WILL YOU SEE

THIS BUT YOU CAN SEE THE OUTLINE

OF CONTINENTS.

GRAY AREAS WHERE THE

BIODIVERSITY AREAS ARE.

THE BLACK SPOTS WHERE THERE HAVE

BEEN MAJOR CONFLICTS IN THE LAST

50 YEARS SO WHY WOULD THEY BE

AROUND, EVERYBODY IS LOOKING TO

HAVE THE FUEL, HAVE THE WATER,

OUR FUEL COME FROM THERE,

POLLINATION, ET CETERA BUT

PEOPLE WILL STRIVE FOR THAT.

WE DON'T HAVE A MINISTER OF

INTERIOR IN IRAQ RIGHT NOW BUT

WHEN HE WAS THERE TWO YEARS AGO,

HE SAID IT WAS QUOTED IN FOREIGN

AFFAIRS JOURNAL.

HE SAID THANK GOD WE HAVE -- WE

HAVE OIL BECAUSE WE CAN NOW BUY

FOOD FOR THE PEOPLE.

THIS WAS THE PLACE BETWEEN THE

TIRES ANEUFRA TERKSS WAS PACKED

THE VEGETATION, THEY NEVER HAD A

PROBLEM WITH FOOD.

THEY DO NOW.

AS A MATTER OF FACT ADDING TO

THE FACT THAT A LOT WAS

DESTROYED WITH THE WAR,

HOPEFULLY YOU CAN SEE THIS IS

TIGRIS AND EUFRATES RIVER.

WHEN THEY MEET, WHAT IS THAT

AREA THEY NEAT MEAT?

DID YOU HEAR THE CRADLE OF

CIVILIZATION, THAT'S WHERE IT

IS.

ABUNDANT WITH FOOD AND REST OF

THE STUFF.

THIS IS DRY AS A BONE NOW.

THE OTHER THING IS THAT THE

TIGRES AND EUPHRATES RIR BEGAN

IN SYRIA AND TURKEY AND THEY

BOTH BUILT DAMS SO RIGHT NOW

THOSE RIVERS IN MANY PLACES ARE

DOWN TO A TRICKLE.

SO MAYBE WHEN TIMES IT COULD

HAVE BEEN NEGOTIATED, THE WAR

HAS BUILT THIS HE CAN ECOLOGICAL

MONSTER FOR THAT PARTICULAR

COUNTRY.

WE DO HAVE PROTECTED AREAS FOR

LAND BASE AND MARINE LIFE, AS

INCREASE IN PROTECTED AREAS ARE

BUILT OR BIODIVERSE AREAS ARE

TRYING TO BE BOUGHT BACK,

HONESTLY THE NUMBER OF SPECIES

AN PLANTS AND THE REST HAS

CONTINUED TO GO DOWN.

WHY?

A LOT HAS BEEN CONTINUALLY

DEFORESTED.

HABITATS HAVE MOVED IN.

BUDGET CONSTRAINTS, ET CETERA,

ET CETERA.

A LOT OF -- NOT MUCH ATTENTION

TO IT.

SO WE ARE LOSING THAT TOO.

SO RESTOCKING GENETIC RESOURCES

ARE CRITICAL AFTER DAS

DISASTERS.

IT'S SCIENCE.

IF YOU PUT IN THE WRONG SPECIES,

THEY WILL TAKE OVER.

AS A MATTER OF FACT ONE ISSUE

THAT DOES OCCUR WITH WAR IS THAT

INVASIVEPECIES GO IN AND TAKE

OVER.

THAT'S ONE OF THE REASONS WHY WE

HAVE MORE RE-EMERGING AN NEW

EMERGING INFECTIOUS DISEASES

FROM CHINA BECAUSE

STRONGER AND THEY CAN -- THEY

CAN ASSUME DOMINANCE.

CLIMATE CHANGE.

WON'T BORE YOU TOO MUCH WITH

THIS.

TO THINK OF IN TERMS OF

DIFFERENT ENVIRONMENTAL

INDICATORS, CLIMATE CHANGE,

BIODIVERSITY, GLOBAL CYCLES OF

NITROGEN AND PHOSPHORUS,

REMEMBER THAT NITROGEN IS

RENEWABLE.

THAT WE CAN DO.

BUT PHOSPHORUS IS NOT.

OUR PHOSPHORUS STORES ARE

DECREASING ABOUT 2% EVERY SINGLE

YEAR.

BUT 50% OF ALL THE PHOSPHORUS IN

THE WORLD IS IN MORE MOROCCO.

EVERY COUNTRY WANTS TO BE

FRIENDS WITH THEM UNLESS THEY

INTEND TO INVADE THEM TO GET

THIS.

THAT'S A REAL PROBLEM, PART OF

THAT DREAM TO GET THESE RAW

MATERIALS FROM ASTEROIDS?

YES.

OR THE DEEP, DEEP SEA?

BUT PHOSPHORUS IS A BIG ONE.

THE PLANET MAY GO UNDER SIMPLY

BECAUSE OF THAT.

OCEAN ACIDIFYCATION, OREGON HAS

CHANGED COMPLETELY SO A ROT LOT

OF BOTTOM FEEDERS HAVE GONE,

CRABS, THAT'S WHY YOU SEE MORE

BIG FISH BITES BECAUSE THEY HAVE

TO GO TO THE SURFACE TO GET THE

OXYGEN THEY NEED, NAMELY THE

FOOD.  THAT'S WHY WE'RE SEEING

MORE SHARK AND OTHER KINDS OF --

OZONE, THE LAND USE I TOLD YOU

ABOUT IN CHINA F. YOU CROSS ONE

BOUNDARY OF ANY OF THESE IT

AFFECTS THE STABILITY OF THE

ENTIRE SYSTEM.

I THINK YOU KNOW THAT PRETTY

WELL.

THE EL NINO WHICH IS SUPPOSED TO

HAVE DISAPPEARED, WE'LL SEE WHAT

HAPPENS BUT DURING EL NINO

YEARS, IN THOSE AREAS IN RED,

THE WARMER THE EL NINO THE

HIGHER THE CONFLICT.

IT'S DOUBLED DURING THAT PERIOD

OF TIME.

WHY DO WE HAVE CONFLICT?

A LOT OF THINGS HAVE CHANGED BUT

PROBABLY IT'S DUE TO THE THE

FACT THAT AGRICULTURAL

PRODUCTION HAS DROPPED IN THESE

AREAS SO IT'S COMPETITION FOR

THE AVAILABLE AGRICULTURE.

PRODUCING CONFLICT.

EASY TO EXPLAIN.

AUSTRALIA, WE THINK THIS IS JUST

BELONGS TO THE DEVELOPING

COUNTRY.

AUSTRALIA, VERY HIGHLY

DEVELOPED.

BUT AMONG DEVELOPED COUNTRIES

AUSTRALIA IS REALLY HURTING.

INCREASED FREQUENCY AND

AGGRESSIVENESS OF THE CLIMATE

CHANGE AFFECTS SO TALK TO SOME

AUSSIE THEY'LL TELL YOU UP FRONT

WHAT'S HAPPENED.

BUT THE MOST VULNERABLE ONE WE

HAVE RISING TEMPERATURES LOWER

OVERALL RAIN FALL EXCEPT IN

OTHER AREAS THEY NEVER HAD RAINS

BEFORE SO HEAVY RAIN AND FLOOD

AND WEST AND CERTAINLY EASTERN

SIDE WHERE THERE CAN BE BOTH

COMBINED DROUGHT AND THEN A LOT

OF FREQUENT RAIN LIKE YOU SEE IN

THE SOUTHERN PART OF THE UNITED

STATES.

THE WESTERN PART WHICH IS

USUALLY DRY NOW THE WORST

MOSQUITO BREEDING THEY HAVE EVER

SEEN BECAUSE THEY HAVE MUCH MORE

WATER.

SO THE INFECTIOUS DISEASES,

MALARIA, ROSS RIVER, VIRUS, DEN

GI, ARE ALL MOVING SOUTH.

REMEMBER THEY MOVE SOUTH TOWARDS

SIDNEY AND INCREASE IN

INFECTIOUS DISEASES.

IF YOU LOOK AT PROMED AND START

SEE THINGS ABOUT MILIDOSES, ROSS

FEVER, OUTBREAKS IN AUSTRALIA.

THIS PICTURE IN THE BACK GROUND,

ANYBODY RECOGNIZE THAT?

THAT'S THE OPERA HOUSE IN

SIDNEY.

TOTALLY COVERED.

THAT DOES NOT -- THAT'S THE WAY

IT LOOKS, THEY TINTED THAT.

THE OPERA HOUSE SIDNEY COVERED

WITH A SUPER DUST STORM SO

THEY'RE REALLY QUITE FRIGHTENED

ABOUT THE WHOLE THING FOR GOOD

REASON.

WHETHER RELATED DISASTER,

INCREASED THE NUMBER AND

FREQUENCY, THAT WE CAN TELL YOU

AS SCIENTISTS.

THE MORTALITY IS INCREASED.

THIS DOESN'T COUNT EARTHQUAKES

BECAUSE IT'S NOT WEATHER RELATED

THIS PAST COUPLE OF WEEKS, AGAIN

AN ARTICLE HAS COME OUT AND SAID

YOU KNOW WHAT, WE TRY TO FIGURE

OUT WHY WE'RE ALSO SEEING MORE

EARTHQUAKE BUS WITH ALL THE

RAIN, FLOODING, THERE'S SOIL

EROSION TIME AFTER TIME AFTER

TIME AND WHAT THEY FIGURE, THESE

ARE AREAS WHERE THE EARTHQUAKES

ARE NOW OCCURRING, THAT IT'S

GOTTEN RID OF THIS MANTEL THAT

ACTUALLY HAD WEIGHT ON IT TO

CONTAIN THE EARTHQUAKES

POTENTIAL.

SO REMOVE THAT, THE EARTHQUAKE

WILL OCCUR.

SO IT IS PROBABLY WE CAN INCLUDE

ON THAT LIST.

WHAT CAN WE TAKE -- TELL THE

SCIENTISTS?

SCIENCE CAN PROJECT FREQUENCY OF

EXTREME WEATHER AND HOW IT

CHANGE.

E SEE CORRELATION WITH HEAT

WAVES.

RUSSIA LAST YEAR HAD 54,000 HEAT

WAVE DEATHS.

INTENSE RAIN FALL, AND THOSE

MASKED CO-2 EMISSIONS.

SCIENTISTS ARE CLEAR ABOUT THAT.

MORE DIFFICULT WHERE THERE ARE

MANY CONFOUNDING VARIABLES, LIKE

WITH SOMALIA, THE DROUGHTSES IN

SOMALIA, WHATEVER, IT IS A

CLIMATE CHANGE ISSUE BUT WHAT

YOU'RE DEALING WITH IS TERRAIN,

NO GOOD MANAGEMENT OF THOSE --

OF THE CROPSES.

BAD SOIL, THINGS LIKE THAT.

IN THIS PAST YEAR THE SCIENCE

HAS OVERCOME NOT WORKING

TOGETHER MUCH MORE

INTERDISCIPLINARY WORK SO YOU

CAN GET MODELING FROM JUST LOSS

OF GRAPHS, LOSS OF FOREST OR

WEAR, INDEPENDENT, NOW WE'RE

DOING THE IT HAS SHOWN CHANGES

SO GUILTY OF SCIENTISTS DOING IT

SEPARATELY BUT NOW THEY'RE

WORKING TOGETHER AND SO THE

SCIENCE IS MORE ACCURATE BECAUSE

IT IS MULTI-DISCIPLINARY AND

MORE HIGHLY INTEGRATED.

AS I TOLD YOU, WHEN I WENT TO

CHINA 83% WERE SUFFERING

MALNUTRITION AND POVERTY.

THIS HAS NEVER HAPPENED TO ANY

OTHER COUNTRY AND I DOUBT I WILL

EVER.

THEY MOVE DOWN POVERTY ATTRITION

RATE, THE POVERTY RATE IS BETTER

THAN POVERTY RATE IN THE UNITED

STATES.

HOW DID THEY DO THIS?

A SINGLE FOCUS OF BUILDING

INDUSTRY.

AS A MATTER OF FACT THEIR

FOREIGN POLICY WHICH IS QUITE

ROBUST THEY ARE SO PROUD THEY

TURNED THEIR COUNTRY AROUND WITH

INTENSE INDUSTRIALIZATION THAT

IN THE AFRICAN COUNTRYSTHEY ARE

BRINGING THE SAME INDUSTRY TO

THEM.

THAT'S THEIR SINGULAR FOCUS AT

THE TIME.

THE UNFORTUNATE THING IS THAT IN

THE UNITED STATES BUT ALSO IN

CHINA, CUBA, SPAIN AND RAW RU

SHAH, FOREIGN POLICY IS DRIVEN

BY -- IS DRIVING HEALTH POLICY

AN HEALTH POLICY IS DRIVING

FOREIGN POLICY.

BUT IT'S COMPETITIVE,

GOVERNMENT-CENTRIC AND THEY'RE

COMPETING AND THE CHINESE ARE

EMBARRASSED TO HAVE A HOSPITAL

SHIP DURING THE TSUNAMI SO THEY

BUILT THE PEACE ARC, GOES THE

AFRICA, BIG MEETINGS IN D.C. AND

WE HAVE TO SIT IN THE HOSPITAL

SHIPS TO AFRICA.

THEY DO PRIMARY HEALTHCARE AND

THEY LEAVE.

IT'S NOT WHAT WE WANT.

AN AWFUL LOT OF MONEY BEING PUT

INTO WHAT, IT'S AVOIDING THE

GLOBAL INITIATIVE, EVEN DEVELOP

STRATEGIES FOR THREATS, WE'RE

NOT DOING IT BECAUSE WE'RE

COMPETITIVE.

CAN WE WORK TOGETHER?

I DON'T KNOW.

THAT'S A BIG THING.

BUT THIS GROUP HERE IS STILL

HAVING POVERTY IS THAT GAP.

THE GAP ANALYSIS, INCOME

INEQUITY.

WHERE WOULD YOU THINK IS THE

INCOME AND EQUITY FOR THE UNITED

STATES?

ANYBODY OFFER A FIGURE, HOW WE

RATE WITH THE REST OF THE WORLD?

WE'RE RATED 93.

WE'RE 3 PERCENTAGE POINTS BEHIND

IRAN, 12 BEHIND CHINA AND 50

BEHIND -- PERCENTAGE POINTS

BEHIND EGYPT.

WHEN YOU GET THIS BIG GAP,

THERE'S MORE CHANCE HISTORICALLY

FOR BYLAWS.

YOU HAVE TO THINK OBJECT THAT IN

THE FUTURE.

OUR INFANT MORTALITY RATE, YOU

KNOW ABOUT THOSE THINGS.

HONESTLY IT IS WHAT WE CALL A

COMPOSITE INDICES, IT TELLS US

MORE ABOUT GOOD GOR NANS THAN

ANYTHING ELSE.

I'M A PEDIATRICIAN AMONG OTHER

THINGS BUT INFANT MORTALITY, WE

THINK ABOUT ANTI-NAY IT NATAL,

PRE-NATAL POSTNATAL CARE, THINGS

LIKE THAT.

IT'S MORE THAN THAT.  WE HAVE

GOOD PROGRAMS BUT DOESN'T MEAN

THE INFANT MORTALITY RATE GOES

DOWN.

IT'S A SENTENCETIVE INDICATOR,

EVERYBODY USES IT IN GOVERNMENT

TO TEST GOOD GOVERNANCE, SO IT'S

EDUCATION, COMMUNICATION,

TRANSPORTATION, ET CETERA, ET

CETERA.

WE WERE -- WHEN -- I'M 72.

WHEN I WAS A LOT OF YOUR AGES WE

WOULD COMPETE FOR THE FIRST OR

SECOND SPOT WITH CUBA, WHICH HAD

A GOOD PRIMARY HEALTHCARE SYSTEM

BUT THEY ONLY STARTED ACCOUNTING

-- ACCOUNTING INFANT DEATHS

AFTER TWO DAYS OF BIRTH.

SO THEY WERE ALWAYS LEADING US.

LAST YEAR WE WERE RATING 19.

THIS YEAR RATED 42ND BEHIND

SLOVINIA.

BUT WE'RE A COMPOSITE.

WE'RE 50 DIFFERENT COUNTRIES.

SO WE HAVE CHUTE SLEUTHLY

REMARKABLE INFABT MORTALITY

RATES IN MASSACHUSETTS, VERMONT.

BUT ONES THAT ARE COMPARE TO

BELIEVE THE THIRD WORLD IN

MISSISSIPPI AND ALABAMA AND

LOUISIANA.

SO THE COMPOSITE IS PULLING THAT

DOWN.

ALSO WHAT DOES THAT HAVE TO DO

WITH DISASTERS?

IT IS A REALLY GOOD -- IT'S A

GOOD MEASURE OF GOVERNANCE IS

THEIR CAPACITY TO RESPOND TO ANY

KIND OF CRISIS.

EVEN NATURAL DISASTERS.

THINK ABOUT KATRINA.

LOUISIANA DID GET -- MISSISSIPPI

DIDN'T GET THE HIT THAT

LOUISIANA DID BUT BOY, DID THEY

RECOVER MUCH QUICKER.

BECAUSE THEY HAD THAT.

SO THERE ARE -- THESE KINDS OF

THINGS DO TELL US.

AS A MATTER OF FACT, THE

ECONOMISTS BELIEVE IT OR NOT,

HOW MANY OF YOU HAVE SEEN THE

MAGAZINE THE ECONOMIST?

IT'S REALLY GREAT.

BUT ABOUT TEN YEARS AGO NOW,

THEY HAD A HALF PAGE ARTICLE

ABOUT URBAN DECAY.

AND HOW TO MEASURE URBAN DECAY.

THEY DIDN'T CHECK WITH ME AND I

DON'T THINK THEY CHECKED WITH

OTHER EPIDEMIOLOGISTS OR

SCIENTISTS OR WHATEVER BUT THEY

CAME UP WITH THE MOST SENSITIVE

INDICATOR FOR URBAN DECAY WAS

DENGY FEVER.

SO I READ THE ARTICLE, THEY WENT

THROUGH ALL SORTS OF

IMAGINATIONS.

-- MASS NATIONS.

WHEN THERE IS URBAN DECAY AND

THE GOVERNMENT HAS JUST SO MANY

FUNDS?

THEY STOP PICKING UP THE TRASH.

SO IT'S MUCH MORE TRASH AROUND,

STYROFOAM CUPS AND TIN CANS,

FILLED WITH WATER, GREAT

BREEDING FOR THE MOSQUITOES.

SO FOR THEM THIS IS THE MOST

SENSITIVE INDICATOR OF URBAN

DECAY.

WE TEND TO USE THE SAME THING.

HERE IS AN IMPORTANT SLIDE.

THE BLUE AIR ARIZONAIAS ARE

THOSE COUNTRIES WITH LITTLE OR

NO WATER SCARCITY.

I'M A PSYCHIATRIST ALSO, I CAN

READ YOUR MINDS BY THE WAY,

DENIAL IS OUR MOST POWERFUL

DEFENSE MECHANISM, SO WHEN

UNIMAGINABLE THINGS LIKE NUCLEAR

THREATS, JUST BLOCKED OUT.

STARTS AT ADOLESCENCE WHEN

THEY'RE CAUGHT DOING SOMETHING,

I DIDN'T DO IT.

SO IT'S WITH US ALL OUR LIFE.

BUT WE'RE NOT STRESSED WITH THAT

BUT YOU CAN SEE RED AREAS, AND

CHINA, ET CETERA, BUT ALSO

ECONOMIC WATER SCARCITY WHICH IS

ALL VERY IMPORTANT.

SO WHEN WE LOOK AT CHINA WATER

SCARCITY IN NOW TWO-THIRDS OF

THE CITIES.

ALSO IN RURAL AREAS BECAUSE

THEY'RE TRYING TO MOVE THE

INDUSTRY TO THE WEST BECAUSE YOU

SEE THE -- BUT THERE'S NOT

ENOUGH WATER TO DO COAL MINING.

THEY'RE DRILLING WELLS, TAKING

IT FROM LAKES BUT THE FARMERS

DON'T HAVE WATER SO THE

AGRICULTURE SYSTEM IS SUFFERING.

AND THEY'RE SEEING THE FARMER AT

THE TOP OF THE LIST BEFORE ARE

NOW SECOND CLASS CITIZENS.

80% OF THE CITIES HAVE NO SEWAGE

TREATMENT FACILITIES.

CAN YOU IMAGINE A CITY ANYWHERE

IN MORE CA THAT -- NORTH AMERICA

THAT DOESN'T?

ALL THIS WASTE FROM HOMES,

BUSINESSES, FACTORIES ET CETERA,

GO INTO LAKES PALMS AN RIVERS.

ALL THIS GOES, HOWEVER, EAST TO

SOUTH SEA, ALONG WITH A NUMBER

OF CHEMICALS, ET CETERA.

SO IT ALTERS THE ECOSYSTEM, NO

BACTERIA KILLED OFF, ALGAE GROW,

DIFFERENT PORE -- VIRUS, THERE

ARE THINGS IN THE WATER

SCIENTISTS SAY WE DON'T HAVE THE

CAPACITY TO RECOGNIZE WHAT THEY

ARE.

ARE THEY PATHOGENIC, ARE THEY

NOT.

SO THIS IS WHAT HAPPENS.

THIS IS ON THE SOUTH COAST.

SO CHEMICALS AND THE NEW

BACTERIAS, PROTOZOAN AND

EVERYTHING COME IN, THEY DIE OFF

OR KILL OFF EACH OTHER BUT ALGAE

IS ONE OF THESE THINGS THAT

GIVEN THE CHANCE, WE HAVE FUNGUS

ON OUR SKIN.

IF WE USE TOO MUCH SOAP, THINGS

LIKE THAT WE END UP GETTING A

RASH WHICH IS FUNGAL.

DIAPER RASH IS BIG THING.

JUST LET IT AIR DRY AND IT GOES

AWAY.

YOU DON'T HAVE TO DO ANYTHING

ELSE.

THIS IS MASSIVE GIANT ALGAE.

COVERED 83% OF THE COAST.

THE CHINESE ARMY ARE THE ONES

THAT ACTUALLY HANDLE DISASTERS,

THE ARMIES ACTUALLY HANDLE 70%

IN ASIAN COUNTRIES BUT THEY HAD

TO GET RID OF THIS, IT CAME BACK

AND THEY HAD TO GET RID OF IT

AGAIN.

THIS IS THE CONSEQUENCE OF

COMING FROM INLAND.

PRETTY BAD OBVIOUSLY.

THEN THERE'S (INAUDIBLE) RIGHT

CLOSE TO A FACTORY, A

LEAD-PRODUCING FACTORY SO WE

HAVE LEAD POISONING IN CHILDREN.

WHEN I WAS A RESIDENT IN YALE WE

HAD LEAD POISONING FROM KIDS

EATING OLD PAINT FROM THE OLD

HOMES.

THAT'S HOW UNHEARD OF BUT THE

HIGHEST RATES ARE IN CHINA

BECAUSE OF THOSE THINGS.

WE CAN IMAGINE WHAT ELSE IN

THERE.

FLOWER RIDES, SULFATES, ARSENIC.

AND THIS ALL COMES DOWN TO THE

-- I HOPE YOU CAN SEE THIS, YOU

CAN SEE THE CABANAS, THAT ARE

DENSE, DENSITY IS LIKE

PORNOGRAPHY, I DON'T KNOW HOW TO

DEFINE IT BUT I NOW IT WHEN I

SEE IT.

WHEN I HAVE AN AUDIENCE OF

PUBLIC HEALTH PEOPLE, NOT PUBLIC

HEALTH PEOPLE, THEY SEE GEE,

WHERE DO YOU GET A HOT DOG OR

HAMBURGER THERE.

BUT WHEN YOU HAVE A PUBLIC

HEALTH AUDIENCE THEY SAY WHERE

ARE THE TOILET?

YOU KNOW DAM WELL WHERE THE

TOILETS ARE.

SO FIRST OFF GETTING IN TO THAT

WATER THAT HAS HAD ALL THOSE

THINGS SENT FROM THE WEST PLUS

THIS.

YOU CAN UNDERSTAND WHY THEY HAD

THE EMERGING AND RE-EMERGING

DISEASES.

NOW THIS IS A POPULATION 6, 7

YEARS AGO WOULD NEVER THINK THEY

HAVE THE RIGHT OR OPPORTUNITY TO

GO TO A BEACH.

IN A LOT OF SITUATIONS WHETHER

POPULATIONS OR GOVERNMENTS, THEY

DOPE KNOW WHAT THEY DOPE KNOW.

SO THAT'S BACK TO THE NLM

ISSUES.

HOW DO WE INFORM THE POPULATION?

THIS IS ALL CHEMICALS IN THIS

PARTICULAR LAKE.

ESOPHAGEAL, STOMACH CANCERS,

BILE CANCERS ARE THE NUMBER ONE

CAUSE OF DEATH IN RURAL CHINA.

NO OTHER COUNTRY LIKE IT.

ALSO THIS IS IN BEIJING.

POLLUTION, 40% OF THE POLLUTION

DEATHS COME FROM CHINA, CAUSING

THE POLLUTION CERTAINLY CAUSING

HEAT WITH ASPHALT AND CONCRETE

WITH CHANGES IN TEMPERATURE AN

RAIN FALL.

SO IT'S WIDESPREAD THROUGHOUT

ALL OF CHINA AND YOU'LL SEE SOME

VIEWS FROM SPACE.

THIS PARTICULAR DAY, THE

POLLUTION LEVEL WAS ACCEPTABLE.

CHINA INTERNATIONAL STANDARDS,

THEY ALSO HAVE A DIFFERENCE

STANDARD FOR BEIJING THAN HONG

KONG BECAUSE THEY WANT THE

TOURISTS TO COME THERE.

COME IN MAY, AT LEAST YOU MIGHT

SEE BLUE SKIES BUT OTHERWISE

IT'S LIKE THIS.

I CAN'T IMAGINE THIS GUY FLYING

A KITE.

30-METERS UP, HE'S NOT GOING TO

SEE IT.

THIS IS TIENNAMAN SQUARE, THIS

IS WHAT THEY LIVE WITH EVERY

SINGLE DAY.

SO CERTAINLY IN THE LANSETT HAS

HAD -- LANSETT HAS GONE AND PUT

AN OFFICE IN BEIJING TO TRY TO

GET THE BEST SCIENCE AND HELP

THEM WRITE ARTICLES.

WHICH ARE COMING FROM CHINESE

SCIENTISTS.

IT'S INTERESTING THE GOVERNMENT

IS ALLOWING THIS TO HAPPEN.

BECAUSE THE DATA IS HORRIBLE.

SO WHERE DOES THIS COME FROM?

NOT JUST THEMSELVES BECAUSE THIS

STUFF CROSSES BORDER BUT

OBVIOUSLY THIS IS INDIA, THIS IS

THE TIBET PLATEAU, SEE THIS AREA

HERE, THAT'S THE SHENDU PLAINS

THE FOURTH LARGEST CITY IN

AGRICULTURAL AND ECONOMIC

CENTER.

BUT PREVAILING WINDS GO UP, HIT

THE TIBET PLATEAU AND GO AND

WHEN THEY GET TO CHINA IT'S

USUALLY THERE SO LET'S LOOK AT

THIS.

THESE ARE THIS IS INDIA,

BANGLADESH, SOUTHEAST ASIA, THE

CIRCLE AREA IS THE JENDU PLATEAU

INDIA IS ALL COLD.

SO ALL THIS BUTTS UP AGAINST THE

TIBETAN PLATEAU AND THEN AS A --

IT HITS THE PLAIN IN THAT

DIRECTION AND HERE IT IS, IF YOU

CAN SEE, THIS IS LIKE AN X RAY,

EVERYTHING THAT IS WHITE IS

REALLY COAL BLACK.

ALWAYS THE REVERSE LIKE GETTING

A CHEST X-RAY SO ALL THIS COAL

THAT'S HITTING THE TIBETAN

PLATEAU.

THIS SPOT HERE WHERE EVERYTHING

SEEMS TO STOP IS THE CHENDU

PLAIN BEFORE IT GOES FURTHER

INTO CHINA.

SO ENDS UP THERE.

THIS IS WHEN -- NOT ONLY THE

CHEN DU PLAIN BUT BECAUSE OF

INDUSTRY COVERING ALL CHINA,

TOTALLY UNPRECEDENTED.

WHEN I WAS IN CHENDU THERE WAS A

CLIMATE CHANGE MEETING, I WAS

ONE OF THE SPEAKERS BUT THIS IS

SPONSORED BY THE CDC IN ATLANTA,

THE C--C IN BEIJING AND SHANGHAI

CHINESE DONE SAY HEY, HUNDRED

LET'S GO VISIT CHENG DU.

THE CDC PEOPLE FROM SHANGHAI AND

BEIJING SAID OH, MY GOD.

THIS IS TERRIBLE.

WE WERE TOLD NOT TO LEAVE THE

HOTEL.

GREAT PLACE FOR CLIMATE CHANGE

MEETING.

THE SCIENTISTS STARTED

COMPLAINTS.

YOU GOT TO BE DOING SOMETHING

ABOUT THIS.

FINALLY A CHINESE SCIENTIST OR

OFFICIAL STOOD UP I ONLY AFRAID

THEY HAVE TO LIVE WIT, THERE WAS

NO CURE.

INDUSTRY IS GOING TO COME FIRST,

AND CHANGE THE ECONOMICS NOT

NECESSARILY HOW WELL YOU LIVE IN

LIFE.

EMERGENCIES OF SCARCITY IS

SOMETHING YOU NEED TO KNOW.

NOT MUCH WRITTEN STUFF LIKE

EVIDENCE IS REALLY GREAT BUT WE

WOULD NORMALLY JUDGE PUBLIC

HEALTH INFRASTRUCTURE AN

CAPACITY OF A COMPANY BASED ON

INFANT MORTALITY RATE, MATERNAL

MORTALITY RATE, ALL THOSE

SENSITIVITIES BUT INCREASINGLY,

COUNTRIES ARE BEING JUDGED BY

HOW MUCH ENERGY, WATER AND FOOD

THEY HAVE.

SO THAT'S DEFINING THE HEALTH

STATUS OF THE COUNTRY.

BECAUSE IT DOESN'T MAKE A

DIFFERENCE IF THEY DON'T HAVE

THAT, THEY'RE NOT SURVIVING.

SO RESOURCE COMPETITION IS

OCCURRING AND BECOMING

AGGRESSIVE.

I'LL GIVE AN EXAMPLE OF THAT IN

A MINUTE.

BUT THEY'RE CALLED

DISTRIBUTIONAL CONFLICTS BECAUSE

PEOPLE GET INJURED AND KILLED.

THEY SAY I HAVEN'T HEARD THAT.

THE REASON BEING, WE ONLY START

COUNTING DEATHS AS WAR WHEN OVER

A THOUSAND PER YEAR.

RIGHT NOW IT'S VERY, VERY

PREVALENT BUT IT HASN'T GONE

OVER THAT.

SO WE'RE NOT REALLY COUNTING

THOSE THINGS.

ESCALATING FOOD PRICES, LEADING

TO STUNTING.

DO YOU KNOW WHAT STUNTING IS?

WHEN YOU DON'T GET ENOUGH

PROTEIN IN YOUR FOOD IN THE

FIRST FIVE YEARS OF LIFE SO

YOU'RE SMALLER THAN NORMAL.

THAT'S CHRONIC MAL NUTRITION

VERSUS ACUTE MALNUTRITION THAT

MIGHT HAPPEN BECAUSE THERE'S A

WAR AND NO FOOD.

SO YOU CAN GET CHRONIC AND ACUTE

MALNUTRITION ON TOP OF EACH

OTHER, THAT'S A BAD SITUATION.

SO THAT WE ARE SEEING A CHANGE

IN THAT, THIS IS A KID WHO FIVE

YEARS OF AGE, SEE HOW LONG HIS

ARMS ARE, LOOKS LIKE AN AILIAN,

YOU CAN SIT UP RIGHT BECAUSE

IT'S CHRONIC AND PHYSIOLOGIC

SYSTEM HAS ADAPTED TO THAT.

ACUTE MALNUTRITION, HE WOULD

FAINT AND HAVE TO GO DOWN.

SO THIS IS WHAT CHRONIC LOOKS

LIKE.

THIS IS ABOUT A THREE-YEAR-OLD.

WE'RE REALLY STOPPING STUNTING

IN AFRICA.

THIS IS GUATEMALA.

YOU CAN FLY DOWN THERE NOW,

YOU'LL SEE GREAT OPEN AIR

MARKETS, GREAT FOOD, AVANT GUARD

CONDOS AN NIGHT LIFE.

BUT THE FOOD PRICES HAVE

INCREASED 83%.

LOOK AT THIS.

50% OF THE CHILDREN HAVE

STUNTING.

THAT IS SHAMEFUL.

IF YOU'RE A MAYAN, A VULNERABLE

GROUP LIKE THE AJ RIDGE NEOANY

-- ABORIGINES, IT'S 80%

STUNTING.

SO IT'S BECAUSE THEY CANNOT

AFFORD FOOD.

LAND GRABBING OCCURS.

THERE ARE COUNTRIES THAT HAVE A

LOT OF MONEY WHAT WE CALL IMPORT

DEPENDENT WHO RECOLLECTS ARE

THEY, CHINA, SOUTH KOREA, JAPAN,

RUSSIA AND A FOOD MIDDLE EASTERN

CONGRESS SO THEY DON'T HAVE

ENOUGH FRESHWATER, THEY DON'T

HAVE ENOUGH FOOD, INDUSTRY TO

BUY RESOURCES.

I WAS GIVING A SPEECH IN NEW

ZEALAND FROM THE AIRPORT AND THE

TAXI DRIVER WAS SHOWING ME ALL

OF NEW ZEALAND, SHOULD HAVE

SHOWED YOU ON THE MAP, IT'S A

BIODIVERSE AREA.

IT'S GREEN ALL THE TIME.

IT'S POINTED OUT ALL THESE

DIFFERENT LANDS AND ISLANDS THAT

THE JAPANESE HAVE PURCHASED.

AND UNFORTUNATELY IN HIS IGNORE

RANS, THEY'RE GOING TO GROW

RICE.

BUT THIS -- THEY'RE PUTTING THIS

STUFF IN THE BANK.

THERE ARE A LOT OF STORIES YOU

NEED TO HEAR ABOUT MADAGASCAR.

AND OFF THE COAST OF AFRICA.

BUT IT'S A DIRT POOR COUNTRY,

HIGH UNEMPLOYMENT, ET CETERA.

BUT THEY HAVE A LARGE, LARGE

BIORESERVE, AS A MATTER OF FACT,

ALL FORESTRY.

SOUTH KOREANS NEGOTIATED WITH

POLITICAL POWER IN MAD MADAGASCAR

FOR A 100 YEAR NO COST LEASE FOR

HALF OF ALL THE ARABLE LAND IN

THE COUNTRY.

THIS WAS IN THE PRESS PEOPLE

SAYING SHOULD THIS BE DONE.

ALL OF A SUDDEN THE POPULATION

THEY WERE COUNTING ON WOULD BE

OVER THEIR HEAD, ACTUALLY THERE

WAS A POLITICAL REVOLT.

THOUGH IT WAS SIGNED, THE FIRST

THING THEY DID IS NULLIFY THIS

CONTRACT.

THEIR STATEMENT IS REVEALING.

THAT'S NOT RICE, IT'S CORN,

THEIR MAIN FOOD TO ENSURE OUR

FOOD SECURITY, FOOD CAN BE A

WEAPON IN THIS WORLD.

THESE COUNTRIES ALREADY KNOW

THAT IT'S GOING TO BE THE FUTURE

WARS WILL BE OVER FOOD, ENERGY,

WATER.

MORE THAN ANYTHING ELSE.

VERY TOUGH.

IT'S A GOOD STORY.

FUTURE FOOD RELATED WARS

PROBABLY GOING TO OCCUR, THIS IS

CHINA, VIETNAM, WHERE I SPENT A

GOOD AMOUNT OF TIME, TAIWAN,

PHILIPPINES DOWN TO MALAYSIA.

THIS LINE IS WHAT'S CALLED THE

CHINA NINE DASH LINE SO YOU CAN

PULL IT UP ON THE WEB.

THIS IS HISTORICAL.

SO CHINA HAS A LEG UP.

THIS IS WHY CHINA CLAIMS THEY

OWN ALL THE FISHERIES SO YOU

HAVE HEARD ABOUT THE THE PAIR

SELL ISLANDS.

YOU'LL HAVE ISLANDS WHICH IS

NOTHING MORE THAN THIS BIG OUT

OF WATER.

WHETHER PHILIPPINES, ANOTHER

COUNTRY OR CHINA, THEY HAVE A

STRUCTURE WITH SOME GUNS.

JUST A YEAR AGO, THE PRESIDENT

IN VIETNAM MOBILIZED BECAUSE OF

CONFLICT WITH„i CHINA OVER THE

FISHING RIGHTS OFF THE COAST OF

VIETNAM.

THIS IS FOOD.

THEY CAN GET RID OF IT QUICKLY.

BUT SO THIS IS A PLACE OF

CONDITION TENSION AND WILL BE SO

KEEP YOUR EYES ON THAT FOR SURE.

IT IS A PROBLEM AREA.

MERGING INFECTIOUS DISEASE,

PLEASE UNDERSTAND IT IS A

WONDERFUL TIME TO BE A VIRUS, IT

REALLY IS.

VIRUSES MUTATE EVERY SECOND.

IN THE 1918s, THE VIRUS JUST

MUTATED ONCE AND THE MUTATION

WAS TO ALLOW THEM TO TRANSMIT

THEMSELVES TO HUMAN BEINGS.

AVIAN INFLUENZA MUTATED, ALL OF

YOU HAD AVIAN INFLUENZA OVER A

TWO MONTH PERIOD UNDER THE

INTERNATIONAL HEALTH REGULATION

WE WOULD GET LIVE VIRUS SAMPLES

FROM YOU AND THEY WOULD BE

GENETICALLY ALL DIMP BUT THEY

CONSTANTLY CHANGE.

THE INTERESTING THING ABOUT

AVIAN INFLUENZA, IT HAS NOT

CHANGED TO WHERE THERE WOULD BE

A HUMAN TO HUMAN TRANSMISSION.

COULD IT HAPPEN?

YES.

REMEMBER WHEN H1N1 HAPPENED IN

2009?

IN CHINA, JAPAN BOUND LET

ANYBODY?

NCI?

WHO IS THE MAJOR OF ONE OF THE

CITIES THAT WAS THERE AND THEY

QUARANTINED HIM.

THE THING ISES THEY HAVE AVIAN

INFLUENZA THERE AND IF THEY

BROUGHT IN H1N1 WHICH IS NOT

HIGH MORTALITY, VERY LOW AS A

MATTER OF FACT BUT USUALLY

TRANSMISSIBLE FROM HUMAN TO

HUMAN, IF THOSE TWO VIRUSES GOT

TOGETHER THEN YOU HAVE A HIGH

MR. CXFC TALLTY ONE THAT'S

EASILY TRANSMISSIBLE.

THAT'S WHAT THEY WERE DOING.

SO AS I SAID BEFORE, 70% OF THE

NEW RE-EMERGING DISEASES COME

FROM SOUTHEAST ASIA, DENSITY OF

POPULATION IN ANIMAL MARKETS AND

EASY THRAFL WE HAVEN'T HAD AND

AS I SAID THERE'S A 100 RESEARCH

STUDIES DONE FROM WHO IN ONE

MANUAL THAT JUST CAME OUT THIS

YEAR SHOWING THE (INDISCERNIBLE)

IS NOW GOING NORTH AND CAN BE

SEEN AND PRESENTING WITH FOOD

POISONING AND THINGS LIKE THAT. 

THE WHOLE WAY IN WHICH HOW

CHOLERA HAS GOTTEN AROUND THE

WORLD WITH HE CAN PLOR RATION,

WHATEVER, BUT NOW IS BEING

HELPED, WE BLAMED CHOLERA IN THE

CARIBBEAN BUT IT'S NEVER IN

HAITI, WE DONE KNOW WHY WHEN IT

WAS AN EPIDEMIC IN THE 1990s

HAITI WAS NOT HIT.

THEN OF COURSE IT WAS BLAMED ON

THE YOU KNOW TROOPS FROM NEPAL.

BUT I'M NOT SO SURE BECAUSE THEY

GOT FRIT THE WATER OFF THE COAST

THAT THIS WAS NOT ALSO PART OF

THE PROBLEM.

I HAD TO MAG A MASSIVE BUBONIC

PLAGUE IN VIETNAM IN '68.

THE IMPORTANT THING HERE IS

PEOPLE LOOK AT INFECTIOUS

DISEASES ENTIRELY DIFFERENT.

WE HAVE A POPULATION OF MONG THE

LARGEST ONE, 40,000 PEOPLE.

BUT THERE'S NOTHING IN THE

VOCABULARY AB INFECTIOUS

DISEASE.

HOW DO YOU INFORM THEM, HOW DO

YOU EDUCATE THEM, IF INDEED

THERE'S A PANDEMIC?

THERE'S NOTHING IN THERE ABOUT

INFECT SHUS DISEASE.

WE CAN TALK AB BACTERIA VIRUSES

AND HOW THINGS HAPPEN IN VIETNAM

BUT WHEN THERE WAS A PLAGUE OUT

BREAK ABOUT NINE YEARS AGO IN

AINDIA, 900,000 PEOPLE FLED INTO

CHINA, PAKISTAN, DOCTORS DID TOO

AND THEY THREATENED THE DOCTORS

WITH PRISON AND DEATH IF THEY

DON'T COME BACK.

ONLY 49 CASES.

THIS IS THE KIND OF THING THAT

THE (INAUDIBLE) IS HERE, THEY

PUT PASTE STUFF LYING AROUND TO

CONTAIN IT.

THIS IS PASTEY STUFF

UNFORTUNATELY KIDS ARE HIT WITH

CHINESE SO THEY SEE THE CHINESE

AS FOLLOWS OF MEDICINE AN ONION

FLAKES IN THE HAIR.

THIS KID WAS COMATOSE.

I SAID THIS IS THE SECOND DAY,

THIS IS MY FIFTH OR 6TH CASE OF

PLAGUE.

AND I SAID BOY I GOT TO TAKE

THIS PICTURE SO YOU CAN SEE --

AS SOON AS THE FLASH WENT OFF,

THE KID HAD A GRAND MAL

CONVULSION.

THE KIDS I TREAT HAD FEBRILE

CONVULSION, PROLONGED SO MORE

PROBABLY DUE TO TOXINS AND

BACTERIA.

BUT THEY PERCEIVE A SEIZURE AS

EVIL SPIRITS.

IF YOU HAVE WELL YOU HAVE GOOD

SPIRITS IF YOU'RE SICK YOU HAVE

EVIL SPIRITS.

SO THIS THING THAT I HAD IN MY

HAND PRODUCED THAT.

SO SHE RAN OUT.

WE HAD TO SEND THE MARINES AFTER

THEM.

SO SHE SAID SHE COME BACK BUT I

WAS NOT SUPPOSED TO SEE THE

CHILD.

I'M THE ONLY ONE SO I MANAGE IT

FROM A DISTANCE.

AND THE KID DID PERFECTLY FINE.ˇM>eIJ-HEAR
SAY THE KIND OF THING YOU

SEE THAT WE'RE DEALING WITH,

MOST OF THE DEVELOPING COUNTRIES

WHERE WE HAVE IT.

THAT IMPEDES OR ABILITY TO

CONTAIN THESE THINGS.

IF WE LOOK AT THE GLOBAL

DISTRIBUTION OF PLAGUE WHEN I

CAME BACK TO VIETNAM WE WERE

BEGINNING TO BUILD HOMES IN

SOUTHERN CALIFORNIA AND ARIZONA,

NEW MEXICO WHERE THEY HAVE

BEFORE.

BUT THEY HAD PLAGUE AMONG

WOODCHUCKS AN SQUIRRELS.

SQUIRRELS ARE RATS WITH FUZZY

TAILS BUT THEY WERE BUILDING

HOMES AND THEY HAD 50 CASES OF

HUMAN PLAGUE DURING THAT TIME SO

I WAS CONTACTED, BECAUSE I HAD

PUBLISHED AN ARTICLE ABOUT THE

EPIDEMIC, JUST IN CHILDREN, AND

SO THAT WAS BACK IN 1969.

EVERY STATE WEST OF MISSISSIPPI

HAD HUMAN OR ANIMAL CASE OF

PLAGUE SINCE THAT TIME.

YOU DON'T KNOW ABOUT IT, YOU

DON'T HEAR ABOUT I. THERE WAS IN

CHICAGO A RESEARCHER ON PLAGUE

WHO DIED IN THE LAST COUPLE OF

YEARS.

BUT YOU SEE IT IN INDIA, AND

PLACES LIKE THAT WHERE IT STILL

HAS THE AURA OF WHAT YOU SAW IN

THE SLIDE FROM VEET VIETNAM.

THE REASON WHY WE HAVE PUBLIC

HEALTH SURVEILLANCE AND GOOD

PUBLIC HEALTH INFRASTRUCTURE.

THEY TAKE CARE OF IT.

THAT'S NOT THE WAY IT IS.

PRETTY MUCH SOMETHING BECOMES AN

EMERGING OR WIDESPREAD DEPENDS

ON PUBLIC HEALTH INFRASTRUCTURE

AND SURVEILLANCE.

SO REMEMBER THE INTERNATIONAL

HEALTH REGULATIONS OR MAN --

WERE MANDATED AFTER SARKS.

REMEMBER WHEN SARS HAPPENED, WE

WERE GETTING RUMORS, ACTUALLY

THE FIRST PERSON OUT WAS A

CHINESE PHYSICIAN WHO CAME TO A

MEETING THAT'S ALL THEY COULD

TALK ABOUT.

SO PEOPLE STARTED SENDING

EMAILS, THINGS LIKE THAT.

EVERYBODY KNEW SOMETHING WAS

GOING ON, WHO, WORLD HEALTH

ORGANIZATION HAD JUST PASSED

THEY SAY TO THE COUNTRY WE'RE

HERE IF YOU NEED US.

CHINA HOE THERE'S NOTHING, DON'T

WORRY ABOUT IT.

FINALLY, THEY GAVE IN BECAUSE

THE RUMORS OF EVERYTHING WAS

GETTING -- THEY HAD SOMETHING

BAD IN CHINA.

SO THEY ALLOWED THE WHO TEAM TO

COME IN.

THEY LANDED IN BEIJING, SO WHEN

THEY LANDED THEY HAD THOUSANDS

OF PATIENTS WITH SARS IN THE

HOSPITALS BUT TOOK ALL BUT A

HANDFUL OF PATIENTS OUT.

PUT THEM IN BUSES, TAXIS, AND

AMBULANCES.

AND DROVE AROUND BEIJING FOR AS

LONG AS WHO TEAM WAS THERE.

SO THEY LEFT.

THAT THAT'S WHEN THE WORLD

HEALTH ALL MINISTERS OF HEALTH

ARE PART OF ASSEMBLY OF HEALTH

MINISTER WHICH IS IS PART OF THE

YOU KNOW.

THEY REALIZED WE HAVE A PROBLEM

SO THEY MET AND IN LESS THAN 24

HOURS, THEY TOOK WORLD

ORGANIZATION FROM A PASSIVE

ORGANIZATION AN GAVE TREMENDOUS

AUTHORITY TO GO INTO ANY

COUNTRY, IF YOU'RE A SIGNATORY

TO THE UN, THAT'S LIKE THE

INTERNATIONAL RED CROSS, GENEVA

CONVENTION, CHANGE SO THEY WENT

IN AN THIS IS WHEN WE STARTED

DOING IT.

WHO WAS LEARNING BUT LOOK WHAT

HAPPENED.

THEY QUARANTINED TORONTO.

ANYBODY KNOW WHY THEY

QUARANTINED TORONTO?

NOBODY HAD THE POWER TO

QUARANTINE SOMEPLACE LIKE

TORONTO.

ANYBODY HAVE ANY IDEA?

THIS IS WHERE MOST THE CASES

WERE IN CANADA.

BUT HOPS WENT SENDING

INFORMATION, WHERE THEY NEED IT,

DEATH, ILLNESS, TO THE THE

CENTRAL PUBLIC HEALTH CENTERS.

DOCTORS WERE SAYING I DON'T WANT

THE SHARE THIS WITH ANYBODY, I

WANT TO WRITE THIS UP.

WHO, WHAT WAS WHO AFTER'

RESPONSIBILITY TORONTO TO

ANOTHER COUNTRY.

THEY ESSENTIALLY PUNISHED

TORONTO BY QUASI QUARANTINE.

IT WENT ON FOR 14 WEEKS.

BUSINESS COMMUNITY SAID COME ON,

WE'RE LOSING TOURISM, TORONTO,

SARS THERE.

SO THEY LET UP AFTER 12 WEEKS

AND A WEEK LATER TWO WEEKS LATER

THEY HAD THE SECOND WAVE OF SARS

WHICH WAS ACTUALLY WORST THAN

THE FIRST.

SO THEY'RE STRONGER NOW, THEY

KNOW WHAT TO DO.

IT'S ACTUALLY, IT ACTUALLY HAS

WORKED WELL.

SO RESPONSE DIFFERENCE REALLY

DEPENDS ON PUBLIC HEALTH

INFRASTRUCTURE AN PROTECTIONS

THAT THEY PROVIDE.

NUCLEAR THREATS BEFORE WE GET TO

CONCLUSIONS BUT I TOLD YOU THE

COUNTRIES THAT HAVE STOPPED

THEIR NUCLEAR PLANTS.

YOU NEED TO KNOW THAT TWO-THIRDS

OF NUCLEAR POWER PLAINTS HAVE

MORE PEOPLE LIVING WITHIN

30-KILOMETERS WHICH IS THE

DISTANCE THEY REMOVE PEOPLE

SURROUNDING FUKISHIMA.

ALL OF THEM WOULD HAVE

POPULATION DENSITY.

THEY HAVE 111 MILLION PEOPLE

WITHIN 75 KILOMETERS.

THERE WAS A FRENCH REACTIVE WENT

OFF, CHERNOBYL WON.

THREE MILE ISLAND.

PEOPLE THINK OLE PLANTS, EVEN

CHERNOBYL WAS A NEW PLANT.

THE FUKISHIMA PLANT WAS SUPPOSED

TO SHUT DOWN TWO WEEKS AFTER

THIS HAPPENED.

SO THAT WAS -- MOST OF THE TIME,

WHEN ACCIDENTS OCCUR, THEY OCCUR

BECAUSE THERE'S LACK OF

TRAINING.

LACK OF QUALITY MAINTENANCE,

COMPETENCY OF OPERATORS.

WORK FORCE COMPLACENCY, NO

REGULATORY OVERSIGHT BUT THE JOB

WAS ABSOLUTELY BORING.

WE NOW HAVE BECAUSE MOST

RETURNED BUT WE HAVE 26,000

OPENINGS FOR PEOPLE TO WORK IN

THESE PLANTS.

WE'RE BUILDING TWO MORE.

TO CHALLENGE THE EMERGENCY

MEDICAL SYSTEM WHICH IS WHAT I

HAVE TO MENTION HERE, NOBODY IS

ADDRESSING.

MASS EVACUATIONS.

UTAH HAD A VIRTUAL ONE OF A

MILLION PEOPLE BUT DOESN'T MAKE

ANY DIFFERENCE.

TRIAGE PROTOCOLS.

ELECTED MEMBER OF THE INSTITUTE

OF MEDICINE, WE DID HAVE ONE A

NUCLEAR RETREE I CAN'T IMAGINE

COUPLE OF YEARS AGO.

I WASN'T HAPPY WITH IT BECAUSE

MILLION TEAR TRAUMA LED, THAT'S

NOT THE WAY IT IS WITH THESE

THINGS.

MASS SHELTERING, AND IN JAPAN

ALL THESE ELDERLY JAPANESE

PEOPLE, YOU KNOW WHEN YOU'RE

ELDERLY YOU WALK EVERY DAY, RICE

BICYCLES, THEY'RE HEALTHY AS CAN

BE.

THEY HAVE GONE INTO THEIR

SHELTERS AND THERE'S BEEN AN

ENDEMIC OF DEEP VEIN THROMBOSIS

FROM PULMONARY EMBOLI, THEY'RE

DYING LIKE FLIES BECAUSE LIKE

THE URBANIZATION AND ISLANDS.

THEY'RE HAVING PULMONARY EMBOLI

ALSO IF YOU CHANGE YOUR ACTIVITY

SO MASS SHELTERING, ALL THESE

THINGS WE NEED TO DO REAL BIG

RESEARCH ON.

BUT ALSO WHEN YOU'RE WORKER WE

NEED TO TAKE BLOOD FROM YOU IN

ORDER TO THEN HAVE -- PROVIDE

STEM CELL TRANSFUSIONS IF INDEED

YOU GET RADIATION EXPOSURE

THAT'S NOT DONE.

WE JUST PUBLISHED AN ARTICLE

LOOKING AT THE NUCLEAR THREAT IN

THE MIDDLE L EAST.

BETWEEN IRAN AND ISRAEL.

WHAT'S INTERESTING IS WE CENTER

OFF TO A -- SEND TO THE JOURNAL

I'M ON THE EDITORIAL BOARD.

SORT OF GO THROUGH COUNTER

REVIEW PROCESS.

I DON'T KNOW HOW IT HAPPENED, I

DON'T WANT TO KNOW.

THE CIAs, NO YOU CAN'T PUBLISH

THIS.

WE SAID TO ANOTHER JOURNAL THAT

WAS ACCEPTED THAT DAY THE BIG

THING ABOUT THIS IS NOT ONLY DO

THE PUBLIC NOT KNOW ABOUT, THIS

IS ONE OF THESE THINGS THAT IS

UNIMAGINABLE.

WHEN YOU LOOK AT THE

INTERNATIONAL NEGOTIATIONS ARE

GOING ON, THE HEALTH

CONSEQUENCES ARE NEVER MENTIONED

IF THERE WAS AN EXCHANGE A

NUCLEAR WEAPON IN ISRAEL, MORE

MUSLIMS WOULD BE KILLED YOU

WOULDN'T GO TO LEBANON, JORDAN,

ISRAEL AT ALL FOR 40 PLUS YEARS.

PEOPLE NEED TO KNOW THAT.

IT'S NOT SOMETHING THAT -- SO

CONCLUSIONS, FIRST OFF

HUMANITARIAN ASSISTANCE IS

MOVING FROM RURAL THE TO URBAN

AREAS.

BUT WHAT WE'RE HAVING IS

INCREASED HAVE AND HAVE NOT

POPULATION.

MUCH MORE SINCE 1950s WHEN

THERE WAS INTENT TO TRY TO GET

EVERYTHING COUNTRY IN GOOD STATE

WITH WOMEN AN CHILDREN BY THE

YEAR 2000.

HUMANITARIAN COMMUNITY SNOT

PREPARED TO PROTECT THE URBAN

HEALTH.

WHERE WOULD YOU START BUILDING

FOR -- ALL THAT WHEN DOWN,

ELECTRICITY.

CERTAINLY NOT PAIRED TO HANDLED

THE EMERGENCIES OF SCARCITY

BECAUSE AGAIN, IT'S ALL ONE

COUNTRY THOSE PURCHASING

RESOURCES AN WHETHER THEY

ACTUALLY HAVE A RIGHT TO SURVIVE

RATHER THAN ETCH THE COUNTRY

GETTING THE RESOURCES FROM.

ALL SORTS OF ETHICAL, MORAL AND

OTHER ISSUES NOT COVERED UNDER

INTERNATIONAL LAW.

WE'RE STILL WAY BACK AT THE

GENEVA CONVENTION WHICH IS

NOBODY IS RECOGNIZING NOW.

IT WASN'T RECOGNIZED IN THE

RECOGNIZED IN THE IRAQ WAR WHICH

WAS A VIOLATION.

SO WE DON'T HAVE MUCH TO FALL

BACK ON BUT WE HAVE TO STOP

CELEBRATING CHINA.

I HAVE HEARD SO MANY POLITICIANS

THIS PAST YEAR SAY WE HAVE GOT

TO BE MORE LIKE CHINA.

WHAT THAT TRANSLATES INTO IS

THAT THEY WANT LESS REGULATIONS.

I THINK YOU HAVE SEEN WHAT

HAPPENS WHEN YOU HAVE LESS

REGULATIONS.

THINK WE'RE AT THE TIPPING POINT

IN A LOT OF ENVIRONMENTAL

THINGS.

BUT AGAIN, THE PEOPLE DON'T

KNOW.

SURPRISE HOW MANY PEOPLE WANT TO

SHOW THESE SLIDES, I DIDN'T KNOW

IT WAS THAT BAD.

BUT THAT'S WHAT HAPPENS.

NO WE DON'T HAVE TO BE MORE LIKE

CHINA.

WE DON'T.

WHAT OUR -- WHEN OUR ECONOMY WAS

GOOD, WE WEREN'T LIKE THAT.

BUT AGAIN, IMPORTANTLY FUTURE

CRISES ARE GOING TO BE SOLVED BY

GLOBAL HEALTH INITIATIVES, NOT

INDIVIDUAL NATION STATES ALONE.

PUSH THAT AT COCKTAIL PARTIES IF

YOU IF

GREATEST CHALLENGES AT THE LOCAL

COMMUNITY LEVEL DISPARITIES

BETWEEN EQUITY AN PUBLIC HEALTH

CAPACITIES.

TO HIRE THE LAST ONES THAT WILL

GET FUNDING.

SO YOU KNOW THE DISASTER CYCLE

PREVENTION PREPAREDNESS,

RESPONSE AN RECOVERY.

I THINK EVERYBODY HEARD THAT,

THAT'S BASIS AND ALSO WITHIN

STRATEGIC TACTICAL AND WILLCAL

LEVEL THINGS BUT IT'S A TOP-DOWN

KIND OF THING.

AND DURING THE PANDEMIC THEY DID

STUDIES AFTERWARDS, ALL

CONTINENTS OF THE WORLD WERE

THERE WAS A SARS THREAT.

THE STRATEGIC TACTICAL PLANS

WERE EXCELLENT, BUT EVERYTHING

FALL APART AT LOCAL LEVEL DIDN'T

MAKE ANY DIFFERENCE HOW GOOD

THEY WERE.

AND IN AUSTRALIA, GPs, BIG

PRIMARY HEALTHCARE, THE GBs

OWN MEDICINE THERE AND THEY'RE

STRONG AN EVERYBODY HAS THEIR

OWN GP SO THEY WON'T SHOW UP IN

EMERGENCY ROOM WITHOUT GP

TELLING HIM TO GO.

BUT THEY, THE GP SAID IT WAS AN

ENDEMIC FAILURE OF THE

AUSTRALIAN EMERGENCY MANAGEMENT

SYSTEM TO KEEP THEM BOTH

INFORMED AND WITH RESOURCES THEY

NEEDED LIKE ANTIVIRALS.

BUT INFORMED.

SO WHAT'S HAPPENING IN AUSTRALIA

IS THEY'RE CHANGING EVERYTHING,

FROM THE BOTTOM UP, THE IMMUNITY

IS IN THE DRIVER'S SEAT.

SO ON THE EAST COAST THERE'S

FLOODING, WHATEVER, THEY CALL IN

WITH RESOURCES AND REALIZE OH,

GOD, IT'S NOT THE RIGHT ONES.

SE THEY PUT THAT IN THE LAB OF

THE COMMUNITY TO DO ASSESSMENTS

AND THAT INFORMATION GOES UP TO

THE REGION, THEY DECIDE ON WHAT

RESOURCES ARE NEEDED, ET CETERA,

ET CETERA.

SO IT'S PUTTING THE COMMUNITY.

COMMUNITIES REALLY VERY GOOD.

ONE OF THE MISTAKES THAT WE MAKE

IS TO ASSUME THAT THERE'S NO

EXPERTISE AT THE COMMUNITY

LEVEL.

LIKE THE OTHER ONE, WHAT THE

COMMUNITY WILL ASK FOR IS GIVE

US INFORMATION.

IF THAT ISN'T A ROLE FOR THE

MEDICAL SPECIALISTS, LIBRARIAN

SPECIAL iISTS, I DON'T KNOW

WHAT.

WE HAVE 2,800 PUBLIC HEALTH

DEPARTMENTS IN THE UNITED

STATES, UNDERFUNDED,

UNDERRESOURCED.

WHERE DO U THEY GET THEIR

INFORMATION?

CDC AND THINGS LIKE THAT, BUT

WHAT IS RELEVANT TO THE

COMMUNITY AT THE TIME SO THERE'S

A BIG, BIG NEED FOR WHAT YOU

GUYS ARE DO L.

ICS EXPAND ON THAT A LOT BUT

MELINDA MOORE WITH CDC, NOW AT

RAND LOOKED AT TEN COUNTRY WHOSE

WENT THROUGH THESE MASSIVE

DISASTERS AND LOOKED AT

COMMUNITY RESILIENCE AND WHAT WE

COULD LEARN IN THE UNITED

STATES.

THE ELEMENTS OF COMMUNITY

RESILIENCE NEEDED ARE COMMUNITY

EDUCATION.

YOU GUYS USE THAT ARTICLE, I

THINK I SENT IT TO YOU,

COMMUNITY EMPOWERMENT, YOU DON'T

BYPASS THE COMMUNITY.

PRACTICE SOCIAL NETWORKS,

FAMILIARITY WITH LOCAL SERVICES

WHICH THE GOVERNMENT AGENCIES

DON'T KNOW.

JOPLIN WILL TELL YOU WHEN IT

HAPPENED, WE DIDN'T HAVE THE

FEDERAL GOVERNMENT WE TOOK CARE

OF OURSELVES.

WHEN YOU NEED TO KNOW IT WAS

2006 WHEN THE WHITE HOUSE CAME

OUT ANTIVIRUS AND SAYING THE

FEDERAL GOVERNMENT IS ONLY AN

ADVISORY ROLE.

IT'S UP TO THE COMMUNITIES.

PROBABLY OUT ON FRIDAY WHEN

NOBODY KNOWS BUT MOST

COMMUNITIES OF COUNTRY THINK THE

FEDERAL GOVERNMENT WILL COME ON

A WHITE HORSE TO SAVE THEM.

THAT'S NOT GOING TO HAPPEN.

MUCH MORE COMMUNITY PREPARED.

THE CONCLUSIONS ALSO IT'S FALSE

THAT BETTER SCIENTIFIC

INFORMATION WHICH IS OUT THERE,

LEADS TO BETTER DECISIONS AMONG

POLITICAL DECISION MAKERS.

WHY?

WELL, CERTAINLY THEY ARE NOT

LOOKING AT THE BENEFITS OF

RESEARCH, BY THAT TIME THEY'RE

MORE CONCERNED WITH SOLVING THE

SOCIETAL PROBLEMS BECAUSE THAT'S

WHAT THE CONSTITUENTS ARE

COMPLAINING ABOUT.

SO -- BUT THE REALITY IS THAT

THE RELATIONSHIP BETWEEN

RESEARCH SCIENTISTS AN POLITICAL

DECISION MAKERS IS THE WORST

IT'S EVER BEEN.

AND ARTICLES ARE WRITTEN HOW BAD

IT IS IN FRANCE, ITALY, UK, I

WORK WITH THE UK ALLOT, THEY SAY

WE'RE NOT DOING ANY RESEARCH ANY

MORE.

POLITICAL DECISIONS ESPECIALLY

WHEN THERE'S US ASERTY.

YOU'RE NOT GOING TO GET FUNNED

NEW SATELLITES NEED REDIRECT

EXAMINATION -- TO FIGURE OUT

CLIMATE CHANGE BUT ALSO WEATHER

INFORMATION IT'S DROPPED BY A

THIRD AND WILL CONTINUE TO DROP

IN THE NEXT FIVE YEARS.

POLITICIANS LISTEN TO

ECONOMISTS.

THEY DON'T LISTEN TO SCIENTISTS.

THEY DO NOT READ SCIENTIFIC JURY

ROOMS AND THEY'RE THREATENED BY

THEM.

SCIENTISTS DON'T MAKE GOOD

LOBBYISTS.

THERE WAS AN ARTICLE IN I THINK

NATURE THAT -- NO PUN INTENDED

WHEN THEY WROTE IT.

THEY SAID SCIENTIST SHOULD JOIN

THE REPUBLICAN PARTY, AT LEAST

GET INTO IT, KNOW THE ENEMY.

I MEAN, IT'S OUT THERE, FOR YOU

THE READ.

IF YOU WANT TO.

BUT CONGRESS, THE OTHER THING

WHEN I TALK MULTI-DISCIPLINARY,

WHEN I ASK PEOPLE LIKE YOU TO DO

SEARCHES YOU GIVE ME WHAT'S ON

MED LINE, PUBMED, I WANT SOCIAL

SCIENCES, I WANT POLITICAL

SCIENCE, CIVIL ENGINEERING, I

WANT LAW.

BECAUSE SOLUTIONS ARE REALLY

CONTAINED WITH THOSE THINGS SO

SEARCHES HAVE TO BE WIDER.

RESEARCHERS KNEW THIS WITH

SOCIAL SCIENCE AND THAT'S

IMPORTANT TO POLITICAL DECISION

MAKERS BUT THEY THEN EXPEL FROM

THE PROCESS.

ADS FUNDING DROPPED.  THERE'S

COLLABORATIVE CITIZEN SCIENCE

WHICH IS THE INFORMATION BUT

ALSO USING THE COMMUNITY AS

RESEARCH, BASED ON FALSE

SCIENCE, WE CAN TAKE CARE OF OUR

OWN PROBLEMS, THAT'S FALSE.

BOTH POLITICAL POWERS

UNFORTUNATELY PARTIES AS OF

TODAY REFUSE TO DEBATE SCIENCE

ON TV.

THAT'S A PRETTY BAD COMMENTARY.

POLITICAL IGNORANCE OF SCIENCE I

FEEL AND OTHERS HAVE WRITTEN

ABOUT THIS, THERE'S A LOT OF

EDITORIAL IS A FAILURE OF

GOVERNANCE.

AND LIZ (INAUDIBLE) WHO WAS A

VISITING LECTURER, BUT SHE'S IN

A BALLET DANCER VISITING HARVARD

BUT THIS QUOTE ASKS A BIG ENOUGH

QUESTION AND YOU NEED MORE THAN

ONE DISCIPLINE TO ANSWER.

SO I THINK THAT MAYBE -- YOU

CAN'T DO WHAT YOU NEED TO DO

FROM THE COMMUNITY OR FOR

POLITICIANS OR ANYTHING UNTIL

QUITE HONESTLY YOU START

STRETCHING OUT FROM JUST SCIENCE

AN MED LINE AND PUBMED.

AM I SCARING THE LIVING DAY

LIGHTS OUT OF YOU.

BUT YOU NEED TO KNOW THAT.

LAST SLIDE, GLOBAL HEALTH MUST

BE -- TAKE PRECEDENCE OVER

POLITICS.

WHAT A DREAMER I AM, AND NOT

DRIVEN BY POLITICAL MOTIVES BUT

PUBLIC HEALTH MERGES THE COMMON

THREAD WE HAVE BEEN TALKING

ABOUT MUST BE SEEN AS A

STRATEGIC SECURE INITIATIVE, I

HAVE SEEN ONE OTHER ARTICLE THAT

USES THE SAME WORDS SOY THINK

THEY GOT -- TOOK IT FROM AN

ARTICLE, THOUGH THEY DIDN'T

REFERENCE IT.

THAT DESERVES NEW PROFESSIONALS.

NEW PROFESSIONALS.

AND ALONG THAT, INFORMATION IS

EXTREMELY IMPORTANT.

INTERNATIONAL MONITORING SYSTEM

AND COMMUNITY FOCUS.

LAST SLIDE, BUSINESS WILL GET

INVOLVED AND GO THE SIDNEY

AIRPORT AND YOU CAN BUY PRIVATE

CHANGE CHOCOLATE.

IT'S THEIR HUMOR.

THAT'S BEEN AROUND THREE OROpr4+„ FOUR

YEARS.

SO THAT'S IT.

I DON'T KNOW WHETHER YOU HAVE

QUESTIONS OR WE HAVE TIME FOR

QUESTIONS?

[APPLAUSE]

>> DOES ANYBODY HAVE QUESTIONS?

(OFF MIC)

>> THANK YOU.

>> CAN BEGIN TO EXPRESS OUR

GRATITUDE.

>> I HOPE SO.

(OFF MIC)

>> THANK YOU.

PSYCHIATRISTS ARE SUPPOSED TO

MAKE PEOPLE ANXIOUS, RIGHT?

THEN THEY GET BETTER.

>> ANYBODY?

DID YOU LEARN ANYTHING?

ARE YOU ANGRY?

(OFF MIC)

>> BUT IT'S DOABLE.

BUT IF WE CAN START DOING SOME

OF THESE THINGS BY ONE NATION

STATE BUT GLOBALLY, I MEAN

THAT'S THE -- YES, MA'AM.

(OFF MIC)

>> I THINK ONE OF THE BIG THINGS

OUT OF THIS, THAT I HEARD BEFORE

AND EXPERIENCED BEFORE IS THE

ISSUE OF POLITICAL BOUNDARIES,

POLITICAL WILL, POLITICAL

EVERYTHING IN BEING THE CONTACT

IN WHICH WE NEED TO WORK.

AND THERE WAS A WHOLE LOT ABOUT

THE FACT THAT WE NEED TO DEAL

WITH THAT BUT HOW SO IT'S NOT

ABOUT THE ONE NATION STATE BUT

EVERYTHING HAS TO DO WB THE

CONTEXT OF PEOPLE WHO MAYBE

DON'T UNDERSTAND WHAT WE'RE

TRYING TO DO OR WHY OR HOW OR

SEE THE VALUE AND FUNDING IN IT.

SO WE HAVE GOT -- YOU'RE LOOKING

FOR NEW PROFESSIONALS.

THEY'RE COMING OUT OF SCHOOL,

THEY'RE BROKE, THERE'S NO MONEY

TO BE MADE, THERE'S NO -- SO

IT'S LIKE ALL THESE OTHER

ISSUES, WHERE DO WE START?

HOW DO YOU BEGIN?

>> IT IS IMPORTANT.

GLAD YOU MENTIONED THAT BECAUSE

I WANT TO TELL YOU A LITTLE BIT

ABOUT AFGHANISTAN IN THAT

REGARD.

BUT IT'S INTERESTING, AT JOHNS

HOPKINS, HE DID NOT KNOW THIS,

EXCLUSIVE PUBLIC HEALTH THEIR

DUTY IS TO TRAIN PEOPLE TO WORK

IN PUBLIC HEALTH DEPARTMENTS.

A LOT OF PEOPLE ARE E RETIRED.

THE ENTERNATIONAL PROGRAM IS

PRIMARILY HARVARD, HOPKINS,

COLUMBIA, A LOT OF PEOPLE IN THE

INTERNATIONAL PROGRAMS THERE.

BUT JOHNS HOPKINS DID NOT KNOW

THIS BUT IT HAPPENEDDED ABOUT A

DECADE AGO.

I THINK YOU REMEMBER.

ALL OF A SUDDEN THEY REALIZED

THEY HAD ENGINEERS, ATTORNEYS,

ECONOMISTS GOING NOR THEIR MPH

BECAUSE THEY KNEW THERE WERE A

PUBLIC HEALTH COMPONENT TO THEIR

PROFESSION.

WE ALSO HAVE A POPULATION OF

YOUNG PEOPLE WHO THEY MAY NOT BE

TALKING TO YOU ABOUT IT BUT THEY

KNOW THEIR PRODUCTIVE YEARS ARE

GOING TO BE DOING SOMETHING

THAT'S GLOBAL A DECADE AGO WE

HAD 100,000 PEOPLE IN THE WORLD

WHO CALLED THEM AND SAID MY

PROFESSIONAL CAREER IS

HUMANITARIAN MANAGER HEALTHCARE

PROVIDER, A LOT OF PEOPLE TAKING

GLOBAL HEALTH PROGRAMS GETTING

MASTER'S DEGREES AND HAVING

TROUBLE GETTING JOBS.

I KNOW, REALLY SAD FIRST START

COMING TOGETHER BUT YOUR

GENERATION DOESN'T HAVE A

POLITICAL VOICE, THERE'S A BIG

PART OF IT SO WHEN SOME PEOPLE

DIE OFF, YOU WANT ME TO NAME

NAMES?

THAT YOUNG POPULATION IF THEY DO

HAVE POLITICAL POWER WE'LL MOVE

THOSE DIRECTIONS, FORCED ON US

IN DRCHT WAY WHICH IS IT IS NOW,

THE FACT THAT COUNCIL OF FOREIGN

RELATIONS HAD THE FIRST MEETING,

DEAL WITH IT WHEN MOST HAVE BEEN

DEALING FOR A LONG TIME, IT WAS

AMAZING HOW AS NEOFIGHTS THEY

WERE REINVENTING THE WORLD.

SO WE KNOW WHAT STATUS THEY'RE

AT AND THEY'RE NOT GOING TO BE

OUR DECISION MAKERS.

UNTIL THEY KNOW A HECK OF A LOT

MORE SO THE KNOWLEDGE BASE IS

GOING TO BE THERE.

THEY'VE GOT TO GET THEMSELVES

OUT OF THAT NATION STATE TO

REALLY THINK GLOBALLY.

I'M LONG DEAD BEFORE THAT WILL

REALLY HAPPEN BUT IT WILL BE

YOUR GENERATION TO PUSH THOSE

BUTTONS I THINK.

I'M OPTIMISTIC ABOUT THAT.

BECAUSE THERE'S TOO MANY OF YOU

THAT KNOW THOUGH THINGS.

I THINK THERE'S ONE BACK THERE.

YES.

>> JUST TO FOLLOW THAT QUESTION,

EVERY ONE OF YOUR SUMMARY

STATEMENTS BASICALLY SUPPORTS IN

MY VIEW THE EMERGING CONCEPT OF

HUMANITARIAN OR DISASTER RELIEF

AND SUSTAINABLE,:i$qQkELOPMENT,

COMING TOGETHER.

WE'RE LOOKING AT INTER

DISCIPLINARY I HAVE OFTEN

QUOTED YOU WITH ATHRI BIEWTION,

YOUR STATEMENT THAT WE HAVE TO

LEARN TO RESPONSIBLY TRESPASS

PROFESSIONAL BOUNDARIES.

NOT ONLY IN TERMS OF ACADEMIA,

BEING STOVE PIPED IN THE

EPIDEMIOLOGY DEPARTMENT

ENGINEERING ET CETERA, NO REAL

BORL PROBLEM OCCURS IN A VACUUM.

'S MULTI-DISCIPLINARY:  HOW DO

WE NOT ONLY MASSAGE OR INFLUENCE

ACADEMIA BUT THE WAY WE LOOK AT

DOING BUSINESS?

IN THE UNITED STATES GOVERNMENT

WE HAVE OFFICE OF FOREIGN

DISASTER ASSISTANCE, WE HAVE THE

SUSTAINABLE DEVELOPMENT SIDE.

BUT THERE'S A DIVIDE FILLED WITH

CROCODILES IN BETWEEN,

BUREAUCRATICALLY AND FINANCIALLY

SPEAKING.

HOW DO WE REJIGGER WHAT WE DO TO

ADDRESS THESE FUTURE PROBLEM?

HAVING BEEN A DIP MAT, OFDA

WORKS WITH ACUTE MEDS SO IT'S

NOT REAL LONG TERM PLANNING.

AND MONEYS ARE DECREASING SO

THOSE THINGS THAT USED TO BE

DONE ARE NO LONGER BEING DONE.

WE JUST PUBLISHED AN ARTICLE NNT

LAND SET.

IT WROTE IT ON A SUNDAY IN

HAWAII.

I SENT TO IT THE LANSETT AND BY

THE TIME I WOKE THE NEXT MORNING

I GOT AN EMAIL SAYING THERE'S

BEEN ACCEPTED WITHOUT -- THAT'S

NEVER HAPPENED BEFORE.

NEVER HAPPENED AGAIN BUT THEY

PUBLISHED IT ONLINE.

IT WAS CALLING FOR A GLOBAL

AUTHORITY FOR -- SO TAKING THE

INTERNATIONAL HEALTH REGULATIONS

AND MOVING IT SO FOR THE HAITIS

AND THE OTHER THINGS.

DEPARTMENT OF HUMANITARIAN

AFFAIRSCH UNDERRESOURCED,

UNDERFUNDED SO WHEN HAITI

HAPPENS, THE U.S. AN EVERYBODY

JUMPS SAYING SEE YOU'RE NOT

PREPARED BUT THEY DON'T HAVE

RESOURCES.  THE U.S. SEES THIS

AS BUSINESS.

WHEN THEY GO THE DISASTERS

WHETHER TSUNAMI OR HAITI.

BUSINESS MAKE MONEY IT'S

DIFFICULT TO SEE BUT WE NEED A

GLOBAL AUTHORITY.

AB ULTRA LIKE I'LL BE GLAD TO

SEND YOU THAT ARTICLE.

LANSETT THOUGHT IT WAS IMPORTANT

TO PUT IT OUT THERE.

WE HAD NO RESPONSES FROM IT.

PEOPLE WERE SCARED.

SO WE WERE NOT GOING TO GET

THERE, UNTIL WE HAVE SOME GLOBAL

AUTHORITY OF CRISIS.

WITH ALL THE RESOURCES THAT WE

GET TO START DOING STRATEGIC

PLANS.

OTHERWISE WE'LL REMAIN IN THE

NAIX STATE LEVEL.

I DON'T KNOW.

I REALLY DONE.

EVEN WITH THE INTERNATIONAL

HEALTH REGULATIONS THOUGH WE GET

BETTER SURVEILLANCE SINCE WE

HAVEN'T HAD A PANDEMIC IN A

WHILE, SOME OF THE DEVELOPING

COUNTRIES HAVE STOPPED DOING

SURVEILLANCE.

THAT'S WHERE THEY BENEFIT

DEVELOPING COUNTRIES BUT WE CAN

STILL DO BETTER SURVEILLANCE

THAN PRIOR TO THAT POINT.

BUT IT'S UPHILL BATTLE BUT WE

NEED A GLOBAL AUTHORITY OF

CRISIS.

THERE'S NO GETTING AWAY.

NO GETTING AWAY FROM IT.

WE HAVE TO KEEP -- WE HAVE TO

GIVE MUSCLE TO THE YOU KNOW.

IT'S -- UN.

IT HAS TO COME FROM A UN AGENCY

WHEN THERE'S AN ULTRA LIGHT

AGENCY.

BUT THE FACT THAT PEOPLE ARE --

DON'T HAVE THE GUTS TO BRING IT

UP, I DON'T KNOW.

I DON'T KNOW HOW IT'S DONE.

THAT'S MY ANSWER TO IT.

I CAN'T THINK OF ANY OTHER WAY

AROUND IT.

>> THANK YOU.

GOING BACK TO THE PREVIOUS

QUESTION, ABOUT PROFESSIONAL

OPPORTUNITIES AND YOUNG PEOPLE

GETTING INVOLVED IN DISASTER

MANAGEMENT HUMANITARIAN

ASSISTANCE, THOSE OF US OF A

CERTAIN AGE WHO GOT INVOLVED

TYPICALLY GOT -- WERE

PROFESSIONALS IN SOME OTHER AREA

AND HAD EXPERIENCE REGARDLESS

THE DISCIPLINE, HAD AN

EXPERIENCE WITH A DISASTER AND

HE CAME ENGAGED.

THIS WHOLE IDEA NOW YOU HAVE

IDENTIFIED THIS AS THE DECADE OF

THE COMMUNITY AND THERE'S A LOT

OF COMMUNITY EMPOWERMENT, THAT'S

REALLY THE OPEN FERTILE FIELD

FOR YOUNG PEOPLE TO GET

INVOLVED.

THE IDEA EXPECTING THAT YOU GO

TO A GRADUATE SCHOOL AND GOING

TO BE PLACED IMMEDIATELY IN SOME

WONDERFUL EXPERIENCE AROUND THE

WORLD IS -- HAS NEVER P BEEN THE

WAY TO GO ABOUT -- IT'S NEVER

BEEN THE ACTUAL WAY MOST PEOPLE

GOT INVOLVED.

AND THE IDEA OF GETTING INVOLVED

IN THE COMMUNITY WHERE THERE ARE

OPPORTUNITIES, WHERE EXPERIENCES

CAN BE HAD AND WHERE THERE'S A

NEED HOPEFULLY WE DON'T USE THIS

COMMUNITY DECADE AS JUST A WAY

TO DEFER RESPONSIBILITY TO

ALREADY CHALLENGED STATES AND

LOCAL COMMUNITIES.

>> I GAVE A TALK ON THE DECADE

COMMUNITY ABOUT THREE WEEKS AGO

TO THE NATIONAL ACADEMY OF

SCIENCES.

AND THERE WERE FEMA PEOPLE THERE

AND OTHERS.

FEMA PEOPLE TALK AND SAY THEY

USED TO BE RESPONSE BUT NOW

GIVING -- THERE'S TIME LIMIT

WITH THE FACT MAYBE WE SHOULD

HAVE MORE RESPONSE KIND OF

CATEGORY BUT IT'S LEFT UP TO A

LOT OF PEOPLE CALL ME, WRITE ME.

HAITI WAS AN ABSOLUTE DEBACLE.

MAJORITY OF PEOPLE WERE UNDER

AGE 30, THEIR FIRST EVENT.

BETWEEN 1 AN 45% YOU HAVE

PHYSICIANS AND NURS SKILLS,

THERE'S A SEPARATE SET OF CORE

COMPETENCIES RELATED TO WORKING

AS A TEAM, WORKING IN A

HUMANITARIAN SETTING WHICH ARE

TOTALLY DIFFERENT.

AND TRAIN BOTH O OF THOSE

BECOMES NEW DISCIPLINES.

WE HAVE WALKED TOGETHER ALL 12

HUMANITARIAN ACADEMIC AFFILIATED

TRAINING CENTERS AND

HUMANITARIAN HEALTH IN NORTH

AMERICA, THREE FROM CANADA

TOGETHER.

FORMING PROFESSIONAL ASSOCIATION

THERE IS ONE AS PART OF THE

(INAUDIBLE) PROCESS, REGIONAL

HOME, ONE IN THE UK, JUST GOT

BACK FROM GERMANY, UNIVERSITY OF

BONNNE AN 21 OTHER ACADEMIC

CENTERS DOING THE EU HAS TOLD

THEM, GIVEN THE -- GIVE THEM THE

MONEY.

I SAID WHAT WE WANT FROM YOU IS

TO KNOW THAT WHEN THERE'S A

MAJOR NATURAL DISASTER IN ANY EU

COUNTRY, THAT THRAI THEY HAVE

EAR GOING TO BE TAKING CARE OF

VERY WELL.

TWO, THE EU SENDS FOR MEDICAL --

FOUR MEDICAL TEAMS OUT TO THE

HAITIS OF THE WORLD, THEY ARE

EXCELLENT TRAIN, GREAT INTEGRITY

BECAUSE REPUTATIONS -- THERE ARE

70 FOREIGN MEDICAL TEAMS ALL

OVER THE PLACE AND WE'RE

COMMUNICATING, IT WAS A REAL

DEBACLE, WE CAN'T HAVE IT ANY

MORE, PEOPLE WILL NOT BE DOING

CARE UNLESS THEY'RE TRAINED BUT

WE MIX THE TEAMS.

THERE ARE A NUMBER OF DIFFERENT

THINGS LIKE MIX PEOPLE WHO ARE

SENIOR EXPERTS ALONG WITH YOUNG

ONES SO MENTORING PROCESS TO

THAT.

SO COMPETENCY BASED TRAINING

BESIDES CURRICULUM.

THEY GET CERTIFICATION, NOT

CREDENTIALING SO NOT ATLS OR

ACLS.

THEN IT GOES TO REGISTRY.

WHEN IT WAS WITH THE REGISTRY

WE'RE ASKING THE INTERNATIONAL

ORGANIZATIONS THE NGO TO ONLY

EMPLOY AND DEPLOY THOSE PEOPLE

WHO ARE PART OF THE RECOMMEND

INDUSTRY.

-- REGISTRY.

SO WE'RE NOT GLOBAL, WE'RE NO

LONGER DOMESTIC AND

INTERNATIONAL.

IT'S GLOBAL NOW.

SO WE EXPECT THAT THING NO

MATTER WHERE.

WE CERTAINLY HAVE THINGS MESSED

UP IN KATRINA.

THE DMAP SHOWED UP THE TRIAGE

PROTOCOLS, TRAUMA RELATED THEIR

PACKS WHAT WERE THEY GETTING?

PATIENTS FROM CRITICAL CARE

UNITS.

THEY KEPT DOING THE SAME TRAUMA

TRIAGE.

SO THERE'S A LOT THAT EVERYBODY

CAN LEARN.

AND A LOT OF THIS HOPEFULLY WILL

COME OUT AT THE IMMUNITY LEVEL,

SO WHEN PEOPLE DEPLOYED TO THE

AREAS KNOW BECAUSE THE

INFORMATION?

AUSTRALIA COMES FROM THE

COMMUNITIES, IN A RISK REJ

REGISTRY.

ANYBODY CAN CAN LOOK.

SO THEY CAN PULL UP THE

COMMUNITY, AND THEY KNOW EXACTLY

WHAT THE RISKS ARE, WHAT THEY

NEED, ET CETERA.

SO IT WILL BE MORE EFFICIENT.

BUT WE'RE JUST IN THE BEGINNING

AND MAKING PROGRESS.

DON'T HAVE ANY MONEY, IT'S ALL

BEING DONE BY IDIOTS LIKE MYSELF

FREE TIME.

BUT WE ARE GOING FORWARD.

BECAUSE WE CAN'T HANDLE THIS

STUFF ANY MORE.

THAT'S SEEMS NOT ONLY DOMESTIC

BUT INTERNATIONALLY.

DOES THAT HELP?

>> THANK YOU.

(OFF MIC)

>> THANK YOU SO MUCH.

[APPLAUSE]