Latest / The Christian Reeve Podcast / Dr Emmanuel Nsutebu | The Christian Reeve Podcast #165

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Dr Emmanuel Nsutebu | The Christian Reeve Podcast #165 · The Christian Reeve Podcast

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Hello and welcome to another episode of the Christian Reef
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podcast. Today's guest is an
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award-winning author. A consultant physician and chair
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of infectious diseases. All the way in Abu Dhabi.
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His name is dr. Emmanuel suitable.
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Welcome to the show. How you doing?
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Thank you. Thank you, Christian.
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And the thank you for having me. It's an absolute pleasure, sir.
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There's, there's many different things we can talk about with
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with you, but I think I'd like to always sort of just go Go
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right to the beginning and talk about.
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How did you sort of get into your line of work or what kind
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of drove I suppose you're interested in or getting into
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your career? So why I'm originally from
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Cameroon in West Africa, British now, because I've been in the UK
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for, I was in the UK for a long time, and then I'm not basing up
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with nothing, but I'm an infection consultant.
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So I look after patients, with suspected or confirmed, the
1:06
infection, all types of infection and infection is a
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very common problem in Africa. And coming home where I
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originally. I'm from, so I developed an
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interest in infections when I was in Cameroon.
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And then also it's a specialty where people tend to get better
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when they are treated, especially when you make the
1:30
right diagnosis, it was quite rewarding, seeing people,
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treating them and then getting better.
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And then in the UK, one of the UK, I also decided to specialize
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in infections also for the same reason.
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It's very fascinating field. Everybody's different people
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have different stories to tell you and and it's very rewarding,
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is there any particular Memories of people that you've helped
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that sort of stick out in your mind when you, when you look
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back over your career. Well, that's in this so many,
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every person you encounter in hospital.
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Every patient is, is special and they infectious diseases.
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We have to, we don't really have a protocol.
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So everybody comes to their story.
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And when we were taking a history as we say, we start from
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scratch. It's like dr.
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House, if you watch dr. House and we have to like
2:29
detectives figure out what's going on.
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And so we always start with Picking a full story including
2:35
or risks for infection and includes pets travel hobbies,
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anything that you do and often it's one clue in the patient's
2:44
story. That tells you what the the
2:46
infection is likely to be. So with, without the most
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exciting bit of our job is to tend to be people who travel Who
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come back with with on infections.
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And we see all sorts sometimes, things like maggots In different
3:04
parts of the body and something called the botfly or tumbu fly,
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who would people sometimes that come with Sullen?
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Looks like an abscess. But then when you look at it
3:15
carefully, you realize is actually a market Under the Skin
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and we five exciting ways of getting it out as well as that
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to find people who who because of troubled also an exposure to
3:30
different infection will come back with.
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What types of parasites parasites, don't tend to need a
3:34
visa to move between countries. So people may need visa better,
3:39
prioritize don't even and even in the UK and in the Abu Dhabi
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where I'm working now, it's even more fascinating because the 80%
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of population is from abroad any part any part of the world?
3:50
So they are a lot of people whose that we see on a daily
3:53
basis with parasitic infections that we diagnose worms in the
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intestines and deliver other parts of the body.
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General Howe, what the kind of most common ways that people
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actually find themselves either coming into contact with these
4:11
parasites and infections or, you know, how is it transmitted like
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does it come from? For example, animals is it a
4:18
result of living conditions or just particular climates and
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regions? Like what the most common causal
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factors? It's a mixture and it varies
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depending on the parasite. But most often it's food and
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water that food and water that you eat or meat that you eat for
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example, tapeworm from get a meeting and meet beef or pork
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and especially if it's from parts of the world where
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tapeworm is quite common in Africa, Asia, South America,
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sometimes it's contact with soil because some some parasites have
4:57
a cycle where part of the product side, maybe in this in
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sand or in soil and if you're walking bare feet, it can get
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into the skin and then, oh my God, important section of
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mosquitoes and other insects also transmit song.
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So, yeah, also different routes but most common, it's in.
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It's in what we eat and what we drinking water or approach. the
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when you were bitten by an insect or a tick or mosquito,
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Given that, you know, you're treating people from around the
5:33
world. And obviously, as a doctor, you
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give them advice of things. They should avoid.
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But are there instances where it's maybe not as possible for
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that person to avoid that? Given where they're from like,
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what there may be as you outlined.
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Like, if it's a problem with say the soil, when that region, or
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the particular meat that they have access to like, how can a
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person avoid that? Exactly like well what what
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steps would they take? It's always important before
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traveling, to seek help from a Travel Clinic and the lots of
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them in the UK. But most other most countries
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will have a Travel Clinic where you can go and seek advice and
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you have experts nurses, and doctors that can give you advice
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based on the risk of the country.
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You're going to and just sit aching sensible.
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Simple measures like drinking Factory bottled water.
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Not drinking water that they sell in the street.
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That is not Factory bottled eating food that is hot and just
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cooked rather than cold food. And if you're eating meat as
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well, especially if you're eating meat that broad make sure
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it is cooked not rare and avoiding insect bites by
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covering up. It's not always easy.
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We know it's hot sometimes and you never go.
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They leave you wearing something hot.
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They're wearing jeans or long sleeve is not.
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Always very comfortable but also using insect repellents to help
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prevent bites from insects sleeping on the mosquito nets,
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for example of the other measures that you can take.
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But we know it's not easy. These behaviors often with you
7:19
on holiday at. You may do that in the first few
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days and then after that you relax you enjoying yourself or
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you had a couple of drinks. People then drop their gods and
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relax. And also, for example, is a
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parasite called schistosomiasis will be hacia which you get from
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certain warm water from rivers and lakes.
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The parasite is in the, from the snails, you get into the water
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and if you come in contact with water directly, then it directly
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gets in through your skin. You can imagine if you go to a
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lake like Lake Malawi, Oh we where she's the same as is quite
7:59
common there. It's a very beautiful Blue Lake
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and so you I might have to, I might have told a patient not
8:06
too deep into nation into Lake Malawi, but they go there and
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it's so blue and beautiful than they just cannot resist the
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temptation and they go in, especially when they see local
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people swimming in there in the lake and that also affects the
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way people behave, was going to ask about that.
8:20
Actually, when it comes to well, two things, one, Salting locals
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about, you know, how to overcome, or avoid these
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parasites. And also, like as you sort of
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outline there, that sometimes they're even not taking that
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advice or I don't know, maybe they build up some sort of I
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don't know strength or resistance.
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Maybe two that I don't mean like, are there any differences?
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Well, of course there are differences but how do you
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consult and advise locals about how to avoid parasites and
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various other infections before for locals is a, it's a bit
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different. So if you take an example like
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malaria, which is a parasitic infection mosquito-transmitted,
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and it when you're living in a local area, you do develop a
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bit. Immunity which stops especially
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adults from developing severe malaria.
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And so people who are living locally, although you still
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recommend that they avoid B, it on the mosquito net.
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They not really at risk of having severe malaria as
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somebody who's visiting. So somebody like yourself or
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myself because I've spent more than six months out of the
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malaria area. When I go back into my Lair
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area. I'm just like Like any expand if
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I go back to Africa to Cameroon because you lose that immunity
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within six months, of our after around six months of living that
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area, you have to actually behave differently.
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And so we we remind people who are traveling that area to make
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sure that they maintain those measures throughout.
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And for the locals where what we'll focus on really is about
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reducing the risk of my of my of my Ultimate key to B and also
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making sure that they seek care early when they become ill.
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That material can be investigated and treated.
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Obviously, when you're living in that area, you're always going
10:17
to be bitten from time to time. You can't completely stopped
10:22
mosquito bites. But because of the semi
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miniature locals have, the risk of severe illness is much less,
10:31
but when you're living in an area where you you you do, I
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just because if you're doing something on a daily basis,
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everybody else is doing it. It's very difficult for you to
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decide, not to do it. So there's also the peer
10:47
pressure and the way people do it here.
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And if you've done it for so many, so many years and got away
10:52
with it, you think I'm probably. Okay.
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It hasn't caught up with me for many years and then
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unfortunately, want one-on-one date happens.
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But most of the things are just simple.
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Simple things and said it's about drinking fracture, bottled
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water in locals. Not everybody can drink.
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Fudge Both Worlds, right? We kind of expensive people made
11:11
out of Is water. So boiling the water filtering.
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The water also helps eating fresh hot food.
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Also helps. It's a balance doesn't have
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because we also have to live. As some sort of No More Alive.
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You can't be too careful especially if you're living in
11:30
that local in the in that area. But you're being sensible to
11:33
reduce the risk. You can't reduce the risk to
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zero. So you have 25 years of
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experience managing And treating infectious diseases.
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And as you mentioned, the parasites and stuff like that,
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what would you say? Have been your kind of biggest
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discoveries during that time or maybe when we surprising So
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surprising, I think it's really with infectious disease, is just
11:59
how uncertain we are and every year we faced with her, to some
12:07
form of a challenge. And the question really is not
12:12
what is going to be happen. That is new.
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It is when it's going to happen. And so, we've had covid for the
12:19
last three years. We've had monkeypox now, As a
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global outbreak of monkey pox and nearly every year, there is
12:28
a an outbreak people don't hear about it, but with an infectious
12:31
diseases where very alert and aware of outbreaks of new or
12:37
strange infections happening throughout the world.
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And every point in time and we keep track of them because of
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the nature of our specialty. Because someday, one person may
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walk in from another continent travel and they have that,
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right? Jonas, with an outbreak
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happening in some part of the room.
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Part of the world. So what has really changed and
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now is, is with the pandemic with covid and then the monkey
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pox is the alertness about how easy it is to prevent infection
13:05
for one area to move to another and also the importance of the
13:08
specialty when I move to to Abu Dhabi, I was a single infectious
13:15
disease physician in a big hospital and trying to build a
13:20
team and trying to raise awareness about how important it
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was. Supposed to have a proper
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infectious disease Department with a big team.
13:27
Looking after infection. After covid-19, we have, we have
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grown. We now have a team of five
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positions by doctors and working, as a whole department,
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and the seen the benefits. And I think most parts of the
13:42
world, health care, services and hospitals are now.
13:46
Understood why infectious diseases?
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As a specialty is important? They knew was important.
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I think they Now understand how why it Been more important
13:55
because of preparedness for emerging infections.
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Well, what would you say, the biggest ways that those units or
14:05
departments have changed as a result of things, like covid and
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such like, what has been learned in that short space and what has
14:12
been changed and adapted other than obviously doubling staff.
14:14
And having more attention, There's more more about planning
14:19
and looking forward and planning for what sin is resilient.
14:23
What would happen if we have to have a surge in number of
14:28
people, developing a specific infection, but also being able
14:35
to identify and control and infection really early and
14:39
having plans for how that were to happen to her.
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If if that were to happen, how we would do that.
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So, for example, if we have a Two patients turn up in Abu
14:49
Dhabi with ebola. Are we prepared to diagnose it
14:54
quickly. It having the Laboratories the
14:57
doctors and nurses to suspected. They send the samples, elaborate
15:01
you to diagnose it and then the team to look after this patients
15:04
in such a way that we don't cause spread of that infection
15:07
in the hospital within the community.
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So I think that has been the main thing really preparedness
15:13
and thinking ahead about what might be the best the next
15:17
Infection, that will arrive. And then how would we respond in
15:21
order to stop it spreading extra?
15:24
Sharon, you mentioned earlier about monkey pox, which I know
15:29
very little about this. I've heard murmurings murmurings
15:32
a bit on the news but since you are actively studying and have
15:37
been for many, many, many years, and it's your kind of your
15:41
field, what? Do you make?
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What do you make? What can we learn?
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What do you understand about monkeypox?
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Like what, what can you tell us about that?
15:53
Monkey pox is it's a viral infection.
15:58
It's really called monkeypox because it was first identified
16:02
in a monkey but the main animal that causing friction is not a
16:08
monkey. It's a bit of an odd name
16:10
because with name because it was first discovered by in in in
16:14
Belgium in it, in a monkey but it won't it not actually it
16:18
wasn't, it wasn't. It wasn't it main reservoir
16:22
animal which then affects us. The monkey.
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It is an affectionate is endemic, which I mean is that
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it's a regular infection in parts of Western central Africa.
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And the reason why I become prominent now is just because
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it's left that part of the world and is now spreading in other
16:41
parts of the world. But it's something that every
16:43
year there will be hundreds and sometimes thousands of patients
16:47
diagnosed with monkey pox. In, were in West and central
16:50
Africa. The Main animals that Host this
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infection before it can transfers to a to human beings
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is rodents so rats and squirrels empty typically and then with
17:10
them getting infection and contact between them and humans.
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Any passes on to a human being and causes the infection, it
17:19
behaves like chicken pox. So you have a rash, which
17:23
Chickenpox. But it's different in that, it
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affects the face, and the arms and legs.
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First, one chicken pox, tend to affect your body and then moves
17:33
your arms and legs and face, and the rash is a bit different in
17:37
terms of the way it looks compared to chicken prompt and
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it's also quite a painful rash, which the rash of chickenpox
17:47
isn't and then causes swollen glands and with monkeypox.
17:51
So they are some ways of a doctor her nurse
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differentiating, a chicken pox runs from a monkey pox Ranch and
18:00
unfortunately the reason much treatment, it's not a very
18:04
deadly virus. Approximately one percent of
18:09
people who get the infection may pass away.
18:13
And it's mainly causes you to be to look ill because you got a
18:22
rash all over. Your body and your face.
18:24
So you don't look very well and you'll feel feel unwell and may,
18:30
you may get bacterial infections on top of the viral infections
18:33
or other complications. But it's not a very deadly virus
18:37
and most people will recover, but it takes weeks to recover,
18:40
but it's not something I require quickly like chickenpox.
18:43
The most people will take three four, five weeks to recover.
18:46
So they tend to be in hospital, especially when they're admitted
18:48
for a long time before the ranch, met Claire, and then they
18:51
are no longer infectious. So we can let them get out of
18:53
hospital. And the reason any specific
18:56
treatment, there are some different drugs that are so
18:58
experimental drugs drugs that have been used for smallpox in
19:03
the past that are also now being used for monkeypox because their
19:09
studies in animals that have shown that it's, it may help.
19:13
But now with the, with the outbreak, the global outbreak is
19:17
lot of research being done. Like this things, Whenever there
19:20
is a global outbreak that when funding Put into into the
19:26
service of the system to try and find a cure and to find a
19:29
vaccine. So although it's a global
19:32
outbreak is a bad thing, it may actually help finding a better
19:36
treatment and vaccines that may actually help prevent further
19:41
outbreaks, just like it did with ebola when you happen in West
19:44
Africa, and many years ago, it's interesting how that happens
19:50
because the thing covid, for example, if nothing else It's
19:53
taught us that you know, when it does get out of hand, there has
19:57
to be a clear process in, you know, the we can kind of Follow
20:03
That. Then can be replicated
20:06
everywhere kind of thing because we've been warned by various
20:10
Physicians, and I think even Bill Gates said it many, many
20:13
years ago, that something of this magnitude would probably
20:17
occur one day and we would be ill prepared for it and lo and
20:22
behold we were I mean, I do think that this this particular
20:26
virus is a little bit different to everything else though,
20:28
because as we were talking, just then about you know, how these
20:31
infections come and go and sometimes they exit the country,
20:34
sometimes they stay contained. You know, I remember thinking
20:39
about in the 2000s, you had things like SARS and I think
20:44
swine, flu and mad cows disease and I think there was I remember
20:48
seeing the At least a British media was really making a big
20:53
deal about the time. They were really just pump it
20:56
and maybe that's just media. I don't know in General, trying
20:59
to make create fear and stuff but at the same time their
21:04
coverage a bit was very serious. And I remember being at school
21:09
during the swine, flu pandemic and remember being a little bit
21:13
concerned about as all this could potentially become really,
21:16
really serious and what I understood at the time, it means
21:18
of contained and they learn various things from it but with
21:23
this, I think because that's how we were Because we've seen that
21:31
happen. So many times when covid came
21:34
along. I think, most people kind of
21:35
assume the same thing would happen like, oh well that's just
21:37
in a some part of the world that again right now, they'll get
21:40
dealt with and then. Yeah, suddenly now it's
21:42
everyone's problem, but I don't know.
21:45
At the same time it's interesting because I'm starting
21:51
to really monitor people. Now, this sounds weird, but it
21:55
is far as like, what, how people's behavior is changed.
21:59
And for a long time, I mean, you still occasionally where I am,
22:02
I'm in Manchester in the UK and I sometimes will see people
22:06
still wearing masks and stuff like that.
22:08
You know, great, you know, whatever works for you like how
22:11
you feel comfortable? And I was optimistic.
22:14
That may be coming out of this people's hygiene would get
22:17
better. But it seems to me as though a
22:21
lot of that has been forgotten. I mean, I won't go into details,
22:25
but certain certain places. You might go and then you see
22:29
people don't wash their hands and you're like, how is this not
22:32
possible? And it, it just, I remember
22:35
reading a medical study many years ago that and this I think
22:39
this was like in the 50s 1950s or something, the particular
22:41
Hospital in the UK. They were trying to improve just
22:45
General Health and they tested People washing their hands and
22:52
then they measured the death rate as a result of doing that I
22:56
think deaths had kind of decreased by 80% as a result of
23:00
doing that. I don't know how if that's a
23:06
credit credited study or whatever.
23:07
But I remember reading that and thinking it makes sense and also
23:11
obviously you're going to any Hospital, what's the first thing
23:13
they ask you to do. But wait, your phone wash your
23:15
hands straight away, you know, and that's and that's always
23:18
been that way. But That we have this worldwide
23:21
pandemic. People's attitudes and habits
23:25
change for a while, but then they kind of start progressing
23:28
and returning to normal. Why do you think that is?
23:30
Do you think it's laziness? Do you think it's, I don't know,
23:34
people just kind of thinking, oh, well that doesn't matter
23:37
anymore. Now, we're fine.
23:39
Why do you think people don't take hygiene as it pertains to
23:43
diseases as seriously as they should?
23:47
Really important question. I think it's complex human
23:50
behavior is always very complex and they did not often people
23:55
think it's knowledge but it's rarely knowledge.
24:00
Really our awareness. It's contributing to different
24:05
kinds of things that contribute to people not doing the right
24:08
thing and and you say you said it even in even in hospital
24:15
where doctors and nurses. I know the importance of hand,
24:19
hygiene, and using alcohol gel. Still find that it's not done as
24:25
well and we actually have programs in hospital to maintain
24:30
hygiene. And if you don't do it, well,
24:33
you find that hygiene and Hospital dips and nurses.
24:38
The doctors may not use use hand gel and we're not clean your
24:41
hands between, and you think they should know, shouldn't I?
24:46
Of course they should. And that's because there are so
24:50
many things that contribute to people's behavior when they may
24:54
get comfortable, and think is no longer a problem.
24:59
Because they are not seeing the patients with the haven't seen a
25:01
patient with infection similar to the public.
25:04
You haven't seen somebody else with covid recently, you think
25:07
out disappeared, so I don't need to do that anymore.
25:11
Similar to help us in hospital. Hospital often is because of
25:15
pressure around you. Pressure because maybe other
25:19
people are not doing it. So there's peer pressure, is the
25:23
consultant. Nurses seniors are not doing it
25:27
in the Juniors. Say, oh, that the way down here.
25:30
I don't need to do it, the Consultants, not doing it.
25:33
So as a junior doctor, they don't do it.
25:35
So, your culture also richer countries and the same applies
25:37
to the community. If your brother sister father,
25:41
mother family members are not doing it.
25:43
You think it's all right, that's a waste on here and then there's
25:47
Also all the different pressure if you're really busy, and
25:52
you've got some other priorities, then that no longer
25:55
becomes a priority. If all you're doing is trying to
25:58
finish the day, you're trying to survive, trying to finish your
26:00
job and do rushing around the, your job.
26:03
Then you, it doesn't become a priority to wash your hands
26:06
anymore. It's all you want to do is is do
26:08
the next ten things before you finish your shift and then you,
26:11
you drop that one. So there is a sort of
26:14
environmental practices. We call them 10 to 2.
26:17
Also to contribute hands wife to get people to do the right
26:21
thing. You have to also make the
26:22
environment conducive for them to be able to do it.
26:25
You're not being rushed. They have time to think they
26:28
have time to do things carefully, then the alumni to do
26:32
it. Making also the alcohol gels.
26:34
Available easily available so you don't have to go and find it
26:37
somewhere. Every corner nearly every
26:39
corner, every sink, every room, bedside is there.
26:43
So you have no excuse not to use because it's always there.
26:46
And that also, It makes it makes it much easier.
26:48
So all these are we have to sew design the system to make it
26:53
easy for people to do the right thing.
26:55
And that's what we do in hospital.
26:56
We consciously as an infection, infectious disease, and
27:00
infection control doctor, we're currently looking at the whole
27:03
Hospital stepping back and saying how do we Design This
27:05
possible to make it easy for people to do the right thing,
27:09
including hand hygiene and other and other things to reduce the
27:13
spread of infection? And I guess we need to do the
27:15
same thing. Also in the Yeah.
27:19
And in the public places, how do you make it easier for people to
27:22
do the right thing? I think that needs to be more
27:24
strictest because as we were talking now, just thinking about
27:27
different places in their attitudes towards these things.
27:30
And in many cases, it's very lacks in a hospital.
27:33
We know when I was growing up, I always remember a, maybe it was
27:36
just because I was a kid, I don't know, but it always seemed
27:38
really serious. Like, I remember many doctors
27:42
and nurses were always just almost a man doing it, like,
27:46
wash your hands. Do this, wash your hands, do it
27:48
now doing that and even to this day there's a little bit of
27:50
that. I mean but it's it's not kind of
27:54
like thrust upon you and I think it should really and one of the
27:58
things you said there is that you know you need to create an
28:01
environment where It has everything readily available so
28:05
that people can get access to that stuff that they need and do
28:08
it but even that sometimes doesn't seem to Spur people on,
28:11
like I'll give you an example. This is something that drives me
28:15
in my housemate knots so we both go to the gym, Tim's five
28:19
minutes from our house is great. But one thing that we don't like
28:22
is the fact that it drives me crazy so people don't clean like
28:30
what that benches and weights and everything.
28:33
After they finish using it, they just get on it and then leave.
28:37
And some, I mean, sort of be graphic, but sometimes they will
28:40
leave like stains and sweat and everything there, which is
28:43
disgusting. Anyway, but what baffles me is
28:46
that other than just a lack of respect and poor hygiene like
28:51
they don't think about like what other people have used this.
28:54
And if I touch this, I am then getting those germs onto my
28:57
hands and if I, you know, don't think about it white, my face,
29:01
whatever that's on my face or I don't know.
29:04
It's like that's how it starts and it's it takes like a minute
29:08
30 seconds, like every time I'm at the gym and again, I don't
29:11
want to sound like, oh, and I so great but like, literally it
29:14
takes 30 seconds in a minute. There's a station in the middle
29:17
of the gym. You go, there you get your
29:19
paper, get the gel, you wipe it down.
29:22
It's done. And there's a little station
29:24
where you can wipe your own hands and then that's it.
29:26
And that takes a minute. that's it, but the point is, You have
29:33
all that stuff in readable and people don't want to do it.
29:35
So the only thing I can think is that they're just lazy, but then
29:39
again, they're not told that's the thing.
29:41
Those things are available there, but there's no one saying
29:44
like, no, let's for argument's sake.
29:46
Let's say there was someone just standing there going, wash your
29:49
hands, clean that clean it. Now you do it because you don't
29:53
want the big scary person to be angry with you.
29:58
I don't know what they would do, they would do it.
30:03
When there's somebody around and maybe they're not looking, they
30:06
may not do it. But but what what you're saying
30:09
is I think is true that if some people do it naturally, some
30:15
people it's sort of a habit and other people have to learn to do
30:20
it and in a gym situation, for example, if you're going to gym,
30:25
not you're not everybody is told when they're being sort of
30:29
induced to the gym that this is an expectation.
30:32
And that's something we do in hospital.
30:35
For example, would getting new stuff.
30:37
We don't assume you're a nurse or a doctor so you should know
30:41
you will be told and and and also we the reefs also what we
30:50
say and not no-nonsense approach.
30:53
So we expect that if you walk into a Ward and you're seeing
30:58
not doing what you should be doing the staff, And the I
31:03
expected to speak up and stop you.
31:06
So, we police police each other to do that way.
31:09
And cut team. Safety is better than individual
31:11
safety. So you walk into an area, you're
31:14
not using hand hygiene hygiene which we try and power people to
31:17
speak up and say, no, you stop, you got to use it and if you're
31:20
not using it, you're not, you're not seeing this patient or
31:23
you're getting out of this world, he doesn't always work
31:26
because sometimes people don't speak up, but we do our best to
31:30
lead by example and and Power. Our people and in the old days
31:33
we had the. So what we considered the
31:38
matrons, a so old start matrons of the worlds, which is some of
31:42
these days things have changed, but in the past you will not you
31:45
will not. If you were to try and not do
31:48
hand hygiene or whether you will be walked out of the ward and
31:51
that's how I should be. I agree with that.
31:53
I think that's going to do it now in our days it's like spit
32:00
we try and steal encourage that that all team members.
32:02
CPC some another member of Staff doing the wrong thing that you
32:05
stop them because it's a patient safety issue.
32:08
It's a safety issue. This is obviously not a very
32:11
black-and-white issue but it's it's interesting because if
32:15
you're in a hospital most hospitals you walk down.
32:17
Those corridors all around them words.
32:19
I mean, how many different units of hand sanitizers, will you see
32:22
on those walls? They'll be everywhere, you know,
32:24
and they'll be signs and everything, but you need to be
32:28
urged to do it and you said before about, you know, the gym
32:31
one maybe. Someone's not being inducted to
32:34
do that. And my first thought was like,
32:37
people shouldn't have to be told, they should know this from
32:40
a young age like, for instance, I go to a bar with my friends,
32:44
we go to the gentlemen's restroom and I see still after a
32:49
worldwide pandemic, still people not washing their hands which is
32:53
disgusting. Anyway, but given everything
32:56
that's happened in the world of the last two years that still
33:00
baffles me. I'm going to talk about things.
33:03
I'm going to better though. They have they have, I mean it's
33:06
good doctor and we'll seen with improvements in covid with the
33:12
coffee pandemic. Also seeing reduction in
33:15
infections that are transmitted the same way as covid.
33:19
So pneumonia caused by a bacteria called and pneumococcus
33:25
streptococcus pneumoniae and pneumococcal.
33:26
Pneumonia number numbers have gone down and other respiration.
33:32
Tract infections because of people wearing masks and hand
33:35
hygiene. And so seeing reductions in
33:37
infections, most parts of the world because of that.
33:41
So I great not where we wanted to be.
33:45
But covid-19 has helped people are more conscious than they
33:49
were three years ago. You've worked quite extensively
33:52
as a consultant physician and one of the clients of yours has
33:58
been the NHS. I've worked in companies that
34:01
have worked with the NHS before, and I mean, you read about how
34:07
the men HS is managed and mismanaged in the media anyway,
34:10
but it's very interesting when you get close to it, where
34:13
you're working. And then you really We start to
34:15
learn how things really are. I just wondered.
34:18
If you could share, maybe your thoughts on how the NHS is
34:21
currently being run. And in general, what do you
34:24
think could improve or how could it be approached in a way that
34:28
might be sort of more effective for running service?
34:32
Don't have been out of the NHS now for three years based in Abu
34:38
Dhabi UAE in the United Arab Emirates.
34:40
So I really don't have experience of the last three
34:46
years of how things are going in the UK.
34:48
Other than what I see on the news and speaking to colleagues,
34:51
because I'm not at the other Frontline anymore.
34:56
But when you are out of the UK use, You do value the NHS?
35:03
Yeah. NHS has a lot of strength,
35:08
especially when you're critically ill, and need care.
35:12
Because case provided purely based on need and it's really
35:15
high level care. And I'm saying that because I
35:19
can now compare with what I see in Abu Dhabi and you can get
35:25
access to care at no cost with the NHS while it is really
35:30
expensive in other parts of the world.
35:32
Getting the type of care you get in the NHS quitting with experts
35:36
and that's made me value the NHS a lot being here.
35:42
And especially when you see the cost of Health Care here and the
35:45
variability, you may go to a hospital and you get not very
35:52
good care, go to another one and you get really good care in the
35:55
NHS. There's more uniformity, most
35:58
hospitals will have good teams of nurses and doctors.
36:02
To is working together to deliver most of the services
36:06
that are needed. So I that is made me actually
36:10
flipped and value the NHS I think, will come to the, to the
36:14
book and the story of sepsis in an opening in it.
36:21
But I also worked in the chest as a, as a clinical advisor of
36:26
the National Health Service for sepsis.
36:28
So, as well as doing clinical work looking after patients, I
36:31
was also trying to improve prove services in the NHS.
36:34
This is, this is why I wanted to kind of ask you about it because
36:38
see being an advisor, a lot of what that role involves is kind
36:42
of looking at what they're doing and then kind of advising them.
36:46
Well this might be how I'm I approach it all this based on my
36:50
experience or what? No, from abroad or Etc.
36:52
Like this is. Yeah and it's interesting
36:54
because the NHS is at this point in time Predominantly still
37:00
public service but certain parts of it.
37:02
Privatized increasingly more and more.
37:04
That's changing. And it's just a very Confusing
37:08
time I think just on all friends.
37:12
Yeah you really raised an important question about
37:17
advising the NHS and and how and the experience of working in the
37:23
NHS and improving services. And I wonder whether in order to
37:28
answer that question fully I should really talk about The
37:33
story and how I ended up doing the sepsis improvement work with
37:38
the NHS. Please share him.
37:40
Yeah, please do. So, the book which I've written,
37:46
which is Struck from struggles, to success how your struggles
37:50
can make, you better stronger and more successful.
37:53
You have a copy of the book to hand on.
37:55
You have a copy of the book. Yeah, it's a share in the skin.
37:58
The thumbnail. Look at that.
38:01
He's here. You can see it.
38:03
There we go. Start with success.
38:05
There you go and test it. And how are you saw this book?
38:11
I just published last month. Oh congratulations.
38:14
And thank you. And the book has a story within
38:19
it and then it uses a story to teach the skill of how to turn a
38:25
major turnaround and major challenge in life into a
38:29
success. And the story in the book which
38:34
I won't tell in detail, you got to get the book but I'll give
38:39
you a hint of What's about in 2003 in a hospital in the
38:44
northwest of England that point. I was a junior doctor working as
38:49
a senior house officer to Junior doctor.
38:52
And I arrived the hospital took my bleep and I was on call and
39:02
just put the bleep on my my belt ready to start a war ground and
39:08
the bleep went off. And it was a crash call somebody
39:13
who had a cardiac arrest in the maternity ward.
39:18
So when you hear Maternity Ward crash, call, you know, it's it's
39:21
a young person because I think only be a young woman pregnant
39:26
in maternity ward. so, I knew it was something it all crash
39:33
caused a serious, but this is a young person arrested And so I
39:39
rushed to the crash to the ward went in and to my shock, the
39:47
person was crashed was Delphine and Delphine was a close friend
39:52
of mine. And she had been in hospital, I
39:56
knew she was on that world, she's been in hospital pregnant
39:59
with a set of twins. After IVF.
40:04
And I'd seen her the night before before I went home, her
40:08
partner was my very close friend and we were neighbors, we live
40:12
five minutes away from each other.
40:14
And so Delphine had arrested and I went to resuscitate the offing
40:20
and initially resuscitated and start associating.
40:24
When the others came. I told him, I knew they often
40:27
and I couldn't continue when they were enough people and I
40:29
had to step out And unfortunately Delphine and the
40:37
twins, she was pregnant with the twin boys.
40:39
They didn't make it. The passed away.
40:44
And Delphine had developed a condition called sepsis.
40:50
And she developed in hospital, she'd come to hospital because
40:54
she was at risk of losing our firm, having the babies early
40:59
and they had done something called a cervical string.
41:02
The donor procedure to try and stop her from delivering the
41:06
babies early, but because of that procedure that had led to
41:12
an infection in her womb. I don't, fortunately, she became
41:18
a well at night and it wasn't recognized that she had this
41:22
infection. And then went on to develop
41:24
sepsis where organs failed as a result of it and she
41:28
deteriorated in hospital and got no loyalty arrested in hospital,
41:33
and it wasn't diagnosed early. And that is how we lost their
41:39
fear. Now you could imagine as a
41:41
junior doctor going to resuscitate a friend.
41:48
Who is he the night before? Who was in very good health?
41:54
Delphine was 30 years old, she was a midwife, everything was
41:59
great in life, she had just bought a house become pregnant
42:04
for IVF was getting ready to get married become a midwife was a
42:09
car. Have a driving license,
42:10
everything was happening, and she went in the hospital and
42:13
then I was it. And I know as a junior doctor
42:19
you can imagine I thought there's nothing I could do.
42:22
How do you, how do you change a system?
42:25
How do you stop this from happening from somebody else?
42:28
And I just put my head down as a junior doctor and we were all we
42:32
grieved and then we wait, which I had to finish my training.
42:36
So I finished my training and then we didn't, then I became a
42:40
consultant in Liverpool. And one day I was in Liverpool
42:45
as a consultant was a great job in the in the world of a
42:48
hospital. And then one of my colleague
42:51
brought a complaint letter from a patient and and the complaint
42:58
that letter was it was in this was in summary was saying, why
43:02
was sepsis not recognize? Why was I, why did I come into
43:06
your hospital services and he wasn't recognized?
43:08
Why did all your doctors and nurses?
43:10
Miss it. Why did I not get antibiotics
43:13
within one hour? And this person says, also a
43:16
young gentleman who had developed sepsis from a protein
43:20
production and ended up in intensive care after many hours
43:26
in hospital without the right treatment and he's written a
43:30
complaint letter to the department saying, why did it
43:33
happen? And do my colleague Consulting,
43:35
brought it to me and saying, what do we do with this?
43:39
And I read it and it said it's pretty obvious.
43:41
We are Blue Jays the patient and we've got to do something
43:45
different. You can't have this in mind you
43:47
could see you see, I was then remembering what happened to
43:51
Delphine saying this? Is it happening again?
43:53
Liverpool, it happen. Another hospital.
43:55
And now it's happening again. And so we decided I decided to
43:59
take that letter to the medical director of the hospital.
44:01
And we had a quite a good conversation about how we need
44:06
to do something completely different.
44:08
And he agreed that we couldn't just Kate people and tell them
44:13
what to do was not just awareness, which is what you
44:15
were talking about, but we had to completely redesign the
44:18
hospital to make staff do the right thing.
44:23
And so we developed systems teens, working on a change in
44:28
the culture in the hospital, as well as education.
44:32
And within a few years, we had completely changed sepsis,
44:36
recognition and management at in the hospital, and we'll saving
44:40
lives in Liverpool. And we did similar thing in
44:44
other hospitals in the northwest of England as a group.
44:47
And that's when I was asked, if I could help be a clinical
44:51
advisor for NHS England and that brings me to the to the to the
44:55
answer. To the question you are asking
44:57
and similarly as a clinical advice via advisor.
45:00
What we're looking at is we it is it's not an education
45:04
awareness issue, nurses, and doctors know, most of them know
45:09
what to do in terms of recognizing and managing sepsis
45:12
The question is, how do we make it easy for them?
45:14
And so how do we make the systems in the hospital?
45:17
Easy for them to be able to do it?
45:20
How do we build teams to support this happening?
45:23
And simple things? For example, an example is
45:28
screening for septic. So we introduced something
45:31
called sepsis screening and it became something that was part
45:34
of hospitals were being measured on how good they were.
45:38
So anybody who comes to the hospital with Section or with
45:43
the measure, the blood pressure pulse, and oxygen levels.
45:46
And we are low if they if they the patient looks ill because of
45:53
those measurements, then have has the healthcare worker
45:58
thought about sepsis and the screen at screen for sepsis.
46:01
So they thinking about substance for every sick, patient or every
46:05
patient we did with infection and that's something that we
46:08
also designed system to make that happen within the NHS.
46:11
And You'll happening now but those are tips systems.
46:15
That is not just telling people what to do but develop systems
46:17
that make people do the right thing and then building teams.
46:21
So for example in Liverpool we had sepsis NE steam.
46:25
So if you could come into hospital with sepsis just like
46:28
you coming with a heart attack and we'll call the the the
46:31
cardiac team heart attack team to come in and see you straight
46:35
away. And make sure they do.
46:37
Certain number of things within the hour with sepsis is also the
46:41
Team is called and the Tomb come and support the other the other
46:44
members of staff and they do that.
46:46
They do what necessary within an hour.
46:48
So with in Liverpool, within a few years, we then have instead
46:52
of having all these incidents and people who had suffered
46:58
because sepsis all own fortune, lost their lives.
47:01
We having people actually praising us because they've come
47:04
to hospital and substance recognized.
47:06
And within one hour, they were treated and they were, they got
47:09
out of Hospital, very, very quickly with with Little
47:12
complications. So it's really about this is
47:18
going back to the culture, teens and systems and to take it as a
47:26
bit further. I told you initially, I was from
47:29
Cameroon and was working in the NHS and doing these improvement
47:34
work in the NHS. It occurred to me that there's
47:38
more sepsis in Africa than any party Of the world where
47:42
infection is so common, but the same Improvement works at
47:45
happening. The NHS and in England, when the
47:48
US was not happening in Africa. So I tell the story in the book
47:53
as well. So, we decided to create the
47:56
African sepsis Alliance. When we were creating it, it was
48:00
now you can't do this. Nobody work, you are in
48:02
Liverpool for God's sake. How are you going to create
48:05
African subsidizing based in Liverpool and make this work?
48:09
It's people tried, but we created a concept.
48:11
It lands with people all around the world when we linked on
48:15
computers and we started come with a team of people all over
48:19
the world working on the African subsidized.
48:22
And within a year of creating our constituents, we had
48:26
developed an organization as a charity.
48:30
We had education events in Africa, conferences teaching,
48:35
and training healthcare workers, nurses, and doctors in Africa.
48:39
We had meetings with the World Health.
48:41
In we had campaigns online with something called a compiler
48:46
resolution advocating for improvement in Africa and then
48:50
we the Liverpool School of tropical medicine my colleagues
48:53
working there. We set up a website for research
48:57
funding and we managed to get two million pounds of research
49:00
funding, to do, African sepsis research in Africa, to answer
49:03
some of the questions Africa. And and now we've got ten
49:09
countries in Africa working on the African research
49:12
collaboration and sepsis and showing some crucial questions
49:15
and producing really useful information that will help
49:17
improve sepsis, recognition and management Africa, because
49:20
Services Africa is different from sepsis.
49:21
In the UK population is younger. The infections are different, so
49:25
you can't just do the things we do in the NHS in Africa, you
49:28
have to do it differently. So This research project is
49:31
determining what we need to do in Africa and helping bring
49:34
about the change. And and there's much more that
49:38
that that that that's happening with the global sepsis lines
49:42
that we work with, but the story and coming back to it is
49:46
Delphine was from Cameroon. She was a British also based in
49:50
the UK she passed away in 2003 as a lot of substance and it was
49:55
a tragedy it should never happened.
49:58
And we could have all after all the crying and that left it as
50:05
it is and it will still happen to other people.
50:08
But we decided to do something about it in the UK and started
50:12
off in Liverpool and did the services improve my work.
50:16
In Liverpool in the northwest of England, and then with the NHS,
50:20
and then ended up creating the African separatist Alliance to
50:22
save lives in a place where a part of the world where sepsis
50:25
kills more people than in any other part of the world.
50:29
And all this is back to Delphine story and it's about how you
50:35
turn a struggle in life and their fins passing away.
50:40
Was the biggest struggle I've had in my career, you can
50:43
imagine as a doctor what it feels like going to resuscitate
50:46
a friend who passes away we developed an infection in your
50:50
hospital and doesn't survive. And the the effectively can have
50:57
on the on you. You but being able to take that
51:00
and produce something, really positive and turn around a
51:04
struggle into something quite successful.
51:06
And that's the basis of the book.
51:07
They often story, but then also the experience life experience
51:11
in in Liverpool, in the eye Abu Dhabi.
51:16
Now we covid and other work that I've done in the in, in the, in
51:20
the in Abu Dhabi telling a struggling says, is actually a
51:25
life skill. And then that's why I wrote the
51:29
book because I've actually realized this is something that
51:33
everybody needs to learn. So, whilst it's a story that
51:36
starts with sepsis and then full turn into something successful
51:39
and how you turn around that it, can they apply to everything?
51:43
We've all had problems with covid.
51:45
People who've lost lives people becoming really ill people lost
51:49
their hand, their livelihood homes, jobs incident at work.
51:53
Do you know anybody who hasn't had a major struggle in life?
51:57
Everybody. Honest.
51:58
And a people still going through it with with with with now and
52:02
everybody who has done something significant in their life and
52:06
some people use you considered successful.
52:08
If you listen to story, you'll find some major struggle and
52:12
Nelson, Mandela going into into prison and coming out to change
52:17
their own frequent. Stop appetite Whitney Houston
52:23
Oprah Winfrey. Churchill everybody.
52:25
If you read the biography. You will see what I'm talking
52:28
about and struggles in life are our gifts.
52:33
When you, when you, you know, how to use them.
52:35
Because I problem, or a major challenge is actually a gift and
52:39
the in hospital when there's an incident issue.
52:42
Yes, you should never happen and we'd elephant's story.
52:46
I've obviously learned how to turn around.
52:50
Incidence into some successful. But whenever there's an incident
52:53
or problem, what I do see is it's an opportunity to
52:57
completely change the system and getting better.
52:59
It's an improvement opportunity. And if we develop that skill in
53:03
life, it's a life skill. You develop that you become a
53:06
much better person. And so this book is about the
53:09
skill. And in the book, I've also
53:11
developed a five-step model. Which you can use and have used
53:16
it often. And I've also seen people use it
53:18
and I've coached people use it. So, I, it is five step of how
53:23
you change a major struggle into success.
53:27
Whatever it is. And the more you do it, the
53:28
better you become. It's like going to the gym, the
53:31
more weight. You lift, you develop muscle the
53:34
more you problems you saw when you turn around.
53:37
Well you become better at it and you become stronger and better
53:39
as you do it unless you do it. The less successful in the mood
53:44
less able you want to do this. So This Book Is is about that
53:48
and it tells death in story in a lot of detail and then it goes
53:52
through the different, the five-step model which which I
53:54
refer to, as my 5 step model of changing or struggling to
53:58
success and also gives you really tips about how you go
54:02
through those different steps. so that was a long, long answer,
54:07
but I hope it covers what what you'll say Perfect.
54:13
Thank you so much for sharing, we appreciate it.
54:17
We've given everything that you've told us I mean what did
54:19
it mean to you to win the 2018, Global sepsis award?
54:25
No, it's all it was. It's an honor waiting on a
54:29
privilege to work one thing. And it's also a dedicated to
54:33
Delphine because all the work that I do with the teams and
54:39
people always was always or back to their friends, giving back to
54:42
their can make sure that they're making sure that their dreams
54:44
life was never lost in vain and that something good comes out of
54:49
them. And and that's really what keeps
54:52
driving the work that you want to do.
54:54
Now. And, and the global Service
55:00
Alliance award actually came with some money.
55:03
And that money is what we also use to run the African subject
55:06
lines. They went back to the African
55:07
steps Airlines as funding to, also help develop educational
55:11
events who people in Africa on September and testing.
55:16
That's really good to hear. Yeah.
55:18
It's not just the, which is great.
55:20
And of itself is something that you can use to then help people
55:23
even more. It's Thank you so much for
55:26
sharing, fantastic stuff. A couple of final questions here
55:30
for you. Just general questions.
55:33
What's the best advice you've ever received?
55:39
the best advice I've ever received is, From Seniors and
55:46
mentors is an archetype actually put in the book.
55:49
So the the five-step model is the first step is developing
55:55
Clarity. When you got a major problem, a
55:57
major Challenge and then the second one is developing
56:01
commitment and the commitment to change.
56:06
And at the third step is developing a team or
56:09
collaboration and team to help you with the change and the
56:12
fourth step. Is developing a plan and then
56:16
the fifth step is implementing the plan and taking action
56:19
without the five-step. And for me and different people.
56:25
When you learn this model and go to detail of it and you apply to
56:29
your problem, you find that you will be different parts, which
56:35
part you're really good at all because that you're not good at
56:37
and that's why you develop the skill, you work on certain
56:40
aspects and some people are really good at understanding the
56:43
problem, but then don't do anything about it.
56:47
Didn't have the commitment ordering some people, really
56:50
good at building the teams and the well, collaboratively build
56:52
a team, but they can't do it. They're not without taking
56:55
action and so we all have different strengths and teams
56:58
have different strengths. So, for me, the most important
57:03
thing that I've learned is to solve a problem.
57:06
You don't understand. And so, when faced with a
57:11
problem, you cannot hit a Target, you can't see.
57:16
And so, I turned. And as also, with leadership for
57:19
that development, learn much much more, most important.
57:22
Most important thing is to stop and think, and reflect, before
57:27
you start, trying to solve a problem, because you might find
57:29
yourself solving the wrong problem.
57:32
So when you're faced with a crisis and problem right in
57:35
rushing and trying to find a solution, stepping back a bit
57:39
and trying to understand the problem before you you you go
57:43
into it. And not rushing that aspect of
57:47
scientists are starting to tell people.
57:48
Do this, do that, do that, do that, actually, that step back
57:52
and try to understand the problem I didn't.
57:54
And then also being able to learning too Develop commitment
58:02
before you solve the problem. So we open get frustrated and I
58:07
could, I could send some of the frustration.
58:10
You was you was talking about other people in the gym, not
58:12
doing not doing good idea. And I wish I see, I do the very
58:16
regularly and I say that very often people mainly may know
58:19
what to do but you're not doing it and and so developing the
58:23
commitment to do it to do it is wrong.
58:25
And developing knowledge is not commitment.
58:28
Knowledge is knowledge is here. It is the heart and, and to get
58:37
commitment, you have to get people emotionally involved,
58:42
right? And you have to feel the heart
58:44
race and Fields. If status quo is not right, they
58:48
have to be able to want that change, but knowing, it doesn't
58:51
mean. I want change and learning that
58:55
also has been really important for me, knowing how to create
59:00
commitment. When you walk into team and say,
59:03
something bad has happened, I didn't know if something bad
59:06
happened but they still haven't committed to change.
59:08
So what you do is is actually making she's trying to get them
59:11
to commit and sometimes and the most important thing I've
59:14
learned is telling a story. Using stories.
59:20
So as a doctor you you're taught a lot of how to use evidence and
59:25
research which is important and I do still use it but I also use
59:29
stories to get commitment. So when I tell any of any of my
59:36
colleagues Delphine story about subsistent her passing away, or
59:42
another patient with sepsis, there is no arguments about what
59:46
they need to do. Once they hear they often story,
59:50
I can bring tons of research and I tell them this is the research
59:54
as well, but what actually makes them changes is the heart.
1:00:00
And and so building that commitment important or what I
1:00:03
do also in the in the book is talk about until as a teach
1:00:07
people how to build commitment, and use my experience of
1:00:11
contribution and commitment. So, I think for me, the most
1:00:14
important things I've learned is, Clarity getting to how to
1:00:19
get to understand the problem before you solve it using the
1:00:23
commitment. And then also the team's yeah.
1:00:29
Getting how to build a team to solve the problem.
1:00:32
Thanks so much for sharing. Some really, really amazing
1:00:34
advice there. This one's a little bit
1:00:38
different, but kind of along the same lines.
1:00:41
What's the biggest life lesson you've learned so far?
1:00:47
And because life lesson, that's a very profound question.
1:00:54
Well, for me the biggest life lesson I've learned is and that
1:01:00
comes back to the importance of the team is how important family
1:01:06
is family and friends. Important family and friends are
1:01:13
for me, that's important, most important, life lesson, when
1:01:17
everything you do in life, whether it's at work or even at
1:01:20
home, resolves around your family and friends.
1:01:23
And so you've got you need to have people around you to help
1:01:28
you support you in everything you do in life.
1:01:31
And even at work, your support you're doing, it is supported by
1:01:35
the people in your family and friends, and you're doing it
1:01:37
with your family and friends. And so, one of the things I've
1:01:40
learned is never to minimize the role of family and friends.
1:01:45
And to always prioritize family and friends again, going back to
1:01:49
Delphine story. The work we've done after they
1:01:55
often passed away with not been done with that, it wasn't really
1:02:00
a real true friend and I keep doing it because it's healthy
1:02:06
and a lot of things that I do. I also do it because of my wife
1:02:10
and kids got three kids, three daughters, and I got the book
1:02:14
this book, but I took me four years to write this book.
1:02:19
And the people who kept me going is My Wife and Kids when
1:02:23
daughters, and they're the people who kept on and that's
1:02:26
what about building a team. The people who kept on saying,
1:02:29
Daddy, where are you with this book?
1:02:31
When is it coming out? Why hasn't he come out?
1:02:36
Well, why is it Ben, you said, six months ago you said one year
1:02:39
ago and the dead people kept me going.
1:02:42
So for me it's from a rich family and friends.
1:02:46
I've also as a doctor I see Will unfortunately not in a good, may
1:02:53
not be in a good State and their health and life. and whenever I
1:02:58
see people who may be terminally ill, quite often, they regret
1:03:03
they have It's not having spent enough time with family and
1:03:07
friends. And so I also use the saying in
1:03:11
the in the book that you a wise man learns from their mistakes
1:03:16
but an even wiser man or woman learn from other people's
1:03:20
mistakes. And when I observe, when I'm
1:03:24
looking at the people who often were terminated Hill is, they're
1:03:28
often regretting not spending enough time with family and
1:03:32
friends. And so I've certainly learned
1:03:35
that now, is I tried whenever I can, I work hard and it is a
1:03:41
lot. I do, as I said in put me right
1:03:43
in my purse, pay time charitable work.
1:03:46
But I also find time to spend time with my wife and kids and
1:03:50
my father and mother and All the other siblings because it's so
1:03:54
important. Those are the people really?
1:03:57
Also, remember you, when you leave work, when you stop doing
1:04:01
what you do at work, that the people will remember you, it
1:04:03
will remember your work, but your family from your friends
1:04:05
are the real people going to remember you.
1:04:07
So I've learned that is what I've learned.
1:04:09
I'm not the most important thing I've learned the importance of
1:04:11
family and friends. Amazing.
1:04:14
Thank you so much for sharing. As we draw things to a close.
1:04:18
Do you have any upcoming projects or some final thoughts
1:04:20
that you'd like to share? With all this nonsense.
1:04:23
Well, it's after the launch of the book, it now available on
1:04:29
Amazon and other out, they Outlets regular outlet for Book
1:04:36
Sales. I, it's really just promoting
1:04:40
the book and trying to get to as many because I see this as a
1:04:46
life skill. I also see this as a purpose.
1:04:49
My purpose in life. Yes.
1:04:51
So sepsis and delphine's Rien sepsis, aligned, and
1:04:55
conceptualize a actually about teaching this life skill to
1:04:58
Children a group of others who can benefit for it, because it
1:05:02
can change people's lives. The life skill of changing a
1:05:04
challenge, a major struggle challenge into success and
1:05:08
coming back and how you can do that very, effectively and
1:05:12
efficiently. So, what I'm doing now is, is
1:05:16
really promoting the book trying to get as many people to know
1:05:21
about it as possible. People share it learn and it is
1:05:27
learning this skill. The skill of turning a struggle
1:05:30
into success, and I want to do that more also increased in
1:05:35
schools because I can see that children will benefit really
1:05:40
formative in learned really early people.
1:05:42
Learn it really late. Some people don't know when they
1:05:44
are working or University or even leaving diversity and still
1:05:47
don't learn it and then they get a challenge in life at work and
1:05:50
it completely breaks down, we need to learn to learn that
1:05:53
skill. Do you make such a difference?
1:05:55
So what the project now is, is, is learning, is getting people
1:06:00
to learn this skill of changing struggling to success.
1:06:03
And for the book and I said the book is available on amazon.com.
1:06:09
You had a search for my name's for table or struggles to
1:06:12
success and it's available there on e-book also.
1:06:16
And also paper. Excellent.
1:06:19
Just, yeah, once again, a massive, thank you for sharing
1:06:21
your story here in fur. Coming on the show.
1:06:24
It's been an absolute pleasure. Thank you so much for your time.
1:06:27
Thank you for having me on the show with been a complete
1:06:30
pleasure, every really enjoyed it.
1:06:32
And thank you, thank you again. Thank you sir.
1:06:35
And to all the listeners of the Christian way podcast, as
1:06:37
always, I hope you enjoyed the episode.
1:06:40
Be safe, be well and I'll see you in the next one.