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Chemical, Biological, Radiological & Nuclear Incidents in the MENA region

With Dr. Hassan Farhat · View profile →

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About this episode

Episode 15 of ParaPodcast.

Chemical, Biological, Radiological & Nuclear Incidents in the MENA region — a conversation with Dr. Hassan Farhat from Qatar. Part of our Episode series, exploring the people, ideas, and evidence shaping global EMS.

The guest

Dr. Hassan Farhat

🇶🇦 Qatar

Dr Hassan Farhat (MRes, MSc, dual PhD candidate at the University of Sousse and University of Sfax in Tunisia) is a Quality Improvement Mentor at the Hamad Medical Corporation Ambulance Service (HMCAS) in Doha, Qatar. He has published extensively on AI-enhanced Delphi methods for CBRN preparedness and prehospital EMS research in Qatar and the MENA region, and contributed to the FIFA World Cup 2022 prehospital response.

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Ladies and gentlemen, everyone, hello. This is the PAR podcast. As we always do, we're bringing you African uh emergency medical care, parame medicine. We're taking it to the world and we want you to understand what's happening there. And also if we have things that we'd like to learn from the world, we want to bring it to Africa. That's what we do too. Um as usual, we have the usual suspect uh from different countries. Lucky today, our guest comes from a country where Tulani is. So we've got Tulani, Sibanda, we've got Elas Thomas who is in New Zealand. And we have a special guest today. I'm very
excited, very excited to have a I think it's important that I say this. I know you don't like these titles, but I have Dr. Fad. Dr. Hassan Fad. He prefers to be called Hassan. Yeah, he prefers that. And we're going to do that, but now and then remind him that he's a doctor, you know, and I I I I learned that he's got two PhDs. We're still going to talk. Did he get that? We're still struggling with the first one.
All right. So you've got the special guest. Yeah. Before you start, I just want to expose Melucas. I hope you jump in on this Hassan. The way and look there is some greatness and the stuff that you've done, but Melucy has been like when are we going to have Hassan? We want Hassan. We want Hassan Hassan. Look, I understand the work that you've done and it is really really good. Just that PhD.
I tell them all the time. Thank you guys actually. Thank you so much. Thank you Malucusi Tani and Das for for this great introduction and thank you for inviting me into this. And yes, actually I prefer to be called Hassan. So the and it's it's an honor actually to be here and to showcase some of the our African experience and to share with each other so we can know how to improve and move on and make greater future for our region. Yeah. I possibly sent a message to you last year already.
I said Hassan I think we should do this. I think you're still busy with some big projects that you're busy with. Um which was okay. Let's let me go back how I met you. I think what what made me excited was that h the way I met you I didn't think that you are an academic I think you are just operations chilled we were sitting at the steps of that clinic we're working in in that island in in in Qatar during the work 55 kifon yes yeah kifa island we're sitting there and I when I approached I think I'm not sure whether I was finishing the shift or was
starting the shift think should be starting the shift so who's this person here and and you were chilling the way you saw relax and you're talking to people. Now, how you know a person has integrated? Well, they're talking to different nationalities, you know. Okay. So, I noticed, all right, this brother here is talking to different nationalities. Let me go and jump in there. Then I joined the conversation. I think there were nurses from Australia and from the UK. And then I jumped the convers.
Yeah. Yeah. It was it was it was it was it was good and I never thought and then the next thing I think I saw a paper by Gangaram or something a Dr. Ajit, you're my friend. Yes. I was like, "Oh, Ajit Gangaram. All right. Oh, Hassan is also there." And then Hassan is publishing. And then I sent a message to Hassan. I went to LinkedIn. I say, "Hassan, congratulations, brother. I didn't know that you're into this stuff." You know, and then that's how things started. And then when we started the podcast, in my hearts, I said, I want Hassan. I want Hassan. I need to talk to Hassan so that
he is part of this. Thank you. Thank you. Yeah. Yes. Thank you, Malust. Yeah, thanks for coming. I think with other people sometimes they say they're going to come and h and you doubt if they want to come, you know, but with you I was sure that you want to come, right? Okay. Now, let's start from here. Who is Hassan? Who's the Bahad? Yes, trust Hassan. Okay.
Thank you, Maluci. Thank you for and actually for bringing back those good memories and um and actually I think I would start from there, you know, for from the story that you said. So I came from operational background and actually I'm a person that I don't like to show up about anything that we are doing and um in my mind I have always believed that the world is enough for everyone and we need to be together and we need I know the differences actually they would make us actually nearer and closer to each other rather than actually away and fighting and um and that's what probably
what I believe in and um so um I'm mostly what if I ask about myself. So what I can say about myself that I am a foremost I'm a finisher person. So when I start something I want to finish it and in every project that I and I like challenging things. So every challenging idea when I do it actually. So I I like actually to to finish it and to go through it. So I so seeing things through and until the end you know I never I never stop. That's what most importantly doing. So I can say I'm a determined person finish it like something like that. And most
importantly what it fuels me as you mentioned is the lean leadership. So what's the lean leadership? It's about just being humble. That's one of the most important and believe always in continuous improvement and that you can change things and most importantly that you empower everyone everyone around you because there is a leader in every one of us you know somewhere there. We have just to believe in them and and to encourage them actually to shine you know to show uh to show what they have to show their capabilities and in order to attack success to succeed at any project even oper operational like you said we were during the world cup the
people they have to believe that you are one of them and not just a leader there is that barrier you know vertical relationship that from operational point of view that's maybe very important but in term of the relation with the team I think blending with each other that the most important. So if you saw me during the world cup. Yes. So I was actually walking everywhere. I was carrying the team's chair. So actually and I asked them to walk you know just but I mean uh to walk through that you know quietly.
What instant said were sometimes that the world cannot change without we change our thinking. Okay. So we have to change our thinking first and that's the most important. And I want to mention something. So I know it always from um some I'm from a Muslim background and I'm sure exist in every paper paper and from the Quran it says that Allah indeed will not change the condition of a people until they change what's in the in them in uh in themselves. And this is what I mean. I mean we we have yes absolutely to change what you know what we have in our heart to be able to build
together a relationship regardless of the differences. As I said, the differences actually make us closer guys and um you know closer and actually we should it help us to build together a better future for our region. I think I hope we're dropping. I hope I gave you just some idea. We're dropping bus today. Someone may be wondering uh we can see that he's likely from Africa.
They're looking at you. Where were you born and when did you start migrating and what happened between that between there being there in the country where you were born to migration? Yeah. Yes. Thank you. I So um I'm Tunisian. So I was born from Tunisia. So it's in North Africa as everyone knows. So it's an African country. Yes. I'm uh so when I used to work there I worked with me I worked there in the disaster management first in the ministry of health as coordinator of the national in the national unit of disaster management with a parame medicine background of course it's senior health emergency
technician or technology in Tunisia in Tunia which is a bachelor degree in emergency medicine in the frophonic system let's say okay um so so this is it and um and actually I had the opportunity to migrate at that time so we we uh we worked in this unit in collaboration with WH. So um we uh participated at managing many of the events together such as the Liby during the Libyan war and during the border and the anti-displaced population in the border and I had opportunity actually to um I mean to migrate elsewhere but one of them was Qatar here in the parame medicine and the reason I chose Qatar is
more it's it's a very nice place that when you can settle with your family and um I was married that time my wife is with me now um and uh So uh it was the best place actually to uh to uh to say if you decide to build a very a good family in good condition is here and actually appreciate it and I would like by the way to appreciate my wife because she uh she was standing behind not I wanted to say behind me actually she she was driving with me every single step in during our journey. We started building uh I mean oursel from scratch and she
stood with me in every single steps and she always believed uh I mean supported me in whatever I have done and in my beliefs and we shared the same vision together. I think it gives a license to call you Dr. Squared. Yes. She wants to tease me. She does that actually from time to time because she knows that I don't like to be called doctor. So yes she does that actually.
you migrating from Tunisia to Qatar. What would you say were some of the push factors for you to move to Qatar? Cuz um we're trying to understand that from a another brother, from another mother, from another African country, especially from Tunisia. What would what are those factors that has made you to take a decision together with your wife to say, "Okay, we like Qatar. it's a very good country but what what were those reasons? Okay, thank you um Tulani for this question and let's go uh straight forward into the answer. So unfortunately what we we are facing in most of the African countries that you
don't have the opportunity to improve and change and be impactful and the there the there there are always a lot of barriers and people that will try to say to bring you down or step you back wouldn't allow you and this is include not only people let's be honest because it's related to many other factors such as the the environment and the thinking itself okay and when I read about Qatar and um I mean the system how it works here and how it's very I mean um advanced and actually I at that time I was surprised that it was actually very advanced system and it's aiming to
compete with the international other system in the world and it's a country that people they they help to support you I mean to advance and move on with your career so that's one one of the objectives and we and what made it actually easier here that we share the same culture as well so when I came here actually I didn't regret that decision and actually um I would be thankful that I think that was um an very impactful decision when we moved to Qatar and it was actually it helped boosting to be the person who I am today.
Interesting. And I think to learn you would share the same uh the same perspective as well as me. Look um I think from what you've said um I just want to share a little bit is that recently we interviewed um Dr. Ravin Naidu and part of that and I like this podcast cuz we get to learn from each other through the conversations that we're having. He mentioned something like um the pestl pneumonic and he said that there's factors that drive and shape the market trends and uh and the life that we leaves and those things are influenced by the political I think the pistol pneumonic is related to uh
political environmental societal technological legal and economic uh factors. So when you look at all of these things, they have an influence on us as um individuals whether you're in America or different regions is that they will always have an influence whether political, environmental, sociomic factors that would make us to migrate from the countries that we coming from.
So I agree with you when you say that. Um I almost wanted to say it's difficult to chase between Dr. Hassan, it's fine. John Hassan, please. Yeah, let's be honest. So, we are not doing politics here. But I was um and but I'm known a person and you know me guys that I always tell the truth regardless of what it's cost. But the politics leadership here is very supportive also here to to to the advancement and uh they provide everything to I mean to so you can improve and boost let's say the the the capabilities within the the new generation which is actually I appreciate and I wish if I mean it's not
about the age because I wish honestly if the leadership where I'm coming from or whatever I mean they change their their thinking and they see such experience and it's not actually about Honey, it's about and it's not at all but most importantly about what we want to do and what we aim to do and how how much we are willing to change the world and that our countries. Yeah. And to those of uh you who hope that they're going to hear what Raven said about the pastel, that was behind the scenes. You didn't hear that. You didn't record that. It was us talking behind the scenes.
Unfortunately, if I remember correctly, that's what happened. Yeah. Now tell me one wonders like one PhD is hard to get. Now you go and get two. How does it work? How did you do that? Okay. So everyone actually they keep asking me the same question and I I I only realized that I I only realized the importance of that only when people actually ask me this question. So sometime also myself I say how did I do that? So let's let's say I got I got my two and for the record I got my two PhDs. I published seven papers from one of them and six from the other one and
all in Q1 and Q2 journal. So it's not it's not just any work. It's really serious work. Um I I I hear I need also to be grateful to the system that we we have also there in Tunisia and I hope that also I hope that other of the African countries also as well they follow. So the first important thing that I was supported by the best let's be honest and there the system it allows actually as long as you are one of the pioneer and you are very well it so you can study in the government for free it's the government is paying the fees as
long as you are I mean of the poner well I mean one of the the very best it's like that and I got the opportunity to be supported with with uh some of the professors that I will be grateful forever Professor Amed Galguri, Professor Muhammad bint, professor um um I I don't want to to uh to forgot any name. So I always forgive you if they do. So I have always I I have professor Mosawi. So I have that's bad. It's remembering name is very hard. So I will be grateful for them forever. That's that's one of the the the the factors. The other important factor
again and I'm not trying to play let's say safety rules because you know when you speak about wives it's always about safety and you need to be careful not to get them upset but I yeah that's that's that's very absolute truth you know that we need to be careful to be aware of but honestly I I encounter my wife she's the best the best person I have ever met she she she's the first she's the first person I love and she's the love of my life And she supported me from every single step. True. I mean she was behind every time I wanted to do something. She
was always behind that and support me and probably because we believe in the same concept. So we we have something in Tunisia we call it when you we are studying in she pioneer in the elementary school. So they to they took that best of the best and they put them in special program and they keep following them until the high school and graduate. She was one of those you know.
So we share the same vision and she she works with me here in DMS in Katar parame medicine as well. So and she's undergoing her PhD as well and I'm I'm now her how you say this mentor or supervisor. Oh yeah supervisor. So so it's mainly like this but most importantly Maluci it's I'm honestly a very determined person you know when I do something I want to do it very well and accurately and I want actually to be impact impactful. So when I'm I remember when I having having all those deep thoughts let's do this project let's do this research project and they were actually very impactful and this will
with the capabilities and the opportunities came together you know and the support as well so so um those were the drivers of this let's say success we're coming to your research Hassan and it's very interesting it's very interesting before we get into the research I think I had a question just um before we get into it and uh of course I understand the support aspect of it and I also understand that you were able to sort of get a little bit of free education. Can I say Tunisia? Is that is that correct? Is that how I'm getting correct? It's yeah it's not I mean you pay something symbolic but not
for everyone of course you have to be I mean um yeah exactly outstanding. So it's not for everyone. Okay. And actually I was outstanding in all of my studies. So that's why I always like that's one of the driver. I was always when I applied for something I got chosen is it's that's one of the reasons. Okay. Okay.
That makes sense. And can you just run us through you know the gap between your two PhDs like did you take at least 6 months off and then you got the next one cuz I'm trying to understand cuz I know everyone's getting feedback. It's a lot of stress. You want a little bit of break. It's a lot of trauma. Then you jump right next into the other one. I just got one now. I have a second card.
Yeah. You will be surprised to stay on car. You will be surprised. Yes. If if I would tell you that I run them both together at the same time. Why? So there was a gap actually of few months between them. So when I started my first PhD and I was working on this the first project that I was passionate in and actually so this this is it you know I'm very hardworking. So I was working on multiple projects at the same time. You can't imagine besides my work.
So if I I remember the time when I was doing this I actually I used to sleep like I think four hours and along like the six years I never like I never went outside to a coffee shop or anywhere. It's always staying here at home with my laptop. So I remember my wife was joking sometimes. She said I think you are married to your laptop not to me. It's like this and and uh so I always take my books with me and my iPad let's say and my my that are the items that I have them even my car wherever I go. So I
always try to do things in between even when I worked in the field like sometime I do clinical before and I work in the field. So what I do I bring my laptop in between calls I open I write on something then I put it back. So uh honestly I work I worked so hard. So let's be honest and some of the projects in the second PhD let's say the one of the projects in the second PhD was very impactful for the work environment in EMS it helped actually exploring something that was never explored before which is the non-transport decision here in the pro hospital setting of Qatar and
then um one of the important this is another important thing so I I like to do the data analysis myself so I don't want anyone else to do my data analysis and I have some skills and some capabilities in data analysis and statistics. Um and the reason is with my respect for all the data engineering uh engineering and data scientists that they don't have the heart that we have as a clinician when we know you know what we when there is something clinical decision you know which which factor you decide to choose them it's not only let's say the regression analysis outcome or the correlation outcome that drives you so I
have I had some capabilities I think that helped a lot guys I mean in this when you have some capabilities in data analysis and statistics and data science So I was doing everything myself. So every time I'm working on something in a method. So it I had that other idea why why can't I do it the other way and then I'm doing them. And recently like since few years I was I work with coding with our programming. So when I'm coding all of this together and doing the data analysis like I have like 2,000 something lines of code like this with with the data analysis and that's not
something easy to do. But when you look at them later, you can see that you can actually do one project from a part and second project from another. And the one that was driving me, it's the quality improvement perspective. So I'm I'm not promoting for anything, but that's one of the best thing that I knew is that I'm from a side that I'm a researcher and quality improvement expert, let's say from the other side. And I had those mixture together to bring the academic into the practical field, you know, so people they can understand it. And every time when I do something to realize that
I'm succeeding on it. So I present it to someone who doesn't know anything about the what I'm doing here in the field. And sometime I do this when I go home to my mother who doesn't know anything. So if she understands what I'm doing, it means clearly that I'm succeeding. I'm able to to translate those academic stuff to the field. So I'm very passionate. Yes. True. About it. So I always read I work even on the plane everywhere. They were very very specific years for four or five years. They were very specific honestly. And um I sacrified a lot you know and as I said
that I'm very determined person to and finisher when I start something I want to do it and effectively that's most important. Yeah. Look. Yeah. Did you want to add it to? Yeah. No, I wanted to add on that question that I has asked and um probably someone else that is currently doing a PhD um maybe married in a relationship um or committed how important and now that the tables have turned you know with your wife doing a PhD got you you're married now I'm keeping quiet how safety reason how important is that support cuz um PhD can take a toll on someone's mental, emotional and physical
health and and I can relate to that that it demand it demands a lot of time. I mean my Lucy and I are doing a PhD and IAS soon will be also embarking on the journey. But how important is that emotional support that you get from your from your spouse, your loved ones, people that are closer to you, even your friends as well that share in the same uh community cuz I can relate that whenever I speak to Meluci or my partner is that we I can get sort of get that comfort or the people that are in the close circle of friends that support
makes it a huge difference. You know, even if you're complaining about something, but it helps cuz there's someone that is listening to you. You know, like see now he was venting that he just got an essay an even focus on this interview. But the fact that you said it, you can see he's smiling. He feels better now. Yeah. Got my coffee.
Got my coffee. Yeah. Thank you actually, man. And I like what you are saying. It's very true. You have to be surrounded by the right people. And I would mention something I read recently in a book from the bus of energy and I advise everyone to read it for for to um it was written by Gordon and uh he spoke about something we call it energy vampires.
So those people energy vampire if you are surrounded with them they will be always let you down bring you back and never let you go. Also they will tell you it's very hard to do this. is you will not you not get anything you're not going to get any money you are losing your time you are losing if you surround yourself with th those people actually you are going to be affected with with what they are saying and you will be always like stepping back actually instead of moving forward so and and this is the key the key thing for for me so the support is very important so this
is it every time I feel like it's very difficult and say how how why did I do this to my to myself you know why I'm doing this So every time when I do something like this, my wife actually was there and she she she sees like when I'm going let's say to my very bad worst time. So she step in and she start like say telling me what you are doing now and why don't you do this and you are doing very very well and encourage me actually and support me and boost me and and they are they were minor thing guys that I still actually appreciate them.
Um when like I wake up very early or 4 4:00 a.m. something on my off and we are both off and I just want to stay outside to review something study. She herself despite that tried not to disturb her she herself she wake up she wakes up and she she she help try to support me prepare coffee something like that and to help let's say and let me what you are doing and um to manage in between to be honest and she she never complained despite she has the right actually to complain at many at many time I I apologize to her that I was not in the
level that I mean I wasn't there I was really taken by this don't cry brother So exactly actually it worth that's it you know that okay but honestly guys I mean she was there with me in very single steps and she she helped me and actually that's very important so as I said here she was not the energy vampire she was energy booster that's what I want to say she's a vampire maybe in some other stuff but not in the energy so this is you you need to be surrounded by the right people the right persons that they will always encourage you and make you feel
that you are doing something that is meaningful And when you publish an article or let's say prepare a paper or we do what even small data analysis uh part or you write something a paragraph they make you feel that it's it means the world for them. Interesting. I wanted to say what's the title of the book again?
Uh it's the the bus of energy. The beds of energy. Yes. And it's by Gordon and it's actually a very nice book and it speaks about the 10 rules and it it tells it tells you know this in very good story when someone had a very bad day. Uh he had a flat tire with his his car and he asked his wife to take him to work and she refused and he was very negative thinking all the time why she's not helping me why she doesn't want to do and he was very sad because he will be riding the bus to go to work. Okay.
And actually when he he ride this this bus he saw something on written 10 rules initially was very negative to everyone and it tells the story during this trip. So the the the the people who ride those that bus and the driver of the bus they talk to him about the 10 rules to be successful in your life and those 10 rules are very important you know about how to succeed in your work. So before riding that bus, his boss was deciding already that he's going to fire him because of the productivity. When he stepped out of that bus with these rules and he started immediately applying
them, suddenly his bot changed and he became very productive and innovative. And this is what we need to do to to do we so when we do something we don't you know life is so short and we don't have to waste it in very very non-meanful things or things that just to replicate or to do to to replicate what other are doing. But whenever we are um spending time and investing time in doing something we have to do it with very innovative way you know to have to be impactful. when people when they see someone that we did something they wouldn't start from zero and actually
they would say I hope someday they would say that that person did this so we start from there you know right Hassan I think now we're going to move to research right and there's two things that we're going to do the first one will be I'd like us to you to give us a summary of this paper like you're talking to your mother yeah like what you did cuz the idea is that we take research we bring it to the operational person on the street and while at the same time a person that writes the policies understands what to do you know and then after that we're
going to talk about the methods and stuff like that and and then after that we come back to the research and talk so the the methods part is for the people that love research I must say though um I think in the papers that I've read that we normally read it's normally is a straightforward to find one method or it's uh two methods and then it just flows. You know where you're going with the paper. Yours is not like that. No, it's not like that.
It's a whole lot of systems that you've created and a person that is not used to reading research. You they will be easily be thrown out because it's technical. You are a very in-depth thinker. I respect you. I respect you. It's like you're showing off in that paper. That's what I say. It's like you're just I'm I'm just going to show them what I can do, you know? I'm not going to play it small.
I'm just going to go hard. Anyway, let let's go back. Let's go back and talk about what how do you describe this paper? So, the title of this paper, if you can Google it, I'm sure is going to post it for you guys. says, "Preparedness in response strategies for chemical, biological, uh, radiological and nuclear incidents in the Middle East and North Africa and artificial intelligence and has deli study." Yeah. What is that? Many words.
What is that? Yeah, exactly. Many words. It's very long title. Um just to I want like to mention this Malusia that I was invited the last couple of months by who in Abu Dhabi in their EMT I mean they invited me to speak about this paper specifically and the work that they have keep shining we love this and and actually it was so they gave me the slot so one of the I think um guys when he was reading it experts in disaster medicine he said I would like to invite you to speak about it and I saw that you have a poster already in in
that band. So when I went there, they gave me two slots and one of them during the innovation in disaster medicine. So it was presented in that context. Uh so actually yes. So this paper it's not like um like other regular paper. It's true. I I used a lot of different methodology and everything was planned. So it didn't come by chance. So I planned from that since the beginning and what I would like here to what's was the driver most the driver of this that the Middle East and North Africa region actually uh which is the main reason let's say the the main reason faces
actually a lot of risk when it comes to related to CBRN CBRN which is chemical biological radiological and nuclear and here to give you a background that my expertise in disaster medicine specifically in CBRM so it comes in this field beside the quality improvement and the quality and patient safety So let's be honest, you know, in the Middle East and North Africa region, we have a lot of geopolitical instability and we have frequent conflicts and infrastructure uh you know um infrastructure that differs from a country to another and that clearly that we need actually to have how we say this is specific preparedness and we have to
address various gaps within the region to face various any potential incident of CBN incidents and it's not like we think that CBR it's very uh yes it's true it's rare But they can always happen at any time. And we would like to remind everyone when in 1995 in Japan when we had that attack in the subway of Tokyo that Japan was class classified that year the most peaceful country and yet they had that CBRN attack. So it's expected and we have a lot of how we say there some I mean um industrial advancement within the country. So uh that industrial advancement come with the cost as well because it increases
the risk of the CBN incident and I didn't and what what what's happening here that we have a lot of effort actually that they are scattered everywhere every country every person even in the same country they do some separate effort they don't want to collaborate with each other and this is the dilemma here and we think that we are trying to improve the systems or let's say the preparedness level for any incident that can happen in the future in disaster management But it's not actually because because it's separate you know when it's scattered you weaken the effort and what drove me here it's the the the what they did in the in
Europe they have an experience they call it enot which kind of it's kind of training program so they cooperate all of them together to build this training program to empower their staff with the necessary training for the for the disasters for disasters such as TV and here actually in this paper in this work. So we try to address the uh prepare operational response guideline.
So I'm actually spend a lot of effort into preparing that from scratch and uh a preparedness checklist that can be actually it's flexible can be used for every country. We we don't have the same the same capabilities especially Middle East and North Africa. So but that paper actually it it can be applicable that checklist can be applicable in every country and one of them also the other part which I tried to write what we call them um simulation scenario training that simulate actually the the their real life the work you know to use them when you are managing sever incidents in prehosp setting and in in hospital and
uh so and at the same context I would like to mention that I was invited to to participate from colleagues from Turkey to write a book about the strategies for preparedness for civilian incident and in one of the paper I spoke about um I mean these scenarios and um I spoke also about the quality improvement in disaster you know in time of disaster so regarding this one so we tried actually to address this and we invited experts from all over the world and this is maybe we we when we have time to speak about it I'm not sure maluci how we did that I mean let's go for it let's go for
it yeah exactly so so we when I was thinking I said we cannot build something from scratch. We need actually to have the the experts the best experts known in the field and the representative for each country to be able actually to give their opinion about that. And I know this is go sorry Hassan that's why I saw Dr. Professor Alan Allen if if you look at the references he is the is the third one in other papers he's the second reference and we've heard him on the podcast so I need to mention that. Okay. And by the way, I would like to deeply appreciate Dr.
Allen, you know, for being I mean, he's very humble person and I think I'm very lucky to thank you. I appreciate I know I wouldn't consider that myself I'm oneird of that person. I'm honestly very lucky to meet to to meet him because he's very supportive and humble. And when I contacted him actually so so how it happened, we didn't know each other when I emailed him and explained actually the purpose. I think he saw the the the the the purpose that it's serious and something I'm doing serious.
He was very supportive and he was helping through that the the all the stage actually he was reviewing every single paper out of this beside the other colleagues here in Qatar professor Gon Dr. James and other here in Qatar to be honest so the uh these are my boss in at work but actually my friends and they were very supporting actually here but Dr. Alan was very helpful in this. So we invited when I contacted actually a mail or Dr. Gregory from Harvard um everyone and from Canada from Iran and every I think this is maybe one of the rarest paper when we have people from South
Korea too South Korea South Korea Dr. Eugene, you know, Professor Eugene, I I hope that they all forgive me that if I forgot to mention anyone from Lebanon, all of them, they were very supportive and I think this is also when I come I said I'm very lucky that I I when I contacted them, they responded very positively. We built together. So when I show them the material that I prepared, actually they reviewed each one of them, you know, and they were very positive into reviewing them. And then they were everyone was thinking how am I going to interview I mean all of the experts from
different countries. M then actually and you know expert when you speak of someone like professor Alan or anyone they they don't have time actually to do this or professor Greg Dr. rigory. So what I have done I used an so I searched about it I found an application that is online that when you can uh record a video to respond it's like interviewing someone. So I recorded all my questions there and you were able actually to answer them in audio or video or writing according to their preferred uh way and it saves automatically every answer they submit. So if they can respond now to two question then later they carry on
to decide to the other three and and tomorrow they carry on the remaining and every time they try to login it takes them where to exactly where they stopped. Well that's why they mention in the reference to this application. So I searched a lot about it and English is my third language as you know guys. So my mother langu my mother tongue language is Arabic then French and that actually helped because I translated question to Arabic and French and I uploaded them all in into that application and um it was very so that's one of the steps you know starting with interview so first we started
interviewing these experts and then when I got their results I analyzed them and based on that I started building for the next phase which is building for the question for the checklist and I wrote my scenario is exactly uh according to them and I prepared the response guideline for CBR and incident according to their answers the experts and then uh I did the systematic review it was actually three years work and I was not alone with the team so again my wife was a core researcher here she helped with she was the second reviewer professor Gon Dr. James, Professor Muhammad. So that that was a systematic review for
every single paces uh sorry every single paper since since ever you know since before until 2020 when we did that paper. So we started initially with more than 3,000 paper then we moved down to 300 and then uh like I I read every single paper one of them to to try to figure out what they did exactly. So this is here when it come guys to the question to your question earlier about being determined how you can do this. So I read I I take my iPad with me and every time I find a space of time I just start reading the paper and doing some
notes and then we build the final guidelines and um scenarios here and um and there you can find the remaining details in the paper. Yeah. So that ladies and gentlemen is two methods that he has used. The first one is called the deli method where he takes the experts put them together in one way or the other. So he was smart about it. Found the software that he used that can assist him to capture what they saying in their time in their comforts in their countries not necessarily have h to be together which is brilliant. And then after that he went and did the systematic review where he looked at the
research that is currently in that space and uh yeah and then he published those two papers. But let me see on this one cuz if you Google your name uh uh Dr. Hassan H you find a whole lot of stuff of papers with the similar uh language. So I want us to to make this uh practical. I think for a person who is a clinician, a person that works on the road, uh there was an incident in the UK where a a person who was a former Russian spy was killed. That was in 2018. That's recent history. We also have another one, another guy that was trying to run
for presidency in Russia that was also killed in a mysterious circumstance. And these agents that I use there, it's the agents are this either chemical or I think it's chemical in this case. And they they you can't see them. You it's hard to identify. They do not smell. True. Yeah. Now in in a country like let's say Australia or South Africa, a developed country or a developing country, a developing economy. For example, in South Africa, there's going to be a G20 summit that is coming. Yeah. Okay. Where everyone is flocking there and and and and if you Google in in the Australian um uh travel advice, they say that they
say that the advice be cautious there's a G20 summit because there something like that. So now let's say a person is trying to develop a policy to prepare their their their team and how to manage this. What do they do? Where do you start? Where do you start now? After seeing Dr. Hassan's paper, Fahad's paper, what do you do? What do you do after? I actually I I like what you mentioned right now, Malucusi, because I actually I spoke of that incident about the Russian spy who was killed in UK. I mentioned it in one of the papers. So I tried to speak about it in detail and
yes, I read it. Yeah, exactly. So when they use that so the thing that um in and I like also when you mention about the summit in South Africa because in one of the scenarios that I prepared out of this papers simulation scenarios it includes visitors that came from a country from multiple country from multiple country to for an event medical event and there were an incident and for for regular clinician let's say on the road we work every day or emergency department that might look like something um out of normal but all of them they have the sign of symptoms that that we know them diarrhea and
vomiting then convulsion but actually when you see a lot of people that they share the same sign symptoms of uh such thing it means that it most probably it's CBR incident it's an attack biological agents here uh so I I like what you are saying so we need actually to expect that and this is what I appreciate the most so so let's be honest worldwide As you see now the world is not stable. So we have a lot of differences and there will be always this attempt of uh someone trying to kill the other person. Uh and there is also that some people they use this
to fight with their beliefs the wrong way and we call them the extremists. So when they can they are not able to convince you with something their aim is to convince you with with with force and in order to do this they try to make you feel with fear. And how you make how to fear with fear kill as much as pos or harm as much as possible to feel their strength. And we have them let's be hon we have those people everywhere. You can never know them you know that sometime they can be next to you or somewhere.
Yes. And and so in order to be seen for them, they choose actually the spec these specific events like when the event when everyone is there or people from multiple countries to do it regardless of of the outcome of what what and when they do it they do it I mean to kill as much as possible or to harm let's say not to kill I mean to harm as much as possible. So in such gathering event that mass gathering event are the most actually vulnerable um how we say this events for such incidents and it's not only that about just we have different events religious event like we have alash in
Saudi Arabia they spend a lot of preparedness I mean along the years just to ensure the safety and protection of everyone we have a lot of summit summit everywhere and trust me I'm sure that the the to in order to be successful in your preparedness plan, you need to consider this happening, you know, and we we rather prefer to be ready for something than not being ready at all. Let's say that's not going to happen to happen. Uh let's not get prepared for it and just leave it like that. But when it happen actually it going to induce a lot of uh injuries and we are clinician like you
said like a life matter a lot regardless you know and we don't want to see to see people are being sick and that's why we choose this field the prehosp care you know it's because we want to help people and this is what I'm telling them is different from people who work in the hospital so when you are working outside it's very difficult it can be rainy weather it can be snowing where are coming from or probably it can be very hot when like here in Qatar But we want to help people. So this this is probably so this is one of the drivers also that we need to get ready
and prepared for the incident regardless or they are going to happen or not. We have always to consider that something is going to happen and this is this is actually what the history taught us as I said Japan that's one of them and there are multiple events in every single countries and country in the world until recently especially in Africa we know this. So when they have different regimes they are trying to fight always the the easiest thing to to to make the people uh scared of that regime it just show them how weak it is and how we can show that that regime is weak when you
induce an incident that kills or harm as much as possible and the the the sorry guys just the very the difference here that the CBRN are not like the other weapon that you can detect them they are undetectable so like the the incident that was used in Russian to to kill Russian to kill the spy that spy it was just in perfume you know so you can never detect that it's there you know it's undetectable so the anthrax before also was undetectable in US in 2001 so all of this material you know CBRN materials they are undetectable so uh that's why they are easiest actually and
and they are being operational operationalized everywhere so we need to be careful that's why so I guess in this case there's nothing that you can do to prevent I guess maybe they can try but the issue is how you react to it is is where we can try and act yeah let's be honest to to prevent there are also how we say mitigation plans for every risk but we have to admit that it's still a risk maluc I mean we it's an avoidable risk let's say so we can try as much as possible to reduce that such you can control the the the the markets of such
materials You can maybe uh do uh some rules that are going to be very strong in controlling and managing and monitoring the exchange of these materials or their use inside the healthcare facility or elsewhere industrial area. And this is actually one of the elements of the readiness checklist that we did in that paper is to assess actually how how much you are ready for that and you have to ensure that you have the legal context into this the appropriate laws that categorize and uh and organized this. So we included that in the checklist actually that we it came out of this paper. So to show how how what's the
level of your strength in this and that that paper is just I mean the beginning of bigger work because we need to be thinking also about leveling the outcome of the the preparedness level and then probably stratify the let's the say response plans and everything according to that. Look I I I'm I'm seeing a trend with you Dr. Hassan, when I listened to you, um, and, uh, when I listened to you, when you started the podcast earlier, when you introduced yourself, you said that when you're working in Tunisia, you were interested in uh, disaster management, but also 10 years later, I don't know how many
years later, but you then also embarked on a PhD journey where you focused on something that you're passionate. the way you speak about it, you're very knowledgeable and um you've shared a lot of information that is um valuable things that I never even thought of. You know, I think one of the things that you you you mentioned is uh being preparedness. I think some of the things that you highlighted in your paper like the Chenobil disaster that happened in Russia, is it Russia? Yeah, one of them.
It's something that means and it's not a question, it's just a comment is that um the the the the the serious critical errors that were made in that were made by inadequately trained operators in a shogill um incident who were poorly trained for planned um safety tests is that resulted in Chernobyl happening. uh and also they tried to conceal when things were going wrong to try and not let it uh go out of control but in them doing that it ended up being becoming a disaster till today the country is still suffering in that area from those disasters. I think it's important that people listening to this is that um
disaster management is important and um from this is that disaster management forms an important aspect of emergency medical services. No, it does not exist on its own but it plays an important role. Yeah, I think that's what I wanted to say. Yeah. Yeah. That's very true actually to to Lani and we have also to think here that CBRN when everyone think about CBRN they think about the intentional and this is the example that I mentioned here but some of them they can be accidental such as because we have industrial advancement especially in Middle East and North Africa here and here in GCC mostly that we are advancing and moving
forward we have prom pet prochemical products and we have that in Africa everywhere so and I So also in the host I mentioned that in the papers that some of the incident in Ghana and many other countries. So and uh the other incident and um and the other type that we have to think of is the natural one such as the pandemic 19 you know it was here. So we had no sign that something is coming.
So the suddenly we found ourselves facing a disease that is spreading regardless of whether it was operationalized as well or not but it was a pandemic there and there will be always something coming soon. I mean it just rest and remember before we had H AH1 and I recall at that time we never thought that such a virus or let's say everyone say influenza virus is going to kill people honestly everyone just going to take some anti-inflammatory paracetamol and everything is going to be fine in the worst case scenario yes exactly antibiotics but was not the case and we see that the v viruses are
evolving even even nowadays and I'm sure this in our during the clinical I mean shifts So we can see that even the clinical presentation of some of the patient. It's honestly different from before like when someone is having uh a gripple infection. So it's it's very different from before. It's not it's not like I mean we used to see it a few years back and this is actually very important. Uh and yes ui also um so what drove me here was mostly the passion because um disaster medicine is not something that I'm just interested. And I'm very passionate about it and when everyone speaks about
response and we need to buy and do things but we need actually to think or about stuff and items that we can do such as preparing our staff and make them know knowledgeable and we have that protected we have the legal uh how say this the ethical framework and the the the educational framework and then we we need to think about the capabilities and it was never about that actually and when I give them the example I told I tell them in the World War II. So, Japan and uh Germany, they were were the countries that they were actually almost totally destroyed, right? I think
80% of their infrastructure they were destroyed and yet you see where they are right now. So, it it's not only about I mean cap it's capabilities I mean or money it's about the well itself and this is what I'm trying to say here that we need to allocate. It's not this is not going to happen in a few years but we need to start somewhere and to build something for the future generation. So we'll try to tell them that we need to build about the what we can do here educational framework and ethical framework and that's not perfect I'm sure but it it's something that people
they can build on it. Yeah. Wow a lot to digest. Sorry I was just holding a few comments and people trying hoping I can get a space in there. Um I like I like few of the points that are made. I think from Chernobyl to sort of like co and I remember when COVID happened no one knew what to do. no one to no one had any protocols or so and you know and I think one of the other things as well is that we lacked the collaboration to share information factual information and as Tani said you know when Chernobyl happened they tried concealing it
instead of like sharing the actual detailed information and I think there's a lack of channels to say that this is the channel that we are going to communicate it's an approved you know existing channels within nations where we communicate factual information and try and get information across. So I think the theme that I'm getting here is be prepared and I think from one of our earlier podcast we had a gentleman from Zimbabwe and he kept saying since he was under resource the main thing that he tried focusing on was try and prevent before we react. So I think it's I think it's a very important aspect when it
comes to to disaster management. Uh I think just because of time I'll probably try and pause there but yeah a lot of things to sort of like sort of like chew on and try and digest really musi look uh Asan thank you very much we we my pleasure we we we highly appreciate you this uh 55 minutes has been very informative literally every line has a punch in it and I had questions We've covered everything that is in the questions and I think there's there was a question that I was going to talk about uh EMS in Tunisia. You answered that in two words. I'm not sure if everyone
I think we need to leave the No. Yeah, I heard him. He answered he said that they in Tunisia they there's a bachelor degree and then it's franophobe and that's it. And it's up to you. You go and Google those words find out what is that. So if it's let's just say so there are two types two type of yeah yeah yeah yeah yeah which is coupon run and treating on sea and us in Tunisia that we focus to to treat everything on sea rather than transporting that to the to those yeah yeah yeah so for for people that do not know much about those things
it'll be huh what happened there you know but I can we can pause this for 15 minutes and you read you you listen to it and then you get a lot of information and then start again for another 15 minutes to get a lot of information. Well done. We highly appreciate you. Um and thank you for your time. Keep on doing the the the good work. Uh we hope to have you again when you have another complicated methodology that you have employed another PhD also PhD if you want. No, I got I got a warning about that from the wife. You know, no more mentioning about stuff about PhDs. Those
are bad words. PhD bad words. in this house we don't mention that exactly for safety issues. Yeah. Yeah. Thank you. Thank you very much Dr. Fad. We highly appreciate you. Keep on doing the good work and we thank you for your time and everything that you have shared. Thank you everyone. Thank you Malusi Tani and Ilas. It's was it was really my pleasure and it was an honor for me and thank you very much for this opportunity and um yes that's it. Well done guys. Carry on what you are doing. honestly. Thank you.