Professionalism in medical_science_-technology_sejojo_mamohato
Organisation for the PROFESSIONALISM IN LABORATORY MEDICINE / MEDICAL TECHNOLOGY Sejojo Phaaroe M.T; C.T(I.A.C) ; M.I.B.M.S firstname.lastname@example.org +266 63102600 -Medical Laboratory Regulatory Council Focal person -Pr. Biomedical Scientist GT# 1337 -Cytologist of the International Academy of Cytology # 6467Health Research & Laboratory Services
Outline• What is a profession ?• What is a Medical Laboratory• Public expectations• Why Regulate Biomedical Scientists• Obligations of a Medical Technologist/ Professionalism in Medical Technology• Overview of Ethics in Medical Technology• Qualities of a good Professional Medical Technologist/Scientist• Dos and don’t in Medical Technology• Professional Registries / levels• Areas of Competencies and assessment• Continuous Professional Development and Benefits• Conclusion
• Queen Elizabeth 11 – Central Laboratories- Irish Regime• Kamazu Teaching Hospital Laboratories: Lilongoe- Malawi- DANIDA – 1989• South African Institute from Medical Research- SAIMR- Capetwon- Somerset Hospital – Green Point• Yvonne Parfait cancer Research Laboratories• University of Cape Town and Grooteschuur Hospital : under Professor Rose and Learmonth• City Park Hospital – Pathcare lab• Marmara University Hospital ,School of Medicine• Oppenheim Hospital – Pathology Laboratories• University Hospital Brussels- path-labs• Victor Babes Medical University: Today, there are 4273 University, 1108 of them are foreigners• SAIMR- Bloemfontein• Lancet Laboratories – Namibia
What is a Profession anyway?• it is an occupation based on a specialised body of knowledge and skills, entry into which is restricted to those who prove their competence, and which is conducted in the interest of those it serves and of the public generally, and is subject to self-imposed rules of ethical conduct• “Medical Technology” is not a replacement Profession
What is a medical lab• “The Medical Laboratory is a place where , under rather difficult conditions , we create a protected island where together with our younger collaborators , we use all our mental power and energy , to be an active part of medical development and to enjoy the thrill of new discoveries in modern science to benefit mankind”. Sejojo Phaaroe 2007 Sheraton ZICC– Harare .• A Med Lab is a FACT -FACTORY• The rose by any language is still a rose- Medical Technologist/ Biomedical Scientist/ Medical Laboratory Scientist / Medical Laboratory Practitioner- Technicians : Maintenance people _Job Trained
Medical Technologists are Respectable members of the community and International DevelopmentResearch conducted by Medical Scientists has resulted inadvanced treatments for many diseases to date.
Public expectations and Client tale • Out patients• Insurances• Drs consulting • Health programs( TB, HIV ETC )• Food Handlers • Families• Travellers • Government departments• Job SEEKERS • Health Policies• Marriage couples • Development partners• New borne • Economic planners• ANC, • Health planners• FP, • Donor agencies• PATIENTS • Investment/ Bond contractors• Private Doctors• Community • Public Health Outbreaks• Criminal investigations • Global health• Legal agencies • International health regulation
Obligations to the Profession• MTs shall uphold their professional status by:• Taking responsibility for their professional acts. Members are responsible for practicing within the specialties authorized on their certificates of registration.• Recognizing the competence of others and seeking their assistance as required.• Maintaining and improving their knowledge and skills. Members shall participate in continuing education programs .• Promoting the image and status of the profession.• Collaborating with other health professionals in the care of patients and the functioning and improvement of health services.• Complying with all current National laws for the protection of patients, health care providers, the general public and the environment.• Sharing knowledge with colleagues, students and other health care practitioners
Biomedical Scientists must have a moral compass and the spectacles of morality• We should be guided by ‘personal conscience’ and must exercise ‘sensitive professional and moral judgment’.• The pursuit of money is not the only thing that can cause the loss of one’s moral compass• True professionalism, implies ‘a pride in work, a commitment to quality, a dedication to the interests of the client, and a sincere desire to help.• Biomedical Scientists should frequently perform research, and publish their findings• Research is variously defined as “scientific investigation that is performed in order to discover new information or to develop or improve products and technology for economic growth ”
Professional skills of Medical scientists-• Medical Technologists must understand personalities, theories of human motivation, and adult development theories (including moral, intellectual, emotional, relational and spiritual development and maturity).• Biomedical Scientists must have the capacity to evaluate different models of personal and leadership styles.
High Technology Medical Equipment instrumentation+ knowledge of Medical Sciences + Management of laboratoryMedicine + Regulatory aspects + Ethics in medical Research +business + science communications Victor Babes University
Competency• Competency is determined by number of flights one has taken• Its determined by number of CPDs and how involved in the Scientific community and developments you are• The age (or use) of airplanes is better seen by their cycles - -A cycle is a takeoff, cruise and landing - -A 747 flies long sectors - 10-12 hrs average - sometimes even more - For these, 1 cycle per day is a good utilisation –• A competent pilot is seen by number of flight taken in a lifetime
Scientists Should not be involved in Fabrication of Data• Fabrication, in the context of scientific inquiry and academic research, refers to the act of intentionally falsifying research results, such as reported in a journal article.• Fabrication is considered a form of scientific misconduct, and is regarded as highly unethical.• In some jurisdictions, fabrication may be illegal.
Adults and children estimated to be living with HIV 2007 Western & Eastern Europe Central Europe & Central Asia North America 760 000 1.6 million [600 000 – 1.1 million] [1.2 – 2.1 million] 1.3 million East Asia [480 000 – 1.9 million] 800 000 Middle East & North Africa [620 000 – 960 000] Caribbean 380 000 230 000 [270 000 – 500 000] South & South-East Asia [210 000 – 270 000] 4.0 million Sub-Saharan Africa [3.3 – 5.1 million] Latin America 22.5 million Oceania 1.6 million [20.9 – 24.3 million] 75 000 [1.4 – 1.9 million] [53 000 – 120 000] Total: 33.2 (30.6 – 36.1) million
Med Laboratory Scientists should not be one of the Following puzzle? Corruption Any Release of non unlawfull reliable results Practice un- Mull- Take unlawfully licensed practice Scandal patient’s money Ethnic / social Discriminate Bioterrorism discrimination Neglegence patients Fraud Misconduct Belief / Religion
Consequences of fabrication of results• Fabrication is generally considered the most serious form of scientific misconduct that a scientist can engage in, and a finding that a scientist engaged in fabrication will often mean the end to his career as a researcher.• Given the tight-knit nature of many academic communities, and the high stakes involved, researchers who are found to have committed fabrication are often effectively (and permanently) blacklisted from the profession, with reputable research organizations and universities refusing to hire them;• Fabricators may also have previously earned academic credentials and professional registries taken away.• In 2004, Jan Hendrik Schön was stripped of his doctorate degree by the University of Konstanz after a committee formed by Bell Labs found him guilty of fabrication related to research done during his employment there
Case 1• It is Early January, Food handlers attend the Public Health screening clinic before they could receive the School feeding and Catering contract and are sent to the Laboratory for Widal test, VDRL and Stool culture .• The Widal test of One of the handler test Positive , so she bribes the Laboratory Technologist to report it falsely as Negative as she desperately needs to win a school feeding tender.• An out break of Typhoid erupts in one of the schools when the school open late January and vertical investigations continue.• What would be the ethical case scenario and consequences of the case. ?
Proactive to PreventPaparazzi after a Medical Lab Scandal ? Social media has become a primary form of communication for the millennial generation. The Professionals should understand the potential benefits and harms of using social media in medical Technology
Medical Technologists should avoid conducts of Biological Warfare What are bioterrorism agents?• Bioterrorism agents are materials, such as bacteria, viruses, fungi, or toxins, that are deliberately used to sicken and kill.• They may be used by terrorists partially because of their psychological impact on the public and partially because they can be deadly, are easy to distribute, and are difficult to detect.• Bioterrorism agents have been used in acts of warfare for thousands of years.• This has included dipping arrows into toxins, poisoning food and water supplies, and deliberately spreading deadly infections. Bioterrorism agents could be carried in food products, dispersed into the air or drinking water, or introduced into crops and livestock, or even sent through the mail
Organisation for the Organisation for the Prohibition of Chemical Weapons (OPCW)• It Advocates for Industry outreach: Promoting Chemical Safety Management• peaceful applications of chemistry in Medical Laboratories ,• the OPCW continues to support small-scale research projects and regulate them .• They focus on the development and promotion of scientific and technical knowledge in the field of chemistry for industrial, agricultural, research, medical, pharmaceutical or other peaceful purposes.
Case 1• Tetryl, (2,4,6-Trinitrophenylmethylnitramine, C7H5N5O8) is a sensitive explosive compound used to make detonators and explosive booster charges.• Tetryl is produced by slowly mixing dimethylaniline with concentrated nitric acid in the presence of sulfuric acid and due to its simple synthesis it is prone for attempted synthesis by terrorists.• Tetryl is a thermally labile explosives that is known to be difficult to analyze due to its degradation.• As a result careful chemical control and regulation of professionals is paramount
MOTIVATE YOUNG SCIENTISTS AND OTHERS• BONUSES• TRAVEL INCENTIVES• DISCOUNTS• INDEMNITY INSURANCE• CREDIT CARDS• LAURETE AWARDS
PROFESSIONALISM Its more than a state of mind: it’s a state of productivity and high performance and trust shown by a specialist practitioner It explores Seven elements1; contribution:-. the effort you make and your perfection of it2: conviction- the motivation you have whatever your circumstances rich or poor3: culture_. the sense of how- FIT_ you feel at performing role, function, exploration or profession4. Commitment:- the Magnitude/ extend to which you are engaged with your tasks5. Confidence:- the believe you have in yourself and the Job6. Safety and protection :- commitment for Public protection , you and others co-workers7. Instil trust and portray How Much you Hundreds, A Million or A Billion ?worth –
Overview of Medical Laboratory Ethical Principles• There are four widely recognized principles in bioethics that apply to both clinical Laboratories and research ethics:• 1. respect for persons,• 2. beneficence,• 3. justice.• 4. Biosafety , bioterrorism, and Biosecurity• (Biosafety: prevention of large-scale loss of biological integrity, focusing both on ecology and human health• Biosecurity: prevention of the use of dangerous chemicals, pathogens and toxins for malevolent use
Ethical principles• Respect for persons entails respecting the decisions of autonomous persons and protecting persons who lack decision making capacity and therefore are not autonomous. ( You won’t Misuse your Power)• It also imposes an obligation to treat persons with respect by maintaining confidences and keeping promises.• Beneficence imposes a positive obligation to act in the best interests of patients or research participants.• the risks of research be minimized and that the risks be acceptable in light of the potential benefits of research.• Finally, justice requires that people be treated fairly.
Professionalism –is complete calling of a practice of Medical Laboratory with Ethical Principles to benefit man kind• ethics defines what is good for the individual and for society and• establishes the nature of duties that people owe themselves and one another.• In Nature we are all Humanitarians as humans have a feel for good.• The first and second Geneva Conventions provide for the humane care of sick and wounded combatants on land and sea without discrimination.• Immunity is to be granted to hospitals, medical personnel to include Laboratory Technologists and army chaplains and also to hospital ships.• Provision was made for recognition of the Red Cross emblem
• promote, support and further advance the character, status and interests of medical science and the members of the Institute;• Promote Best Practices for Managing Conflicts of Interest• promote, advance and develop scientific knowledge by means of lectures, demonstrations, discussions and debates in all branches of medical science;• communicate with other scientific and research societies throughout the world.
• Professional Medical Technologists should Promote Education and practice standards• Bench mark the profession• Market and promote the profession• Regional, National cooperation –AMLSCSA, ASLM Membership, IBMS, IAC.• Networking , with institutions, Line departments• Best Practices - Medical Device Procurement• therapeutics (P&T) committees are an effective tool for Laboratories to ensure the practice of quality, cost effective and evidence-based Medical Technology.• Conflict of interest issues arise when individuals who have a direct role in decisions related to medical equipment procurement also have financial relationships with manufacturers, including any receipt of gifts, grants, contracts or an otherwise compensated relationship
Instil trust to the community• Cultivate your personal core competencies• Act professionally• Explore new information and latest technologies• Publish and establish new novel technologies to nourish Science• Avoid Ghost Writing_ where a scientists attach their name to articles they did not produce originally• Tell the people who you are , and they will start calling you by your name
Be A Communicator of Medical Science , and An Effective Team Member in all walks of life• Scientific work should be communicated by Scientists• Medical Scientists should Communicate constructively• Teams need medical scientists/technologists who speak up and express their thoughts and ideas clearly, directly, honestly, and with respect for others and for the work of the team. That’s what it means to communicate constructively.• Medical Scientist does not shy away from making a point but makes it in the best way possible- in a positive, confident, and respectful manner.
COMMUNICATE: Medical Technology developments YES WE CAN!!!!!
Become a volunteer as a Medical Scientist• Any number of community organisations would benefit from our services.• Pick a place to volunteer that is of interest.• Perhaps it is a church.• Or a school board.• Or an arts group.• Or an animal shelter.• Or a poverty centre.
To avoid these we Regulate the profession by Licensing/Professional registration What is Professional Registration?• Professional registration is an important career milestone for Medical scientists.• It shows that you’re a medical technology professional and have the technical competence which is valued by medical fraternity , scientific community, academia and research industry.• Professional registration identifies you as a highly skilled professional with technical knowledge and competence
4.2 Develop and manage a Professional MANAGEMENT SYSTEM INPUTS PROBLEM SOLVING 4.1 Organisation 4.8 Complaints 4.3 Document Control 4.9 Control of Non-conformities 4.4 Review of Requests, Tenders & Contracts 4.11 Corrective Action 4.6 Purchasing Services and Supplies 4.12 Preventive Action 5.1 General 5.3 Accommodation & Environmental conditions COMPETENCE 5.4, 5.6, 5.7 4.5 Subcontracting 5.2 Person 5.5 Test/Calibration of tests and nel Equipment Methods, Measurement calibrations Traceability; Sampling 5.9 Assuring the quality of test/calibration results MONITORING & IMPROVEMENT OUTPUTS 4.10 Continual Improvement 4.7 Service to the Customer 4.14 Internal Audits 4.13 Control of Records 4.15 Management Review 5.10 Reporting the Results
Personnel Performing specific Medical Laboratory tasks Qualified Professional + Demonstrated CBE TrainingEducation Experience Skills + Passed Professional Different Board Exams MLS Regulatory Board License + Professional Qualifications/ Credentials
Specific personnel to perform: Sampling Tests / calibrationsKeep records Include dates Issue test reports/calibrations certificatesReadily available Give opinions/interpretations Authorisations Competence Operate particular equipment Training Skills Experience Educational & professional qualificationsChecklist of Minimum Standards : Areas of personnel assessment for competency
Professional Medical Technologist• Medical Laboratory Scientists• - Degree in Medical Laboratory Sciences• -National Diploma in Medical Laboratory Sciences + 3 years Specialist professional training /Registry/ in a recognised institution• - Board Examination• -Board Certified in the Category• General subject covered : chemistry , physics, anatomy and physiology, Instrumentation, cell biology, biochemistry, genetics, molecular biology, immunology, Pathophysiology, communication sciences , Quality Management Essentials , Research Methology• specialist subjects Professional QualificationsMedical Microbiology, Histopathology, Clinical Biochemistry,Clinical Immunology, Clinical Haematology, Blood TransfusionSciences, Molecular Pathology , Cytopathology and cytogenetics.
PROFESSIONAL LEVELS & ROUTESFELLOWSHIP-FIMLS/FIBMS Ph.D. /DSc/DLM./FIAC/FAIMS/CFIAC/FAMLS PROFESSIONAL DOCTORATES LEVEL 4Advanced Specialist Registry M Med Sc./ M.Phil./MSc Med .Diplomas . M.A.M.L.S ;M.I.B.M.SSpecialist B Med Sci.Registry (Hon.)Diplomas/GIBiol MEDICAL MEDICAL MEDICAL LEVEL 3 SCIENTISTS SCIENTISTS SCIENTISTS B Med Sci.CertificateDiploma/Licentiate of MEDICAL MEDICAL Dip. MLSMLS Practice LEVEL 2 TECHNOLOGIST TECHNOLOGIST LEVEL 2 MEDICAL Cert MLS Assistants LEVEL 1 LEVEL 1 TECHNICIANS
The CPD programme shall present opportunity for the professional to;• continuously update their scientific theory and professional practice• acquire new skills and knowledge• demonstrate continuous competence• develop individually in personal and professional terms• take necessary steps to adapt to new job roles• contribute to the knowledge base of the profession
Documentation of continuing education is mandatory to retain the Professional License ( FIBMS, MIBMS, CT(IAC) ,FIMLS, CLS(ASCP), CFIAC, MRCPath )• note that credits can only be given for educational activities that have taken place within each year prior to renewal : Continuing Education Categories:• Category 1: Employment in cytology Maximum number of credits 100• Category 2: Educational activities Maximum number of credits 180• Category 3: Cytotechnology teaching Maximum number of credits 60• Category 4: Papers and publications Maximum number of credits 80• Category 5: Research in cytology Maximum number of credits 40
What are the benefits of Professional registration?• Indicating that your competence and commitment to professionalism have been assessed by other natural and Medical science professionals.• Recognition that you have received education and training that meets standards for knowledge and experience and breasted with latest information and TECHNOLOGY .• Acknowledgement of professional standing by peers and colleagues.• Identifying you as having competences that employers value.• Higher earnings, How Much you worth , better employment prospects and career mobility.• Access to a network of qualified professionals in your area of expertise, so you keep abreast of the latest developments.
Other professional qualifications• Membership of The Royal College of Pathologists- MRCPath• Fellow of Faculty of Pathology- FFPath ( Pathology Faculty)• Chartered Textile Technologist: CText, ATI (Textile Institute)• Chartered Town Planner: MRTPI (Royal Town Planning Institute)• Chartered Valuation Surveyor: MRICS & FRICS (Royal Institution of Chartered Surveyors)• Chartered Waste Manager: MCIWM (Chartered Institute of Wastes Management)• Choir Master: (CHM) (Royal College of Organists)• Fellow of the Institution of Mechanical Engineers: FIMechE (Institution of Mechanical Engineers)• Fellow of the Institution of Civil Engineers: FICE (Institution of Civil Engineers)• Fellow of the British Computer Society: FBCS(British Computer Society)• Fellow of the Chartered Institute of Arbitrators: FCIArb (Chartered Institute of Arbitrators)• Fellow of the Chartered Institute of Bankers: FCIB (Chartered Institute of Bankers)• Fellow of the Chartered Institute of Housing: FCIH (Chartered Institute of Housing)• Fellow of the Chartered Institution of Civil Engineering Surveyors: FCInstICES (Chartered Institution of Civil Engineering Surveyors)• Fellow of the Geological Society of London: FGS (Geological Society)
Legislation within the workplace LAW RIGHTEmployment Equity a) Right not to be unfairlyAct (EEA) discriminated against on the basis of your HIV status b) Right not to be tested for HIV unless your employer ahs applied to the Labour Court for authorisation c) Do not have to disclose HIV statusOccupational Right to a safe working environmentHealth and SafetyAct
PAY YOUR PROFESSIONAL DUES FOR - INDEMNITY INSURANCE• Professional liability insurance , called professional indemnity insurance• more commonly known as errors & omissions (E&O) is a form of liability insurance• helps , protect, professional advice- and service- providing individuals and companies from bearing the full cost of defending against a negligence claim made by a client, and damages awarded in such a civil lawsuit.• The coverage focuses on alleged failure to perform on the part of, financial loss caused by, and error or omission in the service by the policyholder
From research to business • Medical Scientist should strengthen their Entrepreneurial mind-set. And under take valorisation process for ther novel inventions • Knowledge technology Transfer Business EconomicRESEARCH Aspects - IPR Planning LICENSES Fundamentals of licensing, owner of patents, agreement to exploit it with Royalty minima, Exclusive, Upfront Geography
Knowledge of Business and Bio Ethics • Medical Technologists should Apply for patent for their Inventions /research resultsPublic domain velorization process from beginning18 months Sixty months A patent expires after 20 years/ 25 years in other Countries
G3 G2 G1 (genomic)-Mammostrat test-Testostrat test RED MIX BLUE/GREEN
In summary Brand yourself as a Professional• You are your own product or service and so you need to ensure that your product/service remains consistent and true to who you are.• Brand positioning differentiates you from others.• Visibility is not enough. You need to be seen in a positive light.• If you always stick to deadlines and achieve outcomes, you will develop a reputation for this.
A consecrate of a Medical Laboratory Technologist/Medical Scientist• Medical scientists/Technologists solemnly pledge to consecrate their life to the service of humanity by generating Quality information and services to the best of my ability• They preserve the Safety, dignity and privacy of patients’ and others• They Pledge to lead their life and practice the profession in uprightness and honor• Pledge to exercise profession solely for the benefit of humanity and perform no act for a criminal purpose
Cont• Have to be loyal to the profession of medical laboratory science• Should maintain and promote standards of excellence in performing and advancing the art and science of medical laboratory technology• Should seek to establish cooperative and respectful working relationships with other health professionals• They should make these promises solemnly, freely, and upon their honor.
Respect Human subject rights• Voluntary, informed consent• Respect for persons: treated as autonomous agents• The right to end participation in research at any time• Right to safeguard integrity• Benefits should outweigh cost• Protection from physical, mental and emotional harm• Access to information regarding research• Protection of privacy and well-being 
Respect the Helsinki Declaration• The Declaration of Helsinki was established in 1964 as a means of governing international research.• Established by the World Medical Association, the declaration recommended guidelines for medical Scientists conducting biomedical research that involves human subjects.• Some of these guidelines included the principles that “research protocols should be reviewed by an independent committee prior to initiation" and that “research with humans should be based on results from laboratory animals and experimentation”.
Non selfish Professional• So much of our culture is inward focused. People are conditioned to think, “What’s in it for me?”• the most rewarding way to live as a professional medical technologist is not with the attitude, Questions like how can I benefit,• that’s living with a shallow, temporary mentality.• “Instead of looking out only for your good, turn it around and say, “How can I be a blessing to others?• Who can I inspire to rise higher? What seeds of greatness can I call forth out of someone?”• Supervise as many students as you practice the profession
Good character• Good character is prized among Biomedical Scientists.• We value honesty and integrity and want them to be our reputation.• We expect to be trusted, and to be able to trust our peers.• We want our word to be our bond.• Admission in to Chartered Scientist category includes an assessment of character, which has been defined as a synthesis of the virtues – honesty, dependability, courage, loyalty – working together as an integrated whole.
Excellence• Excellence is, for most of us, a lifelong goal.• The ranks of Medical Scientists are filled with overachievers and perfectionists.• ‘Good enough’ is not heard from a good Medical Technologist .• Professional Code:Be clean , personal hygiene and neat.Talk and walk Professionally
Personal development• At the level of the individual, personal development includes the following activities:• improving self-awareness as a Medical Scientist• improving self-knowledge• building or renewing identity as a Medical Scientist• developing strengths or talents• improving wealth• spiritual development of Medical Science• identifying or improving potential• building employability or human capital• enhancing lifestyle or the quality of life• improving health• fulfilling aspirations in Scientific discoveries• initiating a life enterprise or personal autonomy• defining and executing personal development plans• improving social abilities
A Professional Obtains CPD point regularly• ....DesktopHEALTH NCP DOCUMENTS - LESOTHOcertificate_of_attendance.pdf
• Professional Medical Technologists/ scientists are skilled at assuming multiple roles, stepping up to do whatever it takes to get the job done on time, on budget-without breaking the rules.• They are autonomous and self-sufficient.• They keep management in the know.• They do not require a supervisor to constantly hover over them or play the role of referee, parent or firefighter”.• They are self-managed.
Management and Managing aspects• Most Managers, although quite capable of “talking the talk”, are often failing to “walk the talk”.• Laboratory Managers in Laboratory Medicine should always walk the talk
Organise information sharing / scientific sessions as aMedical Scientist
Converting Research and Science into Business Acumen• Good Medical Technologists/Scientists are familiar with basic business concepts and practices, basic financial concepts, and business functions and their interdependencies.• Medical laboratory Professionals are be able to link strategic planning with team and individual goal setting, goal-directed feedback and follow-up.• Medical Scientists understand the business context, including legal, -Human resource, - IT, -sales, -marketing , and rules and regulations regarding claims -and other functional areas of Laboratory Medicine .
Coaching Knowledge• A good Medical Scientists understands: systems perspective, results orientation, business focus, partnership mindset, competence, integrity and judgement.• We should be able to accurately measure coaching outcomes and processes.• We should differentiate between the various roles – trainer, mentor, advisor, coach, counsellor, consultant, therapist and professional – that a manager must play• Medical Scientists should be multi-tasked and pluro-potential
Be International in Professional practice INTERNATIONAL PROFICIENCY TESTING SCHEMESNov 2012
• Thank you for listening• email@example.com• +266 63102600