2025-03-31-accounts

FIFTEENTH ANNUAL REPORT OF THE METHTHA FOUNDATION-UK ACTIVITIES FOR THE PERIOD 1 June 2024 to 7 June. 2025

Contents:

15.1 Overview

.1 Funding and material donations including special funding events for MF and MRFs

.2 Meththa Rehabilitation Foundation (MRF) activities in Sri Lanka

.3 R&D projects

15.2.2 Progress on goals set for 2024

15.3.3 Projections for 2025-26

15.1 Overview

• 1 Funding etc… In Sri Lanka, on the 31st March 2025, we carried over a bank balance of SLR 92009.96.. The audited income and expenditure for MRFGL will be presented at their AGM in October . For this report, only the gross income is presented here, from April 24 to March 25. .

Income and expenditure summary in Sri Lanka in SLR
Brought Forward from last year 2024	3,866,682.19
Janathakshana project clinical services at NOCHCHIYAGAMA and POLPITIGAMA	2,309,900.00
Balapitiya project	2,471,465.00
Manithaneyan Trust	6,078,911.60
OMI Lebara	6,973,400.00
Maho Outside donations & Dr Panagamuwa	5,685,377.32
Donations from patients at Mahawa	8,999,379.46
Website sponsorship	300,000.00
Killinochchi Buiding Fund from Manitha Neyam and Dr Panagamuwa	10,209,966.26
Total income in Sri Lanka	36,685,115.57
Total expenditure	36,593,105.61
(Expenditure for bulding construction Killinochchi	10,522,760.00)
Surplus on 31 March 2025	92,009.96

• The financial and other difficulties we had at Mankulam in the last few years have been resolved to a great extent with

the appointment of Rev Fr Anpurasa as Director. He has a very good working relationship with our CEO. He, as a previous Director Director at Mankulam has a better understanding of our service contribution. He has been more efficient in paying invoices. Professional relations have since improved. However, the costs for services for the Vanni is heavily subsidised. Fr Anpurasa helped us to get a 15% increase in costs from previous year but this is still less than what is charged at Mahawa and Balapitiya for people who can afford to pay the full amount. However, less than 10% of the total number of service users at Mahawa and Balapitiya can afford to pay the full cost of our products. With the commencement of work at Kilinochchi, we have moved the senior technician to this Centre from Mankulam. This leave two technicians at Mankulam. The workload is such that they will be able to cope. A new Manager has been appointed to Mankulam. In addition to management at of the Centre, he will liaise with Vanni Social Services officials and Provincial Secretarial staff to get the government’s official payments that are given to SS Benefit holders amputees. This amount is Rs 20,000 per person. Additional staff have also been appointed to Kilinochchi. New staff increases our expenditure on salaries but hopefully, the regular income will also increase with the maturation of Kilinochchi Centre

• The Kilinochchi Centre opened for patients on 15 March. Formal ceremonial opening will be on 6 June. At present, Manitha Neyan is very prompt with payments and they have not put a limit on the numbers that can be treated.

They have stated a strong desire to be non partisan in the choice of patients. They sponsored a large mobile workshop on 5 April at Vavuniya where 27 Sinhala, Tamil and Muslim amputees from Vavuniya and Trincomalee districts were treated by the Kilinochchi team. The need for a mobile service at Kilinochchi is less now and we anticipate an increase in the net positive balance for funds in the Vanni.

• The output and services at Kilinochchi and Mankulam are carefully monitored by Senior managers of MRFGL, Lebara-OMI and Manitha Neyam. No adverse events or patient complaints have been received by MRFGL

• Donaions from service users at Mahawa and Balapitiya continues at a low level. We have increased the unit costs of limbs by 20%. However, many people find it very hard to pay for their services. Our Manager - Liaison officer at Balapitiya has identified a group of people who need limbs but there is the problem regarding funds and attendance at Balapitiya, which is not present in the Vanni. Therefore, we plan to conduct mobile clinics in the South on a regular basis and funding avenues for this is being explored.

• Nothing to report on the US funded research project managed by the University of Alabama in Birmingham. We did not receive any input from the Birmingham team regarding analysis of data collected last year.

• Social Service Department at Kuliyapitiya requested a mobile service. This was arranged by the CEO. However, this did not yield any significant outcome. A few walking aids were provided and it did not bring any income to MRFGL

• Container shipment and clearance in Birmingham and Colombo poses a major problem. In addition to costs at both ends, the official processes in Colombo are very fluid and new rules are added each time leading to unexpected costs and delays. However, wheelchairs and orthotic materials are in high demand and sending them to Sri Lanka remains a worthwhile task at present

• The Annual Retreat was held at the Dale Hill Hotel, Ticehurst, East Sussex. As usual, this was well attended and provided funds as well as refreshing relationships.

• Balapitiya clinic is functioning well, even though the numbers are slightly less than expected initially. Since inception, 46 prostheses have been provided. Follow up of those people have shown that those who are alive continue to use the prostheses and appreciate the services. Three people have passed away, causes unknown. Social Services have paid Rs 20,000 per head for 7 people and this was facilitated by our Liaison officer. A regular donation covers the rent for the Temple.

• Gillingham, Brighton, Derby, Burton Birmingham Centres and Rehabmatters wheelchair service at Leicester continue to donate their surplus components. We are very grateful for these donations

• MF-UK accounts will be provided separately in this AGM as is usual practice.

.2 MRF activities

Clinical output of MRF for the year January 2024-December 2024

Category	Mahawa	Mankulam	Manitha Neyam mobile clinics	Balapitiya	Total
New Lower limb prostheses	124(102)	135 (91)	85 (63)	31	375 (256)
New Upper limb prostheses	4 (4)	1 (1)	0	0	5 (5)
All repairs to P&O devices	267 (227)	197 (182)	56 (74)	5	525 (483)
Orthoses	374 (82)	15 (19)	1(3)	1	391 (104)
Walking aids	223 (100)	15 (4)	64	1	303 (104)
Wheel chairs	247 (476)	7 (0)	8	0	262 (476)
Medical assessments	68 (34)	40 (31)	9	0	117 (65)
Total. Number of service user contacts	1307 (1025)	410 (328)	223 (140)	38	1978 (1493)

The output is improving but still not at pre COVID 19 levels. Financial difficulties continue to affect the poor and disadvantaged whilst the affluent pay large amount to private institutions to obtain their prostheses. We are exploring new initiatives to find extra funds as described elsewhere in this report.

• The management and staff at Mahawa are providing an excellent service. Recent surveys show that these services are highly valued by our service users.

• A B Sc qualified Physiotherapist was appointed to Mahawa to provide clinical input and supervision. He and three trainee Prosthetists and Orthotists who were appointed last year received regular Zoom lessons which has enabled them to function independently. Dr Panagamuwa is available for Zoom consultations as needed. The Physiotherapist is managing the neurodisabled children and diabetic foot ulcer patients whilst providing physiotherapy input for management of amputees and those provided with orthoses.. This has created a wealth of information that needs to be collected, analysed and presented. This is the full time job for a dedicated Research Assistant

• Before the substance of the Concept Paper presented to the previous Health Secretary, proposing a pilot project to use our components at three selected hospitals could be implemented, there were major changes to MoH senior administration. Therefore, these papers were re-submitted to the new Ministers of Health, Small Industries with copies to HE the President. Private Secretary to The President wrote to the Private Secretary of Health Minister asking him to take action because the project is worthy of consideration. In spite of repeated attempts, we were unable to meet any of the political leaders. In the mean time, with a lot of effort, we managed to get an appointment with the new Secretary of Health. He was obviously very busy but gave us a hearing and delegated a SR in Admin training to look into the matter. A team of MRFGL officials and a new Consultant in Rehab Medicine were present at this meeting. The SR outlined the official process that has to be followed in order for our components to be used by the MoH. This process has already begun and we are pushing this through various influential people. The aim of this process is to find a local

market for our products in the MoH, at the same time, making the prosthetic provision more widespread and easily accessible for the amputees.

• The Diabetic Foot Clinic is functioning well. We have designed our own bespoke footwear which are being issued together with bespoke insoles. This is a new project with a lot of potential and a significant source of income. The data is being collected regarding outcomes.

• The annual appraisal of staff was conducted informally and piecemeal by the CEO. It did not reveal any major problems

•

3 R&D and training

• No new research projects implemented this year. An undergraduate from Peradeniya who is studying Social Science is spending a three month attachment at Mahawa. She is collecting valuable data about the socio-economic problems of our service users as a part of her training. Her findings are similar to what we have gathered in our previous studies.

• Training of three prosthetic technicians has been completed. Funded by the Rotary Grant, a senior prosthetist from Brighton visited Balapitiya last October to train and assess our prosthetist. Her report on the prosthetist is very satisfactory. The prosthetist manages most cases independently and Dr Panagamuwa is freely available to him for consultation on WhatsApp and Zoom. The two new prosthetists at Mahawa have access to our Senior Prosthetist there.

• Following the establishment of a link with the Maliban Rehabilitation Unit at Karapitiya Hospital last year, the Consultant there requested some formal training in prosthetics and posture and mobility for the entire Island. We made a successful appeal to Rotary Foundation to utilise the savings from their Global Grant for this training. This enables a senior prosthetist and Dr Panagamuwa to travel to Sri Lanka to conduct a two day training workshop on modular prosthetics on 31 May and 1 June. A senior prosthetic technician also will join this team, utilising already approved grant money for travel. It is hoped that there will be fifteen consultants, registrars and prosthetists attending this workshop. Temple accommodation will be used for overnight stay , funded by each participant who will also pay Rs 5000 as course fees. There will also be a Posture and Mobility training workshop at Mahawa on 7 June.

15.2 Progress on goals set last year.

• Balapitiya clinic is functioning well

• Kilinochchi Centre operational. Formal opening on 6 June.

• Three new prosthetists and Physiotherapist working independently but have access to Dr Panagamuwa when needed. A short question paper was used to assess their theory knowledge. Unfortunately, only one prosthetist was able to score more than 50 marks. Whilst their practical skills are reasonably good, their theory knowledge is at a basic level. Without the ability to read English books, this may not reach a higher level but this is not a major issue at present.

• Managers have been recruited to Balapitiya and Kilinochchi. Balapitiya manager is very experienced and knowledgable about the needs in the South. She is proving to be very useful. Mankulam manager has just ben appointed. CEO and Fr Anpurasa are advising and monitoring him

• Mechanical Quality certificate for our modular components were obtained from the Engineering Faculty of University of Peradeniya. The products withstood a static force exerted by 200 pounds, which is more than twice the likely force exerted by a grown man. Dynamic testing up to one million cycles will be done after fabricating a test rig for this purpose.

• First mobile clinic planned for Akuressa. Seven amputeees have been identified.

15.3 Projections for 2025-26

Funding activities both in the UK and Sri Lanka needs attention from the Trustees at both places. The following are outline proposals.

1. UK Funding. Whilst there is no doubt that the Annual Retreat remains popular among the Meththa Family, the financial benefit to MF-UK from this is relatively small when compared to the money spent by the participants. Raising sponsorship money through Justgiving or other means is increasingly difficult. Therefore, it may be a good idea to separate the Annual Retreat from fund raising. Keep the Retreat as a means of getting together and enjoying and think of another one or two events where there will be a wider participation, food and entertainment provided at a cost. Additionally, regular small monthly donations from all Meththa family members will be greatly appreciated because these have been diminishing in the recent past. Please also encourage the younger generation to participate in Meththa activities as an important succession plan. We should seriously consider leaving a bit of our wealth to Meththa Foundation in our last wills. This is a suggestion from me personally for consideration.

2. IN Sri Lanka, continuing the services at Mahawa and Balapitiya free of charge cannot go on indefinitely. In major hospitals, amputee people receive very little advice about rehabilitation. As a result, they are at the mercy of an organised group who approach amputees whilst they are recovering in hospital after surgery, quite vulnerable and confused about the future and direct them to various private suppliers of prostheses. We have found that people spend enormous amounts to receive inappropriate or sub standard products. With the help of the newly appointed Consultants, we are attempting to break this habit. The Concept Paper we presented to the Health Secretary was aimed at enabling the Consultants to provide prostheses at selected government hospitals using our components. MRFGL has proposed a very affordable cost for transtibial prostheses. In addition, two Sri Lankan organisations have approached MRFGL to form a consortium to market our products in Sri Lanka, Pakistan and some African countries. These discussions are still at a very early stage but MRFGL is looking at coming out of the non profit nature and moving into the commercial arena. Together with prosthetic components, MRFGL is looking at manufacturing wheelchairs and specialised footwear for diabetic people.

3. Expand the Outreach service south of the Vanni region to Southern, Uva and Sabaragamuwa provinces

4. Prepared by Dr B P

5. "# April 2025

THE METHTHA FOUNDATION- UK

INCOME & EXPENDITURE ACCOUNT

FROM 01 April 2024 TO 31 MARCH 2025

RECEIPTS Notes Charity Walk Sponsorship 1 HMRC - Gift Aid Claim Amazon & PayPal Bank Interest Standing Orders 2 Balapitiya Project Donations 3 TOTAL RECEIPTS PAYMENTS Freight & Transport Limb stuff, thermoplastics etc. Aluminium castings Tools Bandages Travel Bank Charges Miscellaneous 4 Balapitiya Project Meththa Srilanka Labour Charges TOTAL PAYMENTS NET RECEIPTS/(PAYMENTS) CASH FUNDS AT 31 MARCH 2024 CASH FUNDS AT 31 MARCH 2025 Note 1 Note 1 General Fund Account Balance Education Grant Account Balance Fund Raiser Account Balance	Year Ended 31 March 2025 15,203 0 0 17 4,415 0 6,103 25,738 9,234 9,569 843 1,512 2,722 444 128 266 0 0 3,000 27,717 -1,979 15,151 13,173 31 March 2025 5,582 556 7,035 13,173	Year Ended 31 March 2024 £ 15,141 2,739 425 62 4,240 4,103 5,755
		32,464
		6,482 11,505 1,114 1,977 1,121 3,866 140 2,265 3,013 1,000 1,660
		34,144
		-1,680
		16,831
		15,151
		31 March 2024 5,621 5,038 4,492
		15,151

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IER

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Oct 2018

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