2020-12-31-accounts - Operation Hernia

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OPERATION HERNIA Company limited by guarantee

DIRECTORS’ REPORT AND FINANCIAL STATEMENTS

FOR THE YEAR TO DECEMBER 31, 2020

Contents Directors’ report Independent examiners’ report Statement of financial activities Balance sheet Notes to the financial statements	Pages
	1 11 12 13 14

DIRECTORS’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2020

1. INTRODUCTION

The Directors, who are also the trustees of the charity, have pleasure in presenting their report and the financial statements of Operation Hernia for the year to December 31, 2020. This serves as the trustees’ report required by The Charities SORP as well as the directors’ report that is required to comply with the Companies Act.

2. ADMINISTRATIVE INFORMATION

2.1 Legal status

The official name of the Company is Operation Hernia. The registered address is 58 Hermitage Road, Plymouth. PL3 4RY

The Company was incorporated on October 20, 2010, under the registration number 7414038 and obtained charitable status on November 11, 2010, under charity registration number 1138936. It is governed by its Articles of Association and is subject to the provisions of the Charities Act, 2011. The Company currently has seven members who agree to contribute £10 in the event of winding up. Its accounts have been prepared in accordance with regulations made under that Act and the Statement of Recommended Practice Accounting and Reporting by Charities (applicable to charities preparing their accounts in accordance with The Financial Reporting Standard applicable to in the UK and Republic of Ireland (FRS102).

The company has a website www.operationhernia.org.uk where further information can be obtained about its work.

2.2 The Directors

The Directors who served the Charity during the period covered by this report are listed below :-

Mr. F.C. Oppong Chairman Mr. Arun Ariyarathenam Vice Chairman, Risk Manager Prof Jacob Akoh Appointed 21 June 2021 Mr. Bassem Amr Appointed 6 February 2021 Mrs. Della Ball Recording Secretary Mr. Shina Fawole Appointed 6 February 2021 Mr. Hedley Hunter Treasurer Ms. Leah Thorne Resigned 9 February 2021

Resigned 15 December 2020

Mr. Roger Watkins

2.3 Advisors

Those acting on behalf of the Company are:

Current bankers:

National Westminster Bank plc 12-16 Old Town Street Plymouth PL1 1DG

Absa Bank Ghana Ltd Takoradi High Street, Takoradi Ghana

Independent Examiner: Mr. Richard Bray, 17 Thornhill Road, Plymouth. PL3 5NF

3. STRUCTURE, GOVERNANCE AND MANAGEMENT

3.1. Organisational structure

The Company is administered by the Board of Directors. The board currently comprises the Chairman and six members.

The Company’s Officers, who are drawn from the Board of Directors, are the Chairman, Treasurer and Honorary Secretary (currently vacant).

Two different directors advise on Company House responsibilities, Risk Management and Charity Commission responsibilities.

3.2. Remuneration

The Directors do not receive any remuneration. Legitimate expenses incurred whilst serving the charity are reimbursed.

3.3. Risk Management

Under the terms of the risk management policy discussed by the Directors, the strategic operational and financial risks to which the Company is exposed are evaluated on a continuing basis and appropriate systems have been put in place to mitigate any major risks which are identified. The Directors are satisfied that this policy is sufficient to identify those risks on a timely basis and to ensure that appropriate action be taken so as to keep perceived risks to an acceptable level.

3.4. Director (Trustee) induction and training

The Directors are aware of the importance of ensuring that they properly appreciate their responsibilities as charity trustees. They also understand the need for the Board to reflect the various skills needed for the Company to act properly and efficiently.

4. OBJECTS AND ACTIVITIES OF THE COMPANY

The objects of the Company are set out in its Articles of Association. These are the relief of sickness and the protection and preservation of the health of persons of limited means residing in low resource countries affected by groin and abdominal wall hernias. This relief is provided in particular but not exclusively, through the provision of financial assistance, surgical operations, surgical equipment, surgical facilities, practical advice and education and the teaching of hernia surgery to practitioners treating such persons.

In practical terms Operation Hernia provides:

Surgeons who carry out operations to correct abdominal wall and groin hernias.
Training for indigenous surgeons at the hospitals where Operation Hernia operates
Surgical equipment and supplies to carry out its work.

5. PUBLIC BENEFIT

The Company fulfils its obligation to enjoy charitable status by delivering the following benefits to the communities where it works: (i) the relief of poverty by returning hernia sufferers to work and productivity and the care of their families, (ii) the advancement of education of surgeons working in the hospitals where it operates and (iii) the advancement of the health of hernia sufferers. This enables not only a considerable improvement in quality of life but also enables patients to regain their economic self-sufficiency. This is a demonstration by directors of due regard to the guidance provided by The Charity Commission.

As well as this direct benefit, the Company’s activities enable surgeons to gain valuable experience operating in a very different environment from the one to which they are accustomed. The challenges this creates help them to develop their skills and to further their clinical expertise to the benefit of their patients in their ongoing medical careers.

Patients with hernias who are likely to benefit from the work of Operation Hernia are informed through a local Hernia Awareness Campaign delivered by available media and by word of mouth. They are invited for an examination by local doctors and nurses to confirm the diagnosis. The patients are screened and prepared for surgery. The visiting teams review the patients on the day before operating on them.

6. IMPACT OF COVID-19 PANDEMIC

The Board of Operation Hernia responded to the Covid-19 Pandemic by suspending all Operation Hernia Missions from February 2020. The only mission that took place in 2020 was the Dutch Mission in January 2020. This is the second time that overseas missions have been suspended due to international health crisis. The first suspension was due to the Ebola outbreak.

6.1 Impact on Patients: The suspension resulted in denial of hernia surgery to several hundred people in the countries visited by Operation Hernia.

6.2 Impact on Training of Local Surgeons: Cancellation of Operation Hernia courses held in Uganda, Rwanda, Ghana and Tanzania has impacted the training of local surgeons. A webinar was held for Rwandan doctors in April 2021.

6.3 Impact on Volunteers: Volunteers were disappointed at the loss of opportunity to improve the quality of lives of hernia patients in the countries we visit.

6.4 Impact on Fundraising: Pandemic restriction prevented face to face fund raising activity. We have however benefit from online fund raising.

6.5 Adoption of Virtual Board Meetings: A positive outcome is the adoption of Virtual Board Meetings. This development may become a regular feature which will allow Board members to join meetings remotely.

7. INDEMNITY FOR SELECTED OPERATION HERNIA VOLUNTEERS

Operation Hernia offers medical indemnity to retired surgeons who do not have medical indemnity. This was suspended during the Pandemic. It will be reactivated in 2022 before missions are restarted.

8. OPERATION HERNIA ELECTRONIC DATA STORAGE

All official Operation Hernia Documents including volunteer application forms have now been uploaded on to the cloud-based data storage, Fast Drive. This development will improve efficiency of Operation Hernia mission administration.

9. FUNDRAISING

9.1 Online Fund Raising

The pandemic has higlighted the need to enhance our fundraising activities on line. The Board will explore the use of social media and other virtual facilities to improve fund raising

9.2 The Herrod Foundation

The Herrod Foundation, a Switzerland based children’s charity, has supported Operation Hernia since 2016. The Foundation informed Operation Hernia in 2019 that they have ended their charity work due to inadequate resources. This will significantly affect funding of Operation

Hernia projects because The Foundation has been our largest donor for the last four years. The last donation of £15,000 received in 2019 remains ring-fenced for funding of the next Rwanda and Botswana mission in 2022.

Operation Hernia is again very grateful to The Herrod Foundation, for the generous support given to the Operation Hernia work in Rwanda and Botswana.

10.DONATION BY MEDTRONIC MEDICAL COMPANY AND EUROPEAN HERNIA SOCIETY (EHS)

Medtronic, a large medical company has proposed a major project to be delivered through The European Hernia Society to support Operation Hernia. Operation Hernia is affiliated to the European Hernia Society. This is a “give back” or a corporate social responsibility initiative. The project has two objectives:

A one off donation of a sum of money.
Promotion of the Operation Hernia brand.

This will raise the profile of Operation Hernia and improve our recruitment of volunteers. The project will be officially launched at the annual conference of the EHS in October 2021.

11. FINANCIAL REVIEW

A summary of the financial performance in 2020 and the financial position at the end of the year are set out in the following paragraphs.

As explained in paragraph 6 above, with the exception of the Dutch mission in January 2020, the impact of the pandemic was the cancellation of all missions of care to hernia patients for the rest of the year and for the foreseeable future. The cancellation had no net financial impact on the charity as the only costs of missions recorded in the accounts are in respect of the value of the gifts in kind received from mission volunteers. These donations of travel and accommodation expenses equal the charge in the accounts of conducting those missions.

The financial result for the year ended December 31, 2020, was a net deficit of £38,167 which arose from the cost of purchasing and installing the Operation Theatre equipment in Dixcove hospital.

The grant received from AGM Petroleum in 2019 provided the funds required for this refurbishment. This grant was made as part of AGM’s CSR partnership with Operation Hernia to improve hernia treatment in Western Region Ghana

The reserves brought forward on January 1, 2020, decreased by £7,371 in general funds and by £30,759 in restricted funds. The charity continues to hold a high level of cash which, together with ongoing donations and other funds collected will more than cover the costs of our aims and objectives in the coming years.

A charge of £3,594 is recorded in 2020 for insurance premiums paid in 2019 to cover risks in 2020 on policies which remained in force until they were no longer needed as all missions had been cancelled.

The charity’s accounts for 2019 were submitted to the Charities Commission and to Companies House on time. Our gratitude goes to Hedley Hunter, our honorary treasurer, for helping to maintain good relations with these institutions.

12. RESERVES POLICY

It is the policy of the Directors to maintain:-

Unrestricted funds, which are free reserves, at a level sufficient to provide services and equipment in compliance with its objects for a period of at least 12 months and
Restricted funds in accordance with the wishes of the donors of such amounts to provide specialised equipment as required for all future charitable needs.

The COVID pandemic has resulted in Operation Hernia incurring less expenditure than would normally be the case. As this is expected to give rise to only a temporary reduction in the scale of the charity’s activities the Directors are content that the level of reserves remains reasonable.

13 GIFTS IN KIND

13.1 Gifts from volunteers: There was only one mission in 2020. This was the Dutch mission to Ghana (Jan 11-18, 2020). The team conducted a study in collaboration with Operation Hernia.

Estimated Cost of Dutch Mission

Estimated Cost of Dutch Mission	Estimated Cost of Dutch Mission
*ITEM* *COST £*
1	Travel for 15 Team Members @423.2 6348
2	Cost of Mesh (38 patients) 420
	TOTAL 6,768

14. ACHIEVEMENTS AND PERFORMANCE

14.1 Collaboration with the Ghana Hernia Society

Operation Hernia and the Ghana Hernia Society have agreed to collaborate in the training of Ghanaian surgeons in hernia surgery. A memorandum of Understanding ( MOU) was signed on 25[th] of May 2020. Operation Hernia agreed to support the training programme with a grant of 60,000 Ghana Cedis. This was funded partly through the AGM CSR project which provided GHS 45,000 (£6,000) and partly through Operation Hernia Funds GHS15,000 (£2,030). The 2020 Hernia course was run with only Ghanaian Trainers because of the pandemic travel restrictions. Operation Hernia surgeons will join the Hernia training Course faculty when travel restrictions

are lifted due to the success of vaccinations and control of global transmission of the COVID-19 virus. A report on the training course has been prepared.

14.2 AGM Petroleum Ghana Limited (AGM)- Corporate social Responsibility ( CSR) in Ghana

Because of the covid pandemic, Operation Hernia could not go on missions to deliver the AGM CSR. The only activity that will be undertaken , in spite of the pandemic, will be the 2021 Hernia Training Courses that will be delivered by Ghana Hernia Society Consultant Surgeons. AGM has approved the funding for the hernia training courses.

14.3 Operation Hernia missions in 2020 and 2021

Missions may resume in 2022. This will depend on several factors, including vaccination of volunteers.

14.4 Collaboration with Rwanda Legacy of Hope Charity

All the mission projects in Rwanda are undertaken in collaboration with RWANDA LEGACY OF HOPE (RLOH), a Rwandan charity that is based in Plymouth UK. Operation Hernia has helped RLOH recruit surgeons in Plastic Surgery, Breast Surgery, Orthopaedic Surgery, ENT Surgery and Neurosurgery to help the hospitals in Rwanda and the Ministry of Health.

15.TRAINING

15.1 Year 5 AND Year 6 of COSECSA Operation Hernia Training in Uganda

The 2020 COSECSA Hernia Training Course was suspended due to the pandemic. The 2021 course was also suspended due to Covid . The decision to organise webinars for Ugandan doctors has also been suspended because of Covid.

15.2 Postgraduate Hernia Training Course in Rwanda

The 2020 Rwanda training course suffered the same fate as the COSECSA course. A very successful webinar was organised in April 2021. Webinars will become an important part of Operation Hernia training programmes.

15.3 The 2020 Shorland Hosking Fellowship was not awarded because of the pandemic. We continue to collaborate with the Association of Surgeons in Training (ASiT) to sponsor UK surgical trainees to join an Operation Hernia mission for training. There is uncertainty about the 2021 Fellowship.

15.4 Operation Hernia Sponsored Research in Uganda. Operation Hernia provided funding of

$1,000 (£846) to Dr Lauben Kyomuka to support his research project in the treatment of hernias. This funding will help treat patients with hernias as well as contributing to the training of Dr Lauben Kyomuka, who is a senior surgical trainee at Kampala International University Teaching Hospital.

15.5 Operation Hernia Supported Dutch Hernia Research

Operation Hernia supported a Dutch Operation Hernia research project at Keta Hospital in Ghana in January 2020, with a grant of £1340. This project which was part of an academic dissertation by two Dutch medical students, was approved by the University of Amsterdam. The research was in two parts:-a Retrospective and a Prospective Outcome of Operation Hernia Operations at Keta Hospital in Ghana. The results are yet to be published.

16. TRAINING OF RWANDAN UNDERGRADUATE AND POSTGRADUATE DOCTORS.

At the request of the Rwandan Ministry of Health, Operation Hernia has linked the Rwandan Ministry of Health with the Plymouth Medical School England in a collaboration to assist with undergraduate training. A link has also been established with the Royal college of Surgeons of England (RCSE) to assist with training of Rwandan surgeons in specialist surgical disciplines. The latter is being coordinated through the Global Affairs at the RCSE.

17 . PUBLICATIONS

	Publication	Journal
1	Improving Surgical Education in East Africa with a standardized Hernia training program. Authors: Ralph Lorenz, M.D. Chris Oppong, Albrecht Founder Michael Lechner, David M. Sedgwick, Atingwa Tasi, Reiko Wiessner.	Hernia (2021) 25:183–192
2	Improving surgical education in East Africa with a standardized hernia training program (Letter to Editor) J A Akoh	Hernia. 2021 Mar 8

18 INVITATION TO PRESENT OPERATION HERNIA AT EUROPEAN HERNIA SOCIETY, COPENHAGEN OCT 2021

The Chairman of Operation Hernia been invited represent Operation Hernia at the launch of the Medtronic and EHS project in October 2021.

19. REVIEW OF 2020 PLANS

To execute a successful second year of Corporate Social Responsibility on behalf of AGM Petroleum. All missions have, however, been suspended because of COVID 19.
To operate a fully digitized volunteer application and feedback system via the cloud application now that relevant documents have been uploaded.

Item 1: Missions remain suspended Item 2: This has been achieved.

20. PLANS FOR THE FUTURE

16.1 To resume Operation Hernia missions. The decision of the Board will depend on the following factors:-

Vaccination of all volunteers
Control of the Covid pandemic in Europe and the countries we visit.
Easing of travel restrictions
Government advice on post travel quarantine
Travel Insurance and Medical Practice Indemnity Premium
Individual conviction of safety

16.2 To start Hernia Course Webinars

16.3 To start a volunteer online application process.

16,4. Complete upgrade of Operation Hernia Website.

21. LONGER TERM PLANS

In the longer-term Operation Hernia plans to continue to provide affordable treatment of hernias in low resource countries. A recent study in Ghana provides evidence to support continuation of the service provided by Operation Hernia. Over a period of 10 years, at the rate of repair of 30 per 100,000, there will be 1 million hernias waiting to be repaired. The collaboration with Rwanda Legacy of Hope in Rwanda will also continue in 2021 and beyond. Operation Hernia suspended all missions in the wake of COVID 19, but this will not affect the collaboration with Rwanda Legacy of Hope.

22. GRATITUDE

Operation Hernia owes a debt of gratitude to several other individuals and organizations who supported the activities of the charity in 2020 as they did in previous years:-

a. Patron Lord Bernard Ribeiro
b. The Board of Directors of AGM Petroleum
c. Medtronic
d. The European Hernia Society
e. Professor Odd Mjaland, Professor of surgery in Norway for valuable advice regarding the AGM CS R
f. Richard Bray our independent scrutineer for advice and for meticulous scrutiny of Operation Hernia accounts.
g. CEO and management of University Hospitals Plymouth
h. Mr. Hedley Hunter, Treasurer
i. All Operation Hernia Board Members.

23. STATEMENT OF DIRECTORS’ RESPONSIBILITY

Company law and the law applicable to charities in England and Wales requires the Directors to prepare financial statements for each financial year which give a true and fair view of the state

of affairs of the Company at the year end and of the financial activities for the year ended on that date.

In preparing those financial statements the Directors are required to select appropriate accounting policies and to apply them on a consistent basis and observe the methods and principles of the Charities SORP, making judgements and estimates that are reasonable and prudent. They must also prepare the financial statements on a going concern basis unless it is inappropriate to presume that the Company will continue in business.

The Directors are responsible for keeping proper accounting records which disclose with reasonable accuracy at any time the financial position of the Company and to enable them to ensure that the financial statements comply with the Companies Act, 2006. The Directors are also responsible for safeguarding the assets of the Company and for taking reasonable steps for the prevention and detection of fraud and other irregularities.

Approved by the Directors on Sept 20, 2021 and signed on their behalf by

F.C. Oppong FRCS Chairman

Independent examiner's report to the trustees of Operation Hernia Charitable Company (“the Company”)

I report to the charity trustees on my examination of the accounts of the Company for the year ended 31 December 2020.

Responsibilities and basis of report

As the charity’s trustees of the Company (and also its directors for the purposes of company law) you are responsible for the preparation of the accounts in accordance with the requirements of the Companies Act 2006 (“The 2006 Act”)

Having satisfied myself that the accounts of Company are not required to be audited under Part 16 of the 2006 Act and are eligible for independent examination, I report in respect of my examination of your charity’s accounts as carried out under section 145 of the Charities Act 2011(The 2011 Act). In carrying out my examination I have followed the Directions given by the Charity Commission under section 145(5) (b) of the 2011 Act.

Independent examiner's statement

I have completed my examination. I confirm that no matter has come to my attention in connection with the examination giving me cause to believe:

accounting records were not kept in respect of the Company as required by section 386 of the Companies Act 2006; or
the accounts do not accord with those records; or
the accounts do not comply with the accounting requirements of section 396 of the 2006 Act other than any requirement that the accounts give a true and fair view which is not a matter considered as part of an independent examination; or
the accounts have not been prepared in accordance with the methods and principles of the Statement of Recommended Practice: accounting and reporting by charities (applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102)).

I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached.

Signed: Name: Richard Bray Relevant professional qualification or body: ACA DChA Address: 17 Thornhill Road, Plymouth PL3 5NF Date: 20 September 2021

OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA

Companylimited by guarantee

STATEMENT OF FINANCIAL ACTIVITIES(INCLUDING INCOME AND
EXPENDITURE ACCOUNT) FOR THE YEAR ENDED 31 DECEMBER 2020

		Unrestricted	Restricted	Total	Unrestricted	Restricted	Total
		funds	funds	2020	funds	funds	2019
		£	£	£	£	£	£
	Notes
Income from:
Donations - Volunteers and equipment		-	6,768	6,768	-	71,673	71,673
Other donations		1,063	17,402	18,465	6,133	75,355	81,488
Investment income		104	138	242	158	285	443
Total income	2	1,167	24,308	25,475	6,291	147,313	153,604

Expenditure on:
Raisingfunds	3	310	-	310	426	-	426
Charitable activities	4	4,216	55,062	59,278	4,214	104,192	108,406
Support costs	5	3,594	19	3,613	846	800	1,646
Governance costs	6	418	23	441	236	55	291
Total resources expended		8,538	55,104	63,642	5,722	105,047	110,769
Income expenditure/income
		7,371 -	30,796	38,167 -	569	42,266	42,835

Reconciliation of Funds:
Net result for theyear		7,371 -	30,796 -	38,167 -	569	42,266	42,835
Transfers between funds		37 -	37	-	232	232 -	-
Funds brought forward		53,629	73,967	127,596	52,828	31,933	84,761

Total funds carried forward	11/12	46,221 43,208		89,429	53,629	73,967	127,596


The statement of financial activities includes all gains and losses recognised in the year. There are no other recognisedgains and losses.

All incomingresources and resources expended derive from continuingactivities.


The notes onpages 14 to 17 form an integralpart of these accounts

OPERATION HERNIA

Company limited by guarantee

BALANCE SHEET AT 31 DECEMBER 2020

c	c	c	c	c	c	c
OPERATION HERNIA

Companylimited by guarantee

BALANCE SHEET AT 31 DECEMBER 2020

			31-Dec-20		31-Dec-19
			£	£	£	£
		Notes
CURRENT ASSETS
	Stock	7	3,943		-
	Debtors	8	-		35,054
	Cash at bank	9	85,811		115,090
	Total current assets			89,754	150,144

LIABILITIES
	Creditors: amounts falling due within one year	10		325		22,548
	Net current assets			89,429		127,596

TOTAL ASSETS				89,429		127,596

THE FUNDS OF THE CHARITABLE COMPANY
	Unrestricted funds	11/12		46,221		53,629
	Restricted funds	11/12		43,208		73,967

TOTAL CHARITABLE FUNDS				89,429		127,596

				-		-

The notes onpages 14 to 17 form an integralpart of these accounts


For theyear ended 31 December 2020 the Companywas entitled to exemption under section 477 of the
Companies Act relatingto small companies. No members have required the Companyto obtain an audit
of its accounts for theyear inquestion in accordance with section 476 of the Companies Act 2006.

The Directors acknowledge their responsibilityfor complyingwith the requirements of the Act with
respect to accountingrecords and for thepreparaton of the accounts.

These accounts have beenprepared in accordance with theprovisions applicable to companies
subject to the small companies' regime.


Signed on behalf of the Directors by

Chris Oppong		………………………………		Chairman of the Board of Directors
				of Operation Hernia
Dated: 20 September 2021

OPERATION HERNIA

Company limited by guarantee NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

1 Accounting policies & significant estimates The principal accounting policies adopted in the preparation of the financial statements are as follows:

a) Basis of preparation of the accounts

The financial statements of the charitable company have been prepared under the historic cost convention and in accordance with the Charities SORP (FRS102)(second edition - October 2019), applicable Accounting Standards, the Financial Reporting Standard 102 (FRS 102), and the Companies Act 2006.

The going concern basis is considered to be appropriate in the context of the company's ability to meet its obligations as they fall due in the period of 12 months following the date of approval of these financial statements. In this consideration, the company's asset position, the level and profile of its liabilities and the company's ability to determine the level of activities have been taken into account.

b) Income

Income is accounted for when the charity has entitlement to the funds, certainty of receipt and the amount is measurable. Gift Aid is recognised once a claim has been prepared and submitted to HMRC Charities.

c) Gifts in kind

Gifts in kind are included in income when the benefit to the charity is reasonably quantifiable and measurable. When held as stock for distribution, gifts in kind are only recognised as incoming resources under voluntary income for the period when they are distributed. When gifts in kind are recognised an equivalent amount is included as resources expended under the appropriate category of the Statement of Financial Activities.

d) Fund accounting

Unrestricted funds are available to use to further any purposes of the charity. Restricted funds are donated for particular areas of work or specific projects undertaken.

e) Expenditure

Expenditure is recognised once there is a legal or constructive obligation to make payment to a third party. Irrecoverable VAT is charged against the category of expenditure against which it was incurred. Expenditure incurred on raising funds includes costs required in order to effectively raise resources to carry on the charity's activities. Expenses allocated to charitable activities are those project expenses incurred on the missions undertaken during the year and grant related studies. Support costs include administrative expenses which assist the charity in carrying on its day to day operations. Governance costs represent the costs of the strategic management of the charity and of complying with constitutional and statutory requirements.

Expenditure is recognised in the period to which it relates. Expenses paid that will be benefited from in a future period are treated as prepayments. Similarly, any expenses paid subsequent to the year end, which relate to activities and missions carried out during the year under review will be accrued.

f) Cash Flow Statement

The charity has taken advantage of the exemption conferred by FRS 102, which enables it to not present a cash flow statement.

g) Foreign currency

Foreign currency transactions are recognised at the exchange rate at the time of the transaction. Foreign currency balances are translated into sterling at the exchange rate at the balance sheet date. Resulting gains and losses are included in the SOFA.

h) Stock

Stock is measured at cost.

i) Significant estimates

The trustees consider that the key estimate used in preparing the financial statements is the computation of the value attributable to gifts in kind. As discussed above and in the Trustees' Report, these comprise of costs borne by our volunteers on missions for travel and accomodation. It would be unduly onerous to require our volunteers to keep detailed records of costs incurred, so instead we use our knowledge and experience of such costs to estimate the value of gifts in kind for the purpose of the financial statements. Due to the pandemic all missions after February 2020 were cancelled and only one mission took place in January 2020.

OPERATION HERNIA

Company limited by guarantee

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA

Companylimited by guarantee

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

2	Voluntary income					2020	2019
						£	£
			Voluntaryincome is made upof the following:
			Gifts in kind		Volunteer expenses	6,348	63,430
					Equipment and resources	420	8,243
						6,768	71,673

			AGM Petroleum - Corporate Social Responsibility grant			14,438	56,855
			Interest received on restricted funds			138	285
						21,344	57,140
			Donation >£750 Miriam Aebibe(support for volunteers)			1,628	-
			Donation > £750 Dr. WolfgangRienpold(for training programmes)			1,336	-
			The Herrod Foundation - funds raised for Rwanda			-	15,000
			Donation RotaryClub of Torquay- Fundingfor the Indiaproject			-	3,500
			Total restrictedfunds			24,308	147,313
			Other unrestricted donations less than £750			-	1,740
			Interest received on unrestricted funds			104	158
			Funds raised markingthe hospital retirement of Operation Hernia Chairman			-	2,700
			Funds raised byJustGiving (includingGift Aid where applicable)			1,063	1,693
			Total unrestrictedfunds			1,167	6,291

						25,475	153,604
3	Cost of raising funds
			Fundraisingconsultancy			94	94
			Fundraisingmaterials			-	116
			JustGivingfees and commission			216	216
						310	426

4a	Analysis of expenditure on charitable activities
			Directproject expenses - Restrictedfunds
			Travel and livingexpensespaid byvolunteers			6,348	63,430
			Donations of services,medical equipment and supplies			420	8,243
			Medical equipment and supplies for Rwanda			-	7,834
			Travel costs and catering,Surgical instruments for Urdala,India			-	3,068
			AGM CSR - Dixcove Hospital expenses(Ghana)			42,189	21,617
			Cost of hospital treatment of herniapatients			105	-
			Donation - Ghana Hernia Society- training grant			6,000	-
						55,062	104,192
			Directproject expenses - Unrestrictedfunds
			Ghana Hernia Society- training grant			2,030	-
		Amagara Lauren studysupport Uganda trainingcourse - theatregowns,local transport,catering				846	-
						-	772
			Contribution to Dutch Operation Hernia study			1,340	-
			Insurance forpersonal accident,travel andprofessional liability			-	3,442
						4,216	4,214
			Total charitable activities			59,278	108,406

			Duringtheyear agrant of £8,030 waspaid to the Ghana Hernia Society. This was funded largelybythegrant
			received from AGM(£6,000)with the remainder coming from Operation Hernia'sgeneral funds.

4b	Project expenses incurred - Restricted and Unrestricted funds;
			The Ghana Hernia Society			2,030	-
			Dutch Operation Hernia study			1,340	-
				Sub total carried topage 16		3,370 -

OPERATION HERNIA

Company limited by guarantee

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA

Companylimited by guarantee

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

				2020	2019

4b(continued)		Directproject expenses benefitted the followingcountries; (frompage 15)		3,370	-
		Ghana		55,062	61,994
		Rwanda		-	36,409
		Uganda		846	2,932
		India		-	5,626
		Botswana		-	1,445
				59,278 108,406
5	Support costs
		Restrictedfunds
		Loss on exchange		19	-
		AGM CSR launch costs		-	800
				19	800
		Unrestrictedfunds
		Personal accident,travel andprofessional liabilityinsurance		3,594	846
				3,594	846
		Total		3,613	1,646
6	Governance costs
		Restrictedfunds
		Bank charges		23	55
		Unrestrictedfunds
		IT Consultant		292	143
		Zoom connection costs		53	-
		Postage and office supplies		73	93
				418	236
		Total		441 291
7	Stock
		Meshpurchased for Uganda but not delivered due topandemic		3,943	-
				3,943	-
8	Debtors
		Prepayment - Insurancepremium		-	1,303
		Other debtor - deposit for equipment		-	33,751
				-	35,054
9	Bank balances
		NatWest Bank - current account earningno interest		63,593	74,197
		Virgin Money- deposit account earningno interest		21,273	21,168
		Absa Bank Ghana - earninginterest at varyingrates		945	19,725
				85,811	115,090
10	Creditors: amounts falling due within 12 months
		Unrestrictedfunds
		Other creditors - office expenses		53	237
		Insurance for medicalprofessional cover		-	201
			Sub total	53	438
		Restrictedfunds
		Other creditors:
		- Ugandaproject - travel expenses		272	272
		- Dixcove Hospital expenses		-	18,770
		- Indiaproject		-	3,068
			Sub total	272	22,110
		Total		325	22,548

OPERATION HERNIA

Company limited by guarantee incorporated 20 October 2010

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA	OPERATION HERNIA
Companylimited by guarantee incorporated 20 October 2010

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

11	Total company funds			Balance	Arisingin	Utilised in	Balance
				31/12/2019	theperiod	theperiod	31/12/2020
				£	£	£	£
		Restrictedfunds
		Funds for Rwanda/Botswana		38,867	-	-	38,867
		AGM CSR		34,668	14,576	48,299	945
		Gifts in Kind - Volunteers		-	6,768	6,768	-
		Donations;
		Miriam Aebibe - volunteers support		-	1,628	-	1,628
		Dr. WolfgangReinpold - training		-	1,336	-	1,336
		Indiaproject		432	-	-	432
				73,967	24,308	55,067	43,208
		Unrestricted funds
		General fund		53,629	1,130	8,538	46,221
				127,596	25,438	63,605	89,429

		Restricted funds arise where specific fundraising has been carried out for a project or where a donor specifies the use of funds. Funds can be restricted to specificprojects, purposes or countries.

		Funds held in the companybank account not subject to specific requirements are classified as unrestricted funds.
		The funds for Rwanda were donated by the Herrod Foundation. Operation Hernia organised two missions to Rwanda in 2019. The balance unspent at theyear end is earmarked to finance more of the same services when

		the travel restrictions caused bythepandemic have been lifted.
		The AGM CSR fund is to helpdevelopthe health sector in the Western Region of Ghana byimprovingaccess
	.	to hernia surgery. Duringtheperiod expenditure was incurred on equipment,trainingand bank charges.
		Thegifts in kind is the estimated value of the costs incurred bythe volunteers for the Dutch mission in January
		2020. This incudes estimated costs of travel and mesh.
		The volunteer support fund is to helpwith the expenses of Operation Hernia volunteers.
		The trainingfund is to helpwith trainingcarried out byOperation Hernia.
		The Indiaproject funds wereprovided to finance the mission byOperation Hernia volunteers in 2019. The unspent
		balance will be used toprovide further surgeryand care to herniapatients in India.

12	Analysis of net assets between funds					Restricted
					General funds	Funds	Total
		Net assets at 31 December 2020			£	£	£
		Bank balances			42,603	43,208	85,811
		Stock			3,943	-	3,943
		Current liabilities			325 -	-	325 -
		Total			46,221	43,208 89,429

		Net assets at 31 December 2019			£	£	£
		Debtors			1,303	33,751	35,054
		Bank balances			52,764	62,326	115,090
		Current liabilities			438 -	22,110 -	22,548 -
		Total			53,629	73,967	127,596

13	Trustees and employees
		The charityhas no employees. No trustee received anyremuneration from the charity. One trustee received £53
		for office expenses incurred in fulfillingtrustee duties.
		In theyear ended 31 December 2020 Kevin Ball,the husband of Della Ball a trustee of Operation Hernia, provided
		IT consultancyservices invoiced at £292(2019 - £143).

14	Corporation taxation
		The charity is exempt from income and corporation taxes on income and gains to the extent that they are applied to charitable objects.

			These notes form an integralpart of the accounts set out onpages 12 and 13