OPERATION HERNIAf REG55TERED CHARITY 1138936 COMPANY 07414038 Iwww.o erationhernia.or Patron The Lord Ribeiro Kt, CBE FRr OPERATION HERNIA Company limited by Guarantee. DIRECTORS, REPORT AND FINANCIAL STATEMENTS FOR THE YEAR TO 31 DECEMBER, 2023 CONTENTS PAGES Directors, report 1-17 Independent examiners, report 18 Statement of financial activities 19 Balance Sheet 20 Notes to the financial statements 21 OPERATION HERNIAttt REGISTERED CHARITY 1138936 COMPANY 07414038 Iwww.o Patron The Lord Ribeiro Kt, CBE FRCS erationhernia.or .uk DIRECTORS, REPORT FOR THE YEAR ENDED 31 DECEMBER 2023 i. IMrRODUCTION The Direttors, who are also the trustees of the charity, have pleasure In presenting their report and the financial statements of Operation Hernia (OHI for the yeaT to December 31, 2023. This 5erve5 as the trustees, report required by The Charitie5 SORP as well as the directors, report that is requlred to comply with the Companies Art. 2. ADMINisfRATIVE INFORMATION 2.1 Legal status The officlal name of the Company Is Operatlon Hernia. The registered address is 58 Hemitsge Road, Plymouth PL3 4RY. The Company was incorporated on October 20, 2010, under the registration number 07414038 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 provision5 of the Charities Act, 2011. The Company currently ha5 seven members who agree to contribute £10 In the event of winding up. Its accounts have been prepared in accordance wlth regulations made under that Act and the Statement of Recommended Prattice Accoundng and Reporting by Charities applicable to charities preparing their accounts in accordan￿ with The Financial Reportlng Standard applicable to in the UK and Republic of Ireland IFRS102). The company has a website wMv.o obtained about its work. erationhernia.o .uk where further infonnation can be 2.2 The Directors The Directors who served the Charity during the perrod covered by this report are listed below. Table I: Operatlon Hemla Dlfectors NAME l Mr. F.C. Oppong 2 Mr. Arun Arlyarathenam 3 Prof Jacob Akoh 4 Mr. Bassem Amr 5 Mrs. Della Ball 6 Mr. Shina Fawole 7 Mr. Hedley Hunter ROLE Chalrman Risk Manager VI￿ Chairman Charity Commlsslon and Compary House Officer Recordlng Secretsry Shorland Hosking Fellowship Coordinator Treasurer OPÈRATION HERNIAfjk REGISTERED CHARIIY 1138936 COMPANY 07414038 www.o erationhernia.or Patron The Lord Ribeiro Kt, CBE FRCS 2.3 Advlsors Those arting on behalf of the Company are: Current bankers: Nat West Bank plc 12-16 Old Town Street Plymouth PLI IDG Absa Bank Ghana Ltd Takoradi High Street, Takoradi Ghana Independent Exarniner., Mr. Richard Bray* 17 Thomhill Road, Plymouth PL3 SNF 3. STRUCTURE, GOVERNANCE AND ￿NAGEMENT 3.1. Organlsatlonal structure The Comparry is adminlstered by the Board of Director5. The board currently comprises the Chalmian and slx member5. The Company's Officers, who are drawn from the Board of Directors, a￿ the Chairman, Treasurer and Recording Secretary Two different directors advise on Company House responsibilities, Risk Management and Charity Commission responsibilitses. 3.2. Remuneratlon The Directors do not receive any remuneration. Legitimate expenses incurred whllst serving the charity are reimbursed. 3.3. Risk Management Policy Under the terms of the risk management policy discussed by the Dlrectors, the strateglc operational and financial rlsksto 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 Director5 are satisfied that this policy is sufficient to identify those rlsks on a timely basis and to ensure that approprlate aciion Is taken to keep perceived risks to an acceptable level. REGISTERED CHARifi 1138936 COMPANY 07414038 Iwww.o eTationhernia.OT Patron The Lord Ribeiro Kt, CBE FRCS 3.4. Director (Trustee) Indurtion and Trdining The Directors are aware of the Importan￿ of ensuring that they properly appreciate thelr 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. No new Directors were trained in 2023. 4. OBJEcfs AND AcrivmES OF THE COMPANY The objects of the Company are set out in its Article5 of A550ciation. These are the relief of sickness and the protection and preservation of the health of persons of limited means residing in low resource countrie5 affected by groin and abdominal wall hernias. This relief Is provided in particular but not exclusively, through the provision of financial assistance, surgical operation5, surgical equlpment, surgical facilities, practical advice and education and the teaching of hernia surgery to practitioners treating such persons. In practical terms Operation Hernla provides: Surgeons who carry out operatlons to correct abdominal wall and specifically groin hernias. Training for local surgeons at the hospitals where Operation Hernla operates. Surgical equipment and supplies to carry out its work. In Rwanda Operation Hernia surgeons carry out operations in other surgical specialties. in line wlth our stated objectFves. 5. PUBLIC BENEFIT The Company fulfi15 its obligation to enjoy charitable status by delivering the followlng benefit5 to the communities where It work5: li) the relief of poverty by returning hernia sufferers to work and productivity and the care of their families, lil) the advancement of educatlon of surgeons working in the hospitals where it operates and liiil the advancement of the health of hernia sufferers. This enables not only a considerable improvement in quality of Ilfe but also enables pattents to regaln thelr economic self-sufficiency. This is a demonstration by directors of due re8ard to the guidance provided by The Charity Commission. As well as this dirert benefit, the Company's activities enable surgeons to galn 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 thelr dinical expertise to the benefft of their patients in their ongoing medlcal careers. REGISTERED CHARITY 1138936 COMPANY 07414038 Iwww.u Patron The Lord Ribeiro Kt, CBE FRCS Patients with hernlas who are likelyto benefit from the workof Operation Hernia are informed through a local Hernia AvRrene55 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 team5 revlew the patlents on the day before operating on them. erationh rnia.or 6. 2023 AcfiviTY REPORT 1.5uccessful Missions 2023 has been another Suc￿ssful year for Operation Hernia, as demonstrated in the two tables below. Nineteen (191 teams of volunteer surgeons and nurse5 went on thirteen (131 humanitsrian mission to Ghana. Uganda, and Rwanda. A total of 1034 operations were performed In 973 patients In 14 hospltals. 34 local doctors partlclpated In tralning programmes. Table 2: 2023 01)eration Hemia Mlsslon Statlstl(s rrEM ,. l NumbeT of Teams . 2 Number of Misslons 3 Number of Patients 4 Number of Operdtlons 5 Number of Hospitals 1 6 Number ol Countries Vlslted 7 Number of Local Dortors Tralned 8 Nurnber of Volunteer5 VALUE 19 13 973 1034 14 59 Table 3: Distribution of Hospltsls COUNTRY Ghana: Rwanda: Uganda: NUMBER OF HOSPITALS 14 2. Unlque Collaboratlon wlth Medtronlc In September 2023, Operation Hemla collaborated with Medtronic, a medical technology companyi to produce five short documentsries about the activlties of Operation Hernia. The documentarie5 will showcase variou5 aspects of an Operation Hernia mission. The documentaries will be an invaluable media tool to promote Operation Hernia. A team of audio-visual profe55ionals and an administrator from Medtronic, travelled wlth an Operdtion r&3, REGisfERED CHARITY 1138936 COMPANY 07414038 Iwww.o erationhern5a.or Patron The Lord Ribeiro Kt, CBE FRCS Hernia team to Bole Hospital in the Savanah Re8ion of Ghana to record the following short documentaries:_ Operation Hernia The Rookie consultant's Journey Bole Hospital. Inside view The Patient's Pe￿pectiVe Beyond Operation Hernia The documentartes will be published later in 2024. 3. 2024: New Operatlon Hernla Centre In Ghana: Berekum Holy Famlly Catholic Hospltal (BHFCH) Berekum Catholic Hospital became the latest Operation Hernia centre in Ghana. Berekum is in the Brong-Ahafo Region of Ghana which has hitherto not been visited by a team from Operation Hernia. The centre was negotiated by the Operation Hernia Norway team who were the first to vlsit in January 2024. There are plans to establish BHFCH as a Hernia Training Centre in Ghana 4. 2023: New Operatlon Hernla Centre In Ghana: Rlthard Nov*i H05Pital in the Volts Reglon of Ghana. SUCCESSFUL M15510N TO RICHARD NOVATI CATHOLIC HOSPITAL IN GHANA I NOVAtI CA7HOU¢H*R A team from Germany visited the fllchard Novati Catholic Hospitsl in the Volts Region of Ghzna In March 2024. The flrst mlsslon to this hospital was In January 2020. just before the Covld Pandemic The RNCH is now another e5tsbli5hed centre for OpeTation Hernla In Ghana REGISTERED CHARITY 1138936 COMPANY 0741¢1038 Iwww.o erationhernia.or Patron The Lord Ribeiro Kt. CBE FRCS 5. 2023: New Operation Hernla Centre In Ghana.. Axim Hospltsl 2023 MISSIoN￿oAxImHOSP1TAL1N WESTERN REGION OEHANA • Axim Hospitsl became a new centre for Operation Hernia in 2023 • The first visit was by the Dutch Operation Hernia team in January 2023. • The second visit in September 2023 was by a UK team • The Dutch team have again visited in January 2024 6. Projects at Bole Hospltal In Ghana. Medtronic funded the refurbishment of projects at Bole Hospitsl, in the Savannah Reglon of Ghana, at the cost of £10,784. This consisted of refurbishment of the Recovery ward and Outpatient /Accident and Emergency Department 7. 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 Ptymouth UK. Operation Hernia has helped RLOH recruit surgeons in Plastic Surgery, Breast Surgery, Orthopaedic Surgery, ENT Surgery Gynecology and Neur05urgery to help the hospitsls in Rwanda and the Ministry of Health. In 2023, Operation Hernia recrulted 3 Gynecologists for 3 hospitals in Rwanda. At the request of the Rwandan Minlstry of Health, a team of 10 consultant trainers from the UK and Germany trained 34 Rwandan district hospital doctors in April 2023. 8. TERMINATION OF AGM / OPERATION HERNIA CORPORATE SOCIAL RESPONSIBIUTY HERNIA ICSR) PROJECT AGM ended the Corporate Social Responsibility ICSR) projett in March 2023. This is because the company stopped trading in Ghana. A statement released by the company on March 6, 2023, said "AGMPetroleum Ghana Llmited (AGM) andits owners hove dedded to rellnqulsh the South Ikep Water Tano (SDWTI block after carefully consldering all oplion5". The CSR was started in 2019 wlth the aim of providing hernia sufferers in the Western Region of Ghana, completely f￿e acce55 to surgery. The end of the CSR has been greeted with disappointment AEGISTEREO CHARITY 1138936 COMPANY 07414038 Iwww.o erationhernla.oi Patron The Lord Ribeiro Kt, CBE FRCS because of the positive impact the programme has had on the health of the people of the Western Reglon of Ghana. In the 2023 Chairman's Report, we celebrated the achievements of the CSR and expressed our gratitude to AGM and their assoclates Ghana National Petroleum Company {GNPCI. Because the termination of the CSR happened in March 2023, it is appropriate to repeat the achlevements of the CSR in this 2024 report. 8.1 Achievements of the AGM / Operatton Hernla CSR. Beneficiaries: Nearly 1000 patients in the Western Region have had hemia operations, which have been offered free of charge. The quality of their lives has been improved and, in some of the patients, Ilves have been saved. Hospltal Equlpment: Dixcove Hospital theatre has been transftjmied with provlsion of new essential equlpment funded through the CSR. A new Theatre Table, Ceillng Operating Lamp, Diathermy Machine, Anaesthetic Machine and Patient Monitor were donated to the Hospital, at a total cost of GHS 316,416 {£ 33,1921. Kwesimintsim Hospital has benefited from a new Diathermy Machine costing GHS 18,0001£ 1,888) Training of Dortors: The CSR has funded the training of 46 distrirt hospital doctors In the following Regions of Ghana: Eastern Region, Oti Region, and Western Region. These doctors have been equipped with new skills that will benefit even more hernia patients in the future. Importance of Industry in Health: This projett has had many challenges in its delivery. There is, however, no denying the fact that it has proven that Industry can collaborate. 8.2 Berbeflt to Patients The CSR has generated enormous benefits for the people of the Western Region. Lives have been Improved, accordlng to a study undertaken by Operation Hernia The 80% of hernia sufferers who could either not work or had difficulty in working would have retumed to their role as fishermen and farmers and other workers. Domestic economies have been impacted because "Health is Wealth." Potentially, lives have been saved. OPERATION HERNIA TrL REGISTERED CHARITY 1138936 COMPANY 07414038 Iwww.o erationhernia.or Patron The Lord Ribeiro Kt, CBE FRCS 8.3 aosure of AGM CSR Account The Operation Hernia AGM CSR Absa Bank account was closed in August 2023. The balance GHS 538.56 was transferred to Operatlon Hernla Absa Account. 8.4 The Ghana Natlonal Petroleum Compary IGNPC) The Ghana National Petroleum Company IGNPCI provided essential logistrcs support for the CSR by offering flights to the Operation Hernia teams from Accra to Takoradi 9 HERNIA HERO PROJEcf: COLLABORATION WITH MEDTRONIC AND EUROPEAN HERNIA SOCIETY {EH5) The Hernia Hero Project Is a collaboration between Medtronic, a medical company, the European Hernia Society and two hernia tharitie5 affiliated to the EHS (Operation Herna and Hernia Internationall. It was set up to promote humanitarian hernia service and trainlng in Low and Middle Income countries. provided by Operation Hernia. One member of Operation Hernia was part-sponsored by Medtronic to attend the 2023 EHS conference at Barcelona, to participate In a fund ralslng activity that was or8ani5ed for the two hernia charities. In 2023, Medtronic donated £6029.34 to Operation Hernia for the refurbishment of a Theatre Recovery Ward at Bole Hospital in the Savannah Region of Ghana. This was successfully carried out in April 2023. Medtronic has provided a further £4215.19 to support the refurbishment of the Outpatient Department and the Accident and Emergency Department in 202312024. 10. TRAINING OF LOCAL DOCTORS ERNIA TRAINING M15510N FEBRUARY 2023 . The 2023 Operation Hernia/Rwanda Legacy of Hope/ Surgeons for Africa teams from the UK and Germany delivered a successful Hernia Training Mission in February 2023. . 34 Rwandan district hospital doctors and surgical residents were trained l.Rwando: 2. Uganda.. Operation Hernia / College of Surgeons of Eastern, Central and Southern Africa {COSECSAI Hernia Course. REGISTERED CHASIITY 1138936 COMPANY 07414038 Iwww.o Patron The Lord Ribeiro Kt. CBE FRCS The hemla tralnlng course In Uganda is a collaboration between Operation Hernia and the College of Surgeons of Eastern, Central and Southern Africa (COSECSAI. The 2023 trainlng course was carrled out successfully in July 2023. Seven COSECSA Residents were trained by a team of Uganda and UK sur8eons. erationhernia.or 11. TRAINING OF UK TRAINEES: SHORLAND HOSKING FELLOWSHIP The 2023 Shorland H05king award was won by Mlss Polly Estridge who joined Mr. Shina Fawole's hernia team to Ghana in October 2023. She was funded by Operation Hernia at a cost of £894.57 The 2024 Fellow is Mr Davld Robiftson. He will be trained by Mr Shina Fawole during the November 2024 mission to Ghana. The training include5 a formal competence assessment. 12. CELEBRATIONS OF THE 20TH ANNIVERSARY OF THE PLYMOUTH-GHANA UNK: SEPTEMBER 2023 AND JANUARY 2024 Operation Hemia participated in the reciprocal celebrations of the 20th Anniversary of Plymouthfjhana Linkin Ghana and in Plymouth. Operation Hernia Is affiliated tothe Link. The Ghana celebration was in September 2023. The Plymouth celebration VRS in January 2024. The Ghana Anniversary Planning Committee Snvlted the Board of Directors of Operation Hernia. The Board approved the attendance of the Chaimian. 13. PUBLICATIONS Table 4: Publl¢alions Publlcatton l Technical aspects of inguino scrotal hernia surgery In developing countrles. K Shlne, C Oppong et al Journal Hernia. 2023 Feb-27111:173-179. 2 Update of the International Herniasurge Guldellnes for I groin hernia management. c stsbilini. D Chen, N I Veenendaal, C Oppong et al BJS Open Accepted for Publication on 16- Jul-2023 This Is a publication of the European Hemia society. C Oppong is a memberofthe team 10- OPERATION HERNIArfk. REGISTEFIED CHARITY 1138936 COMPANY 07414038 www.o erationhemi Patron The Lord Ribeiro Kt, CBE FRCS 14. INVITATIONS TO OPERATION HERNIA .or Table 5: Invltations Date Invltstion February 2024 Hellenic Hernia Society. Speaker on °Hernla Hero" May 2024 EHS Prague. Speaker on "Operation Hernia" June 2024 Medtronic Conferen￿, Speaker on 'How MedTe¢h Companies Can Support Surgical Access in Low-lncome Countrles: Exploring the j Journey of Operation Hernla and the Hemia Heroes" 15 OPERATION HERNIA MISSIONS IN 2024 Thirteen113) mlsslons have, so far been successfully delivered in Ghana and Rwanda. 16. FINANCIAL REVIEW The financlal result for the year ended December 31, 2023 was a net deficit of £24.467 which reduced the restricted funds to £34.793 and the unrestricted funds to £26.408 to carry forward to the year ending December 31, 2024. The final grant from AGMICSR of £6.775 was received in March 2023 and used to discharge their final obligations to hospltals and patients in Western Region Ghana. This was income that was accrued in the accounts for the year to 31 December 2022. Donations were re￿iVed for the payment of hospital costs in the Western Region. Fund Raislng in 2023 Thls was organised by Medtronic In conjunction wlth the European Hernia Society. An amount of £65(K). was not transferred to Operation Hemia a¢￿Unt untll 2024. This amount will be recognised as income In the 2024 financial statement. 17. RESERVES POUCY It is the policy of the Dlrectors to maintain:_ Unrestricted funds, whldi are free reserves, at a level sufficient to provlde services and equipment in compliance with its objects for a period of at least 12 month5 and Restricted funds in accordance with the wishes of the donors of such amounts to provide specialised equipment as required for all future charitsble needs. The COVID pandemic has resulted in Operation Hernia Incurrlng less expenditure than would normally be the case. As this is expected to give rise to only a temporary reductton In the scale of the charity's activities, the Directors are content that the level of reserves remains asonable. 11 OPERATION HERNIArtL REGISTERED CHARITY 1138936 COMPANY 07414038 Iwww.o Patron The Lord Ribeiro Kt, CBE FRCS erationhernia.or 18 GIFTS IN KIND 19.1 Gffts from volunteers: Global Missions January-December 2023 Our volunteer5 are our most valuable "resource." They volunteered a total estimated glft in klnd of £42,994 In 2023 and £40,530 in 2022. The cost was estimated from known expenditure and cost of flights a5 on the websites of airlines. Table 6: Volunteers Gfft in Kind Operatlon Hernla Mlsslons To Ghana January To December 2023 DATE 2023 TEAM HOST COUNTRY SIZE HOSPITAL COUNTRY OF ORIGIN ofTEAM EsfiMATED TOTAL COST PER COST £ VOLUNTEER Jan 9-16 14 Ghana Holland 820 11.480 Feb 22-29 Mar 12-18 April 15-22 Rwanda Ghana Ghana UK Norway UK and Sweden 716 840 716 2,148 2,520 1,556 July 21-28 Aug 12- Sept 5 Sept 16-23 Uganda Ghana UK UK 700 + 160 770 1560 770 Ghana Belglum 820 3,280 Sept 16-23 Ghana Belglum 820 3.280 Sept 16- Ort15 Sept 18-22 Nov 11-18 Nov 13-20 Nov 18-25 TOTAL io Rwonda UK 716 7,160 Ghana Ghana Ghana BMC Ghana Bole UK UK UK UK 770 770 770 770 3,850 2,310 1,540 42,994 20.2 Donatlons in Kind From Companies Operation Hernia is gratsful to the various companies that donated new and refurbished equipment to support our missions. The cost of the equipment was either provided by the companies or estimated from the internet prices of equlvalent products. 12- OPERATION HERNIAffr. REGISTERED CHARITI 1138936 COMPANY 07414038 erationherniè.or Patron The Lord Ribeiro Kt, CBE FRCS www.o Table 7: Donatlons from Companies ', COMPANY | PRICE / ESTIMATED CC)ST Advanced Medical Solutions Steris Healthcare Sterls Healthcare Erbe Medical UK Ltd . TOTAL 21. INDEMNITY FOR SELEcfED OPERATION HERNIA IIOWNTEERS Neurosurgical Supplies 2035.70 -7 Surglcal Instruments -rsurgical Instruments l Refurbished ERBE VIO 300 782 2,000 6.154.70 Until May 2023 when the last Operation Hernia medical indemnity explred, Operation Hernia offe￿d medical indemnityto retired surgeons who do not have medlcal indemnity. This facility has been wlthdrawn because of the unafft)rdability of 2023 premiums. 22. DRIVE.. OPERATION HERNIA ON LINE DATA STORAGE The Fast Drive platform was established to Improve Operatlon Hemla data securlty and to facilitate access of volunteer5 to inft)rmation on mi55ion5 and medical registration. The online data storage has improved prOCe￿Ing of medical registrations. 23. FUNDRAISING The Hernia Hero pmjert referred to ealierwa5 the onlyformal fund raising activity in 2023. It was a collaboration between the European Hernla Society and Medtronic. Operation Hernia received £6029.34 from this event. The donation was ringfenced for the refurbishment of a Theatre Recovery Ward at Bole Hospltal In the Savannah Region of Ghana. The renovation was completed in April 2023. 2Q PAYMENT OF FEE5 IN GHANA FOR TEMPORARY MEDICAL REGISTRATION Operation Hernia surgeons have since our establishment in 2005 been exempted from paying fees for temporary medical registration in Ghana. This concession has been granted by the Director Generals of the Ghana Health Service and incorpordted into the memorandum of understsnding IMOUI agreed between Operation Hernia and the Ghana Health Service. Unfortunately. in May 2022, the concession wa5 Withdrawn, without prior notice, by the new Director General. Consequently, Operation Hernia was compelled to pay a fee of $2000 for the medical registration of 3 surgeons from Norway. The Chairman renewed the agreement with the Ghana Health Service in 2023. 13- OPERATION HERNIAfftL REGISTERED CHARSTY 1138936 COMPANY 07414038 Iwww.o Patron The Lord Ribeiro Kt, CBE FRCS erationhernia.or 25: GRATITUDE TO VOLUNTEERS GRATITUDE TO OPERATION HERNIA VOLUNTEERS The success of Operation Hernia would not be possible without our dedicated volunteers. • In 2023, we had 59 voluntee from the UK, Germany, The Netherlands. Sweden, Belgium and Austria They all funded their travel. The helped relieve the suffering of 973 patients and performed 1034 operdtions. • OPERATION HERNIA is very grateful for the magnanimous sacrifice of our voluntee[5. 26. GRATITUDE TO GHANA MANAGEMENT COMMrrrEE GRATITUDE TO GHANA MANAGEMENT TEAM Without the huge sacrifice of time and resources given bymr Eddie Prah and Dr Bernard Boateng-Duah we would not have achieved this success. I would Ilke to thank especially Dr Boateng for almost single handedly organising all the 2023 missions and for his hospitality. The team has benefited enormously from sound counsel received from Mr Prah and Prof Odd Mjaland. From Norway 14- OPERATION HERNIAfTr. EGISTERED CHARITY 1138936 COMPANY 07414038 erationhernia.or Patron The Lord Ribeiro Kt, CBE FRCS WWW.D .uk 27. REVIEW OF 2023 PLANS Table 8: Review of 2023 Plans Action Taken Plan 1 5 year Plan: A committee has December 2023 Proposals discussed by been set up to present proposals Operation Hernia Board to the Board. and accepted. Plan 2 Appolnt a Paid Administrator December 2023 Position yet to be (subject to funding} advertised. Plan 3 Execute Philippines Mission Plan December 2023 Suspended. Plan 4 Refurbish Bole Hospital Recovery December 2023 Completed in April 2023 Ward wlth funding from Medtroni Plan 5 Appoint new Treasurer for 2024 Decembèr 2023 No replacement recruited yet. December 2023 In progress. Plan 6 Revamping of Operation Hernia Website 28. LONGER TERM PLANS Table 9: Future PLANS . COMMENT Support Estsbllshment of Berekum In di5CUSsion stsge. This IS the plan of the Catholic Hospital as a Hernia Training Hospital A￿hOritieS as part of a regional plan. Centre in Ghana Operdtlon Hernla would be a collaborator. This is a crltlcal requlrement Included in 5 year plan It is important that Operation Hernia establishes a formal acce55 to legal advice The Hernia burden in low and middle resource ountrie5 (LMRCI remains high Appointment of a new Treasurer Appointment of an Admlnistfdtor To review our access to legal advlce To contlnue to provlde affordable treatment of hernias in low resour countrfes. To continue with Training Programmes in Africa This Is the most sustslnable way to improve acce5$ to safe and timely hernia surgery in LMRC'S To review collaboration wlth Rwanda Operation Hernia collaljorates in Rwanda with Legacy of Hope IRLOHI In Rwanda RLOH 15- OPERATION HERNIAfftL REGISTERED CHARITY 1138936 COMPANY 07414038 Iwww.o Patron The Lord Ribeiro Kt, CBE FRCS Reliable means of financial 5UPPOrt in the long- .' term needed. erationhernia.or Fund Raising Operation Hernia Amba55adors ,' To be revamped. 29. ACKNOWLEDGEMENT Operation Hernia owe5 a debt of gratitude to several individuals and organizations who supported the activitie5 of the charity in 2023 as they did in previous years:. Patron Lord Bernard Ribeiro The Board olDirertors of AGM Petroleum and GNPC Dlrector Genernl oAGhona Heolth 5eThl SpeaalAdvlsor on Health to Presffdent of Ghona Medtmnlc The Europeon Hernla Soclety AdvoncedMedicalSolutTorts Unlverslty Hospltals Plymouth Keybomed UK DP Medlcoi Systems Steris Healthcare Pmfessor Odd Mjalan4 Proftssor of suryery in NorwayAor valuable advl regordinq theAGM C5R ch(fftl Brny ow independent scrutineer for advice and for meliculo scrutiny of Opernlion Hernia accounts. All Operation Hernio Board Members and Ghant7 Operation Hernio Committee members. 30. sfATEMENT OF DIRECTORS, RESPON51BILrrY Company law and the law appli￿ble to charitie5 in England and Wales require the Dlrectors 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 goin8 concern basis unless It Is inappropriate to presume that the Company will continue In business. The Directors are responsible for keeping proper accounting records whlch disclose wlth reasonable accuracy at anytime the financial posttion of the Company and to enable them to ensure that the financial ststements comply with the Companies ACL 2006. The Directors are 16- OPERATION HERNIAfTr REGISTERED CHARITY 1138936 COMPANY 07414038 Iwww.o Patron The Lord Ribeiro Kt, CBE FRCS a150 responslble for safeguarding the assets of the Company and for taking reasonable steps for the p￿ventiOn and detection of fraud and other irregularities. erationhernia.o Approved by the Directors on September 27, 2024 and slgned on thelr behalf by F.C. Oppong FRCS Chairman 17- Independent examiner's report to the trustees of Operation Hernia Charitable Company ("the CompanV) I report to the charity trustees on my examination of the accounts of the Company for the year ended 31 December 2023. Responsibilities and basls of report As the charitWs trustees of the Company {and also its directors for the purpose5 of company lawl you are responsible for the preparation of the accounts in accordance with the requirements of the Companies Act 20061'Yhe 2006 ACV) 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 charitVs account5 as carried out under section 145 of the Charities Act 2011lThe 2011 Act). In carrylng out my examination I have followed the Dlrections given by the Charity Commission under section 14515) {b} of the 2011 Act. Independent examlner's statement I have completed my examlnatlon. I confirm that no matter has come to my attention in connection with the examination giving me cause to believe: l. accounting record5 were not kept in respett of the Company as required by sectton 386 of the Companies Art 2006; or 2. the accounts do not accord with those records; or 3. the accounts do not comply with the accounting requlrements of section 396 of the 2006 Art otherthan any requirement thatthe accounts glve a true and falrvlew which is not a matter considered as part of an independent examination; or 4. the accounts have not been prepared in accordance with the methods and prlnciples of the Statement of Recommended Prartice: accounting and reporting by charities (applicable to charitie5 preparing their account5 In accordance wlth the Financial Reporting Standard applicable in the UK and Republlc of Ireland IFRS 102)). I have no concerns and have come across no other matters In connettlon 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 professiorsal qualification or body: ACA DChA Address: 17 Thornhlll Road, Plymouth PL3 5NF Date: 27 September 2024 18 OPERATION HERNIA Company Ilmlted by guarantee STATEMENT OF FINANCIAL ACTIVITIES {INCWDING INCOME AND EXPENDITURE ACCOUNTI FOR THE YEAR ENDED 310ECEMBER 2023 Unrestritted Restri¢ted funds fund5 Total 2023 Unrestrfcted Restricted funds funds Total 2022 Notes Incomefrom.. Donations- Volunteers and equipment Other donatlons and legacies Investment and other In¢ome Total income 49,148 5,284 49,148 6.123 61.233 5.100 54.868 188 427 5.288 116,528 61.233 59,968 615 121,816 839 1.603 2A42 54A32 56,874 Expendlture on: Charitable activities Support costs Governance costs Total resources expended 7.834 5,493 520 13,847 67.494 75,328 5,493 520 81.341 3,671 123.214 5,047 369 9.087 123,214 126,885 5,047 369 132,301 67,494 Net expenditure 11,405 13,062 24,467 3,799 6,686 10.485 Reconclllation ot Funds: Net result forthe year Funds brought fonvard IIA05 37,813 13.062 47,855 24,467 85,668 3,799 41,612 6,686 54,541 10,485 96,153 io Total funds carried forward io 26.408 34,793 61,201 37.813 47,855 85,668 The statement of financial attivlties Indudes all galn5 and losses recogn15ed in the year. There are no other recognised gains and losses. All Incomlng resources and resources expended derive from continuing artivities. Page 19 The notes on pages 21 to 24 form an Integral part of these accounts OPERATION HERNIA Company limlted byguarantee BALANCE SHEEfAT 31 DECEMBER 2023 31-Dec-23 31-0e¢-22 Notes CURRENT ASSETS Stock Debtor5 Cash at bank Total current assets 61,300 81,944 62,948 98.544 LEABILIMES Creditors: amounts falling due within one year Net cuYret)t assets 1.747 61.201 12,876 85,668 TOTAL ASSETS 61,201 85,668 THE FUNDS OF THE CHARITABLE COMPANY Unre5trirted funds Re5trirted fvnds ioni ioni 26.408 34,793 37.813 47.855 TOTAL CHARrrABLE FUNDS 61.201 85.668 The notes on pa80s 21 to 24fomi an integral part ofthe5e a¢¢ourts Forthe year ended 31 December 2023 the Company was entitled to exemptlon under settion 477 of the Companles Art relètingto small companies. No members have required the Company to obtain an audit of its actountsforthe year in quèstion In accordance wth 5ertlon 476 of the Companies Act 2(K)6. The Dlrectors acknowledge thelr responslbiiityfor complylng wlth the requirements of the Art wlth respett to accounting records and forthe preparaton of the accounts. These accounts have been prepared In accordance with the provlsioDs appIl￿bEe to companie5 subjert to the small companie5, regime. s18r￿d on behalf of the Direttors by Chri5 Oppong Chairman of the Board of Dlrectors of Operation Hernia CCif5￿rt 30, 2024 Page 20 OPERAllONHERN Companylimited bywJaranteE NOTESTOThE FThANCL1L￿A1EmEl&TSFOft ThEYE￿IENDED3IDECEm*EK2O23 l ArypuThI￿lpolklt$￿ 5knWlr4nte5tlDwt¢s ThepdrtyIatt￿ufftjryPQ￿￿$adQPted kkY*prepJrnthinoltr*fiTrJnckn15tateThtents￿eo5fulf0￿7'. al 80￿50￿prepo1Vtitsno1￿E¢￿roUTrts The*nanc￿lS1Jte￿eTrts Dfthecharitablecompanyhave been prepBrod unrterthÈhtstorKm5*cW5hpFward Lo55 Èirhaoge AdMIn￿tratIOn support lThGhana D0n¥tiDntoQpe￿tvJ￿ Hern* Ghana ITcosts 815 38 260 93 295 S GLwrnirrf¢¢o&ts Zoorn meetkngcosts nkcharEE5 Postage andofft£osuppThAS Total 172 193 117 369 MÉshf¥sutgIralo￿l￿1(y GrantfromAGM toftnancethe ￿Monts0￿¢t0 hDspkalslor paitenttstè RÈfund olynatyfor latE5utsTTr1551onoffinancl?1srdternents Travelewses pthln advan InSUran￿- Premlum pald I￿a￿￿Le rDt•l 12,376 Iso 474 WatWestBank Mon Ab5J BinkGhaDa 5,258 71547 $1,914 61 9 fJedhws:•nwn15tsNlnzdueTwltlthoneyear fjener41 prvjeEtexppn5e5 Ttav&ItoAxim htsspitalBo*EnglGhanal Travd h05pRalMacklSn IGhanal GÈnÈt*orfvrO￿lWe hosp￿￿1 lfjhanal Acwmcdauon, mea15andtra¥tl Dueto hoSpIta￿forpdr￿nt¢3re U￿ndatI¥1nl￿gfftb*on￿xPP[￿5 AdmlrLC05ts1nGhana P4HS inwKEfordtUB5defNeredin 2022 pJldlTrMJy2024 Zoom meeiingwen5eS Totsl 153 59 1,141 35 11,313 2SI 75 78 747 10 TotaluThwanyfuTrds B*L4rtp 31A¥20Z2 5kn8 the porknd u111￿d in the wrknd Batsn 3VJ212023 Re5trfrtedfvnds Gfftsln klftdvoFunteerscosts 41994 42,594 6.IS4 Fund5fDrRwèndalBotswana 34.614 2.695 4.02Z Prolects atBole Hospltal Shana Nur5etraknlnB Toialst4rrledto Pw14 10.114 10.784 S92 $92 34￿61 OPEIiAnOF4IIERNiA Comp3nyllrnlted byguaTrntee Incor￿)rated20ortO￿er2OIo FIOTESTOntEFINAI4OALsfATÈMErirsFOR THEYEARENDED31DECEMBER2D21 34061 Oonalk)n5in p[￿ID￿5¥*Ir5 notyetfulyutlltsed.. Intha prc*ct 432 47W5 432 34,793 5,284 GèhÈtaltsnd 13 fundsattsEwhere5pedftfundrdTln8 ha5 been Ca￿ed outfora proJectorwherea donor5pedffesthe L¥eoffwndkFunds¢an bere51rict￿ tDspethprotert5i PWPDse5 orcountrle& nd5 h￿d ihthe wmynybankaccL¥Jntn0t5ublectt05pedfkrery￿lreM2ntsdrecla5Sff￿daS￿nresb1cled funds. fund5. Thefvndsfor Rw9￿daWeredOnated bytheHeThDI Fourd*hiTr. ThebaL7n￿u￿speDtat1heVearend &earma￿￿￿ TheAGMCSRfvndhelped ttsdÈvek>pthohpath5ECtorinthpWe5tem ofGhsnJ bylmpnwlngacces5 to hemlè5u￿ery. L￿T￿ngtheYearexpRnd￿Jre ¥Yd51nDJrredon equlpmeni,tralnln8and bank thar8es Th* Hfrrnla H•rofvnd bt•trnkn do4tstsiD low1n¢omeo￿ntries￿ hErnia sijrgery. ThevohJntew5UPPOrtfund tsto helpvAththeexpensesDFOpe1at￿fi Rovn￿3¥0￿￿t¢￿r5. Th&tralnin8fund tst¢ h￿PYAth t¥alnln8 rltrwout byOper*lon Hernla. Thelndki pro]￿tfUnds￿￿eVr0W￿ettI0finanCethe mwon byoperniion H•rnk¥¢lunteerskn2019.The unspent bahn(e¥AII be ￿￿dI0 pro￿dEfurthErsUls￿3nd¢Ireto ￿tie￿ts ID Ivdia. 11 AnalythOfn￿assetsaett￿Wnfvllds Re5tr1¢iBd Fwds Generalf￿d5 Nda55etsat31 December2023 nkbal8 Debtors enirob 26,507 34793 61.300 1.747 2Q4D8 1.747 61,201 Tor 34,793 N￿aSS*tsat81DÉt•￿b￿r2QII Bankba￿￿Ce5 Stackandpyep3yn*nts CurrEnt kbdhity Tatsl 33&67 4,224 78 48,277 12,376 12.798 8L944 iQ600 12.876 ThpE￿￿￿tyh￿ noempfoyEe5. Iptheyearended 31 L*cembpr20Z3 notN5teerecwved rernuneratton frorn thetharty trIAthreetnisteEsln￿rred0fficÈeX￿ÈnSeS.tTa¥èJc¢s￿&x￿￿¢hOrtrs8lld ￿[Ch$S1￿¥te￿nlc￿l egUiprnEntwhIefuffillingtheirtsts5teerespan5ibSlh￿srDrWhlth t*wererelrnbursed a to*alof £2.119. 1£1.727kn 20221. DurlnBthp53¢nEPErl(KIKevlD &ll, the hu5baThl of Ba￿atrI￿eeOf Operation Hemla, provid￿ ITwn5UhanryservknS%%th￿ h¢lnyok&datQEIJ IE5591n2022 In 2023. itw*4greed bythecornitteeth¥tthe younger broiherDf thechalrman ChrT50pponi5hQu￿ be en8a8edon acontrattual basb to tarryouta numberof admin&tratNèftshctsonS InGhanafOrWh￿h hp￿￿￿d retel¥eafte Df£25 perTnonth.onth15ba5i5htre￿￿edfe￿5 of£750in2023backd*& fromJuty202L ThetharftylsÈxèmptfromknctynpandcorpDrntbnla¥e50n IncunEand8aln5t0thee￿enIthall￿are applkdto thar4tsbleprole¢ts. Th25enote5forman Inwalp*QlthfrHLu￿rrtsHtOlltI￿PW£ lJ*rAXI Page24