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2024-12-31-accounts

REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk) Patron The Lord Ribeiro Kt, CBE FRCS

OPERATION HERNIA Company limited by Guarantee.

DIRECTORS’ REPORT FOR THE YEAR TO 31 DECEMBER 2024

Page 1 of 16

REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk)

Patron The Lord Ribeiro Kt, CBE FRCS

DIRECTORS’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2024

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 (OH) for the year to December 31, 2024. 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 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 provisions of the Charities Act, 2011. The Company currently has six 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.

Table 1: Operation Hernia Directors

NAME ROLE
1 Mr F.C. Oppong Chairman
2 Mr Arun Ariyarathenam Risk Manager
3 Prof. Jacob Akoh Vice Chairman
4 Mr Bassem Amr CharityCommission and CompanyHouse Officer
5 Mrs Della Ball RecordingSecretary
6 Mr Shina Fawole Shorland HoskingFellowshipCoordinator
7 Mr HedleyHunter Treasurer

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REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk) Patron The Lord Ribeiro Kt, CBE FRCS

Retirement

Mr Hedley Hunter retired on March 31, 2025.

2.3 Advisors

Those acting on behalf of the Company are:

Current bankers:

Nat West 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 (currently vacant) and Recording Secretary

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 Policy

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

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REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk)

Patron The Lord Ribeiro Kt, CBE FRCS

timely basis and to ensure that appropriate action is taken 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. No new Directors were trained in 2024.

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:

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

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REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk)

Patron The Lord Ribeiro Kt, CBE FRCS

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. 2024 ACTIVITY REPORT

1.2024 Missions Highlights

2024 was a groundbreaking year for Operation Hernia. A team was sent to a hospital in Nigeria for the first time after the last Nigeria mission which is more than 10 years ago. In 2024 “ALFRED” a surgical training platform developed in Norway, was used in an African country on Operation Hernia mission to train local doctors in Ghana. Operation Hernia contributed to the development of the hernia section of ALFRED. The work of Operation Hernia was again presented at the European Hernia Society annual conference, held in Prague, Czechia.

2. 2024 Mission Statistics

67 Operation Hernia volunteers delivered 928 operations and treated 888 patients. Comparison with outcome in 2023 shows differences but these were not significant.

Table 2: 2024 Operation Hernia Mission Statistics

ITEM NUMBER IN 2024 NUMBERS IN 2023
1 Teams 23 19
2 Missions 11 13
3 Patients 888 973
4 Operations 928 1034
5 Hospitals 18 14
6 Countries Visited 5 3
7 Local Doctors Trained 33 34
8 Volunteers 67 59

Table 3: Distribution of Hospitals in 2024

COUNTRY NUMBER OF HOSPITALS
2024
NUMBER OF HOSPITALS 2023
Ghana: 8 8
Rwanda: 8 5
Uganda: 1 1
Nigeria 1 0
TOTAL 18 14

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REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk)

Patron The Lord Ribeiro Kt, CBE FRCS

3. Medtronic Operation Hernia Videos

In September 2023, Operation Hernia collaborated with Medtronic, a medical technology company, to produce four short documentaries to showcase the activities of Operation Hernia. The documentaries were filmed at Bole Hospital in the Savanah Region of Ghana. The four documentaries were published in May 2025 on Medtronic You tube channel. The four documentaries are: -

  1. Operation Hernia: Unveiling The Essence

  2. A surgeon’s Diary: A rookie consultant’s Journey

  3. A Patient’s Pathway

  4. A sense of Belonging: A volunteer surgeon’s perspective

4. 2024: New Operation Hernia Centre in Ghana: Berekum Holy Family Catholic Hospital (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 visited by the Operation Hernia Norway team in January 2024. BHFCH is now a Postgraduate Training Centre in Ghana. The 2024 mission was a training mission. The team from Norway used “ALFRED” a surgical training platform in the training programme.

5. 2024: New Operation Hernia Centre in Ghana: Richard Novati Hospital in the Volta Region of Ghana.

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REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk) Patron The Lord Ribeiro Kt, CBE FRCS

6. 2024: New Operation Hernia Centre in Nigeria: Sagamu

7. Development at Bole Hospital in Ghana Funded Through Operation Hernia

8. Collaboration with Rwanda Legacy of Hope Charity

The collaboration with Rwanda Legacy of Hope continued in 2024. The first mission in February 2024 was dogged by inadequate communication between the Rwanda Ministry of Health and Operation Hernia. The second mission in September 2024 was upended by the

Page 7 of 16

REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk)

Patron The Lord Ribeiro Kt, CBE FRCS

Marburg Virus outbreak in Rwanda. The Operation Hernia teams had to return to the UK without starting work in their host hospitals.

7 HERNIA HERO PROJECT: COLLABORATION WITH MEDTRONIC AND EUROPEAN HERNIA SOCIETY (EHS)

The Hernia Hero Project is a collaboration between Medtronic, a medical company and the European Hernia Society to raise funds to support two hernia charities affiliated to the EHS (Operation Herna and Hernia International). This project continues to be an invaluable source of financial support for Operation Hernia as shown below. Covidien AG is a subsidiary of Medtronic and made two donations through the Hernia Hero programme in 2024.

Table 4: Donations from Hernia Hero Programme

DATE IN 2024 DONATION
April 12 £28,000
June 12 £5094.34

8. TRAINING OF LOCAL DOCTORS

Ghana:

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REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk) Patron The Lord Ribeiro Kt, CBE FRCS

Rwanda :

Uganda :

Operation Hernia / College of Surgeons of Eastern, Central and Southern Africa (COSECSA) Hernia Course.

The hernia training course in Uganda is a collaboration between Operation Hernia and the College of Surgeons of Eastern, Central and Southern Africa (COSECSA). The 2024 training course was carried out successfully in July 2024. Nine COSECSA Residents were trained by a team of Uganda and UK surgeons, led by Jacob Akoh

9. TRAINING OF UK TRAINEES: SHORLAND HOSKING FELLOWSHIP

The 2024 Fellow was Mr David Robinson. He was trained by Mr Shina Fawole during the November 2024 mission to Ghana.

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REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk)

Patron The Lord Ribeiro Kt, CBE FRCS

10 . PUBLICATIONS

Table 5: Publications

Publication Journal
1 Lorenz R, Hubert L, Paasch C, Conze J, Oppong C, Akoh
JA, Sedgwick DM, Nsabimana V, Mantke R. Structured
hernia surgery training program for general practitioners
in Rwanda - feasibility and evaluation.
Hernia. 2025 Jan
2 Shitu H, Mubezi I, Akoh JA. Giant spigelian hernia in an
elderly woman: a case report.
Ann Med Surg (Lond). 2025 Feb

11. INVITATIONS TO OPERATION HERNIA IN 2024

Table 6: Invitations

Date Host Topic
May 29-31 European Hernia Society, Prague Operation Hernia Surgery – Chris
Oppong
June 4-6 Medtronic Conference Operation Hernia Surgery – Chris
Oppong

12. OPERATION HERNIA MISSIONS IN 2025

Only two missions have, so far been successfully delivered in Ghana and Rwanda. The training mission to Uganda was cancelled due to Mpox outbreak. A training mission to Bole Hospital in Ghana was cancelled due to security issues.

13. FINANCIAL REVIEW

Details of the financial review are attached in the financial statement

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REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk) Patron The Lord Ribeiro Kt, CBE FRCS

14. RESERVES POLICY

It is the policy of the Directors to maintain: -

15 GIFTS IN KIND

1 Gifts from volunteers: Global Missions January -December 2024

Our volunteers are our most valuable “resource.” They volunteered a total estimated gift in kind of £64,848 in 2024. The cost was estimated from known expenditure and cost of flights as on the websites of airlines.

Table 7: Volunteers Gift in Kind

Operation Hernia Missions January To December 2024

DATE TEAM
COMPOSITION
HOSPITAL COUNTRY
OF ORIGIN
of TEAM
TRAVEL
COST PER
HEAD
TOTAL TRAVEL
COST
1 January 13-20 5 Axim Holland 950 4,750
2 January 13-20 9 Bole Holland 950 8,550
3 January 13-20 3 Berekum Norway 1040 3,120
4 Feb 22-Mar 2 24 Hernia
Training Team
Rwanda UK /
Germany
760 18,240
5 March 2-9 8 Hernia
Training Team
Rwanda UK /
Germany
1060 8,480
6 Feb 22-Mar 4 3 Gynae Team Rwanda UK 1060 3,180
7 March 22-30 5 Team
Members
Richard
Novarti.
Ghana
Germany 1040 5,200
8 July 12-20 3 Trainers Bole Ghana UK/Sweden 1181 3,543

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REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk)
Patron The Lord Ribeiro Kt,CBE FRCS
REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk)
Patron The Lord Ribeiro Kt,CBE FRCS
REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk)
Patron The Lord Ribeiro Kt,CBE FRCS
REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk)
Patron The Lord Ribeiro Kt,CBE FRCS
REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk)
Patron The Lord Ribeiro Kt,CBE FRCS
REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk)
Patron The Lord Ribeiro Kt,CBE FRCS
9 July to
September
1 COSECSA
Hernia Course
HHC.
Uganda
UK 680 680
10 Aug 12-18 2 Botswana UK 1600 3,200
11 Nov 2024 5 Shina Fawole Axim UK 1181 5,905
TOTAL 67 £ 64,848

2. Donations in Kind from Companies

Operation Hernia is grateful 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 equivalent products.

Table 8: Donations of Equipment from Companies

COMPANY ITEM PRICE / ESTIMATED
COST £
Medtronic Theatre Hat and T-Shirts
Hernia Instrument Kits
£3000
Medtronic Hernia Mesh £1000
Steris Healthcare Surgical Instruments £500
Erbe Medical UK Ltd · Refurbished DiathermyMachine £1,843.00
TOTAL £6,343

16. INDEMNITY FOR SELECTED OPERATION HERNIA VOLUNTEERS

Until May 2023 when the last Operation Hernia medical indemnity expired, Operation Hernia offered medical indemnity to retired surgeons who do not have medical indemnity. This facility has been withdrawn because of the unaffordability of 2024 premiums.

Page 12 of 16

REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk)

Patron The Lord Ribeiro Kt, CBE FRCS

17. FUNDRAISING

The Hernia Hero project is currently the main fundraising activity supporting Operation Hernia. In 2024, however, Operation Hernia also benefited from donations from other sources.

Table 9: Donations

Date Organisation Amount Ringfencing
Jan 5, 2024 Hernia
Hero
Project
Medtronic/Covidien AG
£1,500.00 Yes, Bole hospital project
April 12, 2024 Hernia
Hero
Project
Medtronic/Covidien AG
£28, 000.00 No
June 12, 2024 Hernia
Hero
Project
Medtronic/Covidien AG
£5,094.34 Yes, Bole hospital project
July 29, 2024 The Salus Quartet £1,907.24 No
Date Individuals Amount Ringfencing
Feb 9, 2024 Ruth Smith £500.00 No
April 25, 2024 Sam Andrews £230.00 No

18. PAYMENT OF FEES IN GHANA FOR TEMPORARY MEDICAL REGISTRATION

The payment of fees for the Medical Registration of Operation Hernia surgeons in Ghana, remains unresolved. The new Director General of the Ghana Health Service has reiterated the decision of the previous Director General, that the fees should be paid by the host hospitals that benefit from number of patients treated. The host hospitals are unable to pay the fees because of their financial constraints. The Board of Operation Hernia has decided that if this issue is not resolved, we would no longer send volunteer teams to Ghana.

19: GRATITUDE TO VOLUNTEERS

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REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk)

Patron The Lord Ribeiro Kt, CBE FRCS

20. GRATITUDE TO GHANA MANAGEMENT COMMITTEE

The Board of Operation Hernia is very grateful to Mr Eddie Prah and Dr Bernard Boateng Duah for all the work they do behind the scenes to ensure the success of missions in the Western Region of Ghana.

21. REVIEW OF 2024 PLANS

Table 10: Review of 2024 Plans

PLANS COMMENT
1 Support Establishment of Berekum
Catholic Hospital as a Hernia
Training Centre in Ghana
The team from Norway delivered a training
Course using a training platform called Alfred.
The Hernia section of the platform was jointly
developed byOperation Hernia
2 Appointment of a new Treasurer A Board member is deputising till a
substantive appointment is made
3 Appointment of an Administrator This is ongoing
4 To review our access to legal
advice
It is important that Operation Hernia
establishes a formal access to legal advice
5 To continue to provide affordable
treatment of hernias in low
resource countries
The Hernia burden in low and middle
resource countries (LMRC) remains high
6 To continue with Training
Programmes in Africa
Training courses were offered in Ghana,
Rwanda,and Uganda
7 To continue collaboration with
Rwanda Legacy of Hope (RLOH) in
Rwanda
This is essential to the success of Operation
Hernia in Rwanda
8 Fund Raising We continue to look for a new Treasurer

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REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk) Patron The Lord Ribeiro Kt, CBE FRCS

22. LONGER TERM PLANS

Table 11: Future

PLANS COMMENT
1 Appointment of a new Treasurer This is still a critical requirement
2 Appointment of an Administrator Closer to appointment
3 To continue to provide affordable
treatment of hernias in low
resource countries.
The Hernia burden in low and middle
resource countries (LMRC) remains high
4 To continue with Training
Programmes in Africa
This is the most sustainable way to improve
access to safe and timely hernia surgery in
LMRC’s
5 To continue collaboration with
Rwanda Legacy of Hope (RLOH) in
Rwanda
This is essential to the success of Operation
Hernia in Rwanda.
6 Fund Raising Reliable means of financial support in the
long-term needed. Renewal of Operation
Hernia JustGiving page is a positive step in
this direction.

23. ACKNOWLEDGEMENT

Operation Hernia owes a debt of gratitude to several individuals and organizations who supported the activities of the charity in 2024 as they did in previous years: -

Committee members

24. STATEMENT OF DIRECTORS’ RESPONSIBILITY

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

Page 15 of 16

REGISTERED CHARITY 1138936 COMPANY 07414038 (www.operationhernia.org.uk)

Patron The Lord Ribeiro Kt, CBE FRCS

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 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 December 31, 2025 and signed on their behalf by

F.C. Oppong FRCS Chairman

Page 16 of 16

OPERATION HERNIA

Company limited by guarantee

STATEMENT OF FINANCIAL ACTIVITIES (INCLUDING INCOME AND EXPENDITURE ACCOUNT) FOR THE YEAR ENDED 31 DECEMBER 2024

Notes
Income from:
Donations - Volunteers and
equipment
2
Other donations and legacies
2
Investment and other income
2
Total income
2
Expenditure on:
Charitable activities
3
Support costs
4
Governance costs
5
Total resources expended
Net income/(expenditure)
Reconciliation of Funds:
Net result for the year
Funds brought forward
10
Total funds carried forward
10
Unrestrict
ed
Restricted
Total
Unrestrict
ed
Restricted
Total
funds
funds
2024
funds
funds
2023
£
£
£
£
£
£
31,662
78,156
109,818
0
49,148
49,148
1,295
0
1,295
839
5,284
6,123
0
0
0
1,603
0
1,603
32,957
78,156
111,113
2,442
54,432
56,874
14,117
85,135
99,252
7,834
67,494
75,328
341
0
341
520
0
520
2,613
725
3,338
5,493
0
5,493
17,071
85,860
102,931
13,847
67,494
81,341
15,886
(7,704)
8,182
(11,405)
(13,062)
(24,467)
15,886
(7,704)
8,182
(11,405)
(13,062)
(24,467)
26,408
34,793
61,201
37,813
47,855
85,668
42,294
27,089
69,383
26,408
34,793
61,201

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

All incoming resources and resources expended derive from continuing activities.

The notes on pages 3 to 10 form an integral part of these accounts

Page 1

Company limited by guarantee

OPERATION HERNIA

BALANCE SHEET AT 31 DECEMBER 2024

Notes
2024
£
£
CURRENT ASSETS
Stock
6
0
Debtors
7
0
Prepayments
776
Cash at bank
8
68,607
Total current assets
69,383
LIABILITIES
Creditors: amounts falling due within
one year
9
0
Net current assets
69,383
TOTAL ASSETS
69,383
THE FUNDS OF THE CHARITABLE COMPANY
Unrestricted funds
10/11
42,294
Restricted funds
10/11
27,089
TOTAL CHARITABLE FUNDS
69,383
2024
£
£
2023
£
£
1,648
0
0
61,300
62,948
1,747
61,201
61,201
26,408
34,793
61,201

The notes on pages 3 to 10 form an integral part of these accounts

For the year ended 31 December 2023 the Company was entitled to exemption under section 477 of the Companies Act relating to small companies. No members have required the Company to obtain an audit of its accounts for the year in question in accordance with section 476 of the Companies Act 2006.

The Directors acknowledge their responsibility for complying with the requirements of the Act with respect to accounting records and for the preparation of the accounts.

These accounts have been prepared in accordance with the provisions 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

2024

Page 2

Company limited by guarantee

OPERATION HERNIA

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024

1. Accounting policies and 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. 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 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 accommodation. 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

Page 3

of gifts in kind for the purpose of the financial statements. 12 missions took place in 2022 and 13 missions took place in 2023.

Page 4

Company limited by guarantee

OPERATION HERNIA

NOTES TO THE FINANCIAL STATEMENTS (continued) FOR THE YEAR ENDED 31 DECEMBER 2024

2. Voluntary income

Voluntary income is made up of the
following:
2024
2023
Gifts in kind — Volunteer expenses
64,848
42,994
Gifts in kind — Equipment and
consumables
6,343
6,154
Total gifts in kind
71,191
49,148
Donations for refurbishment at Bole
Hospital
6,594
4,692
Donations for Nurse training
371
592
Interest arising on restricted fund
0
0
Total restricted funds
78,156
54,432
Unrestricted funds — Donations:
L Lucas
110
0
Della Ball fundraiser
465
0
Ruth Smith
500
0
COVIDIEN AG
28,000
0
Sam Andrews
230
0
Pauline Powell Efford
50
0
B George
200
0
Crowdfunder Ltd
1,907
0
FC & KT Oppong
200
0
Total
31,662
0
Other donations and legacies
0
839
Other income:
Profit on foreign exchange transaction
0
1,142
Flight insurance compensation
399
0
Imprest refund Jacob Akoh
220
0
Interest received on unrestricted funds and other income
676
461
Total unrestricted funds
32,957
2,442
Total income
111,113
56,874
3. Analysis of expenditure on charitable activities
Direct project expenses — Restricted funds
2024
2023
Travel and living expenses
64,848
42,994
Donations of services, medical equipment and supplies
6,343
6,154
Total gifts in kind
71,191
49,148
Restricted — Charitable Activities:
Chris Oppong imprest Rwanda
500
0
Osee Ntavuka — Capes and gowns
663
0
Ntavuka travel and hotel Rwanda
2,389
0
Bernard Boateng refund
286
0
2024
2023
64,848
42,994
6,343
6,154
71,191
49,148
6,594
4,692
371
592
0
0
78,156
54,432
110
0
465
0
500
0
28,000
0
230
0
50
0
200
0
1,907
0
200
0
31,662
0
0
839
0
1,142
399
0
220
0
676
461
32,957
2,442
71,191
49,148
500
0
663
0
2,389
0
286
0

Page 5

Oppong imprest — Bole
Autoclave Bole Hospital
Bole hospital refurbishment
Nurse training
Rwanda — mesh
Theatre lamp Rwanda
Subtotal
Charitable activities — Restricted funds
500
0
2,314
0
6,594
10,784
0
592
0
6,970
698
0
13,944
18,346
85,135
67,494

Page 6

Company limited by guarantee

OPERATION HERNIA

NOTES TO THE FINANCIAL STATEMENTS (continued) FOR THE YEAR ENDED 31 DECEMBER 2024

Charitable activities — Unrestricted funds:

Chris Oppong excess baggage
Steris parts & repairs
UHPN NHS
Della Ball
Advanced medical OH
Ghana mission
Jacob Akoh imprest
Training Ramia Stolt
Postage diathermy machine
Jason Melville
Jacob Akoh Uganda expenses
TK Rajesh mesh
EHS Conference expenses
Uganda mission
Bole mission
Hunter claim for expenses
Total unrestricted funds
Total charitable activities
4. Support costs
Unrestricted funds:
2 volunteers registration Ghana
Hunter claim for expenses — ink
Felix Oppong — Admin support
Gallagher insurance
OPC cards
Travel costs — Chris Oppong OHB meeting
Shorland Hoskins Fellowship
Loss on exchange
Donation to OH
IT costs
Total unrestricted support costs
Restricted funds:
Registration fees x2 — Ghana
Total restricted support costs
Total support costs
5. Governance costs
Zoom meeting costs
Bank charges
Companies House postage and penalty
Postage and office supplies
Total
208
0
2,392
0
1,268
0
36
0
1,485
0
503
2,639
500
0
1,108
0
24
0
702
0
1,012
0
3,499
0
1,372
0
0
3,797
0
1,398
8
0
14,117
7,834
99,252
75,328
654
0
87
0
360
815
1,482
2,049
30
0
0
544
0
895
0
892
0
38
0
260
2,613
5,493
725
0
725
0
3,338
5,493
105
140
43
187
193
0
0
193
341
520

Page 7

6. Stock

As at 31 December 2024 the charity held no stock.

7. Debtors

Prepayments:

7. Debtors
Prepayments:
Zoom bills
Insurance
Travel
Total
8. Bank balances
NatWest Bank
Virgin Money
Total
35
0
741
648
0
1,000
776
1,648
16,337
9,386
52,270
51,914
68,607
61,300

9. Creditors: amounts falling due within one year

The charity had no creditors for the year ended 31 December 2024.

Page 8

Company limited by guarantee

OPERATION HERNIA

NOTES TO THE FINANCIAL STATEMENTS (continued) FOR THE YEAR ENDED 31 DECEMBER 2024

10. Total company funds

Movement in funds for the year ended 31 December 2023 (comparative period):

Restricted funds
Gifts in kind volunteers costs
Gifts in kind donations from
companies
Total value of gifts in kind
Funds for Rwanda/Botswana
Hernia Hero campaign
Recovery Ward project at Bole
Hospital, Ghana
Nurse training
Totals
Balance 31
Dec 2022
Arising in the
period
Utilised in the
period
Balance 31
Dec 2023
0
64,848
64,848
0
0
6,343
6,343
0
0
71,191
71,191
0
27,644
0
4,250
23,394
2,695
0
0
2,695
4,022
6,594
10,419
197
0
371
0
371
34,361
6,965
14,669
26,657

Donations in previous years not yet fully utilised:

India project
Restricted funds total
Unrestricted funds:
General fund
Total company funds
432
0
0
432
34,793
6,965
14,669
27,089
26,408
32,957
17,071
42,294
61,201
39,922
31,740
69,383

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 specific projects, purposes or countries. Funds held in the company bank account not subject to specific requirements are classified as unrestricted funds.

The funds for Rwanda were donated by the Herrod Foundation. The balance unspent at the year end is earmarked to finance future work in the region.

The AGM CSR fund helped to develop the health sector in the Western Region of Ghana by improving access to hernia surgery. During the year expenditure was incurred on equipment, training and bank charges.

The Hernia Hero fund is to train doctors in low income countries in hernia surgery.

The volunteer support fund is to help with the expenses of Operation Hernia volunteers.

The training fund is to help with training carried out by Operation Hernia.

The India project funds were provided to finance the mission by Operation Hernia volunteers in 2019. The unspent balance will be used to provide further surgery and care to hernia patients in India.

11. Analysis of net assets between funds

Net assets at 31 December 2024:

General funds Restricted
funds
Total
Bank balances 41,518 27,089 68,607
Debtors 776 0 776
Current liabilities 0 0 0

Page 9

Total
Net assets at 31 December 2023:
Bank balances
Stock and prepayments
Current liabilities
Total
42,294
27,089
69,383
General funds
Restricted
funds
Total
26,507
34,793
61,300
1,648
0
1,648
1,747
0
1,747
26,408
34,793
61,201

12. Trustees and employees

The charity has no employees. In the year ended 31 December 2024 no trustee received remuneration from the charity, but three trustees incurred office expenses, travel costs, Zoom charges and purchasing supplies while fulfilling their trustee responsibilities, for which they were reimbursed a total of £2,421 (£2,119 in 2023).

During the same period Kevin Ball, the husband of Della Ball, a trustee of Operation Hernia,

In 2024, it was agreed by the Board that the younger brother of the Chairman, Chris Oppong, should be engaged on a contractual basis to carry out a number of administrative functions in Ghana, for which he would receive a fee of £90 per quarter. On this basis he received fees of £360 in 2024.

13. Corporation taxation

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

These notes form an integral part of the accounts set out on pages 1 and 2.

Page 10