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| Page **2** of **16** 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 Page **3** of **16** ## 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: - Surgeons who carry out operations to correct abdominal wall and specifically groin hernias. - Training for local surgeons at the hospitals where Operation Hernia operates. - Surgical equipment and supplies to carry out its work. - In Rwanda Operation Hernia surgeons carry out operations in other surgical specialties, in line with our stated objectives. ## **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 Page **4** of **16** ## 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**| Page **5** of **16** ## 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.** Page **6** of **16** 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:** Page **8** of **16** 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. Page **9** of **16** 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 Page **10** of **16** 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: - - Unrestricted funds, which are free reserves, at a level sufficient to provide services and equipment in compliance with their 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. ## **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| Page **11** of **16** ||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** Page **13** of **16** ## 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| Page **14** of **16** 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: - - _**a. Patron Lord Bernard Ribeiro**_ - _**b. Director General of Ghana Health Service**_ - _**c. Medtronic and its subsidiary Covidien AG**_ - _**d. The European Hernia Society**_ - _**e. Advanced Medical Solutions**_ - _**f. University Hospitals Plymouth**_ - _**g. Professor Odd Mjaland, Professor of surgery in Norway for valuable advice**_ - _**h. Richard Bray our independent scrutineer for advice and for meticulous scrutiny of Operation Hernia accounts**_ - _**i. All Operation Hernia Board Members and Ghana Operation Hernia**_ ## _**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 ## ## ## ## ## ##