## **FRIENDS OF SICK CHILDREN IN MALAWI** **REPORT AND FINANCIAL STATEMENTS YEAR ENDED 31 DECEMBER 2024** Charity Number 1140578 FRIENDS OF SICK CHILDREN IN MALAWI - REPORT AND FINANCIAL STATEMENTS **2024** ## **Contents** REFERENCE AND ADMINISTRATIVE DETAILS .......................................................................................... 2 STRUCTURE, GOVERNANCE AND MANAGEMENT .................................................................................. 2 OBJECTIVES AND ACTIVITIES .................................................................................................................. 3 Public Benefit ..................................................................................................................................... 4 ACHIEVEMENTS AND PERFORMANCE .................................................................................................... 4 In Malawi ............................................................................................................................................ 4 Fundraising ......................................................................................................................................... 4 Grantmaking ....................................................................................................................................... 5 LOOKING FORWARD ............................................................................................................................... 5 Reserves Policy ................................................................................................................................... 7 Statement of Financial Activities ........................................................................................................ 7 Balance Sheet ..................................................................................................................................... 8 Notes to the Financial Statements ..................................................................................................... 9 Independent examiner's report to the trustees of Friends of Sick Children in Malawi ................... 12 Respective responsibilities of trustees and examiner .................................................................. 12 Basis of independent examiner's report ...................................................................................... 12 Independent examiner's statement ............................................................................................. 12 Page | 1 FRIENDS OF SICK CHILDREN IN MALAWI - REPORT AND FINANCIAL STATEMENTS **2024** The Trustees present their annual report and financial statements of the charity for the year ended 31 December 2024. The financial statements have been prepared in accordance with the accounting policies set out in Note 1 to the accounts and comply with the Trust Deed, the Charities Act 2011 and Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS102) effective 1 January 2019. ## **REFERENCE AND ADMINISTRATIVE DETAILS** **Charity Name:** Friends of Sick Children in Malawi **Registered Charity Number:** 1140578 **Principal Address:** c/o Squire Patton Boggs (UK) LLP Rutland House 148 Edmund Street Birmingham B3 2JR **Website address:** www.friendsofsickchildreninmalawi.com **e-mail address:** info@foscim.org **Trustees** who have acted during the year: Alexis Cowie Gordon Cowie MBE Professor Elizabeth Molyneux OBE Stuart Reynolds **Bankers** to the Charity: HSBC PO Box 68 130 New Street Birmingham B2 4JU ## **STRUCTURE, GOVERNANCE AND MANAGEMENT** ## **Governing Document** ‘Friends of Sick Children in Malawi’ (also known as ‘FOSCiM’) is governed by a Declaration of Trust dated 22 December 2009 as amended (with the prior consent of the Charity Commission) by a Deed of Amendment dated 5[th] April 2016. The objects of the charity are: “to preserve, protect and advance all or any aspects of the health of children in Malawi by providing and assisting in the provision of facilities, support services and equipment not normally provided by the statutory authorities; to advance the education of the public in children's health by the dissemination of health information; and to advance and promote knowledge and education in children's medicine by paying or contributing to the costs of training and education of healthcare workers.” Page | 2 FRIENDS OF SICK CHILDREN IN MALAWI - REPORT AND FINANCIAL STATEMENTS **2024** ## **Organisational Structure** The Charity does not employ any staff or pay for offices. The board of trustees comprise the key management personnel of the charity, in charge of directing and controlling the charity and operating the charity on a day to day basis. All Trustees give of their time freely and no remuneration was paid in the year. By making use of modern technology wherever possible, costs of running the Charity are kept to an absolute minimum. ## **Recruitment and Appointment of Trustees** The power of appointing new or additional Trustees is vested in the continuing or surviving Trustees. The Trustees seek to appoint trustees with skills, knowledge and experience needed for the effective administration of the Charity. All Trustees served throughout the year. ## **OBJECTIVES AND ACTIVITIES** The overriding objective of FOSCiM is to preserve, protect and advance all or any aspects of the health of children in Malawi. The Trustees regard as essential the continued development of paediatrics in Malawi, one of the world’s poorest countries, and aim to support the professionals working in Malawi in this objective. They do this by raising funds: - to help pay for resources necessary to treat some of the poorest children in the world; - to contribute to relevant training and staff development; - to buy medical and other supplies and equipment; and - to provide for the manufacture of wheelchairs, home chairs and other orthotic devices for children with severe mobility issues. The Charity donates money to Friends of Sick Children (‘FOSC’), a Malawi children’s charity with similar objectives and which operates from The Queen Elizabeth Central Hospital (‘QECH’), Blantyre, Malawi, and to the Orthopaedic Department workshop at the same hospital. From time to time it also helps purchase medical and other supplies and arranges shipment to Malawi. The health needs of children in Malawi continue to be a pressing issue. Children aged under 18 years of age represent roughly half of the total population yet specialist paediatric health provision in Malawi is still developing. The under-5 mortality rate has improved dramatically over the past 25 years, but is still several times more than the equivalent UK figure. More than half of these deaths are due to preventable disease and many are associated with malnutrition. Malaria, malnutrition and HIV are common in Malawian mothers and contribute to a high proportion of infants weighing less than 2.5kg at birth. Simple interventions have been shown to have major benefits in health outcomes and relatively modest contributions (by Western standards) from outside Malawi can make tangible differences to outcomes for sick children in Malawi. Grants from FOSCiM to FOSC are of particular help in allowing the Children’s Department of the QECH to invest in human and physical resources, acquire equipment and supplies, and develop their services for children. Page | 3 FRIENDS OF SICK CHILDREN IN MALAWI - REPORT AND FINANCIAL STATEMENTS **2024** ## **Public Benefit** The Trustees confirm that they have had regard to the guidance contained in the Charity Commission's general guidance on public benefit when carrying out their grant making activities during the year. ## **ACHIEVEMENTS AND PERFORMANCE** ## **In Malawi** The development of paediatrics, paediatricians and specialist paediatric staff and the development of paediatric facilities at the Queen Elizabeth Central Hospital (QECH) continued in the year. ## **What has been achieved since we started our work in Malawi** : - Ø A major revamp of the Children’s Accident & Emergency centre. - Ø Creation of a High Dependency Unit for Children. Renovation of Children’s Outpatients and Medical Bay. - Ø 24 years ago hospital in-patient child mortality rates were 20%; today they are less than 5%. - Ø Infant and maternal mortality rates have reduced substantially but are still high compared to most nations. - Ø Malawians studying at The University of Malawi Medical School and graduating and practising paediatrics in _their own_ nation. As a result there are more General and Specialist Malawian Paediatric Consultants and Registrars at work in Malawi. - Ø Malawians studying at The Kamuzu College of Nursing and graduating and practising paediatric nursing in _their own_ nation. - Ø Malawian nurses supported in 4 year BSc (Paediatrics and Child Health) degree courses at Mzuzu University. - Ø Various other medical personnel supported in their further development so as to be important parts of driving forward sustainable paediatric healthcare in Malawi. - Ø Malawian postgraduate BSc Clinical Officers and students supported in training. - Ø The neonatal intensive care and Kangaroo Care unit that was built is one of the best facilities of its type on the continent of Africa. - Ø In collaboration with RICE University of Texas, first prize won in the first ever _Glaxo Smith Kline-Save the Children Global Award for Innovation in Child Healthcare_ . - Ø The first ever One Stop Centre for abused women and children in Malawi built. - Ø The creation of a paediatric surgical unit with theatres and intensive care facilities. - Ø Collaboration with the QECH Orthopaedic Department and workshop completed its 11[th] year and continues to successfully help children with severe mobility issues by manufacturing and fitting wheelchairs, home chairs for very young children, and making various orthotic devices. ## **Fundraising** To be in a position to make grants or to deliver charitable benefits in Malawi, the Charity needs to raise funds. Thanks to our loyal supporters, in 2024 we were able to continue our efforts in this regard. Page | 4 FRIENDS OF SICK CHILDREN IN MALAWI - REPORT AND FINANCIAL STATEMENTS **2024** Trustees greatly appreciate all the support the Charity receives each year – support which comes from a variety of people, organisations and places; support which ranges from goodwill and encouragement, through making and donating knitted and other goods, to the all important and essential financial donations, large and small. As disclosed elsewhere in this Report, we incur minimal costs so that almost all of every donation is applied at the frontline of needs in Malawi. In past Annual Reports we have named our largest (by donation) donors. Because every donation received, whatever the monetary size, is greatly valued and appreciated, with one exception this year we have decided to cease this disclosure. All our donors know how much they are appreciated and they are kept informed of how their generosity is applied in Malawi. The exception referred to above is the Estate of the late Irene Duddy from which the charity received a substantial legacy for the educational development of nurses and the provision of medication and equipment. The terms of the legacy allow for discretion to be applied according to the circumstances existing at the hospital. Non-monetary donations include: - Our _**‘army’ of knitters and sewers**_ from all over the UK who continue to amaze with the quality and quantity of baby clothes and bed clothes they produce. - _**Donation of transport**_ for donated goods to the Malawi bound sea containers; - _**Independent Examination**_ of these accounts. ## **Grantmaking** In 2024 the Charity made grants and purchased items for the benefit of sick children in Malawi totalling £97,840 (2023: £116,740). Grantmaking should increase significantly in 2025 as, amongst other needs, the Paediatric Special Care Ward will be renovated and piped oxygen supply will be introduced to some of the wards. ## **LOOKING FORWARD** The Trustees will continue to do their best to support the work of healthcare professionals and others in Malawi whose objectives are in line with FOSCiM. Every step forward in Malawi seems to be accompanied by new challenges but with the help of our supporters we continue to be able to forge forwards. Currently our **three areas of focus** are: - **Education and further development of human resources in paediatrics** Training and development of Malawian healthcare professionals, nurses, clinical officers and post-graduates is an essential focus and there are a number of funding needs here. **A particular need is for stipends for registrars** . In the face of Public Sector remuneration that Page | 5 FRIENDS OF SICK CHILDREN IN MALAWI - REPORT AND FINANCIAL STATEMENTS **2024** during the year fell well short of covering even basic living costs, we had no option but to find funds for stipends so that there could be sufficient, appropriately remunerated registrars to maintain the level of healthcare necessary throughout the wards and facilities. This could become a regular need unless Public Sector funding increases. - **Facilities and infrastructure** Overall, the infrastructure throughout the various paediatric departments, wards and facilities needs upgrading to improve healthcare delivery and better enable delivery of specialist services. **The Paediatric Special Care Ward is a** _**priority**_ in this regard and is expected to be the subject of major renovations in 2025. In addition, piped oxygen would be a big advantage in many more areas, such as The Nursery Ward. All teams would benefit from better access to scanning/ultra sound equipment. Access routes between some wards and facilities need improvement, including overhead cover in some cases, and improved floor surfaces and corridors around many others. Included under ‘Facilities’ is equipment – monitors, infusion pumps, portable x-ray; and reagents for the laboratory are all current priorities. - **Drugs and Medical Consumables** The Central Government supply of essential drugs continues to be erratic and unpredictable. We are fortunate in having a supporter who makes a substantial monthly donation to help in this regard and to have supporters who come to the rescue at times of outages. Special thanks in this regard to Mai Aisha Trust, Luton Sixth Form College business students, and to a West Midlands of England family who wish to remain anonymous. The Charity’s costs will continue to be kept to an absolute minimum. For 2024, 98.7p of every £1 raised and spent by FOSCiM delivered charitable benefit in Malawi (2023 - 97.3p). Overhead costs were mostly confined to unavoidable charges, such as payment processing and online donation fees. The more the Charity is able to raise the greater the amount that will directly benefit sick children in Malawi. Page | 6 FRIENDS OF SICK CHILDREN IN MALAWI - REPORT AND FINANCIAL STATEMENTS **2024** ## **FINANCIAL REVIEW** ## **Reserves Policy** FOSCiM does not have any endowed funds, so all of its capital and income is available to be spent on charitable activities. It is the policy of Trustees to retain only the minimum reserves necessary to cover known and anticipated costs and to spend the remaining available resources to benefit the children of Malawi. Where donations have been received that are designated for a particular purpose (for example the purchase of equipment) they may be retained whilst suitable equipment is identified and sufficient additional funds have been raised. During 2024 the Government of Malawi mandated that foreign currency transfers to Malawi must be converted to local currency on receipt. In order to protect the purchasing power of our grants we now retain donations in the UK in Sterling until our partners in Malawi require funds for their immediate cashflow. This may result in us holding slightly higher balances than in the recent past. ## **Statement of Financial Activities** |**Income**
- Donations
- Grants
- Fundraising by supporters
- Legacies
- Bank Interest
**Total Income**
**Expenditure**
- Online Transaction Charges
- Telephone Costs
- Bank Account Charges
- Website
- Governance
Expenditure on charitable
activities
- Grants
- Orthopaedic Centre
- Medical equipment
**Total Expenditure**
**Net income/(expenditure)**
Total Funds Brought Forward
**Total Funds Carried Forward**|**2024**
**Unrestricted**
**Funds**
**£**
68,277
21,000
20,162
382,835
1,156
493,430
909
60
146
90
98
80,235
15,750
1,855
99,143
394,287
29,098
423,385|**2024**
**Total**
**Funds**
**£**
**68,277**
**21,000**
**20,162**
**382,835**
**1,156**
**493,430**
**909**
**60**
**146**
**90**
**98**
**80,235**
**15,750**
**1,855**
**99,143**
**394,287**
**29,098**
**423,385**| |---|---|---| Page | 7 FRIENDS OF SICK CHILDREN IN MALAWI - REPORT AND FINANCIAL STATEMENTS **2024** ## **Balance Sheet** |**Current Assets**
- Debtors
- Cash at Bank
**Total Current Assets**
**Liabilities**
- Creditors falling due
within one year
**Net Current Assets**
**Net Assets**
**Funds of the Charity**
- Unrestricted income
funds
**Total Charity Funds**|Unrestricted
Funds
2024
£
9,596
413,789
423,385
-
423,385
423,385
423,385
423,385|**Total**
**Funds**
**2024**
**£**
**9,596**
**413,789**
**423,385**
**-**
**423,385**
**423,385**
**423,385**
**423,385**|Prior Year
2023
£
1,616
27,482| |---|---|---|---| ||||29,098| ||||-| ||||29,098| ||||| ||||29,098| ||||29,098| ||||29,098| Approved by the Trustees on and signed on their behalf by Stuart Reynolds Trustee 19 August 2025 Page | 8 FRIENDS OF SICK CHILDREN IN MALAWI - REPORT AND FINANCIAL STATEMENTS **2024** ## **Notes to the Financial Statements** ## **1. ACCOUNTING POLICIES** ## **(a) Basis of preparation and assessment of going concern** The accounts (financial statements) have been prepared under the historical cost convention with items recognised at cost or transaction value unless otherwise stated in the relevant note(s) to these accounts. The financial statements have been prepared in accordance with the Statement of Recommended Practice: Accounting and Reporting by Charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019) and the Financial Reporting Standard applicable in the United Kingdom and Republic of Ireland (FRS 102) and the Charities Act 2011. The trust constitutes a public benefit entity as defined by FRS 102. The trustees consider that there are no material uncertainties about the Trust’s ability to continue as a going concern. ## **(b) Funds structure** Unrestricted income funds comprise those funds which the trustees are free to use for any purpose in furtherance of the charitable objects. There are no restricted funds, however donations totalling £415,579 held at the year end (2023: £15,930) have been designated for various purposes including education, facilities and wheelchair production as detailed below: |**Fund**|**2024**|**2023**| |---|---|---| |Duddy Legacy - Education & Facililties|383,986|-| |Facilities|11,866|-| |Wheelchairs etc. manufacture|8,682|10,159| |Drugs|5,430|3,767| |Other designated funds|2,340|950| |Education|2,875|690| |Children’s A&E|396|364| |FOSC Staff Pay|-|-| |**Totals**|**415,577**|**15,930**| ## **(c) Income recognition** All income is recognised once the charity has entitlement to the income, it is probable that the income will be received and the amount of income receivable can be measured reliably. Donations are recognised when the Trust has been notified in writing of both the amount and settlement date. In the event that a donation is subject to conditions that require a level of performance before the charity is entitled to the funds, the income is deferred and not recognised until either those conditions are fully met, or the fulfilment of those conditions is wholly within the control of the charity and it is probable that those conditions will be fulfilled in the reporting period. Page | 9 FRIENDS OF SICK CHILDREN IN MALAWI - REPORT AND FINANCIAL STATEMENTS **2024** Legacy gifts are recognised on a case by case basis following the granting of probate when the administrator/executor of the estate has communicated in writing both the amount and settlement date. In the event that the gift is in the form of an asset other than cash or a financial asset traded on a recognised stock exchange, recognition is subject to the value of the gift being reliably measurable with a reasonable degree of accuracy and the title to the asset having been transferred to the charity. Interest on funds held on deposit is included when receivable and the amount can be measured reliably by the charity; this is normally upon notification of the interest paid or payable by the bank. ## **(d) Expenditure recognition** Liabilities are recognised as expenditure as soon as there is a legal or constructive obligation committing the charity to that expenditure, it is probable that settlement will be required and the amount of the obligation can be measured reliably. All expenditure is accounted for on an accruals basis. All expenses including support costs and governance costs are allocated or apportioned to the applicable expenditure headings. Grants payable are payments made to third parties in the furtherance of the charitable objects of the Trust. In the case of an unconditional grant offer this is accrued once the recipient has been notified of the grant award. Provisions for grants are made when the intention to make a grant has been communicated to the recipient but there is uncertainty as to the timing of the grant or the amount of grant payable. ## **(e) Irrecoverable VAT** Irrecoverable VAT is charged against the expenditure heading for which it was incurred. ## **(f) Charitable activities** Costs of charitable activities include grants made and directly attributable support costs. ## **2. CHARITABLE STATUS** The Trust is recognised by HMRC as having charitable status and was registered by the Charity Commission on 24 February 2011 once the minimum income threshold for registration could be demonstrated. ## **3. TRUSTEES’ REMUNERATION** No remuneration was paid or payable in respect of the year out of the funds of the Charity either directly or indirectly to any Trustee. £129.29 was reimbursed to Trustees in 2023 for amounts they paid on behalf of the Charity (2023 - £237.77). ## **4. EXAMINATION OF THE ACCOUNTS** No fees were paid or are payable for the independent examination of the accounts. ## **5. EMPLOYEES** The Charity had no full or part time employees during the year. Page | 10 FRIENDS OF SICK CHILDREN IN MALAWI - REPORT AND FINANCIAL STATEMENTS **2024** ## **6. GRANTS AND SUPPORT COSTS** The Charity delivers its charitable benefits by making grants to a Malawi charity, Friends of Sick Children (FOSC), which has similar aims and objects to the Charity, and by direct purchase of equipment and facilities for the Children’s Department and The Orthopaedic Centre of the Queen Elizabeth Central Hospital, Blantyre, Malawi. An analysis of charitable expenditure and associated support costs in this and the previous year is as follows: |**2024**
Grants
Orthopaedic Centre
Medical Equipment
Support & Governance|Direct
charitable
expenditure
Bank
charges
Other
Costs
**Total**
**2024**
80,074
161
0
**80,235**
15,716
34
0
**15,750**
961
17
877
**1,855**
0
608
695
**1,303**| |---|---| ||96,751
820
1,572
**99,143**| |**2023**
Grants
Orthopaedic Centre
Medical Equipment
Support & Governance|Direct
charitable
expenditure
Bank
charges
Other
Costs
**Total**
**2023**
86,478
69
0
**86,547**
26,688
58
0
**26,746**
2,866
69
512
**3,447**
0
824
2,319
**3,143**| |---|---| ||116,032
1,020
2,831
**119,883**| _£834 was paid to transport 4.2cubic metres of donated items to Malawi [£512 was paid for 2.5 cubic metres in 2023]_ ## **7. RELATED PARTY TRANSACTIONS** The Charity made grants to FOSC, a Malawi charity of which one of the Trustees, Professor Molyneux, is also a Trustee. The other Trustees value the expertise that Professor Molyneux is able to bring to the Charity and her particular knowledge and understanding of where charitable support can make the biggest difference to sick children in Malawi. The Charity had no transactions with any Trustee or (with the exception of FOSC) with any connected or related party of any Trustee, and no Trustee received any benefit, direct or indirect, from the Charity. ## **8. CONTROL RELATIONSHIP** The Charity is under the control of the Trustees. Page | 11 FRIENDS OF SICK CHILDREN IN MALAWI- REPORT AND FINANCIAL STATEMENTS 2024 Independent examlnerfs report to the trustees of Frlends of Slck Children in Malawl I report on the accounts of the Frlends of Sick Chlldren In Malawl for the year ended 31 December 2024 whlch are set out on page5 7 to 11. R•sp•rtbV• diTllrt•es and •xwnln•f The charl￿$ trustees are responsible for the preparation of the accounts. The charity's trustees con5&der that an audit is not required for this year under section 144121 of the Charltles Act 2011 Ithe 2011 Act) and that an Independent eJtamlnatSon is needed. It15 my responslbillty to.. examine the accounts under sedon 14S of the 2011 Act,. to follow the procedures lald down In the 8eneral Diredlons glven by the Charity Comrnl5- sion under section 14515llbl of the 2011 Act- and to state whether particular matters have come to my attention Basis of independent examiner's report My examlnatlon was carrled out In accordance wlth the general Dlrertlons glven bythe Charlty Commlsslon. An examlnatlon Includes a revlew of the accountln8 records kept by the charlty and comparison of the accounts presented with those records. It also include5 conslderation of any unusual items or disclosures In the accounts, and seeking explanatlons from you as trustee$ concerning any such matters. The procedures undertaken do not provlde all the evidence that would be requlred In an audlt and consequently no oplnlon Is glven as to whether the accounts present a 'true and fair view, and the re￿￿rt Is Ilmlted to those matters set out In the statement below. Independent ¢Jtaminer's statemont In connectlon wlth my examlnatlon, no matter has come to my attentlon.. 111 whlch glves me reasonable cause to belleye that In any material respect the requlrements.. to keep a¢￿UntIng records in accordance with sertlon 130 of the 2011 Act,. and to prepare accounts whlch accord with the accountlnz records and comply wlth the account- Ing Tequirements of the 2011 Act have not been met.. or 121 to which. In my oplnlon. attentlon should be drawn in order to enable a proper understandlng of the accounts to be reached. AN Andrfft FCA 15 W•ntworth Rorf Sutt•n C•ldfi•ld, W••t Mldl•nth 074 25D 19 Au811rt 202S Page | 12