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2021-12-31-accounts

UK Registered Charity No: 1145080 www.letthechildrenhear.com www.letthechildrenhear.cominfo@letthechildrenhear.com Ugandan Registered NGO No: 10054

Our vision

Improved hearing outcomes for children aged 0-16 years in developing countries.

Our Mission

To improve the hearing outcomes of children in Uganda by adopting strategies which focus on the prevention and early intervention of childhood hearing loss, to aid social integration, speech and language development and access to education. From its inception, LTCH has created a clear vision, mission, goals and set of objectives which underpin its strategy with the aim of providing a strong foundation on which the project can grow and become sustainable long term.

Our objectives

Ø To educate health care workers and the public about childhood hearing loss and the importance of prevention and early intervention.

Contents Welcome 3 Our story 4 Impact report 5 The numbers 7 Education 8 Financial review 10 The Future 14 Our partners 16 Thanks, and get involved 17

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Welcome

Firstly I would like to

welcome you to our annual report for 2021. The past year has been one of change and challenge for the charity.

We were buoyant after the progress and growth of the charity that was made during 2020 mainly, in part, to the securing of a Small Charities Grant from UK AID. In January 2021 last year everything was looking positive, with a second year of funding from DFiD approved and we were in the process of completing the final judiciary review. The UK Government had mooted in the Autumn of 2020 that they were cutting UK Aid but we really didn’t believe they would not honour the commitment made as we were just a week away from signing the agreement when they halted all charity projects while they underwent

a review of funding. In May we found out that we had lost the funding. This presented us with some big challenges and tough decisions. We had to drastically scale back the operation, letting some staff go and reducing the hours the clinic was open. We then looked for new funding streams and we showed a great deal of resilience and by working with new partners we ended the year on a more positive note.

Through this period we did continue with our training program, supporting two audiologist who undertook a South African course in Paediatric Audiology. We also have a student who started the audiology diploma. These students have been further supported by a team of expert UK audiologists and hearing specialists who donate their time to mentor and train our staff in Kampala.

We have grown our relationship with the team at Global Partnership for Hearing Health (GPHH) they are now funding our screening programmes across three hospitals. We are also nurturing a new relationship with Pieter at East Africa Children's Project.

We are nothing without the staff and volunteers who have worked hard and remained loyal during this difficult time. I would like to say a big thank you to the LTCH board. Geoff, Elspeth, Kevin and especially Liz and Paul, you have all worked so hard for the charity over the past year. We are a small board and would welcome

new members so if you would like to join us please get in touch.

Jude Chapman, Let the Children Hear

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----- Start of picture text -----
Our story Timeline
• Renamed to Let
Our First trip to Uganda the Children Hear
• Screener training
Four friends come
together in the Mobile clinic • New Born Screening Trial • Audiologists from UK programme sponsored by • Two Ugandan
memory of their International Rotary
visit and train screeners Rotary Club audiologists are given
friend Ian Hutcheon fund a new mobile clinic •
to form a charity Health talks to parents • Audiologist from UK • New waiting room is built Partnership with Paediatric audiology
make it apparent that visits and delivers at Kisenyi thanks to a local Boston University training and complete
our services are much needed • trainingKisenyi Clinic opens • businessman LTCH spoke at the Hearing saw students visit the clinic to develop • South African courseOne student enlisted on
conference a monitoring and the Diploma Course in
in Kampala evaluation plan Kampala
• UK Aid
budget
is cut
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
• Ian Hutcheon Clinic First Clinic Mulago hospital ENT
for Children (IHCC) • Kisugu Health Centre Department
is formed • Maternity and other • Facilities for sedation
•• Fundraising commencesRotary Luton North • outpatients' servicesMOU with service •• Out reach • Access to screen Children in Mulago
becomes a big supporter provider KCCA Schools programme • Future inclusion in the
• Our first annual golf day • Trained two staff – students screened Capacity building ENT Dpt
• Local schools fund raise and resourced clinic in our mobile clinic with UK Aid Grant
Screening programme
• Website is launched Kawempe Hospital, Uganda
• New-born screeners trained funding is taken up by
• School Screener trained
• Paediatric Audiologist trained
• Recruitment – nine employees
• Communication • National Referral Hospital-Kawempe
drive and TV • Data collection started
appearance • MOH – resources-room and staff
----- End of picture text -----

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2021 IMPACT REPORT

2021 was a year of mixed fortunes. There was a sudden halt in grant funding from a major donor and the impact of covid continued which affected project activities throughout the year.

The impact of Covid-19 continued to affect project activities. Activities were reduced due to the continuing curfew in Uganda and all activities were suspended for a month during the second lockdown. Schools remained closed for the second year which resulted in hearing screening of school age children being adapted and carried out in Kisenyi Health Centre and some children’s organisations. Many children had been relocated and remained living in the villages where the cost of living is cheaper. Transport costs remained high. All these combined factors continued to affect the numbers of children accessing the screening, audiology and rehabilitation services leading to an increase in the number of children lost to follow up.

On the upside, emphasis was placed on capacity building of local audiologists for the future expansion of LTCH services and the growth of paediatric audiology in Uganda.

The UK Aid 12 month grant for 2020 was successfully concluded in March 2021. The second year of approved funding was abruptly withdrawn due to the cut in the UK foreign aid budget. As a result of this sudden withdrawal of funding, some project activities had to be terminated such as school screening and others were scaled back. The number of employees was also reduced.

From April 2021 onwards following completion of the UK Aid 2020 grant, the project activities that continued

Covid proved a challenge but we met it with innovation and a fantastic team.

were, medical treatments for common ear conditions, health education, newborn hearing screening, training of audiologists, audiology assessments, hearing aid fitting and rehabilitation.

screened . This was mainly influenced by the health education talks among HCW’s and 2,451 mothers (of which 80% prior to the talks had never known of hearing screening tests). The talks covered topics such as common causes and possible prevention of childhood hearing loss and increased awareness on the availability and relevance of the services being provided by LTCH and the referral pathways. HCW’s serve as our main referral points within the health facilities we are working with so these health talks empower them with knowledge to correctly refer.

TREATMENTS

The ear clinic continued to operate on a smaller scale. The number of new patients attending the clinic saw a 11% decline with a total of 447 new patients seen. However when it came to follow up appointments, attendance remained low, as in the previous year, due to the impact of covid and high transport costs.

HEALTH EDUCATION

During the project period, health education continued. There was increased knowledge and awareness on childhood hearing loss mainly among health care workers (HCWs) and mothers whose babies were

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2020 IMPACT REPORT

NEWBORN HEARING SCREENING

Newborn hearing screening was scaled back to include screening ‘at risk babies’ in the Neonatal Intensive Care Unit (NICU) of Kawempe Hospital. These babies are babies that spend time in the intensive care unit due to various risk factors that also make them more susceptible to hearing loss, for example, severe jaundice and birth asphyxia. 2,451 babies were screened during this reporting period.

AUDIOLOGY ASSESSMENTS

The audiology clinic continued to operate on a part time basis. LTCH’s experienced paediatric audiologist worked with the younger cohort of children aged 0-4 years, who required advanced knowledge and skills in audiological assessment. Children aged 5 years and above were seen by two part time audiologists and mentored via Zoom by volunteer UK paediatric audiologists.

195 new cases were seen during the year which was a decline of 45% on the previous year,2020. This was a direct result of the reduction in funding and hence project activities. This in addition to the impact of covid, had an impact on the number of children fitted with hearing aids. A total of 17 new children were fitted during the year.

SPEECH THERAPY

Speech therapy attendance during the year fluctuated and was interrupted during the period of lockdown. However during the last 5 months of the year the attendance improved and 10 children in total, benefitted from improved communication skills.

ICLOUD TECHNOLOGY

During 2021, LTCH made the transition from paper-based records to an electronic medical record system (EMR). The outreach EMR is a charitable organisation formed by a

group of UK GP’s. The system is for use in developing countries and is free of charge.

This transition has streamlined the patient record system and has complemented the zoom trainings and mentoring of audiologists, making it easier to discuss individual cases and their management. It also enables remote scrutiny of records by the UK audiology and medical team for quality assurance purposes.

In addition to the EMR system, the appointment system also went digital. This can also be accessed remotely by the UK team for monitoring and reporting purposes.

Both systems are free of charge; have provided very cost-effective patient management systems for LTCH and have transformed and improved the management of patient data. Not all patient data has been transferred to

the EMR system immediately, only some of the audiology clinic patients. This is very time consuming and is generally done by some of the UK audiologists and Project Adviser when time permits. All audiologists, clinic clerks and project managers have received initial training. Further training and additions to the system are ongoing.

Liz Choudhury Operation Advisor

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THE NUMBERS

195 New cases and 317 Follow-ups – Children assessed for hearing loss and appropriate intervention given

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2020 IMPACT REPORT

Education Health Talks & Training

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Training Audiologist and screeners is vital for us to grow a robust hearing clinic in Uganda

2021 EDUATION & TRAINING

During this project period, there was a lot of emphasis put on training of Audiologists both internally via zoom with support of the UK audiology team and externally through the various sponsorship programmes.

Prior to 2021, LTCH only had one full time trained paediatric audiologist and this restricted the number of patients that could be seen. She was supported by other audiologists who worked on a locum basis. The clinic has many younger children attending for assessment and they have additional complex medical needs that requires audiologists to have paediatric skills in assessing them. Many of the locally qualified audiologists have little paediatric knowledge and lack experience in paediatric audiology.

One audiologist and One speech therapist were sponsored for a 6- month paediatric audiology course with Eduplex training Institute in Pretoria, South Africa. The course received sponsorship from the ENT UK Global Health Grant and The Oswal Pharmacists, UK. This training provided a robust six-month online theory component and later a practical component in Pretoria. This training has capacity built the number of audiologists working in the clinic and most importantly built the confidence and equipped the audiologists with knowledge and skills in paediatric audiology to better manage and handle the increasing number of younger children attending the clinic.

Internal training and mentoring by UK Audiologists continued throughout this period. 1 diploma level audiology student sponsored via LTCH started her 18 month course and is doing her internship with LTCH. She attended the clinic one day a week for practical training and mentoring via zoom. On completion of her training in 2022 and as part of her sponsorship agreement, she will work for LTCH for 2 years.

Ongoing mentoring and joint clinics via zoom with all the audiologists continued on a regular basis. This provided practical and theoretical support during the clinic sessions. In addition, it enabled assessment of the services being provided for the purposes of quality assurance.

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Let the ,Children Hear Clinic5for Children in Uganda Financial review Let the ,Children Hear www.letthechildrenhear.com | 10

Funding remains our biggest challenge

2021 FINANCIAL REVIEW

Incoming resources

LTCH’s total income during the year was £63,769 2020: £60,648) a 5% increase on 2020. Income, except for interest on funds held on deposit, was split between the residual UK Government funding which has now been discontinued, new US grant funding from The Church of Latter-Day Saints, voluntary donations and fund-raising activities as shown in the following table:

A further breakdown of our general fundraising activities

Year ended 31 December 2021 Year ended 31 December 2021 Year ended 31 December 2021 Year ended 31 December 2020 Year ended 31 December 2020 Year ended 31 December 2020
Total
£		 Unrestricted
£		 Restricted
£		 Total
£		 Unrestricted
£		 Restricted
£
Income
DFiD Grant 5,741 - 5,741 44,550 - 44,550
US GRANT 22,215 - 22,215 - - -
Donation– general 10,095 10,095 - 5,229 5,229 -
Donations– restricted 13,430 - 13,430 - - -
Fundraising activities 12,266 12,266 - 10,790 10,790 -
Interest 22 22 - 80 80 -
63,769 22,383 41,386 60,649 16,099 44,550
Year ended 31 December 2021 Year ended 31 December 2020
Fundraising Total
£		 Unrestricted
£		 Restricted
£		 Total
£		 Unrestricted
£		 Restricted
£
General fundraising 10,587 10,587 - 9,029 9,029 -
Charities Trust 480 480 - 720 720 -
Gift Aid - - - 0 - -
Fundraising events 584 584 - 1,041 1,041 -
Miscellaneous 615 615 - 0 - -
12,266 12,266 - 10,790 10,790 -

Our largest source of income, this year, was from the US Church of Latter-Day Saints, organised by the Global Partnership for Hearing Health (GPHH) which replaced the DFiD grant which was discontinued due to UK Government cut backs. This replacement funding will allow for the continuation of the expansion initiative in Kampala in 2022. Due to the discontinuation of the DFiD funding, Paul and Liz Choudhury, secured additional replacement monies to fund specific initiatives, previously funded by DFiD. The result of this being that overall funding for the year increased by 5% (£3,121) on the previous year. General donations and fund-raising events also increased this year compared to the previous year’s income following the end of the Covid restrictions. Except for specific funding applications, we seek to raise grant funding on an unrestricted basis, so that it may be applied where most needed.

Donations from individuals by regular standing order have declined slightly from the level in 2020.

We benefit from Gift Aid on most of the regular donations we receive via Just Giving.

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2021 FINANCIAL REVIEW

Funding remains our biggest challenge

Resources expended

During the year, LTCH expended a total
of£40,106(2020: £57,818) a
reduction of 30% on 2020, as shown in
the following table:		 Year ended 31 December 2021 Year ended 31 December 2021 Year ended 31 December 2021 Year ended 31 December 2020 Year ended 31 December 2020 Year ended 31 December 2020
Expenditure Total
£		 Unrestricted
£		 Restricted
£		 Total
£		 Unrestricted
£		 Restricted
£
Ugandan Funding1 38,385 19,214 19,171 49,169 10,169 39,000
Fundraising costs 167 167 - 444 444 -
Administration costs 759 759 - 3,311 3,311 -
Trustee monitoring 795 795 4,894 4,894 -
40,106 20,935 19,171 57,818 18,818 39,000

1.Including money transfer costs

As in most previous years, the bulk of expenditure is committed directly to the project in Kampala. Funding decreased considerably (30%) this year due to the withdrawal of the UK Dfid grant. This has caused us to temporarily reduce our programme and staffing levels, in Uganda whilst we waited for the new funding from The Church of Latter-Day Saints. This funding came in towards the end of the year and will enable us to again expand our programme in 2022.

Fund raising and Trustee visit costs declined significantly due to the impact of Covid.

Administration costs were lower than the previous year as we used the hiatus caused by Covid, in the previous year, to overhaul the charities website and branding. We are now better placed to apply for future direct grant funding and submitted a number of grant applications throughout the year.

As a small charity run entirely by volunteers, we strive to minimise our expenditure on items other than direct project costs. Our fundraising cost solely comprised the entrance fee for The London Marathon.

Other than the costs for media and marketing our administration costs were only £759 for insurances, Just Giving subscriptions, internet, and bank charges.

Inspection of accounts

As our income for the year exceeded £25,000, we are required to have our accounts inspected by an independent examiner. This service has been provided on a pro bono basis.

Reserves policy

LTCH’s reserves policy is, subject to exceptional circumstances, to maintain a minimum reserve of £6,000 or three months anticipated committed expenditure, whichever is the lower. On 31 December 2021, we had unrestricted reserves of £16,253 (2020: £16,231) held in a Virgin Money Interest Bearing Charity Account which is more than sufficient to cover three months of committed expenditure at current levels.

Surplus funds are held in the Virgin Charity Account and although interest rates are low, the Trustees do not consider it appropriate to invest funds where there is a risk of capital depreciation.

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2021 FINANCIAL REVIEW

Fundraising

Fundraising has remained a challenge with covid making many of our large events virtually impossible. We again didn’t hold out golf day or the Bollywood night. These plans are still in the pipeline. However some people came forward and took on great personal challenges to raise funds for us.

Nathan Choudhry ran the London Marathon in October and Sam Wilson, Mike Lewis and Andrea Dragoescu ran the Virtual Marathon. Between them they raised over £5,200.

Kevin Davey, who is never far from his trusty bike, devised his own challenge and not wishing to just put himself through this test of endurance he dragged Toni along. The challenge was to see how far they could cycle in 24 hours. Kevin and Toni departed from London and ended in Sheringham via Windsor, Leamington and East coast travelling an amazing 279 miles and raising £1,681.25.

On behalf of the charity, I would like to say a massive thank you to all these super humans for not only their hard work, grit and determination but also for raising funds for us it really does make a huge difference.

Unfortunately, for 2022 the London marathon has decided not to run its charity Ballot so we will not be able to enter any candidates into it.

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Let the ,Children Hear Clinic5for Children in Uganda IS NOT. The Future Letthe ,Children Hear www.letthechildrenhear.com | 14

Summary and future direction

2021 had been a challenging year due to various restrictions namely a major funding cut and the impact of covid. Because of this the project had to adapt and operate at a reduced capacity. However, LTCH’s project model is based on future sustainability and integration of the audiology service within the national health care system of Uganda. This was very much the focus of direction in 2021 through capacity building of audiologists which in the short term will service LTCH clinic but in the long term will increase the pool of paediatric audiologists available to work in other health facilities in Uganda.

LTCH continued to provide an ongoing paediatric audiological training programme for local audiologists which was very successful. These audiologists continued to work in the clinic on a part time basis during the year to gain

further experience and enhance their skills. Mentoring of their clinics was ongoing and they were very well supported by the various UK audiologists.

As a result of partnership with Mulago National Referral hospital through the MOU with the Ministry of Health, LTCH was able to secure space and extend the audiology services to the ENT paediatric clinic operating every Tuesday. This close working relationship has increased the number of referrals LTCH is receiving from Mulago Hospital. The LTCH audiologist also had access to the hospital theatre which provided support in handling difficult cases where sedation was required prior to audiological assessment. Such cases could not be managed in Kisenyi Health Centre.

In 2022, LTCH will be working with Mulago Hospital to resource a new audiology centre. Integration of the

project with support of the hospital administration and the entire ENT department of Mulago Hospital is key to ensuring success and future sustainability.

The future plan over the next 5 -6 years is to embed and integrate the audiology services in the main hospital. In addition by collaborating with government and professional leaders, and by sharing LTCH screening and audiology data, it is hoped that a realistic national plan for implementing hearing screening and a capacity building programme for paediatric audiology in Uganda can be developed.

The introduction of iCloud based technology in the form of an electronic patient medical records system and an appointment system has been very beneficial It’s use is still in its infancy but there is scope to maximise its potential in terms of data management and project reporting.

With further training, this will be refined over the next year.

At the conclusion of 2021, LTCH secured a grant from Global Partnerships for Hearing Health and Latter-day Saint Charities ( LDSC) of USA . This grant was for an infant and early childhood hearing screening programme commencing in 2022.

In summary, 2021 started well but was then followed by a few setbacks in the second quarter of the year.

In the last half of the year progress was being made and there was an upturn as covid restrictions began to relax and some new funding came in for the start of 2022.

In 2022 it is hoped that project activities will increase and the number of new patients will see a steady increase back to pre-covid levels

Paul Choudhury Medical Advisor

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Our Partners

LTCH continued to manage and engage it’s existing partners and key stakeholders including the Ministry of Health, Mulago National Referral Hospital, KCCA and Kawempe National Referral Hospital maintaining continued support for the project activities. This was strengthened through MOUs that were signed with these stakeholders and provision of space in these health facilities to implement the programmes. An additional MOU was created with Nsambya Hospital a not-for-profit hospital who are interested in commencing a newborn screening programme in 2022 for babies in their hospital.

A big thank you to our partners

success in 2021 Pam Layton, Fatima Hashim, Keri Abbott and Vicky Jordan.

A new partnership was created between LTCH and Global

Partnerships for Hearing Health (GPHH) and the Latter Day Saints Charities (LDSC) to work together on an initial 12 month screening project.

We also like to thank all our regular donors, fundraisers, and supporters. Without their continued support, it would not be possible to sustain this project, hence LTCH would like to say a BIG thank you to everyone.

LTCH would like to thank our volunteer audiologists in the UK who have contributed to our

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www.letthechildrenhear.com

Get involved

If you would like to…. work with us, fundraise for us or get involved please email liz@letthechildrenhear.com

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www.letthechildrenhear.com

Let the Children Hear

Receipts and Payments Account - Year Ended December 31 2021 Draft Accounts

Receipts
General Donations, Unallocated
Ring Fenced Donations, Allocated
Dfid Receipts
US Grant Funding (Latter Day Saints)
General fundraising (Just Giving Virgin Givingetc)
Tax credits on donations (Gift Aid)
Charities Trust Donations
Golf Day
Lingerie Sales
Quiz Nights
Shrap Sacks
Aquaman
Amazon Smile
PayPal refund
Make up Evenings (Tropic etc )
Gourmet Lux
Soft Toys & Card sales
Trustee Expenses Refund
Virgin Deposit Account Interest
Payments
Golf Day
London Marathon Entry Fee & Sundry Costs
Website,computer, Office 365
Data Protection Registration
Insurance
Just Giving charges
Virgin Giving
Bank charges
Media and marketing charges
Room hire
Transfers to Uganda
Ugandan costs :
Trustees/volunteers expenses
Ambulance,medical equipment & medicine
Bank accounts as at December 31 2020
Bank accounts as at December 31 2021		 Year ended
Dec 31 2021
£
10,095.00
13,430.00
5,741.34
22,214.84
10,587.43
0.00
480.00
0.00
124.00
0.00
0.00
0.00
25.34
589.64
380.00
30.00
50.00
0.00
21.56
63,769.15
0.00
166.50
350.99
40.00
142.80
216.00
0.00
0.00
10.00
0.00
31,000.00
794.50
7,385.18
40,105.97
32,726.41
56,389.59		 Year ended
Dec 31 2020
£
5,229.10
0.00
44,550.03
0.00
9,028.81
0.00
720.00
0.00
0.00
630.00
0.00
0.00
11.55
337.60
0.00
62.00
0.00
79.42
60,648.51
0.00
444.00
248.86
0.00
155.80
216.00
180.00
10.00
2,500.00
0.00
39,000.00
4,894.44
10,168.53
57,817.63
29,895.53
32,726.41		 Variance
Comments
In period
£
4,865.90
13,430.00
-38,808.69
22,214.84
1,558.62
0.00
-240.00
0.00
124.00
-630.00
0.00
0.00
13.79
42.40
30.00
-12.00
0.00
-57.86
2,531.00
0.00
-277.50
102.13
40.00
-13.00
0.00
-180.00
-10.00
-2,490.00
0.00
-8,000.00
-4,099.94
-2,783.35
-17,711.66

CHARITY COMMISSION FOR ENGLAND AND WALES Independent examinerfs report on the accounts Section A Indépendent Examinèr's Report Report to the trusteesl members of Let the Chiklren H8ar On accounts for the year onded Dec6mber 2021 Charfty no Ilf any) 1145080 Set out on pages I report to the trustees on my examination of the acL¢)unts of th8 abov8 charity (Ihe Trust'l for the year ended 3111212020. Responslbllltles and As the charity trustees of the Trust. you a￿ respMsible for the p￿paratIon basls of report of the a(xounts in accordance with th8 requirements of the Charities Acl 2011 fthe Acr). I rep￿t in respect of my ex8mlnalion of the Tntst's 8ccounts Ggrried out under section 145 of the 2011 Act and in carying out my examination, I have followed the applicable Directions given by the Charity Commission under seclion 145(5)Ibl of the Act. I have completed my exafflination. I confimi that no material matters have come to my attentson (other than that disclosed below") in connecth)n with the examinab'on whkh gives me causé to ￿lieve that in, any material respecL' accountlng records w8r8 nol kept in ac¢￿anCe With séction 130 of the Act or the accounts do not a￿￿d wblh the accounting records Independent examlnerfs statement I have no concerns and have come aLYoss no other matters in connection viith the examination to vthKh attentK)n should be drdwn in order to enable a proper underslanding of the accounts to be reached. ase te tho vths in the brackets rfthey do not 8ppIy. Slgnod: Name: pfv-,2KciA tJ Relevant professional qualification(s) or body (If any): FC Address." OLII CKOX IER October 2018