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2022-12-31-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

Contents

Welcome 3

Our story 4

Impact report 5

The numbers 11 Financial review 13 The Future 17 Our partners 19 Thanks, and get involved 20

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Welcome

Firstly, I would like to welcome you to our annual report for 2022.The year has been one of recovery and growth for the charity post covid.

During 2022 the charity activities began to recover and grow post covid. At the back end of

2021,LTCH secured funding from a new partnership with Latter Day Saint Charities and Global Partners in Hearing Health USA. The project being funded in 2022 focused on capacity building of hearing screening and remediation activities in various health care settings and schools. The school screening project had been suspended for more than a year due to school closures and it was good to be able to resume this activity again in 2022.. LTCH also strengthened its partnership with East Africa Childrens Project (EACP) who funded

our speech therapy project for 2022.. In addition to the increase in activities aimed at the direct beneficiaries, health education and training activities for indirect beneficiaries i.e. parents, health care workers and teachers also increased. A UK donor funded a UK Paediatric Audiologist to volunteer in our clinic in Uganda for 2 weeks. This provided further ongoing paediatric audiology training for the audiologists including our diploma audiology student. Joint clinics on Zoom continued in 2022 with the UK volunteer audiologists mentoring the local audiologists in their clinics. This provided ongoing practical training and quality assurance of service delivery. A parental support group was started in June 2022 to support parents whose children have been fitted with hearing aids. Some of the older children also had the opportunity to come together to share their experiences, challenges and the

positive impact hearing aids have made to various aspects of their lives..

The growth of project activities in 2022 and successful outcomes could not have been achieved without the commitment of the Ugandan team and UK volunteers who have worked very hard throughout the year. I would like to take this opportunity to thank them all. I would also like to say a big thank you to the LTCH board; Geoff, Elspeth, Jude and Kevin. who have all worked so hard

for the charity over the past year. Before Christmas, Kevin set off back to Africa to resume his charity bike ride which was suspended in 2020 due to the covid pandemic.

During the year we parted with our mobile clinic which has served us well over the past seven years reaching out to many children in community outreaches and schools. However,

post covid it no longer proved cost effective to maintain .

At the end of November we were sorry to say goodbye to Jude our Chair of trustees for many years. Her invaluable expertise in the field of communications and marketing experience was put to good use at LTCH over the past 5 years. Looking ahead, we now need to build our UK team and recruit more trustees and team members to assist with the operational activities and future growth of the charity. .

Liz Choudhury Let the Children Hear

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Our Storyline

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UK Registered Charity No: 1145080 Ugandan Registered NGO No: 10054

Capacity building sums up 2022

2022 IMPACT REPORT

2022 was a year that saw capacity building of the Ugandan team and project activities with the project reaching out to more than 9,000 direct beneficiaries. The grant funding from Global Partners in Hearing Health and Latter-Day Saints Charities. funded an Infant and Early Childhood Hearing Detection and Early Intervention Project for children 0-6 years. This twelvemonth project was delivered in over five different health facilities and KCCA primary schools It encompassed training, health education, screening, assessment , hearing aid fitting and rehabilitation.

The impact of Covid-19 and the general economic situation continued to affect some of the project activities. In particular, high transport costs impacted on follow up rates in the screening, audiology and rehabilitation clinics and as a result

many children were lost to follow up during the year. Schools remained closed for the first quarter of the year, finally opening in April after a two-year closure .Many children had been relocated to live with extended family in the villages during the covid period which also contributed to the high lost to follow up rate for children who required further intervention.

Despite the challenges around missed appointments and lost to follow up, 2022 was a very successful year for the charity in terms of awareness and capacity building of the screening, audiology and rehabilitation

programmes.

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Ugandan Registered NGO No: 10054UK Registered Charity No: 1145080 info@letthechildrenhear.com| 5

HEALTH EDUCATION

HEALTH EDUCATION

included health care workers from two of our screening sites-Nsambya Hospital where newborn screening was introduced and Baylor Paediatric HIV Clinic where targeted hearing screening was being carried out.

During the project period, health education played an important part of our work. For every newborn baby and young child that was screened the accompanying parent/guardian received health education on childhood hearing loss. This equated to 7,124 persons.

These sessions provided an opportunity to introduce the work of the charity, the team , how to refer children to our main centre at Kisenyi Health Centre and to increase knowledge and awareness around childhood hearing loss..

In addition, 171 teachers and 650 pupils received health education talks in schools. Some of the pupils were nominated to be ‘hearing heroes’ and to share the impact of the health education talks on their knowledge and awareness of childhood hearing loss. Some of the teachers were also asked to provide beneficiary feedback on the sessions and this was captured in both instances via video recordings.

60 health care workers received health education during the year. This

Increased knowledge and awareness provides better hearing outcomes for our beneficiaries

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UK Registered Charity No: 1145080 Ugandan Registered NGO No: 10054

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TRAINING

TRAINING

but had not be trained on how to use it. It is hoped that capacity building of screening services at the Watoto site will soon be implemented after the machine has been calibrated and the trainees have successfully completed a competency test.

Supervision and mentoring of the Ugandan audiologists by the UK audiology team of volunteers continued throughout the year. During the summer we were lucky enough to have Keri Abott a paediatric audiologist from Manchester visit the audiology clinic in Kampala. She provided hands on training for the 4 audiologists. The South African online paediatric training course concluded in May 2022 and the two audiologists successfully completed the course and continued to work in the LTCH clinic to gain further experience in paediatric audiology during the mentored sessions.

At the beginning of the year and in preparation for the commencement of the early infant and childhood screening project, 8 screeners were trained. All screeners successfully completed the National Centre for Hearing Assessment (NCHAM) Utah, US Hearing Screening Training online course and were awarded certificates of completion. In addition, practical training was supervised by LTCH Lead New-born Screener and competency assessments were carried out periodically for quality assurance purposes.

At one of the screening sites –Watoto Children’s Home, hearing screening training was given to health care workers who had previously been donated a hearing screening machine

Vital component of our work –essential for capacity building of children’s hearing health care services in Uganda

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UK Registered Charity No: 1145080 Ugandan Registered NGO No: 10054

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ACTIVITIES

TREATMENTS

Post covid, the ear clinic continued to operate on a small scale providing medical treatments for common ear diseases . High transport costs and lack of availability of clinic staff to run the clinic meant the number of new patients attending the clinic saw a 30% decline from the previous year with a total of 308 new patients seen. Follow up also remained a challenge. The plan for the future of the ear clinic is to train more health care workers to treat ear disease and integrate it into the Outpatients Department of Kisenyi Health Centre and this has been agreed by KCCA for 2023.

NEWBORN HEARING SCREENING

Newborn hearing screening was scaled up as part of the US funded hearing screening and early intervention project. This included: i) Ongoing screening of ‘at risk babies’ in the Neonatal Intensive Care Unit (NICU) of Kawempe Hospital i.e , those babies who are classified as

to various factors associated with time spent in NICU. For example, prematurity, jaundice, birth asphyxia. II) Screening of 6 day old babies at Kisenyi Health Centre. These babies attend for follow up health checks and immunisation. Hearing screening has been incorporated into the health checks and therefore the mothers are well motivated by the health care workers and attendance for screening is high.

III) Screening of ‘at risk’ babies in the NICU AT St Francis Hospital Nsambya.

A total of 5,069 babies were screened. Babies screened at St Francis Hospital were screened by their own screeners trained by LTCH whose role in this project was to support them to set up their own screening programme within the next two years. For this project period LTCH loaned a screening machine.

.

Providing the full pathway of hearing health care for children

being more at risk of hearing loss due

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UK Registered Charity No: 1145080 Ugandan Registered NGO No: 10054

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ACTIVITIES

Providing the full pathway of hearing health care for children

SCHOOL HEARING SCREENING

EARLY INFANT HEARING SCREENING

2022 was the first year that LTCH extended its hearing screening programme in hospitals to include infants and young children aged 6 years and below. This formed part of the US funded early intervention project. Three different hospital sites were used during the project period. Baylor Paediatric HIV Clinic, Mulago Paediatric ENT Clinic and Naguru Paediatric Outpatients Department. The HIV clinic and the Ent clinic were targeted screening sites due to hearing loss being more prevalent in children with HIV and in children attending the ENT clinic. Children and parents benefitted from access to screening and health education The direct beneficiaries were our target cohort of children 0-6 years. However, in addition we had many indirect beneficiaries of the project. These were children who were outside the screening cohort but required referral to the audiology clinic.

Schools re-opened in March following the covid outbreak.. 1,982 children were screened. The target beneficiaries were children aged 3-6 years in Nursey Schools, Primary Schools. and Children’s

Organisations. Alongside screening, health education played an important role in educating students, teachers and carers about hearing loss and services available at LTCH.

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UK Registered Charity No: 1145080 Ugandan Registered NGO No: 10054

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Supporting children & their families

REMEDIATION & REHABILITATION

ASSESSMENTS & REMEDIATION

The audiology clinic at Kisenyi Health centre saw an increase in the number of new referrals.There were 320 new referrals in total which was a 64% increase on the previous year..61% of these referrals were from the screening project and the various screening sites. 114 children were diagnosed with normal hearing .219 children were diagnosed with varying degrees of hearing loss of which 128 children ( 58% ) had disabling hearing loss. This is defined as hearing loss >35 decibels in the better hearing ear as per World Health Organisation guidelines. 99 children had appointments for hearing aid fitting. 46 were new children fitted with a hearing aid and 8 children were given a second hearing aid. 45 children required a replacement hearing aid either due to requiring an upgrade or because the hearing aid was faulty or had been lost.

SPEECH THERAPY

The Speech therapy project was funded in 2022 by the East African Childrens Project . 11 children were enrolled on the project which provided each child with 12 sessions. One child dropped out leaving 10 children who completed speech therapy. All children who attended benefitted from better communication and listening skills and many parents reported better school performance. Speech therapy progress reports were shared by the Speech Therapist highlighting the impact of the project. In addition, beneficiary feedback was received from parents using videos and questionnaires.

SUPPORT GROUP

In June 2022 a parental support group was set up. This group meets monthly and is formed of parents and children who are enrolled on the hearing aid programme. It has proved very beneficial in providing a platform for both parents and children to come together, share experiences and learn from each other. 60 beneficiaries were impacted by the project. Some sessions were parent led and informal. Other sessions were led by audiologists and speech therapists and discussed various topics for example the difference between hearing and listening. In addition to the meetings, a Whatsapp group was also created to provide a platform for ongoing support in between meetings.

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THE NUMBERS

320 New cases seen in audiology clinic 555 Follow-up appts – in audiology clinic

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THE NUMBERS

351 children were medically treated and managed for ear diseases

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Let the Clinics for Children In Uganda . Financial r.eview Let the .Children Hear www.letthechildrenhear.com | 13

2022 FINANCIAL REVIEW

Funding remains our biggest challenge

Incoming resources

LTCH’s total income during the year was £52,760 2021: £63,769) a 17% decrease on 2021. Income, except for interest on funds held on deposit, was split between a grant from the CAF and continuing 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 2022 Year ended 31 December 2022 Year ended 31 December 2022 Year ended 31 December 2021 Year ended 31 December 2021 Year ended 31 December 2021
Total
£		 Unrestricted
£		 Restricted
£		 Total
£		 Unrestricted
£		 Restricted
£
Income
UK Grants 20,000 - 20,000 5,741 - 5,741
US GRANT 21,335 - 21,335 22,215 -
 22,215
Donation –general 3,432 3,432 - 10,095 10,095 -
Donations – restricted 2,000 - 2,000 13,430 - 13,430
Fundraising activities **5,951 ** 5,951 - 12,266 12,266 -
Interest 43 43 - 22 22 -
63,769
Year end		 22,383
ed 31 Decem		 41,386
ber 2022		 60,649
Year ende		 16,099
d 31 Decem		 44,550
ber 2021
Fundraising Total
£		 Unrestricted
£		 Restricted
£		 Total
£		 Unrestricted
£		 Restricted
£
General fundraising 5,946 5,946 - 9,029 9,029 -
Charities Trust - - - 720 720 -
Gift Aid - - - 0 - -
Fundraising events - - - 1,041 1,041 -
Miscellaneous 5 5 - 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 previously discontinued due to UK Government cut-backs. The replacement funding allowed for the continuation of the expansion initiative in Kampala in 2022. Due to the discontinuation of the DFiD funding. Paul and Liz Choudhury, secured an additional grant from the CAF to fund specific initiatives, previously funded by DFiD. General donations and fund-raising events decreased this year compared to the previous year’s income as we concentrated on securing grant funding. 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 2021. We benefit from Gift Aid on most of the regular donations we receive via Just Giving.

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2022 FINANCIAL REVIEW

Funding remains our biggest challenge

Resources expended

During the year, LTCH expended a total of £47,564 (2021: 40,106) a reduction of 18% on 2021, as shown in the following table:

Year ended 31 December 2022 Year ended 31 December 2022 Year ended 31 December 2022 Year ended 31 December 2021 Year ended 31 December 2021 Year ended 31 December 2021
E1penditure Total
£		 Unrestricted
£		 Restricted
£		 Total
£		 Unrestricted
£		 Restricted
£
Ugandan Funding1 40,445 8,445 32,000 38,385 19,214 19,171
Fundraising costs 90 90 - 167 167 -
Administration costs 2,063 2,063 - 759 759 -
Trustee monitoring 4,966 4,966 795 795 -
47,564 15,564 32,000 40,106 20,935 19,171

1.Including money transfer costs and Dfid refund

As in most previous years, the bulk of expenditure is committed directly to the project in Kampala. Funding decreased (18%) this year. This has caused us to adapt and modify our programme and staffing levels, in Uganda, to suit the level of funding. Core activities funded by The Church of Latter-Day Saints remained unaffected during the year.

Trustee visit costs increased significantly following the end of Covid restrictions as the Medical Trustees were able to return to Uganda.

Administration costs increased during the year as we had to refund an overpayment to Dfid for previous grants and invested in new computer technology to enable better remote working and monitoring of the operation in Uganda. 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 service charges for Just Giving.

Our administration costs were only £160 for insurances, 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 £16,296 (2021: £16,253) 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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2022 FINANCIAL REVIEW

Fundraising

Fundraising has again remained a challenge following Covid. We have been concentrating on securing grant funding. General Fundraising throughout the year raised £4,946.

General and Ring Fenced Donations raised £5,432 throughout the year.

We would like to say a massive thank you to all these super humans and organisations who have donated and fundraised for us throughout the year as this really does make a huge difference to us.

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Let the Clinics for Children In Uganda IS NOT The Future i• Let the .Children Hear www.letthechildrenhear.com | 17

Summary and Future Direction

2022 has been a very

successful year of post covid recovery and growth and one which impacted over 9,000 direct beneficiaries.

LTCH engaged new stakeholdersnamely Baylor Paediatric HIV clinic and ENT Paediatric Clinic at Mulago Hospital, Children outpatients Department at Naguru Hospital and Neonatal Intensive Care Unit at St Francis’ Hospital Nsambya.. In addition, LTCH continued to work with Kawempe Hospital to screen ‘at risk’ babies. Screening of l babies recommenced at Kisenyi Health Centre after a break in 2021 due to covid restrictions and lack of funding.

Capacity building of screening services at these sites included: newborn and

infant screening which resulted in a 200% increase in numbers screened in 2022 compared to 2021.

As a result, the number of new

referrals requiring assessment at the audiology clinic in Kisenyi Health Centre increased by 64% .Notably, 61% of the new referrals to the clinic were from the screening project.

screening equipment and to making any refinements to the programme as needed. The screeners and data will continue to be monitored and

evaluated by LTCH for quality assurance purposes. Any babies requiring further assessment will be referred to our clinic at Kisenyi Health Centre.

One of the highlights of 2022 was the new partnership with St Francis Hospital, Nsambya .LTCH worked in collaboration with Nsambya Hospital under a signed Memorandum of Understanding to support them with setting up their own newborn hearing screening programme. Help was given with training screeners and loan of equipment during the period. This is the first hospital in Kampala and possibly Uganda to initiate steps towards funding their own newborn hearing screening programme and therefore securing future sustainability and capacity building of the service to ultimately include all newborn babies.. LTCH will continue to support the hospital in 2023 as they transition to owning their own

Similarly, hearing screening of children in the outpatient's department at Naguru Hospital during the second half of the year laid the foundation for future capacity building of hearing screening services at the hospital in 2023 .

Another notable achievement in 2022 was the launch of a parental support group for parents whose children are being supported on the hearing aid programme.. This was well overdue, and the monthly meetings were well attended.by both parents and children. It was lovely to be able to see the positive impact it has had in providing a platform for parents and

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children to connect with one another and share experiences.

In 2022, LTCH has continued to work towards laying the foundation for embedding and integrating the audiology services in a hospital setting.

Scoping the possibilities of integrating the audiology services in the Mulago National Referral Hospital continue. Other hospital sites are also being considered at this stage.

In 2023 it is hoped that the screening and early intervention project will continue and there are plans being put in place for capacity building of the project. In addition, LTCH is planning to send a minimum of four UK audiologists to Uganda to provide further training.in paediatric

audiology.

Liz Choudhury Project Advisor

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Our Partners

A big thank you to our partners

The partnership between LTCH and Global Partnerships for Hearing Health (GPHH) and the Latter-Day Saints Charities (LDSC) was formally agreed prior to the commencement of the screening project in January 2022.

LTCH continued to engage its existing partners and key stakeholders including the Ministry of Health, Kampala Capital City Authority (KCCA), Kawempe National Referral Hospital, Mulago Hospital and Kisenyi Health Centre all of whom continued to support the project

activities. East African Children's Project (EACP) continue to fund the speech therapy project in 2022. Additional partnerships were created with two new stakeholders, namely, St Francis Hospital Nsambya and Naguru China Friendship Hospital. These two new hospitals became screening sites in 2022.

mentorship for the

Audiologists in Uganda enhancing their knowledge and skills to benefit our patients and families.

We would also like to thank all our regular donors, fundraisers, and supporters in 2022. 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 success in 2022. Pam Layton, Keri Abbott and Anushri Patel. They have all worked tirelessly to provide

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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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Let the Children Hear

Receipts and Payments Account - Year Ended December 31 2022 Draft Accounts

Receipts
General Donations, Unallocated
Ring Fenced Donations, Allocated
Difid Receipts
CAF Grant
US Grant Funding (Latter Day Saints)
AUD Medical Grant
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
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
Difid Refund
Media and marketing charges
Room hire
Transfers to Uganda
Ugandan costs :
Trustees/volunteers expenses
Ambulance,medical equipment & medicine
Bank accounts as at December 31 2021
Bank accounts as at December 31 2022		 Year ended
Dec 31 2022
£
3,431.84
2,000.00
0.00
20,000.00
21,334.66
1,000.00
4,946.02
0.00
0.00
0.00
0.00
0.00
0.00
0.00
5.00
0.00
0.00
0.00
0.00
42.72
52,760.24
0.00
0.00
1,883.29
0.00
142.80
90.00
0.00
37.00
1,082.43
0.00
0.00
32,000.00
4,965.58
7,362.25
47,563.35
56,389.59
61,586.48		 Year ended
Dec 31 2021
£
10,095.00
13,430.00
5,741.34
0.00
22,214.84
0.00
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
21.56
63,769.15
0.00
166.50
350.99
40.00
142.80
216.00
0.00
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		 Variance
Comments
In period
£
-6,663.16
-11,430.00
-5,741.34
20,000.00
-880.18
1,000.00
-5,641.41
0.00
-480.00
0.00
-124.00
0.00
0.00
0.00
-20.34
-589.64
-380.00
-30.00
-50.00
21.16
-11,008.91
0.00
-166.50
1,532.30
-40.00
0.00
-126.00
0.00
37.00
1,082.43
-10.00
0.00
1,000.00
4,171.08
-22.93
7,457.38

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