Friends of Nixon Charity no. 1145455 ## www.friendsofnixon.org **THIRTEENTH ANNUAL REPORT** 30[th] November 2024 ## _**Introduction**_ Our work supporting the Nixon Memorial Hospital in Segbwema, Sierra Leone, has continued with drive and compassion. Through collaboration and effective partnership working we have been able to meet our proposed annual objectives of safeguarding the hospital’s electricity supply, re-establishing a programme of supporting voluntary international healthcare professionals to work alongside local colleagues and improving the laboratory. After several years of closure, significant investment in the nursing school’s rehabilitation and development has come to realisation with it re-opening its doors to a new intake of nursing students in 2024; an unequivocal asset for both Segbwema and the hospital. In addition, we have been able to embark on further activity including establishing a pilot feeding programme for women and children at the hospital together with delivery of a dental training workshop which aimed to start addressing the huge unmet need in oral health care. ## _**Trustees and Governance**_ It is with great sadness we acknowledge the loss this year of our founding Chairman, Reverend Colin Rowe. Together with his wife, Dr Mary Rowe, he established the foundations and values of which the charity is built upon; much of what we are able to continue to achieve is as a result of their initial endeavours. His kindness, pragmatism and warmth together with a quiet but determined ambition to help those less fortunate than himself will be sorely missed. The work of the Trust continues to be delivered and scrutinised by a team of trustees who remain committed to our aims of enhancing healthcare provision to the population surrounding Segbwema in the Eastern Province of Sierra Leone. Through increasing direct connections with in-country suppliers, contractors and expertise we are able to respond dynamically to the hospital’s requests for support. Frequent communication with the management and staff, together with on-site trustee visits and feedback from volunteers provides oversight and a continued understanding of the evolving needs and challenges. ## _**Fundraising**_ Last year we acknowledged that substantial additional funding would need to be sought to meet the large cost of replacing the batteries of the hospital’s electrical solar system; an amount historically beyond our capabilities. We are thereofre immensely grateful that a significant grant from the EJ Spice Trust has not only enabled this work to go ahead, but has also provided additional financial stability through grant funding to be dispersed over the next 10 years, specifically for the hospital’s solar electrical infrastructure and initiatives aimed at healthcare staff training. However, the enduring and selfless support from longstanding partners including the Stamford Methodist Church and the Gibbs Family Trusts, together with the many individuals and groups that choose to donate, remains the cornerstone of our functioning as a charity. We continue to be incredibly thankful for this generosity. As further funding opportunities develop, we are keen to ensure that increasing support is offered and delivered in a sustainable way. We aim to achieve an appropriate balance of scrutiny and oversight whilst recognising the need to foster development of autonomy by the hospital and its stakeholders in how health care is delivered in the region. ## _**Charitable activity**_ The relaunch of a programme supporting international voluntary healthcare staff to work alongside local colleagues has been a success with two incredibly productive placements from Dr Emma Butterfield and Dr Trevor Tan. The Trust is indebted to their commitment and dedication to the hospital which has resulted in both direct improvements to patient care and service delivery, increased staff morale and has led to additional project activity. Sharing of knowledge, experience and skills to further develop staff and care provision has an unquestionable impact. We are very appreciative that Emma has chosen to continue her support by coordinating this programme as it expands and moves forward. In May and June 2024 work to extend the solar field and replace the batteries for the electrical system was undertaken and completed by Tara Energy SL. This was directly funded and made possible through the generosity of the EJ Spice Charitable Trust. The project was the third stage of recommendations from an independent report commissioned by Friends of Nixon in 2019 on the hospital’s electrical needs. An additional capacity of 11Kwp Solar panels were installed with two charge controllers and a total capacity of 48V/300Ahr, 90Kw-hr Lithium batteries. A remote system of monitoring has been put in place to allow technical support to be provided and troubleshooting to be performed. Local staff were trained by external technicians, one of whom will remain on site for the next 12 months. The completion of this work enables the continued use of medical equipment including oxygen concentrators, neonatal warmers, theatre lights and ultrasound scanners. Collaborating with laboratory staff, we have been able to source and procure a needed new blood fridge for the hospital. This was achieved through working with suppliers in country to ensure appropriate maintenance was possible and that it met the required safety standards. This piece of medical infrastructure will make life-saving blood transfusion safer and enable it to occur in a timelier manner. It forms part of a long-term ambition for the hospital to house a community blood bank. In response to a growing number of children being admitted with malnutrition we have been able to support a pilot inpatient feeding project for women and children at the hospital. This was achieved through a programme of staff and patient education together with provision of appropriate nutritional supplements and meals. There are two distinct aspects to this work; medical treatment of severe acute malnutrition and a social feeding programme which we hope will increase patient numbers by alleviating the burden placed on relatives to provide food to patients whilst in hospital. Review of the pilot will take place at 6 monthly intervals. After work by Dr Trevor Tan identified the impact poor dental health was having on the local community, we had the privilege of co-funding a dental health training workshop facilitated through Oral Health Africa Initiative. This involved dentists from Nigeria travelling to work with the team at the hospital, providing dental care and training select staff in basic dental techniques including scaling, polishing and tooth extraction. Over 100 patients were treated, 2 of whom had life threatening conditions and dental health promotion work was undertaken with the community. As well as these new projects we have ensured that our pre-existing investments of support have been protected and maintained. This included funding needed repairs and maintenance to previously donated oxygen concentrators as well as completing electrical work for the hospital’s new mortuary. We have additionally continued to support the hospital pharmacy. ## _**Future Plans**_ The Trust’s plans for next year will in part focus on support for local staff at the hospital. This will be achieved through offering scholarships to staff for continuing professional development and expansion of our programme of international volunteer recruitment to nursing, midwifery and medical practitioners to work with and support local colleagues. We also plan to guarantee staff have the right equipment they need to do their jobs through meeting resource deficits in surgical and dental equipment. We aim to continue the new feeding programme and look forward to working with the Eastern Technical University in facilitating the delivery of high-quality education at the nursing school. ## _**Conclusion**_ We can rightly celebrate that the programme of activity we have supported this year has been the most extensive to date. However, we remain very aware that the path to improvement in the hospital, and translating this to a sustained positive impact on people’s life course does not follow a straight-line trajectory. Although there will continue to be difficult balances to achieve and ongoing learning for both Friends of Nixon and the hospital, the knowledge and stories of the lives and livelihoods that are saved or improved through our work gives undeniable grounds to continue in these efforts. Dr Rob Burnie Chairman FRIENDS OF NIXON MEMORIAL HOSPITAL ACCOUNTS FOR THE PERIOD ENDED 31 AUGUST 2024 ## STATEMENT OF FINANCIAL ACTIVITIES |Note
Incoming Resources
Donations
Grants
1
Investment Income
Total Incoming Resources
Resources Expended
Charitable Activities
2
Total Resources Expended
Net Movement in Funds
Transfers between funds
Total Funds Brought Forward
Total Funds Carried Forward
BALANCE SHEET AT 31 AUGUST 2024
Current Assets
Cash at Bank and In Hand
Debtors
3
Current Liabilities
Accruals
4
Net Assets of the Charity
Funds of the Charity
Unrestricted Funds
Designated Funds
Restricted Funds
Total Funds|Unrestricted
Funds
Designated
Funds
£
£
21,049
-
16,000
-
3,064
-
40,113
-
33,636
-
33,636
-
6,477
-
-
-
24,672
-
31,149
-
2024
133,523
-
133,523
361
361
133,162
31,149
-
102,013
133,162|Restricted
Funds
Total this
year
Total last
year
£
£
£
-
21,049
20,242
150,000
166,000
13,600
-
3,064
843
150,000
190,113
34,685
47,987
81,623
35,471
47,987
81,623
35,471
102,013
108,490
(786)
-
-
-
-
24,672
25,458
102,013
133,162
24,672
2023
25,127
25,127
455
455
24,672
24,672
-
-
24,672| |---|---|---| Signed Dr Robert Burnie Chair of Trustees Date ## 1 Accounting Policies ## a) Basis of preparation The financial statements have been prepared in accordance with 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 (FRS 102) (effective 1 January 2019) - (Charities SORP (FRS 102)), and the Companies Act 2006 The charity meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy note(s) ## b) Fund accounting Unrestricted funds are available for use at the discretion of the Trustees in furtherance of the objectives of the charity. These include grants given under services level agreements. Restricted funds are funds which are used in accordance with specific restrictions imposed by donors which have been raised by the charity for particular purposes. The aim and use of each restricted fund is set out in the notes to the financial statements. ## c) Incoming Resources All incoming resources are included in the Statement of Financial Activies when the charity is legally entitled to the income and the amount can be quantified with resonable accuracy. ## d) Resources expended All expenditure is accounted for on an accruals basis and has been included under expenses categories that aggregate all costs for allocation to activities. Governance costs are those incurred in connection with enabling the charity to comply with external regulation, constition and statutory requirements and in providing support to the trustees in the discharge of their statutory duties. ## e) Tangible fixed assets Individual fixed assets costing £1000 or more are capitalised at cost and are depreciated over their estimated useful economic lives. No depreciation is provided on assets which have not yet been bought into use. ## i) VAT The charity is not registered for VAT. In common with many other similar charities Friends of Nixon Memorial Hospital expenses are included VAT, which cannot be removes. 1 Income from grants |Stamford MC
Gibbs Trust
EJ Spice Trust
2 Charitable activities
Accountancy Fee
Printing, Postage & Stationery
Consultancy
Subscriptions
Travel & Subsistence
Bank Fees
Grants > £500
Grants < £500|Unrestricted
Restricted
Total
10,000
10,000
6,000
6,000
150,000
150,000
16,000
150,000
166,000
Unrestricted
Restricted
Total
896
896
823
823
50
50
47
47
117
117
21
21
30,932
47,987
78,919
751
751
33,637
47,987
81,624| |---|---| ## 3 Debtors & prepayments Debtors - ## 4 Creditors & accruals Accruals 361 ## 5 Transactions relating to the Trustees None of the trustees were remunertaed directly or indirectly. During the year no expenses for travelling were paid to the trustees. (2023 - Nil). There were no transactions with parties related to the trustees or senior management. Some trustees use the services of the charity. This is in line with the chairty's stated objective that service users should be represented on the management committee. ## 6 Restricted funds Balance Movement in funds Balance 01.09.20 Incoming Expeniture Transfers 31.08.24 EJ Spice - 150,000 - 47,987 - 102,013 ## **FRIENDS OF NIXON MEMORIAL HOSPITAL** ## **INDEPENDENT EXAMINER’S REPORT TO THE TRUSTEES OF FRIENDS OF NIXON MEMORIAL HOSPITAL** I report on the accounts of Friends of Nixon Memorial Hospital for the year ended 31 August 2024 ## **Respective responsibilities of trustees and examiner** The charity’s trustees are responsible for the preparation of the accounts. The charity’s trustees consider that an audit is not required for this year under section 144(2) of the Charities Act 2011 (The 2011 Act) and that an independent examination is needed. Having satisfied myself that the charity is not subject to audit under company law and is eligible for independent examination, it is my responsibility to: - examine the accounts under section 145 of the 2011 Act - follow the procedures laid down in the General Directions given by the Charity Commissioners under section 145(5)(b) of the 2011 Act and; - to state whether particular matters have come to my attention. ## **Basis of independent examiner’s report** My examination was carried out in accordance with the General Directions given by the Charity Commissioners. An examination includes a review of the accounting records kept by the charity and a comparison of the accounts presented with those records. It also includes consideration of any unusual items or disclosures in the accounts, and seeking explanations from you as trustees concerning any such matters. The procedures undertaken do not provide all the evidence that would be required in an audit, and consequently no opinion is given as to whether the accounts present a ‘true and fair view’ and the report is limited to those matters set out in the statement below. ## **Independent examiner’s statement** In connection with my examination, no matter has come to my attention: (1) which gives me reasonable cause to believe that in any material respect the requirements - to keep accounting records in accordance with section 130 of the 2011 Act; and - to prepare accounts which accord with the accounting records, comply with the accounting requirements of the 2011 Act - have not been met; or - (2) to which, in my opinion, attention should be drawn in order to enable a proper understanding of the accounts to be reached. Laura Parfitt-Marr FMAAT First Floor Front Office, 13-14 Market Place Penzance, Cornwall, TR18 2JB Date: .............................................