Company registration number: 07603941 Charity registration number: 1145662 ## Andean Medical Mission (A company limited by guarantee) Annual Report and Financial Statements for the Year Ended 30 April 2021 ## **Andean Medical Mission** ## **Contents** |Reference and Administrative Details|1| |---|---| |Trustees' Report|2 to 5| |Independent Examiner's Report|6| |Statement of Financial Activities|7| |Balance Sheet|8| |Notes to the Financial Statements|9 to 15| ## **Andean Medical Mission** ## **Reference and Administrative Details** **Trustees** Mr Pieter Gouws Mr Stephen Byard Mr Bruce Kenvyn Mcleod Ms Gillian Michelle Wood **Charity Registration Number** 1145662 **Company Registration Number** 07603941 The charity is incorporated in England & Wales. **Registered Office** 8 Densihale Densihale Aldwick Felds Bognor Regis PO21 3SE **Principal Office** 8 Densihale Densihale Aldwick Felds Bognor Regis PO21 3SE **Independent Examiner** SRC-Time Ltd 2nd Floor Stanford Gate South Road Brighton East Sussex BN1 6SB Page 1 ## **Andean Medical Mission** ## **Trustees' Report** ## **Structure, governance and management** The Trustees meet a minimum of twice a year, they are responsible for the appointment of the general manager the direction and accountability of the mission and are responsible for the safety of all Andean Medical Mission patients. They have final say on the selection of patients for surgery the surgical protocol and follow up of treatment. Directors appointments are made through a process of application by the candidate and a review meeting by the directors to assess the qualities and suitability of the applicant before any appointment can be made. The usual security and suitability checks are carried out. The Andean Medical Mission leadership team is made up of 3 directors who are consultant ophthalmic surgeons. One director who is a specialist in the field of marketing and communications and one director with many years’ experience in running hospital clinics and organising complicated events. The charity employs one full time General manager to oversee the planning of the surgical trips, the adherence to Bolivian Laws and requirements, the training of Bolivian doctors, audit and reporting and the selection and screening of some patients. The general manager reports to the trustees on all matters relating to the running of the charity as well as the appointment of the medical teams and selection of villages and towns within Latin America within which to work. In accordance with the Article of Association at every annual general meeting one third of the Trustees, other than the representative Trustees, shall retire from office. Due to the specialist nature of the Medical Director Trustee role, it is permitted for trustees to stand for subsequent re-election. Trustee appointments are recommended by the Trustees holding office, they must show by training and experience that they are professionally able to uphold the aims of the Charity. The trustees have given due consideration to the Charity Commission's published guidance on the Public Benefit requirement under the Charities Act 2011. No assets were held as custodian trustee during the reporting period. Page 2 ## **Andean Medical Mission** ## **Trustees' Report** ## **Objectives and activities** The company is limited by guarantee and its objectives are to relieve sickness and to promote good health of the people of Latin America, in particular but not exclusively in Bolivia by: - the provision of medical help and services at cost or free of charge to remote localities where access to medicine and surgery is difficult. - the provision of medical training to healthcare professionals at cost or free of charge with focus on remote localities where access to medical services is limited. Donations, grants and funds have been received to undertake the required work. Equipment and medicine has been purchased from these funds to be used for existing and future missions. The Mission focuses of providing free ophthalmic surgery for isolated communities living in Bolivia. Our focus has been in the El Beni region where local services are extremely limited. The Charity provides training of local doctors and healthcare workers the building up of infrastructure to support the development of local services and the promotion of eye health. Additionally, the Andean Medical Mission carries out audit and study into some blinding conditions which affect the people of this region in the hope that better understanding will lead to reduction in the number of people becoming blind in the first place. Page 3 ## **Andean Medical Mission** ## **Trustees' Report** ## **Achievements and performance** March 2020 saw Bolivia hit hard by covid19 as the pandemic swept the globe. The acting government, knowing that the fragile national health system would not manage well, made the decision to impose a rigid militarily enforced lockdown. In doing so they protected many isolated communities and delayed the spread of Covid19 in as efficient way as was possible until hospitals were more able to cope. A ban on all travel apart from one half day a week to buy food locally, was imposed with prison sentencing and fines for anyone who broke the law. The lockdown continued until August 2020 after which local travel more than once a week was slowly opened up. It wasn’t until October 2020 that departmental travel was allowed. The strategy was somewhat successful with case numbers and mortality much lower in Bolivia than in Peru or Brazil who had a more liberal protocol. The impact of Covid19 on The Andean Medical Missions activities was severe. We were unable to carry out any surgical activities, medical teaching was limited to online communications and fundraising activities such as talks and events closed for the year. As a result, we decided to suspend all activities and spending and applied for furlough support for our General Manager who remained in Bolivia, unable to carry out his role. As we reached the end of 2020 it became obvious that our normal activities could not be delivered safely during 2021 either. At our AGM the Trustees decided to suspend surgery for a further year and focus on delivering the accident and emergency ophthalmic training programme once travel allowed. It was further decided that AMM would involve ourselves in using our local knowledge, connections and logistical management skills to help in the vaccinating against Covid19 in remote villages in the Beni region. This had the duel benefit of protecting our patients and once a high level of vaccination had been achieved, it would expedite the safe return to carrying out our ophthalmic surgical trips which remain a priority in the elimination of avoidable blindness in this region. In January 2021 we made our first return to the Beni for teaching and scoped out where we would have the most impact with vaccinations. Plans were put into place and by April 2021 we had already vaccinated over 2500 patients and had carried out the eye emergency training for Bolivian doctors in each location. Meetings, retail sales and fundraising activities, were still on hold from March 2020 for the whole year and as we were unable to fulfil on delivering our current grant activities, we made very few new applications for additional funds. We kept our supporters informed and would like to thank them for their understanding and overwhelming continued support. The Andean Medical Mission is fully compliant with Bolivian Law. We are registered fully as a charity here now and under the new regulations have permissions from the Ministry of Health to carry out the work we do. During 2021 Bolivia had a change of government with new personal incoming but as of today, the requirements for charities appear largely unchanged. The Andean Medical Mission has continued to build on our relationships with the Ophthalmology Society of Beni and have gained considerable support with the new government of Beni for our training programmes, vaccination programme and ophthalmic activities. We met with the British Embassy in January to gain support for inclusion into the delivery of the vaccine against COVID19 programme in Bolivia which has subsequently gone very well. Page 4 ## **Andean Medical Mission** ## **Trustees' Report** ## **Financial review** The trustees receive quarterly, half yearly and annual reports on operational and financial matters. These provide a formal check that the charity is performing legally, safely and within its means. All Trustees have assessed major risks to which the Charity is exposed, in particular those related to the operations and finances of the fund and are satisfied that systems are in place to mitigate exposure. The charity is in a healthy position despite the slight fall in income as explained above and continues to grow and therefore, the going concern status is appropriate. ## _**Policy on reserves**_ Due to the extreme environment, humidity and temperature, the nature of running a mobile eye hospital in the Amazon and the constant movement of equipment, the mission budgets to service equipment regularly and to replace equipment every 5 to 7 years. Reserves are held for these purposes. An estimated £100,000 every 7 years is budgeted for. Additionally, the trustees have established a policy of maintaining an appropriate level of reserves to enable the adequate function of the charity in order to maximise the charitable work that it carries out. The trustees review the level of reserves at regular intervals as a part of their review of the quarterly, half yearly and annual review of the operational and financial matters reports which they receive. The annual report was approved by the trustees of the charity on .................... and signed on its behalf by: ......................................... Mr Pieter Gouws Trustee Page 5 ## **Andean Medical Mission** ## **Independent Examiner's Report to the trustees of Andean Medical Mission** I report to the charity trustees on my examination of the accounts of the Company for the year ended 30 April 2021. ## **Responsibilities and basis of report** As the charity’s trustees of the Company (and also its directors for the purposes of company law) you are responsible for the preparation of the accounts in accordance with the requirements of the Companies Act 2006 (‘the 2006 Act’). Having satisfied myself that the accounts of Andean Medical Mission are not required to be audited under Part 16 of the 2006 Act and are eligible for independent examination, I report in respect of my examination of your charity’s accounts as carried out under section 145 of the Charities Act 2011 (‘the 2011 Act’). In carrying out my examination I have followed the Directions given by the Charity Commission under section 145(5)(b) of the 2011 Act. ## **Independent examiner’s statement** I have completed my examination. I confirm that no matters have come to my attention in connection with the examination giving me cause to believe: 1. accounting records were not kept in respect of Andean Medical Mission as required by section 386 of the 2006 Act; or 2. the accounts do not accord with those records; or 3. the accounts do not comply with the accounting requirements of section 396 of the 2006 Act other than any requirement that the accounts give a ‘true and fair view' which is not a matter considered as part of an independent examination; or 4. the accounts have not been prepared in accordance with the methods and principles of the Statement of Recommended Practice for accounting and reporting by charities [applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102)]. I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached. ...................................... Mr Richard Wernick CTA 2nd Floor Stanford Gate South Road Brighton East Sussex BN1 6SB Date:............................. Page 6 ## **Andean Medical Mission** ## **Statement of Financial Activities for the Year Ended 30 April 2021 (Including Income and Expenditure Account and Statement of Total Recognised Gains and Losses)** |||**Unrestricted**||**Total**| |---|---|---|---|---| |||**funds**||**2021**| ||**Note**|**£**||**£**| |**Income and Endowments from:**||||| |Donations and legacies|3|40,706||40,706| |Total income||40,706||40,706| |**Expenditure on:**||||| |Charitable activities|4|(31,745)||(31,745)| |Total expenditure||(31,745)||(31,745)| |Net income||8,961||8,961| |Net movement in funds||8,961||8,961| |**Reconciliation of funds**||||| |Total funds brought forward||54,398||54,398| |Total funds carried forward|14|63,359||63,359| |||**Unrestricted**||**Total**| |||**funds**||**2020**| ||**Note**|**£**||**£**| |**Income and Endowments from:**||||| |Donations and legacies|3|47,377||47,377| |Total income||47,377||47,377| |**Expenditure on:**||||| |Charitable activities|4|(40,599)||(40,599)| |Total expenditure||(40,599)||(40,599)| |Net income||6,778||6,778| |Net movement in funds||6,778||6,778| |**Reconciliation of funds**||||| |Total funds brought forward||47,620||47,620| |Total funds carried forward|14|54,398||54,398| All of the charity's activities derive from continuing operations during the above two periods. The funds breakdown for 2020 is shown in note 14. The notes on pages 9 to 15 form an integral part of these financial statements. Page 7 ## **Andean Medical Mission** ## **(Registration number: 07603941) Balance Sheet as at 30 April 2021** |||**2021**||**2020**| |---|---|---|---|---| ||**Note**|**£**||**£**| |**Fixed assets**||||| |Tangible assets|11|7,667||10,311| |**Current assets**||||| |Debtors|12|475||750| |Cash at bank and in hand||58,662||46,701| |||59,137||47,451| |**Creditors: Amounts falling due within one year**|13|(3,445)||(3,364)| |**Net current assets**||55,692||44,087| |**Net assets**||63,359||54,398| |**Funds of the charity:**||||| |**Unrestricted income funds**||||| |Unrestricted funds||63,359||54,398| |**Total funds**|14|63,359||54,398| For the financial year ending 30 April 2021 the charity was entitled to exemption from audit under section 477 of the Companies Act 2006 relating to small companies. Directors' responsibilities: - The members have not required the charity to obtain an audit of its accounts for the year in question in accordance with section 476; and - The directors acknowledge their responsibilities for complying with the requirements of the Act with respect to accounting records and the preparation of accounts. The financial statements on pages 7 to 15 were approved by the trustees, and authorised for issue on .................... and signed on their behalf by: ......................................... Mr Pieter Gouws Trustee The notes on pages 9 to 15 form an integral part of these financial statements. Page 8 ## **Andean Medical Mission** ## **Notes to the Financial Statements for the Year Ended 30 April 2021** ## **1 Charity status** The charity is limited by guarantee, incorporated in England & Wales, and consequently does not have share capital. Each of the trustees is liable to contribute an amount not exceeding £10 towards the assets of the charity in the event of liquidation. ## **2 Accounting policies** ## **Statement of compliance** 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)) (issued in October 2019) - (Charities SORP (FRS 102)), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006. ## **Basis of preparation** Andean Medical Mission 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 notes. ## **Going concern** The trustees consider that there are no material uncertainties about the charity's ability to continue as a going concern nor any significant areas of uncertainty that affect the carrying value of assets held by the charity. ## **Exemption from preparing a cash flow statement** The charity opted to early adopt Bulletin 1 published on 2 February 2016 and have therefore not included a cash flow statement in these financial statements. ## **Income and endowments** 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 the income receivable can be measured reliably. ## **Expenditure** All expenditure is recognised once there is a legal or constructive obligation to that expenditure, it is probable settlement is required and the amount can be measured reliably. All costs are allocated to the applicable expenditure heading that aggregate similar costs to that category. Where costs cannot be directly attributed to particular headings they have been allocated on a basis consistent with the use of resources, with central staff costs allocated on the basis of time spent, and depreciation charges allocated on the portion of the asset’s use. Other support costs are allocated based on the spread of staff costs. ## _**Raising funds**_ These are costs incurred in attracting voluntary income, the management of investments and those incurred in trading activities that raise funds. Page 9 ## **Andean Medical Mission** ## **Notes to the Financial Statements for the Year Ended 30 April 2021** ## _**Charitable activities**_ Charitable expenditure comprises those costs incurred by the charity in the delivery of its activities and services for its beneficiaries. It includes both costs that can be allocated directly to such activities and those costs of an indirect nature necessary to support them. ## _**Grant provisions**_ Provisions for grants are made when the intention to make a grant has been communicated to the recipient but there is uncertainty about either the timing of the grant or the amount of grant payable. ## **Support costs** Support costs include central functions and have been allocated to activity cost categories on a basis consistent with the use of resources, for example, allocating property costs by floor areas, or per capita, staff costs by the time spent and other costs by their usage. ## **Governance costs** These include the costs attributable to the charity’s compliance with constitutional and statutory requirements, including audit, strategic management and trustees’s meetings and reimbursed expenses. ## **Taxation** The charity is considered to pass the tests set out in Paragraph 1 Schedule 6 of the Finance Act 2010 and therefore it meets the definition of a charitable company for UK corporation tax purposes. Accordingly, the charity is potentially exempt from taxation in respect of income or capital gains received within categories covered by Chapter 3 Part 11 of the Corporation Tax Act 2010 or Section 256 of the Taxation of Chargeable Gains Act 1992, to the extent that such income or gains are applied exclusively to charitable purposes. ## **Tangible fixed assets** Individual fixed assets costing £100.00 or more are initially recorded at cost, less any subsequent accumulated depreciation and subsequent accumulated impairment losses. Page 10 ## **Andean Medical Mission** ## **Notes to the Financial Statements for the Year Ended 30 April 2021** ## **Depreciation and amortisation** Depreciation is provided on tangible fixed assets so as to write off the cost or valuation, less any estimated residual value, over their expected useful economic life as follows: **Asset class Depreciation method and rate** Medical equipment 25% reducing balance Motor vehicles 25% reducing balance Computer equipment 33% straight line ## **Fund structure** Unrestricted income funds are general funds that are available for use at the trustees' discretion in furtherance of the objectives of the charity. Designated funds are unrestricted funds earmarked by the directors for particular future project or commitment. Restricted funds are subjected to restrictions on their expenditure declared by the donor or through the terms of an appeal, and fall into one of two sub-classes: restricted income funds or endowment funds. ## **Financial instruments** ## _**Classification**_ Financial assets and financial liabilities are recognised when the charity becomes a party to the contractual provisions of the instrument. Financial liabilities and equity instruments are classified according to the substance of the contractual arrangements entered into. An equity instrument is any contract that evidences a residual interest in the assets of the charity after deducting all of its liabilities. ## **3 Income from donations and legacies** ||**Unrestricted**||| |---|---|---|---| ||**funds**||**Total**| ||**General**||**funds**| ||**£**||**£**| |Grants, including capital grants;|||| |Grants from companies or HMRC|21,105||21,105| |Regular giving and capital donations|19,601||19,601| |**Total for 2021**|40,706||40,706| |**Total for 2020**|47,377||47,377| During the year the company received a grant of £21,105 (2020: £Nil) from HMRC for Covid Wages. In the previous year there were grants received of £13,622 from Allergan International Foundation, £9,000 from Ulverscroft Foundation, £4,810 from the Veta Bailey Charitable Trust and £1,010 from Angela Gallagher Memorial Trust. Page 11 ## **Andean Medical Mission** ## **Notes to the Financial Statements for the Year Ended 30 April 2021** ## **4 Expenditure on charitable activities** |||**Unrestricted**||||| |---|---|---|---|---|---|---| |||||**Total**||**Total**| |||**General**||**2021**||**2020**| ||**Note**|**£**||**£**||**£**| |Grant funding of activities||830||830||3,641| |Staff costs||17,548||17,548||17,548| |Allocated support costs|5|2,577||2,577||6,261| |Governance costs|5|10,790||10,790||13,149| |||31,745||31,745||40,599| In addition to the expenditure analysed above, there are also governance costs of £10,790 (2020 - £13,150) which relate directly to charitable activities. See note 5 for further details. ## **5 Analysis of governance and support costs** ## **Governance costs** ||**Unrestricted**||| |---|---|---|---| ||**funds**||**Total**| ||**General**||**funds**| ||**£**||**£**| |Staff costs|||| |Wages and salaries|5,849||5,849| |Other governance costs|204||204| |Allocated support costs|4,737||4,737| |**Total for 2021**|10,790||10,790| |**Total for 2020**|13,149||13,149| ## **6 Analysis of grants** Below are details of material grants made to institutions |Below are details of material grants made to institutions|||| |---|---|---|---| ||**2021**||**2020**| |**Name of institution**|**£**||**£**| |Grants - Purchases|742||3,641| |Grants - Salaries|17,548||17,548| |Grants - Travel|2,577||6,261| ||20,867||27,450| ||||| Page 12 ## **Andean Medical Mission** ## **Notes to the Financial Statements for the Year Ended 30 April 2021** ## **7 Net incoming/outgoing resources** Net incoming resources for the year include: |||||**2021**||**2020**| |---|---|---|---|---|---|---| |||||**£**||**£**| |Depreciation|of|fixed|assets|2,556||3,599| ## **8 Trustees remuneration and expenses** No remuneration or other benefits from employment with the charity or a related entity were received by the trustees. ## **9 Staff costs** The aggregate payroll costs were as follows: |The aggregate payroll costs were as follows:|||| |---|---|---|---| ||**2021**||**2020**| ||**£**||**£**| |**Staff costs during the year were:**|||| |Wages and salaries|23,397||23,397| The monthly average number of persons (including senior management / leadership team) employed by the charity during the year expressed as full time equivalents was as follows: ||||**2021**|||**2020**|| |---|---|---|---|---|---|---|---| ||||**No**|||**No**|| |Number|of|staff||1|||1| ||||||||| No employee received employee benefits of more than £60,000 during the year. (2020: Nil). ## **10 Taxation** The charity is a registered charity and is therefore exempt from taxation. Page 13 ## **Andean Medical Mission** ## **Notes to the Financial Statements for the Year Ended 30 April 2021** ## **11 Tangible fixed assets** |**11 Tangible fixed assets**|||||||||| |---|---|---|---|---|---|---|---|---|---| ||**Furniture and**||||||||| ||**equipment**|||**Motor vehicles**||||**Total**|| ||**£**|||**£**||||**£**|| |**Cost**|||||||||| |At 1 May 2020|2,747|||19,965||||22,712|| |Disposals|(1,661)||||-|||(1,661)|| |At 30 April 2021|1,086|||19,965||||21,051|| |**Depreciation**|||||||||| |At 1 May 2020|2,496|||9,905||||12,401|| |Charge for the year|41|||2,515||||2,556|| |Eliminated on disposals|(1,573)||||-|||(1,573)|| |At 30 April 2021|964|||12,420||||13,384|| |**Net book value**|||||||||| |At 30 April 2021|122|||7,545||||7,667|| |At 30 April 2020|251|||10,060||||10,311|| |**12 Debtors**|||||||||| |||||**2021**||||**2020**|| |||||**£**||||**£**|| |Prepayments||||475||||750|| |**13 Creditors: amounts falling due within one year**|||||||||| |||||**2021**||||**2020**|| |||||**£**||||**£**|| |Other taxation and social security||||30||||-|| |Other creditors||||1,807||||1,810|| |Accruals||||1,608||||1,554|| |||||3,445||||3,364|| Page 14 ## **Andean Medical Mission** ## **Notes to the Financial Statements for the Year Ended 30 April 2021** |**14 Funds**|||||||| |---|---|---|---|---|---|---|---| ||**Balance at 1**||**Incoming**||**Resources**||**Balance at 30**| ||**May 2020**||**resources**||**expended**||**April 2021**| ||**£**||**£**||**£**||**£**| |**Unrestricted funds**|||||||| |General|54,398||40,706||(31,745)||63,359| ||**Balance at 1**||**Incoming**||**Resources**||**Balance at 30**| ||**May 2019**||**resources**||**expended**||**April 2020**| ||**£**||**£**||**£**||**£**| |**Unrestricted funds**|||||||| |General|47,620||47,377||(40,599)||54,398| ## **15 Analysis of net assets between funds** |**15 Analysis of net assets between funds**|||| |---|---|---|---| ||**Unrestricted**||**Total funds at**| ||**funds**||**30 April**| ||**General**||**2021**| ||**£**||**£**| |Tangible fixed assets|7,667||7,667| |Current assets|59,137||59,137| |Current liabilities|(3,445)||(3,445)| |Total net assets|63,359||63,359| ||**Unrestricted**||**Total funds at**| ||**funds**||**30 April**| ||**General**||**2020**| ||**£**||**£**| |Tangible fixed assets|10,311||10,311| |Current assets|47,451||47,451| |Current liabilities|(3,364)||(3,364)| |Total net assets|54,398||54,398| Page 15