## **Andean Medical Mission Limited**
**(A company limited by guarantee)**
## **Charity No. 1145662**
**Company No. 07603941**
**Trustees' Report and Unaudited Accounts**
**30 April 2022**
**Andean Medical Mission Limited Contents**
||Pages|
|---|---|
|Trustees' Annual Report|2 to 5|
|Independent Examiner's Report|6|
|Statement of Financial Activities|7|
|Balance Sheet|8|
|Notes to the Accounts|9 to 15|
Page 1
**Andean Medical Mission Limited Trustees Annual Report**
The trustees, who are also directors of the charity for the purposes of the Companies Act 2006, present their report with the unaudited financial statements of the charity for the year ended 30 April 2022.
## **REFERENCE AND ADMINISTRATIVE DETAILS**
## **Company No. 07603941**
## **Charity No. 1145662**
## **Registered Office**
8 Densihale Bognor Regis West Sussex PO21 3SE
## **Directors and Trustees**
The Directors of the charitable company are its Trustees for the purposes of charity law. The following Directors and Trustees served during the year:
S. Byard P. Gouws B.K. Mcleod G.M. Wood
## **Accountants**
Time Accounts Limited Room 34 Basepoint Business Centre Little High Street Shoreham-by-sea BN43 5EG
## **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.
Page 2
**Andean Medical Mission Limited**
## **Trustees Annual Report**
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.
## **ACHIEVEMENTS AND PERFORMANCE**
The Covid pandemic has had an impact on the work of the Andean Medical Mission, limiting what we have been able to do in lots of ways, but in no way stopping us. During 2021 and 2022, the pandemic provided opportunity for us to save lives through making sure our patients living remotely received Covid19 vaccines to protect them.
We haven't been able to perform eye surgery since the pandemic began. Many reasons obviously, lockdown, the risk of transmitting new Covid strains and an initial lack of vaccine availability in developing countries. The main limiting factor was that in 2021 only about 60% of Bolivians were vaccinated meaning that there was a risk of infection to our patients by holding screening camps where many hundreds of potential patients gather. Also with an 8-day quarantine in place for international visitors on arrival to Bolivia, it was not possible for medical teams to get enough time in field to make a trip viable.
Therefore, this year saw the Andean Medical Mission take on more of a general medical role as we worked hard to vaccinate as many people as we could, to protect against Covid19. Our expertise in reaching remote communities in the hard-to-reach areas without proper road communications proved crucial to the success of the roll out of vaccines.
Getting to some of these communities in the rainy season was a real challenge as well as keeping the medicines at the correct temperatures in villages with no electricity. However, we worked through the difficulties to make sure these people were protected. Over all, we vaccinated or provided vaccines to over 4,000 people. We used the J&J vaccine as it is a single dose making the programme faster and more efficient.
Additionally, we identified and vaccinated 240 children for measles and polio who had been missed by the health system here due to the remoteness of where they lived.
We kept our teams small to reduce the risk of transmission of Covid and continued to focus on training village doctors in managing eye emergencies and setting up a 24-hour emergency mobile phone line for patients and healthcare workers to call when an eye emergency presents.
The problem of unattended trauma (30% of blindness in Beni) was highlighted to us in 2019 when a little girl presented to a village hospital, with a knife wound to the eye. It was 12 days before she was able to access help. The family were poor and local doctors didn’t know what to do, or who to contact that would help for free. We put together a training course on improving communication to speed up access to specialist treatment across the whole of northern Bolivia to prevent this situation from ever occurring again.
We have been traveling all over the Beni teaching and training to this end and it is working well. Our one-day workshop covers a range of traumas, infections, pressure in the eye and many conditions that would typically present in a village setting. We teach the doctors how to spot key disease identifiers, what they can manage safely themselves and how to prepare a patient for the journey to see a specialist. We provide phone numbers of Bolivian specialists and the AMM helpline which is open 24 hours, every day, all year round.
Page 3
**Andean Medical Mission Limited**
## **Trustees Annual Report**
Our service can provide a diagnosis and treatment plan over the phone and by WhatsApp video meaning that patients can start treatment before they reach a specialist and these few hours are often the difference between retaining vision or going blind.
Since we started training, we have received about numerous calls where we were able to help save vision. There are still many villages in the Beni that we still need to visit and over the next few years we will be delivering and refining the course so that we reach even more doctors and nurses.
We have a collection service in place with ophthalmologists in La Paz who provide sample medicines for us so that we can make sure the villages have a small stock of antibiotics, artificial tears, anti-inflammatory drops and are able to bring down eye pressure if they have a case of suspected high ocular pressure. AMM provide some basic equipment to help with the diagnosis.
Finally, we have kept going with glasses and eye screening. As well as refractive error, we often identify skin tumours, glaucoma and uveitis and diabetic retinopathy all of which we can help with. We can make glasses from -5 to + 5 dioptres and have many ready readers and magnifiers that we give out for low vision.
2022 was also our ten-year anniversary!! It’s hard to believe how time flies.
In summary, we have been very busy and have worked hard to be useful even though AMM’s surgical side has been somewhat on hold. Our take on the last two years is that there has always been something we can do to help.
Our focus will always be on eliminating avoidable blindness - through medicine and surgery, training and supporting Bolivian health professionals, developing services and through early screening and refraction. However, the pandemic has allowed us to be a broader medical mission. To expand our thinking as to other ways we can help to make people’s lives a little easier and a little better and that is a good place for us to be.
## **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.
Page 4
**Andean Medical Mission Limited Trustees Annual 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.
The Trustees are responsible for keeping proper accounting records that disclose with reasonable accuracy at any time the financial position of the charity and to enable them to ensure that the financial statements comply with the Companies Act 2006. The Trustees are also responsible for safeguarding the assets of the charity and hence taking reasonable steps for the prevention and detection of fraud and other irregularities.
The above report has been prepared in accordance with the provisions applicable to companies subject to the small companies regime as set out in Part 15 of the Companies Act 2006 and in accordance with the Charities SORP (FRS 102).
Signed on behalf of the board
P. Gouws Trustee 27 January 2023
Page 5
**Andean Medical Mission Limited**
**Independent Examiners Report**
## **Independent Examiner's Report to the trustees of Andean Medical Mission Limited**
I report to the charity trustees on my examination of the financial statements of Andean Medical Mission Limited for the year ended 30 April 2022 which comprise the Statement of Financial Activities, the Summary Income and Expenditure Account, the Balance Sheet and the related notes.
## **Responsibilities and basis of report**
As the trustees of the charity (and also its directors for the purposes of company law) you are responsible for the preparation of the financial statements in accordance with the requirements of the Companies Act 2006('the 2006 Act').
Having satisfied myself that the financial statements of the charity 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 financial statements 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 can confirm that no material matters have come to my attention in connection with the examination giving me cause to believe that:
- accounting records were not kept in accordance with section 386 of the 2006 Act ; or
- the financial statements do not accord with those records; or
- the financial statements do not comply with the accounting requirements under section 396 of the 2006 Act other than any requirement that the financial statements give a 'true and fair' view which is not a matter considered as part of an independent examination; or
- the financial statements have not been prepared in accordance with the Charities SORP (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 financial statements to be reached.
Mrs Hannah Thatcher, FCA LLB Institute of Chartered Accountants England & Wales
Room 34 Basepoint Business Centre Little High Street Shoreham-by-sea BN43 5EG 27 January 2023
Page 6
**Andean Medical Mission Limited Statement of Financial Activities**
## **for the year ended 30 April 2022**
|**Notes**
**Income and endowments**
**from:**
Donations and legacies
4
**Total**
**Expenditure on:**
Charitable activities
5
Other
6
**Total**
Net gains on investments
**Net income**
7
Transfers between funds
**Net income before other**
**gains/(losses)**
**Other gains and losses**
**Net movement in funds**
**Reconciliation of funds:**
Total funds brought forward
**Total funds carried forward**|**Unrestricted**
**funds**
**2022**
**£**
37,606|**Total funds**
**2022**
**£**
37,606|**Total funds**
**2021**
**£**
40,706|
|---|---|---|---|
||37,606
14,059
22,557|37,606
14,059
22,557|40,706
11,620
20,125|
||36,616
-|36,616
-|31,745
-|
||990
-|990
-|8,961
-|
||990|990|8,961|
||990
63,359|990
63,359|8,961
54,398|
||64,349|64,349|63,359|
Page 7
**Andean Medical Mission Limited**
**Balance Sheet**
## **at 30 April 2022**
|**Company No.**
**07603941**
**Notes**
**Fixed assets**
Tangible assets
9
**Current assets**
Debtors
10
Cash at bank and in hand
**Creditors:**Amount falling due within one year
11
**Net current assets**
**Total assets less current liabilities**
**Net assets excluding pension asset or liability**
**Total net assets**
**The funds of the charity**
**Restricted funds**
12
**Unrestricted funds**
General funds
12
**Reserves**
12
**Total funds**|
**2022**
**£**
6,410
6,410
417
61,296
61,713
(3,774)
57,939
64,349
64,349
64,349
64,349
64,349
64,349|**2021**
**£**
7,667|
|---|---|---|
|||7,667
475
58,662|
|||59,137
(3,445)|
|||55,692
63,359|
|||63,359|
|||63,359|
|||63,359|
|||63,359|
|||63,359|
These accounts have been prepared in accordance with the special provisions of Part 15 of the Companies Act 2006 relating to small companies.
For the year ended 30 April 2022 the company was entitled to exemption under section 477 of the Companies Act 2006 relating to small companies.
The members have not required the company to obtain an audit in accordance with section 476 of the Companies Act 2006.
The directors acknowledge their responsibilities for complying with the requirements of the Companies Act 2006 with respect to accounting records and the preparation of accounts.
Approved by the board on 27 January 2023
And signed on its behalf by:
P. Gouws Trustee 27 January 2023
Page 8
**Andean Medical Mission Limited**
**Notes to the Accounts**
## **for the year ended 30 April 2022**
- 1 **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) (effective 1 January 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.
## **Fund accounting**
Unrestricted funds These are available for use at the discretion of the trustees in furtherance of the general objects of the charity. Designated funds These are unrestricted funds earmarked by the trustees for particular purposes. Revaluation funds These are unrestricted funds which include a revaluation reserve representing the restatement of investment assets at their market values. Restricted funds These are available for use subject to restrictions imposed by the donor or through terms of an appeal.
## **Income**
Recognition of Income is included in the Statement of Financial Activities (SoFA) when the charity income becomes entitled to, and virtually certain to receive, the income and the amount of the income can be measured with sufficient reliability. Income with related Where income has related expenditure the income and related expenditure is expenditure reported gross in the SoFA. Donations and Voluntary income received by way of grants, donations and gifts is included in the legacies the SoFA when receivable and only when the Charity has unconditional entitlement to the income. Tax reclaims on Income from tax reclaims is included in the SoFA at the same time as the donations and gifts gift/donation to which it relates. Donated services These are only included in income (with an equivalent amount in expenditure) and facilities where the benefit to the Charity is reasonably quantifiable, measurable and material. Volunteer help The value of any volunteer help received is not included in the accounts. Investment income This is included in the accounts when receivable. Gains/(losses) on This includes any gain or loss resulting from revaluing investments to market value revaluation of fixed at the end of the year. assets Gains/(losses) on This includes any gain or loss on the sale of investments. investment assets
Page 9
**Andean Medical Mission Limited Notes to the Accounts**
## **Expenditure**
Recognition of Expenditure is recognised on an accruals basis. Expenditure includes any VAT which expenditure cannot be fully recovered, and is reported as part of the expenditure to which it relates. Expenditure on These comprise the costs associated with attracting voluntary income, fundraising raising funds trading costs and investment management costs. Expenditure on These comprise the costs incurred by the Charity in the delivery of its activities and charitable activities services in the furtherance of its objects, including the making of grants and governance costs. Grants payable All grant expenditure is accounted for on an actual paid basis plus an accrual for grants that have been approved by the trustees at the end of the year but not yet paid. Governance costs These include those costs associated with meeting the constitutional and statutory requirements of the Charity, including any audit/independent examination fees, costs linked to the strategic management of the Charity, together with a share of other administration costs. Other expenditure These are support costs not allocated to a particular activity.
## **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 and depreciation**
Depreciation is provided at the following annual rates in order to write off each asset over its estimated useful life:
Computer equipment 33% Straight line Motor vehicles 25% Reducing balance Medical equipment 25% Reducing balance
## **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.
## **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 Limited Notes to the Accounts**
## 2 **Company 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.
## 3 **Statement of Financial Activities - prior year**
|3 **Statement of Financial Activities - prior year**||||
|---|---|---|---|
|**Income and endowments from:**
Donations and legacies
**Total**
**Expenditure on:**
Charitable activities
Other
**Total**
**Net income**
**Net income before other**
**gains/(losses)**
**Other gains and losses:**
**Net movement in funds**
**Reconciliation of funds:**
Total funds brought forward
**Total funds carried forward**
4
**Income from donations and legacies**
Regular giving and capital
donations
Grants from companies|**Unrestricted**
**£**
11,082
26,524
37,606|**Unrestricted**
**funds**
**2021**
**£**
40,706
40,706
11,620
20,125
31,745
8,961
8,961
8,961
54,398
63,359
**Total**
**2022**
**£**
11,082
26,524
37,606|**Total funds**
**2021**
**£**
40,706|
||||40,706
11,620
20,125|
||||31,745|
||||8,961|
||||8,961|
||||8,961
54,398|
||||63,359|
||||**Total**
**2021**
**£**
19,601
21,105|
||||40,706|
During the year the company received grants totalling £26,524 (2021: £21,105) of this £6,824 was received from HMRC in relation to Covid job retention scheme. A further £19,700 of unrestricted grants were received to be used for the training of doctors and nurses in Bolivia.
Page 11
**Andean Medical Mission Limited**
## **Notes to the Accounts**
## 5 **Expenditure on charitable activities**
|5|**Expenditure on charitable activities**||||
|---|---|---|---|---|
|||**Unrestricted**|**Total**|**Total**|
||||**2022**|**2021**|
|||**£**|**£**|**£**|
||_Expenditure on charitable_||||
||_activities_||||
||Vaccine purchase and
shipping|3,193|3,193|830|
||_Administrative costs_||||
||Other administrative costs &||||
||depreciation|4,896|4,896|4,941|
||Governance costs||||
||Staff salaries|5,970|5,970|5,849|
|||14,059|14,059|11,620|
|6|**Other expenditure**||||
|||**Unrestricted**|**Total**|**Total**|
||||**2022**|**2021**|
|||**£**|**£**|**£**|
||Transport and travel|4,644|4,644|2,577|
||Employee costs|17,913|17,913|17,548|
|||22,557|22,557|20,125|
|7|**Net income before transfers**||||
|||**2022**||**2021**|
||This is stated after charging:|**£**||**£**|
||Depreciation of owned fixed assets|2,246||2,556|
|8|**Staff costs**||||
|||**2022**||**2021**|
||Salaries and wages|23,883||23,397|
|||23,883||23,397|
||No employee received emoluments in excess of £60,000.||||
||The average monthly number of full time equivalent employe|
es during the year was as follows:|||
|||**2022**||**2021**|
|||**Number**||**Number**|
||Number of staff|1||1|
|||1||1|
Page 12
**Andean Medical Mission Limited**
## **Notes to the Accounts**
## 9 **Tangible fixed assets**
|At 30 April 2022
**Net book values**
At 30 April 2022
At 30 April 2021
10**Debtors**
Prepayments and accrued income
11**Creditors:**
amounts falling due within one year
Other taxes and social security
Other creditors
Accruals
**Cost or revaluation**
At 1 May 2021
Additions
At 30 April 2022
**Depreciation and**
**impairment**
At 1 May 2021
Depreciation charge for the
year||1,060
659
-
**Computer**
**equipment**
**£**
730
989
1,719
730
330||14,306
5,659
7,545
**2022**
**£**
417
417
**2022**
**£**
53
1,950
1,771
3,774
**Motor**
**vehicles**
**£**
19,965
-
19,965
12,420
1,886|264
92
122
**Medical**
**equipment**
**£**
356
-
356
234
30||**Total**
**£**
21,051
989|
|---|---|---|---|---|---|---|---|
||||||||22,040|
||||||||
13,384
2,246|
|||||||
|15,630|
||||||||6,410|
||||||||7,667|
||||||||
**2021**
**£**
475|
||||||||475|
||||||||**2021**
**£**
30
1,807
1,608|
||||||||3,445|
Page 13
**Andean Medical Mission Limited**
**Notes to the Accounts**
## 12 **Movement in funds**
|12**Movement in funds**|||||||||
|---|---|---|---|---|---|---|---|---|
|**Unrestricted funds:**
**General funds**
**Total funds**
**Unrestricted funds:**
**General funds**
**Total funds**
13**Analysis of net assets between funds**
Fixed assets
Current assets
Current liabilities
Total net assets
Fixed assets
Current assets
Current liabilities
Total net assets||**At 1 May**
**2021**
63,359
63,359
**At 1 May**
**2020**
54,398
54,398||**Incoming**
**resources**
**(including**
**other**
**gains/losses**
**)**
**£**
37,606
37,606
**Incoming**
**resources**
**(including**
**other**
**gains/losses**
**)**
**£**
40,706
40,706||**Resources**
**expended**
**£**
(36,616)
(36,616)
**Resources**
**expended**
**£**
(31,745)
(31,745)
**Unrestricted**
**funds**
**£**
6,410
61,713
(3,774)
64,349
**Unrestricted**
**funds**
**£**
7,667
59,137
(3,445)
63,359||**At 30 April**
**2022**
**£**
64,349|
|||||||||64,349|
|||||||||**At 30 April**
**2021**
**£**
63,359|
||||||||63,359
**Total funds**
**at 30 April**
**2022**
**£**
6,410
61,713
(3,774)|63,359|
||||||||||
||||||||64,349
**Total funds**
**at 30 April**
**2021**
**£**
7,667
59,137
(3,445)|64,349|
|||||||||63,359|
Page 14
**Andean Medical Mission Limited Detailed Statement of Financial Activities**
## 14 **Reconciliation of net debt**
|Cash and cash equivalents
Net debt||**At 1 May**
**2021**
**£**
58,662
58,662
58,662||**Cash flows**
**£**
2,634
2,634
2,634||**At 30 April**
**2022**
**£**
61,296|
|---|---|---|---|---|---|---|
|||||||61,296|
|||||||61,296|
## 15 **Related party disclosures**
## _**Controlling party**_
The company is limited by guarantee and has no share capital; thus no single party controls the company.
Page 15