Safe Anaesthesla Worldwide April 2022/23 rus ees nnua ## Safe Anaesthesia Worldwide Trustees’ Annual Report 6th April 2022 to 5th April 2023 Safe Anaesthesia Worldwide, White Lyon House, Marden, Kent, TN12 9DR, UK. Registered Charity Number: 1148254 Telephone: 07527506969 Email: info@safe4all.org.uk Website: www.safe4all.org.uk ## **Trustees** Roger J Eltringham, President Michael C Cox, Chair Geoffrey R Burr, Treasurer Dr Julie Morgan Colin E Whittle Anne Cox ## **Advisers** Secretary: Carol Newman Technical Adviser: Robert Neighbour **Bankers:** CAF Bank, 25 Kings Hill Avenue, Kings Hill, West Malling, ME19 4JQ The Trustees present their annual report and financial statements of the charity for the year ended 5th April 2023. The financial statements have been prepared in accordance with the charity’s trust deed, the Charities Act 1993 and the Charity reporting and accounting: the essentials November 2016 (CC15d). 1 **Structure, governance and management** The Trust is a registered charity, number 1148254, and is constituted under a trust deed dated 18th July 2012. New Trustees are appointed by the existing trustees by a resolution at a special meeting. The Trust Deed provides for a minimum of 3 trustees. The Trustees do not benefit financially from their Trusteeship. The Trustees hold at least two ordinary meetings a year to oversee the charity’s work. The day to day running of the charity is carried out by volunteers and there are no paid staff. The charity’s work overseas is made possible by the voluntary contributions of professionals working in or visiting developing countries to deliver anaesthesia and support. Risks associated with delivering safe anaesthesia in low-resource settings are taken into consideration by the Trustees. Importantly, only appropriate equipment that is safe, effective and inexpensive to use and maintain is provided by the charity. Equipment is only supplied to end-users who are suitably trained to use it safely. Training and continuing support is provided wherever requested. 1 ## **Objectives and activities** The objectives of the charity Safe Anaesthesia Worldwide (SAWW) are to preserve and protect good health by: the provision of suitable anaesthetic equipment to deprived areas of the world; and the support of research, education, and training to ensure its effective use, care and maintenance. ## Anaesthesia services are crucial to achieving the **United Nations Sustainable Development Goal 3 Good** **Health and Well-being** , and SAWW’s objectives support this goal and in particular the following targets: - _3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births_ - _3.2 By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under5 mortality to at least as low as 25 per 1,000 live births_ - _3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment_ - _3.6 By 2020, halve the number of global deaths and injuries from road traffic accidents_ - _3.8 Achieve universal health coverage, including access to quality essential health-care services_ ## SAWW’s objectives focus on the provision of: - Safe anaesthesia and pain relief to help women in labour and to reduce the unacceptably high number of women who currently die in pregnancy and childbirth. - Appropriate anaesthesia for remote low-resource locations to enable essential surgery to treat lifethreatening, painful or disabling conditions such as trauma, tumours, hernias, obstetric fistulas, wounds, animal bites, burns, infections and congenital deformities. - Oxygen therapies for newborns and infants to prevent unnecessary deaths from pneumonia, malaria, sepsis and premature birth. - Portable anaesthesia equipment for emergency response to save lives of those affected by natural disasters or war. To achieve its objectives the charity undertakes the following activities: - The purchase and supply of equipment that is suitable for use in low-resource settings and remote locations, to people in need. - The delivery of training for medical and technical staff in poor countries, to enable them to deliver safe anaesthesia and maintain equipment in good working order. - Support for research into ways of improving the safe delivery of anaesthesia in poor countries. In planning and conducting the charity’s activities for the year the Trustees have given due regard to the guidance on public benefit published by the Charity Commission. Day-to-day administration of the charity is carried out by the Trustees and other volunteers. Co-ordination of activities and secretarial support is provided by Carol Newman who is recompensed by Diamedica (UK) Ltd. Voluntary work by numerous individuals has enabled the delivery of anaesthesia training and the provision of research. 2 ## **Activities** This year SAWW responded to anaesthetists who reached out to us from difficult and dangerous situations in Ukraine and Yemen. We continued to equip rural hospitals in low-income countries by donating appropriate anaesthesia equipment that operates reliably and affordably in low-resource locations. This year we donated equipment to hospitals in Cameroon, Ethiopia, Kenya, Somaliland, Uganda and Zambia. We also began a new collaboration with the organisation GASOC to bring virtual reality training to Uganda. ## **EQUIPMENT DONATIONS** Recipients of equipment donations during this year were as follows: ## **1. CAMEROON** The Cameroon Baptist Health Service (CBHS) runs non-profit hospitals and numerous health centres that assist the poorest of the poor. Their services are spread over 9 of the 10 Regions of Cameroon and are open 24/7. SAWW contributed to a donation of a portable anaesthesia machine for use by the CBHS for emergency operations. Nkwen Baptist Hospital, a relatively new CBHS hospital, requested help to establish two intensive care beds, for which CBHS had limited funds and could only afford one ventilator. SAWW assisted by donating an additional ventilator, enabling both new intensive care beds to be properly equipped. Both Helix ventilators can be run from a single oxygen concentrator, making them affordable to run for a low-resource hospital. The new intensive care beds are now providing lifesaving ventilation and care for seriously ill patients. ## **2. ETHIOPIA** SAWW responded positively to an appeal from anaesthetists in Ethiopia for equipment for hospitals in the north of the country where facilities had been damaged due to the civil war. Jamma Primary Hospital serves a population of over 200,000 people, but lacks reliable mains electricity and its backup generator had been stolen during the conflict. In addition, medical oxygen is supplied in cylinders and occasionally runs out. To ensure that anaesthesia for essential surgery can be conducted at any time SAWW donated a portable anaesthesia machine that functions without electricity, together with an oxygen concentrator to generate medical oxygen from air. Both items of equipment are simple to operate and affordable to run, making anaesthesia available whenever it is needed. ## **3. KENYA** A basic anaesthesia machine, patient monitor and oxygen concentrator were donated to the small rural hospital in Homa Bay County, Kenya. Nyagowa Elck Dispensary has two anaesthesia staff but without an anaesthesia machine or monitor emergency cases had to be referred to the district hospital, causing delays in treatment, sometimes with tragic results. The hospital is without reliable electrical and oxygen supplies. The equipment donated by SAWW will work reliably even in these hostile conditions and many emergency operations such as caesarean sections, wounds, hernias and accidents are now dealt with promptly, preventing suffering and saving lives. ## **4. SOMALILAND** 3 Awdal Hospital in Borama, one of the largest cities in Somaliland, provides health care to a population of over 800,000 people. Resources are extremely limited and stretched to capacity. The hospital has two operating theatres, but only one small anaesthesia machine that runs on cylinders of oxygen that makes it extremely expensive to use. SAWW identified a private donor to support the hospital and we assisted in the donation of a full hospital anaesthesia machine (Glostavent Helix) and patient monitor. This machine generates its own oxygen and medical air, making it very affordable to run and has ensured that one of the operating theatres is appropriately equipped at all times. SAWW only donates equipment that works reliably and economically in resource-poor locations and we will continue to provide help with spare parts and servicing, to ensure the longevity of donated equipment. This year, we were happy to send some minor spare parts to Gargaar Hospital in Somaliland for the anaesthesia machine donated and installed in 2017, which is in daily use. ## **5. UGANDA** The neonatal intensive care unit (NICU) at Mbale Hospital has transformed the care of premature and sick babies in this region of Uganda. SAWW has previously supported the NICU by donating appropriate equipment, in particular the cost-effective CPAP machines that keep babies breathing. The nurses at Mbale call them ‘miracle machines’. SAWW was delighted to assist in the donation of a further lifesaving miracle machine to Mbale Hospital this year. ## **6. UKRAINE** February 2022 saw the outbreak of war in Ukraine and almost immediately SAWW received appeals from Ukrainian doctors for anaesthesia equipment that would work in emergency situations and mobile hospitals. There was also an enormous response from the public who wanted to help those caught up in the conflict. Whilst aware of the risks associated with sending medical equipment into a war zone, the Trustees agreed that the need to alleviate suffering of people injured in Ukraine could not be ignored and hence much of SAWW’s focus this year was on supply of equipment to Ukraine. SAWW donated portable anaesthesia equipment for mobile hospitals run from Odessa. We provided three portable anaesthesia machines, a ventilator and oxygen supply equipment. There were reports of hospitals running low on supplies of medical oxygen and many hospital facilities in Ukraine have been damaged or destroyed in the war. SAWW sent equipment that can be used to deliver anaesthesia anywhere, even in the most basic emergency conditions, such as field hospitals and mobile intensive care units. This equipment is now being used on a daily basis by anaesthetists who risk their lives to treat patients. Delivery of this equipment was enabled by anaesthetist Dr Andrey Varvinskiy of Torbay Hospital and Scott Cheadle of Help Ukraine. ## **7. YEMEN** A newly established Yemini Society of Anaesthesiologists contacted SAWW to tell us of the everyday difficulties they face in the training and delivery of anaesthesia due to the civil war. A shortage of even basic equipment for operating theatres had led them to set up a central store of badly needed items. SAWW responded by sending them ten laryngoscope sets with boxes of intubation equipment, and medical reference books, as requested. This equipment is now making anaesthesia safer for patients in Yemen. 4 ## **8. ZAMBIA** SAWW contributed towards the donation of three CPAP devices to Kapiri District Hospital in Zambia. These devices are crucial for supporting the breathing of premature and seriously ill babies, who would die without respiratory support. These lifesaving CPAP machines are in constant use at the neonatal intensive care unit being run at Kapiri. ## **EDUCATION AND TRAINING** ## **Virtual Reality Training in Uganda** A new collaboration was established this year with GASOC (Global Anaesthesia, Surgery and Obstetric Collaborative). SAWW funded a GASOC workshop that utilised virtual reality to teach ultrasound guided regional anaesthesia and advanced airway techniques to 43 anaesthetic officers from 6 regions in Uganda. This was the first time VR had been used to teach anaesthesia and it has enormous potential to improve training and patient safety in remote locations. 5 ## **Plans for the coming year** In the coming year April 2023/2024 SAWW will continue to improve anaesthesia services for those in need. SAWW’s specific plans for the coming year include: ## **Equipping rural hospitals** SAWW will continue to provide anaesthesia equipment to rural hospitals in low- and middle-income countries, to enable safe surgery to save lives in the event of emergency surgical procedures. This will include anaesthesia machines, accompanied by monitors that include pulse oximetery and capnography, as well as ventilators and oxygen concentrators. ## **Collaboration with other groups** SAWW continue to collaborate with other organisations with shared aims to provide anaesthesia training and equipment to hospitals in need, including support for GASOCs widening programme of virtual reality training. ## **Expanding governance and advisory expertise** SAWW currently relies on the expertise and advice from anaesthetists and other medical professionals. We plan to continue to seek to enlist more advisors, ambassadors, educators and potentially board members to guide us in the coming year. 6 **Financial review** ## **Income** Total income for the year was £46,320 The charity’s principal sources of funding have been donations from charitable trusts, groups and individuals. Total expenditure for the year was £41,129 - 85% Medical equipment £34,818 - 12% Training £5000  <1% Governance £150  1% Printed materials £532 - <1% Banking and other charges - <1% Banking and other charges £72 - 1% Fundraising £557 Balance at the end of the year was £13,845 An independent examiner, Fiona Kite, approved the accounts and completed the Independent Examiner’s Report required by the Charity Commission. ## **Declaration** The trustees declare that they have approved the Trustees’ Report above. Signed on behalf of the charity’s Trustees Signature: Date: 24/10/23 Michael Cox Chair 7 30/11/2023, 15:38 SAWW Annual Account 2022-23 (1).jpg https://mail.google.com/mail/u/0/#inbox/WhctKKZPDRpDGjrfBhlfgWvSkQmZWCGmJzXsFKmgVLWqZDFwwwtWdtPVFGfQGBZMRVgkvwG?proj… 1/1 30/11/2023, 15:39 SAWW Anual Account 22-23 (2).jpg https://mail.google.com/mail/u/0/#inbox/WhctKKZPDRpDGjrfBhlfgWvSkQmZWCGmJzXsFKmgVLWqZDFwwwtWdtPVFGfQGBZMRVgkvwG?proj… 1/1 30111tt023, 15-.22 SAWW lThknndeni Ex*))me¢s Rtsptrt 28.11.23.jp9 • CHARITY COMMISSION FOR ENGLAND ANO WALES Independent examinerfs report on the accounts Section A Independent Examiner's Report Report to the trusts051 m•mb•rn of SAfE ANAL i +fSIfi On accounts forth• y•*r end•d Chaflty no Ilf any) S•t out on p•g•S l rnport to the tmst••s on my examinatton ofthe aw)unts olthg charity Ilhe Twsfi for the year end•J Respon•lbllStlM and As tho ¢harity Irusle86 ofthe Trust. you arn r8$pon*t4• forthe pr•paration ba•1• ol rnport of the a￿oUnt$ in xcJ)thrK• with th8 r•Juir•m8nts crfth• Charities A 20111lhe Acri. 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