Safe
Anaesthesla
Worldwide
April 2023/24
rus
ees
nnua
## Safe Anaesthesia Worldwide Trustees’ Annual Report 6th April 2023 to 5th April 2024
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 Anne Cox Bridget Harvey (appointed 12 March 2024) Dr Julie Morgan Colin E Whittle
## **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 2024.
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).
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**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 the charity employs 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.
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## **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_
- _3.8 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.
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## **Activities**
An important step for SAWW in September 2023 this year was joining with Partners for Equity (PFE) to improve anaesthesia provision in developing countries. PFE delivers aid by partnering with local organisations working in communities that are disadvantaged or living in poverty. Thanks to funds from PFE we were able to supply anaesthesia and related equipment to hospitals in Burundi and Madagascar.
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 Cameroon, Ethiopia and Somaliland. We also maintained our collaboration with the organisations Global Anaesthesia, Surgery and Obstetric Collaborative (GASOC) and The Zambia Anaesthesia Development Program (ZADP) to deliver anaesthesia training in Cameroon and Zambia.
## **EQUIPMENT DONATIONS**
Recipients of equipment donations during this year were as follows:
## **1. CAMEROON – TRINITY POLYCLINIC**
A portable anaesthesia machine and patient monitor was donated to the lone anaesthetist working at Trinity Polyclinic in Tubah Health District in North West Cameroon. The new machine was to replace a very old drawover anaesthesia machine, donated from the Gulf War (1990-91) that had broken. The new machine enabled surgical procedures to continue at the hospital, mainly C-sections and injuries. Subsequently, internal conflict in the region caused the hospital to temporarily close, but the anaesthetist was able to take the portable machine to another hospital in the region where he used it to continue to treat patients, many of whom were displaced people.
## **2. CAMEROON – NKWEN BAPTIST HOSPITAL**
A donation of a full hospital anaesthesia machine (Glostavent Helix) was made possible by a major donation from an individual. The machine was sent to Nkwen Baptist Hospital in Bamenda, the capital of the North West region of Cameroon, which serves a growing number of patients from beyond the region and neighbouring countries. The hospital has five operating theatres and 12 anaesthesia staff, but had only 2 fully functioning anaesthesia machines, limiting the number of operations that could be performed. The donation of the new anaesthesia machine has increased the capacity of the surgical facilities at the hospital, enabling more patients to be treated and thus preventing suffering and disability.
## **3. ETHIOPIA**
A patient monitor was donated to the Children’s Burns Unit in Addis Ababa to accompany a new anaesthesia machine purchased by the hospital. Many children with serious burns need to have their dressings changed daily and this requires sedation and monitoring. Burns are common in African countries, especially in children, due to the use of open cooking fires, causing significant morbidity and mortality. The donated monitor will help in the treatment of these children.
## **4. SOMALILAND**
A ventilator and oxygen concentrator were sent to Gargaar Hospital in Somaliland. Prior to this donation, anaesthetised patients were ventilated manually, which necessitated the anaesthetist pumping air into the
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patient’s lungs by hand squeezing a bag, sometimes for several hours. This was not safe or convenient, and exhausting for the anaesthetist. SAWW donated a robust gas-driven ventilator to do this job mechanically. The ventilator is driven by an oxygen concentrator that also delivers oxygen and air to the patient, making it efficient and economical to run. This donation has improved the safety for patients undergoing anaesthesia at the hospital.
## **5. MADAGASCAR**
SAWW’s new partnership with Partners for Equity enabled the donation of oxygen equipment to the Good News Hospital (Hopitaly Vaovao Mahafaly ) in Mandritsara in the North of Madagascar. Oxygen is an essential medicine used to care for patients at all levels of the healthcare system and is often lifesaving, yet is frequently in short supply in LMICs. The donated equipment consisted of two Baby CPAP and two oxygen concentrators to provide vital respiratory care for sick patients and new born or premature babies.
## **6. BURUNDI**
A further donation made possible by Partners for Equity was a hospital anaesthesia machine for the Van Norman Clinic in Bujumbura, Burundi. This hospital cares for an increasing number of patients, especially expectant mothers in need of caesarean sections and who have few choices for maternity care. The Van Norman Clinic deals with some 600 deliveries per month. The new machine will improve anaesthesia provision for the expanding surgical services at the hospital, especial for essential C-sections, to reduce rates of maternal mortality in the region.
## **EDUCATION AND TRAINING**
## **Virtual Reality Training Workshops**
SAWW continued its collaboration with GASOC (Global Anaesthesia, Surgery and Obstetric Collaborative) to support their training workshops that use virtual reality techniques to teach ultrasound guided regional anaesthesia and advanced airway techniques. Workshops were held in Cameroon with local partner ASCOVIME in Yaoundé and in Zambia partnered with the University of Zambia in Lusaka. Training covered 12 essential airway and regional anaesthesia skills delivered to physicians and non-physician anaesthetists. A total of 105 participants attended across Cameroon, Benin, Zambia and Democratic Republic of Congo. This approach is proving to be a cost-effective and efficient way to deliver training to remote locations.
## **Zambia Anaesthesia Development Program (ZADP)**
The Zambia Anaesthesia Development Program works to develop safer anaesthesia in Zambia through education and training of physician anaesthetists. Like many LMICs, Zambia has a critical shortage of physician anaesthetists to serve a growing population. SAWW supported the work of the ZADP in 2022 and 2023. During this period, 19 Zambian doctors were supported in their speciality training. 153 days of incountry training were provided by ZADP volunteers. An Impact Report was recent published by ZADP that describes their achievements in greater detail. https://gadpartnerships.com/wp-content/uploads/ZADPImpact-Report-2023.pdf
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## **Plans for the coming year**
In the coming year April 2024/2025 SAWW will continue to improve anaesthesia services for those in need. Requests for funding are considered twice a year at Trustees’ meetings in March and September.
## **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 intends to continue to collaborate with other reputable organisations with shared aims to provide anaesthesia training and equipment to hospitals in need. This will include working with Partners for Equity to provide appropriate anaesthesia and monitoring equipment. SAWW intends to retain ties with ZADP and GASOC to support anaesthesia training.
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**Financial review**
## **Income**
Total income for the year was £62,190
The charity’s principal sources of funding have been donations from charitable trusts, groups and individuals.
Total expenditure for the year was £66,101
- 93% Medical equipment £61,550
- 6% Training £3,895 <1% Governance £179 <1% Banking and other charges £91 <1% Fundraising £386
Balance at the end of the year was £9,934
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: -
Michael Cox Chair
Date: 28/10/2024
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**Charity Name No (if any) Safe Anaesthesia Worldwide Receipts and payments accounts CC16a For the period** Period start date Period end date **To from** 06/04/2023 05/04/2024
## **Section A Receipts and payments**
|**A1 Receipts**|**Unrestricted**
**funds**
**to the nearest £**
**4,223**
**590**
**1,433**
**15,200**
**433**
**23**
**-**
**-**
**21,902**
**-**
**-**
**-**
**21,902**
**21,262**
**3,895**
**179**
**91**
**386**
**-**
**-**
**-**
**25,813**
**-**
**-**
**-**
**25,813**
**- 3,911**
**-**
**-**
**9,934**|**Restricted**
**funds**
**to the nearest £**
**14,983**
**-**
**-**
**25,300**
**5**
**-**
**-**
**-**
**40,288**
**-**
**-**
**-**
**40,288**
**40,288**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**40,288**
**-**
**-**
**-**
**40,288**
**-**
**-**
**-**
**-**|**Endowment**
**funds**
**to the nearest £**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**|**Total funds**
**to the nearest £**
**19,206**
**590**
**1,433**
**40,500**
**438**
**23**
**-**
**-**
**62,190**
**-**
**-**
**-**
**62,190**
**61,550**
**3,895**
**179**
**-**
**91**
**386**
**-**
**-**
**-**
**66,101**
**-**
**-**
**-**
**66,101**
**- 3,911**|**Total funds**
**to the nearest £**
**19,206**
**590**
**1,433**
**40,500**
**438**
**23**
**-**
**-**
**62,190**
**-**
**-**
**-**
**62,190**
**61,550**
**3,895**
**179**
**-**
**91**
**386**
**-**
**-**
**-**
**66,101**
**-**
**-**
**-**
**66,101**
**- 3,911**|**Last year**
**to the nearest £**|
|---|---|---|---|---|---|---|
|Donations from individuals|**4,223**|||||**7,297**|
|Donations from Groups|**590**|||||**1,270**|
|Fundraising|**1,433**|||||**10,274**|
|Donations from Charitable Trusta|**15,200**|||||**25,200**|
|Gift Aid|**433**|||||**2,262**|
|Interest|**23**|||||**17**|
||**-**|||||**-**|
||**-**|||||**-**|
|**_Sub total_**_(Gross income for_
_AR)_|**21,902**|||||**46,320**|
||||||||
|**A2 Asset and investment sales,**
**(see table).**|||||||
||**-**||||||
||**-**
|||||**-**|
|~~**_Sub total_**~~|**-**|||||**-**|
|**_Total receipts_ **
**A3 Payments**|||||||
|||||||**46,320**|
||||||||
|Anaesthetic and medical equipment|**21,262**|||||**34,818**|
|Training|**3,895**|||||**5,000**|
|Governance|**179**|||||**150**|
|Printing||||||**532**|
|Bank charges|**91**|||||**72**|
|Fundraisingcosts|**386**|||||**557**|
||**-**|||||**-**|
||**-**|||||**-**|
||**-**|||||**-**|
|**_Sub total_ **|**25,813**|||||**41,129**|
||||||||
|**A4 Asset and investment**
**purchases, (see table)**|||||||
||**-**||||||
||**-**||||||
|**_Sub total_ **|**-**|||||**-**|
|**_Total payments_ **
**_Net of receipts/(payments)_**
**A5 Transfers between funds**
**A6 Cash funds last year end**
**_Cash funds this year end_**|||||||
|||||||**41,129**|
||||||||
||**- 3,911**|**-**|**-**|
**- 3,911**||**5,191**|
||**-**|**-**|**-**|**-**||**-**|
||**-**|**-**|**-**|**13,845**||**8,654**|
||**9,934**|**-**|**-**|**9,934**||**13,845**|
CCXX R1 accounts (SS)
31/10/2024
1
|**Section B Statement of assets and liabilities at the end of the period**|**Section B Statement of assets and liabilities at the end of the period**|**Section B Statement of assets and liabilities at the end of the period**||
|---|---|---|---|
|**Categories**
Signed by one or two trustees on
behalf of all the trustees
**B5 Liabilities**
**B3 Investment assets**
**B2 Other monetary assets**
**B4 Assets retained for the**
**charity’s own use**
**B1 Cash funds**|**Details**
**Details**
**_Total cash funds_**
(agree balances with receipts and payments
account(s))
**Details**
**Details**
**Details**
Signature|**Unrestricted**
**funds**
**Restricted**
**funds**
**to nearest £**
**to nearest £**
**9,934**
**-**
**-**
**-**
**-**
**-**
**9,934**
**-**
OK
OK
**Unrestricted**
**funds**
**Restricted**
**funds**
**to nearest £**
**to nearest £**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**Fund to which**
**asset belongs**
**Cost (optional)**
**-**
**-**
**-**
**-**
**-**
**Fund to which**
**asset belongs**
**Cost (optional)**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**-**
**Fund to which**
**liability relates**
**Amount due**
**(optional)**
**-**
**-**
**-**
**-**
**-**
Print Name
MICHAEL COX|**Endowment**
**funds**
**to nearest £**|
||||**-**|
||||**-**|
||||**-**|
||||**-**|
||||OK|
||||**Endowment**
**funds**
**to nearest £**|
||||**-**|
||||**-**|
||||**-**|
||||**-**|
||||**-**|
||||**-**|
||||**Current value**
**(optional)**|
||||**-**|
||||**-**|
||||**-**|
||||**-**|
||||**-**|
||||**Current value**
**(optional)**|
||||**-**|
||||**-**|
||||**-**|
||||**-**|
||||**-**|
||||**-**|
||||**-**|
||||**-**|
||||**-**|
||||**When due**
**(optional)**|
|||||
|||||
|||||
|||||
|||||
|||||
||||Date of
approval|
|||MICHAEL COX|25/10/2024|
|||||
CCXX R2 accounts (SS)
31/10/2024
2
CHARITY COMMISSION
FOR ENGLAND AND WALES
Independent examiner's
report on the accounts
Section A
Independent Examiner's Report
Report to the trusteesl
member£ of
fiTho£TÉR6D LNZ -
Relevant professlonal
qualificationlsl or body
lrfany):
Address:
HU
PJNf4trJCL
TN120
IER
October 2018