Safe Anaesthesla Worldwide April 2024/25 rus ees nnua ## Safe Anaesthesia Worldwide Trustees’ Annual Report 6th April 2024 to 5th April 2025 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 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 2025. 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 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. 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_ - _3.8 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 continued to collaborate with DAK International and Partners for Equity (PFE) to improve anaesthesia provision in developing countries. This mutually beneficial partnership enabled us to supply anaesthesia and related equipment to hospitals in need in Somaliland, South Sudan and Zimbabwe. A rural hospital in Nepal reached out to us for help in equipping a new Special Newborn Care Unit and we were able to supply specialist respiratory equipment to support sick and premature babies. Training equipment that included manikins for teaching anaesthesia intubation techniques were sent to the Democratic Republic of Congo (DRC). Further assistance was sent to Ukraine in the form of equipment for surgical treatment of wounds. ## **EQUIPMENT DONATIONS** Recipients of equipment donations during this year were as follows: ## **1. NEPAL** Two bubble CPAP machines were donated by SAWW to Chaurjhari Hospital, a remote rural hospital in Nepal. Dr Dhiraj Mahara is the only paediatrician at the hospital, which has few resources and lacked specialist equipment. The CPAP devices were needed for a newly established Special Newborn Care Unit. These devices help premature and sick babies to breathe and are invariably lifesaving. An orientation class was held for the staff on how to operate the new CPAP devices and the equipment is now installed and in use to treat vulnerable tiny patients, who would not otherwise survive. Feedback has included the following case studies: - A critically ill two-year-old boy with severe pneumonia and respiratory distress. With no access to advanced ICU care, the boy was treated with the CPAP machine and after five days, he was strong enough to go home. - A one-day-old baby with early onset neonatal sepsis and severe pulmonary artery hypertension was admitted and improved very well on the CPAP device, ultimately being discharged back to his delighted family. - A 34 weeks of gestation preterm baby, nearly 1800g delivered on the road, presented in emergency with lethargic, poor feeding and respiratory distress. Treatment with the CPAP, spoon feeding, and IV fluids, the baby began to recover and is currently still under our care. ## **2. SOUTH SUDAN** SAWW partnered with DAK International and Partners for Equity (PFE), to donate a Glostavent Helix anaesthesia machine with accessories to the St. Theresa Hospital in Nzara, South Sudan. South Sudan is one of the most fragile states in the world, with violent conflict and political instability. Healthcare is non-existent in many parts of the country. St. Theresa Hospital stands as an outpost of hope for some 300,000 people, serving the south western region of South Sudan, Democratic Republic of Congo, and Central African Republic. The hospital provides critically important services for maternal, child and infant medical care. The 3 new anaesthesia machine has been delivered, installed and is now in use, with a report on its impact expected in the coming year. ## **3. SOMALILAND** Somaliland is an impoverished territory in the Horn of Africa. Now peaceful, a civil war destroyed most of the health services, which are now slowly being rebuilt. Foremost among the hospitals is the Edna Adan University Hospital (EAUH), founded by a former midwife and politician and health care advocate, Edna Adan Ismail. The EDUH provides crucial medical care to many Somalilanders who are largely poor rural farmers. The latest addition to the EAUH is a new operating theatre to increase their capacity to conduct surgical procedures mainly for C-section, hydrocephalus, spina bifida, and cleft palate/lip. A new Glostavent Helix anaesthesia machine was donated by SAWW and DAK International to equip the new theatre and hence enable more surgeries and alleviate supply chain issue and backlogs. Since EAUH is also a training site for new anaesthetists, this will also enable training on newer equipment. The impact of the new machine will be huge in both the hospital and the overall education of future anaesthetists. We await feedback from the hospital in the coming year. ## **4. UKRAINE** Since the outbreak of war in Ukraine, SAWW has sent items of portable anaesthesia equipment for use in mobile hospitals run out of Odessa to treat wounded patients. During this year, remaining funds raised for Ukraine were used to supply suction cups and stands for anaesthetist Dr Andrey Volna working in Kyiv. His work involves surgically restoring limbs of Ukrainians injured by mines and explosive wounds. This equipment has made a considerable impact, as the surgeons are working intensively in conflict conditions and equipment wears out quickly in these circumstances. ## **5. ZIMBABWE** An opportunity arose during this year to work with DAK International to donate a Glostavent anaesthesia machine, patient monitors and other equipment to improve patient care at Bulawayo United Hospitals in Zimbabwe. This project was led by Australian Doctors for Africa (ADA) who, following a visit by Professor David Wood (orthopaedic surgeon), undertook a comprehensive scoping study of the United Bulawayo Hospitals and met with the Head of Orthopaedics. Prof Wood reported that the hospital is well run, and that the Orthopaedic Department is staffed by well-trained surgeons but would benefit from provision of equipment and dedicated operating space. ADA renovated an operating theatre and ward in the Richard Morris Building for use by the Orthopaedic Department, completed in November 2024. An anaesthesia machine, patient monitors and other vital equipment to improve patient care were provided by DAK and SAWW in December 2024. Visiting volunteer medical teams are continuing to provide training and mentoring. ## **EDUCATION AND TRAINING** ## **DEMOCRATIC REPUBLIC OF CONGO (DRC)** Congolese Dr. Furaha Nzanzu Blaise Pascal received support from SAWW back in 2020 to complete his Master of Medicine in Malawi, where he graduated top of his class. He subsequently returned to his native DRC to work at the teaching hospital of the Université Catholique du Graben of Butembo and at Matanda Hospital, where he is the only anaesthesiologist in the region covering the cities of Butembo and Beni and 4 surrounding territories. He initiated the first department of Anaesthesia and Critical Care at the University, and started a training program from February 2024 to train locally anaesthesiologists and improve anaesthesia services. He is also conducting refresher courses for nurse anaesthetists as they are the main ones providing the anaesthesia care. During this year SAWW sent training equipment for the new training courses, which included adult and paediatric intubation training manikins, a Laerdal Baby Anne CPR manikin, larygascope sets, oxygen masks, other accessories and text books. These items will help to improve anaesthesia teaching for the whole region and to overcome the lack of skills in currently practicing anaesthesia providers in a region where anaesthesia experts are almost impossible to find. ## **Plans for the coming year** In the coming year April 2025/2026 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. 5 **Financial review** ## **Income** Total income for the year was £80,978 The charity’s principal sources of funding have been donations from charitable trusts, groups and individuals. Donations have been received from the following charitable trusts: DAK Foundation, the Fulmer Trust; the Hillier Trust; the Kathleen Beryl Sleigh Charitable Trust, and Partners for Equity. Total expenditure for the year was £74,152 ||97% Medical equipment|£72,048| |---|---|---| ||2% Freight charge|£1,540| ||>1% Training|£238| ||>1% Banking charges|£104| ||>1% Governance|£222| Balance at the end of the year was: £16,760 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: 09/09/2025 6 Receipts and payments accounts CC16a For the period from To 08ffj4r2024 05ffj4r202S Section A Receipts and payments Unre$trirted funds to th¢ nearest R•strict•d funds Endobvment funds Total funds L8St year fo the neares1£ t• the thoarest£ to th• rbw•st£ Al Recei ts Donatronsffon Inthfjduas Donattonstron gFOUPS Fundr**ng DonatK)nsfrom Ch8n18tde Tru8t8 GftAid Intere 2.553 338 1,677 1S.500 2.637 33B 6.313 70,944 715 19.206 4.636 55,444 467 1,433 23 Sub total(Gmss incon7e for AR) 20.3$2 60.626 10,978 62,19) A2 Asset and investment salès. (sèè tabl•l. Sub total 20.352 60,626 80,978 62,190 A3 P4ym•*it¥ Anaesthetc atxl rned￿al equlpment 31.313 40,735 72,048 61.SX) 3.895 179 91 Goveinance Bgnk Charge5 Fioighi ¢haigÉ Fundwasng ¢08t8 222 104 222 104 Sub total 33.417 40,735 74,152 60,101 A4 Asset and investmènt purchasès, Is•• table) Sub total 33,417 40,735 74,152 66,101 Not of roceipts/(payments) AS Transfers betr￿n funds A6 Cash funds last yèar •nd Cash funds Ihis year end 13.065 19,891 6,826 3,911 9,934 3,131 9.934 16.760 13,845 9.934 19,891 CCXX Rl a￿0￿[￿ ISS) 19111r2025 Section B Statement of assets and liabilities at the end of the period Un￿stricted funds to neorest£ Restrieted funds to ne8rest£ Endowmènt funds ID near￿t£ B1 Cash funds 16.780 Total cash funds 16.16Q ttsymt(iii Unr•strict•d funds to neare5t£ Restrlcted funds to neartstt Endowment funds to n8arest£ 82 Other monetary assets Fund asset CurreThtvabJe Cost lopyonafl 83 Investment assets Fund to bebn ¢urront valu• cost lopthonall 84 Assets r¢talnod for the harlty's own u¥0 Fund to wh*h 141￿1 tes Amountduv WTh¢n duo BS Llabllltlo8 Date ol ro¥al SKJn8d by one or hyo trustees on t4h8lf of all the trustees Signatyre Print N8me el, 0/1 19M112025 ¢CXX R2 accounts ISSI 19/11/2025, 17:18 Indepentent Examiner's report 19.11.25.bmp https://mail.google.com/mail/u/0/#inbox?projector=1 1/1