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2021-03-31-accounts

Charity Registration Number: 1153053

Company Registration Number: 08457433 (England and Wales)

HAMLIN FISTULA UK (a company limited by guarantee) UNAUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 MARCH 2021

HAMLIN FISTULA UK

CONTENTS

Page
Legal and administrative information 2
Trustees’ Report 3 to 11
Independent examiners report 12
Statement of financial activities 13
Balance sheet 14
Cash flow statement 15
Notes to the cash flow statement 16
Notes to the financial statements 17 to 27

1

HAMLIN FISTULA UK

LEGAL AND ADMINSTRATIVE INFORMATION

Directors and Trustees

Greg Morris - Chairman Sarah Hewitt-Clarkson Alison Murray Libby Grundy MBE – Appointed 31 July 2020 Beverley Cooper – Resigned 7 July 2020 Ross Spencer – Resigned 22 June 2020 Jean Hadley – Resigned 29 September 2020

Life President

Malcolm Hewitt OBE

Company Secretary Helen Marriott

Registered Office 4 Parade Buildings Nimmings Road Halesowen B62 9JJ

Charity number: 1153053

Company number: 08457433 (registered in England and Wales)

Independent Examiner

BVSC 138 Digbeth Birmingham B5 6DR

Bankers

TSB Bank plc. 23 Hagley Street Halesowen B63 3AY

Charities Aid Finance Bank Kings Hill West Mailing Kent M19 4TA

Legal Advisors

Anthony Collins Solicitors LLP 134 Edmund Street Birmingham B3 2ES

Investment managers

EFG Harris Allday 33 Great Charles Street Birmingham B3 3JN

2

HAMLIN FISTULA UK

TRUSTEES’ REPORT (INCLUDING DIRECTORS’ REPORT) YEAR ENDED 31 MARCH 2021

The trustees, who are also directors of the charity for the purposes of the Companies Act 2006, present their report and unaudited financial statements of the charity for the year ending 31 March 2021.

Trustees

The trustees, who are also the directors for the purposes of company law, and who served during the year and up to the date of signature of the unaudited financial statements were:

Greg Morris - Chairman Sarah Hewitt-Clarkson Alison Murray Libby Grundy MBE – Appointed 31 July 2020 Beverley Cooper – Resigned 7 July 2020 Ross Spencer – Resigned 22 June 2020 Jean Hadley – Resigned 29 September 2020

None of the directors has any beneficial interest in the company. All of the trustees are members of the company and guarantee to contribute £1 in the event of winding up.

Structure, governance and management

The trustees are the directors of the charitable company which is governed by the Articles of Association as amended by a Special Resolution dated 5 July 2013.The company is a company limited by guarantee and therefore does not have a share capital. The liabilities of the members, who are also the directors and trustees, together with details of their guarantees, are shown in the notes to the accounts. The company was registered with the Charity Commission for England & Wales on 24 July 2013.

The charity has a formal introduction process for new trustees. Regular financial reviews and reports are prepared for the trustees by the charity's administrative staff and presented at trustees’ meetings.

Details of the directors who served during the year are shown in the Reference and Administrative details on page 1.

Objects

The objects of the charity, as set out in the amended Articles are:

  1. To relieve the needs and advance the health of patients who have suffered from childbirth injuries in Ethiopia

  2. Such other charitable purposes in Ethiopia as the Board shall from time to time decide 3. If the continuance of such charitable work in Ethiopia becomes in the opinion of the Board impracticable, such general charitable purposes in any part of the world as the Board shall from time to time decide

3

HAMLIN FISTULA UK

TRUSTEES’ REPORT (INCLUDING DIRECTORS’ REPORT) YEAR ENDED 31 MARCH 2021

Activities

The charitable company supports Hamlin Fistula Ethiopia with cash, medical consumables or other requirements funded by means of regular donations made in tax-efficient ways by donors and income from investments held for the longer term.

In addition to Hamlin Fistula Ethiopia's headquarters hospital in Addis Ababa, Hamlin Fistula Ethiopia operates five regional fistula hospitals in Yirgalem, Bahir Dar, Mekelle, Harar and Metu. The organisation also founded and operates the Hamlin College of Midwifery to train and deploy midwives across Ethiopia, and Desta Mender – a rehabilitation centre for longer term fistula patients. As well as providing general funds used across these hospitals and centres, this charity has undertaken to cover the operating costs of the Yirgalem Regional Hospital. A combination of restricted and unrestricted funds are used to meet our commitment to fully fund Yirgalem Regional Hospital.

Hamlin Fistula UK additionally coordinates the production of colourful knitted blankets by volunteers, which are sent to Hamlin Fistula Ethiopia to be given to each patient on their arrival at a Hamlin hospital.

Principal sources of funds

Our income is derived in the main from individual donors, trusts and foundations and legacies. In addition, we received approximately £110,000 (2020 £131,000) from investment income.

We would like to thank all our donors over the past year, who have included, among others, The Band Aid Charitable Trust, Kirby Laing Foundation, The Hodge Foundation, The Big Give, EthiopiAid, Ericson Trust and the Oakdale Trust. We would also like to thank all donors who wish to remain anonymous and our generous individual donors, friends and volunteers.

Strategic report

Background

Hamlin Fistula UK, a registered UK charity, is dedicated to restoring the health and dignity of women in Ethiopia who have survived the horrendous – and preventable – childbirth injury: obstetric fistula. Obstetric fistula can be repaired with a single life changing surgery.

We exist to raise funds and awareness for Hamlin Fistula Ethiopia, to support the development and delivery of their services in Ethiopia.

Founded in 1968, we are part of the Hamlin family of international charities, which was established by pioneering Australian surgeons Drs Catherine and Reg Hamlin. Catherine and Reg were in Ethiopia to train midwives when they first discovered the overwhelming numbers of women suffering the plight of obstetric fistula and realised that little was being done to help them. They established the Addis Ababa Hamlin Fistula hospital, to provide the country’s first fistula services.

Today, Hamlin Fistula Ethiopia has expanded to include five regional hospitals, the Hamlin College of Midwives and Desta Mender, a rehabilitation centre for long-term patients. To date, Hamlin Fistula Ethiopia has treated over 60,000 women.

4

HAMLIN FISTULA UK

TRUSTEES’ REPORT (INCLUDING DIRECTORS’ REPORT) YEAR ENDED 31 MARCH 2021

Vision and mission

Our vision is to realise Dr Catherine Hamlin's dream for every Ethiopian woman to be free from devastating childbirth injuries and to gain access to quality maternal healthcare. Our mission is to support the treatment and prevention of childbirth injuries in Ethiopia.

Achievements and Performance during the year

Where we supported services

The statement of financial activities shows that we contributed £543,373 to Hamlin Fistula Ethiopia during the period. This supported medical expenses at Addis Ababa Fistula Hospital and other regional centres and the full operating costs of Yirgalem Regional Fistula Hospital in Sidama Region .

Hamlin centres are located across Ethiopia.

Taking action: UK FY 2020-21 Hamlin Fistula Ethiopia programme results.

Prevention

Hamlin is growing the number of trained midwives in Ethiopia through training students in a BSc degree in Midwifery at The Hamlin College of Midwives. In what was a challenging year, Hamlin Fistula Ethiopia was delighted to be able to congratulate the 2020 Hamlin College of Midwives graduating class of 25 newly qualified Hamlin Midwives.

Whilst there was no official graduation ceremony for students this year due to the Covid-19 pandemic, a socially distanced photo session took place to mark the moment, and the 25 new graduates returned to their home communities to begin new deployments as midwives, providing thousands of rural women with family planning services and skilled healthcare during pregnancy.

Due to the Covid-19 pandemic, the initial classes of the 2020-21 school year were conducted virtually, and tutors supported students with online learning resources and telephone support. The College re-opened in line with Government of Ethiopia guidelines in November 2020.

5

HAMLIN FISTULA UK

TRUSTEES’ REPORT (INCLUDING DIRECTORS’ REPORT) YEAR ENDED 31 MARCH 2021

Treatment

Hamlin Fistula Ethiopia’s vital work is continuing at this challenging time of pandemic. Hamlin Fistula Ethiopia is taking all necessary measures at its hospitals and centres to protect staff, patients and students using WHO guidelines. Across the year all public visits to Hamlin Fistula Ethiopia were suspended and access to Hamlin facilities was limited to essential Hamlin staff, patients and Hamlin College of Midwifery students.

Six Hamlin hospitals treated women across Ethiopia with childbirth injuries including obstetric fistula, prolapsed uterus and other obstetric and gynaecological conditions. Over the UK financial year 3,486 women were examined at hospital outpatient departments. Of these, 1,134 women underwent surgery and also received additional services including physiotherapy, stoma care, urodynamics and psychiatric counselling.

Hamlin surgeons are also refining the techniques they use to treat more complex fistulas and academic research projects are an important contribution towards achieving this. In 2020, Hamlin's medical specialists participated in three research projects.

The Addis Ababa Fistula Hospital remains a world recognised training facility for fistula surgeons. Hospital teams regularly train visiting doctors and nurses and empower surgeons with advanced skills as part of the International Federation of Gynaecology and Obstetrics (FIGO) Fistula Training Initiative. In the UK financial year 2020-21, due to the Covid-19 outbreak, no in-person training for international health professionals took place, however some training is now taking place virtually.

Rehabilitation

Hamlin Fistula Ethiopia provides physical therapy and livelihoods training to women following surgery, restoring their self-esteem and capacity to generate their own income after returning home to their communities. In UK financial year 2020-21, Hamlin provided short term rehabilitative education and training to 496 women and supported 41 women to return to their homes following specialised counselling. The rehabilitation centre at Desta Mender (meaning 'Joy Village') has continued to give women with more complex fistula injuries a place to heal with physiotherapy and counselling and to grow with education and training.

6

HAMLIN FISTULA UK

TRUSTEES’ REPORT (INCLUDING DIRECTORS’ REPORT) YEAR ENDED 31 MARCH 2021

Snapshot of Hamlin Fistula Ethiopia's overall treatment programme results during UK financial year 2020-21

April 2020- March 2021 Programme Activities Results
Prevention
Newly qualified midwives deployed to rural health centres 25
Treatment
Number of women examined 3,486
Fistula surgeries 375
Fistula-related surgeries 108
Minor surgical procedures–bilateral tubal litigation and cytoscopy 209
Pelvic Organ Prolapse surgery 421
Caesarean section surgeries for past fistula patients 21
Rehabilitation
Women receiving short term rehabilitative education and training 496
Women re-integrated to communities after surgery 41

Other programme highlights

Coping with Covid-19

Like the rest of the world, Ethiopia is being impacted by the Covid-19 pandemic, and this affected activities across the year. From April to August, a five-month state of emergency and partial lockdown was declared. Immediately after the first confirmed case of Covid-19 in Ethiopia in March, the Government of Ethiopia took several public health measures to prevent increased levels of infection.

In order to protect both our patients and staff, robust infection, prevention and control procedures were put in place at all Hamlin Fistula Hospitals including Yirgalem, and these are under constant review in light of the latest national and international (WHO) guidelines.

A pause in Hamlin’s outreach patient identification programme (detailed below), coupled with a reduction of availability of public transport and fears among patients about coming to hospital resulted in a reduced number of women coming forward for services at regional hospitals in the first three quarters of the year.

However, daily life has since begun to resume a “new normal”. After a hibernation of services at regional hospitals from June – August (during which time the lower number of patients received at the hospitals were triaged and then either provided with outpatient services or transferred to Addis Ababa Fistula Hospital), their activities resumed fully from September 2020.

7

HAMLIN FISTULA UK

TRUSTEES’ REPORT (INCLUDING DIRECTORS’ REPORT) YEAR ENDED 31 MARCH 2021

Patient Identification programme

Patient Identification activity to date

In Spring 2020 Hamlin launched a new patient identification programme which has identified districts across Ethiopia where women are likely living with untreated fistula injuries – in remote areas where access to the health care is limited and roads are restricted. Hamlin-trained local health workers will travel to these areas to find vulnerable women in need of treatment through door-to-door outreach. The first phase of the programme in February and March 2020 identified 24 women who were subsequently brought to Hamlin for life changing surgery during Spring 2020.

Following the outbreak of the Covid-19 pandemic, outreach paused for some time in 2020 and patient numbers at centres decreased for a period over the spring and summer due to travel restrictions and community fears about attending hospital. This highlights more than ever the importance of the patient identification programme. Outreach activities resumed in early 2021 and we are working hard to encourage women to come forward for services through radio promotion.

Fistula surgery during times of pandemic: Jallene’s story

Jallene is from a remote village in Western Ethiopia and supports her family of five children through subsistence farming. During her sixth pregnancy, Jallene sadly lost her baby; however her seventh pregnancy would result in even more tragedy. Unlike her previous pregnancies, Jallene experienced a prolonged and obstructed labour.

Jallene tried to deliver at home, but sadly after two days of pain, she was taken to a nearby government clinic where she eventually delivered a stillborn child. In addition to the anguish of losing a child, Jallene suffered a devastating fistula injury.

Jallene’s social support systems crumbled in the wake of her fistula injury. “After this injury, my husband abandoned me and I struggled to feed my children by myself,’’ she told us. For 10 years, Jallene needlessly endured the agony of obstetric fistula without any medical attention. However, in Spring 2020 Jallene was identified by an outreach worker as part of Hamlin’s Patient Identification Programme and she was brought to the Addis Ababa Fistula Hospital for treatment. Jallene had fistula surgery in May 2020 and Hamlin’s rehabilitation team believe there to be a good chance that she will be fully cured. “I have no words to explain my gratitude for everybody at the hospital. They have worked so hard with the current pandemic and gave me such motherly care” Jallene. Future plans

Future plans

The charitable company will continue to support Hamlin Fistula Ethiopia and carry on the legacy of Dr Catherine Hamlin. The level of support will depend upon the hospital's requirements which are set out in their annual budget.

If considered necessary, we may decide to realise some of the investment portfolio.

8

HAMLIN FISTULA UK

TRUSTEES’ REPORT (INCLUDING DIRECTORS’ REPORT)

YEAR ENDED 31 MARCH 2021

Reserves policy

Unrestricted funds

It is the policy of the trustees to hold significant funds in the form of listed investments and bank deposits held by the Investment Managers. At 31 March 2021, the charity held investments with a market value of £2,834,519 (2020: £2,135,558) and bank deposits held by the Investment Managers for re-investment pirposes of £40,360 (2020: £141,710).This level of investment fund is considered necessary in order to generate investment income to contribute to the ongoing operations of the charity.

In addition to general unrestricted funds held in the form of investments, it is the policy of the trustees to hold a buffer of funds to enable the charity to operate in the event of a decrease in incoming resources. A buffer of £110,000 which is equivalent to approximately three months expenditure would enable activities to continue whilst consideration was given to replacing income or changing activities. At 31 March 2021, general undesignated unrestricted funds, excluding those held in listed investments and bank deposits held by the Investment Managers, for re-investment purposes amounted to £166,421 (2020: £341,348). However, bank deposits for re-investment purposes by the Investment Managers of £40,360 were available on demand if necessary (2020: £141,360).

Designated Reserve

On 6 February 2019, the trustees agreed that two thirds of net assets, which at 31 March 2018 amounted to £2,000,000, should be designated solely for the use of the outreach hospital at Yirgalem. On 26 February 2021 trustees agreed that the designated fund was no longer required and agreed to undesignated it.

Revaluation Reserve

The difference between the historic cost of investments and their revalued amount, if positive, is included in the balance sheet as a Revaluation Reserve.

Investment policies and objectives

Investments are held with a view to producing income and as a protection against inflation in view of the long-term commitment of support for the Yirgalem outreach hospital and other projects.

The charity's investment powers are prescribed by The Trustee Act 2000. The trustees confirm that the investments, the majority of which are held in the UK, are held in accordance with their powers.

Public benefit

Under the Charities Act 2011, charities must demonstrate that their purposes are for the public benefit. The trustees confirm that they have taken regard of the Charity Commission's guidance on public benefit. Key features of public benefit included an identifiable benefit, to the public or a section of the public and people on low incomes must be able to benefit.

The charity supports the work of Hamlin Fistula Ethiopia which provides free treatment to women suffering from childbirth injuries, irrespective of race, background or religion. The trustees have therefore concluded that Hamlin Fistula UK meets the key principles as described above.

9

HAMLIN FISTULA UK

TRUSTEES’ REPORT (INCLUDING DIRECTORS’ REPORT) YEAR ENDED 31 MARCH 2021

Risk management

The trustees regularly review risks in order to mitigate any major risks to which the charity may be exposed and to design systems accordingly. Throughout the year, the world has been exposed to the effects of the Covid-19 pandemic. The effects of this pandemic during this period have included, inter alia:

After an initial sharp decline at the beginning of the year investment portfolio valuations have now recovered. Trustees and staff continue to monitor valuations regularly and work closely with the charity’s investment management company to manage risk.

Trustee meetings have been held using Zoom or other electronic means.

During the brief period of hospital ward closures at regional hospitals in Summer 2020, patients were transferred to Addis Ababa Fistula Hospital for treatment.

To address the decrease in donations from individuals, and to maintain and continue to grow our funding of Hamlin Fistula Ethiopia in the future, we have taken a range of measures including continuing to seek grants from charitable trusts and foundations, carrying out regular appeals to existing donors and takings steps to recruit additional regular donors via digital channels.

Donated services

In addition to financial donations we receive contributions from supporters in the form of knitted blankets and baby clothes which are sent to Ethiopia for distribution to patients across Hamlin hospitals. These gifts are donated freely. We have not put a financial value to these gifts in these financial accounts.

Results

The financial statements have been prepared in accordance with the Statement of Recommended Practice "Accounting and Reporting by Charities" which was published in 2015 ("SORP 2015") and Financial Reporting Standard FRS 102.

10

HAMLIN FISTULA UK TRUSTEES, REPORT {INCLUDING DIRECTORS, REPORT) YEAR ENDED 31 MARCH 2021 Slatemont of Tnths rnspon8lbllrtl•6 The trustees I￿9 are also the directors for ihe puwes of compory law) are responsible for preparing the Report of the Tnjslees and the fInar￿la1 statements in acts)rtlance with ap￿1¢ble law and United Kingdom Genèrally Accepte(i Aco)unting PT8clice. Company law requires the Irusle8s to prepare financiol statements for each financial year whith gfve 8 true and fair Mew of the state of affai￿ of the charitable company and of the incoming resource5 an(J 8pplulion of resources. induding the income 8nd èxpendlture. of the ch8rll8ble oompony for that penod. In prewlng those financial ststements. thg trustees are requir&J to select surtable accounting policies •rKI than apply them consislenlty: observe the methods and W1￿[A8$ in the Charity SORP.. make judgements and estimates th8t we reasonoble prudent: state Ythelher applicable UK Accwnting StarKlaTds have been fdlovRd, subiect to any material departures disdosed ar￿ eX￿ained in Ihe fina￿181 sl8tements: prepsre the fin8nci•l statemthits on tho goir¥J concem basts unloss il is inappropnate lo presume that the ¢h8ritatAe ccrfnpary ill con11n￿ in bu5intss. Thè truslogs •ro responsi￿ for keeping proper accounling reconls disclose reasonable accuracy at any time the finanaal position of the charitable company and lo enable them to ensure Ihat the finanual slalements compty with the Compan18$ Ad 2006. They are o1$0 responslble for safeguarting the assets of the charitable company and hence for laklng reasonable Steps for tho p￿Vents.1)n and dgtodion of fra￿j arbd other irwularibès. Approval The T￿￿1988 R8Wrt Was 8pproved by Ihe Board ol Twstees and signed on its behalf by.. Trustee Dated: li

HAMLIN FISTULA UK

INDEPENDENT EXAMINERS REPORT

TO THE TRUSTEES OF HAMLIN FISTULA UK

I report to the trustees on my examination of the financial statements of Hamlin Fistula UK for the year ending 31 March 2021.

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 an independent examination. I report in respect of the examination of the charity’s financial statements carried out under section 144 of the Charities Act 2011 (the 2011 Act). In carrying out my examination I have followed all the applicable Directions given by the Charity Commission under section 145(5)(b) of the 2011Act.

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 that in any material respect:

  1. accounting records were not kept in respect of the charity as required by section 386 of the 2006 Act; or

  2. the financial statements do not accord with those records; or

  3. the financial statements 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 financial statements 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 financial statements to be reached.

Paul Bowater ACA Birmingham Voluntary Service Council 138 Digbeth Birmingham B5 6DR

Dated: 13 July 2021

12

HAMLIN FISTULA UK

STATEMENT OF FINANCIAL ACTIVITIES (INCLUDING INCOME AND EXPENDITURE ACCOUNT) YEAR ENDED 31 MARCH 2021

Note
Income from;
Donations and legacies
3
Charitable activities
4
Investments
5
Total income
Expenditure on;
Charitable activities
6
Raising funds
7
Total resources
expended
Net gains/(losses) on
investments
Net expenditure for the
year/Net movement in
funds
Opening fund balances
Transfer between funds
Closing fund balances		 Unrestricted
funds
2021
£
221,877
215
109,883
331,975
458,873
39,097
497,970
588,679
422,684
2,618,616
-
3,041,300		 Restricted
funds
2021
£
84,500
-
-
84,500
84,500
-
84,500
-
-
-
-
-		 Total
2021
£
306,377
215
109,883
416,475
543,373
39,097
582,470
588,679
422,684
2,618,616
-
3,041,300		 Total
2020
£
499,183
428
131,198
630,809
398,113
34,574
432,687
(554,509)
(356,387)
2,975,003
-
2,618,616

The statement of financial activities also complies with the requirements for an income and expenditure account under the Companies Act 2006.

13

HAMLIN FISTULA UK BALANCE SHEET AS AT 31 MARCH 2021 Nol• 2021 2020 Fix•d ass•ts Investments 10 2 874 879 2,277.268 Curront a•••ts Debtors Cash at b8r and in hand 12 15.328 161.009 314.005 176.337 348.887 Cr•dltovs: amounts falllng du• wlth on• yoar 13 (9.9161 17.$39) N•t curr•nt a•s•ts Tot•1 u••t• l•u curr•nt Il•bllltl 3 041300 2 618 616 In¢om• lundi Restn"cted funds Unrestricted fund$ 14 3.041.300 2,618,616 3,041.300 2.618616 For the year ending 31 March 2021 the company was ertiued to exempticffi from 8udil under section 477 of the Companies Act 2(X)6 relating lo sm811 companies. No rneMbe￿ have required the company lo obtain an autjtt of the financb81 $18lemenls for the year ending 31 March 2021 in accordance with secllon 476 of the Compantes Act 2006. The tnJ8lees novAedge Ihdr resp(Thbliti"es for c¢Xn￿lng of the Act vAth respect lo aCc￿n11Th9 records 8nd the preparailon of ffinarrial ststemeftts. These flnand81 slalemenls have been preparnd in accordart8 Twilh th8 provisNJns applicable lo companies sublect to1he small companies regNne. The fin8nclal stslemenls were approved ty Ihe Board of Trustees on signed on behalf of the board by: and C•4 Trustse 14

HAMLIN FISTULA UK

CASH FLOW STATEMENT YEAR ENDED 31 MARCH 2020

Note
Cash flow from operating activities
Net cash provided by (used in) operating
activities
1
Cash flow from investing activities
Dividends and interest from investments
Purchase of investments
Proceeds from sale of investments
Net cash provided by (used in) investing
activities
Change in cash and cash equivalents during
the year
Cash and cash equivalents at start of year
2
Cash and cash equivalents at end of year
2		 2021
£
(253,947)
109,883
(1,177,107)
1,168,175
100,951
(152,996)
314,005
161,009		 2020
£
(85,589)
131,198
(1,485,017)
1,635,017
281,198
195,609
118,396
314,005

15

HAMLIN FISTULA UK

NOTES TO THE CASHFLOW STATEMENT YEAR ENDED 31 MARCH 2021

1. Reconciliation of net income/(expenditure) to net cash flow from operating activities

Net income/(expenditure) for the year
Adjustments for:
(Gains)/losses on investments

Dividends and interest on investments

(Increase)/Decrease in debtors
Increase/(Decrease) in creditors
Net cash provided by (used in) operating
activities
2. Analysis of cash and cash equivalents
Cash at bank and in hand
Total cash and cash equivalents
2021
£
422,684
(588,679)
(109,883)
19,554
2,377
(253,947)
2021
£
161,009
161,009		 2020
£
(356,387)
554,509
(131,198)
(10,921)
(141,592)
(85,589)
2020
£
314,005
314,005

16

HAMLIN FISTULA UK

NOTES TO THE FINANCIAL STATEMENTS YEAR ENDED 31 MARCH 2021

1. Accounting Policies

Accounting convention

The accounts have been prepared in accordance with the Companies Act 2006 and “Accounting and Reporting by Charities: Statement of Recommended Practice (SORP) applicable in the UK and Republic of Ireland (FRS 102)” (as amended for accounting periods commencing from 1 January 2016). The charity is a “Public Benefit Entity as defined by FRS 102.

The financial statements are prepared in sterling, which is the functional currency of the charity.

The financial statements have been prepared under the historical cost convention. The principal accounting policies adopted are set out below.

Going concern

At the time of approving the financial statements, the trustees have a reasonable expectation that the charity has adequate resources to continue in operational existence for the foreseeable future. Thus the trustees continue to adopt the going concern basis if accounting in preparing the financial statements.

Charitable funds

Unrestricted funds are available for use at the discretion of the trustees in furtherance of their charitable objectives unless the funds have been designated for other purposes.

Restricted funds are subject to specific conditions by donors as to how they may be used. The purposes and uses of the restricted funds are set out in the notes to the financial statements.

Incoming resources

These are included in the Statement of Financial Activities (SOFA) when:

Income from donations and legacies is included when receivable, except as follows:

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HAMLIN FISTULA UK

NOTES TO THE FINANCIAL STATEMENTS YEAR ENDED 31 MARCH 2021

1. Accounting Policies (continued)

Investment income is accounted for when receivable.

Resources expended

Charitable activities includes all costs relating to the conference, newsletters and general administration, which support the charitable purpose.

Grants offered subject to conditions, which have not been met at the year-end date are noted as a commitment, but not accrued as expenditure.

Expenditure is accounted for on an accruals basis and has been classified under headings that aggregate all costs related to the category. Where costs cannot be directly attributed to particular headings that have been allocated to activities on a basis consistent with the use of the resources.

Incoming resources with related expenditure

When incoming resources have related expenditure (as with fundraising or contract income) both are reported gross in the SOFA.

Investments

Investments are stated at fair value measured by reference to closing market prices. Any gain or loss on revaluation is taken to the Statement of Financial Activities..

Cash and cash equivalents

Cash and cash equivalents include cash in hand, deposits held at call with bankers, other short term liquid investments with original maturities of three months or less, and bank overdrafts. Bank overdrafts are shown within borrowings in current liabilities. Cash held by the investment Mangers for re-investment purposes are included in long term investments.

Financial instruments

The charity has elected to apply the provisions of Section 11 “Basic Financial Instruments” and Section 12 “Other Financial Issues” of FRS 102 to all of its financial instruments.

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HAMLIN FISTULA UK

NOTES TO THE FINANCIAL STATEMENTS YEAR ENDED 31 MARCH 2021

1. Accounting Policies (continued)

Financial instruments are recognised in the charity’s balance sheet when the charity becomes party to the contractual provisions of the instrument.

Financial assets and liabilities are offset, with the net amounts presented in the financial statements, when there is a legally enforceable right to set off the recognised amounts and there is an intention to settle on a net basis or to realise the assets and settle the liability simultaneously.

Basic financial assets

Basic financial assets, which include debtors and cash and bank balances, are initially measured at transaction price, including transaction costs and are subsequently carried at amortised cost using the effective interest method unless the arrangement constitutes a financing transaction, where the transaction is measured at the present value of the future receipts discounted at a market value of interest. Financial assets classified as receivable within one year are not amortised.

Basic financial liabilities

Basic financial liabilities, including creditors and bank loans are initially recognised at transaction price unless the arrangement constitutes a financing transaction, where the debt instrument is measured at the present value of the future payments discounted at a market rate of interest. Financial liabilities classified as payable within one year are not amortised.

De-recognition of financial liabilities

Financial liabilities are derecognised when the charity’s contractual obligations expire or are discharged or cancelled.

Pensions

The charity operates a defined contribution pension scheme and the pension charge represents the amounts payable by the charity to the fund for the year.

Hire purchase and leasing commitments

Rentals paid under operating income are charged to the Statement of Financial Activities on a straight line basis over the period of the lease.

Taxation

The charity is exempt from Corporation Tax as all its income is charitable and applied for charitable purpose.

The charity is not registered for Value Added Tax. Expenditure therefore includes nonrecoverable VAT where applicable.

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HAMLIN FISTULA UK

NOTES TO THE FINANCIAL STATEMENTS YEAR ENDED 31 MARCH 2021

2. Critical accounting estimates and judgements

In the application of the charity’s accounting policies, the trustees are required to make judgements, estimates and assumptions about the carrying amount of assets and liabilities that are not readily apparent from other sources. The estimates and associated assumptions are based on historical experience and other factors that are considered to be relevant. Actual results may differ from these estimates. The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised where the revision affects only that period, or in the period of the revision and future periods where the revision affects both current and future periods.

3. Donations and legacies

Donations
Legacies
Total for the year
Analysis by fund
Unrestricted funds
Restricted funds		 Unrestricted
Funds
2021
£
207,307
14,570
221,877		 Restricted
funds
2021
£
66,000

18,500
84,500


 Total
2021
£
273,307
33,070
306,377
221,877
84,500
306,377		 Total
2020
£
442,798
56,385
499,183
292,183
157,000
499,183

4. Income from charitable activities

Book sales
Total for the year
Analysis by fund
Unrestricted funds
Restricted funds		 2021
£
215
215
215
-
215		 2020
£
428
428
428
-
428

20

HAMLIN FISTULA UK

NOTES TO THE FINANCIAL STATEMENTS YEAR ENDED 31 MARCH 2021

5. Investment income

Income from UK listed investments
Income from overseas investments
Bank and other interest
Total for the year
Analysis by fund
Unrestricted funds
Restricted funds		 2021
£
106,202
3,125
556
109,883
109,883
-
109,883		 2020
£
89,708
37,127
4,363
131,198
131,198
-
131,198

6. Expenditure on charitable activities

Hamlin Fistula
Ethiopia
Hamlin Fistula
Ethiopia -
Restricted
Other centres		 Direct
costs
£
406,582
84,500
-
491,082		 Support
costs
£
48,794
-
-
48,794		 Governance
costs
£
3,497
-
-
3,497		 2021
Total
£
458,873
84,500
-
543,373		 Total
2020
£
218,053
157,000
23,060
398,113

21

HAMLIN FISTULA UK

NOTES TO THE FINANCIAL STATEMENTS YEAR ENDED 31 MARCH 2021

6. Expenditure on charitable activities (continued)

Support costs
Occupation costs
General office
Staff costs
Staff training
Staff recruitment
Travel expenses
Capital expenditure
written off
Governance costs
Independent examination
Trustee indemnity
insurance
AGM expenses
7. Expenditure on raising funds
Fund raising costs
Fundraising consultant		 2021
£
5,192
11,170
31,289
60
1,024
59
-
48,794
2,730
767
-
3,497
2021
£
4,711
34,386
39,097		 2020
£
4,695
10,922
28,557
-
-
9,182
1,512
54,868
3,750
767
143
4,660
2020
£
4,850
29,724
34,574

8. Trustees

Remuneration

None of the trustees (or any persons connected with them) received any remuneration from the charity during the year (2020 - £nil).

Expenses

During the year the total expenses incurred by four trustees amounted to £Nil (2020: £4,407). This principally represents travel and subsistence costs incurred in the management of the charity's affairs, including travel to Ethiopia. Travel to Ethiopia and other face to face meetings could not take place this year due to Covid-19 restrictions.

22

HAMLIN FISTULA UK

NOTES TO THE FINANCIAL STATEMENTS YEAR ENDED 31 MARCH 2021

9. Employees

Wages and salaries
Social security costs
Other pensions costs		 2021
£
27,898
-
3,391
31,289		 2020
£
26,057
-
2,500
28,557

The average number of employees during the year was1. (2020 – 1). No employee received emoluments in excess of £60,000. There is a volume of willing volunteers, throughout the UK, who raise funds for the charity by organising various events, such as coffee mornings. It Is not possible to estimate their total numbers.

10. Investments

At fair value
UK listed investments
Overseas investments
Cash held by Investment Managers
Total
Movement in the fair value
of investments
Fair value at 1 April
Proceeds of disposal

Acquisitions
(Decrease)/increase in investment bank
balances
Net gains/(losses) on revaluation at 31
March
Fair value at 31 March
Realised/unrealised
gains/(losses)
Realised
Unrealised		 2021
£
2,226,076
608,443
2,834,519
40,360
2,874,879
2021
£
2,277,268
(1,168,175)

1,278,457
(101,350)
588,679
2,874,879
2021
£
98,445
490,234
588,679


2020
£
1,637,895
497,633
2,135,558
141,710
2,277,268
2020
£
2,981,778
(1,635,017)
1,343,384
141,632
(554,509)
2,277,268
2020
£
(33,213)
(521,296)
(554,509)

23

HAMLIN FISTULA UK

NOTES TO THE FINANCIAL STATEMENTS YEAR ENDED 31 MARCH 2021

10. Investments (continued)

Historical cost at 31 March

Investments representing 5%
or more of the total value
Sequoia Economic Infrastructure Income
BB Healthcare
Primary Health Properties
Tritax Big Box REIT
SDCL Energy Efficiency Inc Trust
BBGI Global Infrastructure SA
GCP Infrastructure Inv Ltd
RTW Joint Venture Fund
Augmentum Fintech PLC
Ruffer Inv Co Ltd
11. Financial instruments
Carrying amount of financial assets
Financial — assets at fair value through net income
I expenditure
-
Fixed asset investments
Carrying value of financial liabilities
Measured on amortised costs
-
Accruals
12. Debtors
Amounts falling due within one year
Trade debtors
Income tax recoverable under Gift Aid
Prepayments and accrued income		 2021
2020
£
£
2,537,292
2,909,510
2021
2020
£
£
-
141,805
236,875
153,750
266,760
128,480
269,250
129,030
168,000
-
171,400
-
205,800
-
212,568
-
159,000
-
289,000
-
2021
£
2020
£
2,950,370
2,538,807
2,520
6,911
2021
£
2020
£
-
9,866
13,151
15,407
2,177
9,609
15,328
34,882		 2021
2020
£
£
2,537,292
2,909,510
2021
2020
£
£
-
141,805
236,875
153,750
266,760
128,480
269,250
129,030
168,000
-
171,400
-
205,800
-
212,568
-
159,000
-
289,000
-
2021
£
2020
£
2,950,370
2,538,807
2,520
6,911
2021
£
2020
£
-
9,866
13,151
15,407
2,177
9,609
15,328
34,882
2020
£
141,805
153,750
128,480
129,030
-
-
-
-
-
-
2020
£
2,538,807
6,911
2020
£
9,866
15,407
9,609
34,882

24

HAMLIN FISTULA UK

NOTES TO THE FINANCIAL STATEMENTS YEAR ENDED 31 MARCH 2021

13. Creditors: amounts falling due within one year

Trade creditors
Social security and other taxes
Pensions
Other creditors
Accruals and deferred income		 2021
£
3,705
1,489
198
2,004
2,520
9,916		 2020
£
-
628
-
-
6,911
7,539

14. Restricted funds

The income funds of the charity include restricted funds comprising the following unexpended balances of donations and grants held on trust for specific purposes:

Current year
Donations re Yigalem
Hospital
Legacies re Addis Ababa
Fistula Hospital
Previous year
Repatriation fund
Donations received re
Yigalem Hospital
Donation received re Desta
Menda Centre		 Balance
at 1
April
2020
£
-
-
-
Balance
at 1
April
2020
£
29,080
-
-
29,080		 Movement
in funds
Incoming
resources
£
66,000
18,500
84,500
Movement
in funds
Incoming
resources
£
-
156,000
1,000
157,000		 Resources
expended
£
(66,000)
(18,500)
(84,500)
Resources
expended
£
-
(156,000)
(1,000)
(157,000)		 Transfer
to
general
funds
£
-
-
-
Transfer
to
general
funds
£
(29,080)
-
-
(29,080)		 Balance
at 31
March
2021
£
-
-
-
Balance
at 31
March
2021
£
-
-
-
-

25

HAMLIN FISTULA UK

NOTES TO THE FINANCIAL STATEMENTS YEAR ENDED 31 MARCH 2021

15. Analysis of net assets between funds

Investments
Current assets
Current liabilities
Investments
Current assets
Current liabilities		 Unrestricted
Funds
2021
£
2,950,370
100,846
(9,916)
3,041,300
Unrestricted
Funds
2020
£
2,838,807
87,348
(7,539)
2,618,616		 Restricted
funds
2021
£
-

-
-
-

Restricted
funds
2020
£
-

-
-
-
 Total
2021
£
2,950,370
100,846
(9,916)
3,041,300
Total
2020
£
2,838,807
87,348
(7,539)
2,618,616

16. Related party transactions

Malcolm Hewitt OBE, our Life President and a former Chairman of Trustees, is a director of Hamlin Fistula Ethiopia (Australia) Limited, operating as Catherine Hamlin Fistula Foundation a charitable company registered in Australia. Transactions with this charity during the year amounted to £227.36 (2020 – Nil).

There were donations from Trustees or related parties during the year amounted to £110 (2020 – Nil).

The Trustees are not aware of any material transaction, contract or other arrangement with any connected person other than that disclosed above.

17. Operating lease commitments

Payments due
Within one year
Between one and five years
Total amounts due to break
point		 Land and
buildings
2021
£
4,500
15,750
20,250		 Other
2021
£
1,856
-
1,856		 Land and
buildings
2020
£
4,500
15,750
20,250		 Other
2020
£
1,856
1,856
3,712

26

HAMLIN FISTULA UK

NOTES TO THE FINANCIAL STATEMENTS YEAR ENDED 31 MARCH 2021

18. Company status and controlling party

The company is limited by guarantee. As such there is no share capital. Under the terms of the Articles of Association, each Trustee who is also a Director, is a member of the company.

Every company member has promised, that if the company is wound up whilst they are a company member or within one year of ceasing to be a Director, to contribute a maximum of £1 towards winding up the company.

At the balance sheet date there were four company members so the amount subject to guarantee was £4.

Each member’s vote ranks pari- passu and there is no controlling party or person of significant interest.

27