**Company number:** 09542896 **Charity number:** 1162031 ## **OPERATION FISTULA (UK) ANNUAL REPORT & FINANCIAL STATEMENTS** For the year ended 31 December 2020 ## **Operation Fistula (UK)** ## **Contents** For the year ended 31 December 2020 ||Page:| |---|---| |Reference & Administrative Information|2| |Trustees’ Annual Report|3-12| |Independent Auditor’s Report|13-16| |Statement of Financial Activities (incorporating an income and expenditure|17| |account)|| |Balance Sheet|18| |Statement of Cash Flows|19| |Notes to the Financial Statements|20-27| Page 1 of 27 ## **Operation Fistula (UK) Reference & Administrative Information** For the year ended 31 December 2020 **Company number** 09542896 **Charity number** 1162031 **Registered office** Shakespeare House 168 Lavender Hill London SW11 5TG **Trustees** Trustees, who are also directors under company law, who served during the year and up to the date of this report were as follows: Nicholas David Jenkins Carl Manlan (Resigned on 15[th] July 2021) Dr Martina Lukong Baye Dr Jerker Liljestrand (Appointed on 15[th] July 2021) **Key management Personnel** Seth Cochran, Founder & CEO **Bankers** CAF Bank 25 Kings Hill Ave Kings Hill West Malling ME19 4JQ **Auditors** Sophie Wheeler Accountants Ltd Rose Cottage High Street Rhosneigr LL64 5YJ Page 2 of 27 ## **Operation Fistula (UK) Trustees’ Annual Report** For the year ended 31 December 2020 The trustees present their report and the financial statements for the year ended 31 December 2020. Reference and administrative information set out on page 2 forms part of this report. The financial statements comply with current statutory requirements, the memorandum and articles of association, and the Statement of Recommended Practice - Accounting and Reporting by Charities: SORP applicable to charities preparing their accounts in accordance with FRS 102. ## **Objectives and Activities** The objectives of the charity are for the public benefit: the advancement of health and in particular, without limitation, the funding of treatment and care for women suffering with obstetric fistula; and the advancement of education in particular, without limitation, in the subject of obstetric fistula. Obstetric fistula is a childbirth injury that results from obstructed labour. This terrible condition affects one million women in Africa and South Asia, and persists because women have no access to safe and timely emergency obstetric care. Operation Fistula’s mission is to end fistula for every woman, everywhere. We exist to create a fistula free world. The main activities undertaken in relation to those purposes, are: **We are working to end fistula across specific geographical locations.** As part of our work to end fistula for every woman, everywhere, we have spearheaded a large project in Madagascar, where we are aiming to eradicate obstetric fistula from 50 communes, in 10 districts, across two regions of the country. This means finding the patients who are most difficult to reach. Our work seeks to design a replicable and scalable delivery model that finds every woman living with fistula, and works to meet their needs. We call this programme FREE – Fistula Repair for Everyone Everywhere. **We have harnessed the power of technology and analytics to trigger collaboration** . Fistula organisations often work in silos, with best practices rarely being shared. Needless duplication, wasted resources, and gaps in coverage, result. To address this challenge Operation Fistula created GOFAR – the Global Obstetric Fistula Automated Registry. GOFAR is a data collection, analysis, and visualisation system that empowers providers working on the ground to monitor, track, and evaluate their efforts. This platform provides a shared measurement system and has the power to improve coordination, collaboration, and quality across our sector. This programme of work is known as ‘GOFAR together ’and aims to both support individual users in their data collection efforts, and strengthen health systems and NGO organisations working to end fistula, by providing them with a shared measurement system. **We empower local service providers with transformative funding.** Our funding model enables on-the-ground providers, who are historically beyond the reach of traditional funding models, to access the funding they need to deliver treatment to women needlessly suffering Page 3 of 27 ## **Operation Fistula (UK) Trustees’ Annual Report** For the year ended 31 December 2020 with fistula. This funding is performance-based, and conditional on data collection and input into GOFAR. It is focused on helping treatment providers serve the patients who are most easy to reach. The data we collect in the process enables us to verify the quality of that care, and monitor and track performance. At Operation Fistula, we call this programme of work ‘Kickstart, ’because this funding is the catalyst for quality treatment and patient care. **We identify and map the system failures and gender inequality that causes fistula.** We do this using data we have collected, and data from partners. We then work with volunteers to visualise this data using Tableau data visualisation software. This visualised data empowers the global community with insights for impact - providing organisations with data advocacy tools, and revealing areas of extreme gender inequality and injustice. This data can then drive cross-partner collaboration and enable more targeted interventions in the work to achieve SDG 5. The goal of this programme is to visualise gender equality, and we call it ‘Viz5.’ ## **Achievements and Performance** 2020 was a transformative year for Operation Fistula. Globally, the year was marked by significant volatility and deep challenges. The COVID-19 pandemic shifted the fundamental mechanics of how work is done and organisations function. It also magnified existing global inequities, with the most extreme impact being felt by the world’s most vulnerable. “ _In humanitarian and fragile settings and low-income countries, where these systems are already weak, the pandemic is disrupting access to lifesaving sexual and reproductive health services. It is also compounding existing gender and social_ - _inequalities.” (_ Impact of the COVID 19 Pandemic on Family Planning and Ending Gender-based Violence, Female Genital Mutilation and Child Marriage, UNFPA, Interim Technical Note Information as of 27 April 2020.) Fistula patients exist in a state of extreme need and suffer hugely as a result of their injury. The pandemic has intensified their suffering in diverse ways. Surgeries were put on hold because health facilities were turned into COVID units. Surgeons were expected to pause their activities to support the pandemic response. Supply chains broke down, roads were closed, public transport restricted, national and international flights halted. In short, the barriers to care that had long existed in the pre-pandemic reality were immeasurably worse in 2020. Despite these significant hurdles, Operation Fistula’s work thrived. In ways both large and small, we built a more solid foundation for carrying out our mission in a consistent, strategic, and responsive manner, while diligently protecting the safety of our patients and staff. ## **2020: SUMMARY OF PERFORMANCE** The start of 2020 was filled with energy and excitement, not only for the new decade, but for a year in which Operation Fistula was poised to fully scale its work in Madagascar. Our Grand Challenges Canada ‘Transition to Scale ’grant, secured in June 2019, set the stage for significant growth. Page 4 of 27 ## **Operation Fistula (UK) Trustees’ Annual Report** For the year ended 31 December 2020 At the close of 2019, Operation Fistula had established a full-time office in Madagascar. We had secured a convention with the Malagasy Ministry of Health, obtained an Accord de Siège (work permit) from the government, and recruited a talented local team - in both the capital and our two target regions - to implement the work. Our plans at the dawn of 2020 were focused on deep and sustained community outreach, and enabling a significantly larger number of women to access fistula repair and social support through our FREE program. At the time, we had no idea just how significantly our plans for 2020 would have to adapt to meet the diverse challenges of the COVID-19 pandemic. Over a period of weeks, our whole operational model had to shift. The lives of our staff changed over-night. The London office moved to complete remote working, and our team in Madagascar faced the reality of having to navigate remote working for the first time. In spite of this, however, both the UK and Madagascar teams adapted quickly to the new circumstances. In fact, the realities of remote work, combined with the UK team having no way to conduct in-person management in Madagascar, meant that the whole organisation had to get better at communicating. We quickly set up daily calls across the two teams, and established additional standing meetings for the management teams to connect on strategy. The result was the opportunity to move from “quick-fix” solutions to deeply considered, consistent actions and policies that improved our ability to react to difficult situations. This is a key development in our transition to scale. We now have robust systems in place for internal communication, personnel and project management, follow up, and review, which can both withstand complex circumstances and exist in an entirely online, virtual environment. There’s no doubt that COVID-19 limited our ability to reach the number of communities and women that we had hoped to help in 2020. There was just no safe way to conduct the deep and sustained in-person outreach we had planned during some parts of the year. But, every member of our team rallied together to drive as much impact and progress as was possible. We ended up accelerating in many areas, far more than we ever planned. We are proud of the work we delivered in 2020, and more than ever, are now poised to deliver our mission to end fistula for every woman, everywhere. In this report, we provide a summary of Operation Fistula’s 2020 accomplishments in each of our core programmes and main activities: ## **FREE** 2020 was a pivotal year for Operation Fistula, both globally and within Madagascar, where our most significant and ambitious project, FREE, unfolded. We are most proud of the number of patients we were able to provide care for, despite a two-month period where COVID forced us to halt nearly all treatment activity. Page 5 of 27 ## **Operation Fistula (UK) Trustees’ Annual Report** For the year ended 31 December 2020 ## **We reached, diagnosed, and treated almost 7x more women than in 2019.** In 2020 Operation Fistula funded treatment for 345 women in Madagascar — nearly seven times the number of women we were able to treat in 2019. This is a huge achievement, and we are confident that our work will continue to grow to full maturity at scale in 2021. ## **We activated treatment facilities and surgeons in five districts of Madagascar, divided between our two target regions.** We developed new partnerships in Madagascar, onboarding surgeons to provide support for complex cases in both the capital and in Toamasina. Through our outreach activities, we have also activated CSBs (local health facilities which provide the first point of care at the community level) in 44 communes. ## **We laid the foundation for a national expansion of our performance-based funding across Madagascar.** In Q4 of 2020, we onboarded 12 new surgeons in Madagascar. These surgeons fall outside our two regions of focus, Vatovavy-Fitovinany (V7V) and SAVA. By supporting these surgeons and monitoring the quality of their work, we can create greater surgical capacity for our future scale-up in the country. ## **We ensured all our field staff were trained to follow clear, consistent protocols:** We built a Playbook — a formal set of protocols — to provide structure and clear written policies for carrying out the program from start to finish. Using these guidelines, in November 2020 the entire management team travelled to both V7V and SAVA to train new and existing staff on best practices and putting patient needs first. The aim of this intervention was to ensure concrete understanding of our strategy and implementation practices, and increase understanding of our work ethic. Analysis of subsequent data collection has shown a clear increase in adherence to best practices. ## **We created a model that ensures patient voices sit at the core of our work.** Health systems and professionals often define success in strictly clinical terms and seldom engage with fistula patients regarding their needs or goals for treatment. Whether a fistula is closed and/or a patient resumes continence is the most common indicator of success in fistula treatment. However, we know that for the patient, there are myriad other factors that contribute to their perception of their own outcome and experience of care. Currently there is no means of quantifying their experiences as data which can be analysed to improve interventions. To begin rectifying this, in 2020 we researched and designed a conceptual framework for a Quality of Life (QoL) tool. We interviewed a small sample of patients and analysed the results to create a framework of domains and sub-themes, which we will expand upon in 2021. Besides enabling us to become better patient advocates, this work will also give us deep insight into the myriad system failures that result in a patient developing a fistula. ## **We became the principal mapping entity in Madagascar in 2020.** The natural environment can provide significant barriers to women and girls reaching health services. It can also make it a challenge for our staff to find patients in need of care. A fistula Page 6 of 27 ## **Operation Fistula (UK) Trustees’ Annual Report** For the year ended 31 December 2020 patient is a needle in a haystack, and often we’re not even sure where the haystacks are located. For this reason, mapping is essential for our work. The communities where fistula is most prevalent are unmapped and extremely remote. Their unknown populations are rarely visited. They are virtually invisible. In 2020 we hired a team of GIS analysts to use satellite imagery, OpenStreetMaps, and, eventually, boots-on-the-ground verification to map every building, field, waterway, footpath, and mountain range in our two target regions. This gives us a deep understanding of the natural environment, the distribution of population within it, and the likely areas of fistula prevalence. As a result of the mapping team’s dedicated efforts, according to OSM’s data, Operation Fistula is now the principal mapping entity in Madagascar! In 2020, we mapped 18,123 square km, and are planning to map 27,000 more in 2021. ## **We conducted significant community engagement and patient outreach work.** Finding women with fistula requires deep outreach with remote communities that may never have heard of fistula. In 2020, we learned a huge amount about how best to reach and learn from these communities. We sent outreach teams to 46 different communes across our two target regions in Madagascar. These teams met with community leaders, held workshops and focus groups, went door-to-door looking for patients, recruited volunteers, and learned about local childbirth practices from traditional birth attendants. These various sessions, meetings, and activities reached more than 50,000 members of the communities we engaged with. We learned about the specific issues in the area, collected vast amounts of contextual information, and received advice on where there are most likely to be patients. **We started to define the model that will enable us to certify that a place is fistula-free.** Having conducted extensive mapping and community outreach in 2020, we now intend to revisit a sample of these communities to determine whether our community engagement model enables us to declare a village “fistula free.” In places where we think that we have found all the fistula patients, we will randomly select a village and deploy a team to visit all homes within that village area. Besides helping us to ensure that we have found every woman in need, this effort also helps us understand and more effectively model fistula prevalence, and cofactors that may influence its prevalence. ## **GOFAR together** ## **We expanded data-collection capabilities to 6 new countries.** We want to encourage surgeons around the world to contribute to our database, even if we are not funding them. Extending our data-collection tools to even one surgeon in a new country requires the creation of a customised data-collection app that everyone in that country can also use. Surgeons may become eligible to receive our funding if they develop a Page 7 of 27 ## **Operation Fistula (UK) Trustees’ Annual Report** For the year ended 31 December 2020 record of their surgical skill through the use of our app. We expect that informing them of this opportunity will increase uptake of the tool, and thus contribute to data collection over the coming years. In 2020, we onboarded a total of 252 new GOFAR users from 11 countries. This year, we added new users in Madagascar (89), Burkina Faso (3), Cameroon (1), DRC (4), Ethiopia (1), Haiti (1), Mozambique (146), Nepal (1), Nigeria (2), Pakistan (1), and Uganda (3). ## **We scaled use of our data-collection tool in partnership with UNFPA Mozambique.** This means that Operation Fistula’s customised data-collection app is now being used in half of the country’s provinces. We intend to build more national partnerships of this kind with UNFPA in 2021. ## **Kickstart** ## **We launched our performance-based funding strategy globally.** In late 2020, we began accepting applications from surgeons around the world who have the skills and capacity to treat fistula, but lack the funding to deliver treatment. We received 103 applications from 26 countries in just three weeks. We plan to onboard all eligible surgeons from this group in Q1 of 2021. To ensure quality outcomes, all new surgeons must submit patient data using our data-collection app. This means that in addition to scaled surgical capacity, we will also be collecting a greater volume of data on the quality of patient care, fistula treatment capacity, and health system capacity across participating countries. ## **Viz5** ## **We launched Viz5, our effort to visualise gender equality.** In 2020, we launched an effort to engage the online data visualisation community known as the ‘DataFam’, in work to visualise gender equality through a project called ‘Viz5. ’This effort was designed to provide a proof of concept for our broader systems-change strategy. Based on present analysis, this effort had over 750 participants who produced more than 1,600 data visualisations on a range of topics related to gender inequality. Designed to raise awareness and drive public advocacy campaigns, the Viz5 visualisations have garnered more than 153,000 views online. ## **We refined our systems-change strategy:** Fistula is caused by a perfect storm of gender inequality. It is for this reason that fistula has so much predictive value when it comes to gender inequality. If we understand how the system caused fistula for every woman - how medical, social, and cultural systems conspired to create and sustain this devastation - we can understand precisely where change is most urgently required. To realise this potential requires collaboration across both a global and local community of practice. In 2021, we intend to expand our systems-change work. We plan to engage deeply with partner organisations also working to achieve SDG 5, using non-public data from our work and our partners ’work. Our goal will be to target topics where deep engagement between national actors, and the global data visualisation community, can increase public awareness and fuel action to end gender inequality. Page 8 of 27 ## **Operation Fistula (UK) Trustees’ Annual Report** For the year ended 31 December 2020 ## **Capacity Building & Support** Beyond our programmatic achievements, Operation Fistula has fundamentally evolved and strengthened its operations and administrative systems – increasing our capacity to drive impact, and strengthening our management and financial systems. All of these developments are in service to the advancement and enrichment of our charitable aims and objectives. Most notably, 2020 saw Operation Fistula shift the centre of operational gravity to the global south, with work being led and implemented by our large and talented Malagasy management team. To give a picture of the scale of this shift, at that start of 2019 the staff of Operation Fistula were 100% UK / USA based. At the close of 2020, we were 14% UK / USA based, and 86% Malagasy. This shift is a direct reflection of our core value and belief in the power of proximity. Operation Fistula has always believed that the work to end fistula for every woman, everywhere, must be locally led and locally managed – we believe that those closest to the problem, know best how to solve it. Our team in Madagascar is so strong and so well managed, that we are planning to add new global staff in Madagascar. So, instead of London being the primary global support centre, it will increasingly be Madagascar that offers services to other implementing countries, as we continue to scale and mature. 2020 has also seen Operation Fistula lean into strengthening its governance systems. This has allowed us to maintain flexibility, quickly onboard new staff, and manage a quickly scaling enterprise. Many people see governance systems as a necessary inconvenience. We see them as a significant strategic advantage. We are investing heavily in continuing to innovate in our governance systems (covering everything from financial and contractual, to policy and procedures). This work has enabled us to create up-to-date staff policy manuals and handbooks, generate robust financial management systems and policies, and enshrine our values into a comprehensive and dynamic “Playbook” of programmatic protocols. This Playbook is designed to ensure that at every juncture of our work, staff are guided to implement our programs according to current best practices, and with an absolute focus on the needs and wants of the women we serve. Page 9 of 27 ## **Operation Fistula (UK) Trustees’ Annual Report** For the year ended 31 December 2020 ## **Financial Review** Results for year ended 31 December 2020 are given in the Statement of Financial Activities. The assets and liabilities are given in the Balance Sheet. The financial statements should be read in conjunction with the related notes. The Trustees regard the financial position of the charity at 31 December 2020 to be satisfactory and they are content that the current unrestricted reserves position leaves it with a sound base from which future activity can be built. In summary, total income amounted to £779,622 (2019: £906,870) and total expenditure amounted to £695,182 (2019: £654,574) resulting in surplus of £84,440 (2019: £252,296). Surplus for this year is less than last year’s because of receipt of less income from Operation Fistula USA during the year. Full details of income and expenditure are set out in notes to the financial statements. ## **Reserves Policy and Going Concern** The charity is currently dependent on donation income in order to maintain its core activities. Earned charitable income alone would not allow it to continue operating. Following risk analysis, the trustees consider that there is moderate risk of need for reserves for the organisation, as well as the potential of other operational risk, based on challenges in the wider policy context. The Trustees aim to maintain unrestricted reserve that will provide sufficient funds to cover, charitable activities, support and governance costs. After considering funds available from Operation Fistula USA, unrestricted reserve at the end of this period covers these costs for the foreseeable future. ## **Structure, Governance, and Management** Operation Fistula (UK) is a charitable company limited by guarantee, incorporated and registered with Companies House and Charities Commission respectively on 15 April 2015. The company was established under a memorandum of association which established the objects and powers of the charitable company and is governed under its articles of association. All members of the Trustees give their time voluntarily and receive no benefits from the charity. Any expenses reclaimed from the charity are set out in notes to the financial statements. ## **Appointment of Trustees** The trustees have regard to the skills, knowledge, and experience needed for the effective administration of the charitable company when selecting individuals for appointment as Page 10 of 27 ## **Operation Fistula (UK) Trustees’ Annual Report** For the year ended 31 December 2020 charity trustees. Trustees have been selected and appointed to ensure that the board has relevant background and skills which are considered important to enable the charity to achieve its charitable objectives. ## **Related Parties and Relationships with Other Organisations** Operation Fistula (USA) is instrumental in raising donation income from US based donors to fund charitable activities. Operation Fistula (USA) and Operation Fistula (UK) were founded by Seth Cochran and he is also CEO of both charities. ## **Statement of Responsibilities of the Trustees** The trustees (who are also directors of Operation Fistula (UK) for the purposes of company law) are responsible for preparing the trustees ’annual report, and the financial statements, in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice). Company law requires the trustees to prepare financial statements for each financial year which give a true and fair view of the state of affairs of the charitable company, and of the incoming resources and application of resources, including the income and expenditure of the charitable company for that period. In preparing these financial statements, the trustees are required to: - ! Select suitable accounting policies and then apply them consistently. - ! Observe the methods and principles in the Charities SORP. - ! Make judgements and estimates that are reasonable and prudent. - ! State whether applicable UK Accounting Standards and statements of recommended practice have been followed, subject to any material departures disclosed and explained in the financial statements. - ! Prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charity will continue in operation. The trustees are responsible for keeping proper accounting records that disclose with reasonable accuracy at any time the financial position of the charitable company, and enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the charitable company, and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities. Page 11 of 27 Operation Fistula (UK) Trustees. Annual Report OPERATION FISTULA For the year ended 31 De￿mber 2020 The trustee5 a￿ responsible for the maintenance and integrity of the corpordte and financial in4ormation included on the charitable company's website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions. Members ofthe charity guarantee to contribute an amount not gxceeding £1 to the assets of the charity in the event of winding up. The total number of such guarantees at 31 Decernber 2020 was 312019.31. The trustees are members of the charity, but this entitles them only to voting rights. The trustees have no beneficial interest in the charity. The trustees 'annual report has been approved by the trustees on signed on their behalf by.. 2021 and Nicholas Da Trustee Jenkins Page 12of27 ## **Operation Fistula (UK) Independent Auditor's Report** For the year ended 31 December 2020 ## **Independent Auditor's Report to the Members of Operation Fistula (UK)** ## **Opinion** We have audited the financial statements of Operation Fistula (UK) (the 'charitable company') for the year ended 31 December 2020 which comprise the Statement of Financial Activities, the Balance Sheet, the Statement of Cash Flows, and notes to the financial statements, including significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice). In our opinion the financial statements: - ! give a true and fair view of the state of the charitable company's affairs as at 31 December 2020 and of its incoming resources and application of resources, including its income and expenditure, for the year then ended. - ! have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice; and - ! have been prepared in accordance with the requirements of the Companies Act 2006. ## **Basis for opinion** We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the Auditor's responsibilities for the audit of the financial statements section of our report. We are independent of the charity in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC's Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion. ## **Conclusions relating to going concern** In auditing the financial statements, we have concluded that the trustees' use of the going concern basis of accounting in the preparation of the financial statements is appropriate. Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the charitable company's ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue. Our responsibilities and the responsibilities of the trustees with respect to going concern are described in the relevant sections of this report. ## **Other information** The other information comprises the information included in the trustees ’annual report, other than the financial statements and our auditor's report thereon. The trustees are responsible for the other information contained within the annual report. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly Page 13 of 27 ## **Operation Fistula (UK) Independent Auditor's Report** For the year ended 31 December 2020 stated in our report, we do not express any form of assurance conclusion thereon. Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements, or our knowledge obtained in the course of the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact. We have nothing to report in this regard. ## **Opinions on other matters prescribed by the Companies Act 2006** In our opinion, based on the work undertaken in the course of the audit: - ! the information given in the trustees' report for the financial year for which the financial statements are prepared is consistent with the financial statements; and - ! the trustees ’report has been prepared in accordance with applicable legal . - requirements ## **Matters on which we are required to report by exception** In the light of the knowledge and understanding of the charitable company and its environment obtained in the course of the audit, we have not identified material misstatements in the trustees' report. We have nothing to report in respect of the following matters in relation to which the Companies Act 2006 requires us to report to you if, in our opinion: - ! adequate accounting records have not been kept; or - ! the financial statements are not in agreement with the accounting records and returns; or - ! certain disclosures of directors' remuneration specified by law are not made; or - ! we have not received all the information and explanations we require for our audit; or - ! the trustees were not entitled to prepare the financial statements in accordance with the small companies' regime and take advantage of the small companies' exemptions in preparing the directors' report and from the requirement to prepare a strategic report. ## **Other Matter** The corresponding figures for 2019 are unaudited. ## **Responsibilities of trustees** As explained more fully in the trustees' responsibilities statement, the trustees (who are also the directors of the charitable company for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error. Page 14 of 27 ## **Operation Fistula (UK) Independent Auditor's Report** For the year ended 31 December 2020 In preparing the financial statements, the trustees are responsible for assessing the charitable company's ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the charitable company or to cease operations, or have no realistic alternative but to do so. ## **Auditor** ’ **s responsibilities for the audit of the financial statements** Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor's report that includes our opinion. Reasonable assurance is a high level of assurance but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements. Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The extent to which our procedures are capable of detecting irregularities, including fraud is detailed below: Because of the inherent limitations of an audit, there is a risk that we will not detect all irregularities, including those leading to a material misstatement in the financial statements or non-compliance with regulation. This risk increases the more that compliance with a law or regulation is removed from the events and transactions reflected in the financial statements, as we will be less likely to become aware of instances of non-compliance. The risk is also greater regarding irregularities occurring due to fraud rather than error, as fraud involves intentional concealment, forgery, collusion, omission or misrepresentation. As part of an audit in accordance with ISAs (UK), we exercise professional judgment and maintain professional scepticism throughout the audit. We also: - ! Identify and assess the risks of material misstatement of the financial statements, whether due to fraud or error, design and perform audit procedures responsive to those risks, and obtain audit evidence that is sufficient and appropriate to provide a basis for our opinion. The risk of not detecting a material misstatement resulting from fraud is higher than for one resulting from error, as fraud may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal control. - ! Obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the charitable company’s internal control. - ! Evaluate the appropriateness of accounting policies used and the reasonableness of accounting estimates and related disclosures made by the trustees. - ! Conclude on the appropriateness of the trustees' use of the going concern basis of accounting and, based on the audit evidence obtained, whether a material uncertainty Page 15 of 27 ## **Operation Fistula (UK) Independent Auditor's Report** For the year ended 31 December 2020 exists related to events or conditions that may cast significant doubt on the charitable company’s ability to continue as a going concern. If we conclude that a material uncertainty exists, we are required to draw attention in our auditor's report to the related disclosures in the financial statements or, if such disclosures are inadequate, to modify our opinion. Our conclusions are based on the audit evidence obtained up to the date of our auditor's report. However, future events or conditions may cause the charitable company to cease to continue as a going concern. - ! Evaluate the overall presentation, structure and content of the financial statements, including the disclosures, and whether the financial statements represent the underlying transactions and events in a manner that achieves fair presentation (i.e. gives a true and fair view). We communicate with those charged with governance regarding, among other matters, the planned scope and timing of the audit and significant audit findings, including any significant deficiencies in internal control that we identify during our audit. ## **Use of our report** This report is made solely to the charity's members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the charitable company’s members those matters we are required to state to them in an auditor's report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charitable company and the charitable company's members as a body, for our audit work, for this report, or for the opinions we have formed. 27[th] September 2021 Sophie Wheeler - Senior Statutory Auditor For and on behalf of Sophie Wheeler Accountants Limited Page 16 of 27 ## **OPERATION FISTULA (UK)** ## **Statement of financial activities** (incorporating an income and expenditure account) For the year ended 31 December 2020 **----- Start of picture text -----**
2020 2019
Unrestricted Restricted Total Unrestricted Restricted Total
Note £ £ £ £ £ £
Income from:
Donations and legacies 2 319,779 416,028 735,807 495,287 396,894 892,181
Charitable activities 3 43,581 - 43,581 12,381 - 12,381
Investments 4 - 94 94 91 - 91
Other 140 - 140 2,217 - 2,217
Total income 363,500 416,122 779,622 509,976 396,894 906,870
Expenditure on:
Raising funds 5 47,114 - 47,114 67,451 - 67,451
Charitable activities:
Fistula Repair For Every Woman Everywhere
(FREE) 5 107,687 348,695 456,382 91,071 144,216 235,287
Global Obstetric Fistula Automated Registry
(GOFAR) 5 101,926 9,440 111,366 243,654 50,931 294,585
Visualise Gender Equality (Viz5 formerly
VGE) 5 66,843 - 66,843 51,328 - 51,328
KICKSTART 5 13,477 - 13,477 5,923 - 5,923
Total expenditure 337,047 358,135 695,182 459,427 195,147 654,574
Net income / (expenditure) for the year 6 26,453 57,987 84,440 50,549 201,747 252,296
Transfers between funds - - - - - -
Net movement in funds 26,453 57,987 84,440 50,549 201,747 252,296
Reconciliation of funds:
Total funds brought forward 68,488 201,747 270,235 17,939 - 17,939
Total funds carried forward 94,941 259,734 354,675 68,488 201,747 270,235
**----- End of picture text -----**
All of the above results are derived from continuing activities. There were no other recognised gains or losses other than those stated above. Movements in funds are disclosed in Note 16 to the financial statements. Company number: 09542896 Charity number: 1162031 Page 17 of 27 OPERATION FISTULA (UK) Balance sheet Company no. 09542896 As at 31 Decwnber2020 2020 2019 Note Flxed assets: Tangibb assets 2.853 5,383 1853 5,383 ¢urr4nt assots: Debtors 12 264,566 139,530 261.488 23.543 Cash at bank and in hand 404.086 285,031 LIabIll￿8￿. Creditors.. amounts falling due within cag 13 {62,2841 120.1791 Net current 088èts I Illabllltlé81 351,822 264,852 rotsl net a889ts I Illablllll8$1 354,676 270,235 The funds ofthe charity: Restricted income fijnds Unrestiict8d inetsme luThJs'. Gèn8r81 funds 14,15,16 259.734 201,747 94941 68,488 rotal ¢harlty lund$ 354,675 270.235 These financial Statsmonts h8Vg t4en pr￿ared in accordance wfth the provisions aFplicabb to cornpafjte5 uThler ttte sm*1 comp?nie8' regirne. Approved by the irusl and ￿9n8d on their behalf by Mr Nicholas D 'd Jenkins Trustee Page 18of27 ## **OPERATION FISTULA (UK)** ## **Statement of cash flows** For the year ended 31 December 2020 |Note
a
b
**Cash flows from operating activities:**
**Cash flows from financing activities**
**Net cash provided by / (used in) investing activities**
**Net cash provided by / (used in) operating activities**
**Cash flows from investing activities**
Purchase of fixed assets
Proceeds from the sale of fixed assets
Cash and cash equivalents at the beginning of the year
**Cash and cash equivalents at the end of the year**
**Change in cash and cash equivalents in the year**|**£**
**£**
**114,955**
**-**
**1,032**
**1,032**
**-**
**115,987**
**23,543**
**139,530**
**2020**|**£**
**£**
728
(3,922)
-
(3,922)
-
(3,194)
26,737
23,543
2019| |---|---|---| |**a)**
**Net income / (expenditure) for the reporting period**
**(as per the statement of financial activities)**
Depreciation charges
Loss/(profit) on the sale of fixed assets
(Increase)/decrease in debtors
Increase/(decrease) in creditors
**Net cash provided by / (used in) operating activities**
**b)**
At 1
January
2020
Cash flows
£
**£**
Cash in hand and at bank
23,543
115,987
**Total cash and cash equivalents**
23,543
115,987
**Reconciliation of net income / (expenditure) to net cash flow from operating activities**
**Analysis of cash and cash equivalents**|**2020**
**£**
**84,440**
**1,638**
**(140)**
**(3,068)**
**32,085**
**114,955**
Other
changes
£
-
-|2019
£
252,296
744
-
(256,765)
4,453
728
**At 31**
**December**
**2020**
**£**
**139,530**
**139,530**| |---|---|---| Company number: 09542896 Charity number: 1162031 Page 19 of 27 ## **OPERATION FISTULA (UK)** ## **Notes to the financial statements** For the year ended 31 December 2020 ## **1 Accounting policies** ## **Statutory information** Operation Fistula (UK) is a charitable company limited by guarantee and is incorporated in England and Wales. The registered office address is Shakespeare House, 168 Lavender Hill, London, SW11 5TG ## **Basis of preparation** The financial statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) - (Charities SORP FRS 102), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy or note. ## **Public benefit entity** The charitable company meets the definition of a public benefit entity under FRS 102. ## **Going concern** The trustees consider that there are no material uncertainties about the charitable company's ability to continue as a going concern. The trustees do not consider that there are any sources of estimation uncertainty at the reporting date that have a significant risk of causing a material adjustment to the carrying amounts of assets and liabilities within the next reporting period. ## **Income** Income is recognised when the charity has entitlement to the funds, any performance conditions attached to the income have been met, it is probable that the income will be received and that the amount can be measured reliably. Income from government and other grants, whether grants or grants, is recognised when the charity has entitlement to the funds, any performance conditions attached to the grants have been met, it is probable that the income will be received and the amount can be measured reliably and is not deferred. Income received in advance of the provision of a specified service is deferred until the criteria for income recognition are met. ## **Donations of gifts, services and facilities** Donated services and donated facilities are recognised as income when the charity has control over the item or received the service, any conditions associated with the donation have been met, the receipt of economic benefit from the use by the charity of the item is probable and that economic benefit can be measured reliably. In accordance with the Charities SORP (FRS 102), volunteer time is not recognised so refer to the annual report for more information about their contribution. On receipt, donated gifts, services and donated facilities are recognised on the basis of the value of the gift to the charity which is the amount the charity would have been willing to pay to obtain services or facilities of equivalent economic benefit on the open market; a corresponding amount is then recognised in expenditure in the period of receipt. ## **Interest receivable** Interest on funds held on deposit is included when receivable and the amount can be measured reliably by the charity; this is normally upon notification of the interest paid or payable by the bank. ## **Fund accounting** Restricted funds are to be used for specific purposes as laid down by the donor or which has been raised by the charity for particular purposes. Expenditure which meets these criteria is charged to the fund. Unrestricted funds are donations and other incoming resources received or generated for the charitable purposes. Company number: 09542896 Charity number: 1162031 Page 20 of 27 **OPERATION FISTULA (UK)** ## **Notes to the financial statements** For the year ended 31 December 2020 ## **1 Accounting policies (continued)** ## **Expenditure** Expenditure is recognised once there is a legal or constructive obligation to make a payment to a third party, it is probable that settlement will be required and the amount of the obligation can be measured reliably. Expenditure is classified under the following activity headings: - Costs of raising funds relate to the costs incurred by the charitable company in inducing third parties to make voluntary contributions to it, as well as the cost of any activities with a fundraising purpose - Expenditure on charitable activities includes the costs of delivering services undertaken to further the purposes of the charity and their associated support costs. ## **Allocation of support costs** Resources expended are allocated to the particular activity where the cost relates directly to that activity. However, the cost of overall direction and administration of each activity, comprising the salary and overhead costs of the central function, is apportioned on the basis of staff time. Governance costs are the costs associated with the governance arrangements of the charity. These costs are associated with constitutional and statutory requirements and include any costs associated with the strategic management of the ## **Tangible fixed assets** Items of equipment are capitalised and depreciation costs are allocated to activities on the basis of the use of the related assets in those activities. Depreciation is provided at rates calculated to write down the cost of each asset to its estimated residual value over its expected useful life. The depreciation rates in use are as follows: - ˜ - Fixtures and fittings 25% reducing balance ˜ - Computer equipment 33% reducing balance ## **Debtors** Trade and other debtors are recognised at the settlement amount due after any trade discount offered. Prepayments are valued at the amount prepaid net of any trade discounts due. ## **Cash at bank and in hand** Cash at bank and cash in hand includes cash and short term highly liquid investments with a short maturity of three months or less from the date of acquisition or opening of the deposit or similar account. Cash balances exclude any funds held on behalf of service users. ## **Creditors and provisions** Creditors and provisions are recognised where the charity has a present obligation resulting from a past event that will probably result in the transfer of funds to a third party and the amount due to settle the obligation can be measured or estimated reliably. Creditors and provisions are normally recognised at their settlement amount after allowing for any trade discounts due. ## **Financial instruments** The charity only has financial assets and financial liabilities of a kind that qualify as basic financial instruments. Basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value with the exception of bank loans which are subsequently measured at amortised cost using the effective interest method. ## **Pensions** The charity operates a defined contribution pension scheme. Costs are allocated between restricted and unrestricted funds in accordance with the time spent on restricted and unrestricted work by staff members. There are no liabilities at year end. Company number: 09542896 Charity number: 1162031 Page 21 of 27 ## **OPERATION FISTULA (UK)** ## **Notes to the financial statements** For the year ended 31 December 2020 ## **2 Income from donations and legacies** |UNFPA
The Noyen-Melendez Family Trust Limited
Cartier Philanthropy
Anonymous donor via IG Partners
Grand Challenges Canada
Anonymous donor
Covid 19 grant from UK government
Total income from charitable activities
Operation Fistula US
Bank interest receivable
**Income from investments**
Others
Tableau Foundation
Donations:
**Income from charitable activities**
Donated services|Unrestricted
£
211,534
-
-
40,000
-
-
67,303
942
-
319,779
Unrestricted
£
43,581
43,581
Unrestricted
£
-
-|£
54,364
355,705
-
-
-
-
-
-
5,959
416,028
£
-
-
£
94
94
Restricted
Restricted
Restricted|**2020**
**Total**
**£**
**265,898**
**355,705**
**-**
**40,000**
**-**
**-**
**67,303**
**942**
**5,959**
**735,807**
**2020**
**Total**
**£**
**43,581**
**43,581**
**2020**
**Total**
**£**
**94**
**94**|2019
Total
£
442,380
195,963
148,377
40,000
822
504
-
13,204
50,931
892,181
2019
Total
£
12,381
12,381
2019
Total
£
91
91| |---|---|---|---|---| ## **3 Income from charitable activities** ## **4 Income from investments** Company number: 09542896 Charity number: 1162031 Page 22 of 27 ## **----- Start of picture text -----**
2019 Total £ 274,318 33 46,803 9,453 1,556 144,216 18,720 20,794 56,173 70,619 7,385 2,774 986 744 654,574 - - 654,574
Support costs 26,261 - 46,803 7,038 1,556 - - 15,661 496 70,619 7,385 2,294 986 744 179,843 (179,843) - -
Governance costs 4,988 - - - - - - - - - - 480 - - 5,468 - (5,468) -
KICKSTART 4,645 - - - - - - - - - - - - - 4,645 1,240 38 5,923
Visualise Gender Equality (Viz5 formerly VGE) 32,158 - - - - - - - - - - - - - 32,158 18,604 566 51,328
Charitable activities Global Obstetric Fistula Automated Registry (GOFAR) 88,086 - - 2,415 - 50,000 - - 55,677 - - - - - 196,178 95,503 2,904 294,585
Fistula Repair For Every Woman Everywhere (FREE) 75,044 - - - - 94,216 18,720 5,133 - - - - - - 193,113 40,930 1,244 235,287
Cost of raising funds 43,136 33 - - - - - - - - - - - - 43,169 23,566 716 67,451
2020 Total £ 280,757 49 2,452 4,707 440 334,799 - 24,687 16,397 22,512 772 2,400 3,572 1,638 695,182 - - 695,182
Support costs £ 41,293 - 348 2,663 420 - - 18,938 601 22,512 747 - 562 1,638 89,722 (89,722) - -
Governance costs £ 6,953 - - - - - - - - - - 2,400 3,005 - 12,358 - (12,358) -
KICKSTART £ 5,856 - - - - - - 1,949 - - - - - - 7,805 4,985 687 13,477
Visualise Gender Equality (Viz5 formerly VGE) £ 47,599 21 674 73 20 - - - - - 25 - - - 48,412 16,200 2,231 66,843
Charitable activities Global Obstetric Fistula Automated Registry (GOFAR) £ 53,564 - 1,073 1,971 - - - 3,800 13,387 - - - - - 73,795 33,023 4,548 111,366
Fistula Repair For Every Woman Everywhere (FREE) £ 86,427 - 232 - - 334,799 - - 2,310 - - - 5 - 423,773 28,661 3,948 456,382
Cost of raising funds £ 39,065 28 125 - - - - - 99 - - - - - 39,317 6,853 944 47,114
Analysis of expenditure Staff costs (Note 7) Publicity Travel and subsistence Training, workshops & conferences Other staff costs Grant to partners Surgeons fee Consultancy Software Premises expenses General office costs Audit fee Sundry expenses Depreciation Support costs Governance costs Total expenditure 2020
5
For the year ended 31 December 2020
**----- End of picture text -----**
**OPERATION FISTULA (UK)** ## **Notes to the financial statements** For the year ended 31 December 2020 ## **6 Net incoming resources for the year** This is stated after charging / crediting: **----- Start of picture text -----**
|||| |---|---|---| |2020|2019| |£|£| |Depreciation|1,638|744| |Audit (2019: Independent examination) fees inc. VAT|2,400|480| **----- End of picture text -----**
## **7 Analysis of staff costs, trustee remuneration and expenses, and the cost of key management personnel** Staff costs were as follows: **----- Start of picture text -----**
|||| |---|---|---| |2020|2019| |£|£| |Salaries and wages|251,134|245,594| |Social security costs|24,222|24,427| |5,401|4,297| |280,757|274,318| **----- End of picture text -----**
One employee earned between £80,000-£89,000 during the year (2019: 1). The total employee benefits including pension contributions of the key management personnel were £135,327 (2019: £156,491). The charity trustees were not paid or received any other benefits from employment with the charity in the year (2019: £nil). No charity trustee received payment for professional or other services supplied to the charity (2019: £nil). Trustees' expenses represents the payment or reimbursement of travel and subsistence costs totaling £3,005 and incurred by 2 (2019: £4,167 incurred by 2) trustees. ## **8 Staff numbers** The average number of employees (head count based on number of staff employed) during the year was as follows: **----- Start of picture text -----**
|||| |---|---|---| |2020|2019| |No.|No.| |Average staff|5.3|5.6| |5.3|5.6| **----- End of picture text -----**
## **9 Related party transactions** During the year Operation Fistula USA made aggregate donations of £265,898 (2019: £442,380) to Operation Fistula (UK ) . On the other hand, Operation Fistula (UK ) made grant of £334,799 (2019: £94,216) to Operation Fistula USA for FREE project in Madagascar. Operation Fistula USA and Operation Fistula (UK ) were founded by Seth Cochran and he is also CEO of both charities. ## **10 Taxation** The charitable company is exempt from corporation tax as all its income is charitable and is applied for charitable purposes. Company number: 09542896 Charity number: 1162031 Page 24 of 27 **OPERATION FISTULA (UK)** ## **Notes to the financial statements** For the year ended 31 December 2020 ## **11 Tangible fixed assets** |**12**
**13**
**14**
Opening unrestricted fund balance at the start of the year (as previously stated)
Prior year adjustment to reclassify unrestricted fund to restricted fund
Prior year adjustment for change in methodology of recognising in-kind support
Opening unrestricted fund balance at the start of the year (as restated)
Opening restricted fund balance at the start of the year (as previously stated)
Prior year adjustment to reclassify unrestricted fund to restricted fund
Opening restricted fund balance at the start of the year (as restated)
At the end of the year
At the end of the year
At the start of the year
Charge for the year
At the start of the year
Additions in year
**Cost**
**Depreciation**
**Net book value**
**At the end of the year**
At the start of the year
Disposal in year
Disposal in year
**Creditors: amounts falling due within one year**
Accruals
Taxation and social security
**Prior year adjustment**
Adjustment has been made to prior year figures in relation to reclassification of unrestricted
fund to restricted fund and accrued income
**Restricted funds:**
**Unrestricted funds:**
All of the above assets are used for charitable purposes.
Other debtors
Prepayments
Accrued grant
**Debtors**|Computer
and office
equipment
**Total**
£
**£**
9,669
**9,669**
-
**-**
(1,299)
**(1,299)**
8,370
**8,370**
4,286
**4,286**
1,638
**1,638**
(407)
5,517
**5,517**
2,853
**2,853**
5,383
5,383
**2020**
2019
**£**
£
**262,681**
56,965
**-**
8,560
**1,875**
195,963
**264,556**
261,488
**2020**
2019
**£**
£
**45,283**
12,235
**6,981**
7,944
**52,264**
20,179
**2020**
2019
**£**
£
168,488
89,022
(100,000)
-
(71,083)
**68,488**
17,939
**£**
£
101,747
-
100,000
-
**201,747**
-| |---|---| Company number: 09542896 Charity number: 1162031 Page 25 of 27 **OPERATION FISTULA (UK)** ## **Notes to the financial statements** For the year ended 31 December 2020 ## **15 Analysis of net assets between funds (current year)** |**Analysis of net assets between funds**|**(current year)**|||| |---|---|---|---|---| |||General||| |||unrestricted|Restricted|**Total funds**| |||£|£|**£**| |Tangible fixed assets||2,853|-|**2,853**| |Net current assets / (liabilities)||92,088|259,734|**351,822**| |**Net assets at the end of the year**||**94,941**|**259,734**|**354,675**| |Net current assets
Tangible fixed assets
**Analysis of net assets between funds**|**(prior year)**|General
unrestricted
£
5,383
163,105|Restricted
£
-
101,747|Total funds
£
5,383
264,852| |Net assets at the end of the year||168,488|101,747|270,235| |**Movements in funds (current year)**
Global Obstetric Fistula Automated
Registry (GOFAR)
**Restricted funds:**
Fistula Repair For Every Woman
Everywhere (FREE)|At the start of
the year (as
previously
stated)
Prior year
adjustment
(Note 14 )
At the start
of the year
(as
restated)
£
£
101,747
100,000
201,747
-
-
-|


Incoming
resources &
gains
£
396,196
19,926|Outgoing
resources &
losses
£
(348,695)
(9,440)|**At the end**
**of the year**
**£**
**249,248**
**10,486**| |**Total restricted funds**|101,747
100,000
201,747|416,122|(358,135)|**259,734**| |General funds
**Unrestricted funds:**|168,488
(100,000)
68,488|363,500|(337,047)|**94,941**| |**Total funds**|270,235
-
270,235|779,622|(695,182)|**354,675**| ## **16 Movements in funds (current year)** Company number: 09542896 Charity number: 1162031 Page 26 of 27 **OPERATION FISTULA (UK)** ## **Notes to the financial statements** For the year ended 31 December 2020 ## **Movements in funds (prior year)** |Total restricted funds
General funds
**Restricted funds:**
Fistula Repair For Every Woman
Everywhere (FREE)
Global Obstetric Fistula Automated
Registry (GOFAR)
**Unrestricted funds:**
Total funds|At the start of
the year
Prior year
adjustment
(Note 14 )
At the start
of the year
(as
restated)
Incoming
resources &
gains
Outgoing
resources &
losses
At the end of
the year
£
£
£
£
£
£
-
-
-
195,963
(94,216)
101,747
-
-
-
50,931
(50,931)
-
-
-
-
246,894
(145,147)
101,747
89,022
(71,083)
17,939
659,976
(509,427)
168,488
89,022
(71,083)
17,939
906,870
(654,574)
270,235| |---|---| ## **Purposes of restricted funds** Fistula Repair For Every Woman Everywhere (FREE) funds are received and allocated for use of Madagascar project (please refer trustees Report for further details). Global Obstetric Fistula Automated Registry (GOFAR) funds are in-kind software support and allocated for use for GOFAR together project (please refer trustees report for further details). ## **17 Legal status of the charity** The charity is a company limited by guarantee and has no share capital. The liability of each member in the event of winding up is limited to £1. Company number: 09542896 Charity number: 1162031 Page 27 of 27