## **Health Care 4 All International** ## **Trustees Annual Report for Period 2020 2021** The Chairman and Board of Trustees of Health Care 4 All International present their annual report and audited accounts for the period 2020-2021, and confirm they comply with the requirements of the Charities Act 2011, the trust deed, and the Charities SORP (FRS 102). - This report was agreed and accepted at the HC4AI AGM ## **Background and Aims:** Formed in 2014 Health Care 4 All International (HC4AI) is a totally ‘not for profit’ charity organization registered with the charity commission UK and interior ministry and PCP in Pakistan as well as with the Kashmir Council and Societies. It is a small organization that has no corporate backing and is funded solely by personal funding and individual supporters. Our services, including consultation, treatment, medicines, and transport all are completely free to all deserving patients in the rural and remote communities. **HC4AI was registered as a charity on 8[th] September 2014 (REGISTERED CHARITY NO. UK 1158474). On 31[st] January 2020 the status of the charity was changed to Charity Incorporated Organization (CIO) with the registered charity number 1187677** ## _**AIM; Providing Good Quality, Easily Accessible and Cost-Effective Primary Health Care to Rural and Remote Communities**_ We aim to provide good quality, cost effective and easily accessible healthcare to the rural and remote communities who either have none or have very difficult access to healthcare. The aim is achieved by using a combination of conventional medical practice through a well-equipped **Community Health & Tele-Medical Centre** and a modified and unique Telemedicine system we developed and call it the **Novel Hybrid System of Telemedicine (NHST).** 1 ## **Organizational Background** Health Care 4 All International (HC4AI) is a Bradford based UK registered development NGO which specialises in providing healthcare for rural communities in some of the poorest parts of the world. The services we provide include telemedicine, medical consultations, diagnostic lab., on-site pharmacy, minor operating facilities and day care observation & treatment beds. Our programs include antenatal care, mother and childcare, emergency treatment, ambulance service and health education programmes for rural and remote communities. We achieve this by using a combination of innovative technology and frontline support workers to open up access to health expertise and prescription medicines for those living in the most remote locations. While the services are open to all we place particular emphasis on maternal and child health. Such has been the success of our initial pilot in rural Pakistan that the project has recently been expanded to include thousands more people in surrounding villages & districts and has the potential to reach many more. The charity was founded in 2014 by a UK based surgeon, Dr Tariq Shah, who felt compelled to act when he came across shameful statistics which compared access to healthcare in the western world with that of people living in rural areas of developing countries (such as a 36-year gap in life expectancy and significantly higher under-fives mortality rates, WHO). Spurred on by this moral and ethical injustice, his wife a Obstetrician and Gynaecologist, Dr Tasneem Tariq, joined him in the quest for equality in healthcare. They recruited friends and colleagues to help them and using their own medical knowledge and the technical skills of others they identified the challenges that needed to be overcome to open up healthcare in rural areas and potential solutions. Uppermost amongst the challenges was the remote nature of the rural communities and the lack of access to health professionals. It was recognized that the cost of setting up and running a medical facility in every remote community made it far too expensive as an option. It was clear that a form of telemedicine could provide an answer but a paucity of communications infrastructure in many developing regions was a major barrier to making this work. The team were aware that telemedicine requires a fast and reliable telecommunication network as well as both the service user and the service provider having access to telecommunication equipment and the knowledge to use them. Again, providing such equipment to every household was considered financially prohibitive. The team worked with both information technology specialists and a range of academics to develop a modified telemedicine system which they named the Novel Hybrid System of Telemedicine (NHST). The existing technology was manipulated and modified to suit the remote conditions where it needed to be 2 used. HC4AI was established in 2014 to pilot and roll out the service initially in Pakistan but aim to ultimately across the developing world. Another hurdle in setting up the service was the lack of connectivity across the target area to make the telecommunications possible. To overcome this hurdle HC4AI and its partners erected a series of masts to establish a broadband network in the region. With the availability of 3G & 4G (in some areas) WIFI signals more recently this problem has somewhat eased. **As well as being a UK registered NGO HC4AI is registered with the interior ministry and Pakistan Centre for Philanthropy as well as with the Kashmir Council and Societies** . ## **Our Services:** **Telemedicine through NHST:** NHST negates many of the technical problems and high costs associated with traditional telemedicine and is therefore extremely effective. Instead of distributing expensive and fragile telecommunications equipment to every household we select suitable men and women from the target villages (with some medical background) and train them as **Community Medical Assistants (CMA)** . The training includes the use of technology and refresher training in routine and emergency medical knowledge. We then equip them with tablet computers, download the tablets with our own unique Electronic Health Record (EHR) software and place the CMAs in a central location (in a building which doubles as a medical facility and a call management centre), the **Community Health & Tele-Medicine Centre (CHTMC)** from which they can reach any household in the area when a request for help is received (usually via mobile phone). The CMAs then travel out to the patient (using one of our dedicated ambulances) with their tablet computer and communicate via video/audio link from the patients’ home with the medical professional who is located remotely (in the medical facility, in other parts of the country or even the world). Most patients can be diagnosed immediately and then can access the appropriate medication through our pharmacy (via the CMA) but for more serious problems they can be transported to the HC4AI CHC or the nearest hospital for treatment on our ambulances. _**The model allows us to provide this service 24 hours a day, 365 days a year. For the majority of patients, the service is free at all points of access but where someone has the ability to pay, they make a donation appropriate to their means and this is used to subsidise the free care for others.**_ ## _**General OPD at the Community Health & Tele-Medicine Centre**_ **:** 3 The CHTMC also allow for walk-in access to extended GP services. The Centre remains open with all its services 24/7, 365 days of the year. A lady doctor with Obstetrics and Gynaecology experience and a male General practitioner working in tandem are available physically at the Centre from 9am to 9pm. Thereafter they remain on-call 24 hours, remotely but if required in emergency are available physically at the Centre. The patients presenting at the Centre or attended to in their homes are first attended by the CMA, who take all the essential history and clinical observations before presenting to the doctor present at the Centre or remotely on our telemedicine network to initiate management. ## _**Emergency Care**_ HC4AI through its CHTMC and Telemedicine network has become the first port of call in the area as the only available medical facility for all kinds of accidents and emergencies, that is _**open 24 hours and 365 days of the year.**_ When called upon, our ambulances respond to any medical or surgical emergency in the extended area. Several casualties are brought in to CHTMC by patients’ relatives or bystanders on self-help basis too. We are also kept quite busy by road traffic and domestic accidents, accidents on the hills and fields as well as cardiac and other medical and surgical emergencies. Our teams also respond rapidly to any major incidents and accidents in the area for example, our teams were among the first to reach the recent earthquakestricken area and the major building collapse that occurred in our area recently. ## _**Antenatal, and Neonatal Care**_ In addition to providing treatment, we also work hard on registering all pregnant ladies on our Electronic Medical Records (EMR) and follow them regularly throughout their pregnancy with necessary lab tests and Ultrasound scans. Information and assistance after delivery for both mother and baby are provided. All antenatal records are maintained on EMR with internationally accepted antenatal cards. If a complication is anticipated in delivery during the antenatal check the patient is then referred to our designated secondary care hospitals for follow-up and delivery. ## **Health Awareness and Disease Prevention Programme** We have now longstanding disease prevention and health awareness programmes for the communities. Our Community Medical Assistants-CMA (previously called Community Health Workers CHW), Medical Officers and visiting doctors (national & international) conduct these health awareness Programme. We remain committed to our three different awareness programmes: 1. Community Health Awareness: Open for all community dwellers 2. Women’s Health Awareness: For women of the communities in their homes 3. Children’s Health Awareness: Conducted for children in schools. 4 ## _**Academic Activities at the Centre**_ To keep our staff updated in current clinical practice we have weekly educational meetings which is obligatory for all clinical staff. These meetings include Topical presentations and discussion, journal club, case presentations and updates on emergency care and resuscitation. All CMA’s keep a log of CME (Continuing Medical Education) credits that is used for their annual appraisals. ## _**- Our Achievements and Activities during 2020 2021**_ ## _**Activities during Covid-19**_ _The COVID-19 pandemic which started at the beginning of 2020 continues relentlessly into 2021 with its second and now third wave. The whole period has been a challenge with the extraordinary speed of spread of the pandemic and the unusual, strange, and extraordinary measures adopted for its treatment, containment, and prevention. Like the rest of the world, HC4AI and its projects were not spared either. The outbreak affected everyone, if not by the disease itself but just by the fear of contacting the virus and the ensuing lockdowns. The world was not prepared for it but reacted rapidly. Guidelines on prevention were formulated by World, International and National Health Organizations to control the disease. These recommendations changed continuously as the scientific community learned through experience the ever-changing behavior and mutations of the virus, with new variants emerging requiring constant vigilance and innovations to combat the problems it brought. The crisis continues._ Hurried measures were taken by each Government to combat this epidemic. HC4AI and its services were affected too. The routine patient attendance decreased as people were confined to their dwellings and lockdowns were imposed literally across the world. As the routine work reduced most of the primary medical facilities closed. Secondary care hospitals were open for Covid19 patients and emergency care only. _**HC4AI Community Heath & Tele-Medicine Centre has remained open throughout the crises. We continued patient care from the Centre but also through telemedicine from patients’ homes when called out. However, we had to put stringent measures to protect our staff and the patients from contacting and spreading the virus** . Following are some of the measures we initiated early in 2020 and continue to date, as the threat of Corona Virus continues, for the communities we serve and for population of the district as well as population in general.:_ - a) Health Care 4 All International (HC4AI) developed Emergency Response Call/Help Center for whole of Mirpur District for information dispersal, patient and suspect surveillance and helps in patient management in collaboration with District Administration and District Health Department. 5 - b) Our staff were trained not only in providing information to general public about measures on prevention, contacting and spreading the virus, they were also trained in handling of Covid19 patients, their management and how to respond to public enquiry when contacted through our Call Centre. They liaised with the District Health Office on daily basis and reported the daily activities to the DHO for statistical analysis that helped in formulating a coordinated response. - c) Our trained staff and equipped ambulances were available for reaching the patients/suspected cases in their premises and transfer to the quarantine and management centers for Covid-19 patients. - d) One of our representatives always related to District Health Office directly and attended daily meetings on Covid-19 situation and planning. - e) Brochures and information leaflets were prepared indigenously on prevention and advice on Covid-19 and were distributed to the community. - f) Our team of doctors and trained medical staff related to First Aid Post (FAPx11), Basic Health Unit (BHUx2) and Rural Health Center (RHCx1) and visited them to coordinate with their staff on Covid-19 prevention, information dispersal, training and management of patient. - g) Food packages were prepared and distributed regularly during lockdown to all vulnerable families in the community. - h) Our CHTMC is also serving as vaccination Centre for the area. ## _**Community Health & Tele-medicine Centre (CHTMC)**_ The building of our Community Health Care Centre as before doubles up as Telemedicine Monitoring Centre. With a separate area dedicated to function as the Call Centre we have two telephone lines (a land line and a mobile) for the patients to contact us any time of the day or night if they require our services to wherever they are located. With computers, Internet connection (x3 back up connections) and our EMR they respond to calls and mobilize the on-call teams to reach the patients swiftly. In emergency cases our response time from the Centre to the patient averages about 15-20 minutes. ## _**Solar Power**_ The Centre uses greener solar power with storage cellular batteries and reduces the dependence on the national grid power. This is not only environmentally friendly but has also reduced our electric bill. As our requirements for power increased (pharmacy, laboratory and consulting room need temperature control particularly in the summer months) we have upgraded our solar system with new storage batteries. A back-up generator is as always on the standby ensuring uninterrupted electrical power. ## _**Laboratory**_ Our well-equipped laboratory at the Centre, continues to provide most of the essential biochemistry and haematology investigations; this helps our clinical staff in better management of the patients. We have now two Laboratory trained 6 technicians who share the responsibility of managing the pharmacy, they also help in clinical areas with other Community Medical Assistant-CMA. Choudhry Mohammad Younis of Regal Food Industries Bradford who donated a substantial amount towards the purchase of most of the laboratory equipment and several new machines continues to support the service. ## _**Pharmacy**_ The bigger licensed pharmacy with extended inventory and facilities continues to provide round the clock service. Supervised by a qualified pharmacist and run by our qualified dispensing (CMA) staff. This pharmacy caters not only for the needs of all medical supplies to the patients who are managed through our facility but also is open for all from far and wide who want to avail this 24-hour service. An independent auditor is given the task of doing regular audit. The areas identified for improvement by the auditors are constantly addressed. ## _**Minor Operation Theatre (MOT)**_ As the trauma and accident cases increase our MOT continues to provide a very valuable service in dealing with these patients, providing first aid and initial management of trauma. It is reasonably well equipped to deal with minor traumas and emergencies. Three of our CMA’s are trained in A&E and skillfully manage the MOT under the supervision of our doctors. It has its own autoclave and sterilizer with multiple separately packed minor operating sets and fracture stabilizing equipment with first aid facilities. ## _**Observation & Treatment Beds**_ The three treatment & observation beds are equipped for continuous patient monitoring of vitals as well as a Crash Trolley, ECG and Defibrillators. ## _**Hospital Management System (HMS) and Electronic Health Record with Video Platform and Our own Servers**_ The HMS is mainly being used for patient registration and creating individual patient clinical folders. It also has streamlined most of our clinical notes and prescriptions, project accounts, stock record and re-order. Our three servers are in the server rooms of Mirpur University of Science and Technology (MUST) providing connectivity and data storage and retrieval facility. We remain grateful to MUST for their continuing support. These servers store the HMS software and all our work data securely. It helps in data analysis and project evaluation and stop our reliance on external data storage facilities. ## _**Governance Structure**_ The governance structure has not changed from previous years. While the HC4AI Board of Trustees (BoT) remains the same we are actively looking for new 7 trustees. The governance structure at the strategic end in UK remains unchanged. The governance structure revamped in 2019, at the operational end in Pakistan is producing good results. To remind the changes made to the governance structure in AJK/PAK; One of the SVP (medical matters) Dr A Q Akhter was appointed to the position of Medical Director (MD), an honorary post. He will oversee all the operational matters and will be reporting to the HC4AI Chair and BoT AJK. Three new directorates were created to manage the operations. smoothly 1. Management including accounts; headed by the project manager (PM) 2. Clinical; headed by Clinical Director (CD) the senior clinician 3. Community: Coordination Committee (CCC) comprised of community representatives ## _**Accounts**_ Accounts are kept on site by salaried accountant, project manager and bookkeeper daily. The accountant manages and prepares these accounts for review and auditing. All accounting is on accounts software and reported to UK. A volunteer with accounting experience, Ms. Lynne Roberts, has been appointed in UK to help with the account received from the project from Pakistan/AJK As previously our annual returns have been audited by independent auditors both for UK and AJK/Pak annual accounts. The reports are included in this report (Appendices 1 & 2) and will be submitted to the Charity Commission UK after approval by the Board of Trustees. We are extremely grateful to all our friends and families who have contributed to this project, and without whom this project would not have materialized and sustained. We would like to acknowledge all the donations from individuals and organizations, unfortunately as many of our donors wished to remain anonymous and because of the data protection act, we have not been able to secure permission for the individual donors we are unable to highlight such generous individuals. To all our supporters we hope that GOD gives them the rewards in this world and the Hereafter. - **1 The Charity has received significant donations from individuals and organizations both within the UK and Pakistan. For this report, only donations received from UK are shown in appendix 1 (UK account summary).** - **2 Some individuals and organizations donated in Pakistan, shown in Health Care 4 All Pakistan/AJK summary account (appendix 2).** - **3 Almost all the expenses are on our project in Pakistan/AJK and are shown in the summary account of Pak/AJK (appendix 2).** 8 ## _**Community Coordination Committee**_ This group, composed of volunteer representing various villages was formed in February 2020 to empower the community, in the matters of the service provision and improvements. The committee chair is elected by the members themselves. This group has not realized its full potential yet, mainly because of the COVID-19 and its restrictions. They have however communicated off and on with the Medical Director and Project Manager with suggestions. The purpose of this committee is: 1. Help in registration on our data base of all individuals and households in their respective villages 2. Identify people who are poor and eligible for free treatment. Identify people who are not well off and are eligible for subsidized treatment (10-90% subsidy) 3. Bring feedback from the community and on our performance and the needs of the community 4. Meet on regular basis with hospital committee (composed of MD, CD & PM) to discuss and address any matters of concern and provide solutions for service improvement. ## _**Teamwork**_ HC4AI has a very relaxed and friendly atmosphere. This helps greatly in the morale of the staff and encourages them in improving performance. Our staff is trained to do multitasking and help each other in improving patient care. We have separate rest and sleeping areas for our staff with basic catering and entertainment provision. ## _**Patient Activity**_ Patient attendance was reduced in 2020-2021, an effect of COVID-19. 9 Over 82% of the patients were either completely free (36%) or subsidized (46%). Subsidy varying between 10 to 90%. Only about 18% patient paid full cost of service received and accounted as donation to the charity. ## **Summary of Patient Activity** 1[st] July 2020 to 30[th] June 2021 **----- Start of picture text -----**
Total Full
Childr OPD Outreach Free Subsidis
No. of Mal Femal Donati
Year en (Clin Telemedici Patie ed 10-
Patie e e ng
u/16 ic) ne nt 90%
nts patient
2019- 359
8982 5384 2209 8769 213 2300 3935 2747
2020 8
July
2020 265
7242 4585 1388 6873 369 2619 3345 1278
-June 7
2021
Ante-Natal patients seen July 2020- June 2021 = 132
**----- End of picture text -----**
10 ## **Board of Trustees UK** - 1 **Chair:** Mr. Syed Tariq Kazim Shah: MBBS. MRCS. LRCP. MMEd. FRCS. Consultant Urological Surgeon, The Yorkshire Clinic, Bingley Road, Bradford BD16 1TW. West Yorkshire UK - 2 **Vice Chair:** Dr (Mrs.) Tasneem A Tariq. FRCOG Rtd. Consultant Obstetrician Gynecologist. - 3 **Secretary:** Dr Akram Khan. MBBS. MRCGP. GP (Rtd.) Ex-Clinical Chair Bradford City Clinical Commissioning Group. Principal, Avicenna Med Practice Bluebell Building, Barkerend Health Clinic, Barkerend Road Bradford BD3 9QH UK - 4 **Trustee:** Mr. Dilshad Khan. CQSW. MBA. MIHSM. JP Rtd. Director Equality & Diversity Bradford Teaching Hospital Trust. - 5 **Trustee:** Mr. Mohammad Ajeeb. CBE Ex Chairman City Primary Care Trust Bradford. Ex Lord Mayor Bradford - 6 **Trustee:** Mr. Asif Saleem Managing Director Nafees Bakers Ltd Bradford. - 7 **Trustee & Treasurer:** Mr. Arif Khan: Member AAT & AAIA Accountancy. BPP University law School Leeds Director Arif Khan accountants - 8 **Trustee:** Ms. Shanaz Siddique Educationist, freelance journalist, You Tuber 11 ## **Our partners** HC4AI acknowledges that without the support of key individuals and organizations this project would not have been feasible. We have come across many individuals who have worked tirelessly in the background to make this project a success (many have asked to remain anonymous), but we would like to take this opportunity to say thank you to all. Although most of our previous partners remain with us we have established new link: - Mirpur University of Science and Technology (MoU) - Huddersfield University faculty of Medicines and Healthcare Dept. of Pharmacology - Rotary Club of Bradford - Intelcare[] Islamabad Pakistan - Government of AJK Ministry of Health (MoU awaiting renewal) - State School of Nursing Mirpur, AJK - MoU of cooperation between HC4AI, Deputy Commissioner Mirpur Div. & District Health Officer Mirpur Div. ## **Thank You** HC4AI is extremely grateful to the large number of our supporters and wellwishers. I have no doubt that without their help this project would never have the success it has achieved. I am specially obligated to the following individuals for their support and guidance. A number of individuals wish to remain anonymous we respect their wishes: - **Haji Mohammad Saleem (Late)** , **Rafay Saleem** (Nafees Bakers Mirpur) and **Asif Saleem** (Nafees Bakers Bradford) for providing invaluable support, insight, advice, and unconditional help in arranging and facilitating all the trips of HC4AI to AJK and office and staff support in UK - **M Younis Choudhry** of Regal Food Industries Bradford for continuing financial generosity and invaluable help and advice both in UK and AJK/Pakistan 12 - **Mohammad Haroon and family** of Leeds for his unflinching support, advice and massive help in fund raising and support in operations - **Tahir Luqman** for his generous financial help, moral support & advice and supplying PPE’s during the pandemic. - **Steve Davison** for being always available for priceless advice, continuous support, editing newsletter, dependable, unflinching and unconditional help - **Kamran Mughal and Brothers** for providing the land and help in building our new centre in Chakswari in memory of their late father. - **Luqman Rashid** for infusing enthusiasm, always being available, dependable and help in organizing events and fund raising - **Ms. Y Dhami** for both generous financial and moral support - **Arif Khan** Bradford for preparing accounts and arranging account audit - **Abid Hussain** of Leeds for his generous contribution and compeering for fund raising event - **Dr Taimur Shah and Imran Azad** for IT development and website support - **Sohail Ali** for being available for advice and help any time - **All the members of HC4AI UK Working Group** - **Numerous friends and supporters in Mirpur, Chakswari and UK cities especially Bradford** who are always ready to help and provide advice with a smile - **Imtiaz Bhatt** Director Network & Telecom. MUST for his continuing technological help - **Ali Ibn Khalid** for his work above and beyond the call of duty - And Last but not the least - **Dr Abdul Quddus Akhter** for his voluntary contribution and supervision of the project in Chakswari, his friendship and being there whenever help is needed ## **Special Thank You** 13 As previous a huge thank you to the **HC4AI Board of Trustees UK (Strategic Board) and HC4AI Board of Trustees AJK (Operational Board)** for their time and complete support in guiding the policies and operations of the project. My final thank you goes to my wife **Dr** ( **Mrs.) Tasneem Aslam Tariq** for her patience, unconditional and relentless support and guidance and for her endurance during the difficult times of the project. She remains a member of the BoT UK ## **Dr. Tariq Shah Chairman for Board of Trustees Health Care 4 All International** ## Appendix 1 ## **- HC4AI Account Period: 2020 2021** ## **Donations and Expenses UK and AJK/Pakistan** ## **Details of Audited Accounts of HC4AI UK and HC4AI AJK are submitted separately** **Note:** The period of account for the UK & Pakistan/AJK are for different periods of the year, hence transfer of funds made from UK to Pakistan do not show in the UK account but will appear in the account for the next account period. Also note that some donations are also made in Pakistan/AJK however almost all the expenditure is in Pakistan/AJK on patient care through our project, as shown in the account. ## **Summary HC4AI UK Account** ## **1[st] February 2020 to 31[st] January 2021** **----- Start of picture text -----**
Entries Debit £ Credit £ Balance £
Opening Balance 42,261
Donations Received 53,808 96,069
HMRC Gift Aid Received 23,316 119,385
**----- End of picture text -----**
14 **----- Start of picture text -----**
Bank Charges 30 119,355
Printing 300 119,055
Travel Expenses 1,080 0 117,975
Total Expenses 1,410
Total Receipts 77,124
Balance from Previous Year 42,261
Total Credit in Bank 117,975
**----- End of picture text -----**
## Appendix 2 ## **Summary of Accounts AJK/Pakistan** ## **1[st] July 2020 to 30[th] June 2021** **Note:** The account periods for the two accounts UK & Pakistan/AJK are for different periods of the years, hence transfer of funds made from UK to Pakistan do not show in the UK account but will appear in the account for the next account period **----- Start of picture text -----**
Entries Debit £ Credit £ Balance £
Opening Balance 32,751.07
Donations Received from UK 47,700.23 80,451.23
Donations Received Pakistan
25,525.86 105,977.18
& Local
Expenditure Direct Patient
52,614.59 53,451.32
Care
Expenditure Indirect Patient
10,544.88 42,906.42
Care Management
Total Expenses 63,159.46
Total Receipts 73,226.09
15
**----- End of picture text -----**
**----- Start of picture text -----**
Balance from previous year 32,751.07
Total Credit in Bank 42,817.70
**----- End of picture text -----**
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IPJ72.16 IJ lJ92J 1220394 J.9W.163 759J37 25lJ90 91419 5.JVJ.24 I1JVJ.91 J375.23 i.iujs 423.29 ItdKlTrE Cmiwrrta 736226 119A15 157.IyJ6 3.gW.19 1.163JJl 137A2 '¢hkk5 K¢N5r& Nl*SM.'. IIYUI35 52*14J9 57.151.19 Stsff Sil¥). & B¢n¢fils Ftt & s￿b$¢r10￿n RtP411 & NliinlENnce lluildm 9.967.14 U9Jg 797.77 14Jlffj &iJ 54h)J iJoJi J 27JOI 1.160 150,989 6,610 31J 25.CWJ 14JJ52 21.437 4J30 I1￿917 651J6 9UO 19JZ 965JO D¥kChylll'llT hliK. oifi¢e E¥r*tt Eyrm 35.19 176J9 A¥dii F¢¢ ExrKJf¢ 2JOI,OJ6 2JJ5272 IOJ41 12J77JJ T￿•1 EiptDdlt#m E¥vsi•fJ•¢omtoYtrExpMdli#rHlr••*fftd CThtMI RdrnT 13.IWJ43 13.11gJ07 63.159.46 69J35.73 I,l*J74 J20Ag2 I•M70 ISgIAg Amtxed kwlpth•ofihu¢fiM*klAW* LLA ISIAs'.&eAD SIIREII rRESIDLYr Ilyahl C*Tr 4 All IvjfrfW•tIM•I F(IA I'EAR T.%Dfii ￿J1174￿. 1•11 1•2• Joli AOW.OJ6 Jl.7S1.07 Jl.76Jll lJ.999.917 1).4J9.7VI lJJ2 7JJ26 16 20Jg TOYALNECEiris 10,crt14.417 23.IOOJ2J 7JJ46.70 70mJ. 19.JIO.167 ioJ.vI7.IJ 101.771.71J ?J.910 23J J3126 13111 75.(iKI 31XI.6J 2J.44 607.11 T1•W￿ 4.jl 342.14 74.910 116.7(Kl 118,320 702.770 175.664 6.097,017 lJ3,520 331.rA3 124,N7 6209.529 23,fKrt) 7J6.226 79.156 3.W5.013 157.996 150,315 219,425 341.jl 3216.34 103.95 27.W)J.97 11.31 3.47523 695.42 Stsff J2J41.30 122.92 3.134.Jl 41227 20JJ8.61 759.337 12.253 3.349.P14 92.419 143,852 258.190 4.330 210.917 15.330.86 423.29 651.36 Dulldin8 713.93 1.142.14 6.1)4 716.40 J4Ji 200J2 19.12 965JO MI￿ OffKt EX￿ 150,919 6,640 31,$( 276.19 11.M.iJJ 12,065,IM3 12 67.359 54.874.75 55217J9 63.192.49 TOTAL PAYhlEKrs 12,314.059 •vNll•blt It tlfyse ofile Yttr I i.ori3.482 7,136.101 $0.78024 37271.40 Aw¢X￿ rrt fonn M inlwil ofihue Lth4eAD VRER PRLSIDENr Ilenllh Cnrc 4 All Inlcrnnilnnnl NOI'Tr'..S T() I'III.. FIliAYI CIAI. %l'hl'b:hlF.Kr8 FOR I'F:AH F:YI l)I.D JOJIINF. 2121 1.1 The &Klct}' iiw re81slered urwkr th¢ So¢ldy Reglitr*lon Ad. Ilrfi u a Non Prnfil Org1niTalion INPO) by Ihe name of IlEAI.TII CARC 4 ALL IiifERNATIONAL The rebiisiertd oifice ofihe S￿l¢lY IJ sliuAied li Sthie of Azad J•mmv & Kashmir. 1.2 Tr rdn¢ipal obJecilve ofihe ownlutlon li lo prnvlde he•hh elfe. f•d11￿1￿ by ¥ ofT¢l¢ Nlediclne Tele Ilealih kchntslo￿ throu￿ i nefwrt of Comm￿llY Hulth Workrr (CHW) lo rnrnl communi1￿ in A7Jd Jamfflv & Kuhmk {AJ&K) Pakistjn who vthcrwije do not have euy or Wby to hulth emplwis ffi mthnwl •nd chlld healih ind ptevenilon ordise•j￿ In 2014. ihe oFrali¢w wcre xtthed from villages of Rjrnih 1hrO￿&h Ihe monilorin8 cenkr ￿ Rwrah Welfare Hojpitsl rvinB Dpproximaiely I￿} 10 150 Ihousjnd p)wliiiofi. In 2017. th se¢(rfMI fflMiWini ttnieriBos¢ Uoil JI Chjkswari sthned (yeThtions. This ￿11 the Fvl¥icn or appioxim4i¢ly70 10 IhthtyDnd WMI In¢lth dozerd of1￿17 r¢nKA¢ vilts 2- Slgnllknllt Attounilni P•lickJ 2.1. Aeeountlbi Conve&iltsn These Financial 5121ements hwe been wepred under the his￿1¢#1 cl￿ cl￿1 except for mejsuremeni of¢enain financial insthmerf ￿ faiTYdlue. 12- Tr*de *Md ￿h¢r hyibles Liabiliknts for trade pa)Hbk we carried a ¢OS¢ *thith És the hir value of the considemion ￿ be pjid in the r￿Ure for J¢rvi¢e5 reca wheiher ornot billed to th¢ OrsaThizaiithL 2J. Ftsed Assets Fixed Assets are S&￿ed ai ¢051 less a¢cumulaied deprt¢i*i¢)n at t￿ in No* No. 5. Depre¢iation is charged through applicatioft of reducing metho Full depreciaiion is ¢harged in the year of Wulsili￿ ofan wet and Th) dewttia1i￿ is charged in they¢trofdi$p)sat. MaiurrcnEwats impn)YaKn¢ ar¢¢4>itslized l& T•xatloTr The charged under clayse 36 of sedion 2 ofthe Income TL¥ Ordin8nc¢ 2ixii. taking into account the Current IrKMK and re¢o8nized in the Inc(ffi% & Expendiiule A¢count. The law allows a tsx credil equal to l(MY/* of the tsx payabl< including rninimum and fiMI taxes pardble underanyofthe 2.& C•sh B•Ak Cash in ￿nd ind cash at b￿k are uffied atC05L OT¥STO TIIF. nNANCIAI. %TATI.hlfr.NV4 R I'FAR F.NI Dl.DMJIIN&. 2011 rvrnml 2121 11.461,19J 11.140.701 14,49).J9 Y,412 12 2.199J71 3M4 Iom 1.069.2J 91357 29 152.05 411.¢W 11747 )￿) 5.144 1201J? 51.Y 14141 213$ I￿21 P4J 493 944 2.374 IJ 2J7Z63 LLA IsL￿Tr1AeAo Iltallh C*ro 4 All InlrrnillnnAI 'OTF.S To Tllfr.. F INANCIAI. %TATf.hi Tr:NTI FOR I'b,AR F.NI)F.i).iQ JIINF, 2021 Cpil noprt(l•ilo For i*• Il••k V•1 PArtk4lA 1> Addlilonl l)tltilon A¢r.' *• •1 JW••.31 14ut.2(1 J•J¥*pll Buildin R¢noi•iion 8113,696 8B3,696 10 167.90J 71.579 239.482 6U214 Furni1u￿ & Fixiiire .435 604,433 10 176,¢K)5 42.75J 219.658 314.777 'ehitle Compwefk CCTV. UPS & Iniemet 2..$01.500 2.501.5C 15 B72.925 244.286 l J84219 1.829.699 7J.910 1,903.609 1,088.080 203,882 91.962 611ffj47 Solar Sisi¢ms Nledie41'NIA¢hinery & Instruments 3CK),000 3(Kl.O(X) 10 57.0 24JthJ 81JO) 218.7Tr) 9.107.271 9.107.271 3,014.621 609265 3.623.886 5.483J85 her Asse 364.510 364,510 10 119221 24J29 143.750 L?0.760 73.910 15M5.021 5 496.655 •OJ94 .717 749 &947.m 30Jun-20 ISA7&911 1122iK¢ &ioJJoi 92.854 &49&655 iQ•94A56 FIXED ASSETS (Pounds) Cost AddltloTrl tkllon rfflAilon For ihe Yttr 338 196 Book y￿•* Alit •1 R•te Act: Is at I4U￿20 768.43 809.63 3.995.08 Buildin Renovalion Fumiture & Fixlure Vehicle Cornputers. C￿. UPS & Intemet Solar Systems Medial Machinery & Insiwments Other Assets 4.044.38 2.766.29 11.448.51 4,044 1766 11,449 10 10 15 1.761 35 5.113 8.37J.91 1.373.(K) 338 &712 1.373 25 10 4.979.77 *60.87 933 5.913 irn 41.680.87 1,668.24 41.681 1.668 13,796.89 545.63 2.788 16.585 658 ?5.096 10 JfyJun.21 71 55 71 5J16 741 3Wu*.20 KO,619.J3 5114JB 112OJ.70 21 73.96 5W&2* Ile•lilJ C•Tr 4 All i•lff••lkn*•l FDH F.IDV.IiJ•Jiixr.i•ii Iimjj )) Jji 1.7CQ07J )JUJ50 {1.1352 3.W•.163 12$1 JAM.9 (1.7tr)pni 3J96.4 iJJoJg5 .195 i•.*rJX Jji 17M91 CHARITY COMMISSION FOR ENGLAND AND WALES Independent examlnerfs report on the accounts Sectioii A Indepcndeiit Exan)iner's Report Ch8rfty N8m• Health Care 4 all Intsrr*tknnal m•mb•rn of On a¢¢ounts for th• y•ar nd•d 3111 January 2020 Chorlty no (If any) 1158474 S•t out on pJg•• I report to the trust￿ on my eyAmlnatlon of the accounts of the above arity (Ihe Tru8V) for the y•ar ended 3110112020 R••ponBlbllltlo• arKI A8 the charfty tru8tee8 of the Tru8t, y(NJ are ro8pon8lblg for the preparatlon bMl• of r•wi of the accounts In accordan(x wlth the requtr•monts ofthe Charltle8 A 2011 rthe A6f. l rnport In re8F*Ct of my •xarninatlon of the Tru8t'8 accounts carried OLrt under 68ctlon 145 cf the 2011 Act 8nd In carrylng Dut my examlnatlon, I heve followed the applicable Dir8Ctlon8 glven by the Charlty CDmmls8lon urKler 8ecilon 14q5Xb) of ts Act. Indop•ndont I have ￿MplaI8d my examlnatlon. I conllmi that no matarlal motters have •xamln6rf• stat•m•th a)me to my attentlon (other than that dls¢lo8ed below.) In connectk>n wlth the examlnatlon whlch m¢ ￿USe to believe that In, any materfal a0￿untIng record6 ￿pre not kept In aLxordanc8 wlth 80Ctlon 130 of theAdor the do not accord vlth the aC(￿untIng record8 I have no concerns and have come acr088 no ¢)ther matters In (X)M￿CtIon the examination to whlch attontlon Should be drawn In order to enabkry a proper undeTStandlng of the accounts to be reached. ' F¥ea8e delete the bwrd8 In the brackat8 rfthey do not apply. Slgn•d: 071&0 Nam•: MR K HUSSAIN Rel￿4nt pn>l•Mlon quallfication(•) or body (If any): FMAAT. AAIA Addr•ss: 21 DUCKWORTrI LANE BRADFORD BD9 SER IER Octob•r 2018 Section B Disc105ure Only complelè ff th8 8xamlner n8•d8 to hlghllght matter8 of ￿nCern {￿ CC32, Independent examlnallon of charlty accounts: dlrKUon8 and gUIdan￿ for examlners). Glv• h•r• l>rl•f d•lalls af any ltsma that th• •xamin•r wl•hM to IER Octol)or 2018