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2022-03-31-accounts

IMPACTG Preventing disability. TransForming lives. Annual Report & Accounts 2021-22

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Foundation Information 2
Trustees’ Annual Report 3
Independent Auditors’ Report 44
Consolidated Statement of Financial Activities 47
Balance Sheet 48
Notes to the Accounts 50
How will you make your IMPACT? 59

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Lady Wilson, OBE, FRCOphth (Hon) Honorary President (resigned from Council 15.07.21 and joined the Advisory Council. Remains Honorary President) Brenda Luck, MB, Ch.B, DHC, DRCOG, MRCGP Chair John Scott Vice-Chair Rob West, BA (Hons) Vice-Chair (resigned from Council 15.07.21 and joined the Advisory Council) Robin d’O. Hope Honorary Treasurer

Nicholas Astbury FRCS, FRCOphth, FRCP Keith Barnard-Jones, MBBS, MRCS, LRCP, D.Obst.RCOG, MRCGP Gordon Bennett, LL.B (Hons), LL.M, Dip Int Law Claire Hicks, MBE David Jameson Evans, FRCS, FRCS (C) John Mowbray, QC Michael O’Connell, MB, BS, BSc, MPhil, FRCS (Otol), FRCS (Orl) Lady Prance Sal Rassam MB BCh BAO LRCSI LRCPI DTM, DO MD FRCOphth Vinit Shah, MBBS, MRCP, FRCPCH David Walker, CMG, CVO Peter Webster, MA, FCA

Judi Stagg Chief Executive/Company Secretary Sarah Smith Deputy Chief Executive Pascale Noel Funding and Development Director Tessa Brown Finance Manager Jackson Medlow-Stagg Fundraising Manager Julia Nottingham Office Manager Lisa Waller UK Programme Manager 151 Western Road Carter Nicholls Haywards Heath Victoria House West Sussex Stanbridge Park RH16 3LH Staplefield Lane Telephone: 01444 457080 Staplefield, Haywards Heath Email: impact@impact.org.uk West Sussex RH17 6AS

Barclays Bank plc Colemans Solicitors 77 South Road Paddockhall Chambers Haywards Heath Paddockhall Road West Sussex Haywards Heath RH16 4LB West Sussex RH16 1HF

Charity Number: 290992 Company Number: 1878297

The IMPACT Foundation is a registered charity in England and Wales and a company without share capital limited by guarantee

As for many organisations and individuals, the past year has seen IMPACT adapting to and learning to live with Covid-19. We and our partners continue to work in Covid-safe ways and this means additional costs for cleaning and PPE. At the same time we have been trying to restore our normal projects to full capacity. Thus more than ever we need to raise funds for our core work, as much of our fundraising in the past two years has been focused on Covidrelated action.

IMPACT’s trustees and staff are totally committed to our nononsense and cost-effective approach. We do not waste money on advertising and image. Our donors appreciate the fact that we concentrate on the essentials.

The 30th Anniversary Appeal for IMPACT India’s Lifeline Express hospital train has raised over £400,000 including the matched funding provided by a generous donor. These funds will make possible three Lifeline Express projects in rural India, the first of which has already started in Chhattisgarh state. Amongst other interventions, local people are receiving sight-restoring cataract surgery.

In the UK, our Tasty Team has also adapted and is expanding, with both online and face-to-face sessions now taking place to equip people with the skills and knowledge to eat healthily on a budget. This work is more relevant than ever in the current national and international situation.

With our partners around the world IMPACT continues to work for the prevention of avoidable disability in communities where access to healthcare is difficult for the average person. Our aims are early identification and treatment, ending malnutrition, safer motherhood and child survival, health education and training, safer water and sanitation, and accessible surgery. As a result of our interventions, poverty is also alleviated and lives are literally transformed every day.

We are immensely grateful for the support and generosity of our donors and volunteers. The threat from Covid19 may be becoming more manageable but this year has already thrown up unexpected challenges and IMPACT needs you – our essential partners – in order to keep moving forward. Together, we are making change happen for the better.

Dr Brenda Luck Chair, IMPACT Foundation UK 4[th] May 2022

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IMPACT’s vision is of a world free from needless disability. We believe that no one should become or remain needlessly disabled through disease, lack of knowledge or shortage of medical services.

Living with a disability is a fact of life for more than a billion people around the world. It is estimated that the vast majority of people with disabilities live with a condition that could have been prevented or could be treated. For example, permanent hearing loss caused by an untreated ear infection; cataracts causing sight loss that could be restored through surgery; or birth injuries caused to a mother giving birth alone or without trained assistance.

Needless disability and poverty are inextricably linked, each perpetuating the other. The poorest sections of society have least access to medical services that could prevent needlessly disabling conditions and people with disabilities too often face discrimination and obstacles to employment or education – stepping stones to improved prosperity. IMPACT’s work to prevent and treat needless disability therefore also makes a vital contribution to the alleviation of poverty around the world.

A core part of our philosophy is the belief that local people are best placed to identify the needs in their own country and how to meet them in a culturally appropriate and cost-effective way. IMPACT UK never imposes ideas or action on our international partners but instead plays a supporting role to facilitate the programmes they have developed in consultation with beneficiaries. We also invest in training and equipping local medical and health workers to serve their communities for the long-term.

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IMPACT has worked with 12 trusted local partners in 10 countries of Africa and Asia during 2021-22. Each partner is autonomous and delivers a programme of action they have designed to prevent and treat needless disability; to promote health; and, as a consequence, to alleviate poverty. We also run a successful project to promote healthy nutrition in our local community in the UK. Our shared priorities for action are:

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Bangladesh
Cambodia
India
Kenya
Nepal
Pakistan
Sri Lanka
Tanzania (+
Ethiopia and
South Sudan)
The UK
Zanzibar

IMPACT’s work makes a clear and valuable contribution to the following three public benefit purposes as defined in the Charities Act 2011. The rest of this report will demonstrate how we do this in more detail.

2) The relief of those in need by reason of youth, age, ill-health, disability, financial hardship or other disadvantage

Across IMPACT’s programme, this year can best be characterised as a tentative return to normality while still responding to new waves of Covid-19 and navigating a raft of restrictions that hindered service delivery, often imposed by Governments at short notice. Covid-19 control measures have ebbed and flowed; while one country was opening up, another was locking down but always mindful of the people who depend on us and have no other access to healthcare, IMPACT UK and our international partners have worked hard to deliver our projects however and wherever possible, whilst at the same time operating in Covid-safe ways.

The many medical professionals and community health workers, without whom our international programme of action would not be possible, remain on the frontline of the pandemic so once again we have focused on their protection. More than 170,000 pieces of PPE have been provided along with almost 8,000 litres of sanitiser and disinfectant. 63 medical facilities have been supplied with PPE and medical equipment.

We have also continued to protect members of the public in our project areas with the provision of face coverings, soap and hand washing facilities, and emergency food parcels since livelihoods have been affected as much as lives. Thanks to IMPACT, 7,621 families received nourishing meals, more than 82,000 people were given face coverings and almost 25,000 bars or litres of soap were provided as hand hygiene plays an important role in stopping the spread of the virus. Health education and awareness about Covid-19 reached nearly 240,000 people.

We responded rapidly to the devastating Delta wave that hit India and surrounding countries in the middle of 2021 by supporting our three Indian partners to purchase medical equipment such as oxygen concentrators, and

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to establish Covid care centres and outreach programmes to assist people living in remote, rural and underserved villages. The wave subsided quickly but our partners stand ready to act again should they need to.

Aside from Covid-19, IMPACT’s usual international programme of action ramped up, and while still not able to operate as before, strides have been made in re-starting any projects that had stalled and catching up on activities that were not possible before. For example, so much of IMPACT’s work is community-based and takes place in schools and remote villages but school closures and lockdowns kept apart our outreach health teams and the men, women and children in need of health care. Our local partners report that even when services are available, people have been reticent to come through fear of catching Covid-19. This has inevitably reduced beneficiary numbers, but as the vaccine roll-out continues, this nervousness is subsiding.

Overall within our normal projects, we have benefited almost 50,000 more people this year than last. 913,168 men, women and children have been reached with health and medical care, training, health education, safe water and sanitation (an increase of 114.5% on FY 2020-21). This is in addition to hundreds of thousands of members of the public who benefited from action on Covid-19 and the thousands of health and medical workers who were protected with PPE.

Our projects always prioritise the least resourced and most marginalised people and the fact that our trusted partners are local people who know their communities well means we can be confident that those in most need are reached.

In addition to our ‘Tasty Team’ project to promote healthy nutrition for vulnerable groups in West Sussex, IMPACT UK has supported 12 partners working in 10 countries of east Africa, south-east Asia and southern Asia to achieve the following:

People examined andprovided with treatment 202,364 145,978
Operations to restore sight, mobility or hearing, or to
repair cleft lipor fistula		 6,493 6,262
Immunisation against disabling disease (including
activities to support Government vaccination
programmes)		 11,309 10,707
Mothers and babies receiving pre andpost-natal care 16,938 22,178
Combatting malnutrition, including home garden and
micronutrient supplement beneficiaries		 54,004 47,204
Healthprofessionals and communityvolunteers trained 2,606 1,948
People participating in health education or otherwise
empowered within their communities		 226,788 160,118
People benefiting from safe water and improved
sanitation		 369,582 18,213
Assistive devices given (hearing
aids/orthotics/prostheses etc.)		 23,084 13,040
Medical facilities upgraded/ provided with equipment 7 13
Hospitals / health centres’ infrastructure built to better
cope with the pandemic		 63
124 health workers trained
42 tablet computers provided for
record keeping during health
outreach
6 Covid or post-Covid care centres
set up
91 mobile clinics held		 125
Items of medical equipmentpurchased 2,155 1,158
Items of PPEprovided to health workers 170,238 293,594
People benefiting from medical assessments / treatment
for Covid and other conditions		 97,529 N/A

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Soap, disinfectant and cleaning products for hospitals
and health centres		 7,895 litres/kg 16,985.5 litres
Public handwashingfacilities established 20 284
Participants in health education and awareness raising
re: Covid-19		 239,474 (plus 50,000 leaflets
produced and distributed; 1 toll-
free medical helpline established
and a ‘Trace, Treat and Track’
system set up covering a population
of 100,000people)		 1,147,146
Families receiving emergency food parcels 7,621 (plus 121 students of schools
for children with disabilities
provided with nutritious meals)		 1,876
Supplies for the public for infection control 82,104 face coverings
24,678 bars/litres of soap		 37,903 face coverings
24,500 bars/litres of soap
Vaccination assistance Provided support to Government
programme during which 129,898
doses were administered		 3 nurses trained to give
Covid-19 vaccines
Flooding relief, Cambodia N/A 420 emergency kits (food,
blankets, soap and water)
to displaced families plus
supply of basic medicines
for healthposts

Notably, the number of people benefiting from medical examination and treatment (up 38.6%), health education (up 41.6%), assistive devices such as prosthetic limbs and hearing aids (up 77%), access to clean water and sanitation (up 1929%), and action to prevent malnutrition (up 14.4%) have increased significantly on the previous year. The large increase in people accessing clean water and sanitation is due to the installation of a water treatment plant at a large hospital in Bangladesh, which is used by hundreds of patients and members of staff every day.

Whenever possible, our projects implement a diverse range of activities in one geographical location (e.g. a village or district) in order to maximise the benefits for the people involved. This is because poverty is multi-dimensional – people rarely lack only access to medical care – so our partners also enable households to meet their need for nutrition and income through initiatives such as growing vegetables and rearing livestock to eat and sell; establish community forums such as Mothers’ Clubs to disseminate health education and empower members to take action to improve their own health; train teachers, NGO workers and local leaders to understand disability and take steps to help people affected; and provide clean water and sanitation, lack of which undermines all other efforts and is one of the biggest causes of ill-health, lost productivity and early death.

We have also invested in building local infrastructure and human resources to support communities for the longterm again this year. We have equipped and upgraded seven hospitals and health posts and supported the training of 2,606 medical and health workers (up 33.8% on FY 2020-21) including providing scholarships for 28 student nurses at IMPACT Foundation Bangladesh’s Nursing and Midwifery Institute, which aims to meet the huge need for nurses in Bangladesh while at the same time offering a rare professional opportunity to young women from rural villages.

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We set ourselves 11 goals in last year’s report – ‘Looking to the Future’ on page 33 – and achieved all of them, despite the many challenges we and our local partners continued to face due to the Covid-19 pandemic and the burden of significant restrictions on all parts of society.

Begin construction of a new building which will eventually
become a standalone IMPACT Nursing Institute and replace
the current facility located within IMPACT Bangladesh’s
hospital in Meherpur. This would enable more nurses to be
trained each year and better help to meet the acute shortage
in Bangladesh.
Architectural and engineering plans for the new building have been completed and 103
piles have been installed to support the foundations. Contracts have been signed with
the selected building contractors for work to begin on the first two floors from 1stApril
2022. It is anticipated that this will be complete by the first quarter of 2023 and that
classes will be held on the new building from the start of the new academic year.
Provide even more specialist surgery including burns
operations in Cambodia and hydrocephalus operations for
children in Bangladesh.		 Thanks to our links with an experienced brain surgeon in Dhaka, 15 more operations
were performed to ease the effects of hydrocephalus (the build-up of cerebrospinal
fluid around the brain) in young children in Bangladesh. The oldest child was 7 years
and the youngest just 25 days. All of the children benefiting came from impoverished
families in rural villages and would not have had access to this life-saving surgery
without IMPACT.
We provide funds for a plastic surgeon in Cambodia to perform operations on people
with burn injuries as we receive gifts restricted for this purpose. This year we have
supported one burn surgery. We hope to support more in the future.
Install additional SIDKO water filtration plants for safe,
accessible water, and renovate toilet blocks in more schools
in Bangladesh, to improve sanitation, menstrual hygiene and
dignity to keep girls in school all month.		 Three new SIDKO water filtration plants have been installed at the following locations in
Chuadanga district, Bangladesh: Chuadanga District Hospital, Munshiganj Girls High
School and Gokulkhali Secondary School. The latter two SIDKO plants were
accompanied by Menstrual Hygiene education, distribution of sanitary kits and toilet
block upgrades. Accessible safe water and clean and private toilet facilities are essential
as part of menstrual hygiene to ensure girls have the confidence to attend school during
their period. More than 5,000 people benefit daily from safe water as a result of these
school SIDKO plants.
Develop the skills of more local healthcare professionals by
supporting training, which is a long-term solution to ensure
delivery of quality health services.		 1,371 health workers were trained through our projects this year and are using their
skills for the welfare of people in the communities in which they work. Training
included paediatric audiology, midwifery and nursing, and leprosy care. In addition
1,235 volunteers were trained, including teachers and students, to perform health
monitoring in their classrooms and community leaders to identify and signpost
treatment services for people with needlessly disabling conditions.
Provide further support for IMPACT India’s award-winning
Lifeline Express hospital train through a very special matched
funding appeal to mark its 30thanniversary.		 IMPACT UK’s matched funding 30th anniversary appeal was a huge success thanks to
the generosity of our supporters and the philanthropic family who provided the
matched funds. In total, £412,670 was raised which is enough to fully fund three
projects of IMPACT India’s Lifeline Express hospital train in the financial year 2022-23
during which approximately 26,000 people could benefit from medical care.
Provide running costs and staff training for the ZOP Academy
in Zanzibar, which provides specialist education and
opportunities to hearing impaired children who might
otherwise never go to school.		 IMPACT UK has funded the running and salary costs of the ZOP Academy for children
with hearing impairments, located in Zanzibar. Dr Naufal Kassim Mohammed, ENT
Surgeon and Medical Advisor on the board, has undergone further training in Paediatric
Audiology in South Africa (including hearing tests, hearing aid fitting and speech and
language development) and is, in turn, training the Academy’s staff.
Work with The Lake Clinic (TLC) to deliver on-going mental
healthcare services for vulnerable people living in the floating
villages of the Tonlé Sap Lake, with a particular focus on
tackling domestic abuse and violence.
We supported The Lake Clinic with funds which contributed to the delivery of mental
health services to 40 people who underwent regular monitoring, counselling and, where
needed, were provided with medication.
TLC’s outreach team has been trained by the Cambodian Women’s Crisis Centre to
recognise signs of domestic abuse and violence and refer people affected to TLC’s
mental health team for ongoing support.
Increase access to safe water sources and sanitation for rural
communities in Kenya through infrastructure building and
health education.		 Safely constructed concrete pit latrines with fully private enclosures were installed in
five schools to provide students and teachers with a facility they can use without danger
and with dignity. There was a constant risk of the old-style hand-dug latrines collapsing
beneath the user. Five schools were provided with handwashing facilities (two tanks
per school) to enable hand hygiene. Five schools were provided with Rain Water
Harvesting systems with 10,000 litre tanks to collect rain for use in the school and the

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surrounding community. Schools were also provided with health education on safe water, hygiene and sanitation.

Respond to the extra needs of our partners to meet the IMPACT UK has once again provided extensive support for Covid-19 related projects in challenges of operating safely in the face of Covid-19 and Bangladesh, Cambodia, India, Nepal, and for our project in the UK. For example, we help to ensure that vulnerable people do not go hungry due have supplied 63 hospitals and health facilities with more than 170,000 items of PPE to loss of income as a result of the pandemic. and more than 2,000 items of medical equipment; given more than 82,000 masks and almost 25,000 bars of soap to the public; provided food for hard-pressed families in our local community and elsewhere, and much more described further in this report. Expand the reach of the Tasty Team project in the UK The Tasty Team has adapted to restrictions and continued to work throughout the through online resources (e.g. cooking videos on a dedicated Covid-19 pandemic. This year, one-to-one Get Cooking sessions resumed in person YouTube channel); restart face-to-face cooking sessions when restrictions allowed and 361 people participated overall. Tasty Sessions in schools when it is safe to do so; launch after-school cooking clubs benefited 170 children. At Christmas, The Tasty Team delivered meal boxes to and work with more of the people who have really struggled struggling households that benefited 98 people. A new YouTube channel expanded the during the pandemic, for example elderly people, to improve Team’s reach by making cooking skills available online to a wider audience through their food security and nutrition. short instructional films to boost confidence covering topics such as making a tomato sauce or cooking rice. In addition, an online resource portal was created for volunteers and participants to use. After school cooking clubs were launched in one school (for children) and one community venue (for children and their parents) and additional sessions were held during the school holidays for families to share a cooking activity together. 33 carefully selected people who were identified as those who would particularly benefit, took part. Respond to emergencies in our projects should they arise. IMPACT responded to the Covid-19 pandemic, as described in the next section of this report. There were no other emergencies within our project areas.

IMPACT has stringent monitoring guidelines which helps us to analyse the impact of our work. All of our partners send regular activity, statistical and expenditure reports and these are carefully monitored against agreed targets, enabling adjustments to be made if necessary. IMPACT UK and our partners work collaboratively in order to deliver the best service we can to the people who rely on us, often as their only hope of health care or medical treatment. Independent project evaluations monitor the impact of many projects and representatives of IMPACT UK make programme visits to ensure that your support is really making a difference.

IMPACT UK relies on voluntary contributions from generous members of the public, companies and organisations to power our programme. Income this year is £2,158,975 (an increase of almost 28% on FY 2020-21 and 44% more than our target of £1.5 million). This can be attributed to the successful 30[th] anniversary matched funding appeal for IMPACT India’s Lifeline Express Hospital Train and for the restricted funds provided for Covid-19 projects.

Expenditure is also up 33.7% on the previous year at £2,326,796 due to the resumption in every country of activities put on hold by Covid-19 along with some specific action in response to the Delta wave in India.

Due to prudent financial management and the fact that our team and offices are small and lean, IMPACT UK has expended an even higher percentage of funds on direct charitable action this year than last. Almost 95 pence of every £1 spent was used for this purpose (FY 2020-21 92.4%).

Further information can be found in the section ‘Financial Review and Policies’ on page 36.

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The World Health Organisation has analysed the number of global excess deaths over the first two years of the pandemic and believes the true death toll from Covid-19 is nearly 15 million people – three times higher than the officially recorded numbers.

Of the people who died, 57% were men and 43% were women. 59% lived in lower or low income countries compared to 15% in high income countries like the UK – highlighting that poverty and its characteristic overcrowded living conditions, inadequate sanitation, lack of clean water, and inequitable access to quality healthcare and vaccines – really is a matter of life and death.

The authors of WHO’s report note the limitations on their findings because they were unable to accurately measure the number of excess deaths in sub-Saharan Africa due to the lack of reliable health and demographic records kept by 41 of the 54 countries in Africa. Better data collection systems are vital to ensure that health services meet the needs of populations generally, and for better preparedness for future pandemics.

This is an issue outside of Africa too, with actual Covid-19 deaths estimated to be nearly 10 times higher than official records in India, eight times higher in Pakistan and five times higher in Bangladesh.

IMPACT’s policy of partnering closely with local people who really know the areas they work in means that our actions to tackle the challenges of the pandemic were highly targeted and efficient.

While vaccination distribution is increasing, just 60% of the world’s people are fully vaccinated against Covid-19, while 24% have received a booster jab, which we know is vital to protect against the highly infectious Omicron variant. Where possible, IMPACT’s partners have supported Government vaccination campaigns in tangible ways such as providing nurses to give injections and health education to ensure people understand how they can get vaccinated and why it is needed. Often this includes dispelling the misinformation that has found its way into every corner of the planet.

Many of the people who died from Covid-19 were healthcare workers on the front line, putting their lives in danger caring for people despite inadequate personal protective equipment. One of IMPACT UK’s priorities within our practical response to the pandemic was to ensure that high-quality PPE was provided to the doctors, nurses and health workers employed within IMPACT’s projects and at the hospitals we partner with around the world. More than 170,000 items were supplied this year.

This second year of the pandemic covered the Delta and Omicron waves, which infected vast swathes of people and further pressurised creaking health systems. The Delta variant was first detected in India and quickly became the dominant strain globally. India suffered an incredibly intense Delta wave infecting millions of people, which peaked and subsided within three months. During this time, we supported three partners in the country in myriad ways including setting up test and tracing systems and Covid care centres; and a small army of health workers making household visits in rural areas. The effects of Covid-19 are ongoing, as is our action.

Aside from the medical consequences of the pandemic, there has been a huge social and economic toll. IMPACT has supported partners around the world to provide food parcels to families struggling financially when they could not work due to restrictions and who were at real risk of hunger. As usual, we added long-term benefit where

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possible by also distributing rice mills to villages to prepare paddy into usable rice, and household water filters to provide potable water.

So much about Covid-19 remains unknown but it is becoming increasingly clear that ‘Long Covid’ will cause a huge burden of ongoing ill-health and disability for the people unlucky enough to develop it, which will inevitably strain already overstretched healthcare systems and diminish economic productivity on an individual, national and global level. There may be an ongoing role for IMPACTs around the world to support people affected by ‘Long Covid’ which will complicate other health conditions. Many affected people will inevitably been seen in our hospitals and clinics in the future.

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During 2021-22, IMPACT UK has raised funds to enable the following supplies and action throughout our international programme in response to the Covid-19 pandemic:

PPE kits 1,874 Non-medical masks (public) 82,104 ~~Z~~ANZIBAR
Shoe covers 1,700 Bars or litres of soap (public) 24,678
Surgical masks/respirators 134,430 Health education (people) 228,474
Pairs ofgloves 17,044 Health education materials 50,000
Head covers/fabric caps 11,550 Toll-free telephone helpline set
up		 1
Disposablegowns 1,310 Handwashing stations set up 20
Goggles 650 Food parcels (families) 7,571
Plastic face shields 680 Students at schools for disabled
children provided with
emergencyfood		 121
Aprons 1,000 Mobile Clinics held 91
Health facilities/hospitalsgiven PPE 63 Household health assessments 92,000
Health facilities/hospitalsgiven equipment 45 Population covered by a newly
established ‘Trace, Treat and
Track’ system		 100,000
Covid care centres set up 6 Village rice mills distributed 10
People treated for Covid-19 or other conditions 5,529 Beneficiaries of rice mills 2,500
Hand sanitiser / disinfectant / cleaning supplies
(litres)		 7,795 Household water filters
distributed		 60
Detergent(kg) 100 Beneficiaries of water filters 300
ICU beds 4
Hospital beds 34
Oxygen concentrators 49
Suction units 4
Nasal cannulas and oxygen masks 1,500
Defibrillators 4
Bloodpressure machines 100
Glucometers 100
Haemoglobin meter 100
Pulse oximeters 119
Multiparapatient monitors 7
Thermometers/thermal scanners 123
Infusionpumps 4
Ventilators 2
Wheelchairs 5
Tablet computers for health workers 42
Vaccination assistance provided for
Government campaigns(doses)		 129,898
Health workers trained 115

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IMPACT Foundation Bangladesh (IFB) runs a highly effective programme of action based at three hospitals – one of which floats! The ‘Jibon Tari’ (Boat of Life) is housed on a 290 ton pontoon which is tugged from riverside village to the next (it has no engines to prevent vibrations during surgery) staying for a month at a time to restore sight, hearing and mobility to people in some of the most underserved parts of this vast, river-streaked country.

The other hospitals are land-based and located in Chuadanga and Meherpur Districts in the south-west of Bangladesh. Like the Jibon Tari, the focus is on treatment of needlessly disabling conditions such as cataract or hearing loss, and the work of the hospitals is supplemented by a thriving community outreach programme which seeks to prevent a host of other causes of needless disability and ill-health, for example, malnutrition, lack of maternity care and services such as physiotherapy, and inadequate sanitation and safe water.

A mobile medical van, the Jibon Jatra , travels to remote villages to

ensure that people do not miss out on vital care because they cannot travel into the town, and the hospital walls are pushed out even further by training community people such as teachers and members of Mothers’ Clubs to know the signs of disabling conditions and refer those affected to IFB’s health workers.

Sustainability is at the heart of IMPACT’s work, for example, training and equipping local people to meet the needs of their communities for the long-term. In 2014, IFB established a Nursing and Midwifery Institute within its hospital in Meherpur to meet the urgent need for professionally qualified nurses and midwives in the country. The Institute has steadily grown to admit more students each year and the current facilities were being outgrown so we are delighted to be supporting the construction of a standalone facility in the hospital grounds that will enable even more students to be trained and will secure the future of this prestigious seat of learning.

People screened and treated for disabling and other health conditions in Outpatients
Departments and clinics in the community		 60,000 60,066
People attending health education and awareness sessions to learn how to protect
themselves and their families		 47,500 64,291
People who benefited from operations to restore their sight, hearing or movement
or to ameliorate other disablingconditions		 3,320 3,562
Peopleprovided with assistive devices and/orphysiotherapy 4,200 9,167
Women provided with ante and post natal care including micronutrient supplements
(folic acid etc.)		 3,100 4,644
Immunisations against infectious diseases and/or Vitamin A to protect eyesight, given
to children		 4,000 9,479
Traditional Birth Attendants trained andprovided with a sterile equipment kit 600 602
Village Mothers’ Clubs meetingregularly 900 3600
Primaryschool teachers trained to check their students’ vision and health 300 301
Children checked bytrained teachers 3,000 3,672
Home gardens established to provide families with nutritious fruit and vegetables to
eat and thepotential togenerate income		 750 752
Local health workers, rural medical practitioners, NGO workers and community
leaders trained to understand and identifyneedless disability		 700 739

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IMPACT UK’s support

has also:

 Funded the training of 28 students at IFB’s Nursing and Midwifery Institute in Meherpur district, in order to help meet the critical shortage of nurses in the country. 11 nurses in particular financial need were given study aids. We also provided 30 sets of furniture to allow for an expanded intake of students and enabled work to start on building the new Institute in the grounds of IFB’s Meherpur Hospital – our support is paying for the first two storeys of the building which should open in 2023

 Provided essential items of medical equipment to IFB’s hospitals to enhance service delivery

 Ran a standalone project in Magura, Jenaidah and Kushtia districts to take eye care into these underserved areas. IFB’s

mobile clinic visited 21 locations, screened and treated 5,168 people, restored sight through cataract surgery to 478 men and women, trained 100 schoolteachers to check the vision of 504 children, and provided 549 children with Vitamin A supplements to prevent night blindness

 Enabled specialist brain surgery for 15 more very young children with hydrocephalus

 Purchased an auto-refractometer and held a special eye surigical camp on board the Jibon Tari floating hospital in memory of Mrs Tineke Van Der Leek Walker, the wife of IMPACT UK’s former Chair Mr David Walker, during which 141 people were screened and 39 people had their sight restored

 Installed SIDKO water treatment plants at Chuadanga District Hospital, Munshiganj Girls High School and Gokulkhali Secondary School. The schools also benefited from a menstrual health project providing education and sanitary kits for 804 girls, plus refurbishment of their toilet blocks to make them safe, hygienic and private. 400 girls at Gokulkhali Secondary School were vaccinated against Rubella to protect any future babies from this major cause of disablement in utero .

 Supported IFB in its work to run the Jibon Mela hospital and community-based primary healthcare project in Meherpur district. Thanks to this project, 28,202 people have been screened and treated for health conditions, 1,171 operations have been performed, 2,175 people have had physiotherapy and/or an assistive device to ease mobility, 3,142 women have received quality pre and postnatal care including ultrasounds, 2,080 non-Covid vaccinations have been administered, 3,109 women and children received dietary supplements as required, 8,203 pathology tests have been undertaken, 3,057 people have attended health education sessions, and 90 people are benefiting from home gardens yielding fresh produce to improve diets.

 Given 15 pairs of geese to families who struggled to meet their nutritional requirements. These not only provide essential protein in the diet, but can also be used to generate income through the sale of eggs.

 Provided 5 arsenic filters to households at risk of drinking contaminated water

 Responded to the COVID-19 pandemic through the provision of 56,800 pieces of PPE for frontline health professionals at 18 hospitals and health centres, 3 thermal scanners for hospitals, 4,850 litres of hand sanitiser and disinfectant, 1,200 face coverings and 790 bars of soap for the public, health education for 61,252 people, emergency food parcels for 500 families facing hunger due to loss of income, and set up 350 handwashing stations for infection control.

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Our partners in Cambodia are IMPACT Cambodia (IC) and The Lake Clinic (TLC). IMPACT Cambodia’s programme focuses on ear care, school health, safe water and leprosy in three provinces: Preah Vihear, Ratanakiri and Banteay Meanchey (all among the very poorest in Cambodia with worrying health statistics and inadequate infrastructure) plus the capital, Phnom Penh and nearby Kandal province. Additional activities such as enhancing maternity care and enabling plastic surgery to treat people with burn injuries are undertaken as funds allow.

TLC delivers primary health care and mental health care to people living very challenging lives in the floating villages on the Tonlé Sap Lake, which is the largest freshwater lake in southeast Asia, and a UNESCO biosphere reserve due to its biodiversity. Life on the lake is precarious and dictated by environmental conditions, with fishing the only source of income. The villages are miles across water from healthcare and other services and there is no sanitation or clean water so disease is rife.

IC’s programme of action has been hampered once again this year by the Covid-19 pandemic which closed schools, restricted travel around the country and made people wary of attending health centres even when they were able to, for fear of catching the virus. As such, the focus this year has once again been on supporting people with leprosy (in a Covid-safe way) whilst also meeting the need for food and safe water, and upgrading maternity facilities with equipment and training to make childbirth safer for women and their babies.

Mr Bunda, the community worker specialising in the care of people with leprosy, has been able to continue his vital work throughout the period, but has experienced challenges due to Covid-19. For example, limits on gatherings of people and the redeployment of health workers to Covid wards made it impossible to hold training and awareness raising sessions for them and members of the community in the numbers and format used in the past. Additionally, lockdowns prevented Mr Bunda from making home visits to his patients and this led to a deterioration of their condition for many people left to fend for themselves. Some good news though, was that when he was once again able to get out into villages, he met people with leprosy living at

the heart of their communities, where previously they would have been ostracised and living in the remote forest areas. This indicates that his awareness sessions are working to dispel the myths associated with leprosy, and that this is benefiting people with leprosy socially. Mr Bunda will now visit them regularly to provide treatment to manage, and eventually cure, their condition.

**Early identification and treatment ***
ENT screening and on the spot treatment (Banteay Meanchey province) 300 0
ENT screening and on the spot treatment (Ratanakiri province) 300 0
ENT screeningand on the spot treatment(Preah Vihearprovince) 300 0
**School healthprogramme ***
School children ENT screening, on the spot treatment and general hygiene education
(Ratakaniri and Preah Vihearprovinces)		 100 0
Screening / treatment sessions (one day, one school) 1 0
**Safe water and sanitation ***
Water wells for schools (Ratanakiri province) 1 0
Water wells for health centres 1 0
Water filters for schools(7per school) 7 0
Water filters for health centres(2per health centre) 2 0

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Leprosy programme Leprosy programme Leprosy programme
Support training sessions on leprosy (Mongkul Borei, Banteay Meanchey province) 4 4
Health workers receive on-going training at above sessions 184 83
Community members benefiting from leprosy awareness raising (Banteay Meanchey and
Battambang provinces)		 962 2,909
People with leprosy identified and receiving treatment and support 10 37

IMPACT UK’s support has also made possible:

 516 people underwent cataract surgery to restore their sight at Preah Angdoung Referral Hospital using high quality Intraocular Lenses supplied by IMPACT UK

 Maternity equipment including two delivery sets, a suction unit, an operating table and an oxygen production machine was supplied to Svey Health Centre in Longvek in order to enhance the service it provides to pregnant women. In addition, 300 food parcels and 100 water filters were given to vulnerable families in the surrounding villages.

 32 midwives working in health posts around Borkeo Referral Hospital, Ratanakiri province, were provided with training on the management of postpartum haemorrhage and the use of non-pneumatic anti-shock garments. They were also given more general refresher training in safe delivery techniques.

 Supported surgery for another person with burn injuries. These operations are paid for as specific funds are raised for each operation.

 Vital maintenance on IC’s head office building in the grounds of Chey Chumneas Referral Hospital in Kandal, which fixed the leaking roof and cracked walls and enabled the audiology room within it to be improved to enable an expanded audiology service in the future. IC provides the audiology ‘feeder’ service for the ENT department at Chey Chumneas hospital.

 In response to the Covid-19 pandemic, IMPACT UK provided 5 hospitals and health centres with a total of 73,000 surgical masks, 750 pairs of gloves, 50 pairs of goggles, 1,000 plastic aprons, 30 hospital beds, 4 oxygen concentrators, 4 suction units, 10 pulse oximeters, 3 patient monitors, and 990 litres of sanitiser and disinfectant, 100 kg of detergent. A further 57,500 face coverings and 3,320 bars of soap were provided to the general public and emergency food parcels were given to 500 hungry families, 60 household water filters were distributed, and 10 rice mills (one per village) were given to enable villagers to make use of their paddy harvest.

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The Lake Clinic (TLC) is a mobile medical centre on a boat which travels to the floating villages on the mighty Tonlé Sap Lake in north-western Cambodia and its tributaries. This vital service provides primary medical care, maternity and newborn care, family planning, vaccinations, eye care, dentistry and health education to some of the most remote and underserved communities in the country and it is a lifeline to those living on the lake where development indicators are lower than elsewhere in Cambodia.

The team has a ‘children at risk’ programme which proactively seeks out under-fives who are stunted, underweight and malnourished and devises a care plan for them to ensure their nutritional needs are met. This is essential to prevent a lifetime of inhibited growth and cognitive underdevelopment. All residents, but especially new mothers, are encouraged and helped to grow and consume nutritious vegetables that can cope with the watery conditions to supplement the major food source – fish.

TLC’s main boat is supported by permanent floating clinics in five villages and smaller boats to ferry the medical team to villages which are difficult to reach when water levels are low. The team aims to visit each village once a month but this is dictated by environmental conditions. Travel across the lake is time consuming and some villages take up to a day to reach from the nearest town, Siem Reap. The team therefore stays out on the lake for several days at a time.

In line with WHO’s recommendation to incorporate mental health care with primary health care delivery, TLC has been expanding its work to deliver mental health care to the people living in floating villages, who face a great many additional challenges due to their particular living environment. 43 people with complex mental health needs have been supported this year with regular counselling or medication. They range in age from 9-59 years. Domestic abuse is common and TLC’s team has to carefully navigate a culture that tolerates it while trying to help those affected.

While the lake dwellers are surrounded by water, none of it is safe to drink so TLC makes and distributes bio-sand filters to households, and trains the woman of the house to maintain and safely use them. This gives them status and TLC has seen use increase as a result of this strategy.

TLC’s work had been hampered by Covid-19 but the start of 2022 saw a return to normal activity. Schools have reopened so the outreach team have once again taken health education and screening for conditions such as viual impairment into the classroom.

As part of a much wider programme of activities run by TLC, IMPACT UK’s support has achieved the following:

Peopleprovided with medical care or mental health care 628
Bio-sand water filters provided to families to make lake water safe to use 86 filters benefiting
430people

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Photo: Patrick Firouzian
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We work with three long-standing partners in India: IMPACT India Foundation, the PNR Society based in Bhavnagar, Gujarat State; and KEM Hospital based in Pune, Maharashtra State.

By late April 2021, India had become the epicentre of the Delta variant Covid-19 wave, the second wave to hit the country and far more devastating than the first. It was the first country in the world to record more than 400,000 new cases in a 24-hour period and health facilities buckled under the sheer weight of people urgently needing medical care. There was a shortage of hospital beds, oxygen, vaccines and ventilators meaning that far too many people did not receive any medical care at all and were unprotected from serious illness and death.

Our three Indian partners quickly made plans to help and asked IMPACT UK for assistance. This enabled a rapid response, untethered by bureaucracy, directing aid to where it was needed. The infrastructure and systems we built together stand ready to help once again should another new variant Covid-19 wave sweep across India in the future.

IMPACT India Foundation (IIF), established in 1983, was at the forefront of the international IMPACT movement and has blazed a trail with innovations such as the Lifeline Express hospital train which travels to railway stations across the country and stays in a siding for a month at a time to restore sight, hearing and mobility to marginalised people who would have little hope of surgery otherwise. Additional services have been added over time and now the Lifeline Express also screens for and/or treats conditions such as cancer and heart disease.

IMPACT UK’s focus this year has been on supporting IIF to meet the challenges of the Covid-19 pandemic, funding surgeries, and on an exciting matched funding appeal to mark the Lifeline Express’ 30[th] anniversary. The latter raised £206,335 from our generous supporters, and this was matched pound for pound by a philanthropic family foundation to make £412,670 – enough to fund three more Lifeline Express projects in the early part of FY 202223.

Our financial support also enabled IIF to take action to mitigate Covid-19 in Mokhada block, a rural area of Palghar District, Maharashstra State. More than 92,000 people live in 188 villages where vaccine coverage was low and as many as half the inhabitants in some villages were infected at some points. IIF set up a ‘Trace, Treat and Track’ systems (aka ‘Triple T’), training health workers to go house-to-house identifying Covid patients, logging and supporting them and mapping people with underlying health conditions for extra care. Food parcels were delivered to hungry families to ward off the ever present threat of malnutrition, and oxygen concentrators, PPE and medical equipment was provided to Primary Health Centres and Covid wards. IIF also supported the Government vaccination programme by providing nurses to deliver doses where there were shortages of trained health workers for the purpose.

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Covid-19:
Human resources built through recruitment and training:
Community Health Workers
Volunteer ‘Covid Fighters’
Health project managers
Tablet computersprovided		 17
70
2
30
People reached byhouse-to-house visits for support and Covid-19 education 92,000
Clinicallyvulnerablepeoplegiven anti-viral drugs 2,000
Face coverings and bars of soapdistributed to thepublic 30,000
Vaccines doses facilitated byIMPACT India Foundation 129,898
Healthposts receivingPPE and sanitiser 24
Medical diagnostic kits (containing items such as pulse oximeters, thermometers etc.) provided to health
workers		 100
Oxygen concentratorsprovided to health facilities alongwith 1,500 nasal cannulas and oxygen masks 25
Families receivingfoodparcels 1,500
Lifeline Express:
Operations to restore sight,hearingor mobility 24
Fundingsecured through special 30thanniversaryappeal(projects) 3

IMPACT UK’s support has also:

 Used restricted funding to help the Akshar Foundation remodel five government schools in Assam using its innovative teaching methods to ensure disadvantaged children are able to stay in school and gain skills for a productive life.

The PNR Society is a coalition of organisations which together form the largest body for disabled people in India. While access to schools has been restricted during the pandemic, preventing the Blindness and Deafness team we usually support from performing screening and treatment for children with visual or hearing loss, we have been able to provide backing to the PNR Society in its efforts to help people affected by Covid-19.

With our support, the PNR Society partnered with the Bhavnagar Indian Red Cross to set up Covid Care Centres, staffed around the clock by medical officers, in schools and community places to provide care for the very poorest people who had lost their jobs and were unable to pay for Covid-19 testing and medication when they fell ill. The aim was to prevent the need for ventilation and hospitalisation by providing oxygen and drug therapy early in the illness along with nourishing food to sustain the people admitted.

A Post-Covid Care Centre was also established which helped people taking a longer time to recover from the virus. Medical support such as physiotherapy was provided as well as other therapies including yoga, breathing techniques, healthy nutrition and counselling.

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Covid-19:
5 Covid Care Centres and 1 Post-Covid Care Centre established
People benefitingfrom these Centres		 1,042
Medical equipment provided to Covid Care Centres:
Oxygen concentrators
Wheelchairs
Hospital beds
Thermometers
Pulse oximeters		 10
5
4
12
9
Health facilitiesgiven medical equipment,PPE and sanitiser 6
Families receivingfoodparcels to last three months 1,367
People benefitingfrom Covid-19 health education 1,100
Face coverings distributed to the public
Bars of soapdistributed to thepublic		 1,500
900
Other:
Used a restricted legacy to establish the Dr I B Sardharwalla Early Intervention and Remedial Centre for
Children with Neurological Disorders at the PNR Society hospital and supported its Speech and Audiology
Clinic

KEM Research Hospital in Pune, Maharashtra State has been a vital IMPACT partner for more than 20 years. Like IMPACT India Foundation and the PNR Society, KEM Research Hospital immediately took action when the second wave of Covid-19 overwhelmed India, using our support to purchase vital medical instruments and PPE and cleaning supplies for the Government-designated Covid ward at the KEM hospital and for rural health centres in the surrounding area. KEM also used its existing ‘Tribal Empowerment Project’, which trains Government ASHA workers (so-called ‘Barefoot Doctors’) who provide the first tier of healthcare in indigenous villages, to provide Covid-19 health checks and health education. A mobile medical van supported the work of the Barefoot Doctors and a toll-free helpline was established for people to seek medical advice to further expand the project’s reach. Food parcels were distributed to meet the most vulnerable households’ basic needs.

Covid-19:
Human resources built:
ASHA workers (‘Barefoot Doctors’) trained on Covid-19, how to use oxygen concentrators, and treating
non-serious symptoms (one BFD per village) and provided with PPE
Tablet computersprovidedfor ASHA workers		 26
12
Mobile clinic visits to undertake testing and provide treatment
Peopleprovided with medical treatment through clinics		 91
1,987
Medical equipment provided to health facilities:
Oxygen concentrators
Multipara patient monitors
Ventilators
Adult ICU beds
Infusion pumps
Defibrilators		 10
4
2
4
4
4
Primary Healthcare Centres and sub-health centres receiving PPE and sanitiser
Population covered byPHCs		 10
60,000
Families receivingfoodparcels 3,028
People benefitingfrom Covid-19 health education 19,654
Face coverings distributed to thepublic 5,200
Toll-free helpline established 1
_Barefoot Doctor training (non-Covid): _
One BFD’sgeneral trainingand equipmentprovided to support her village 1

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‘The project area is remote and poverty stricken. As we distributed food kits, people explained the problems in their lives. Work is scarce, and they often sleep hungry. Life is even harder for anyone who is widowed, separated or with a large family. There is no government help for people in these situations and they are constantly looking for work. During the pandemic, many lost their loved ones either from the coronavirus or other medical illnesses. The food parcels have been so positively received in these difficult times’ KEM Society Team Leader

IMPACT Nepal has been delivering effective action to prevent and treat needless disability since 1993 when an inaugural primary ear care project was quickly followed by surgical camps to treat ENT and orthopaedic conditions for people living in remote areas. Many of these camps were held in a special tented operating theatre which was transported up mountains and across the Terai to reach areas where there was no formal medical care.

Over the past three decades, IMPACT Nepal has expanded its role into the prevention of malnutrition, delivery of ante and postnatal care to keep women and babies safe, and an ever growing number of Primary Ear Care Centres in rural villages.

It has also played an important role in protecting health care workers with PPE, building the infrastructure of hospitals and health posts to meet the new challenges thrown up by the virus, and feeding hungry people during the Covid-19 pandemic. National and local restrictions have made some elements of IN’s programme impossible to deliver once again this year since people have been forced to stay in their homes during lockdowns, but as they – and the flooding and landslides also widely experienced – have eased, the dedicated local team have restarted their work with even more commitment and drive than ever in order to serve the people who have been waiting patiently with ear conditions that need treatment, mobility issues to be improved, and many more medical concerns.

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IMPACT UK’s support has also:

 Thanks to our supporters purchasing ‘gift tokens’ it has been possible to provide 39 pairs of chickens and 9 goats so that families can use eggs and milk to fortify their diets, and 3 menstrual hygiene kits to help women manage their monthly periods.

 Provided restricted funds to help meet additional needs created by the Covid-19 pandemic. This included supplying 7 health centres with 810 gowns, 1,050 surgical masks and respirators, 3,444 pairs of surgical gloves, 600 pairs of googles, 600 shoe covers, 10,450 head covers, 680 plastic face shields, 35 litres of hand sanitiser/disinfectant and 8 thermometers. The public were given 1,704 face coverings, 4,668 bars of soap and 301 families and 121 students at schools for people with disabilities were provided with emergency food parcels due to the immediate risk of hunger. 54,568 people had their awareness raised about Covid-19 through health education.

Primaryhealth care workers,ear assistants and rehabilitation technicians trained 4 11
Communityfield workers trained 1 1
Female communityhealth volunteers trained 72 98
Health centres/healthposts upgraded 4 2
Adults received screeningand treatment services 9,879 10,421
Children aged 0-16years received screeningand treatment services 1,221 4,720
Ear surgical camps held in remote locations 5 9
Orthopaedic surgical camps held in remote locations 1 0
Adults benefited from hearing-restoringsurgerythrough mobile camps or at hospital 1,071 952
Children aged 0-16 years benefited from hearing-restoring surgery through mobile
camps or at hospital		 179 337
Adults benefited from mobility-restoring orthopaedic surgery through mobile camps
or at hospital		 19 0
Children aged 6-18 years benefited from mobility-restoring orthopaedic surgery
through mobile camps or at hospital		 6 0
Adults received rehabilitation support/ physiotherapy 184 1,342
Children aged 0-16years received rehabilitation support/ physiotherapy 6 1,332
People benefited from theprovision of assistive devices such asprosthetic limbs 250 712
People benefited from theprovision of hearingaids 40 153
Womenprovided with ante andpostnatal care 2,000 2,900
Women motivated to take up immunisation for themselves and their 0-5 year old
children		 1,000 2,965
Pregnant women/new mothers received iron supplements 2,000 3,182
Children aged 0-5years received Vitamin A supplements toprotect their vision 7,000 9,428
Women received de-wormingtablets 1,000 814
Children aged 0-5years received de-wormingtablets 7,000 8,158
People reached through a health awareness radioprogramme 50,000 70,000
People reached through health awareness raisingin the community 6,000 2,842
Homegardens established to feed families and reduce malnutrition 2,200 2,300

‘Since my childhood, I always suffered from earache and ear discharge and I could not hear properly. I needed surgery but due to my family’s poor financial status, we could not afford it. We would have had to sell rice from our small field, leading to a food deficit for all of us. We are grateful to IMPACT Nepal for conducting an ear camp near my home. Now, I am feeling better and my hearing is improved. I feel as though I have got a new life and I am planning my marriage ceremony’ Jyoti Kumari (26)

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In 2005, IMPACT Pakistan supported communities in mountainous villages of Kashmir in the aftermath of the huge earthquake which resulted in the loss of more than 86,000 lives, while tens of thousands of people were made homeless and lost their possessions and livelihoods. Grassroots level health facilities were also reduced to rubble. From an initial focus on delivering dry clothes, medicines, food and tents, IMPACT Pakistan helped to provide buildings so that schools could move back indoors (lessons were being held outside in the elements as classrooms had been destroyed in the earthquake) and permanent homes for families with disabled members.

Realising a long-term need for health services, by 2006 IMPACT Pakistan was moving ahead with the construction of community clinics. 16 were built, one per village, and called ‘Mamta’ (motherly feeling) clinics. Run by a fully trained local

Female Health Volunteer with ongoing support from IMPACT Pakistan, the clinics provide maternity and infant care, supporting women through pregnancy and birth - which is particularly risky in remote rural areas - but also primary healthcare for the entire community.

A General Practitioner doctor visits each clinic at least once a month to prescribe medication and see patients with more complex conditions. Women experiencing complications of pregnancy or delivery are quickly referred to the nearest hospital. This can mean the difference between life and death for them or their baby.

Health education sessions are helping people to take action for their own wellbeing although pandemic restrictions on gatherings have hampered this element of the project. It is encouraging to note that very few women in the villages where there is a ‘Mamta’ clinic now give birth at home without any trained assistance because they understand the importance of regular check-ups and help when it comes time to deliver their baby.

Women attending antenatal check-ups 3,200 3,120
Women and their babies attending postnatal check-ups 1,280 777
Babies delivered at a Mamta Clinic 860 416
Babies delivered at home assisted by a trained Female Health Volunteer No more than
60		 0
Babies delivered at home with noprofessional assistance No target 0
Pregnant women experiencing complications who were referred to a hospital to give
birth		 No target 33
Men, women and children who benefited from general primary healthcare at the
clinics		 12,400 11,294
Health education sessions run 22 2
People who attended health education sessions 1616 370
Local health workers who underwent continuing professional training to keep their
skills up-to-date		 64 53

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In 2004, a devastating tsunami struck in the Indian Ocean, washing away villages, towns, livelihoods and resulting in the loss of 230,000 lives across the region.

We worked with IMPACT Sri Lanka to provide emergency medical care and other support to affected people and when the emergency had receded, we helped to establish a ‘Wellness Centre’ to provide long-term health services in Weerawila, a low-lying coastal district.

A local doctor runs the clinic and provides primary health care to people in the area. A pharmacy gives access to essential medication. Once again this year, Covid-19 has taken its toll on activities with the health centre being forced

to close during lockdowns, and at other times being open only to long-standing patients. The rapidly rising cost of medicines in Sri Lanka has also been a challenge but the service has continued to be a lifeline for people with chronic health conditions in this area, which has been hit hard by the loss of tourist income.

People receiving primary healthcare:

Men		 212

Women		 327

Children aged 0-16years		 270

TOTAL		 809

IMPACT East Africa (IEA), our long-standing partner in Kenya, implements a programme of community level action to prevent needless disability and improve health in rural communities of Mwingi, Kitui County. This year, action was taken to northern Mwingi – an area overlooked by Government agencies and NGOs due to its distance from the main town over difficult terrain.

Once again this year, the Covid-19 pandemic has cast a long shadow over IEA’s work. Kenya endured one of the longest school closures in Africa and was one of the last countries to fully open its schools. For a programme which is so heavily focused on schools as the gateways to the wider community, this inevitably had an impact on what could be achieved. Many Kenyan children never returned to school. In addition, there were stringent travel restrictions which meant the IEA health team could not get to remote villages, and the Government of Kenya asked all NGOs to limit their contact with patients.

Whenever restrictions were eased, IEA powered ahead with its activities which include a School Health Programme of health checks and health education, First Aid, and on-the-spot treatments for conditions such as parasitic infection, ringworm and hearing impairment; provision of handwashing tanks, rainwater harvesting systems and pit latrines; and tree planting to improve soil conditions and provide much-needed shade.

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The team also benefited the wider community. Camps and mobile clinics were organised – some travelling 75kms from the hospital over unmade roads – to provide medical interventions for ENT conditions, and IEA’s Community Nurse supported the under-resourced government health service by providing care to expectant and new mothers and infants at outlying health posts. IEA has also played a vital role in ensuring that childhood vaccinations are available to youngsters in the remotest areas of Mwingi North, where it is estimated that fewer than half of children are up-to-date with their immunisations.

Water,Sanitation & Hygiene(WASH)
Install Pit Latrines in Schools(4 toiletsper school) 4 schools 5 schools benefiting1,750 students and teachers
Provide Handwashingequipment(2 tanksper school) 3 schools 5 schools benefitting1,750 students and teachers
Create ‘TalkingWalls’ for hygiene awareness 4 schools 0 schools – to be completed in summer 2022
Install Rainwater Harvesting systems in Schools 5 schools 5 schools received a 10,000 litre tank and associated
pipework to store rainwater for ongoinguse.
Surgical Camps
Eye – 3 daycamps benefittingapproximately25people 2 camps 0 camps *
ENT – 3 day camp benefitting approximatley 25 people 1 camp 1 camp benefiting 62 people, including screening, surgery
where appropriate (11 operations were performed and 6
people identified for surgery were found to no longer need
it due to their condition improving), referral to a different
hospital for further investigation through CT scans (4
people) and provision of non-surgical management of
conditions.
Clinics – screeningand treatment
ENT clinics for the community 3,000
people		 2,112 beneficiaries had their ears checked and treatment
provided
School eye clinics:
Spectaclesprovided 40 children 0 *
Clinics held in schools 48 clinics
benefiting
360
children		 5,515 children were reviewed for a number of health
conditions – including eye problems – by IMPACT East
Africa’s school health team but specialist eye clinics were
not possible due to the closure of the eye unit at the local
hospital meaningtreatment could not beprovided *
School Health Programme
First aid kits, drugs (ENT and de-worming), tree
planting, and health education		 32 schools 31 schools received supplies to supplement the work of
IEA’s school health team; 275 trees were planted during
the rainy season to prevent soil erosion and provide shade;
5,515 children were reviewed, de-wormed and
participated in health education sessions
Training provided to Teacher School Health Monitors 64
teachers		 68 teachers were trained and equipped to monitor the
health of students in their class and report concerns to
IEA’s team
Training provided to Pupil School Health Monitors 640 pupils 460 pupils were trained to support the teacher health
monitors and check their classmates for common
conditions
Maternal and Child Health Services
Training Community Health Volunteers at remote
health posts to run maternity clinics with support from
IEA’s nurse		 3 health
posts		 0. Remote health posts were shut due to Covid-19
Establish Mothers’ Clubs and provide members with
seeds to create home gardens and poultry and goats to
rear		 1 Mothers’
Club		 0 Mothers’ Clubs were established due to Covid-19
restrictions on gatherings
Provision of Ante and Postnatal monitoring for
pregnant women and new mothers		 300
mothers		 63 Mothers
Provision of health monitoring for children under 5
years		 400
children		 1,114 New-born babies and children under 5 years
Provision of standard vaccinations to babies 125 Babies 696 babies were vaccinated against common childhood
diseases

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IMPACT UK’s support has also:

‘By installing school toilets, our aim is to put an end to the widespread practice of open defecation and ensure that children understand the importance of handwashing to control the spread of preventable illnesses and parasitic infections. A further benefit is that it has also inspired parents from these schools to see the value of having pit latrines in their homes’ Mildred Omondi, IMPACT East Africa’s Community Nurse

We work with Maternity Africa (MA) and the Barbara May Foundation (BMF), who are sister organisations, to make motherhood and childbirth safer for women and their babies in their dedicated medical facilities in very rural areas of east Africa. With high rates of infant and maternal mortality (1,150 mothers died for every 100,000 live births in South Sudan in 2017) and many women who survive left with devastating birth injuries such as obstetric fistula, there is a real opportunity to significantly improve outcomes for women having children through the kind of monitoring and care that is routinely offered to women in countries such as the UK. The death of a mother is devastating for the whole family and threatens the survival of her baby and their older siblings too.

Maternity Africa (MA) runs a dedicated 48-bed maternity hospital (opened in 2018) in Kivulini, Arusha, which is located in northeast Tanzania and lies in the shadows of the country’s second highest peak, Mount Meru. It is also a stone’s throw from Mount Kilimanjaro and a wealth of national parks. Despite the thriving tourist and safari economy, many of the area’s people are extremely poor.

MA’s Kivulini Hospital also incorporates an obstetric fistula treatment unit and a midwife training centre, to enhance the skills and knowledge of local midwives working in government facilities in the region.

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This year, IMPACT UK has provided funds to MA to support women through pregnancy and childbirth, including Caesarean-section deliveries where medically required, and high dependency care for very poorly newborns. This action not only saves the lives of women and their babies, but also reduces the risk of them developing birth injuries such as obstetric fistula, and disabilities, for example, brain damage when babies have insufficient oxygen during difficult deliveries.

Many of the women giving birth or undergoing fistula repair at Kivulini are extremely vulnerable, traumatised and have few resources or family support so we have also funded the provision of ‘care packages’ to help them manage in the first weeks after discharge. These contain essential hygiene items, food, clothes and blankets and help women find their feet and care for their babies. They are also signposted to organisation which can provide ongoing support.

Once again this year, we have provided funds to support the work of BMF’s Vision Maternity Care Hospital in Barhirdar, Amhara, which provides medical services to approximately 200 women each month and provides around 12,000 free clinic visits for pregnant and postnatal mothers every year. Our support has seen 116 women safely through pregnancy, delivery and the weeks after birth.

War has ravaged the northernmost part of Ethiopia in recent years and since July 2021, the Tigray People’s Liberation Front rebel group’s offensive has spilled over into Afar, which shares a long border with Amhara. This has been met with attempts by Government forces to fight back leading to an ever more dangerous and bloody conflict which is killing and wounding civilians, and causing widespread starvation, suffering and internal migration. We have supported our partner maternity hospital in the area to provide an outreach programme of supplementary feeding for displaced pregnant women and new mothers, whose nutritional requirements are higher than normal. This has involved providing a carefully selected package of foods (for example, wheat flour, ground barley, sugar and dates) that require minimal cooking, are energy dense, and are also suitable for children. Parcels are targeted at the most malnourished women and last each recipient for one month. The outreach health team conducts monthly follow-up visits and nutrition screening to monitor the women. 1,090 women have received supplementary feeding support.

IMPACT’s also supports Maternity Africa and BMF to work in South Sudan as restricted funds are donated, however none were received this year.

IMPACT UK has supported Maternity Africa and the Barbara May Foundation with funds to provide:

Carepackagesprovided to new mothers,Arusha,Tanzania 7
Carepackagesprovided to women leavinghospital followingbirth injurysurgery,Arusha,Tanzania 2
Maternity care, delivery and postnatal care for women (and their babies) in Tanzania and Ethiopia,
includingCaesearean sections where medicallynecessary		 182
Supplementary feeding for malnourished pregnant and lactating women in war-torn regions of
Ethiopia		 1,090 women

IMPACT Zanzibar (IZ) started with medical care to prevent and treat hearing loss from a base at the main hospital in Stone Town and has expanded into a wide-ranging programme of action to prevent many causes of needless disability and ill-health for people living in rural communities across Zanzibar’s two main islands Unguja and Pemba, and sometimes beyond! For example, to Kojani Island, the only inhabited island east of Pemba in the Indian ocean, which is home to artisanal fisher-folk who live in challenging conditions and have no health facilities on the island. IMPACT Zanzibar’s team travel by small boat to reach Kojani to hold an annual health camp. This year 709 people benefitted from screening and treatment for a variety of conditions.

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IMPACT UK’s support is largely focused on helping IZ take eye and ear care into schools and community meeting places to make sure that people have easy access to medical care that can prevent common eye and ear problems turning into irreversible hearing or visual loss. Lack of alternative services in many of the villages IMPACT visits means that other health issues are addressed too – from hypertension and diabetes to maternity care and skin infections.

The School Health Project trains teachers and older pupils to conduct regular checks on children within the classroom and IZ’s team follows up to carefully diagnose suspected conditions and provide whatever treatment is necessary. This project teaches everyone about the early signs of needless disability, information that they also take home to their families, and which is crucial to ensure people seek treatment in good time to prevent longterm impairment. Often, people do not realise that treatment is available and live with deteriorating health quite unnecessarily.

IZ also established the first, and only, neonatal hearing screening programme in Zanzibar to identify babies who have impaired hearing. This uses a special test that shows up hearing loss in children too young to respond verbally to aural stimuli and is important because the earlier affected children receive specialist support such as hearing aids, the better their chances of avoiding delays to their speech, language, social and communication development.

Without specialist interventions, children born with severe hearing loss may never learn to communicate and this can lead to a lifetime of isolation with detrimental effects on mental health and wellbeing. The children identified by the neonatal screening programme are offered a place at the ZOP Academy, which we also support. This educational facility is solely for children with hearing impairment. It provides education and meets their additional needs for skills such as sign language.

ENT outreach camps 6 18
People screened/treated at outreach ENT camps 600 1,743
ENT operations to restore hearing 120 631
Mobile ENT and eye clinics held 6 12
People screened/treated at mobile ENT and eye clinics on Unguja island 900 5,402
Communitycamps held on Pemba island 3 6
People screened/treated at Communitycamps held on Pemba island 450 2,334
Schoolsparticipatingin the School Health Project 70 72
Children screened through the School Health Project 10,000 54,389
Children treated through the School Health Project 1,000 1,425
Babies reached by the Neonatal Hearing Screening team to identify hearing impairment
as soon aspossible		 3,000 3,087

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IMPACT UK’s support has also:

 Provided essential running costs for the ZOP Academy (a school for 28 young children with severe hearing impairment) and training in paediatric audiology for Dr Naufal Kassim, ENT surgeon and governor who is, in turn, training the Academy’s staff. Children with hearing loss are often kept home, do not attend mainstream education and may struggle to develop speech and communication skills without specialist teaching. The ZOP Academy provides basic schooling in maths and Swahili, with additional classes in speech, sign language, lip reading, English and more. The school also builds ‘soft’ skills such as confidence, sociability and self-worth while older students are taught practical skills from which they will eventually be able to earn a living. The school premises also house a hearing test centre and ear mould laboratory to provide the children with hearing aids since the earlier they get one, the better their chances of developing communication skills and learning.

 The generous legacy left to us by IMPACT UK’s former Trustee, Dr Immie Sardharwalla, enabled IZ to hold an additional 6 ENT screening and treatment camps, during which people with impaired hearing or other ear problems received the medical care they urgently needed. We felt this was a fitting tribute to Dr Sardharwalla, who spent his early years in Zanzibar.

Our work in the UK continues to provide vulnerable families with the skills and confidence to cook healthy meals

from scratch. 18% of the population of Sussex, around 310,400 people, report having a health problem or disability affecting their day to day activity. Investing time and energy in enabling people to cook cheap, nutritious food for themselves and decrease their reliance on ultraprocessed food is designed to improve people’s health and wellbeing. Our work in schools, local community hubs, with the previously homeless and teenage mums living in shared housing has also helped to reduce the social isolation felt by many during the pandemic. We have seen changing levels of restrictions throughout the year that has, at times, limited our work to online only sessions or group sessions with fewer participants to enable greater social distancing. Our series of easy to follow cooking videos on the ‘IMPACT Tasty Team’ YouTube channel are now available and we have launched our after school cooking clubs alongside further sessions during the school holidays for families to share a cooking activity together.

Our one to one sessions, whether held in person or via Zoom, enable our volunteers to work with people individually to help them cook for themselves and their families, introducing simple techniques, overcoming problems with dietary requirements and providing inspiration with easy, nutritious recipes. One such family was Sian and her son Oliver who were struggling to eat healthily on a tight budget. With Oliver due to start school this year Sian was keen for them to do some simple cooking together and to ensure he ate a wide range of different foods;

“I just wanted to let you know I spoke to Sian today and she said that she was really enjoying the cookery sessions, she has made apple crumble, a sauce for pasta and bolognaise, pizzas and pancakes (both sweet and savoury). She said it was really nice to have someone to be with her and teach her and that her confidence is growing and she is really looking forward to her lessons. It was so lovely to hear this! And obviously little Oliver will be benefiting immensely from having a healthier diet and being involved in the cooking process.”

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As another lockdown loomed in December we returned to supporting the local community with healthy recipe boxes over the Christmas period providing them with all the ingredients necessary to cook a delicious family meal along with some Christmas essentials. Over the coming year, along with building even stronger connections with the community groups we support, we are planning further development of our online resources to support both our loyal team of volunteers and local residents.

Lisa Waller, UK Programme Manager.

TastySessions inprimaryschools to introduce healthyfoods 6
TastySession Beneficiaries 170
Get Cooking Sessions with adults and children to develop the cooking skills
and nutritional awareness ofpeople in need of extra support		 80
Get CookingBeneficiaries 361
Recipe Box Deliveries 28
Recipe Box Beneficiaries 98
Number ofpeople benefitingfrom other events 85

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IMPACT works at the national and international level in partnership with many other governmental and civil society organisations, with the corporate sector and with community service organisations such as Rotary, Inner Wheel and Lions. We are members of Vision 2020/International Agency for the Prevention of Blindness, Sound Hearing 2030, Global Club Foot Initiative, Walk for Life and World Hearing Forum. We are members of the Fundraising Regulator, and several staff are members of the Chartered Institute of Fundraising; both organisations are designed to promote ethical standards and good practice in fundraising.

Our philosophy is shared with our many partners around the world through the International Federation of IMPACT Organisations and in practice through our working culture. We encourage our local partners (which are autonomous organisations in their own countries) to work with other NGOs and to collaborate with relevant stakeholders to influence policy on a local and national scale. Individuals from IMPACT Foundations are often asked to speak at professional conferences and to share ideas and practices more widely within their networks.

However, it is at the grass-roots level that our advocacy work makes the most impact by sharing knowledge and skills with often very marginalised communities, so that people can make informed decisions about their own health and take steps to minimise their – and their family’s - risk of needless disability. In turn, they become our best advocates by sharing learning with their neighbours and spreading the word about IMPACT so those who need us can make use of our services.

IMPACT is committed to equality and the creation of a barrier-free environment for all in accordance with British legislation (the Human Rights Act 1998, the Equality Act 2010) and international treaty obligations (the UN Convention on the Rights of Persons with Disabilities).

Accessibility for everyone is the keystone of IMPACT’s international programme of action. By preventing and treating needlessly disabling conditions and providing assistive devices such as hearing aids, spectacles and prosthetic limbs to overcome physical barriers, obstacles to training, education and employment are also removed. Our projects also directly seek to overcome other barriers to accessing health and medical care, for example, poverty, geographical remoteness and difficulty accessing information.

Recognising that there is no ‘one size fits all’ when it comes to accessibility and that people with different disabling conditions require different solutions, we make best efforts to accommodate everyone within the physical constraints of our small office, regardless of needs. IMPACT UK’s website has been carefully designed to be accessible. Please see www.IMPACT.org.uk/accessibility for further details.

Disability is a human rights issue. The 17 ‘Sustainable Development Goals’ (SDGs) to be achieved by 2030 were adopted in September 2015 to shape the post-Millennium Development Goals (MDGs 2000-2015) international development framework. People with disabilities are specifically referenced in five of the SDGs which is an important milestone, since disability was conspicuous by its absence in the MDGs.

IMPACT believes strongly in the power of education and training as a driver of long-term beneficial change. We work with local people to develop skills and gain knowledge that enables them to deal with the specific challenges they, and their communities, face. For example, we fund training and equipment for female health workers to meet women’s need for care during pregnancy, birth and in the post-natal period in areas where the nearest health post may be hard to access. This is keeping mothers and babies safe during a time of elevated risk.

We also work with our local partners to train health and nutrition volunteers, ear care workers, teachers to check their students’ health, and specialists such as nurses, surgeons and audiologists to deliver the best possible

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medical treatment – 2,606 of them in total this year. All are local people who make huge contributions to their communities as a result.

We provide people with information so they can make informed decisions about their own health behaviours and 226,788 people have participated in health education sessions or tuned into IMPACT’s health-based radio programmes this year. These focus on the steps everyone can take to protect themselves and their families and also give practical information about what health and medical services are available through their local IMPACT or IMPACT partner, or via Government programmes (e.g. vaccination or micronutrient supplement delivery). A further 228,474 people had their awareness of Covid-19 and how to mitigate their risks raised.

IMPACT is firmly committed to community-led development and by ensuring knowledge and skills are widely shared, we are working with marginalised people to make sustainable improvement in their lives and in the lives of others.

IMPACT UK takes the safeguarding of children and vulnerable adults extremely seriously. We are committed to ensuring safeguarding practice reflects statutory responsibilities, government guidance and complies with best practice and requirements of the Charity Commission. Our policies are regularly reviewed by IMPACT UK’s senior management team and board of Trustees. Every member of IMPACT UK staff regularly undergoes a Disclosure and Barring Service (DBS) check and we have ‘whistleblowing’ structures in place, should these be needed by staff or volunteers.

Here in the UK, our Tasty Team project works in primary schools and with vulnerable adults and children in our local community. Each of our volunteers is carefully vetted, undergoes a Disclosure and Barring Service check, receives full training and careful monitoring, and signs up to a raft of relevant policies including Child Protection; Code of Behaviour for Working with Children and Vulnerable Adults; Lone Worker; and Safeguarding Adults. They are regularly reminded of their responsibilities under these policies.

Our partners overseas are all autonomous organisations but we share safeguarding policies and best practice with them and strongly encourage them to ensure they have policies and practices in place to comply with safeguarding rules in their own country.

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IMPACT UK has ambitious plans for the future because we recognise that with a growing and ageing population, needless disability around the world continues to affect more and more lives every year. We receive no Government grants and our work is funded entirely by voluntary contributions from generous members of the public, charitable trusts, community services organisations and businesses.

underserved areas of Cambodia, to deliver quality medical care with a particular focus on maternity care

must be undertaken every four years to ensure the safety of the vessel and everyone using it

with rice mills to ensure they can make use of their rice harvest as a sustainable source of food for hungry families

 Continue to improve the resources (online and physical) available to volunteers and participants of the Tasty Team project in the UK and to explore opportunities to work with more local people to improve their food security, while building lifelong cooking skills and nutrition knowledge

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We start each year with the goal of generating at least £1.5 million of incoming resources to drive our programme of international action to prevent and treat needless disability for some of the most vulnerable people in our world. This amount enables us to meet the commitments we have made to international project partners for ongoing work, and more besides for new initiatives or partners, pilot projects and the emergency situations that sometimes arise and to which we can respond rapidly. It also makes our ‘Tasty Team’ project possible, here at home in the UK. With more income we can do even more – the need for our work is great. Our partners always have a long list of projects ready to be implemented as soon as funds are available.

Our income was £2,158,975 this year and all but £8,872 (investment income) came from fundraising. As mentioned in other parts of this report, the 30[th] anniversary matched funding appeal we ran for IMPACT India’s Lifeline Express Hospital Train and some large donations for Covid-19 work helped us to generate such incredible income.

We receive no statutory funding so fundraising for voluntary contributions is the driving force that makes everything described in this report possible. We have a specific Fundraising Policy and Procedure which is readily available and lays out our promise to our supporters and the general public that our fundraising, in all its forms, is legal, open, transparent and respectful. This policy covers in detail: legal requirements, fundraising compliance, staff responsibilities, vulnerable people, accepting donations, restricted donations, responding to donations, gifts in memoriam, cash donations and resolving complaints.

As a charity, IMPACT has a legal duty to raise funds effectively in order to deliver public benefit. We have a nimble and highly efficient fundraising operation and results belie its small size. This year we have generated £27.68 of income for every £1 expended on fundraising (FY2020-21 £21.73:£1).

We have never paid a third-party organisation to raise funds or send appeals on our behalf and we never share supporters’ information with other charities or purchase mailing lists. We believe that our fundraising is so successful because we keep it all ‘in house’ and only contact people who have already shown an interest in or commitment to our work. Perhaps most importantly, we work hard to develop personal relationships with the people who contribute to our work and make it easy for them to contact any member of the team, including the Chief Executive and Trustees. We understand that our supporters are essential partners who drive forward our work as much as the people on the ground delivering healthcare in remote villages of Africa and Asia.

We only pay for services where we cannot do it ourselves (for example graphic design and print) or where using a trusted supplier is more cost-effective.

Our fundraising almost exclusively takes the form of applications to charitable trusts, foundations and community service organisations, and appeals to individuals by letter or email, in strict adherence to rules governing data protection. Recipients are given ample opportunity to ‘unsubscribe’ so that we do not write to them again. However, we occasionally undertake events and support members of the public in their efforts to raise funds for us.

Legacies are an essential source of funds (£122,190 this year) and whilst we receive some legacies from people we have not had a prior relationship with, most come from people who have supported our work during their

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lifetime. We are humbled that so many supporters choose to remember us in their wills and strive to ensure that their legacy makes a real difference for the next generation. Legacies are usually unrestricted and we always try to invest them in action that we feel the legator would have supported during their lifetime. Restricted bequests are ring-fenced and spent entirely in line with the legator’s instructions unless this is impossible (for example, a project has ceased), in which case we work with the executors of the will to find an alternative use.

We also generate unrestricted income from selling small gifts such as water bottles and tote bags, and Christmas cards in our online shop, and restricted income from gift tokens representing aspects of our projects which people buy to ‘gift’ to their friends and relatives. Popular last Christmas were ‘gaggles of geese’, ‘chirpy chickens’, home gardens and operations.

IMPACT is fully signed up to and regulated by the Fundraising Regulator, an independent non-governmental organisation which exists to maintain standards and public confidence in fundraising within England, Wales and Northern Ireland. It provides guidance and a Code of Conduct for charities and acts as an investigator and arbiter where complaints about fundraising cannot be resolved between the charity and complainant directly.

Members of IMPACT’s fundraising team are individual members of the Chartered Institute of Fundraising and have completed the CIoF’s professional qualification. They are bound to adhere to its codes of conduct and practice.

As required by regulators, we maintain a log to record any complaints about our fundraising activity and we also receive a weekly summary of any complaints made against us to the Fundraising Regulator directly. There have been no complaints again this year and we attribute this to our very considered approach; sending careful appeals in a targeted manner to ensure that we only contact people we believe are genuinely interested in our work. We ensure that supporters’ contact preferences are recorded and respected so if a person requests no further contact, they will not hear from us again. Our policy is never to bombard supporters with appeals, and this has served to engender a large core of committed and long-standing supporters.

When a supporter engages with a charity, it usually involves the provision of personal data. This is an act of trust and IMPACT takes its protection very seriously. We regularly review data protection legislation and adhere to the relevant rules (General Data Protection Regulation (GDPR) etc.) All personal data is recorded on an industryleading database and stored on its secure servers, with multi-factor authentication for access. This further protects records from access by illegitimate parties. Hard copy data is kept in locked filing cabinets within our locked office and when no longer needed, is securely destroyed by shredding.

We have Data Protection and Fundraising policies which set out and formalise the good practice we use every day and which are reviewed annually by Council and staff.

The small staff team at IMPACT UK are assisted in their fundraising efforts by volunteers who raise money in numerous ways from sporting events and feats of endurance; ask for gifts to IMPACT in lieu of presents to mark life events such as marriages; to a mother who sustained a birth injury and committed to raising funds for our maternity work by being sponsored to regularly do her rehabilitation exercises. We provide information about good fundraising practice and Gift Aid, and support them with literature, sponsorship forms, help using online fundraising platforms and any other assistance they may request.

The IMPACT Luncheon Club has once again been able to meet each month to enjoy a delicious meal, listen to an interesting speaker, and raise much-needed funds for IMPACT’s work, for which we thank everyone involved. Profit this year has totalled £11,615; up 109% on the previous year which was so hampered by Covid-19 restrictions. The money raised this year has been used to pay for ear surgeries to restore hearing to people in Nepal, when hearing impairment remains a leading cause of needless disability.

Our sincere thanks also go out to the community service organisations that support IMPACT. Rotary Clubs in Great Britain and Ireland have been raising funds for our project work for more than three decades. Rotary clubs’ generous gifts have remained steady this year, totalling £21,941 (FY 2020-21 £22,100).

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We work with people fundraising on our behalf to ensure they are also adhering to good practice in fundraising, data protection, and safeguarding vulnerable people in the same way our small team in Haywards Heath does.

IMPACT has safeguarding policies to ensure vulnerable people are protected within our project activity, for example, the Tasty Team’s in the UK works with children and vulnerable adults and all volunteers are issued with a copy of the policy and stringent checks (including Disclosure and Barring Service) are made before they have any contact with beneficiaries. IMPACT staff members also undergo a regular DBS checks. Working practices are also designed with safeguarding in mind. Our autonomous international partners adhere to local legislation and we encourage them to consider safeguarding at all points of their projects from design to implementation.

However, vulnerable people must also be protected as part of good fundraising practice. Our high standards and good practice in fundraising generally also protects vulnerable people. For example, we never exert pressure on people to donate and our contact is only with people who have come to us, rather than been contacted ‘cold’. We respect requests not to be contacted whether they come from the individual or someone acting on their behalf, and because all gifts are processed by our team, we know many donors personally and are alert to gifts which might appear unusual. Any suspicions must be reported to the management team for further investigation and they will refer to the Board of Trustees to consider the information and make a final decision on how to proceed. While investigations are being conducted, the funds are ring-fenced and unspent. Our complaints procedure and membership of regulatory bodies provide a fall-back for vulnerable people, or those acting for them, in respect of IMPACT’s fundraising.

This year has been incredibly successful for income generation and funds have been rapidly put to work within our projects. Significant funds were pledged to help mitigate the effects of the Delta wave of Covid-19 which swept through India and surrounding countries at phenomenal speed in the middle of the year, causing a huge burden of illness as health systems struggled to cope with the sheer number of affected people. Our three local partners reacted quickly and efficiently to help in their project areas. A special matched funding campaign to mark the 30[th] anniversary of IMPACT India’s Lifeline Express hospital train was very successful and we are grateful to everyone who donated and the philanthropic family who matched the total. Both helped IMPACT UK’s income total £2,158,975, an increase of 27.8% on the previous year (FY 2020-21 £1,688,896).

We know that our supporters entrust their gifts to us because the maximum possible will be invested in our charitable activities in Africa, Asia and the UK. 94.31% of every £1 expended this year was used for this purpose which is well above our target of 90%. The remaining expenditure was split between our effective fundraising which powers the projects (3.34%) and essential Governance costs (2.35%) which ensure the Foundation is well run and meets legal obligations.

Our investment policy is set out in Note 5 of the Notes to the Accounts, below. Maximising returns with very low risk underpins the decisions made by the Council’s Investment sub-committee. This year, investment income was £8,872, down 13.6% on the previous year (FY 2020-21 £10,265).

Balances on restricted and designated funds (notes 20 and 21 in the accounts) show that significant commitments are made towards future programme expenditure. We pledge funding for up to three years so that implementing partners can plan their work and in turn avoid letting down the people who rely on the healthcare they deliver. Longer-term projects also allow greater depth in service delivery and provide partners with time to develop other income streams for their project’s future.

We continue to actively fundraise and explore new sources of income in order to meet any shortfall on specific projects and if restricted funds are subsequently raised and received, designated funds are released to be used elsewhere. Balances are held by the Foundation on interest-bearing deposit until and whilst the project is implemented.

Rigorous financial controls are in place and our cash position remains healthy.

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The Foundation expended £2,326,796 this year, up 33.6% on the previous year (FY 2020-21 £1,741,098) and this reflects the return to a more normal level of project implementation after Covid-19 restrictions were eased in most countries. The table below shows expenditure by country within our international programme with a comparison to last year.

We are immensely grateful for the gifts in kind of goods and services that we receive, and which make every pound go even further. This year, the value of gifts in kind was £18,306 (FY 2020-21 £90,554) made up of donations of PPE for use by health workers in Bangladesh, Cambodia and Nepal, and food and other goods from members of the public, Tesco and Waitrose, for the UK Tasty Team’s healthy meal boxes, which were delivered to families facing economic uncertainty at Christmas.

Thank you also to Jenny Stone CIPD, who provides Human Resources advice at no charge, and to the 10 volunteers who make the Tasty Team project in mid Sussex so transformational and also fun.

Africa(Maternity) £69,832 3% 2%
Bangladesh £563,616 24.2% 26.2%
Cambodia £195,798 8.4% 11%
East Africa(Kenya) £130,320 5.6% 6.8%
India £702,342 30.2% 13.4%
Nepal £201,744 8.7% 5.8%
Pakistan £38,977 1.7% 0%
Zanzibar £111,316 4.8% 9.7%
The UK(nutritionproject) £15,287 0.7% 1.4%
Other International £1,245 0.05% 6.2%

We encourage and work with our international partners to grow their ability to raise funds from which they can power their programmes as this is the way to secure long-term sustainability and is the best antidote to aid dependence. It underscores our relationships as equal partners and enables us to free up funds to pilot new projects and work with new partners. This in turn fosters diversification of our shared programme of action and allows us to reach beneficiaries in more areas.

Since every partner is fully independent of IMPACT Foundation UK, these funds are not included here, but on top of charitable gifts, income is generated in resourceful ways including rental from unused office space or spare operating theatre capacity, selling produce from farms, and cost-recovery from the delivery of medical care or pharmacy services to patients who can afford to pay.

Thanks to a Sussex-based charitable trust gifting us our premises in the early 1990s, we have no mortgage or office rental costs, and this enables us to keep our running costs very low.

It will be seen from the Balance Sheet that all our investments are represented by cash and short-term deposits. The balance on unrestricted, non-designated reserves is £164,968.

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Structure, governance & management

The IMPACT Foundation is a registered charity (number 290992, July 1985) and a public benefit company without share capital limited by guarantee (number 1878297). The Foundation is organised under the direction of its governing body, which is the Council of 12-20 Trustees who, for the purposes of company law, are also Directors of the Company. They are responsible for determining the policies and strategic direction of the IMPACT Foundation but, as there is no share capital, the Trustees have no interest in the IMPACT Foundation as defined by the Companies Act 2006.

The IMPACT Foundation operates in accordance with its constitutional mandate, the Articles of Association, and subject to relevant legislation. We are aware of the Directors’ duties under the Companies Act 2006.

The Trustees hold meetings at least three times a year to review detailed financial and progress reports and discuss new project proposals. The Trustees delegate the IMPACT Foundation’s day-to-day operations to the Chief Executive and the senior management team. Other meetings by sub-committees and task forces appointed for specific purposes take place on a regular basis. For example, a Staff Committee is delegated to consider human resource issues, policies and remuneration and an Investment Committee to consider investments. Recognising the need to keep up with the raft of new regulations and employment legislation, the Trustees retain the services of a volunteer Human Resources Consultant. All staff and members of the Advisory Council are invited to attend Trustees’ meetings.

The Trustees are responsible for preparing the Trustees’ Report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice). They prepare accounts for each financial year which give a true and fair view of the state of affairs of the charitable company; of the incoming resources; and of the application of resources, including the income and expenditure of the charitable company, for that period.

In preparing those accounts the Trustees are required to:

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.

The Trustees are responsible for the maintenance and integrity of the corporate and financial information 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.

In so far as the Trustees are aware: there is no relevant audit information of which the charitable company’s auditors are unaware; and the Trustees have taken all appropriate steps to make themselves aware of any relevant audit information and to establish that the auditors are aware of that information.

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The Board of Trustees’ other responsibilities include:

Trustees are asked each year at the beginning of a meeting to declare any conflicts of interest. A policy is in place to manage any conflicts which might arise.

Trustees serving during this period are listed on page 2. Trustees have no financial interest in the IMPACT Foundation and receive no remuneration for their services. Our Governance costs this year were £14,312 (FY 2020-21: £13,969).

The appointment of Trustees is conducted in line with the IMPACT Foundation’s Articles of Association and the terms of service were amended in 2021. Trustees collectively have the power to appoint any person to be a Trustee but the Board of Trustees must consist of not less than 12 and not more than 20 people. The skills mix and diversity of the Board of Trustees is also considered. As set out in the Articles of Association, from the 1[st] January 2022, a Trustee may serve for a maximum term of three years and is then eligible for re-election by secret ballot. A Trustee may serve no more than three consecutive three year terms, although may be appointed anew after an interval of at least six months.

Policies apply for the recruitment, selection, induction and training of Trustees and members of staff, all of whom have agreed job descriptions.

We recognise the importance of providing new Trustees with sufficient information to equip them to become effective members of Council. All new Trustees receive a comprehensive induction pack of background material. They are invited to spend time with the staff team and visit project activities. Fellow Trustees are invited by the Chair to act as mentors to new Trustees. Prospective new Trustees may be invited to first become members of the Advisory Council, which has no powers, in order to gain a better understanding of the Foundation.

During the course of this financial year, a group of Trustees (collectively the ‘Sub Committee, Board Management and Future’) which had been undertaking a review of board composition and succession planning, wound up having completed their work.

The Advisory Council is made up of people with an interest in the Foundation and its work, and with relevant skills and experience on which the Board and staff may draw. Members do not have voting- or decision-making rights but are encouraged to attend meetings and participate fully in discussions. It is a valuable resource and repository of knowledge.

After a natural hiatus, the Advisory Council has been reinvigorated this year and has its first new members – Lady Wilson and Mr Rob West – who stepped down from the Board in July 2021. It is anticipated that the Advisory Council’s membership will expand in the future and that members may move from the Advisory Council onto the Board, while it will also provide a means for retiring Board members who wish to stay involved with the Foundation to do so, thus retaining their experience and expertise for the benefit of the Foundation.

A meeting was held on 20[th] June 2018 to review the previous five-year strategy and plan for 2018-2023.

The new strategy confirmed IMPACT’s six priority areas and set out funding goals including maintaining at least 90% of expenditure on direct charitable activities; greater emphasis on funding new projects; and helping partners to contribute a greater proportion of funds themselves. In addition, some wider goals were agreed

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including seeking new partners to work with and new countries in which to work; pursuing the possibility of digital initiatives to deliver our work; and greater emphasis on malnutrition, obesity and diabetes within our work.

Progress towards meeting the objectives of the strategy is reviewed regularly by the Senior Management Team and discussed at Council level at least once per year. A full report will be completed at the end of the five-year period.

The staff team remains remarkably lean and effective and its achievements belie its small size. This year there were seven employees (three full-time and four part-time). The team is led by the Chief Executive who, with the Deputy Chief Executive and Funding and Development Director, form the management team which is tasked with implementing the strategic vision of the Board of Trustees and responsibility for the day-to-day running of the charity. The senior management team is ably assisted by the Finance Manager, Fundraising Manager, Office Manager and UK Programme Manager. All employees have access to the Employee Handbook and policies.

Volunteers add enormous value to IMPACT’s work and stretch limited financial resources as far as possible. Together, we achieve more and reach many more people in our collective fight against needless disability.

Covid-19 has once again meant that medical volunteers such as surgeons and anaesthetists from around the world have not been able to visit IMPACT’s projects to fill skills gaps, provide training and learn from local medical teams. Greater internet connectivity does make the world much smaller though, so advice can still be shared between medics via Zoom, email and more.

The Tasty Team in the UK is powered by volunteers from our local community in Mid Sussex – 10 people have given their time and skills freely this year to work with people who are learning cooking skills and nutrition and to deliver food parcels to families facing difficulties at Christmas. We are indebted to them all.

We are also immensely grateful to the people who run our successful fundraising Luncheon Club, help with mailings and raise funds or awareness about our work.

In addition, approximately 950 local volunteers work within our projects around the world; invaluable contributors to the health and wellbeing of their communities enabling IMPACT to reach more people than we possibly could otherwise.

Our 14 partner organisations in Africa, Asia and Europe (IMPACTs Norway and Switzerland are income generating organisation that exists to fund project work in communities of Africa and Asia) all share the same aim – a world free from disability.

When IMPACT was established in the 1980s, the organisation was ahead of the times in being set up not as a British head office with regional offices around the world run by British staff, but rather as a coalition of autonomous partners; each led and staffed by local people who initiate and drive the work in their country. Sir John Wilson, IMPACT’s visionary founder, was almost unique at the time in understanding that local people know best what is needed and how to meet those needs, therefore the role of the UK foundation should be to support them.

These partners are autonomous, registered not-for-profit organisations in their own country whose accounts are fully audited. Most of them are IMPACT Foundations although we do work closely with other organisations where we share aims and a long-standing relationship, and where is it more efficacious to partner with them than to set up an IMPACT Foundation which would duplicate effort.

Although on a forced hiatus thanks to Covid-19, the International Federation of IMPACT Organisations (IFIO) usually meets approximately every two years to exchange good practice, reaffirm our shared mission and ensure our priorities for action are still relevant.

42

We follow the ‘data protection principles’ set out by the Data Protection Act 2018 which is the UK’s implementation of the General Data Protection Regulation (GDPR). It has never been our policy to sell or exchange names and addresses with other organisations, or to disclose such data to a third party. We use an industry-respected database to store data safely. Confidentiality agreements and normal security procedures are in place. We keep Data Protection under regular review. We adhere to individuals’ rights to find out what information we hold about them and how we use their data, as set out by the 2018 Act, and would respond to requests in a timely manner.

The Charity Commission requires the Trustees to identify and review the risks faced by the IMPACT Foundation. A full risk assessment is kept up-to-date and also reviewed annually by the Management team and the subcommittee on staffing. It is then approved by the Board of Trustees.

The assessment covers risks under the following categories: reputation, financial, legislative/compliance, governance, staff/volunteers, infrastructure (property and assets), operational and fire, and sets out mitigations.

The UK Programme Manager conducts risk assessments for every part of the Tasty Team project before implementation.

43

INDEPENDENT AUDITORS’ REPORT TO THE MEMBERS AND TRUSTEES OF IMPACT FOUNDATION

OPINION

We have audited the financial statements of Impact Foundation Limited (the 'charity') for the year ended 31st March 2022 which comprise the Statement of Financial Activities, the Summary Income and Expenditure Account, the Balance Sheet, and the related notes. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards (United Kingdom Financial Reporting Standard 102).

In our opinion the financial statements:

 give a true and fair view of the state of the charitable company's affairs as at 31st March 2022 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 OF 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 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 the provisions available for small entities, in the circumstances set out in note to the financial statements, 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 charity's ability to continue as a going concern for a period of at least twelve months from when the original financial statements were 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 trustees are responsible for the other information. The other information comprises the information included in the annual report, other than the financial statements and our auditor’s report thereon. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon.

In connection with our audit of the financial statements, 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 audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether there is a material misstatement in the financial statements or a material misstatement of the other information. 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.

44

RESPECTIVE RESPONSIBILITIES OF TRUSTEES AND AUDITORS

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.

Our responsibility is to audit and express an opinion on the financial statements in accordance with applicable law and International Standards on Auditing (UK and Ireland). Those standards require us to comply with the Auditing Practices Board's (APB's) Ethical Standards for Auditors.

SCOPE OF THE AUDIT OF THE FINANCIAL STATEMENTS

An audit involves obtaining evidence about the amounts and disclosures in the financial statements sufficient to give reasonable assurance that the financial statements are free from material misstatement, whether caused by fraud or error. This includes an assessment of whether the accounting policies are appropriate to the charitable company's circumstances and have been consistently applied and adequately disclosed, the reasonableness of significant accounting estimates made by the trustees, and the overall presentation of the financial statements. In addition we read all the financial and non financial information in the Annual Report to identify material inconsistencies with the audited financial statements. If we become aware of any apparent material misstatements or inconsistencies, we consider the implications for our report.

OPINION 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

MATTERS ON WHICH WE ARE REQUIRED TO REPORT BY EXCEPTION

In the light of our knowledge and understanding of the charity 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 where the Companies Act 2006 requires us to report to you if, in our opinion:

• adequate accounting records have not been kept or returns adequate for our audit have not been received from branches not visited by us;

• the directors 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.

RESPONSIBILITIES OF TRUSTEES

As explained more fully in the Statement of Trustees' Responsibilities (set out on page 4), the trustees 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.

45

In preparing the financial statements, the trustees are responsible for assessing the charity'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 charity or to cease operations, or have no realistic alternative but to do so.

AUDITOR 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.

The extent to which our procedures are capable of detecting irregularities, including fraud is detailed below:

Based on our understanding of the Charity, we identified that the principal risks of non-compliance with laws and regulations related to breaches of UK regulatory principles, and we considered the extent to which non-compliance might have a material effect on the financial statements. We also considered those laws and regulations that have a direct impact on the financial statements such as the Companies Act 2006. We evaluated management’s incentives and opportunities for fraudulent manipulation of the financial statements (including the risk of override of controls), and determined that the principal risks were related to management bias in accounting estimates. Audit procedures performed included:

• assessing the impact of COVID-19 on the inherent risk of fraud, including potential opportunities for fraud with more remote working and where internal controls may not be operating the way they usually do.

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.

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 charity'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 charity and the charity's members as a body, for our audit work, for this report, or for the opinions we have formed.

STEPHEN POTTER FCA (Senior Statutory Auditor)

For and on behalf of

CARTER NICHOLLS LIMITED, STATUTORY AUDITOR Chartered Accountants, Victoria House, Stanbridge Park, Staplefield Lane, Staplefield, West Sussex, RH17 6AS

Dated:

46

IMPACT FOUNDATION STATEMENT OF FINANCIAL ACTIVITIES (including income and expenditure account) FOR THE YEAR ENDED 31ST MARCH 2022

Expendable Expendable
Unrestricted Restricted Endowment Total Funds Total Funds
Note Funds Funds Funds 2022 2021
£ £ £ £ £
INCOME AND ENDOWMENTS FROM :
Donations and Legacies 6 225,973 1,902,189 - 2,128,162 1,650,976
Income from Charitable Activities 7 - 21,941 - 21,941 27,655
Income from Investments 5 2,270 2,283 4,319 8,872 10,265
Total Income and Endowments 228,243 1,926,413 4,319 2,158,975 1,688,896
EXPENDITURE ON :
Expenditure on Raising Funds 8 77,670 - - 77,670 77,232
Expenditure on Charitable
Activities 9 440,231 1,808,895 - 2,249,126 1,663,866
Total Expenditure 517,901 1,808,895 - 2,326,796 1,741,098
Net gains / (losses) on investments 12 - - - 63,829
Net Income / (Expenditure) (289,658) 117,518 4,319 (167,821) 11,627
NET MOVEMENT IN FUNDS (289,658) 117,518 4,319 (167,821) 11,627
RECONCILIATION OF FUNDS
Total Funds brought Forward 665,412 529,370 986,799 2,181,581 2,169,954
Total Funds Carried Forward £ 375,754
 £ 646,888
 £ 991,118
 £ 2,013,760
 £ 2,181,581

The statement of financial activities includes all gains and losses recognised in the year.

All income and expenditure derive from continuing activities.

The notes on pages 50 to 58 form part of these accounts

47

IMPACT FOUNDATION BALANCE SHEET AS AT 31ST MARCH 2022

Note
FIXED ASSETS
Tangible assets
11
Property Investment
12
CURRENT ASSETS
Debtors
13
Short term deposits
Cash at bank and in hand
CREDITORS : amounts falling due
within one year
14
NET CURRENT ASSETS
TOTAL ASSETS LESS CURRENT LIABILITIES
NET ASSETS
FUNDS
2
Expendable Endowment
19
Restricted
20
Unrestricted
Designated
21
Fixed Assets replacement
19
Other
19
Total Funds		 2022
2021
£
£
111,758
115,167
-
-
111,758
115,167
9,156
22,696
1,840,126
1,854,677
62,870
198,977
1,912,152
2,076,350
10,150
9,936
1,902,002
2,066,414
2,013,760
2,181,581
2,013,760
£
2,181,581
£
991,117
986,798
646,888
529,370
1,638,005
1,516,168
99,029
367,670
111,758
115,167
164,968
182,576
375,755
665,413
2,013,760
2,181,581

The notes on pages 50 to 58 form part of these accounts

The above accounts have been prepared in accordance with the special provisions of Part 15 of the Companies Act 2006 relating to small companies

Signed on behalf of the board of Directors/Trustees

Robin d’O. Hope (Honorary Treasurer)

Peter Webster (Director/Trustee)

Approved and authorised by the Board:

48

IMPACT FOUNDATION STATEMENT OF CASH FLOWS FOR YEAR ENDING 31ST MARCH 2022

Note
Net cash used in operating activities
22
Cash Flows from investing activities
5
Increase / (decrease) in cash and cash
equivalents in the year
Cash and cash equivalents at the
beginning of the year
Total cash and cash equivalents at the
end of the year		 2022
2021
£
£
(159,529)
253,468
8,872
10,265
(150,657)
263,733
2,053,654
1,789,921
1,902,997
2,053,654

49

IMPACT FOUNDATION NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31ST MARCH 2022

1 ACCOUNTING POLICIES

Accounting Convention

The financial statements have been prepared in accordance with Accounting & Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK (FRS 102) (effective 1 January 2015) - (charities SORP (FRS 102) and the Companies Act 2006.

Reconciliation with previous Generally Accepted Accounting Practice

In preparing the accounts the trustees have considered whether in applying the accounting policies required by FRS102 and the Charities SORP FRS102 the restatement of comparative items was required. At the date of transition no items were identified that required restatement.

Capital Expenditure

Items of an enduring nature are treated as fixed assets. Other items are written off in the year of purchase.

Depreciation

Depreciation is provided on tangible assets, at a rate calculated to write off the cost less estimated residual value, of each asset over its useful life as follows:

Buildings Over 50 Years Computers and Equipment Over 4 Years

Investments

Investments are included in the accounts at market value at the year end.

Income and Debtors

Income is accounted for on a receivable basis taking account of entitlement, probability and measurement as defined within current accounting regulations. Debtors are measured by income receivable at the year end.

Gifts in Kind

Gifts in kind of assets held as stock for distribution by the charity are recognised as incoming resources within "voluntary Income" only when distributed with an equivalent amount being included as resources expended under the appropriate category of the Statement of Financial Activities to reflect its distribution. The assets are valued at the open market cost for equivalent items.

Expenditure and Creditors

Liabilities are recognised as soon as they become known. Expenditure on Charitable Activities includes the proportion of salaries, secretarial costs and other relevant expenses which relate to the planning, development and administration of these activities. Staff costs are allocated proportionally on a time spent basis. Other indirect costs are apportioned as the trustees deem appropriate from time to time.

Pension Costs

By agreement with the Trustees, the Foundation makes defined contributions to personal pension arrangements chosen by the relevant staff, and administers an auto enrolment pension. The costs of such contributions are charged to expenditure as they fall due.

50

2 FUNDS

These accounts include four categories of fund within the general headings of restricted and unrestricted.

Restricted Funds may be used for specific purposes and may not be used by the charity for any other purposes, without the prior consent of the donor.

Expendable endowment is a fund where the donor wishes income to be used for limited charitable purposes. The Trustees have power to convert the fund to income. This is also a restricted fund.

Unrestricted funds are expendable at the discretion of the Trustees who have designated funds which are earmarked for particular projects. Such designation is not a binding restriction - the Council can redesignate such money if they consider it appropriate.

Fixed Assets fund is an amount equal to the net value of functional fixed assets. This is treated as an unrestricted fund.

3 RESERVES

Unrestricted reserves are needed:

a) to provide funds which can be designated to specific projects to enable these projects to be undertaken at short notice, and

b) to cover administration, fund-raising and support costs without which the charity could not function.

The Trustees consider it prudent that other funds within unrestricted reserves excluding designated and fixed asset replacement should be sufficient to cover six months administration, fund-raising, governance and support costs.

Other unrestricted reserves as defined above currently equate to the minimum considered prudent.

The level of reserves is monitored and reviewed by the Trustees three times a year.

4 CAPITAL COMMITMENTS AND FINANCIAL LEASES

There were no capital commitments at the year end. There were no material commitments in respect of financial leases.

51

5 INVESTMENT POLICY

The Foundation's policy is to invest with careful consideration of the following:

a) SECURITY

d) ETHICAL

The need to avoid incurring losses and to take into account what level of risk is acceptable.

The need for easy and speedy realisation without incurring material loss.

Need to avoid unethical investment.

e) INCOME FROM INVESTMENTS

Bank and deposit interest
Property net income		 2022
2021
£
£
8,872
11,975
-
(1,710)
8,872
10,265

6 DONATIONS AND LEGACIES

Gift Aided Donations
Legacies
Other Donations
Sub-total
Gifts in Kind		 Unrestricted Restricted
Expendable
Total
Prior Year
Funds
Funds
Endowment
Funds
Total Funds
53,355
185,262
-
238,617
252,126
86,040
36,150
-
122,190
161,340
86,578
1,662,471
-
1,749,049
1,416,956
225,973
1,883,883
-
2,109,856
1,560,422
-
18,306
-
18,306
90,554
225,973
1,902,189
-
2,128,162
1,650,976

Gifts in kind of £18,306 represents donations of PPE for use by IMPACT Foundation in Bangladesh, Cambodia and Nepal, and donations of food and other goods for the UK Tasty Team's healthy meal boxes.

7 INCOME FROM CHARITABLE ACTIVITIES

Supporters Lunch Club
Rotary		 2022
2021
£
£
-
5,555
21,941
22,100
21,941
27,655

Profit from the Supporters Luncheon Club in 2021-22 totalled £11,615 and this was moved before year end to Nepal General to fund ear surgeries.

8 EXPENDITURE ON RAISING FUNDS

Staff Costs
Other Costs		 £
£
67,761
65,643
9,909
11,589
77,670
77,232

52

9 EXPENDITURE ON CHARITABLE ACTIVITIES

Bangladesh
Cambodia
East Africa
India
Nepal
Africa (maternity)
Zanzibar
Pakistan
Other International
United Kingdom
Support Costs		 Unrestricted Restricted
Expendable
Funds
Funds
Endowment
2022
2021
£
£
£
£
9,692
553,924
-
563,616
458,698
57,695
138,103
-
195,798
194,481
61,760
68,560
-
130,320
118,624
7,747
694,595
-
702,342
234,074
100,244
101,500
-
201,744
102,280
-
69,832
-
69,832
35,120
54,783
56,533
-
111,316
169,379
33,315
5,662
-
38,977
4,670
-
1,245
-
1,245
120,285
-
15,287
-
15,287
8,103
325,236
1,705,241
-
2,030,477
1,445,714
114,995
103,654
-
218,649
218,152
440,231
1,808,895
-
2,249,126
1,663,866

Included in the Restricted Fund resources expended is the sum of £18,306 which represents the value of Gifts in Kind as shown within note 6 to the accounts.

Support Costs are further analysed
Note
International Research
International
United Kingdom
Administration
Governance Costs
10
GOVERNANCE COSTS
Audit
Staff Costs
Other		 Staff
Other
23,107
1,746
95,292
18,802
21,201
3,763
33,780
6,646
7,183
7,129		 2022
2021
£
£
24,853
24,623
114,094
114,612
24,964
24,005
40,426
40,943
14,312
13,969
218,649
218,152
2022
2021
£
£
4,687
4,507
7,183
7,037
2,442
2,425
14,312
13,969
Total Expenditure
180,563
38,086

10 GOVERNANCE COSTS

53

11 TANGIBLE FIXED ASSETS

Cost
At 01.04.21
Additions during year
At 31.03.22
Depreciation
At 01.04.21
Charge for year
At 31.03.22
Net Book Value
At 31.03.22
At 31.03.21
12
PROPERTY INVESTMENT
At 01.04.21
Disposal
At 31.03.22		 Land and
Buildings
£
167,725
-		 Computers
Total
other equip.
£
£
8,581
176,306
-
-
167,725 8,581
176,306
53,213
2,754		 7,926
61,139
655
3,409
8,581
64,548
-
111,758
655
115,167
2022
2021
£
£
-
256,000
-
(256,000)
-
-
55,967
111,758
114,512

The property investment represents a bungalow donated to the IMPACT Foundation which was sold in the prior year.

13
DEBTORS
Accrued Interest
Income tax recoverable
14
CREDITORS - amounts falling due within one year
Sundry Creditors and Accruals		 2022
2021
£
£
5,189
6,794
3,967
15,902
9,156
22,696
2022
2021
£
£
10,150
9,936
10,150
9,936

54

15 EMPLOYEES

The average number of persons employed by the
Foundation was:
Full time employees
Part time employees
Staff costs during the year were as follows:-
Salaries and wages
Social Security costs
Defined pension contributions		 2022
2021
3
3
4
4
7
7
214,275
209,402
15,347
14,776
18,702
18,334
248,324
242,512

No employees received emoluments including pension contributions totalling more than £60,000

16 DIRECTORS / TRUSTEES

There were seventeen trustees, all of whom are members of the Executive Council and none of whom receive any remuneration from the Foundation.

Trustees did not claim reimbursement for expenses

17 AUDITOR'S REMUNERATION

The auditor's remuneration for audit work was £2,587 (2021- £2,587).

18 FUND MOVEMENT

FUND MOVEMENT
RESTRICTED UNRESTRICTED RESERVES
Expendable Other Fixed Asset Designated General Total
Endowment 2022
At 01.04.21 986,798 529,370 115,167 367,670 182,576 2,181,581
Income and Endowments 4,319 1,926,413 - - 228,244 2,158,976
Expenditure - (1,808,895) - (360,641) (157,261) (2,326,797)
Other - Designated - - - 92,000 (92,000) -
Asset replacement - - (3,409) - 3,409 -
At 31.03.22 991,117 646,888 111,758 99,029 164,968 2,013,760

55

19 ASSETS AND LIABILITIES SPLIT BY FUND

RESTRICTED RESTRICTED UNRESTRICTED UNRESTRICTED RESERVES
Expendable Other Fixed Asset Designated General Total
Endowment 2022
Fixed assets - - 111,758 - - 111,758
Current assets 991,117 646,888 - 99,029 175,118 1,912,152
Current Liabilities - - - - (10,150) (10,150)
Fund Balances 991,117 646,888 111,758 99,029 164,968 2,013,760

20 RESTRICTED FUNDS

Balance Increase Decrease Balance
01.04.21 31.03.22
Bangladesh
Riverboat Hospital and Prevention Project - 33,292 22,395 10,897
Coronavirus support - 52,078 52,078 -
General - 94,078 62,030 32,048
Nurses Institute 140,362 178,188 158,631 159,919
Community Health Care Centre 20,043 12,862 17,806 15,099
20th Anniversary Appeal 98,939 245 99,184 -
Fistula & Hydrocephalus 9,600 9,600 9,600 9,600
Equipment - 8,800 4,750 4,050
Water Appeal 3,229 26,516 16,516 13,229
BBC Radio 4 Jibon Tari Appeal 2021 105,985 28,900 132,110 2,775
Cambodia
General - 93,782 93,782 -
Lake Clinic 8,535 6,088
 14,200
 423
Lake Clinic Mental Health 375 2,700
 3,037
 38
Coronavirus support - 41,102 39,528 1,574
East Africa
Disability Prevention 874 144,515 85,878 59,511
Tumaini Children's Charity 1,134 563
 1,603
 94
Water Projects 696 35,880
 33,886
 2,690
India
Disability Prevention Bhavnagar 48,969 1,031 50,000 -
Integrated Project Pune 416 1,713 85 2,044
Lifeline Express Hospital Train 3,232 1,269 558 3,943
Lifeline Express 30th Anniversary Appeal - 165,655 9,106 156,549
General 1,697 203,327 200,186 4,838
Pakistan
Safer Motherhood 4,670 26,807 31,477 -

56

RESTRICTED FUNDS - Cont.

Nepal
General
Rautahat - Safer Motherhood
Surgical Camps
Coronavirus support
Africa
Africa General
Africa Fistula
Zanzibar
Water
General
School For The Deaf
Coronavirus support
Sir John Wilson
Memorial Fund
International
General
Eye Care
Coronavirus support
United Kingdom
Tasty Team Project		 -
95,644
84,029
11,615
533
-
533
-
3,000
-
3,000
-
-
40,938
40,938
-
1,561
71,357
69,805
3,113
316
163
446
33
180
675
33
822
-
44,830
44,830
-
-
91,024
48,857
42,167
10,551
26
10,577
-
3,256
244
3,500
-
-
154,794
105,350
49,444
54,750
622
-
55,372
1,059
544,811
545,870
-
5,408
16,692
17,099
5,001
529,370
2,230,811
2,113,293
646,888

All the above balances are held in cash.

57

21 DESIGNATED FUNDS

Bangladesh
Riverboat Hospital & Prevention Project
General
Nurses Institute
Cambodia
General
East Africa
Disability Prevention
Water projects
India
Disability Prevention Bhavnagar
Nepal
General
Pakistan
Safer Motherhood
Sri Lanka
Clinics
Zanzibar
General
International
General
Contingency Fund
All of the above funds are held in cash.		 Balance
Designated
Expended
Balance
01.04.21
during year
during year
31.03.22
9,693
9,693
-
5,219
12,000
13,350
3,869
9,000
-
9,000
-
23,674
20,000
43,674
-
54,487
-
54,487
-
269
-
-
269
4,587
-
4,587
-
67,420
40,000
81,150
26,270
26,807
-
26,807
-
2,192
-
500
1,692
37,759
20,000
49,830
7,929
76,563
9,000
76,563
9,000
50,000
-
-
50,000
367,670
101,000
369,641
99,029
22
RECONCILIATION OF NET MOVEMENT IN FUNDS TO NET
CASH FLOW FROM OPERATING ACTIVITIES
Net movement in funds
Adjustments for :
Depreciation charges /(purchase fixed assets)
Interest and rent from investments
Cash flow on investment disposal
(Increase) / decrease in debtors
Increase / (decrease) in creditors
Net cash used in operating activities		 2022
2021
£
£
(167,821)
11,627
3,410
4,900
(8,872)
(10,265)
-
256,000
13,540
(8,162)
214
(632)
(159,529)
253,468

58

How will you make your IMPACT?

The work you have read about in this report is only made possible by the generosity of our supporters. Funds are urgently needed to continue and expand our projects so that even more people benefit in the coming years. Please send us a donation using the Gift Form provided. Alternatively, telephone 01444 457080 or visit our website to make your gift. Thank you.

UK taxpayers can add more to their gift without it costing them an extra penny. Please tick the Gift

Aid box on the Gift Form, return it to us and we will do the rest. This will also enable us to claim Gift Aid on donations you have made to IMPACT in

You can change lives

the past four years. Higher rate taxpayers can also benefit from additional tax relief on their gifts which can be claimed via their self-assessment tax return or by asking HMRC to change their tax code.

Setting up a standing order using the regular giving form makes supporting IMPACT’s work simple and knowing that we can depend on regular gifts enables us to implement long-term projects. Ticking the Gift Aid box on the Gift Form means we can reclaim tax on your generous donations too.

Remembering IMPACT in your will gives a gift to future generations. Donations to charity are currently free of inheritance tax which can help to reduce the tax burden on your estate. Our special leaflet provides more details and is available upon request or online: www. IMPACT.org.uk/donate/remember-us-in-your-will

Tax relief is available on gifts of shares.

It is simple to support IMPACT using Just Giving, an online service which enables fundraisers to set up dedicated pages for their event or to collect gifts in memory of a loved one by debit or credit card. Please visit www.justgiving.com/impactfoundation

Please visit our website at www.IMPACT.org.uk. We publish regular newsletters and reviews and you can sign up for our e-newsletter online. You can also follow us on Twitter @IMPACT_UK_ and Facebook www.facebook.com/IMPACTFoundationUK and Instagram @impactfoundation_uk

We are only a telephone call away on 01444 457080 and would love to hear from you.

59

Could establish a garden to feed another family

Could help to restore sight, hearing or mobility; or repair another child’s cleft lip

Could help train and equip a local health worker or traditional birth attendant

Could bring clean water to a whole community

Knowing that we can depend on regular gifts enables us to implement long-term projects. You can set up a standing order to IMPACT using the regular giving form (right).

Remembering IMPACT in your will can make a difference to others long into the future. When the time is right, please consider leaving us a legacy.

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