medair uk annual report and financial statements 2010

Charity number: 1056731 Company number: 3213889

Medair UK

TRUSTEES’ REPORT AND FINANCIAL STATEMENTS

YEAR ENDED 31 DECEMBER 2010

PKF (UK) LLP

- 1 -

Medair UK TRUSTEES’ REPORT AND FINANCIAL STATEMENTS

31 DECEMBER 2010 CONTENTS Page DIRECTORS, OFFICERS & REGISTERED OFFICE 2 TRUSTEES’ REPORT INTRODUCTION Chair’s Introduction 3 INPUTS

Legal Basis, Objects & Principal Activity, Organisational Values, Related Parties 4 Structure, Governance & Management 5 Recruitment of Trustees 5 Contribution of Volunteers 6 Cost of Operation 6 OUTPUTS 2010 Operations 7 OUTCOMES Performance Against 2009 Targets & Targets for 2010 8-9 Financial Position 9 Future Plans 10 Awards & Memberships 11

IMPACT Selection of Beneficiaries, Beneficiary Accountability 12 Core Competencies 13-14 Field Visit Report 15-16 D.R. Congo 17-19 Haiti 20-22 Madagascar 23-25 POLICIES & RISK Restricted & General Funds 26 Reserves 26 Ethical Investment 26 Environmental Stewardship 27 Risk Management 27 Trustees 27

STATEMENT OF TRUSTEES’ RESPONSIBILITIES 28 INDEPENDENT AUDITORS’ REPORT 29 STATEMENT OF FINANCIAL ACTIVITIES 30 BALANCE SHEET 31 NOTES TO THE FINANCIAL STATEMENTS 32-37

- 2 -

Medair UK DIRECTORS, OFFICERS & REGISTERED OFFICE

TRUSTEES F Alldridge P L Doyle (Appointed 12/03/2010) J Eyre K I Frost N R Harris (Resigned 07/09/2010) E M Hughes J R C Ingram T W Lewis (Resigned 18/05/2010) N R S Longworth (Appointed 12/03/2010) K Osborn J Rey SECRETARY F Alldridge SENIOR STAFF B M Paine Development Director COMPANY NUMBER CHARITY NUMBER 3213889 1056731 REGISTERED OFFICE Unit 3 Taylors Yard 67 Alderbrook Road London SW12 8AD Tel.: 020 8772 0100 Fax: 020 8772 0101 Web: www.medair.org Email: [email protected] BANKERS AUDITORS HSBC PKF (UK) LLP 1 High Street Farringdon Place Harpenden 20 Farringdon Road Hertfordshire London AL5 2RS EC1M 3AP

Medair UK TRUSTEES’ REPORT

YEAR END 31 DECEMBER 2010

- 3 -

INTRODUCTION CHAIR’S INTRODUCTION

Dear Friend, I’m pleased, on behalf of the Board of Medair UK, to present our Report and Accounts for 2010. We hope you’ll find the information easily accessible, showing how inputs were turned into life-saving impact for the world’s most vulnerable people. Accountability is one of Medair’s core values – and our commitment to it continues to be recognised: Intelligent Giving ranks Medair UK as its no. 1 International charity and no. 1 religious charity. The accounts show that overall income to Medair UK fell in 2010 compared with 2009. This reflects the decision to run new European Commission grants directly between Medair (Switzerland) and the Commission, without Medair UK. We welcome this move to reduce risk and further increase efficiency. As a result, overall income to Medair UK fell in 2010 compared with 2009 and the relative cost of generating funds rose accordingly. This fall in institutional income was accompanied by a rise in private funding, and despite the challenging economic climate, we are delighted to report very strong fundraising performance across the year with our overall target exceeded by 17%. This allowed Medair UK to grant over £350,000 in privately-generated income to vital humanitarian projects, and to end 2010 in a strong financial position. 2010 was also an excellent year for our other measures, exceeding recruitment and support targets, and with two wonderful new trustees welcomed onto the Board. Pages 15-25 show why all of this is so important: the world’s most vulnerable people – those who need most help, but so often get the least – face very real challenges just to survive. With the support of many generous people, churches, companies, trusts and other organisations, Medair UK has this year continued to provide the people, funding and prayer needed to deliver life-saving help where it’s needed most. We offer them our deepest thanks. Please get in touch, attend an Open Evening or consider applying to work with us if you’d like to join us in serving the most vulnerable. Esther Hughes Chair of the Board and former Logistician, Medair Kosovo [email protected]



- 4 -

INPUTS

LEGAL BASIS

Medair UK is registered in England and Wales, both as a charity (no. 1056731) and a company limited by guarantee (no. 3213889). It is governed by a Memorandum and Articles of Association dated 19th June 1996.

OBJECTS & PRINCIPAL ACTIVITY

Medair UK’s objects are to relieve human need, hardship and suffering in whatever parts of the world particularly by means of mobilising and deploying human and material resources to provide appropriate relief and aid to distressed populations, without racial, political or religious discrimination. In keeping with this and paragraphs (g), (h) and (k) of its Memorandum and Articles of Association, Medair UK pursued these objects through the provision of resources in support of the multisectoral relief and rehabilitation projects co-ordinated by Medair (Switzerland). During 2010, Medair (Switzerland) co-ordinated field operations in Afghanistan, D.R. Congo, Haiti, Indonesia, Madagascar, Somalia/Somaliland, Sudan and Uganda. In setting objectives and planning activities, Medair UK’s Directors and Officers have given careful consideration to the Charity Commission’s general guidance on public benefit and, in particular, its supplementary benefit guidance on prevention or relief of poverty. An overview of the significant activities and achievements undertaken in order to carry out the charity’s aims of providing relief and aid without discrimination to some of the world’s most vulnerable, and bringing their needs to the attention of the wider public, can be found in the Outputs, Outcomes and Impact sections of this report.

ORGANISATIONAL VALUES

Integrity – We strive to live out our values and principles consistently at every level of the organisation, and in every location – from the most remote team to international headquarters. Our desire is that, as we work together, our attitudes, words, and actions will be true to Medair’s vision and character. Hope – We seek to bring hope to people devastated by crisis and caught in apparently hopeless situations. Together with the communities we serve, we strive to make sustainable improvements and increase their capacity to build a better future. Compassion – We desire to relieve human suffering in times of crisis, disaster, and conflict. We seek out people who are the most vulnerable, come alongside them and offer practical support through relief and rehabilitation initiatives. Accountability – We are committed to best practices in our management and operations, pursuing excellence in all that we do. We make ourselves accountable to our supporters, our staff, and those we serve, and seek input from them to help us improve our activities and procedures. Dignity – We believe that each person has been made in God’s image and is therefore uniquely valuable and worthy of highest respect. Consequently, we reach out to all in need, irrespective of their race, gender, religion, age, or nationality. Wherever possible, we personalise our assistance, taking individual needs and circumstances into account, and respecting the dignity and independence of the people we serve. Faith – Because we follow Jesus Christ, who taught that our highest goal is to love God and to care for those in need, we are motivated to care for those who suffer. Our faith inspires us to give our best in all circumstances. By faith, we pray for wisdom when facing difficult decisions, and for courage to live and work in demanding and often dangerous situations.

RELATED PARTIES

Medair UK is a Medair affiliate office, co-operating with Medair (Switzerland) through an Affiliation Agreement, which governs this relationship. Medair (Switzerland) is a registered charity in the Swiss Canton of Vaud, with offices at Chemin du Croset 9, 1024 Ecublens, Switzerland. There are other Medair affiliate offices located in France, Germany, the Netherlands and the United States.



- 5 -

STRUCTURE, GOVERNANCE & MANAGEMENT

In 2010, Medair UK’s Board of Trustees (who are also Directors for the purposes of company law) oversaw the work of a Development Director, Development Manager, Development Officer (new role), Finance & Support Services Manager and volunteers, delegating responsibility for day-to-day decision-making to the former.

RECRUITMENT OF TRUSTEES

Before appointing (a) new Trustee(s), existing Trustees carry out a self-assessment process to identify areas for development, and expertise desirable in new Board members. The Trustees consider the attributes they believe to be most relevant in ensuring that the Trustee body is best able to serve the charity’s beneficiaries.

Following a review of its membership in the second quarter of 2009, the Board pursued the following process for the recruitment and appointment of a new Trustee(s):

1. Solicit expressions of interest through existing supporter network and other public advertisements. 2. Applicants receive skills and person specifications, requirements of a Medair UK Trustee (including

eligibility criteria), overview of Medair UK’s Objects and activities, request for CV and letter of motivation. 3. Shortlist applications and invite shortlisted applicant(s) to meet one to three existing Trustees. 4. Invite approved applicant(s) to attend and observe next Board meeting. 5. Reconfirm applicant’(s’) willingness to stand as Medair UK Trustee. 6. Existing Trustees vote to appoint successful applicant(s) at next Board meeting. 7. Continue comprehensive Trustee induction process, including founding, financial and planning

documents, Charity Commission approved literature and meetings with all staff. During 2010, two Trustees resigned and two new Trustees were recruited, appointed and inducted. In addition, policies and procedures for the ongoing development of the Board were further improved, and one trustee visited Medair’s Zimbabwe field programme. Accordingly, the 2011 Operating Budget provides for further investment in Governance training and development, including travel to review the work of Medair (Switzerland) in person.



- 6 -

CONTRIBUTION OF VOLUNTEERS

Throughout 2010, Medair UK’s operations were ably and generously supported by volunteers. Details of the areas in which volunteers assisted are shown below, together with an indicative value of the salary which would have been payable to waged workers carrying out the same work.

Volunteer role Hourly value Hours donated Total Fundraising £12.00 408 £4,896 Recruitment of field staff £12.00 115 £1,380 Administration £12.00 763 £9,156 Total 1,286 £15,432

The Trustees and staff are extremely grateful to all the volunteers who gave their time and skills during the year, without whose contribution Medair UK would not have functioned as effectively or fully as it did.

COST OF OPERATION

Medair UK’s total operating expense for 2010 is summarised below. Direct costs represent expenses attributed directly to key activities (e.g. staff time and appeal mailing costs etc.). Indirect costs represent expenses attributed to activities in support of key activities (e.g. accounting and office costs).

The apportionment of indirect costs was tracked against staff time throughout the year. It is by this method that Medair UK calculates its fundraising return on investment (ROI), reported below under Outcomes.

Activity Direct costs Indirect costs Total Fundraising £168,556 £49,733 £218,289 Recruitment of field staff £22,748 £12,240 £34,988 Prayer coordination £1,139 £1,137 £2,276 EC grant management £430 £592 £1,022 Support of field staff £775 £1,067 £1,842 Other activities in support of Medair (Switz.) £1,708 £1,491 £3,199 Governance (inc. audit) £11,688 £2,351 £14,039 Total 75% 25% £275,655



- 7 -

OUTPUTS 2010 OPERATIONS In 2010, Medair UK sought to enable and support field operations co-ordinated by Medair (Switzerland) by pursuing the following key aims and achievements: 1. Raising funds from individuals and organisations

Medair UK appealed directly to individuals, churches and other organisations for funds to meet our charitable objects. Fundraising approaches were made via post, email, internet, telephone and in person. In seeking to develop the value of the relationships it already enjoys with its supporters, Medair UK produced and disseminated newsletters (Medair News) and targeted appeal mailings (focused during this period on Afghanistan, Haiti, Somalia/Somaliland and Sudan in particular). In addition, email and other fundraising methods were used and evaluated and staff and Trustees made numerous presentations to groups and individuals in person. In seeking to acquire new supporters, Medair UK attended and spoke at events and churches and otherwise pursued a strategy of networking, largely via its Board of Trustees and returned field staff.

2. Acting as legal partner in the receipt and disbursement of humanitarian grants made by the European Commission

Medair UK represented Medair (Switzerland) in acting, under a Framework Partnership Agreement, as legal partner with the European Commission. As lead partner, Medair UK formally applied for and received grant funding from the Commission. For each grant received, a binding Project Implementation Agreement was made between Medair UK and Medair (Switzerland) and the full value of the grant disbursed from the former to the latter, as received. Medair (Switzerland) then co-ordinated all operational activities in the field and provided regular progress, expenditure and impact reports to Medair UK and the Commission.

3. Recruitment of field staff on behalf of Medair (Switzerland)

Medair UK attended, exhibited and presented at events and churches and placed recruitment advertisements with targeted publications and web sites. Opportunities were also communicated via email and a series of Open Evening events. These actions aimed to encourage appropriate candidates to apply to attend the Relief and Rehabilitation Orientation Course (ROC) run by Medair (Switzerland) as a means of both selection and initial training of field staff.

4. Encouraging and resourcing prayer support

Prayer partners were recruited through departing field staff and at events and churches. Monthly prayer reports and urgent requests from each country programme were forwarded by email to prayer partners throughout the UK.



- 8 -

OUTCOMES PERFORMANCE AGAINST 2010 TARGETS & TARGETS FOR 2011 1. Maintain and develop relationship as legal partner with the

European Commission. 2010 Target: Maintain positive and fruitful relationship with European Commission. 2010 Performance: During 2010, Medair UK facilitated 3 EC-funded programmes across Africa and Asia and disbursed a total of €931,771 (£800,307) to Medair (Switzerland) accordingly. No new EC grant agreements were signed. In late 2007, Medair UK’s partnership with the European Commission was renewed and extended once again, including the signature of a new Framework Partnership Agreement (FPA) with the European Commission Humanitarian Aid department (ECHO), which remains valid until 31st December 2012. In addition, following ECHO’s extensive annual partners assessment exercise, Medair UK (in partnership with Medair (Switzerland)) was selected for the group of most reliable partners, with a risk level indicating that there should be a decrease in administrative burden. This is seen as a great achievement and will support further gains in efficiency. In full agreement with Medair (Switzerland), Medair UK’s role in facilitating EC grant agreements is being reduced, where possible. Medair UK will continue to facilitate existing grants and any future grants, where required, but the Board expects this role and its income to reduce significantly.

2011 Target: Maintain positive and fruitful relationship with European Commission (albeit at likely reduced level of income).

2. Grow private / voluntary income.

2010 Target: Raise £500,000 or more in private income. 2010 Performance: Total private income raised £588,325. In total, £272,352 was received in donations restricted to specific programmes and £248,099 in unrestricted donations. These figures were increased by £30,456 and £37,418 respectively, by reclaiming tax on eligible donations through the Gift Aid scheme. The Board is pleased to report a strong performance in private fundraising, exceeding the overall income target by 18%. In addition, the following notable successes were recorded in 2010: The number of active major donors grew by 21%; The number of regular (mainly monthly) donors grew by 20%; 49% of private income was unrestricted, enabling it to be applied where most needed; Intelligent Giving continued to rank Medair UK its no. 1 ‘religious’ and no. 1 ‘international’ charity.



- 9 -

Overall in 2010, alongside its other activities, Medair UK invested £218,289 in income generation and achieved a 2.7 average return on investment (ROI). ROI is calculated for income generated from private sources using a cost apportionment method. Once direct costs have been allocated, indirect support costs are apportioned to Charitable Activities, Cost of Generating Funds, and Governance. The basis for apportionment is staff and volunteer time spent on each activity. ROI is the total generated funds divided by the sum of directly allocated and apportioned indirect costs of generating funds.

It should also be noted that a proportion of this expenditure relates to income expected to be received in future periods, such as legacies and other major gifts which are not reflected in this year’s ROI.

2011 Target: Raise £550,000 or more in private income.

3. Solicit applications to Medair’s Relief & Rehabilitation Orientation Course (ROC) from potential field staff. 2010 Target: Medair (Switzerland) invites at least 25 UK applicants to the ROC. 2010 Performance: Medair (Switzerland) invited 29 UK applicants to the ROC. 2010 was a very successful year in field staff recruitment terms. Of 350 UK applicants, 29 attended the ROC (32% of all attendees). At year end, 22 had joined field projects. UK-sourced staff continued to represent the largest group (33%) of all international field staff. In addition to this, 89 applications for HQ vacancies at Medair (Switzerland) and 276 applications for specific field vacancies were received from UK-based candidates during the year.

2011 Target: Medair (Switzerland) invites at least 25 UK applicants to the ROC.

4. Reinvigorate and grow the UK Medair supporter network. 2010 Target: 3,000 active contacts across donors, ambassadors and prayer supporters. 2010 Performance: 3,266 active contacts (2,221 contactable donors, 730 prayer partners, and 315 new contactable non-donors at 31st December). The development of Medair UK’s supporter network exceeded its target in 2010 thanks in part to the highly-publicised Haiti emergency to which Medair responded.

2011 Target: 4,000 active contacts across donors, ambassadors and prayer supporters.

FINANCIAL POSITION As set out above, successful fundraising amongst very generous supporters in 2010 delivered Medair UK’s second strongest private income result to date. Medair UK was therefore able to maintain a good level of reserves (see page 26), whilst continuing activities and investment in fundraising for income in future periods. This affirms the appropriateness of the long-term fundraising strategies instigated in previous financial periods. At the end of the period, Medair UK remained in a healthy financial position, holding free reserves of approximately £90.5k which it expects to draw on as working capital during the next 12 months. Free reserves comprise general unrestricted funds less fixed asset and rent deposit funds and are subject to Medair UK’s Ethical Investment Policy (see page 26).



- 10 -

FUTURE PLANS Fundraising shall remain Medair UK’s focus. Medair UK’s medium-term fundraising objective is to raise at least £500,000 per year in unrestricted funding on an ongoing and sustainable basis. This will represent a very significant contribution in serving the needs of those caught in crises in Africa, the Middle East, and Asia. It is expected that the majority of this income will be sourced via channels which Medair UK has already been developing, but additional fundraising plans are also in place for 2011 in the areas of legacies and other new income streams.



- 11 -

AWARDS & MEMBERSHIPS Intelligent Giving Intelligent Giving has continued to rank Medair UK first amongst all ‘religious’ charities, and first amongst all international charities. This assessment places Medair UK in the top three out of the 1,400+ UK charities reviewed. The mission of Intelligent Giving is to help people give happily and with confidence. Their objective is to increase standards within the charity sector, reassuring people that their donations are being put to use wisely and accountably. Fundraising Standards Board Medair UK remained a member of the Fundraising Standards Board (FRSB), having joined ahead of the FRSB’s public launch in 2007. The FRSB is the body for self-regulation of fundraising in the UK. The FRSB scheme is open to all fundraising organisations and members agree to adhere to the highest standards of good practice with their fundraising and a Fundraising Promise. They demonstrate membership of the scheme by using the tick logo on their fundraising materials. By participating in the scheme charities are both advertising their commitment to best fundraising practices and giving the public the comfort of a 'safety net' provided by a robust complaints system. At the time of writing, Medair UK has not received any complaints. ImpACT Coalition Medair UK also remained a member of the ImpACT (Improving Accountability, Clarity and Transparency) Coalition of charities during 2010. The Coalition works together to improve public trust and confidence in the sector, its values and the way charities work. The Coalition aims to raise awareness among the general public of the nature and activities of modern charities, to focus the public debate on the benefits charities bring, rather than on the costs of running them and to improve the standards of transparency and accountability within the sector, communicating with clarity and openness. ISO Medair was the first humanitarian NGO to become ISO 9001:2000 certified at worldwide level. This includes the activities and operations of Medair UK, as well as those of other affiliate offices, headquarters and field operations. Medair UK’s on-going certification requires not only the maintenance of defined quality processes, but also its commitment to continuous improvement.



- 12 -

IMPACT The provision of resources from Medair UK played a key role in enabling Medair (Switzerland) to provide life-saving relief and rehabilitation to the world’s most vulnerable people in 2010. The following pages highlight principles, practice and examples of impact from the three country programmes coordinated by Medair (Switzerland) that have received the most funds from Medair UK over the course of the year (including EC grants and private donations).

SELECTION OF BENEFICIARIES

Medair seeks out the neediest, most vulnerable and neglected people in some of the most remote and hostile regions on earth. During 2010, the Operations Team met to consider prayerfully who and where were the world’s most vulnerable people. By combining two key European Commission reports, the Global Needs Assessment and the Forgotten Crises Assessment, with other information, Medair identified its beneficiaries – the most urgently needy, most forgotten people on earth.

BENEFICIARY ACCOUNTABILITY

When a severe crisis strikes, people are torn away from their familiar routines and forced to use all their resources to survive. These vulnerable people often need assistance, but they also need a voice. You wouldn’t want strangers from other countries telling you what you need without consulting with you. If your community were in crisis, you would want to have input into the recovery process.

At Medair, we make ourselves accountable to the people we serve. We involve beneficiaries in the design, implementation, and monitoring of our relief and rehabilitation projects. Our teams prioritise building positive relationships with local communities in order to understand their real needs.

We work with beneficiaries, not instead of or in spite of them. We listen to their needs and respond to them. In this way, we help people recover from their crisis with dignity, with integrity, and with hope for a brighter future. Building Bridges to the Community

In the jungles of D.R. Congo, armed militia have terrorised people for years with vicious attacks. In Ituri district, countless families have fled from their home villages to live as “IDPs”—internally displaced persons—sometimes living in crowded temporary settlements, sometimes sleeping under trees.

Medair wants to make sure that these IDPs have access to quality health care. We regularly meet with health officials and local medical authorities, confirming the level of need, and gaining a better understanding of the current situation. Our staff often travel to remote villages and IDP camps and assess the conditions. We consult with community groups and individuals about their most pressing needs and how we can best help them.

After careful consideration, Medair determines the most needy areas to provide free health care for vulnerable people. We also train and supervise local health clinic staff to help strengthen the overall health system.

We work closely with community groups as key partners. These partnerships with IDP committees and community health workers help keep us accountable to our beneficiaries. Community groups make us aware of any needs and concerns within the community, and they also help ensure that everyone knows that free services are now available to them.

“We are like a bridge that connects the health centre to the community,” said Akyenga Rungu, a community health worker in Bukiringi. “If there is a member of the community who is very ill, we mobilise people to bring the person to the health centre. We also receive information from the clinics and pass the messages to the population.”



- 13 -

Two months into a recent project, Medair held focus groups with community members to make sure that we fully understood beneficiary expectations and concerns. We asked for opinions on the quality of service and for new ideas that might improve services. We provided all IDP representative groups and health officials with a Medair number to call with any complaints. So far, the feedback has been encouragingly positive. “If Medair did not help the clinic to treat IDPs for free, many people would have died—many, many people,” said Rakole Kanyamali, President of Bukiringi’s IDP Committee. “That is why we are grateful for Medair.” CORE COMPETENCIES

Emergency Relief

When a sudden crisis hits or a natural disaster strikes, Medair teams respond rapidly to help save lives and reduce suffering.

In 2010, a deadly outbreak of kala-azar, a potentially fatal parasitic disease affecting the internal organs, swept through Southern Sudan’s Jonglei state. Medair’s Health Emergency Response Team responded, often treating afflicted patients for malnutrition at the same time.

Nyajang was on the brink of death when her mother carried her into the Medair clinic in Ayod, malnourished and suffering from kala-azar. We tried to feed her, but with painful sores in her mouth, she was unable to eat. Nyajang, just two years old, soon lost even more weight and grew listless.

There was only one chance of her survival: a feeding tube. “I had a long discussion with her mother about it, but she was very unsure,” said Dr. Lea Lauridsen, Medair Medical Manager. “People here have never seen feeding tubes and don’t know how they work.”

Nyajang’s mother had given up hope. She just wanted to take her child home. But with the encouragement of our local staff, she agreed to the feeding tube.

For five days, the Emergency Response Team fed Nyajang through the tube and treated the sores in her mouth. When we removed the tube, Nyajang started eating normally and gaining weight at a healthy pace.

Over the next weeks, Nyajang made a full recovery from her illnesses and was discharged in good health. “This child was already dead when you brought her here, but now she’s alive,” remarked an elderly woman in the neighbourhood. “These people have healing in their hands.”

In 2010, the Emergency Response Team provided more than 4,000 people in Jonglei state like little Nyajang with life-saving treatment for kala-azar and/or malnutrition.



- 14 -

Rehabilitation

Once emergency relief needs are met, Medair works alongside vulnerable communities to sustain lives and help improve essential services and infrastructure.

In 2010, we trained 10 villages in Sudan’s Northern States in “Community Approaches to Total Sanitation” (CATS), a method that empowers communities to take collective action to stop open defecation.

El Shair is a remote village of 100 families, set against a backdrop of large rocky hills that turn lushly green in the rainy season. Residents have a mosque and a functioning hand-pump, but until recently, they faced health risks because they defecated out in the open.

“Last year, I only defecated after dark, in the bushes, so that no one would see me,” confessed Asha. “And there was a long trek each time to the bushes.”

Although it’s hard to imagine, more than one billion people in the world practice open defecation, this practice is a deadly threat to human health and a barrier to dignity and safety, especially for women. We can build countless latrines for vulnerable communities, but that doesn’t mean they will be maintained or even used. True change needs to come from within the community.

In 2010, Medair motivated people to take responsibility for their health through better sanitation. We educated people about the health risks of open defecation and provided them with the basic knowledge and training they needed to improve their own hygiene and build sanitation facilities.

“The amazing thing about the sanitation program is that we did little more than hold a community meeting to discuss the problem of open defecation, conduct a two-day latrine slab-making workshop, and do several follow-up visits to reinforce the training, check on progress, and respond to any questions,” said Medair’s Janna Hamilton.

Just four months after Medair’s first discussion with community leaders in El Shair, every household had built themselves a latrine. El Shair became the first village to become “100 Percent Open-Defecation Free” in all of South Kordofan.

“An NGO just came to our village and asked us about the sanitation in our community,” community leader Bushara told us, grinning, his voice full of pride. “I looked at him and told him, ‘You can go to any household in this whole community, and you will find a latrine... and people are using latrines.’ We don’t have any person practicing open defecation anymore.”

“Boreholes come and go, latrines come and go,” said Janna. “That’s why Medair invests in building relationships with people in communities, relaying hygiene knowledge, and showing them that they can make a difference themselves. That kind of change is really empowering and will stay with them long after we leave.”



- 15 -

FIELD VISIT REPORT

By Sara de Villiers, Medair UK’s Development Officer

In November 2010 I spent an eye-opening and inspiring nine days in Zimbabwe.

In 2010, Medair completed its first urban WASH (Water, Sanitation and Hygiene) Project in Marondera, about 100km south-east of Harare. There are an estimated 120,000 inhabitants in the town.

The focal problem of the projects in Zimbabwe is the high incidence of water-borne disease (specifically cholera) in urban areas, arising from intermittent and insufficient piped water supplies and the consequent use of alternative shallow water sources and polluted raw water sources.

A large cholera outbreak in 2008-09 affected 55 out of 62 districts in Zimbabwe and was one of the largest outbreaks ever documented in sub-Saharan Africa. As of week 25 in 2009, a total of 98,550 cases and 4,282 deaths were reported. Unlike previous outbreaks the most recent one affected major urban communities, especially those in and around Harare. The outbreak spread rapidly, especially in urban areas. The movement of people from high-density urban areas affected by cholera also contributed to its spread to other urban and rural areas.

The lack of a consistent and sufficient supply of safe drinking water is one of the main problems facing the people of Marondera. Therefore the object of this project was to rehabilitate the water supply system and increase the quantity of water provided, in order to prevent the risk of outbreaks of cholera and other water-borne diseases. This has entailed installing pumps, laying pipes and working alongside the local municipality to ensure that the needs of the local people are met in terms of the supply of clean water to their homes.

During my time in Marondera I was able to meet with many of the beneficiaries with whom Medair is currently working – it was a privilege to spend time with these inspiring people.

Agnes is a young mother who has to walk with her baby tied to her back for 30 – 40 minutes each way every day to collect unsafe water from the quarry. The only way she is able to transport the water home is by carrying it on her head.

Depending on how much water people are able to carry and how much their households use, the journey to the quarry to collect water sometimes has to be made as many as three times a day. For Agnes, this could mean over three hours of walking per day.

Many people are aware that the water is unsafe and that some get diarrhoea and become sick, but in an area like Marondera, people often have no option other than to make the long, back-breaking journeys to collect the contaminated water.

Gertrude is a 54-year-old widow with six children. All of the children bar her youngest daughter have left home. She also looks after her granddaughter, 13-year-old Karen, as Karen’s mother has had to go to Harare to find work. To be able to provide for her household, Gertrude works in the fields, harvesting crops.



- 16 -

The quarry where people go to collect water when they have no running water is some three kilometres from Gertrude’s house, and the task of collecting the unsafe water is dangerous as the banks are slippery and the water is deep. People stand in the water while gathering it, using a variety of containers. Wastes of many kinds wash into the quarry, and some even wash their baby’s nappies in it, all of which contributes to making the water unsafe to drink. Gertrude says that people can also fall into the quarry and few people are able to help them out, as it is very deep. ‘People are scared,’ she told me.

The only other place where she could collect water is at a borehole one kilometre away but ‘the queues are always long there,’ she says.

Gertrude is now digging a trench in her back yard so that Medair can work together with her and the Marondera municipality to lay the pipes that will bring treated and potentially life-saving water to her home.

As someone who has always taken clean running water for granted, it was really eye opening to experience one of (the many) parts of the world where this isn’t the norm. I had not fully realised what a struggle some people face every day, just to ensure that they have water in their homes – even if this water is unsafe to drink and they know it. What also really struck me was a phrase I heard over and over again: ‘We have no other option.’ To have no option other than to spend hours each day collecting unsafe water for your family is a scary reality.

Without the support from generous donors, we would not be able to bring life-saving water to Agnes and Gertrude and the rest of the people of Marondera – they would still have no other option.

Having the opportunity to meet people who have for so long struggled to provide even something as basic as safe drinking water for their families was a very humbling experience. It was a privilege to share their joy and excitement, knowing that soon they would no longer have to walk long distances to collect water – or worry that they and their families would become sick.



- 17 -

D.R. CONGO Background Medair has been present in Oriental Province in the northeast of D.R. Congo since 1996, before tribal, regional and international conflicts killed 5.4 million people, most of whom died because of hunger or preventable diseases. We work in the south of the province in an area affected by various rebel militias who have forced 90,000 people from their homes and in the north of the province, which has been affected by the Lord’s Resistance Army (LRA), resulting in 120,000 displaced people. Our main overall objective is to improve the health status of the population in the areas we serve. We do this by supporting over 200 health structures and vulnerable areas of northeast D.R. Congo, improving the quality of care by training the staff in the health centres, providing essential medical equipment and ensuring a good supply of medicines. For displaced people and especially vulnerable host populations, we subsidise the cost of health care. In 2010 in the town of Isiro, we provided access to safe water by repairing springs and hand-pumps, digging two new wells, and building latrines for school and a hospital. Medair has bases in Bunia, Dungu, and Isiro. In 2002 and 2003, Bunia was the centre of an intense civil war and many communities remain affected by the war even today. Around Bunia many communities are affected by the actions of armed rebel militias and clashes with the forces of the Congolese army and the U.N. peacekeeping force, MONUSCO. In 2010, 59 rebel attacks were reported in Ituri district, 90 percent of which were in the territory of Irumu (where Medair operates). Consequently, 41 people were reportedly killed and 19 others abducted. There are many thousands who have repeatedly fled their homes and have lost everything. In the area of Gety, 50km south of Bunia, it is estimated that 100,000 people fled their homes during 2010.

Chronic insecurity in Boga and Gety regions has destabilised dozens of villages in the region and hugely affected the health systems as they have been left dilapidated without the necessary equipment to deal with crucial health issues like deliveries. Health centres are targeted in looting attacks by militias who pilfer all sorts of essential equipment including medicines, mattresses, kits, etc. Approximately 250,000 people in Boga and Gety health zone still remain in a situation of need given the increasing instability and insecurity in the region. Isiro and Dungu are in the region of Haut Uélé, an area affected by the LRA, an army that originated from

northern Uganda and is known for extreme violence, mutilations, and abductions of children. Over 150,000 people reportedly fled their homes for more secure locations. Medair is one of the very few NGOs in Isiro and we were the first to establish a presence in Dungu following the arrival of the LRA in the area in late 2008. Throughout 2010, there was continued movement of the LRA between Central African Republic, Southern Sudan and Haut and Bas Uélé. Even though the LRA leadership has reportedly moved from Haut and Bas Uélé, small factions of the army continue to terrorise the community. In 2010, 202 LRA attacks were reported in Haut and Bas Uélé, 254 people reported dead, 171 adults abducted, and 102 children kidnapped.



- 18 -

Androzo’s Story “I was out working in a farm nearby, when I suddenly heard gunshots. At first I thought it was military troops returning to their camp, but the gunshots continued for about five minutes. I grabbed my hoe and machete and started running towards my house,” says 25 year old Androzo Tabu. Androzo managed to find his wife and three children – ages seven, two and four months − and they joined throngs of other villagers as they ran for safety to a forest about five km from their home in Sorodo village, a small commune in Ituri district in Province Orientale, eastern D. R. Congo. Militiamen had attacked the village and proceeded to terrorise and loot the homes of innocent civilians, including the Medair-supported Sorodo health post. Androzo says that he lost everything during the attack. Sorodo village, home to about 2,555 internally displaced persons (IDPs), and about 1,987 people who have recently returned to their original homes (returnees), has had its fair share of militia attacks. Androzo arrived at Sorodo village a year ago with nothing but the government’s promise that his family would be safe there. He ekes out a living working in the fields of the host community, producing barely enough to feed his family. Because they live under very precarious circumstances, affording good quality healthcare is almost impossible for displaced people like Androzo. It is with this in mind that Medair has been supporting health structures like the Sodoro health post by providing free medical assistance to displaced people and returnees in southern and north western districts of Province Orientale. Androzo remembers how sick his seven-year-old daughter Sylvie was when they first arrived in Sorodo last year, after hiding in the forest for days. “I do not know what she was suffering from, but her cheeks were swollen, and she was unconscious,” he says. They took her to the health post in Sorodo, but it was ill-equipped to deal with her case so they transferred her to Boga hospital about 18 km away. She was admitted for two weeks there, and treated for acute anaemia and kwashiorkor and discharged. “I did not pay a cent for any of the costs; Medair took care of all of it. If it were not for Medair, my child would be no more,” says Androzo. “I am very grateful to Medair for the assistance I have received for my family, with everything I have to worry about as a displaced person; at least I do not have to worry about paying hospital bills. When we fall sick, we come to the clinic and all the assistance we receive is completely free. It is because of organisations like Medair that I feel as if I am among brothers.” A glimpse of hope returns to his eyes as he says this.

Medair immediately reacted to the news of the looting by sending supplies to restock the health post. “With support from Medair, we have been offering free healthcare to these vulnerable groups. But it has been difficult these last few days. After the attack, we lost everything, our sterilizers, weighing scales, blood pressure gauges and most of the medicines,” explains Mateso Rusa, a nurse at the Sorodo health post. Beatrice Kavira, a medical supervisor, explains why Medair decided to intervene: “These attacks put such a strain in the lives of displaced people who are already



- 19 -

vulnerable owing to extreme poverty. We realise the importance of reacting as a matter of urgency during such incidents, because without the necessary equipment, the health centres will not function,” she says. “We have delivered health reproduction kits for family planning, infusions kits, and restocked the medicines so that the clinic can continue to treat the patients,” she adds. 2010 Country Statistics Total Beneficiaries Direct: 466,897 Indirect: 2,764,358 Staff Nationally Recruited Staff: 90 Internationally Recruited Staff: 12 Emergency Relief 700,000 new consultations supported 2,400 mosquito nets distributed 12,000 malaria rapid diagnostic tests distributed 61,961 internally displaced persons received free health care 4,367 women received free antenatal care 229 health care workers trained 37,278 received subsidised health care 73,291 received free health care 793 health centre staff trained 377 HIV/AIDS patients received antiretroviral drugs 88,000 patients treated, of which 41,000 treated for malaria, diarrhoea, and respiratory infection 2,575 clean delivery kits distributed 10,071 mosquito nets distributed to pregnant women and for children under one Rehabilitation New distribution centre for medicines and medical supplies opened in Dingila Incinerators supplied to 3 health centres 2 wells dug 4 latrine blocks (total 30 stands) constructed 6 protected springs rebuilt 4 hand-pumps repaired In 2010, Medair has re-oriented the programme towards emergency relief and added a new sector (Water, Sanitation, and Hygiene). Successful bids for funding have laid the foundation for an expanded programme in 2011, with road rehabilitation added as a new sector.



- 20 -

HAITI

Background On 12 January 2010, Haiti was shaken by a 7.0-magnitude earthquake and aftershocks of over six on the Richter scale. The epicentre was in a highly urban area. According to the U.N., the earthquake killed 222,570 people in Haiti, making it one of the deadliest natural disasters in history and compounding Haiti’s chronic poverty. Haiti was already the poorest country in the Western Hemisphere, with over half of Haitians in extreme poverty.1

The disaster left 1.5 million homeless in a country that is in a well-trodden hurricane path. Many organisations flooded into the badly hit capital. Since the earthquake struck, Medair has been meeting the shelter needs of the affected population in the south, in Jacmel (where 80 percent of buildings were affected) and the surrounding underserved areas of the South East District around Jacmel town. Rapid response

Medair was on the ground within days of the earthquake. Shelter was clearly a critical need. Medair supported rubble collection at the early phases in partnership with other organisations and the help of beneficiaries, clearing parcels of land so that homes could be rebuilt, or to create space for emergency shelter.

There was an initial emergency phase of providing World Wide Shelters (WWS). These could be put up in 20 minutes, reinforced to withstand the hurricane season and supported by a sturdy metal frame to be used as a structure for a permanent home later on. The technical teams started to repair homes but due to the poor quality of the original construction and maintenance, termites and years of harsh weather, building new homes was a more effective, cost- and time-efficient way to guarantee a safer house.

Medair rolled out the in-house design of an Emergency Shelter Kit (ESK), a durable transitional shelter that was resistant to hurricanes and earthquakes. The goal was to create high-quality housing as fast as possible. Built in a few days, with solid foundations, timber frame and metal roof, the transitional shelters can be ‘transitioned’ from hardwearing plastic to stone walls. A later stage of the programme will train communities how to transition their houses.

Medair has encouraged as much community participation as possible. Beneficiaries are expected to collect the materials provided by Medair from various bases, to find stones and sand for the floors themselves (which is then filled in with concrete), and are expected to complete the walls themselves.

Medair, with the support of USAID, was able to contribute 12 WWS shelters to create cholera treatment centres in response to the epidemic. Medair prioritised the beneficiaries living in the worst camp situations, whether on their own land, or in an official camp meeting the highest international standards. They have substantial housing with security, wash and health facilities onsite. It is an organised camp and well run by the International Organization for Migration.

Medair staff were part of bringing warnings about Hurricane Tomas (November 2010) to those living in the camps, supporting the local authorities in voluntary evacuations to safe buildings.

1 (76% below poverty line / half of Haitians illiterate).



- 21 -

In a country where employment, livelihoods and opportunities hit rock bottom after the earthquake, Medair has been able to employ 85 contract staff, 77 local Haitians as casual labour and around 242 Cash-for-Work positions for local communities in 2010. At highest capacity, the team can build 60 transitional shelters a week (six people on average live in each shelter).

Beneficiary Accountability

The project has a large beneficiary accountability element. Community Mobilisers visit each site before and after construction to answer questions and hand over the shelters to the families. All construction is overseen by a Technical Officer to verify the quality of the carpentry meets Medair and Sphere standards. The onsite Monitoring and Evaluation Team visit 30 percent of beneficiaries personally after their shelter is built to recheck construction quality and monitor community satisfaction. The team is often asked if Medair will visit again after this, as the communities enjoy the visits and want an opportunity to thank Medair.

Roland’s new home

“I feel safe from earthquakes in my new house. In the hurricane, we slept in our new house. We slept well; Florencia did not even notice it was windy outside. All the children slept well. It was not wet. We are pleased with how it stood in the storm.

I am relieved to be living in the new house. My life changed. I was here when they constructed the new house. I had joy in my heart that day. I was very happy and I felt that my life had changed when I saw the house being built. I was very pleased. The children did not say anything but the way they were helping, I could see that they were happy. I felt good. I was very excited the first night we slept in the house.

Medair is doing a great work Haiti. In our neighbourhood, we love what Medair have been doing for the community.

If I had not received a house, I would still be sleeping in the damaged house with my family. My life is different after the assistance because I have a beginning. I do not have enough crops to feed my family and sell to buy materials for a house. If I had money to rebuild a house, I would use that money to buy food to feed the

children and pay for their school fees. I am very happy because I have the house. I am happy that I have a place to sleep with my family. Now, I do not have to worry about building a house. If there is another earthquake, I will not get scared because the house is strong. Also, I do not have to worry about getting wet when it rains.

I would like to say thanks to the people who gave money to Medair very much because life was very difficult, and I did not know where I was going to get money to start building the house. Tell them thanks for the beginning. It is a great thing they have done for me and my family.”



- 22 -

2010 Country Statistics Total Beneficiaries 11,184 beneficiaries affected through the shelter programme (working on the principle that there are 6 people per house). 1,093 beneficiaries affected through the Cash for Work programme Staff Nationally Recruited Staff: 84 Internationally Recruited Staff: 12 Contract staff: 84 Casual labour support: 77 Cash for Work beneficiaries: 250 weekly Total Cash for Work man days so far: 33,219 Total contract Nationally Recruited Staff: 100 to date (includes leavers) Emergency Relief

561 World Wide Shelters erected 12 tents provided for set-up of emergency Cholera Treatment Centre units following the outbreak of

cholera Tools distributed in rubble removal phase 180 Non-Food Item kits distributed

Rehabilitation

Repairs: 120 Transitional homes / Emergency Shelter Kits: 1,181 Permanent show case finished homes: 2



- 23 -

MADAGASCAR

Background

Medair is working in Madagascar to give an appropriate and immediate emergency response in case of cyclones. Medair also actively works to reduce the vulnerability of populations before the cyclone through Disaster and Risk Reduction projects.

In 2010, Medair was involved in a WASH (Water, Sanitation, and Hygiene) project giving access to clean water and sanitation to thousands of people as well as hygiene promotion.

We worked in the northeast of Madagascar in the District of Maroantsetra and most of all in the rural communes in this area. We also worked in partnership with a local NGO (FSG) in the southeast coast area.

Medair is ready to implement emergency responses not only in these regions but wherever in Madagascar they are needed. We have an emergency stock of WASH kits and equipment for disinfecting wells and restoring access to clean water. Three projects were run in parallel during 2010 in Madagascar:

The Rano Tsara (Good Water) project (A four-year project that ended in December 2010)

The objective was to create a wide partnership for the improvement of the WASH situation.

One of the key concepts was the creation of forums for discussion and dialogue to ensure a better participation of all the actors. The intervention’s main focus is on capacity building with the private sector, authorities and associations, and research of innovating low-cost and adapted technology.

This project supported more than 100 communities in nine communes and as many local associations, 10 enterprises to give better access to water and sanitation. Medair constructed 650 new water points, more than 1,000 family latrines, and equipped 30 schools with water infrastructures over the four years of the project.

The Fiaro Tsara project (Good Protection) (This project ended in April 2010)

The goal was to reinforce the local actors’ capacities to reach a long-term decrease of the populations’ vulnerability with cyclones.

Medair worked with local authorities, local village committees, village elders and local mayors to implement Madagascar’s National Strategy of Disasters and Risks Management. Through a coaching and participatory approach, the goal was to help communities to improve their own capacity to anticipate, mitigate and recover after a cyclone.

The main activities of the project were the principles of Disaster and Risk Reduction (DRR): spreading the word to everyone, the participatory analysis of risks and vulnerability, the setting up of DRR committees, the elaboration of contingency plans, cyclone resistant infrastructures, realisations such as elevated water points, flood proof latrines, cyclone resistant community shelters, rice storage and pre-positioned emergency supplies, and also the organisation of village cyclone simulations.



- 24 -

The Tsara Kobaby (To Take Care) project (Commenced in August 2010) The main goal of this project is still to increase the capacity of local populations so that they will be better prepared in case of cyclone, be able to mitigate and to respond by themselves and through their local village committees to cyclones and floods. Medair is accomplishing this by building upon the knowledge created in our previous Disaster and Risk Reduction project (Fiaro Tsara). Our work is based on a strong participation of local beneficiaries, for example through organisation of local cyclone simulations. This project has a special emphasis on building more cyclone shelters and creating demand for construction of individual houses that are resistant to cyclones and floods. This project will also allow us to test new ways of restoring access to clean water immediately after a cyclone. We will work on some critical points of the rivers to help decrease the depths and the length of the floods. Another ambitious part of this project is to set up a flood alert system. All of Medair’s activities will leave the communities better prepared to act during a cyclone and the transition back to normal life will be smoother. Medair’s infrastructure team, with the advice of the Medair reconstruction advisor, is also developing new construction methods to strengthen the local houses. Rasolofomanana Barjohn Johnny Patrick, “Chef District de Maroantsetra” comments “I don’t want to flatter Medair, but I will just tell you the truth. Thanks to Medair, there have been a lot of changes: better access to safe, clean water, better preparation for cyclones warnings, and awareness of populations in how to take care of infrastructures.

A lot of help was made through various trainings at different levels, such as training for teachers or villages’ authorities. For Disaster Risk Reduction, Medair inspired the different actors and worked to help us develop a plan for an emergency response. Thanks to Medair, I inaugurated hundreds of pumps and I saw how happy the inhabitants were. Medair has already helped a great deal to reduce the vulnerability of the population of some villages by constructing cyclone shelters.

We are also really happy for the stock of food provided by Medair in collaboration with the World Food Programme. I feel respected; our relationship with Medair is very good. There is no difficulty. I hope for the continuation of the partnership with Medair and that in a few years that the populations will be able to take care of themselves. I would like to see the number of communes touched by Medair’s work increased. I hope Medair will take care of the ones that haven’t yet received help. In one word, I wish that Medair could stay in our region: there have been so many good things brought by this NGO. Medair is so important for us. We are really far away from everything as we have almost no roads. If Medair leaves, for financial reasons it will be very hard for authorities to continue the work and the follow up.”



- 25 -

2010 Country Statistics

Total Beneficiaries 197,597 (Direct and indirect) (Medair 167,484, FSG 30,113)

Staff Nationally Recruited Staff: 67 Internationally Recruited Staff: 7

Water, Sanitation, and Hygiene 206 new boreholes drilled, fitted with hand-pumps and drainage, and passed on to the community

(21,900 beneficiaries) 2 gravity-fed water-supply systems built with hand-washing facilities at the village school (2,146

beneficiaries) 368 family latrines Eco-San adapted to the needs of the area and the government standards installed

(696 beneficiaries) 16 schools equipped with hand-washing facilities. 12 elevated pumps built 161 meetings with communities ( benefitting 11,986 people) 74 awareness raising cinema mobile shows (reaching 40,160 people) 58 awareness raising puppet shows (reaching 19,546 people, especially children) 46 radio programmes 71 hygiene volunteers trained to encourage better hygiene in their village 28 workshops undertaken, providing training and facilitating discussions concerning technical,

management and governance issues about water and sanitation 1 inter-communal platform created to assure sustainability of infrastructures. (Village based Water

Users have been federated and supported to ensure a proper operation and maintenance system. On top a local private water business has been set up and capacity built to respond to the needs of the Federation of Water Users.)

1 district + 1 village cyclone simulation organised 45 new village Disaster and Risk Reduction Committees set up 12 Communes Disaster and Risk Reduction Workshops held Continued support to the District Committee, and main support focus to the 7 most vulnerable

Communes of the District. Deeper study has been undertaken to have a better knowledge and understanding of the

Maroantsetra Hydraulic Basin

2010 was intense and rewarding. In December, we finished a four-year Water, Sanitation, and Hygiene project with more than 600 new water points and almost 1,200 new latrines in the district. From the very beginning of our work in this area, Medair has not focused only on infrastructure, but on changing people’s lives. That happens through construction, but it’s not an end in itself. This approach makes also our time, effort, and money investment sustainable. In 2010 we improved our approach to assuring the maintenance of the infrastructure after Medair’s departure. Now in the district there are water federations that assure the good maintenance. And it’s not only theory, they have already almost USD 20,000 to do it, and none of it comes from Medair or outside, but rather from small family contributions. Seeing this in action is incredibly encouraging.

USE OF FUNDS

Further information is available in the Medair Consolidated Annual Report 2010, available here: www.medair.org/annualreport



- 26 -

POLICIES & RISK

RESTRICTED AND GENERAL FUNDS Any funds accepted from private or institutional donors which provide for a specific restriction will always be honoured. These funds are recorded as restricted funds and are accounted for separately. All such funds allocated for specific field operations, are transferred in their entirety to Medair (Switzerland) for use in the appropriate programme. All undesignated funds will first be used to meet operational needs of Medair UK, according to a pre-approved budget. In 2010, these operational needs were 29.5% of incoming resources. RESERVES The charity aims to hold free reserves which would enable operational and fundraising activities to continue for a period of six months, or the charity to be wound up, should there be a significant drop in funding. After careful consideration, the Trustees believe that £100,000 would be adequate for this purpose. At the time of writing, free reserves held amount to £72,353. Given the seasonal nature of private fundraising, the Trustees have agreed that, in the course of a year, up to £50,000 of these reserves may be used as working capital. However, it is their intention that the charity replenishes its reserves to the full £100,000 and holds this amount at each year end. Free reserves comprise general unrestricted funds less fixed asset and rent deposit funds. The Trustees intend to maintain reserves at this level over the course of 2010. Both the policy and its implementation shall be under regular scrutiny. ETHICAL INVESTMENT The charity does not currently hold any investments other than the free reserves detailed above. These reserves are held on deposit in an instant access UK bank account. If in future periods the Trustees consider it prudent to hold investments over and above the level of desired reserves, the following ethical investment policy shall be reviewed and applied: The Charity Commission has stated that “Trustees should not invest in companies pursuing activities which are directly contrary to the purpose of the trust or the charity”2. Further, that a strategy of avoidance may be appropriate if investment in a particular type of business could “conflict with the charity’s aims,… hamper its work, either by making potential beneficiaries unwilling to be helped because of the source of the charity’s money, or by alienating supporters”, or even if it could be considered inappropriate “on moral grounds”, provided that the Trustees are satisfied that this would not involve a “risk of significant financial detriment”3. In accordance with this guidance and the charity’s aims, the Trustees deem it inappropriate to invest in businesses involved in, or associated with the following sectors: Arms trade; Tobacco; Child labour. Therefore, as and when Medair UK makes investments, a filter will be applied in assessing investment opportunities. Both the policy and its implementation shall be under regular scrutiny.

2 Sparkes, R. (1995), The Ethical Investor. (London: Harper Collins). 3 Charity Commission (2004), CC14: Investment of Charitable Funds.



- 27 -

ENVIRONMENTAL STEWARDSHIP In keeping with the charity’s Christian ethos, Medair UK seeks to be a ‘good steward’, not only of its funds, but also of the planet. This is accomplished in the following practical ways: Sourcing supplies and services from sustainable sources e.g. recycled stationery; Minimising waste and maximising that which is recycled; Avoiding unnecessary printing – storing documents in electronic form wherever possible; Switching off electrical appliances and lights whenever not in use. Both the policy and its implementation shall be under regular scrutiny. RISK MANAGEMENT Medair UK is committed to the highest standards of integrity, quality and professionalism in all aspects of its work. Throughout 2010, the Trustees and staff continued to review the demands on the organisation and ensured the mitigation and management of the risks it faces. To this end, the Trustees and senior staff reviewed the Medair UK Risk Register at each of their meetings, assessing and ranking risks according to their likelihood and potential impact, assigning responsibility and agreeing and tracking actions accordingly. TRUSTEES New Trustees are appointed by ordinary resolution and unanimous consent of sitting Trustees. J R C Ingram is also a Director of Medair (Switzerland). Each of the Directors has confirmed that, so far as they are aware, there is no relevant audit information of which the company's auditors are unaware, and that they have taken all the steps that they ought as a director, to make themselves aware of any relevant audit information and to establish that the company's auditors are aware of that information. The Trustees did not receive any fees or derive any benefits from the charity in the current or preceding year.

The Trustees and staff of Medair UK sincerely thank its volunteers, donors and other partners, whose generous support throughout 2010 has enabled it to respond to so much human suffering.

BY ORDER OF THE BOARD F ALLDRIDGE Secretary 2011

- 28 -

Medair UK STATEMENT OF TRUSTEES’ RESPONSIBILITIES

The Trustees are responsible for preparing the Trustees’ report and the financial statements in accordance with applicable law and United Kingdom Generally Accepted Accounting Practice.

Company law requires the Trustees (as Directors for the purpose of company law) to prepare financial statements for each financial year which give a true and fair view of the state of affairs of the charity and of the incoming resources and application of resources including the net income or expenditure, of the charity for the year. In preparing those financial statements, the Trustees are required to: select suitable accounting policies and then apply them consistently; observe the methods and principles in the Charities SORP; make judgements and estimates that are reasonable and prudent; state whether applicable accounting standards have been followed, subject to any material departures

disclosed and explained in the financial statements; and prepare the financial statements on the going concern basis unless it is inappropriate to presume that the

charity will continue in business. The Trustees are responsible for keeping proper accounting records which disclose with reasonable accuracy at any time the financial position of the charity and to enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the charity and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

- 29 -

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF MEDAIR UK

We have audited the financial statements of Medair UK for the year ended 31 December 2010 which comprise statement of financial activities, balance sheet and related notes. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).

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 auditors’ 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.

Respective responsibilities of trustees and auditor

As explained more fully in the statement of trustees' responsibilities, the trustees (who are also directors of the 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. We have been appointed as auditor under the Companies Act 2006 and report in accordance with that Act. Our responsibility is to audit 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 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 charity'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 Trustees' Report and Financial Statements 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 financial statements

In our opinion the financial statements: give a true and fair view of the state of the charity's affairs as at 31 December 2010 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.

Opinion on other matter prescribed by the Companies Act 2006

In our opinion the information given in the trustees’ annual report for the financial year for which the financial statements are prepared is consistent with the financial statements.

Matters on which we are required to report by exception

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 in respect of the charity, or returns adequate for our audit

have not been received from branches not visited by us; or the financial statements do not accord with the accounting records; or certain disclosures of trustee's remuneration specified by law are not made; or any information or explanation to which we are entitled has not been afforded to us.

Charles Cox Senior Statutory auditor For and on behalf of PKF (UK) LLP, Statutory auditor London, UK

- 30 -

Medair UK STATEMENT OF FINANCIAL ACTIVITIES

FOR THE YEAR ENDED 31 DECEMBER 2010 Unrestricted Restricted Total Total Notes Fund Fund 2010 2009 £ £ £ £ Incoming resources From generated funds: Donations, gifts and legacies 285,517 302,808 588,325 431,813 Gifts in kind and donated services - - - - Interest receivable 67 - 67 149 From charitable activities: Grants receivable for humanitarian aid 2 - 343,935 343,935 1,277,489 Other incoming resources 2,465 - 2,465 925 Total incoming resources 288,049 646,743 934,792 1,710,376 Resources expended Costs of generating funds 3 218,289 - 218,289 175,455 Charitable activities: 3 Humanitarian aid grants transferred - 343,935 343,935 1,277,489 Donations transferred 80,241 277,135 357,376 104,243 Other charitable activities 43,327 - 43,327 42,408 Governance costs 3 14,039 - 14,039 12,900 Total resources expended 355,896 621,070 976,966 1,612,495 Net (outgoing) / incoming resources (67,847) 25,673 (42,174) 97,881 for the year Net movement in funds (67,847) 25,673 (42,174) 97,881 Balance brought forward at 1 January 2010 163,634 18,756 182,390 84,509 Balance carried forward at 31 December 2010 95,787 44,429 140,216 182,390 All gains and losses recognised in the year are included in the Statement of Financial Activities, and are derived from continuing activities.

- 31 -

Medair UK BALANCE SHEET

AS AT 31 DECEMBER 2010 (Company number: 3213889)

2010 2009 Notes £ £ £ £

FIXED ASSETS Tangible assets 4 2,124 2,200 CURRENT ASSETS Debtors 5 337,886 905,308 Cash at bank and in hand 99,221 176,102 437,107 1,081,410 CREDITORS: Amounts falling 6 due within one year Due to associated undertaking (187,200) (672,769) Other creditors (111,815) (228,451) (299,015) (901,220) NET CURRENT ASSETS 138,092 180,190 NET ASSETS 140,216 182,390 RESERVES 7 Restricted funds 44,429 18,756 Unrestricted funds General 95,787 82,824 Designated 0 80,810 95,787 163,634 TOTAL FUNDS 140,216 182,390 The financial statements were approved by the Board and authorised for issue on 2011 Signed on behalf of the Trustees

E M HUGHES F ALLDRIDGE

- 32 -

Medair UK NOTES TO THE FINANCIAL STATEMENTS

YEAR ENDED 31 DECEMBER 2010 1 ACCOUNTING POLICIES

1.1 Accounting convention

The financial statements are prepared under the historical cost convention and in accordance with applicable accounting standards and the Statement of Recommended Practice Accounting and Reporting by Charities issued by the Charity Commission in March 2005.

1.2 Incoming resources

Income is taken to the credit of the Statement of Financial Activities on an accruals basis. Restricted grant income is credited to incoming resources when the charitable company is entitled to receipt of the grants, measured by reference to the stage of completion of the projects funded.

1.3 Resources expended

Grants transferred to Medair (Switzerland) are included as expenditure when the grant is recorded as income. This means restricted grant income is matched with an equivalent amount in resources expended. Restricted donations are included as expenditure when remitted to Medair (Switzerland). All other resources expended are included as expenditure on an accruals basis. Direct costs represent expenses attributed directly to key activities (e.g. staff time and appeal mailing costs etc.). Indirect costs represent expenses attributed to activities in support of key activities (e.g. accounting and office costs). The apportionment of indirect costs was tracked against staff time throughout the year. Governance costs are the cost associated with the governance arrangements of the charity. These costs are associated with constitutional and statutory requirements and include any costs associated with the strategic management of the charity’s activities.

1.4 Tangible fixed assets and depreciation Tangible fixed assets costing more than £500 are capitalised and depreciated by equal annual instalments over their estimated useful life as follows: Office equipment: 5 years; Computer equipment: 3 years.

1.5 Foreign exchange

Grant income received in foreign currency and grants and donations transferred to Medair (Switzerland) are accounted for at the average rate of exchange in the year. Monetary assets and liabilities are translated into sterling the rate of exchange ruling at the year end.

1.6 Fund accounting

General funds are unrestricted funds which are available for use at the discretion of the Trustees in furtherance of the general objects of the charity and which have not been designated for other purposes.

Designated funds comprise unrestricted funds that have been set aside by the Trustees for particular purposes. The aim and use of each fund is set out in the notes to the financial statements. Restricted funds are funds which are to be used in accordance with specific restrictions imposed by donors or which have been raised by the charity for particular purposes. The aim and use of each restricted fund is set out in the notes to the financial statements.

- 33 -


YEAR ENDED 31 DECEMBER 2010

1 ACCOUNTING POLICIES (continued)

1.7 Operating lease rentals

Rentals relating to operating leases are charged to expenditure as incurred. 1.8 Pension costs

The charity contributed an agreed percentage of the salary to the personal pension plan of two of its permanent employees. The pension provider is selected by the individual employees and thus the pension scheme is independently administered by, and the funds are held by, recognised pension companies. The pension cost charge (note 3) represents contributions payable by the charity to the pension fund.

2 GRANT INCOME

Grants attributable to year 2010 2009 £ £ European Commission Humanitarian Aid Office - 378,968 EuropeAid Cooperation Office 343,935 898,521 343,935 1,277,489 During the year, no new grants were added neither were there any modifications to the existing grants set out in the note below. The grants were in support of aid projects in the countries shown below and are released in accordance with specified criteria over the course of the agreed project period. Revenue recorded in the Statement of Financial Activities is based on contracted grant monies attributable in the year to 31 December 2010. These have been included in the Statement of Financial Activities as follows: ----------------------------------------------------- Grants ------------------------------------------------------- Awarded but not Awarded Awarded but not Reclaimed Attributable to year ending taken to income in taken to income in 31 December 31 December at 31/12/2009 year at 31/12/2010 year 2010 2009

€ EUR € EUR € EUR € EUR £ GBP £ GBP

Angola - - (380) - (327) (4,858) D.R. Congo 271,536 - (78,374) - 165,908 441,340 Madagascar 238,031 - - - 204,447 466,950 Uganda - - (28,073) (2,306) (26,093) 374,057

509,567 - (106,827) (2,306) 343,935 1,277,489

As noted above grants are awarded in Euros and an average rate of £0.85891 to €1 has been used to calculate income attributable to the year.

- 34 -


YEAR ENDED 31 DECEMBER 2010 3 RESOURCES EXPENDED Unrestricted Restricted Total Total Funds Funds 2010 2009 £ £ £ £ Cost of generating funds

Fund raising 218,289 - 218,289 175,455 Charitable activities Grants transferred to Medair (Switzerland) - 343,935 343,935 1,277,489 Donations transferred to Medair (Switzerland) 80,241 277,135 357,376 104,243 Other charitable activities 43,327 - 43,327 42,408 123,568 621,070 744,638 1,424,140 Governance Auditors’ remuneration 6,000 - 6,000 6,228 Other governance costs 8,039 - 8,039 6,672 14,039 - 14,039 12,900 Total resources expended 355,896 621,070 976,966 1,612,495

The principal components of resources expended are as follows: Other Total Total

Staff costs Depreciation costs 2010 2009 £ £ £ £ £ Cost of generating funds 99,337 1,724 117,228 218,289 175,455 Charitable activities 22,622 573 721,443 744,638 1,424,140 Governance costs 4,965 81 8,993 14,039 12,900 126,924 2,378 847,664 976,966 1,612,495 Net incoming / (outgoing) resources are stated after charging: Auditors’ remuneration – audit 6,000 6,228 Depreciation 2,378 5,262 Operating lease rentals 12,500 12,500 Staff costs Wages and salaries 111,018 97,792 Social Security costs 11,590 10,350 Pension costs 4,316 1,365 126,924 109,507 No employee earned £60,000 per annum or more.

- 35 -


YEAR ENDED 31 DECEMBER 2010 The average number of employees analysed by function was: 2010 2009 Management and administration of the charity 1 1 Fundraising and recruitment 2 2

Trustees receive no remuneration for their services. Actual expenses may be reimbursed.

4 TANGIBLE FIXED ASSETS Computer and office equipment Total £ £ Cost At 1 January 2010 17,577 17,577 Additions 2,302 2,302 At 31 December 2010 19,879 19,879 Depreciation At 1 January 2010 15,377 15,377 Charge for the year 2,378 2,378 At 31 December 2010 17,755 17,755 Net book value At 31 December 2010 2,124 2,124 At 31 December 2009 2,200 2,200 5 DEBTORS 2010 2009 £ £ Amounts recoverable from grant funders 282,512 890,597 Due from associated undertaking 608 100 Other debtors and prepayments 54,766 14,611 337,886 905,308

- 36 -


YEAR ENDED 31 DECEMBER 2010 6 CREDITORS 2010 2009

£ £

Amounts falling due within one year Due to associated undertaking 187,200 672,769 Restricted income payable to Medair Switzerland - - Grants unearned or repayable 95,312 217,829 Other creditors 5,874 1,463 Other taxes and social security 4,120 2,931 Accruals 6,509 6,228 299,015 901,220 The amount due to associated undertaking consists of project funds receivable from grant funders by Medair UK and subsequently due to Medair (Switzerland) which implements all European sponsored humanitarian aid projects.

7 MOVEMENTS IN FUNDS Unrestricted Designated Restricted funds funds funds Total £ £ £ £ At 1 January 2010 82,824 80,810 18,756 182,390 Net (outgoing) / incoming resources (67,847) - 25,673 (42,174) for the year Transfer between funds 80,810 (80,810) - - At 31 December 2010 95,787 - 44,429 140,216

During the year, the composition of restricted and unrestricted funds was reviewed and the above transfer reflects the outcome of this review. In accordance with the Policy on General Funds, the designated £80,810 of surplus unrestricted funds at the prior year end was transferred to Medair (Switzerland) in furtherance of Medair UK's charitable objectives.

8 ANALYSIS OF NET ASSETS BETWEEN FUNDS

The net assets are held for the various funds as follows: 2010 2009 Unrestricted Designated Restricted Total Total £ £ £ £ £

Tangible fixed assets 2,124 - - 2,124 2,200 Cash at bank 54,792 - 44,429 99,221 176,102 Other net current assets 38,871 - - 38,871 4,088 95,787 - 44,429 140,216 182,390

- 37 -


YEAR ENDED 31 DECEMBER 2010 9 RELATED PARTY TRANSACTIONS

During the year the Charity made payments of £1,157,683 (2009: £1,412,837) to Medair (Switzerland), a related charity registered in Switzerland. Medair (Switzerland) discharges the Charity’s charitable objectives on behalf of the Charity. There was an amount due from Medair (Switzerland) of £608 (2009: £100) at the date of these financial statements. There was an amount due to Medair (Switzerland) of £187,200 (2009: £672,769) at the date of these financial statements.

10 OTHER COMMITMENTS

At 31 December 2010, annual commitments under operating leases were as set out below: 2010 2009 Land and Land and buildings Other buildings Other

£ £ £ £ Operating leases which expire: Between one to five years 14,200 - 12,500 -

medair uk annual report and financial statements 2010

Documents

medair uk directors

board of medair uk

medair switzerland

recruitment of trustees

financial statements

independent auditors

overall income

field visit report