IMPACT Foundation – Annual Review 2012
Action today to prevent disability tomorrow
Page 1
Chairman’s message
This year, IMPACT India’s Lifeline Express is 21 years old. In that time no fewer than 700,000 people have had life enhancing operations to repair conditions such as club foot, cleft palate, cataracts, hearing loss, or received another treatment on board. The Lifeline Express has become an Indian national symbol. IMPACT UK played a pivotal role in the launch of the train and, with enthusiastic support from Rotary in Great Britain and Ireland, the total renovation and re-equipping of a replacement train in 2007. We are very happy that most of the money needed to run the Lifeline Express is raised locally. The crucial thing is that every one of those operations meant a rebirth for the person concerned and a platform for independence and self-reliance. IMPACT’s partners also take the hospital to the people by boat in Bangladesh and Cambodia, by tented operating theatre in Nepal, and mobile clinics elsewhere.
Meanwhile, our work in prevention of needless disability goes on in so many fields and countries. Home gardening, which is dramatically reducing the incidence of child blindness due to the addition of Vitamin A to the diet through green leafy vegetables; mother and baby clubs; health monitoring programmes in schools; rubella vaccinations; training local health workers and more......
In all this we work closely with our local partners from Cambodia to Zanzibar. Their enthusiasm and dedication is boundless. They know the local scene and what is most appropriate. They are on the ground, serving our common cause "Action today to prevent disability tomorrow".
But none of this would be possible without your continuing support, particularly in these economically difficult times. So, a heartfelt thank you to you and I hope you will enjoy this report detailing all we have done over the last year. And, for an even wider and more informative picture (moving pictures!) visit our new and excellent website at www.impact.org.uk which was very kindly funded by one of our supporters.
David Walker, CMG, CVO
Chairman
Page 2
Needless Disability – the Challenge
IMPACT’s work is urgently needed because:
· There are 700 million disabled people in the world (10% of the population)
· 80% of them live in developing countries; one-third are children
· Most were not born with a disability and appropriate healthcare could have prevented or could reverse their condition. It is simply unavailable to the majority
· 285 million people have sight problems and 275 million people have hearing loss. At least half is preventable or treatable
· More than 100,000 babies are born with club foot each year but early treatment can straighten the foot and ease mobility
· Every day, 800 women die in pregnancy or childbirth; 90% of them live in Africa or Asia
· For every woman who dies, 20 more are damaged. Antenatal care and trained midwives can protect mothers and babies
· Immunisation has saved more lives than anti-biotics but 20% of children born each year are not fully protected
· More than one-third of the world’s people do not have adequate sanitation; 1 in 8 lack safe water
· Malnutrition affects 1 in 3 men, women and children causing physical and mental disability on a wide scale
IMPACT is taking positive, cost-effective steps to prevent and treat needless disability. Disabled people rank disproportionately among the very poorest in our world and face discrimination at every turn. As well as better health, the people we serve can also look forward to renewed opportunities, independence, education and employment. It all starts with the support of someone like you.
Page 3
Our Aim:
IMPACT’s aim is simple – that no one should become or remain needlessly disabled by disease, lack of knowledge or shortage of medical services
Our Priorities for Action:
1) Early Identification and Treatment – to diagnose and treat potentially disabling conditions in their early stages
2) Accessible Surgery – too many people live with disabling conditions which could be reversed if surgery was available to them
3) Safer Mother and Child Survival – to ensure a happy outcome for the whole family
4) Immunisation – protecting people from infectious diseases that can cause disability
5) Ending Malnutrition – essential nutrients in the food we eat can keep us healthy
6) Safe Water and Sanitation – the foundations of good health
Our IMPACT:
In addition to the life-transforming effects of our work on an individual level, we are also making a valuable contribution towards meeting the Millennium Development Goals and alleviating poverty in the communities where we work. Healthy people are better able to learn in school, earn a living and tend to have greater opportunities generally. Reducing the threat of needless disability and helping communities to meet their basic needs for water, sanitation, nutritious food and healthcare gives them a ‘hand up’ on which they can build for the future.
Page 4
Where we work
IMPACT takes action to prevent disability in many parts of Africa, Asia and Europe. We work with local IMPACT Foundations and other trusted partners on the ground to implement the initiatives described in the following pages.
Working through local people helps to keep costs down and means we have a direct link to the people we serve without maintaining expensive offices staffed by expatriates. It also ensures that we meet our beneficiaries’ real needs, and not just the needs we think they have since our partners come from the communities and have a deep understanding of what life is really like in each place. Money is therefore not wasted on inappropriate schemes that do not work and can be targeted where the need is greatest.
IMPACT’s action also places great emphasis on training and health education so that people are not powerless against threats of disease and disability (so many of which can be prevented). This ensures that positive changes are long-lasting and reduces dependency on outside help.
Together, we make an IMPACT in:
Africa: Kenya, Tanzania, Zanzibar
Asia: Bangladesh, Cambodia, India, Nepal, Pakistan, Sri Lanka, Thailand, The Philippines
Europe: The UK, Norway*, Sweden*, Switzerland*
*Fundraising only
Pages 5-6
Early Identification and Treatment
‘The disease processes are much more advanced in Bangladesh compared with what we see in the UK. Patients in the UK may complain that they cannot see a golf ball at 80 yards. In Bangladesh, many patients have been blind for 5 years by the time we see them and are destitute and unable to feed their families.'
Mr. David Moss, MA, FRCS, FRC Ophth
Ophthalmic surgeon from the UK who has volunteered with IMPACT Bangladesh
Prevention is always better – and usually cheaper – than cure. The timely diagnosis and treatment of illnesses can prevent a lifetime of disability, human suffering and poverty, as well as serving to reduce the disease burden which is so unjustly borne by men, women and children in poorer countries.
Even relatively minor illnesses and infections have the potential to cause permanent disability in the absence of appropriate intervention. For example, Otitis Media (a common ear infection which can be easily cured in its early stages by a course of anti-biotics) is a major cause of acquired hearing loss in the developing world. Yet since it is the most impoverished people in rural areas who are least able to access medical attention, they are also the most likely to become needlessly disabled and this perpetuates a downward cycle of poverty and disability.
IMPACT’s thriving primary healthcare clinics in Bangladesh, Cambodia, India, Kenya, Pakistan, Sri Lanka, Tanzania, The Philippines and Zanzibar serve impoverished people who would otherwise have nowhere to turn in the event of ill-health. We also support specialist clinics. For example, this year IMPACT Nepal expanded its network of rural ear care centres by opening a new facility in Guar, Rautahat District.
Mobile units take medical care deeper into remote areas. IMPACT Cambodia travels unmade roads by four-wheel drive vehicle to stage village clinics in Kandal Province; the Lake Clinic transports doctors, nurses, dentists and midwives by boat to isolated communities on the vast Tonlé Sap Lake; IMPACT Zanzibar’s mobile treatment camps and clinics focus on ophthalmic and ENT conditions, maternal health, and orthopaedic care; and, as part of its outreach programme, IMPACT Bangladesh promotes eye care and distributes vitamin A tablets to protect children from deficiency of this micronutrient (which is a major cause of blindness).
More than seven million children will die this year from preventable illnesses so reaching out to vulnerable children is a priority. Innovative solutions include training teachers and nursery school teachers, as well as students themselves, to identify the early signs of ill-health and refer children to our medical teams for treatment. First Aid kits are distributed to schools to avert infection following minor injury. We also train local health workers as a sustainable solution to the critical shortage of trained medical personnel in the developing world.
Thanks to IMPACT, over half a million children in Maharashtra State have benefitted from health screening this year; more Bangladeshi teachers are skilled in testing their pupils’ eyesight; our local partner in Bhavnagar District, India, has visited hundreds of schools and nurseries to conduct screening for eye and ear problems and provided spectacles and hearing aids where necessary; and School Health Monitoring projects in Kenya and Zanzibar are thriving, with every rural primary school in Zanzibar now involved.
£15,000-25,000 establishes a mobile clinic
IMPACT’s good news
1,273,101 men, women and children have been examined and provided with treatment this year
Pages 7-8
Accessible Surgery
“Countries with developing economies have not considered surgical care to be a public health priority, yet surgically treatable conditions—such as cataracts; obstructed labour…osteomyelitis; [and] otitis media…add a chronic burden of ill health to populations. These acute and chronic conditions take a serious human and economic toll”.
Debas, Gosselin, McCord and Thind in Disease Control Priorities in Developing Countries. 2nd edition.
Jamison DT, Breman JG, Measham AR, et al., editors.
In countries such as the UK, treatment or surgery for ear infections, cataracts, cleft lips and other conditions are usually provided quickly but in the developing world medical care is scarce and disability is often for life.
Even when operations are provided by the state, they can still be out of reach of the poorest people, who may not be able to afford all the associated costs, such as travel to hospital, food whilst they are there or loss of wages. Poverty and disability thus form a vicious cycle.
IMPACT takes the hospital to the people to restore sight, movement or hearing, and to repair cleft lip. We also enable operations in Tanzania and Bangladesh for women damaged by fistula during mismanaged childbirth.
This year our supporters have helped to fund special surgical programmes in Bangladesh and Tanzania to treat children with hydrocephalus and spina bifida. The pioneering surgery carried out can enhance quality of life and life expectancy for seriously ill children who would otherwise have no hope of treatment.
IMPACT India’s Lifeline Express hospital train celebrated 21 years of service this year. Over the past two decades the lives of more than 700,000 people in rural India have been transformed thanks to treatment or surgery on board.
Elsewhere, the ‘Jibon Tari’ (Boat of Life) floating hospital in Bangladesh, a tented sterile operating theatre in Nepal, and mobile clinics across many of our projects, enable IMPACT’s medical and surgical teams to reach people who are vulnerable to ill health and disablement. We have also helped to equip operating theatres and provide training for ENT and plastic surgeons in Cambodia.
In some contexts a combination of mobile and static service provision works in tandem. The PNR Society (our local partner in Bhavnagar District, India) holds diagnostic screening camps in remote areas to identify people with sight-loss due to cataracts. Those needing surgery are transferred to the PNR Hospital for free treatment. In Tanzania, a mobile orthopaedic clinic travels to villages identifying children with club foot and burned limbs. Mobility-restoring operations are carried out at our partner hospital in Arusha.
We are truly grateful to Rayner Intraocular Lenses Ltd. for their regular gifts of intraocular lenses for use in cataract surgery in Bangladesh, and to volunteer medical staff who travel from the UK and other countries to conduct operations and support and train local surgeons within our projects.
Operations to reverse disability can have life-changing results. Once sight, hearing or movement has been restored, adults can return to work and children learn unhindered in school.
In addition to the provision of remedial treatment, IMPACT has aided our partners to provide assistive devices such as callipers, prosthetic limbs, hearing aids, and spectacles to thousands of people. In Bhavnagar District, India, we support community-based rehabilitation for children and adults with irreversible disabling conditions.
£40 restores sight, hearing or mobility
IMPACT’s Good News
21,005 men, women and children received surgery to alleviate a disabling condition
Page 10-11
Safer Motherhood and Child Survival
“Since 1990…an estimated 10 million women have died from complications related to pregnancy and childbirth, and some 4 million newborns have died each year within the first 28 days of life…Most maternal and neonatal deaths can be averted through proven interventions including adequate nutrition, improved hygiene practices, antenatal care [and] skilled health workers assisting at births”.
Ann M. Veneman, Executive Director, United Nations Children’s Fund
Motherhood can be a perilous time for women all over the world but the lives of mothers and babies in the developing world are particularly at risk during pregnancy and childbirth because of general poor health and lack of medical care. Maternal deaths do not occur on a large scale in wealthier countries, where medical resources are more equitably distributed.
Death is not the only tragedy to result from inadequate care during pregnancy and childbirth. For every woman who dies, WHO estimates that 20 more will suffer from serious injury and long-term disability. Combatting needless maternal death and disability is a key IMPACT priority.