THE

BRITISH

PALAWAN

TRUST

2007

ANNUAL

REPORT

Aims of the Trust. “ ..to relieve sickness and suffering and preserve and protect the health of the people in Palawan in the Philippines particularly by the establishment and maintenance of an Orthopaedic Project.”

BOARD OF TRUSTEES 2007

THE BRITISH PALAWAN TRUST

CHAIRMAN’S REPORT 2007

The last twelve months have been very hectic but very rewarding. I was there for the start as my visit took place at the beginning of the financial year, over the Easter period. The year had started with the completion of our Training Centre called Bahay Sanay (house of training and exercise). The building for this was funded by an oil company and the land donated by the Bishop of Palawan. In April the Bishop of Palawan performed the Opening ceremony and blessing. This was very well attended by British Palawan Trust Staff, Village Health Workers, local Doctors and local Politicians. The event was broadcast on local radio and television, and I reported on this in the last Annual Report.

The first full training course in Bahay Sanay was held in June. This was to teach School Nurses the basics of the care of children with musculo-skeletal injuries. It was very well received by the attendees. Since then there have been courses for Village Health Workers and Municipal Health Officers. The concept of CPD has not really reached Palawan but remembering the time it took to be accepted in UK we are still hopeful. The increase in training has placed a strain on all the existing staff, especially Soc and Cecile, but also the Therapists, Secretaries and Workshop Staff. It is however by training those at the basic level of care that the standard of trauma care and Appropriate Orthopaedics can be improved for the whole population.

We have been lucky in having received donations from H.E. the British Ambassador for an articulated full sized skeleton and a full set of DVDs of human anatomy, other donors supplied a video projector.

Later in the Year Soc attended a Ponseti course in Helsinki. This has fired him with renewed enthusiasm. CTEV is a very common problem with many presenting late and all requiring closely supervised treatment. Initial results using this method are very encouraging and it will be interesting to see if they are better than the “old” casting methods.

The number of patients attending with congenital deformities and musculo-skeletal injuries continues to increase. Soc has been very busy both treating out-patients and in-patients as well as using the operating theatre. The clinic area of Bahatala and the BPT Ward are often full. Soc has had some help in Puerto Princesa Provincial Hospital from another Orthopaedic Surgeon who trained in the Philippines. There are however rumours that he like so many Pilipino doctors is retraining as a nurse so that he can get a job in the USA.

The Rehabilitation services both based at the hospital and within the community have also seen a significant increase not only in numbers treated but also in the areas covered. There are nevertheless still some areas of the province not covered fully from the centre at Bahatala. The skills and information are spreading through the training of Village (Barangay) Health Workers and School Nurses. Cecile continues to work very hard running the CBR and in her role as Chief Executive of Bahatala Inc and of BPT.

There are plans for much more ambitious developments. Soc is working with the Department of Health and the University of the Philippines to develop and spread the concepts of Appropriate Orthopaedics. The first step will be the publication of Soc’s two manuals. One is for village health workers and the other for doctors who do not have access to trained Orthopaedic Surgeons. The initial books will be published in Tagalog (Pilipino) and we hope will be funded by Handicap International, a charity based in France.

In May Soc was in Switzerland attending the Sixtieth World Health Assembly of WHO where he is to be presented with the Sasakawa Health Prize for 2007. This is given for outstanding innovative work in health development. The award ceremony is was held at the World Health Assembly on Thursday, 17 May 2007 in the Assembly Hall of the Palais des Nations, Geneva.

I plan to visit Palawan in August 2007. I am looking forward to observing the many new developments and seeing old friends. During my visit I will arrange a belated ceremony to present Soc with the Eyre-Brook Medal he was awarded in 2005.

It is with great sadness that once again I have to report lack of interest from the younger consultants in becoming Trustees. In fact I never received any response at all to my personal letter to them with full details of the Trust. I am also still waiting for one of the current Trustees to volunteer to visit Soc. I feel it is very important that there is another Trustee who knows and is known to Soc and Cecile, and also understands the working of the Trust.

I have tried during the year to keep the Web site as up to date as possible and hope that people have enjoyed it and found it useful. The site has generated a number of e-mails and enquiries. Please let me have suggestions for improvement or additions.

THE BRITISH PALAWAN TRUST

TRUST REPORT 2007

We have tried during the year to edit and renew the main mailing list. The original mailing list was made in 1990 at the start of the Trust. Many names have had to be removed over the years some unfortunately due death and others where we have no new or forwarding address. This left a list of fewer than 2000 names of loyal regular donors. The Chairman managed to purchase at reduced (charity) price a copy of the Medical Directory on down-loadable CD. We have started by writing to all those who qualified between 1960 and 1969 and will then move on to the next decade. Experience has showed that on the whole most donors are over fifty. Perhaps the younger ones are still paying mortgages or school fees!

We do anticipate an increase in expenditure over the next few years. The favourable rise in the Peso exchange rate has come to an end and in fact most financial commentators expect a fall over the next year or so. There were 43 Pesos to the UK pound in 1992 three years ago it reached 100 and has fallen slightly since. We have to be ready for the new expenses of the Training Centre, in addition the number of patients treated each year increases as does the cost of medical supplies. This all leads to the question of sustainability. We are very aware that in the long run a significant proportion of the funding must come from local sources whether this is central government, local government or donations from within the Philippines. There is already some government funding that has taken over areas that were originally covered by the British Palawan Trust but not yet enough. The creation of Bahatala Inc has involved many local people in the administration and I hope this will lead to the development of increasing local funding at least in part for our work.

Bahatala Inc. continues to be the vehicle that all local work and administration are carried out. The majority of the income for this comes from the British Palawan Trust but Cecile, as chief executive, is very successful in obtaining support from other sources. The figures, given below, show that for 2006 the total income of Bahatala was made up from three other sources. I am particularly pleased to see the local support which although small is a significant increase on previous years.

Income of the British Palawan Trust has kept place with expenses over the year to 31 March 2007. This has been greatly helped by our generous corporate donor who so far has supplied the Training Centre and the 4X4 people carrier enabling the Trust to concentrate on patient care and treatment as well as developing the administrative infrastructure.

The accounts have been examined by Beatons again this year. There is a summary at the end of this Annual Report. I would like to thank Beatons for their help and for keeping the cost of the independent examination as low as possible.

The financial statements are produced according to The Deeds of Declaration of The Trust. The Income and expenditure accounts are limited to transactions in The United Kingdom. Accounts are monitored in Palawan by Bahatala Inc. The chairman makes regular visits to Palawan to check local accounts and expenditure, and to attend board meetings of Bahatala Inc.

It should be noted that the surplus is maintained for the following agreed purposes,

1. To allow continuation of the Trusts work if donations are insufficient until such time as new funding can be identified.

This Annual Report and the Report and Financial Statement (Beatons) were accepted at The Annual General Meeting of the Trust Board held on 7^th February 2008.