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The British Palawan Trust

Annual Reports

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THE

BRITISH

PALAWAN

TRUST

2016
ANNUAL

REPORT

 

BRITISH PALAWAN TRUST

 

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.”

 Registered Office

 The Orthopaedic Department,

       The Ipswich Hospital,

Heath Road,

Ipswich, Suffolk, IP4 5P

Registered Charity number ~ 328651

Web site: www.britishpalawantrust.org.uk

 

BOARD OF TRUSTEES 2013-2014

 

Mr. Louis Deliss FRCS.            Chairman.

Mr Mark Bowditch FRCS (Orth).

Dr Stephen Ball, BSc, MB, BS.

Mr. Andrew Gunn, MA, FRCS.

Mr. Jeffrey Hallett, FRCS.

Miss Clare Marx CBE, PRCS.

Mr Sam Matthews.

Mr. David Sharp, MD, FRCS.

Mr. Mike Shanahan, FRCS.

Dr Phyllis Turvill, MB, BS.       

                                        

Public Benefit Statement

The principle charitable purpose of the Trust is “the advancement of health” by providing medical care for the people of Palawan (population about 700,000) in particular the indigent people.   The care is specifically for those with orthopaedic conditions, congenital deformities and those affected by musculoskeletal trauma. We also provide for “the relief of those in need by reason of disability” a Community Based Rehabilitation Service.   In addition, we work for “the advancement of education” through a Training Centre where we teach our methods to other health care workers and doctors.                               

 These fulfil the Charity Commission purposes b), d) & j).

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

THE BRITISH PALAWAN TRUST

 

CHAIRMAN’S REPORT 2015-2016

 The past year was remarkable for the developments in the Workshop.   This was dominated by the presence of Udo Foester.   Udo is an Orthotist and Prosthetist funded by the Australian Volunteers for International Development and lived in Puerto Princesa for a year.   Initially he spent time assessing our unit and its needs.   Then inevitably came requests for equipment, which we were able to fulfil mainly using locally donated funds.   Then Udo started training.   He began by introducing modern modular manufacturing methods using prosthetic parts he had bought and then by purchasing them from China at a considerably lower price than the European firms.    He taught our original technician, Romy, then trained his assistant, Reymon.   In addition he involved the staff of the clinic one of whom made a complete leg.   

The arrival of the thermoplastic oven towards the end of Udo’s time enabled all the staff to be taught the basics of orthotic assessment and fabrication.  We are hoping to get another Orthotist to build on this early training as soon as possible.  The development of the ability to make braces is important.   The local doctors prescribe a lot of braces and we will be able to make them and charge for them as well as enhancing the treatments available to patients.

The increasing co-operation with the local doctors has continued to develop.    The outreach clinics have also been repeated and now encompass many new parts of the province.    These have changed a bit as it was found to be more successful to work with the Medical Social Workers (MSW) rather than the Rural Health Units as the MSWs are responsible for supporting Persons With Disability (PWDs) and this is a large group that can benefit from our services.

All these advancements continue to support my optimistic view for the long term.

            Finance.

            A full financial report by our accountants, Beatons, is available separately.   However there is a summary at the end of this Annual Report.   It shows good reserves but we are planning building maintenance and equipment renewal.

            The donors within the UK both individuals and various Trusts have maintained their loyal support so that income has been good.   We also carry on getting support from CBM. Norfil (who have taken over the work of Lillianes Fonds) and PCSO (Philippine sweepstake).   We are also getting increasing donations locally both direct and into the clinic donation box.   This is helped by a number of Filipinos living in the USA.   Suggestions about how we might increase our income would be gratefully received.

All the staff and the members of the Board of Bahatala Inc. are looking forward to meeting some of the other Trustees in the near future.

 

Louis Deliss

Chairman

British Palawan Trust

             

THE BRITISH PALAWAN TRUST

REPORT OF CHAIRMAN’S VISIT 2016

 I visited Palawan and our clinic and workshop in March 2016.  I come back more inspired and optimistic than ever.  The last twelve months have seen much changed.  Udo Forster an Australian Prosthetist and his wife and three lovely daughters lived in Puerto Princes and I think thoroughly enjoyed their stay, we certainly did.   Udo’s work is described above in the Chairman’s Report

Udo’s job description was to modernise the methods and equipment in the workshop.  We have been making prostheses and other aids for persons with disabilities for twenty years but were still using the techniques that we started with.  Mrs Socrates and I had been worried about this for some time especially as our in-house prosthetist is nearing retirement age.  Our worries were quickly dispelled by Udo’s enthusiasm and work ethic.  He soon identified our needs.  He introduced new, modern techniques to the prosthetist and also involved all the other members of staff.  He reorganized the layout of the workshop and requested new equipment which with our funds and locally raised funds we were able to purchase.   Now we have three people who have made legs from start to finish independently.  This is one reason for my optimism and we are very grateful to Udo and the Australian Government.

 The other optimistic development is the change of emphasis and working methods of the Clinic.  We have one attending Orthopaedic Surgeon on one afternoon a week.  He really comes for our thriving Ponseti club foot clinic but will see other patients. 

 The emphasis of our unit is now more on persons with disability (PWDs) and we have found that working with the Municipality Medical Social Workers rather than the Rural Health Units allows us to help many more patients.  We still help many people with fractures and other orthopaedic conditions some we can treat, others need finance and an appropriate referral.   Unfortunately, the cost of healthcare is too high for the majority and the standard of specialist ability (all specialties) is generally low with resulting poor patient confidence making some opt for no treatment or to attend ‘faith healers’ (hilots).  The generally low standards coupled with the total lack of any commitment to post-graduate education is very concerning for the future.  I have offered to help develop some form of CME but can’t even get the three or four orthopaedic surgeons to meet.  They perceive that they are in competition and are jealous of their income.  (Thank goodness for the NHS).  The recent Lancet Commission has some ideas and leads as did the GSF Conference at the RCS that I hope will help.

I was not idle whilst there.  I saw many patients and treated some.  Two patients with un-displaced tibial fractures were initially told there were no doctors in A&E as it was a ‘holiday’ then that they would need to find over 100,000 pesos (£1700) as a down payment for the “essential” surgery.  I put the both in POP casts with weight bearing.  The youngest aged 7 was clinically healed before I left.

We also went on “out-reach” clinics to two remote towns.  There we saw between 40 and 90 patients a day.  The spread of diagnoses was truly incredible.  A 30 year old man who had dislocated his knee twenty years before leaving him with an under developed leg and a 90 fixed flexion at the knee.  We gave him a pair of crutches.  Many were easier, lots of children with cerebral palsy needing wheelchairs.  Older patients after stokes needing physio, walking aids or wheelchairs.   A not insignificant number of amputees who were waiting for legs or who did not know how or where to get one.  The national sweepstake funds support the cost of limbs for indigent patients.  There were many other patients some of whom can be seen on the British Palawan Trust Facebook page.

 There is still a good flow of funds from our loyal supporters.  This is supplemented by grants from other European charities and from donations from the USA. Locally we get an increasing amount into the donation box in the clinic, from local donors and Philippine government sources.

Louis Deliss

 

BRITISH PALAWAN TRUST

Summary of Accounts 2015-2016

 

 

 

£

Total income

£49,493

Charitable expenses

£40,733

Total other expenses

£2,879

 

 

Surplus for the year

£5,881

 

 

Total reserves

£115,772

 

 

Our accountants, Beatons, have produced a separate full financial statement.

                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.

2.       To provide for future capital expenses.

3.       To allow for any local natural disasters.

4.       To allow for unexpected incidental expenses.

5.       To compensate for fluctuations in the money exchange rates.

 

Bank.                                                                     HSBC

                                                                                41, Woodbridge Road East

                                                                                Ipswich

Suffolk, IP4 5QN.

 

Auditors and accountants.                              Beatons

                                                                                Chartered Accountants

                                                                                York House

                                                                                2-4 York Road

                                                                                Felixstowe

                                                                                Suffolk, IP11 7QG

~~~~~~~~~~~~~~~~~~~~~

This Annual Report and the Report and Financial Statement (Beatons) were accepted at The Annual General Meeting of the Trust Board held on 8th January 2017.

Louis Deliss M.B., Ch.B., F.R.C.S.

Chairman of the Trustees.


 

THE BRITISH

PALAWAN TRUST

 2014
ANNUAL REPORT

 

BRITISH PALAWAN TRUST

 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.”

 

Registered Office:

                                               The Orthopaedic Department,

                                               The Ipswich Hospital,

Heath Road,

Ipswich, Suffolk, IP4 5P

 

Registered Charity number ~ 328651

 

Web site: www.britishpalawantrust.org.uk

 

BOARD OF TRUSTEES 2013-2014

 

Mr. Louis Deliss FRCS.            Chairman.

Mr Mark Bowditch FRCS (Orth).

Dr Stephen Ball, BSc, MB, BS.

Mr. Andrew Gunn, MA, FRCS.

Mr. Jeffrey Hallett, FRCS.

Mr. Ivan Hudson, FRCS.

Miss Clare Marx CBE, PRCS.

Mr Sam Matthews.

Mr. David Sharp, MD, FRCS.

Mr. Mike Shanahan, FRCS.

                               Dr Phyllis Turvill, MB, BS.       

                                                 

Public Benefit Statement

The principle charitable purpose of the Trust is “the advancement of health” by providing medical care for the people of Palawan (population about 700,000) in particular the indigent people.   The care is specifically for those with orthopaedic conditions, congenital deformities and those affected by musculoskeletal trauma. We also provide for “the relief of those in need by reason of disability” a Community Based Rehabilitation Service.   In addition we work for “the advancement of education” through a Training Centre where we teach our methods to other health care workers and doctors.                   

 These fulfil the Charity Commission purposes b), d) & j).

 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

THE BRITISH PALAWAN TRUST

CHAIRMAN’S REPORT 2013-2014

 The year saw a new beginning with the move to our new site in Abanico Road.   This was a long time in gestation and was one of Soc’s dreams which he saw started but not completed.   Cecile and the staff of Bahatala have worked very hard to achieve the dream and make it work.

 The move from the very dilapidated and threatened old building in the grounds of the Provincial Hospital was accomplished in June 2013.   Immediately patients started attending especially as the access to the clinic is so easy for those in wheelchairs and with walking difficulty.   There were some problems without the medical input from Soc but we quickly developed a system.   The girls in Bahatala took a history and made an examination sometime supplemented by an X-ray and sent the details to me by e-mail.   Then by return e-mail or by using WeChat I could give some advice.   This was often physiotherapy and sometime application of a simple cast but at other times the patient needed to be sent to one of the four orthopaedic surgeons or other specialists.   We helped such patients to raise the necessary money for medical fees.

 The new workshop also started work, Romy making artificial legs and braces, and Reymon making many pieces of equipment for the disabled.   They were also busy making final touches to the buildings.    Reymon and Mang Andres had done much of the work such as making windows, grills and furniture.

 hen an exciting new venture occurred in September.   Steve Mannion (Orthopaedic surgeon in Blackpool & Malawi) supported by CBM and Global Clubfoot Initiative ran a Ponseti course.   This added greatly to the skills of the staff in Bahatala to replace those that Soc had learned at such a course in Finland.    In addition Dr A Favila a local, new orthopaedic surgeon attended.   He was shown how to perform the necessary Achilles tenotomies.    These he now does under local anaesthetic in the clinic.  He attends every Wednesday afternoon to assess and treat the club feet.    Romy makes the braces that he was shown by the Prosthetist who came with Steve.   So now Bahatala is the Ponseti centre for Palawan, one of the first in the Philippines.    We also have an orthopaedic surgeon who teaches the girls and assesses other patients meaning that I receive fewer e-mails with patient problems.    Naldz Favila often accompanies Cecile and other staff when they go on out-reach medical visits.   Cecile continues to run the whole unit the future for which I believe is very good.

Financial Report

There is a full examination and report from our auditor, Beatons.   But there are some things that need expanding.

Income has remained fairly good thanks to our generous and loyal donors in the UK.   There has been a slight drop in donations which this year was slightly offset by a legacy. We have covered the cost of buying land and building the new clinic and workshop without using all our reserves.    This is mainly due to the generosity of Dr Phyllis Turvill.   Our reserves now stand at about two years of expenditure which is within the limits advised by the Charity Commission.

We are still not certain if the costs of the new clinic are as I suspect somewhat higher than for the old building but so far we seem to be living within our income.    I have been trying to get new donors but with limited success possibly a bad time to ask for money but as the recession fades maybe we will be more successful.    We continue to be supported by the Oak Trust, the Cadburys Trusts and others including some Rotary Clubs notably the Vikings in York.   Income from within the Philippines is still too low and Cecile and I will be exploring this when I visit in February.

Suggestions about how we might increase our income would be gratefully received.

Louis Deliss Chairman


      BRITISH PALAWAN TRUST

Summary of Accounts 2013-2014

 

 

£

Total income

45,935.00

Charitable expenses

49,723.00

Total other expenses

1317.00

 

 

Deficit for the year

5105.00

 

 

Total reserves

89,493.00

     

 

Our accountants, Beatons, have produced a separate full financial statement.

                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.

2.       To provide for future capital expenses.

3.       To allow for any local natural disasters.

4.       To allow for unexpected incidental expenses.

5.       To compensate for fluctuations in the money exchange rates.

 

Bank.                                                                     HSBC

                                                                                41, Woodbridge Road East

                                                                                Ipswich

Suffolk, IP4 5QN.

Auditors and accountants.                               Beatons

                                                                                Chartered Accountants

                                                                                York House

                                                                                2-4 York Road

                                                                                Felixstowe

                                                                                Suffolk, IP11 7QG

~~~~~~~~~~~~~~~~~~~~~

This Annual Report and the Report and Financial Statement (Beatons) were accepted at The Annual General Meeting of the Trust Board held on 18th January 2015.

Louis Deliss M.B., Ch.B., F.R.C.S.

Chairman of the Trustees

 

 

 

 

 

THE

BRITISH

PALAWAN

TRUST

 2012
 

ANNUAL

REPORT

 BRITISH PALAWAN TRUST

 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.”

 

Registered Office:

                                               The Orthopaedic Department,

                                               The Ipswich Hospital,

Heath Road,

Ipswich, Suffolk, IP4 5P

 

Registered Charity number ~ 328651

 

Web site: www.britishpalawantrust.org.uk

 

BOARD OF TRUSTEES 2011-2012

 

Mr. Louis Deliss FRCS.            Chairman.

Mr. Andrew Gibbs, BSc, FRCS.

Mr. Andrew Gunn, MA, FRCS.

Mr. Jeffrey Hallett, FRCS.

Mr. Ivan Hudson, FRCS.

Mr. John Powell, FRCS.

Mr. David Sharp, MD, FRCS.

Miss Clare Marx CBE, FRCS.

Mr. Mike Shanahan, FRCS.

Mr R Baxandall, FRCS (Orth).

Mr M Bowditch FRCS (Orth).

Mr J Hopkinson-Woolley FRCS (Orth).

 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Public Benefit Statement

The principle charitable purpose of the Trust is “the advancement of health” by providing medical care for the people of Palawan (population about 700,000) in particular the indigent people.   The medical care is specifically for those with orthopaedic conditions, congenital deformities and those affected by musculoskeletal trauma. We also provide for “the relief of those in need by reason of disability” a Community Based Rehabilitation Service.   In addition we work for “the advancement of education” through a Training Centre where we teach our methods to other health care workers and doctors.                   

 These fulfil the Charity Commission purposes b), d) & j).

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 

THE BRITISH PALAWAN TRUST

CHAIRMAN’S REPORT 2011-2012

I have to report the tragic death of Soc which has overshadowed everything.   He died of a massive heart attack whilst on his usual early morning swim.   I have included a brief obituary in this report although it occurred in the year after the period covered by this Annual Report.  There is a fuller obituary on the Trust web site.

In the year to March 2012 the work in Palawan continued unabated.   The path to the Bahatala building in the hospital compound became more and more difficult due to the construction works for the new extension of the Provincial Hospital.   Despite this many patients attended but some, those in wheelchairs and with strokes, found great difficulty getting to the clinic.   One of our Physiotherapists resigned towards the end of the financial year, as she had to return to her home to assist her mother who runs a Call Centre.   This means the staff now consists of two Physiotherapists, a Nurse, two technicians and two in the office with Cecile overseeing them all.     We also now have an auditor, Charlie, who visits on a regular basis and provided a full audit at the end of the year (31 December in the Philippines) to satisfy the Government’s requirements.

There continued to be some difficulty with the Director of the Hospital, Dr G Juan.   He has an Orthopaedic interest and still resented that Soc and Bahatala provided the indigent patients with free treatment.   He is due to retire in August 2012 so the relationship with the hospital should improve.   The Secretary for Health (based in the Department of Health in Manila) is very keen to support this beneficial co-operation.   In fact he has expressed the desire that the British Palawan Trust should act as an advisor to the Philippine Government as they wish to set up similar units attached to the Government hospitals in all the provinces of the Philippines.

Work at the new site in Abanico Road has got on quite well despite the early start of the rainy season.   I met with our Architect who is very enthusiastic about the work.   We agreed to use some of the additional funds from a generous donation from the Girdlers Company to authorise the hiring of a mechanical digger to speed up the work on the foundations.   The Architect was hopeful that the building could be finished by spring 2013 at the latest.

The finances remain healthy with a good response to our special appeal.  It is gratifying that the “credit crunch” does not seem to have affected us too much as our regular donors have remained very loyal and income from this source had remained about the same.   The combination explains the increase total income which also included over £6000 recovered from Gift Aid.   The report by Beatons is summarised in this Report and a full audit appended.

I visited in March 2012 and my report is below.   I also visited in October 2012 following the death of Soc and a report of this will be included in next year’s Annual Report. I remain hopeful that another Trustee will visit soon.   Perhaps the opening of the new clinic in March or April 2013 would be the ideal time.

Louis Deliss,  Chairman.


 

Dr Jose Antonio Socrates MD, FRCSEd.

1948-2112

Dr. Jose Antonio Socrates (Doc Soc) was born in 1948 in Bohol and grew up in the University of the Philippines campus where his parents were Faculty members. He and his eight siblings spent their happy childhood years inside the UP campus where their parents instilled in them the value of sound work ethic, diligence and discipline. All nine children successfully completed their college education.

Soc originally graduated from the University of the Philippines as a Geologist.  It was in the field as a geologist that he wondered if he too, like h  is brother could be a doctor.  He returned to Manila and graduated from the U.P. College of Medicine in 1974.   Whilst at Medical School he met and married Cecile who was studying psychology.  Soon after he left the country to join the United Nations as a UN Volunteer in 1977 and was posted in Africa.

He did not return to the Philippines for 15 years, during which time he acquired a medical license in the United States. Then he experienced the UK health service working in Bangor, Cambridge and Ipswich.   He specialised in Orthopaedics and gained his Fellowship of the Royal College of Surgeons of Edinburgh.  In Ipswich that he was shown the non-operative methods of fracture care that he used later.   His hospital consultants in Ipswich were so impressed with his work ethic, dedication and resolve to return to his country they formed the British Palawan Trust in 1990 whose objective was to provide orthopaedics and rehabilitation services for the people of Palawan especially to those who could not otherwise afford them. 

He arrived in Palawan in 1992 and rapidly became known to the people of Palawan especially the poor.   He never charged for his services and expenses were met by the British Palawan Trust.   He became the Provincial Heath Officer and medical superintendant of the Provincial Hospital.  He changed much in the hospital and built an Orthopaedic ward, funded by the British Palawan Trust.   He made himself available for patients every day and all day.   For years he was the only doctor with orthopaedic training on the island so was incredibly busy.  He treated thousands of patients who would otherwise have no treatment because it was not available or they could not afford it.

Soc found that the facilities were limited so developed his method of fracture management without surgery which he called Appropriate Orthopaedics, outlined in his book, which is still available from the British Palawan Trust.   His non-operative methods and giving his services for free antagonised some doctors especially those with an orthopaedic interest.   Soc never let this worry him and in fact he rather relished being different but it was a worry for others.

He started a clinic at the hospital, this became Bahatala from Bahay Hawak Tayo Lakad (Tagalog for "house to hold, to stand, to walk”) which remains the headquarters of all the work supported by the British Palawan Trust.     In the last year of his life he was working hard to develop a new building that the whole unit could move to.  Soc never saw it completed, it will open in 2013.   He obtained funds with the help of Handicap International and Tahanang Walang Hagdanan (The House without Stairs) in Manila, to train technicians and build a workshop which is the only supplier of artificial limbs in the Palawan.   A second technician was trained to repair and modify wheelchairs and make aids for the disabled.

Throughout his work he was very ably helped by his wife, Cecile.   She gained a degree in Community Based Rehabilitation in Developing Countries in London.   This led to the full development of the rehabilitation services both in Bahatala and the community.  They made a wonderful team despite their occasional differences as Soc was not always the easiest person to work with.

Soc has gained many honours. In 1999 the UP College of Medicine awarded him an Outstanding Alumnus Award.   In 2005 the International Committee of World Orthopaedic Concern gave him the Arthur Eyre-Brook Medal.  In 2007the World Health Organisation awarded him the Sasakawa Health Prize. In 2008 the University Of The Philippines ' Centennial Celebrations awarded him an Outstanding Alumnus Award.

Soc never forgot that he was a geologist and called himself a DOG, a doctor of orthopaedics and geology.   It was always a pleasure to go for a walk with him because he could give details of the geology of the area and of every stone he picked up.    His hobby was collecting stones with which he built many rock gardens.   He became geological advisor to the Province and helped to set up the St Paul Park which has recently become one of the New Seven Wonders of the World.

Soc was a humble man with very simple needs, a wonderful companion in all his activities.    I was very privileged to know him.  We will miss Soc and remember his enthusiasm, energy and inspiring leadership.  The people of Palawan will always be grateful for what he achieved.  

Soc is survived by his wife, Cecile, his daughter, April and his Grandson, Ethan.  We extend our sincere condolences to them and all his siblings.

Louis Deliss

THE BRITISH PALAWAN TRUST

REPORT OF CHAIRMAN’S VISIT MARCH 2012

 I visited in March which was before the death of Soc, to see the work being done in Palawan, Philippines.   We now work through a locally registered NGO called Bahatala which is still based in the old building in the grounds of the Provincial Hospital.  The work has gradually changed a little over the years.   We now have a very active rehabilitation service to complement the orthopaedic work of Dr Socrates (Soc) that treats post-injury patients, amputees, CP children and others with physical disabilities.   The rehabilitation is carried out by about (the number varies from time to time) four physiotherapists in our central location and by many and various health workers in the more remote areas, that have trained in our Training Centre. Soc makes visits to the outlying villages taking two of the Physiotherapists and sometime the prosthetist with him.  Cecile is also an important part of these visits taking photos for the records, making lists of patients for the German plastic surgery team and arranging funding for indigent patients.

The typical cases seen every day are CP, strokes, post fracture and those requiring prostheses and wheelchairs.   The prostheses are made by our “in house” prosthetist.   The technician mends and modifies wheelchairs and well as making standing and sitting frames for the CP children.   He has developed a padded wooden chair with wheels, the “Reymon Chair” which enables these children to sit up and be taken out of the house.

Whilst there, I saw a great many patients some of whom are more memorable.   There were three fresh tibial fractures treated by manipulation or traction and then a cast.  All were open fractures requiring intensive wound care.  One boy presented with a displaced upper tibial fracture.   He had sustained this six months earlier but because he could not raise the money (about £500) required as a deposit by the surgeon (he did not ask to see Soc) he went away untreated.  The fracture had healed with gross deformity of the tibial articular surface and now requires osteotomy and fixation.  We will arrange for him to be treated in the Orthopaedic Hospital in Manila as Palawan does not have the necessary equipment or good enough theatres – yet.

A 40 year old man who worked as a diver collecting shellfish presented with a collapsed femoral head due to Caisson disease.  The only treatment would be a THR but again not available in Palawan and completely outside his ability to pay.   THR in Manila costs more in surgeon’s fees than the average in UK.

On our trip to a distant Municipality, Sta. Vincente, my general medical knowledge was stretched by three children.  All presented with discharging ears.  No otoscope was available but I did find a torch.   Two had foreign bodies, probably pebbles, and one a fairly gross infection with, I think, a perforated tympanic membrane.   We arranged for them to come to Bahatala where we would refund their travel costs and refer them to a local ENT surgeon.

A number had knee pain following minor trauma.  Most of these appeared to be minor medial ligament sprains.   One was more difficult as he had injured the knee a year earlier and treated himself with OTC oral steroids and now had a chronic synovitis.  One had suffered a gap fracture of the patella but, again, decided to have no treatment as he could not afford it.  He had a gap of about 4 inches but walked remarkably well.  His worry was a common one in the Philippines that it would develop into a cancer.   The swelling of callus if often thought to be cancer and cancerous swellings are thought to be fractures.

There were patients with often minor fractures, Colles and others that had very severe swelling.  This is caused by the Hilot, the local traditional healer, who treats every injury with vigorous massage.    These healers can often be as expensive as more conventional treatment but like alternative therapists in the West make a good living based on the natural ability of the human body to heal itself.   One patient had spent about £600 on ineffectual treatment by one well known Hilot.

It was not all work.  We went to a small island for a short stay.   It has white coral sand with completely clear and warm sea.   A few yards out there are magnificent reefs with corals and fish of every shape and colour.    No need for full scuba kit as they are only a few feet down and a mask is all that is necessary.   We walked through jungle (rain forest) and groves of coconut palms to visit some patients who lived literally “off the beaten track”.    Sometimes this was hard work especially at mid-day when the temperature was well over 95°F with humidity over 85%.   At these times the offer of fresh young coconut water (Buco) was very welcome.   A small boy often sub-teenage was sent to climb the trees, some over 40 feet high, carrying a machete and without any aids. They are aware that their drinking water, often rainwater, was not safe to drink especially for a European.

I spent some time visiting the site of our new clinic.   They have cemented the road outside which makes access easier.  The workshop is virtually finished, and then it will become the secure storage for the materials needed to build the clinic.   The exact site of the clinic was marked out for foundation digging to start the week after I left.   Our local architect is very good and came with an outline model of the new clinic building.  It is all very exciting and hopefully we will move in within the next twelve months.    We do still need some more funds for this building so please continue to be generous with your donations.

My visit was exciting and enjoyable.   I came back filled with enthusiasm and optimism for the future.  Soc and Cecile are aware that they cannot go on for ever and are working towards sustainability for both personnel and local funding.  Palawan is a wonderful island for a holiday and well worth a visit.

For those with access to Facebook the British Palawan Trust page has some photographs of my visit.  I have also updated the web site.

 Louis Deliss

 

BRITISH PALAWAN TRUST

Summary of Accounts 2011-2012

 

 

 

£

Total income

100,454

Charitable expenses

47,489

Total other expenses

4545

 

 

Surplus for the year

48,420

 

 

Total reserves

169,343

     

 

Our accountants, Beatons, have produced a separate full financial statement.

                 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.

2.       To provide for future capital expenses.

3.       To allow for any local natural disasters.

4.       To allow for unexpected incidental expenses.

5.       To compensate for fluctuations in the money exchange rates.

 

Bank.                                                  HSBC

                                                            41, Woodbridge Road East

                                                            Ipswich, Suffolk, IP4 5QN.

 

Auditors and accountants.               Beatons

                                                            Chartered Accountants

                                                            York House

                                                            2-4 York Road

                                                            Felixstowe, Suffolk, IP11 7QG

~~~~~~~~~~~~~~~~~~~~~

This Annual Report and the Report and Financial Statement (Beatons) were accepted at The Annual General Meeting of the Trust Board held on 4th November 2012.

 

Louis Deliss M.B., Ch.B., F.R.C.S.

Chairman of the Trustees.

 


BRITISH PALAWAN TRUST ANNUAL REPORT 2011

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.”

 

Registered Office:

                                               The Orthopaedic Department,

                                               The Ipswich Hospital,

Heath Road,

Ipswich, Suffolk, IP4 5P

 

Registered Charity number ~ 328651

 

Web site: www.britishpalawantrust.org.uk

 

BOARD OF TRUSTEES 2011

 

Mr. Louis Deliss FRCS.            Chairman.

Mr. Andrew Gibbs, BSc, FRCS.

Mr. Andrew Gunn, MA, FRCS.

Mr. Jeffrey Hallett, FRCS.

Mr. Ivan Hudson, FRCS.

Mr. John Powell, FRCS.

Mr. David Sharp, MD, FRCS.

Miss Clare Marx CBE, FRCS.

Mr. Mike Shanahan, FRCS.

Mr R Baxandall, FRCS (Orth).

Mr M Bowditch FRCS (Orth).

Mr J Hopkinson-Woolley FRCS (Orth).

Public Benefit Statement

The principle charitable purpose of the Trust is “the advancement of health” by providing medical care for the people of Palawan (population about 700,000) in particular the indigent people.   The medical care is specifically for those with orthopaedic conditions, congenital deformities and those affected by musculoskeletal trauma. We also provide for “the relief of those in need by reason of disability” a Community Based Rehabilitation Service.   In addition we work for “the advancement of education” through a Training Centre where we teach our methods to other health care workers and doctors.                   

 These fulfil the Charity Commission purposes b), d) & j).

THE BRITISH PALAWAN TRUST

CHAIRMAN’S REPORT 2010-2011

            I described fairly fully the scope of the work carried out in Bahatala, in the hospital and elsewhere in last year’s Annual Report.   The past year has been very similar with huge numbers of patients being seen despite the problems.   The Bahatala building has new hospital buildings going up on two sides with builders rubble and equipment all round.   This means that access is very restricted and the unit is now only approachable on foot.   The result is significant difficulty for patients especially individuals with restricted mobility and those in wheelchairs or on stretchers.  Fortunately there are usually enough people to help or to even carry such patients.

            The part played by out out-reach workers has been consolidated.   The unit now works very closely with the Rural Health Workers.   These are paid by local government or by the local community and mostly they work from the Rural Health Units.   These vary from one room to larger buildings with clinics, treatment areas and offices.   They are visited by both government and private doctors some providing specialist services such as X-ray and ultrasound.  Many aspects of this collaboration could I believe continue even if BPT ceased to support it although there is no suggestion that this will happen in the near future.

            The real excitement during the year has been the purchase of the land which I describe in my visit report below.    The wonderful generosity of one donor has meant that we have used very little of our reserves for this.   The next stage is building and equipping the new facility.   We need to construct the clinic and the therapy areas.  The preliminary designs have been discussed and we are approaching a local architect for help.   In addition we need a separate building to house the prosthetic and wheelchair workshops with somewhere to make the ADL equipment.   This needs to be separate because some of the machines are rather noisy.  We hope that the workshop will be fully funded by local donations.

            Our original plan was that the Bahatala buildings would only need about half the total area of land and that the rest could be used for income generation.   The present thoughts are to put up some simple single story offices to let out.   Already a number of other NGOs have expressed an interest in renting these.  It would mean raising more money or possibly borrowing from a local bank.  It would be better if we did not have to borrow even if it is possible.  The alternative suggestion is for a small hotel which the growing tourist traffic could probably support.   This will be discussed by the local Bahatala Inc Board of Directors.

Financial Report

            The accounts are difficult to compare with previous years.   During the year we purchased 4000 square meters of land for our new clinic and workshop.  This was largely covered by a single donation from one of our regular donors.   Some additional income came from the Chairman’s Special Appeal letter written from UK to all those on our mailing list.  The basic income from donors was in line with last year.

            Future finances are not quite so clear.   We need about 7 million Pesos to build the Clinic and Workshop.  A donation from a local politician has provided enough to build the workshop.   The Clinic needs about £85,000.  We have promises for about a half of this total.    We plan to use some of our reserves but will be appealing for extra donations.

            In the long term the British Palawan Trust will have to find additional income for the running costs of the new buildings.   We hope to offset some costs by donations from those patients who could afford to pay for their medical care, especially those receiving orthoses or wheelchairs.

Full details of the accounts are in the report by our accountants, Beatons, which can be accessed through the Charity Commission web site..

Trustee Activity Report

Last year I wrote the following paragraph which unfortunately is still the position.  “The AGM held in early 2009 discussed the importance of having at least one other Trustee involved with the detail of the administration of the Trust.   Unfortunately none of the existing Trustees were willing or did not have the time for such involvement.    This remains the case.”

Louis Deliss

Chairman.

 

REPORT OF CHAIRMAN’S VISIT 2011

            I visited Palawan in March 2011 for three weeks.   I had planned a longer trip than usual because of the number of decisions that needed to be made about our move and the new building.  I wrote about the need to move out of the Bahatala house in the Hospital grounds in last year’s report.   Much has happened since.   Due to the enormous generosity of a single donor we were able to purchase 4000 sq.m. of land in Abanico Road.  This is about halfway between the Provincial Hospital and Bahay Sanay (The BPT Training Centre) and near to the main highway to the south.   In addition it is quite near the New Market where the buses and Jeepneys have their terminals so not far for patients from outside Puerto Princesa city proper to travel.   It is a fairly quiet road but traffic will probably increase a bit as the area is developed.   The land is presently covered with scrub and trees.  Soc has made a detailed map of the trees which include a number of the beautiful Palawan Cherry, so we can make plans and avoid cutting down too many trees.  A lot of the scrub has already been cleared and plans made for perimeter fencing.

            Cecile had produced a preliminary plan for the clinic and therapy areas which we showed to a local architect, Mr Quipquip, who is a charming and helpful man.   Since I returned they have drawn what I hope will be the final plan.   We hope that building can start within the next few months although this depends on getting a building permit (should not be a problem), finding a builder (probably already decided but we are taking advice from the architect) and not least on the amount of rain at the end of the dry season.  There is a copy of the basic plan in this report.   It sounds as if I had allowed too much time for all this but things move slowly!

            Despite the fact that the Bahatala house is surrounded by new building still in progress and the approach is difficult over the builders’ rubble the work continues.   There are currently three therapists in addition to the Prosthetist and handyman (who is also assistant prosthetist) as well as the two staff in the office.  A nurse has been helping on a voluntary basis but was not there at the time of my visit.  We also now have the part-time help of a very nice accountant, Charlie.  I anticipate that we may have to slightly increase our staff when we move.

Every day I spent some time in Bahatala seeing patients and talking to the therapists who are always keen to have little tutorials.   The range of patients was the same as in other years and I will not list them all.   One who stood out was a young boy who had suffered a severe compound fracture of tibia and fibula.   He had presented during the week that the German mission of plastic surgeons was visiting.  They achieved skin cover so that the fracture could be treated in a windowed cast.   This German group comes every year and treat cleft lip & palates as well as some post-burns and others needing expert plastic surgery.  There is no cost to BPT as they are sponsored from Germany and bring all their equipment but Cecile has to do a lot of work to facilitate their visit.   In fact they leave a lot of drugs and dressings for us.  There were two patients who presented at Bahatala with rather advanced cancer, one a bronchus the other possibly gynaecological.  Both wanted advice on where to go in Manila which Soc was able to help them with.  We also visited a number of patients in their homes in Puerto Princesa.   One was a man who had suffered a fracture of the lumbar spine (L1) leaving him para-paretic three months earlier.  He had been seen somewhere else and advised to buy from the doctor a small lumbar brace for £150 but had not been advised how to mobilise.   We got him sitting and started on Physiotherapy.  It was all made more difficult because he came by boat from his village 12 hours away and was living on the boat.   At one house we found a very worried lady with a Neer three part (but minimally displaced) humeral fracture.   She had been told by one of the other Orthopaedic surgeons to go away and raise enough money for implants and an operation.   Soc and I were happy to treat her with a collar and cuff after a couple of hours with a weight on her arm effected a good reduction.

I was lucky to make some interesting trips to remote parts of the island.   The first was to the island of CocoLoco where there is a resort in which you stay in individual huts on the beach and eat very good local fish in their restaurant.  This was primarily to celebrate the birthdays of Cecile and Jack, a friend who was a Peace Corps worker and settled in Palawan. 

 We took the opportunity of the trip to visit some patients.   One, Angie, about whom I have written about before is a girl crippled by Polio.   We had helped her become mobile by providing a wheelchair and she was then able to go to school.  During my visit she “graduated” from school.  This is a great ceremony at the end of schooling where the pupils all dress in their best “ball gowns” and it was wonderful to see photos of Angie in hers.    She is planning to go to university (there are now two in Palawan) to study to become a Social Worker.   Social Workers are an important part of the Rural Health Units (RHU) in the countryside.

The next trip was a longer one on which we visited Roxas, El Nido, San Vincente and a number of smaller communities in northern Palawan.   At each place the local Health Workers had arranged for patients (always an unknown number) to attend the Rural Health Unit (RHU).   In the communities we were sponsored by the local Mayor so at each stop we first paid a courtesy visit to the Mayor’s Office.   This often involved drinking sweet coffee or a soft drink. 

The majority of the patients we saw had chronic problems some of which had been present for many years but they had heard of the visit by Soc and came along.   I saw a number but Soc saw more and had to explain our findings in Tagalog as I still only know a few words.   We saw a number of babies with Club Feet and usually made arrangements for them to attend Bahatala for Ponsetti casting.   Soc was also able to see patients he had treated in the past as they were keen to show off their new ability, especially in the case of the club feet that of wearing normal shoes.   There were other congenital conditions and here again we made plans to get them to Bahatala if treatment was indicated.  Many men came complaining of back ache that they put down to carrying heavy weights usually because the ground conditions preclude the use of wheelbarrows.    They were shown simple exercises by the Therapists who came with us.  

Occasionally the local health worker would ask us to make a home visit “nearby” which was sometimes an hour away.   We followed as they showed the way riding their motorcycle, the commonest and best form of transport in the remote areas, but our Ford Everest was usually up to it.   One man we visited had a severe equinus deformity following a soft tissue injury and we told him to come to Puerto Princesa where we could do a TA lengthening, I am not sure he was convinced and may or may not turn up in time.   There were many other patients typical of those I have described in previous reports.  On the way back we called on a man with deformities from Osteogenesis Imperfecta who we have tried to help in the past but he has done well on his own and now runs a Sari Sari store (small general shop) however his life could be improved with a proper wheelchair rather than the rather crude and heavy one he made himself.   We also visited a very remote Ostrich farm.   They are doing well selling eggs, some for food others blown for the tourist trade and also supplying meat.  

 On the trip the days were long and quite tiring but each time we stayed in comfortable “resorts” sometimes paid for by the sponsoring Mayor.  It was a wonderful chance to see more of the countryside and meet more people who were all welcoming and happy.   It also made me realise how the effects of the BPT have reached many remote parts of the province.

 We had a day trip to Napsan where there is a resort owned by a Filipina who used to work in Switzerland but has now retired to upgrade and run her resort.    It is on a wonderful long beach with white sand and coconut palms.   Unfortunately the Dap Dap trees did not have their bright red flowers.   Mimi the owner has planted even more flowering plants some of which I recognised but others were really exotic.  The sea is very warm although the locals were worried if we went too far out due to the currents.   We drove back to Puerto Princesa in the dusk so we saw and heard a great many birds which are difficult to see and quiet in the mid-day sun.   The noise of the rainforest is incredible and we drove with the windows down to listen and arrived back in the dark.

 The next trip was to the south, further south than I had been before.   We left early and had lunch with Maylene.    She is the local heath worker who a very hard working and a great advocate for the persons with disability (PWDs) as she herself has a high above knee amputation.    I had brought with me some new ferrules for her crutches which she wears out very quickly.   In turn she presented me with some delicious peanuts that she had fried in garlic and oil.    She is a truly remarkable woman who not only looks after the sick and disabled but brings up her adopted son, grows much of her own food and finds time to keep chickens and pigs.     She is currently living in a rented house but took us to the plot of land she has bought and on which she plans to build a house.   She accompanied us on the rest of the trip.   From her home in Narra we went to Quezon visiting some patients on the way.   

 In Quezon it was the usual set up in the RHU.  Unfortunately the health worker there has not really cottoned on to the system yet so initially there were not many patients.   We did see some who needed prosthetic legs and Romy, our prosthetist, had come with us and he took casts of their stumps.  We also visited some patients in their homes.  This is always fascinating to me as one gets to see into the houses.   I find it incredible to see the primitive open fire for cooking and a modern TV set almost side by side.   The walls have religious images and crucifixes, and always posters of scantily clad girls supplied by Tanduay the local rum makers!

Near Quezon are some famous caves.   First we visited the local museum which gave us the history and had many artefacts including remarkable burial urns.   The caves were in constant use from 50,000 to 700 years ago.   The local Palawans laid out their dead until the bones were clean then put them in large pots and into the caves.   To get to the caves involves a trip of about an hour in a “pump boat”, a wooden vessel with outriggers and a noisy diesel engine.     The caves are now a national park and one of the rangers showed us round.   There are six or seven caves in the limestone cliffs reached by somewhat uneven concrete steps.  It was hot (well over 30°) and very humid so quite hard work as in many places the steps were very steep.   The guide took us to his favourite cave which involved walking on a trail through the rain forest jungle, fascinating and beautiful.   Quezon itself is not really on the tourist route yet so the facilities are simpler than in other places further north.

 In addition to the work and visits to outlying parts it was wonderful to meet many old friends especially Susan and Oscar Evangelista who are a great support to Soc and Cecile both being on the Board of Bahatala Inc.    We had a board meeting whilst I was there when we had frank discussions about the ongoing problems with the medical superintendant of the hospital, Dr G Juan, who is keen to get Bahatala out of the hospital grounds.   I was unable to meet him this time as he was away from work having apparently caught a dose of Dengi Fever.  He has tried to make a legal case against Bahatala but fortunately the Judge who was adjudicating basically said do not be so silly and sort yourselves out.   This will certainly give us enough time to build the new Bahatala.   It is however important that Soc continues to have access to the hospital especially the path lab, the x-ray facility and the operating room as well as the BPT Orthopaedic Ward.

 Once again my stay in Palawan was rewarding and enjoyable.  My thanks go to Soc and Cecile, the staff of Bahatala and my, now many, local friends.   I can safely encourage other Trustees to visit and see for themselves the wonderful work being done and enjoy the equally wonderful countryside.

Louis Deliss

Visit to Palawan by Dr Phyllis Turvill.

 

 Having been a long-term supporter of BTP, last year I decided to go to look at the work for myself. I was given much support and advice by Louis (the chairman) and Soc and Cecile.

 Cecile organised logistics: I was a little worried over safety of stopover in Manila, but Cecile organised all, so there was no hitch. I was met in Manila by driver who took me to hotel (the Tropicana) where I spent the night, was taken to airport for flight to Puerto Princesa where I was met by Cecile and taken to an excellent hotel the Hibiscus (see photo of my own "back garden" above), clean and comfortable with good breakfast (English/American or Filipino - I fell for the dilis -dried anchovies - and had those with rice most mornings), pretty garden with flowers and birds.

 Next day I was taken to the hospital where Soc operates, has clinic and where the workshop is sited) and I met the team (physiotherapists, secretaries, workshop technicians and some of the patients.

 One was Michael (see newsletter of April 2011) a boy with open fracture tibia/fibula after an older friend on motorbike accidentally drove into him; he was being cared for in the hospital by the friend's mother as his own mother had had a stroke and died some days earlier; although he was in traction(most fractures being dealt with without operation) and daily lavage with water sterilised by sunlight - which is used instead of saline which is of course expensive - he needed reconstructive surgery; another a woman with a sarcoma of leg who had returned, after a year of consideration, for amputation.

 In subsequent days I had the privilege of going with Cecile, Angel a physiotherapist, Mayleen (a volunteer on whom a bus had fallen some years earlier and who gets around well on crutches) to outlying villages to take replacement/renovated wheelchairs, sacks of sand (to build ramp to enable access) etc.   I met some memorable people:     

  Christopher, aged 21, another victim of motorbike accident, paraplegic after transection of spinal cord, developed bedsores in hospital and a private doctor wanted £1000 for an operation which would have been useless.  His father has to carry him up and down the hill on which his house is (a rail was provided  by Bahatala in the house for physio);  he had been looking very gloomy but smiled brilliantly when given his wheelchair. Wheels at last! Wheels are very important for machismo in the Philippines, but the roads are terrible.

Jesus, whose spinal cord was transected after he fell out of a tree but who provides for his family by making palm leaf roofs, was brought sand for a ramp for his house.

 Dexter, paraplegic from another RTA, was very depressed after his accident but when provided with wheelchair by Bahatala, started to work with it adapted with a cart with which he can earn money by shopping for his village at a local market, met his wife though the internet (Filipinos are very IT savvy) and when I met him had independence, a broad smile, a small son and beautiful wife who was pregnant with his next child.

Angela, a polio victim lives in a house provided by Bahatala and who makes and sells beautiful cane handbags is now able to attend high school (she learned English from copying an English dictionary proved by her mother, herself a teacher).

 Alfredo, who fell off a roof, runs a market garden outside his own house from his wheelchair.   Fernando is a polio victim who helps in the workshop and lives and works in a tiny shop where he mends all sorts of electrical goods (see photo) and whose mother may come to help with cooking and washing.

 All these people welcomed Cecile and the team with delight; on our return the van had offloaded its chairs and sand but was full of gifts for the team, plants for the garden outside the Training Centre, many coconuts and live chickens which would be used for the Christmas party.

 I also was able to attend a training session given by Cecile (who has degree in rehabilitation) to the local health workers, almost all female, encouraging them to call her directly for help when necessary. There is no NHS as we know it in the Philippines; almost all medicine is private, though the local health workers, mainly midwives carry out immunisations.

 I heard of a case where a man with a minor hip fracture, whose leg was opened and stitched from hip to knee without any internal operation who was charged for fixation. Bahatala provides its services free, only asking for contributions from those who can afford it. The mayor of the village with a health centre brought a contributory cheque to Dexter's house.

 Also I was lucky enough to be invited for dinner by Susan and Oscar, who are members of the committee, who gave me more background on the Philippines many of whose population are Catholic, so birth control is an issue.

 Of course we discussed how to make sure the work of Bahatala continues after the death of its founders, and to improve its cash flow locally (ideas discussed were selling the items produced in workshop, see below (maybe these beds for stroke victims could be sold to hotels as sun loungers?) letting out space in the new Centre to NGOs, accommodation for disabled students at nearby University, etc.

It was not all work; I was taken to watch birds in the local huge open prison (Iwahig penal colony), where one of the warders is an expert, self-taught ornithologist and was finally (on second visit) able to show me the Palawan hornbill, an endemic with white horn and tail.

 Although a prison, some areas are open to visitors on some days and families may come to swim and picnic. Soc had worked in the prison in the past so of course has special visiting privileges. He is also a geologist so was able to collect stones on this visit.

 There is also a shop where prisoners sell their handmade wares (I bought magazine/newspaper holders, hats etc). By the way the shopping (particularly beautiful hand carved goods made by hill tribes) was good. Also transport by tak-tak (local cab like trishaw but with motorbike) around Puerto Princesa is very cheap; after a few days I felt safe enough to venture on my own. 

I was also given a days snorkelling with the orthopaedic team; the fish were wonderful). The fresh fish in the restaurants was also delicious. Other birds I saw were eye-browed thrush (on lawn outside the Training Centre), common iora, common fantail, kingfisher (common and collared), sunbird, herons of various sorts, yellow-breasted leafbird etc etc.  

 Rain prevented a trip to Sabang with its Underground River, but that means that I need to return.....maybe this year, if not next when the new centre will definitely be up and running.

 It was a pleasure and a privilege to visit this beautiful and exotic country with its charming, independent and welcoming people.

Phyllis Turvill,

5 November 2011 

Chairman’s note

We are extremely grateful to Dr Turvill.   She has been a loyal supporter for many years and her recent generous donations have allowed us to buy the land and has kick-started the construction of the new buildings.

Dr Turvill is planning to visit again in 2012.

 

BRITISH PALAWAN TRUST

Summary of Accounts 2010-2011

 

 

 

£

Total income

124,660

Charitable expenses

147,048

Total other expenses

1,918

 

 

Deficit for the year

24,306

 

 

Total reserves

120,923

 Our accountants, Beatons, have produced a separate full financial statement.

                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.

2.       To provide for future capital expenses.

3.       To allow for any local natural disasters.

4.       To allow for unexpected incidental expenses.

5.       To compensate for fluctuations in the money exchange rates.

 

Bank.                                                  HSBC

                                                            41, Woodbridge Road East

                                                            Ipswich

Suffolk,  IP4 5QN.

 

Auditors and accountants.               Beatons

                                                            Chartered Accountants

                                                            York House

                                                            2-4 York Road

                                                            Felixstowe

                                                            Suffolk, IP11 7QG

~~~~~~~~~~~~~~~~~~~~~

This Annual Report and the Report and Financial Statement (Beatons) were accepted at The Annual General Meeting of the Trust Board held on 5th December 2011.

Louis Deliss M.B., Ch.B., F.R.C.S.

Chairman of the Trustees.


ANNUAL REPORT 2010

BRITISH PALAWAN TRUST

 

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.”

 

Registered Office:

The Orthopaedic Department

The Ipswich Hospital,

Heath Road,

Ipswich, Suffolk, IP4 5P

 

Registered Charity number ~ 328651

 

Web site: www.britishpalawantrust.org.uk

 

BOARD OF TRUSTEES 2010

 

Mr. Louis Deliss FRCS.            Chairman.

Mr. Andrew Gibbs, BSc, FRCS.

Mr. Andrew Gunn, MA, FRCS.

Mr. Jeffrey Hallett, FRCS.

Mr. Ivan Hudson, FRCS.

Mr. John Powell, FRCS.

Mr. David Sharp, MD, FRCS.

Miss Clare Marx FRCS.

Mr. Mike Shanahan, FRCS.

Mr R Baxandall, FRCS (Orth).

Mr M Bowditch FRCS (Orth).

Mr J Hopkinson-Woolley FRCS (Orth).


Public Benefit Statement

The principle charitable purpose of the Trust is “the advancement of health” by providing medical care for the people of Palawan (population about 700,000) in particular the indigent people.   The medical care is specifically for those with orthopaedic conditions, congenital deformities and those affected by musculoskeletal trauma. We also provide for “the relief of those in need by reason of disability” a Community Based Rehabilitation Service.   In addition we work for “the advancement of education” through a Training Centre where we teach our methods to other health care workers and doctors.                   

 These fulfil the Charity Commission purposes b), d) & j).

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

 

THE BRITISH PALAWAN TRUST

CHAIRMAN’S REPORT 2009-2010

 

Work Activities Report

 

            The work in Palawan carries on relentlessly.  The indigent population of Palawan continue to need and rely on our services.   We are however getting an increased amount of funding locally from such resources as the Philippine National Lottery.   This lottery provides funds for health care but patients have to apply for it.  It does however provide another and welcome source of “sustainability” with local funding supporting our work.

 

            The work in Palawan can now be seen in a number of different fields which in many ways are separate but interdependent.   They all complement each other but some could manage as “stand alone” organisations if the need were to arise.   These activities can be summarised as,

1.      Rehabilitation.

a.       Physiotherapy in Bahatala.

b.      Community Based Rehabilitation through our local workers.

c.       Manufacture of Orthotics and Prostheses.

d.      Manufacture and maintenance of wheelchairs

e.       Manufacture of Aids to Daily Living for the disabled and injured.

 

2.      Trauma & Orthopaedics.

a.       Treatment of fractures and soft tissue injuries.

b.      Treatment for congenital deformities such as club foot.

c.       Care of degenerative conditions.

 

3.      Training.  We continue to use the separate purpose built Training Centre.  Here Soc and the Bahatala staff train doctors, nurses and village health workers in the principals of Appropriate Orthopaedics. (See Soc’s book for details.  This can be obtained from the Chairman)

 

This list also illustrates the enormous amount of work that Soc and Cecile undertake or supervise.   It does not however quantify the huge number of patients who benefit both directly and indirectly from the work of the British Palawan Trust.  I can testify the numbers and the variety of patients treated as could any visitor.

 

The list also shows how much goes on in the Bahatala building.  This building was appropriated by Soc about 12 years ago for use by BPT.  The house was originally designed as a residence for the Medical Administrator of the hospital to live in but it had not been used for many years.   It is now showing its age and the termites have added to the decay.  It is getting too small to house all the activities of the British Palawan Trust and of Bahatala Inc.   In addition the hospital has plans to build a new wing on the site housing modern operating theatres.  We have therefore been looking at ways of moving to an independent site which would free us from the ever changing government plans and the inevitable political involvement.   We think that we have identified a site in an ideal position, near the BPT Training Centre and near the bus routes for patients.  It is not far from the Provincial Hospital and most importantly is being sold at a reasonable price. (The price of building land in Puerto Princesa has shot up to ridiculous figures.)      This exciting development will mean much more work for Soc and Cecile and I am looking to all our UK supporters for backing and of course money.

 

Financial Report

The finances which are summarised at the end of this Report and covered more fully in the Report by Beatons, are in a fairly healthy state.  There was slight drop in donations during the year which was disappointing but the large payment from HMRC of  Gift Aid covering more than one year made up for the shortfall.   We were hoping that the new mailing list would increase the donations but it seems that the “credit crunch” may have had an effect.   It all means that the fundraising effort must be increased especially in view of the proposed acquisition of a site and the building a new Bahatala.

The reserves look large but we are in the process of purchasing some land on which we propose to build replacements for the current old Bahatala clinic, office and workshops.

 

Trustee Activity Report

The AGM held in early 2009 discussed the importance of having at least one other Trustee involved with the detail of the administration of the Trust.   Unfortunately none of the existing Trustees were willing or did not have the time for such involvement.    This remains the case.

 

THE BRITISH PALAWAN TRUST

REPORT OF CHAIRMAN’S VISIT 2010

 

            I have just returned (written in June 2010) from another wonderful trip to see the work of the British Palawan Trust and to see more of the province of Palawan.  I flew via Dubai and was met in Manila by Soc.  The next morning we visited a very active convent, La Consolacion, where the nuns run schools for all ages.  We were asked to see a number of the nuns with various aches and pains mainly related to their great age.  Then we flew to Puerto Princesa.

            The whole of the Philippines is suffering from a severe drought that is also affecting most of East Asia, and is caused by El Niño.  This meant that it was fairly hot, usually over 35° C in the shade at midday but still very humid.   The fields especially the paddies were parched and mainly unproductive.   In addition the inshore fishermen were not catching the usual numbers as the fish had gone to deeper, colder water.   One island that we visited had caught no fish for two months which meant no income at all and little food.   They were understandably rather fed up!

            I stayed as usual in the simple but very pleasant little hotel, Casa Linda.   It has all one wants and is well situated being a short walk from Soc’s house and from the hospital, although I always took a tricycle taxi.   The price of a room has not gone up much although the weak UK pound has caused a slight rise over the last two years.   The staff, who remain the same happy bunch, now recognize me which adds to the pleasure of my stay.

            The week-days are all similar.   I start by arriving at Bahatala at about nine.  Soc is usually there as is the staff.  This includes the Therapists, the Prosthetist, the office girls and the odd job man who makes things and repairs them, things such as seating for children with Cerebral Palsy and also wheelchairs.  There are always a number of new and follow up patients being seen or treated.   We also visit the BPT ward.  This is now in general use, as there are currently two other doctors who treat trauma patients.  Soc usually has three or more of his own patients.  Unfortunately because we no longer have control of the ward it has deteriorated with dirt and loss of the pictures on the walls.

During my stay the ward patients included two fractured tibiae and four fractured femora.  One tibia was mid shaft the other upper involving the tibial plateau.  The shaft fracture was treated by skin traction and then put into a cast.  The upper tibial injury was taken home to be on traction there for about four weeks.  The femora were at all levels; supra-condylar with extension into the knee, one mid-shaft, one sub-trochanteric and one per-trochanteric.  These were all treated with traction through a Denham pin, the first in 90/90, the second by classical Perkins traction followed by a thigh brace, the upper one in abduction and flexion and the NOF by traction and transfer to her home before early mobilisation.

The out-patients varied from simple closed fractures of the arm to more difficult cases.  The arm fractures were most often in children.  Distal radius, fore-arm bones and supra-condylar fractures made up the majority.  There was a case of tibial osteomyelitis in a teenage boy requiring sequestrectomy.    I was asked to see two cases of pseudo-winging of the scapular producing muscular pain and both caused by mild mid-thoracic scoliosis in young women.   There were two cases of fractured clavicle plus a fracture of the glenoid neck.  One had minimal displacement but the other had an upper brachial plexus lesion with a Horner’s syndrome.   All the fractures are treated without any internal fixation. 

We saw one case of carpal tunnel syndrome and one bilateral ulnar palsy from elbow pressure whilst in hospital.    A young man presented with osteoarthritis of the hip secondary to either an impacted subcapital fracture or possibly a slipped epiphysis.  There were the usual number of babies (Soc seems to have dealt with the older untreated club feet) coming for change of plaster using the Ponsetti method, and also patients with the puzzlingly common constriction band syndrome.  There are usually a small number of elderly patients who appear to have “burnt out” or quiescent Rheumatoid but I have never felt any evidence of synovitis.

I am sure that I have left out many patients but I do know that any visitor would see a vast and wide variety of both orthopaedic and other specialty pathology.  It is often a test of one’s retention of basic medical school training!

Two days were spent in Bahay Sanay our purpose built Training Centre.   The programme was to teach doctors from the, often remote, Rural Health Units.  Some are recently qualified and are sent to the more remote parts on a Government scheme.   They were shown how to apply bandages and slings, how to set up upper and lower limb skin traction and how to apply POP back-slabs.   They were very enthusiastic and keen to go back and try out their new skills.   On their return they started sending photos by text taken on their mobile phones for advice about management.

Some of the most interesting days are spent visiting patients in their homes.   We went south principally to measure a number of patients, paraplegics, amputees and cerebral palsy children for wheelchairs.  We now get the wheel chairs from a factory set up in the Philippines by Handicap International.   These chairs are of a very high standard and are able to cope with the local conditions.  The rough ground and the humidity wears out less well made chairs very quickly.

            We made three visits to the north of Puerto Princesa to follow up patients.   These included a young woman confined to a wheelchair because of Polio with major social problems.  Another was an 89 year old spinster who farmed in a very remote part of the country.  Four months earlier she had fallen (pushed by a bad spirit she said) and fractured the mid-shaft of her femur.    She came to hospital which must have been a difficult and painful journey in a bus where she was treated with traction followed by a thigh brace.   She was delightful and because I was the first white man to visit her we had to go upstairs for a cup of coffee.

            The trips to the outlying barangays (villages) are not always pure work.  Once we stayed on a small island on a reef, CocoLoco.   This resort is quiet and remote with the most marvellous coral and fishes just a meter or two down.  Another time we stayed in a new very comfortable resort (the local name for hotels with the rooms in individual huts or buildings) on a beach near the St Paul’s Park, a World Heritage site.    The sea water is always as warm as a bath and crystal clear, the beaches white coral sand and almost empty.

I spent a great deal of time in discussion with Soc and Cecile.   The Bahatala building in the hospital grounds is beginning to show its age and we have been talking about plans to replace it for some years.      The generous offer of a significant gift from one of our loyal donors just before I left UK was the stimulus we needed.   We put the word out that we might be interested in purchasing land and in this were helped by the other NGOs working in Palawan.   A plot of land was identified and we visited it.    The land is near the main highway, useful for patient access and near the BPT Training Centre and importantly was at a price we felt reasonable.  Negotiations were started and a small deposit paid.   There are some legal matters to be tidied up before we can take possession which should be towards the end of 2010.    The next task would of course be designing and building the new clinic, therapy area, office space, workshops and staff facilities.  I hope that Soc and Cecile will be able to undertake this enormous workload in addition to the regular help for indigent patients.   It is however very exciting and we will put more details in forthcoming News Letters and on the web site as things develop.   There are some more details in the Trust Report above.

 

I would like to thank all the people who made my visit so enjoyable - the Staff of Bahatala and the many friends in Palawan especially Oscar and Susan, and special thanks as always to Soc & Cecile.

Louis Deliss

 

BRITISH PALAWAN TRUST

Summary of Accounts 2009-2010

 

 

 

£

Total income

67,540

 

Charitable expenses

49,623

Total other expenses

1,960

 

 

Surplus for the year

15,957

 

 

Total reserves

145,229

 

 

 

 

 

Our accountants, Beatons, have produced a separate full financial statement.

 

                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.

2.       To provide for future capital expenses.

3.       To allow for any local natural disasters.

4.       To allow for unexpected incidental expenses.

5.       To compensate for fluctuations in the money exchange rates.

 

Bank.                                                  HSBC

                                                            41, Woodbridge Road East

                                                            Ipswich

Suffolk,  IP4 5QN.

 

Auditors and accountants.               Beatons

                                                            Chartered Accountants

                                                            York House

                                                            2-4 York Road

                                                            Felixstowe

                                                            Suffolk, IP11 7QG

~~~~~~~~~~~~~~~~~~~~~

This Annual Report and the Report and Financial Statement (Beatons) were accepted at The Annual General Meeting of the Trust Board held on 25th November 2010.

Louis Deliss M.B., Ch.B., F.R.C.S.

Chairman of the Trustees.


 

 

 

BRITISH PALAWAN TRUST

ANNUAL REPORT 2009

 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.”

 

Registered Office:

    The Orthopaedic Department,

  The Ipswich Hospital,

Heath Road,

Ipswich, Suffolk, IP4 5P

 

Registered Charity number ~ 328651

 

Web site: www.britishpalawantrust.org.uk

 

BOARD OF TRUSTEES 2009

 

Mr. Louis Deliss FRCS. Chairman.

Mr. Andrew Gibbs, BSc, FRCS.

Mr. Andrew Gunn, MA, FRCS.

Mr. Jeffrey Hallett, FRCS.

Mr. Ivan Hudson, FRCS.

Mr. John Powell, FRCS.

Mr. David Sharp, MD, FRCS.

Miss Clare Marx FRCS.

Mr. Mike Shanahan, FRCS.

Mr R Baxandall, FRCS (Orth).

Mr M Bowditch FRCS (Orth).

Mr J Hopkinson-Woolley FRCS (Orth).

 

Public Benefit Statement

 The principle charitable purpose of the Trust is “the advancement of health” by providing medical care for the people of Palawan (population about 700,000) in particular the indigent people.   The medical care is specifically for those with orthopaedic conditions, congenital deformities and those affected by musculoskeletal trauma. We also provide for “the relief of those in need by reason of disability” with a Community Based Rehabilitation Service.   In addition we work for “the advancement of education” through a Training Centre where we teach our methods to other health care workers and doctors.            

 These fulfil the Charity Commission purposes b), d) & j).

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

THE BRITISH PALAWAN TRUST

CHAIRMAN’S REPORT 2009

 

Work Activities Report

The year to the end of March 2009 has been one of continued hard work in the fields of Orthopaedics, Rehabilitation and Training.

We continue to work through our registered non-governmental organisation (NGO) in the Philippines, Bahatala Inc.    Some find a confusion between Bahatala Inc the legal umbrella and Bahatala the building within the Provincial Hospital grounds where much of our activity takes place. The main bulk of the Orthopaedic work takes place in the Bahatala building where Soc has his daily clinic and the therapists see their patients.  The vast majority of patients are treated as out patients.  When necessary Soc will admit patients and can of course use the operating theatre in the Provincial Hospital.  Soc and Cecile continue to do out-reach clinics.  These are usually at the week-end and involve a trip in the 4x4 people carrier, essential to negotiate the Palaweno roads.   They often take some of the Bahatala staff with them.  The visits are arranged through the Community Rehabilitation Officers (CRO) in each administrative area who are organised by Cecile. 

Bahatala has upstairs the office where Marly, the secretary, and Dang, the bookkeeper work under Cecile’s watchful eye, and now has downstairs the new clinic area for Soc.   The workshops have been moved into the separate building which was initially funded by the New Zealand ambassador.  Romy, the orthotist & prosthetist with the carpenters and handymen, Mang Andres and Reymon  making and mending braces, artificial limbs, wheelchairs, ADL equipment as well as maintaining the equipment in Bahatala.  

The Community Based Rehabilitation service set up so successfully by Cecile has continued to be the backbone to the function of the whole unit.  It remains based at Bahatala but with Rehabilitation Officers who are now based in many of the provinces of Palawan.  These vary from paid full-time to unpaid part-time.  They all however report on the progress of patients, supervised post-treatment rehabilitation therapy and find new patients from their community. 

 

Financial Report

The finance which are summarised at the end of this Report and covered more fully in the Report by Beatons, are in a fairly healthy state.  The work to increase the numbers on the list of regular donors and the work by Cecile in preparing regular News Letters has produced a very satisfactory increase in donated income although this was partially offset by the increase in hospital expenses.

We still have the probability that we will have to find a new building for all the activities of Bahatala.    The plans that seemed to be developing last year have gone rather quiet.   This was an area earmarked for discussion during the aborted Chairman’s visit.

 

Trustee Activity Report

The AGM held in early 2009 discussed the importance of having at least one other Trustee involved with the detail of the administration of the Trust.   Unfortunately none of the existing Trustees were willing or did not have the time for such involvement.    The Chairman should have looked into finding new Trustees who would be more willing to become involved but unfortunately his house move has prevented any such activity.

 

    REPORT OF CHAIRMAN’S VISIT 2009

 

My annual visit was planned for February 2009.   We managed to sell our house and buy a new one and it all came to a head despite the “credit crunch” at the end of January so my trip had to be cancelled.

I am, however, in regular contact with Soc and Cecile thanks to modern technology and communicate with them using e-mail, SMS and VOIP as well as the old fashioned telephone.

  

 

BRITISH PALAWAN TRUST

Summary of Accounts 2008-2009

 

 

£

Total income

£55,231

Charitable expenses

£51,990

Continuing Professional Development

£0

Total other expenses

£1045

 

 

Surplus for the year

£2196

 

 

Total reserves

£129,272

 

Our accountants, Beatons, have produced a separate full financial statement.

 

                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.

2.       To provide for future capital expenses.

3.       To allow for any local natural disasters.

4.       To allow for unexpected incidental expenses.

5.       To compensate for fluctuations in the money exchange rates.

 

Bank.                                                  HSBC

                                                            41, Woodbridge Road East

                                                            Ipswich

Suffolk, IP4 5QN.

 

Auditors and accountants.               Beatons

                                                            Chartered Accountants

                                                            York House

                                                            2-4 York Road

                                                            Felixstowe

                                                            Suffolk, IP11 7QG

~~~~~~~~~~~~~~~~~~~~~

This Annual Report and the Report and Financial Statement (Beatons) were accepted at The Annual General Meeting of the Trust Board held on 7th January 2010.

Louis Deliss M.B. Ch.B. F.R.C.S.

Chairman of the Trustees.

 

 

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