THE LEPROSY MISSION2011-2012

Annual Review

leprosymission. org.ukcharity no: 1050327

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East Mediterranean

4,080up 51

South East Asia

156,254 down9,861

Africa 25,345down3,590

Americas37,740down2,734

W. Pacific5,055down188

2010 statistics

Increases in countries reporting more than 1,000 new cases during 2010

What is leprosy?

Leprosy is a disease of our time - a disease of poverty caused by a bacillus called Mycobacterium Leprae (a distant relative of the TB bacillus). Most people are naturally immune but the majority of people a!ected by leprosy live in developing countries where resources are scarce and poverty is widespread, which leads to reduced life expectancy.

A devastating conditionLeprosy can also damage nerves in the face. The eyes will not blink automatically because leprosy damages the eye nerves so that the eyelid muscles stop working. The eyes then become easily damaged as they are not protected by the blinking mechanism which eventually leads to blindness. Leprosy can also damage the bones of the nose. In time this causes the nose to collapse and flatten.

TreatmentMedical and lifestyle interventions are essential to prevent disability and blindness. Leprosy is curable with multidrug therapy but millions of people have visible impairments and many people a!ected by leprosy have irreversible disabilities. In 2010 there were 13,000 new cases of leprosy diagnosed where irreversible disabilities were detected.

What happensLeprosy starts by damaging the small nerves in the skin’s surface. The first outward sign is usually patches with no feeling. If treated at this early stage there is unlikely to be further damage or disability. If left untreated, leprosy goes on to damage the large nerves in the elbow, wrist, knee and ankle. The resulting damage can lead to loss of sensation in the hands and feet and muscle paralysis, which causes clawed fingers and drop foot. Loss of sensation in the hands and feet means that everyday activities are fraught with danger – burns go unrecognised and stones in shoes unnoticed so ulcers develop, which are di"cult to heal and may result in shortened digits.

New casesIn 2010 there were 228,474 new cases of leprosy diagnosed – around one every two minutes. 59 per cent of these were found in India.

Ethiopia

4,430 (2009: 4,417)

Mozambique

1,207 (2009: 1,191)

Philippines

2,041 (2009: 1,795)

Sri Lanka

2,027 (2009: 1,875)

Sudan

2,394 (2009: 2,100)

The above statistics are based on records for 2010 released by the World Health Organisation on 2 September 2011.

Having joined The Leprosy

Mission England & Wales

early in 2011, this was my

first year as National

Director and I have been

greatly encouraged by the

successes and changes

I have witnessed in that time. As part of its

commitment to influencing long-term change, The

Leprosy Mission has spent the year forging new

partnerships and working on new initiatives that

promote an holistic way of targeting the sometimes

horrendous consequences of leprosy.

Whether that means working with mainstream

disabled people’s organisations to break down the

stigma surrounding leprosy-a!ected people,

empowering communities to speak out against

discriminatory laws or working with governments

on new solutions, I am confident that progress has

been made and that lives have been changed.

2011 was not without challenges and like many

other organisations The Leprosy Mission has been

impacted by the di"cult economic climate at home

and abroad. But at the same time we began to

reach out to a new generation of potential

supporters through promoting advocacy amongst

university students and exploring how to e!ectively

reach young people with the message of

The Leprosy Mission. The vital role advocacy plays

in changing the lives of people a!ected by leprosy

means it has become an area of growth for the

organisation. As well as our continuing concern for

early detection and care for individuals with

leprosy-associated needs such as reconstructive

surgery and ulcer care, we recognise the invaluable

role that advocacy plays in changing the lives of

people a!ected by leprosy.

Looking to the year ahead, I am excited by what it

may have in store for us. Late in 2011 it was decided

that our work would focus on 12 key partner

countries. This will enable us to have strong

relationships with those partners and makes it

easier to monitor progress and overall impact. As

we continue to work in these countries in 2012, I

look forward to the positive change this will have

for both individuals and communities.

WelcomeCONTENTS3 Welcome

Introduction from The Leprosy Mission's new National Director Peter Walker

4 Change Where we work and how The Leprosy Mission is evolving

6 Connections The media, providing education and working with governments

8 Communities Tackling stigma and increasing social integration

10 Where we work The 12 countries in which The Leprosy Mission England & Wales works

12 Champion Advocacy and challenging discrimination

14 Contribute The supporters making The Leprosy Mission's work possible

16 Challenges Obstacles and looking ahead

18 2011 Finances Income, expenditure, financial statement and balance sheet

Peter Walker visits Anandaban Hospital, Nepal.

Peter WalkerNational Director

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'Please donate £35 to restore someone's eyesight through our Gifts for Life scheme at www.leprosymission.org.uk/donate/gfl

This year, we have worked to become more e!ective influencers of holistic change rather than simply delivering services. Through advocating for the inclusion of people a!ected by leprosy and disability in government programmes and mainstream development, we can have a greater impact on their lives, reach more people and help them to be empowered to change their own communities.

Saving sightThe Leprosy Mission is committed to using its expertise to help general patients experiencing poverty as well as those a!ected by leprosy. Our hospitals frequently hold eye camps, where large numbers of people from rural communities come to receive surgery for conditions like cataracts and glaucoma. In rural areas where there are few public services and farming and manual labour are the main livelihoods, loss of vision is particularly devastating. Without The Leprosy Mission’s work, marginalised people would have no access to the treatment they need and many would be left, at best, with limited sight or could lose their sight forever.

A disability-focused approachMainstreaming leprosy as a disability issue helps to break down stigma. In the past some countries have not allowed people with leprosy-related disabilities to become members

of disabled people’s organisations. With a broader disability-focused approach, The Leprosy Mission in Myanmar is breaking down exclusion while providing a far more accessible and available service for people a!ected by leprosy.

One new focus of our work in Myanmar is training other Non-Government Organisations (NGOs) on the issue of disability. This is helping to raise awareness of leprosy and promotes social inclusion.

Change

HIGHLIGHTS 1,449 people with

disabilities and a!ected by leprosy were served by Disability Resource Centres in Myanmar

4,543 patients a!ected by leprosy and 8,031 general patients were admitted to The Leprosy Mission supported hospitals in India for treatment

2,875 patients in India received eye surgery

The Leprosy Mission works in 26 leprosy-endemic countries globally. In 2011 it was decided that The Leprosy Mission England & Wales would focus its e!orts on 12 countries chosen because of our existing partnerships there, high levels of poverty and the number of new cases of leprosy being diagnosed every year. This tighter focus enables clearer monitoring of projects, and a better overall impact.

leprosymission.org.uk 7

Through school sponsorship

programmes The Leprosy

Mission is enabling 779 children to go

to school

Learn how your donation of £40 will fund a month’s worth of vocational training helping someone to find a job. Visit www.leprosymission.org.uk/donate/gfl

Choice, dignity and integrationOur Choice, Dignity and Integration project covering 378 villages is part-funded by the European Commission and works with 5,780 of the most marginalised people in Indian society. The Leprosy Mission is working with several women’s rights groups to help those who wish to come out of the devadasi (temple prostitution)

system and change their lives. In the process, it also addresses

the needs of people a!ected by leprosy in these communities.

The Leprosy Mission is supporting members of the project’s 428 self-help groups into independence through literacy training and connecting them to banks to support income generation. Part of the project also involves working to foster acceptance and tolerance, which one day will lead to full community integration.

Equipping the next generationThrough school sponsorship programmes, The Leprosy Mission is enabling children to go to school, paying for essentials such as uniforms, books and stationery. In countries where poverty forces families to stop sending their children to school, this has a long-term impact. The Leprosy Mission also supports vocational training centres which are connected to local businesses for work placements. As a result of finishing their education, the young people are better placed to find work, earn money and achieve their dreams. In addition, education was improved for 234 children in a leprosy colony in Nigeria when The Leprosy Mission built new classrooms.

2011 also saw The Leprosy Mission partner with the media in new ways,

raising awareness about leprosy through Twitter, Facebook and the

leprosyvoice blog. In March 2011 the award-

winning Channel 4 current a!airs series ‘Unreported World’

focused on leprosy, featuring Naini hospital in India. This was an excellent opportunity for the public to learn more about leprosy and why our work matters.

Connections

HIGHLIGHTS 708 students

received vocational training at five centres in India

234 children from a leprosy colony in Nigeria are now accommodated in new classrooms

521 children in India received school sponsorship through The Leprosy Mission

2,854 self help group members in the Choice Dignity and Integration project received training in rights and entitlements, book keeping and literacy

As part of its commitment to ensure its work is driven by the needs of people a!ected by leprosy, The Leprosy Mission has increased its support for the Association for Leprosy A!ected People in Mozambique (ALEMO). Moving from being ‘implementers’ to becoming ‘influencers’, we are also working to support governments to develop their leprosy control programmes and partnering with like-minded organisations such as the Salvation Army in Bangladesh.

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Why not give a community gift that lasts a lifetime? £800 will buy a new house. Visit www.leprosymission.org.uk/donate/gfl

HIGHLIGHTS 466 people a!ected

by leprosy or disability in the Gaibanda district of Bangladesh started their own businesses

248 people accessed savings and credit in Nigeria

715 people received self-care training in Mozambique

Leprosy-a!ected communities also tend to struggle with extreme poverty and related problems such as poor housing and sanitation, as well as other health issues such as HIV/AIDS. Many of our projects work to address these issues, ensuring an impact that really changes lives.

Transformation through self-careRanking a very low 184 out of 187 on the United Nations’ International Human Development Index, Mozambique is a challenging place to live, particularly for more vulnerable members of society such as women, disabled or older people.

Members of self-care groups are in no doubt about the value of learning how to take care of wounds and prevent further injury. The friendship, support and chance to work

together to improve lives makes these groups invaluable. They are also actively educating their community on leprosy, to promote early diagnosis and treatment.

New livelihoodsIn Bangladesh, the Food Security for the Ultra Poor project is helping people to earn a living and feed their families. Through funding to start their own businesses, 466 people now have a regular source of income. The Leprosy Mission’s intervention in a leprosy colony in Nigeria has meant a savings co-operative has been established. Members can now save money and take out loans to start income generation activities.

CommunitiesSocial integration is a key issue for The Leprosy Mission. One of the main challenges faced by people a!ected by leprosy is stigma. Often manifested in rejection by family or the local community, it has a huge impact on people’s lives. This is why we take a community-based approach to tackling stigma - promoting friendship, support and integration through self-care and self-help groups.

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Where we work

Our 12 countries of focus

7MOZAMBIQUEAhiena was diagnosed with leprosy five years ago. After

undergoing treatment she is now a member of a group that teaches self-care and owns a plot of land for farming vegetables.

8 INDIAThese women have been supported in setting up a milk

collection enterprise where they sell milk produced by their bu!aloes to a local dairy. They have been delighted with the increase in income.

9NEPALSeikh has had successful reconstructive surgery on his

hand. It was clawed and paralysed but now he can use it again and return to school.

.

10 BANGLADESHParvin attended a tailoring course and was provided

with a sewing machine. The clothes she now makes are in high demand and Parvin earns enough to provide for her family.

11MYANMARMytin is taking medication to cure his leprosy and is also

having physiotherapy. In the future he will be supported in finding employment or starting his own business.

12SRI LANKAFamilies a!ected by leprosy, disability and

poverty are benefiting from healthcare, education and training. Awareness-raising helps to reduce discrimination against them.

1NIGERCommunities in Danja are receiving vocational training,

literacy classes and education in farming techniques to improve their livelihoods.

2NIGERIAIshola is part of a savings co-operative and has

purchased a motorcycle which he uses to provide a passenger taxi service. He can now support his family and send his daughter to school.

3NORTH SUDANOur work in Khartoum State sees communities benefiting

from better medical care and increased awareness of disability issues.

4 SOUTH SUDANWe are hoping to develop new projects in South Sudan during

the course of the next 12 months.

5ETHIOPIACommunities are benefiting from improved access to

sanitation and safe drinking water, as well as receiving help in developing sustainable livelihoods.

6DR CONGOChildren in West Kasai province receive support enabling them

to go to school.

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"The Leprosy Mission is the

facilitator but it is people a!ected by leprosy

who have to stand in front and raise

the flag."

Sign up online to the charter and support our cause at www.leprosyoutloud.org.uk. You can also ‘like’ us on Facebook by searching for Leprosy Out Loud!,or follow us on Twitter @H_R_Defender

One piece of legislation in the UK which discriminates against people a!ected by leprosy is included in UK immigration guidelines. The guidelines recommend that people a!ected by leprosy are refused entry to the country. The Leprosy Mission has met with MPs to discuss this and

is also part of the All-Party Group on Malaria and Neglected Tropical Diseases.

Don’t Call Me A LeperOur ‘Don’t Call Me a Leper’ campaign is encouraging people to be careful with their language. The word ‘leper’ is o!ensive to people a!ected by leprosy,

with connotations of being untouchable and dirty. When its use has been noted in the media, we have contacted the parties responsible to explain our position, asking them to refrain from using it in future.

Challenging discriminationThe Challenging Anti-Leprosy Legislation project in India is working to advocate against discriminatory laws and empower leprosy-a!ected people to speak out against them. In India, leprosy is grounds for divorce and having leprosy can mean people are denied a driving licence or prevented from travelling on trains.

Mr Inglay, one community leader who is working with us to mobilise communities to challenge discrimination, says, “If you want your rights you have to speak out. The Leprosy Mission is the facilitator but it is people a!ected by leprosy who have to stand in front and raise the flag.”

Victory in BangladeshOne example of advocacy having a positive impact in 2011 was the repeal of the 1898 Lepers Act in Bangladesh. This law had confined people a!ected by leprosy to state-run institutions. Now, they will be able to integrate better into society and access their rights and entitlements.

ChampionHIGHLIGHTS

The Challenging Anti-Leprosy Legislation project in India has made 1,532 people aware of their rights and entitlements. 565 of these are now accessing benefits such as pensions and ration cards

Increased engagement from UK MPs on leprosy issues through the All Party Parliamentary Group for Malaria and Neglected Tropical Disease

Discriminatory legislation (1898 Lepers Act) repealed in Bangladesh

In 2011 we launched the Leprosy Out Loud! campaign, piloted amongst university students. It highlights the human rights abuses faced by people a!ected by leprosy both in the UK and overseas. Leprosy Out Loud! calls people to engage with these issues and speak out.

leprosymission.org.uk 15

Natalie

challenged herself

to change the world for 1,000

people a!ected by

leprosy

Order your copy of Blisters and Blessings today from TLM Trading Limited priced at £6. Call 0845 166 2253 or visit www.tlmtrading.com for further details.

Trust and foundation partnerships continue to make an important contribution to The Leprosy Mission's work and in 2011 our projects have benefited from the generosity of, among others, the Vitol Charitable Foundation, R Care (Midlands) Limited, and The Military & Hospitaller Order of Saint Lazarus of Jerusalem. We look forward to continuing these partnerships in 2012.

Natalie’s walk of hopeOn 30 June 2011, The Leprosy Mission's Area Co-ordinator for the South West, Natalie Husk and her dog Toby completed an epic two-month sponsored walk covering 630 miles along the length of the South West Coast Path.

Natalie challenged herself to change the world for 1,000 people a!ected by leprosy by raising money for specially adapted shoes and prostheses. She was inspired to do this after meeting people a!ected by leprosy at The Leprosy Mission’s hospitals in India in 2009.

Her target was £10,000 – to date she has raised more than £20,000. She has also raised awareness about leprosy as her story was covered in numerous articles and broadcasts including a mention on Radio 2. Natalie kept a diary of her experiences on the walk, and her writings have been published as a book, Blisters and Blessings.

Contribute

HIGHLIGHTS Over £20,000

generated through the South West Coast Path Walk

£92,479 donation from Guernsey Overseas Aid Commission for three projects, the largest ever donation we have received from them

Tearfund funded emergency relief to leprosy-a!ected communities following the Eastern Shan Earthquake in Myanmar

In 2011 we were grateful for the support of the Department for International Development (DFID) for the Challenging Anti-Leprosy Legislation project in India and like-minded organisations such as Tearfund who funded projects in Myanmar. Likewise our ongoing thanks go to Guernsey and Jersey Overseas Aid Commissions which have supported our leprosy work for 25 years. In 2011, they funded projects in Bangladesh, Nepal, Niger, and Nigeria.

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We invite you to transform a life today – donate by texting JUMA11 and £amount to 70070.

we must

find new ways to

reach out to younger

generations to ensure the future of the The

Leprosy Mission

HIGHLIGHTS Increase in the number

of online donations

E-newsletter coverage to 5,900 people

Government of India has carried out improvements to the drainage systems in a leprosy colony in Chhattisgarh after advocacy e!orts

Another challenge is the fact that despite our faithful and dedicated donor base, we must find new ways to reach out to younger generations to ensure the continuation of our work in transforming lives. Work has already been done in 2011 – for example through the Leprosy Out Loud! Campaign – and new ways of giving online and by text. We are harnessing social media tools and will, in the year ahead, engage further with new audiences to seek donations, prayer support, advocacy partners and new initiatives.

Overseas aidAt present, the issue of providing aid to India is a controversial one and there is concern that India has the resources to tackle many of its issues itself. The Leprosy Mission recognises that withdrawing aid to India would mean the poorest people would su!er. There is more leprosy in India than in any other country in the

world and, combined with other problems such as malnutrition and discrimination, means there is still much work to be done.

Our work in India is increasingly focusing on advocacy and empowerment. This includes supporting people in accessing entitlements and benefits from the Government, helping them navigate through bureaucracy, enabling local authorities to improve communities, and advocating for greater investment in leprosy services from the government. This is a di!erent approach to our work in the past and is proving to be e!ective.

ChallengesIn keeping with the rest of the world and the situation for other charities in 2011, The Leprosy Mission England & Wales has had to deal with a drop in income due to the economic downturn. In order to prioritise funds some field programmes have had to close, although we are confident that our new focus on 12 countries will enable us to have a better impact through our current projects.

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£5,023,704 £5,762,260Voluntary income

£381,090 £281,762Government grants

£11,915 £9,501Investment income

£4,000 £4,000Other income

£4,137,248 £5,178,675Charitable activities

£67,682 £82,340Governance costs

£5,420,709 £6,073,488Total incoming resources

£5,264,263 £6,355,065Total resources expended

£156,594 (£316,499)Net movements in funds

- £15,965

Gains on revaluation/disposal of fixed assets for charity’s own use

£148 (£34,922)Gains/losses on investment assets

£1,592,691 £1,909,190Total funds brought forward at 1 January 2011

£156,446 (£281,577)

Net incoming/ (outgoing) resources before other recognised gains and losses

£1,057,920 £1,092,923Costs of generating voluntary income

£1,413 £1,127Investment management costs

£791,155 £810,377Tangible assets

£958,130 £782,314Net current assets

£678,130 £502,314General funds

- -Investment assets

£379,630 £547,561Debtors

£2,823 £2,675Investments held

£385,181 £550,186Cash at bank and in hand

£791,155 £810,377

£1,047,634 £1,380,422

£1,749,285 £1,592,691

(£89,504) (£598,108)Creditors: amounts falling due within one year

£1,749,285 £1,592,691Total assets less current liabilities

£280,000Tangible assets – properties for sale £280,000

£1,090,377

Designated Reserve (inc. reserve in respect of thevalue of the tangibleassets) £1,071,155

Statement of financial activities Balance sheet at 31 December 20112011 2010 2011 2010

Other incomingresources

Resources expended

Reconciliation of funds

Incoming resourcesfrom generated funds

Fixed assets:

Current assets:

Liabilities:

The funds of the charity: Restricted income funds, Unrestricted income funds

Thank you for helping us provide essential services and support in 2011 for people a!ected by leprosy.

Incoming resources

£1,749,285 £1,592,691Total funds carried forward at 31 December 2011

£280,000

This summary financial information is not the statutory accounts but has been derived from the audited financial statements which were approved by the Trustees on Thursday 17 May 2012 and other financial information. The full

statements have been audited and given an unqualified report. Copies of the full statements have been submitted to the Charity Commission and the Registrar of Companies. This summary may not contain su"cient information to

allow for a full understanding of the financial a!airs of the charity. The full accounts, including the audit report, may be obtained from The Leprosy Mission England, Wales, the Channel Islands and the Isle of Man.

Finances 2011

leprosymission.org.ukThe Leprosy Mission England & Wales, Goldhay Way, Orton Goldhay, Peterborough, PE2 5GZ

Tel: 01733 370505 Fax: 01733 404880 Email: post@TLMEW.org.ukThe Leprosy Mission England & Wales @leprosytalk leprosyvoice

Reg. charity no: 1050327 A company limited by guarantee reg. in England and Wales no. 3140347