1Amref Health Africa in Canada Annual Report 2013

Annual Report

2013

www.amrefcanada.org2

Amref Health Africa (formerly AMREF — the African Medical and Research Foundation), the largest African led international organization on the continent, provides training and health services to over 30 countries in Africa. Founded in 1957 as the Flying Doctors of East Africa to bring critical health services to remote communities, Amref Health Africa now delivers preventative, community-based health care. With a focus on women and children, Amref Health Africa manages a full range of medical and public health programmes tackling the most critical

health challenges facing the continent: maternal and child care, HIV & TB, malaria, clean water and sanitation and surgical and clinical outreach.

Much of our credibility with local communities and African governments stems from the relationship and trust that we have built over the past 57 years. Since our inception, Amref Health Africa has trained over 600,000 health workers.

Board of Directors (2013 term)Mary Ann MacKenzie, ChairRené BeaudoinLotte DavisDoug HeighingtonJette James Diane MacDiarmid Dr. André NdikuyezeJeff PentlandMuriel Truter

StaffAnne-Marie Kamanye Executive Director

Todd Carmichael Director of Programmes (to March 2014)

Kevin O’Neill Director of Programmes (from April 2014)

Jennifer Foulds Communications and PR Director

Shane Burt Marketing and Fundraising Manager

Liz Doyle Operations and Donor Relations Manager

Kate Giesbrecht Programmes Coordinator (to April 2014)

Graham Atkinson Programmes Coordinator (from August 2014)

Sean Power Project Manager (part-time)

Glenda Opsahl Finance Manager (to July 2014)

Tasneem Haiderbhai Finance Manager (from June 2014)

CreditsDesign Timothy ArndtWriter Jennifer FouldsEditors Shane Burt, Kevin O’Neill, Liz Doyle, Anne-Marie Kamanye

Front cover photo A Community Health Worker in Tanzania uses a bicycle to help her reach people in remote areas. Both her health training and bicycle were provided through an Amref Health Africa project. The sign on her bicycle, in Swahili, can be translated into English as: ‘Reduce the deaths of mothers and babies by improving their health.’ Photo by Amref Health Africa.

Back cover photo A midwife examines a pregnant woman at a health centre in the South Omo region of Ethiopia. Photo by Paolo Patruno, www.birthisadream.org. The project is funded through the Department of Foreign Affairs, Trade and Development (DFATD), Canadian businesses and foundations and individual Canadians.

Charitable Number: 11921 1282 RR0001

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3Amref Health Africa in Canada Annual Report 2013

It has been such a busy year!

When we started our project to train community health workers in Kenya, Tanzania, Uganda and South Africa just over three years ago it was the largest one that the Canadian office of Amref Health Africa had managed.

With a budget of $3.1 million — of which $2.3 million was received from the Government of Canada through the Department of Foreign Affairs, Trade and Development (DFATD) — the project had big goals including training community and formal health workers to reach nearly 500,000 people in rural, remote and marginalized communities.

We are proud to say that in this final year of the project we achieved so much of what we set out to do (you’ll read more on pages 6 and 7). Support from Canadian businesses, foundations and individuals — which contributed 25% of the overall budget — was key to the project’s success. It truly was a Canadian initiative of global significance.

While this first big project for us has wrapped up, our second one continued this year in the remote region of South Omo, Ethiopia. This $2.9 million project, also a DFATD partnership with financial contributions of 25% from Canadians, focuses on helping mothers and their children access health care to increase their chances of surviving pregnancy and childbirth. In 2013 alone, more than 3,000 pregnant women received potentially life-saving pre-natal and post-natal care. Page 5 describes additional successes.

2013 was a good year for the Canadian office on the financial front. We were able to increase the amount of funds contributed directly to projects in Africa for the third year in a row — this year distributing more than $1.6 million.

Globally, it was a big year for us. We changed our name from AMREF (the African Medical and Research Foundation) to Amref Health Africa to better reflect our innovation and expertise in improving health in Africa. And while we have a new name, our commitment to lasting health change that has been the foundation of our work for 57 years remains. Our staff and volunteers in Europe, North America and Africa worked hard together in 2013, reaching nearly 11 million people in sub-Saharan Africa with our health programs.

With the Government of Canada’s renewed commitment to improving the health of mothers and their children in the world’s poorest regions, announced by Prime Minister Stephen Harper at a special global Summit in May 2014, Amref Health Africa is excited about the opportunities ahead of us. We have the experience, expertise, history and know how to be a vital partner in efforts to meet the global goals to significantly reduce the maternal, newborn and child mortality rates in sub-Saharan Africa. And, most importantly, we have the support of dedicated Canadians who make these life-saving projects possible. As the global Summit declared, Saving Every Mother, Every Child is Within Arm’s Reach.

Together, we can create a lasting legacy of better health in Africa. Thanks so much for your continued support!

Mary Ann MacKenzieChair, Board of Directors

Anne-Marie KamanyeExecutive Director

From the Board Chair and Executive Director

AnnualReview

4www.amrefcanada.org

Program Reach

Office and Programs

South Sudan

Sudan

Angola

Senegal

Zambia

Lesotho

Malawi

Burundi Rwanda

DemocraticRepublic of Congo

Congo

Cameroon

Nigeria

Mali

Liberia

BeninGuinea

Ghana

Somalia

Eritrea

Zimbabwe

Swaziland

Namibia

South Africa

Mozambique

Ethiopia

UgandaKenya

Tanzania

CoteD’ivoire

^SierraLeone

Madagascar

The Big Picture

What Amref Health Africa Accomplished in 2013Amref Health Africa supporters from around the world made it possible for us to achieve significant

results for better health in Africa.

We reached 5.2 million children and teens, and 5.4 million adults to help improve their health.

We trained more than 228,000 people in health care.

We provided HIV testing and counselling to 1.4 million people .

We helped to ensure that more than 75,000 births were assisted by a skilled attendant.

We worked with communities to provide nearly 75,000 people with access to clean water.

We helped bring improved sanitation to more than 118,000 people.

Map created by Alli Q Design

5Amref Health Africa in Canada Annual Report 2013

Moms & Babies

Canadian Support for Mother and Child Health Shows ResultsSouth Omo is a remote area of Ethiopia with high rates of mother and child death, and a very low rate of access to even basic health care. With support from the Government of Canada through the Department of Foreign Affairs,

Trade and Development (DFATD), Canadian businesses, foundations and individuals, Amref Health Africa is helping mothers and their children in South Omo survive pregnancy and childbirth.

As a midwife working in the South Omo region of Ethiopia, Martha faces the joys and challenges of childbirth every day. Martha feels more prepared for the challenges of childbirth after completing training in basic emergency obstetric care, made possible by the Canadian-funded project. Not only is the training important for her work, but Martha’s eyes light up when she talks about the new skills she has learned. She particularly enjoyed learning about safe delivery, episiotomy, and malpresentation. Emergency obstetrics are an essential skill in reducing child and maternal mortality.

“In our woreda [district], related to maternal and child health, there are many problems… many mothers are suffering from obstetric problems, like antepartum hemorrhage and other causes of maternal death. This project is helping us decrease maternal and child mortality. We are very much equipped now; we are going to start delivery activities in our health centre that will address many problems for maternal and child health.”

“ I got a chance to visit the South Omo office and see first-hand the amazing impact of the project. I spoke with a Health Officer and a midwife, both participants in the emergency obstetric care training, and they were overjoyed to share their thanks and appreciation for the program. The training has made their opportunities as health practitioners seem boundless; because of this incredible professional development opportunity they feel that Canada has made a real investment in Ethiopian health care. Both are thrilled to be better equipped to face the health challenges their communities face every day.”

Martha is a midwife in Jinka, a town in the remote region of South Omo, Ethiopia. Photo by Rachel Levee.

Anteneh is a Health Officer who has been working at the remote Selemago health centre in South Omo for three years. Photo by Rachel Levee.

Rachel Levee is a Canadian who interned with Amref Health Africa in Ethiopia between June and December 2013.

3,136 pregnant women received potentially life-saving care.

2,733 pregnant women received services to prevent the mother-to-child transmission of HIV.

9,847 children were immunized against deadly childhood diseases.

1,563 women were vaccinated against tetanus.

1,700 mothers and care givers received community-based education on nutrition.

2013 Project Successes

6www.amrefcanada.org

CommunityHealth

Workers

Canadians Help Deliver Health Care in Kenya, Tanzania, Uganda and South Africa

Program Successes

Africa carries 25% of the world’s disease burden yet has only 3% of the world’s health workers, according to The Lancet. Nowhere is this more evident than in rural, remote and marginalized communities where it can be virtually impossible to access health care.

As we shared in our 2012 Annual Report, for the past three years Amref Health Africa has worked with governments, communities and partner organizations in Kenya, Tanzania, Uganda and South Africa to train community health workers, who are critical to reaching the most vulnerable people. Community health workers are at the frontline of health care, providing the foundation for improved health family by family.

In what was the largest project implemented by Amref Health Africa in Canada when we started it in 2011, the Government of Canada, through the Department of Foreign Affairs, Trade and Development (DFATD), Canadian businesses, foundations and individuals together contributed $3.1 million. This innovative project recently concluded, and we are proud to say we received positive feedback from DFATD on the project’s accomplishments and learned many lessons that can be applied to future projects.

“Together with my other fellow health workers, we carry out community health education on maternal and child health, improved hygiene, HIV/AIDS etc. It was difficult initially as we got some resistance from community members… but with continuous assurance and support from the project and determination to transform the lives in our community, we eventually got a breakthrough as people got interested… With the changes I have seen happening in my community, it has given me more energy day-by-day to work tirelessly as a volunteer in order to create impact to the needy community like the one I live in.’’

• 1,415 community health workers were trained, with focused

attention on mother and child health.

• 100,617 household visits were carried out by community

health workers to provide information on the treatment and

prevention of diseases (such as HIV and malaria), mother and

child health, immunization and reproductive health.

• 161,296 people attended special health promotion days aimed

at raising awareness of common preventable illnesses.

• 12,245 anti-malaria bed nets were distributed to help prevent

malaria, leading to 86% of children under the age of five and

79% of women sleeping under the nets.

• 26,306 patients were referred to health facilities by community

health workers for further treatment.

Victoria Kabuye, a trained Community Health Worker in Uganda

7Amref Health Africa in Canada Annual Report 2013

Faith Ndonye gave birth to her first five children at home in eastern Kenya. “With no other option,” she says “the only thing I worried about was being strong and delivering my babies safely. When Amref Health Africa came to our area I was one of the people identified by the community to be a Community Health Worker. I was trained on the importance of health facility delivery under the care of skilled and qualified attendants.” When expecting her sixth child, Faith used her new training — she went for pre-natal care regularly, gave birth at the local health centre, went for post-natal check ups and made sure the baby received all his vaccinations. And, as a tribute to Amref Health Africa for the life-saving training it provided, Faith and her husband named their baby Amref. ‘Baby’ Amref is now over three years old and healthy.

“While travelling in South Africa, I was able to visit Amref Health Africa’s project in KwaZulu-Natal province. Traditional healers there have the trust and confidence of the communities. I met some of the healers who received training from Amref Health Africa on how to identify the symptoms of HIV, encourage testing, and counsel their patients on prevention. They were very appreciative of the training because it is helping them fulfill their role as a trusted healer. ”

Jette James (left), a member of Amref Health Africa in Canada’s volunteer Board of Directors, met with a Traditional Health Practitioner while visiting the Canadian-funded project in South Africa.

“In my ward we have a total of 24 community health workers working for this project. Each of them has been allocated a number of households to visit and give services including referrals to pregnant mothers and children… These people work very hard despite many challenges including long distances and they are very few. This project is really wonderful in one thing — to be able to reach the traditional elders. You know this group of people is everything here when it comes to making decisions.”

Deodatus Waikama, a Ward Executive Officer for Nyanungu Ward in Tarime, Tanzania.

ABOVE: Amref Munyao with his mother Faith Ndonye. // RIGHT: 3-year-old Amref Munyao at home in Kenya.

8www.amrefcanada.org

2013 in Brief

PHOTO: Midwife students at the Arba-Minch Health Science College in Ethiopia learn new life-saving skills.

Photo by Paolo Patruno, www.birthisadream.org

PHOTO: 10 young Canadians interned with Amref Health Africa for six months in 2013.

PHOTO: Executive Director Anne-Marie Kamanye (centre) with lab technicians Rosemary Alak and David Kyobe.

PHOTO: Prime Minister Stephen Harper welcomes the President of the United Republic of Tanzania, Jakaya M. Kikwete, to the global Summit on Maternal, Newborn and Child Health.

Photo courtesy of the Department of Foreign Affairs, Trade and Development.

Joining with 70 Canadian organizations in the Maternal, Newborn and Child Health Network, we helped make the case that Canada’s work in global mother and child health is not done. Thanks to the Network’s efforts, Prime Minister Stephen Harper announced a renewed commitment of $3.5 billion in funding to decrease global maternal, newborn and child mortality at a special global Summit to which Amref Health Africa was an invited participant.

Support from the Canadian-funded Dr. John Nixon Memorial Fund made it possible for two lab technicians from rural communities in Uganda — David Kyobe and Rosemary Alak — to take Amref Health Africa’s 12-week refresher course in essential laboratory skills. They are able to use their hands-on training to process vital lab work, leading to quick, accurate identification of sickness and disease.

10 young Canadians interned with Amref Health Africa in Ethiopia, Tanzania, Uganda and Kenya thanks to the International Youth Internship Program, part of the Government of Canada’s Youth Employment Strategy. The interns gained valuable work experience, and 70% of them are now employed full-time in global development.

5,595 African midwives are trained or in training thanks to Amref Health Africa’s global Stand Up for African Mothers campaign. Canadian support is training 78 midwives in South Omo, Ethiopia — a remote area where more than 90% of women lack access to health care.

Midwives Trained Canadian Interns Lab Program Canadian Partnerships

9Amref Health Africa in Canada Annual Report 2013

2013 in Brief

PHOTO: Students at the improved Patongo Primary School in northern Uganda.

Photo by Conrad Koczorowski.

PHOTO: Amref Health Africa in Canada Executive Director Anne-Marie Kamanye with lawyer Anthony Morgan (left) and actor Ntare Guma Mbaho Mwine (right) at a Coffeehouse event.

PHOTO: Dr. Peter Ngatia, Director of Capacity Building, receives the Partner Award on behalf of Amref Health Africa from Marie-Paule Kieny, Assistant Director-General, Health Systems & Innovation, WHO.

PHOTO: Guests celebrate improved health for moms and babies at MAMATOTO.

Amref Health Africa received the prestigious Partner Award from the Global Health Workforce Alliance in November 2013 for our dedication to training African health workers. Since our founding in 1957, Amref Health Africa has trained more than 600,000 health workers.

Looking out over Lake Ontario in Toronto, Amref Health Africa in Canada supporters celebrated MAMATOTO, the 16th Annual African Marketplace Gala, raising more than $100,000 for our work with African communities to improve health.

644 Canadians contributed to the lively discussions during our Coffeehouse Speakers Series on global development held in Toronto. Topics ranged from how Hollywood portrays Africa to improving mental health. The series was funded by the Department of Foreign Affairs, Trade and Development.

Healthy Schools Public Debates Fundraising Event Global Award

AG Hair’s Women Leading Change Foundation, in partnership with Chatters Canada Ltd., Buron Holdings and Clive and Susan Lonsdale, continued its focus on education in 2013. More than $350,000 was donated to provide important health information to students as well as improve classrooms, latrines and dormitories in two schools in northern Uganda.

10www.amrefcanada.org

REVENUE 2013 2012Institutional/ DFATD Funding $1,301,277 $1,518,758 Corporate $369,199 $1,000Foundation $166,622 $79,665 Individual $111,960 $117,248Gala/Events $139,341 $169,172Marketing Solicitation $174,010 $362,908Administration Fees $19,716 $20,078Development Fund/ John Nixon $103,625 $82,941Contributions $1,307 $1,773

Total Revenue $2,387,057 $2,353,543

EXPENDITURESDisbursements to Projects in Africa $1,671,782 $1,573,843 Project Support $343,146 $201,747

$2,014,928 $1,775,590

Public Awareness $59,664 $40,686 Fundraising $88,188 $268,644

$147,852 $309,330

Administration $394,970 $434,631 $394,970 $434,631

Total Expenditures $2,557,750 $2,519,551

Surplus(deficit) ($170,693) ($166,008)

STATEMENT OF FINANCIAL POSITIONOperating Assets $195,572 $164,960 Restricted project funds available for disbursement $186,711 $185,400Development Funds $829,554 $1,047,164

$1,211,837 $1,397,524

Liabilities $105,073 $120,067Net Assets $1,106,764 $1,277,457

$1,211,837 $1,397,524

FinancialReport

$2,014,928

$394,970

$88,188$59,664

FUNDS DISTRIBUTED TO PROJECTS IN AFRICA

EXPENDITURES

as at December 31, 2013

The deficit of $170,693 is comprised of:Operating deficit: $31,000Restricted Fund deficit: $243,000 Development Fund surplus of $103,000

NOTE:  The $242,930 Restricted Projects deficit is due to transfers of $225,000 from the Development Funds and $19,000 from the Operating Fund included in the Disbursements to projects in Africa

$690

,902

$596

,423

$1,2

58,0

34

$1,5

73,8

43

$1,6

71,7

82

11Amref Health Africa in Canada Annual Report 2013

ThankYou

David and Kate AngellWallace BankertLynn BayerRené and Lisa BeaudoinRichard BlouinJ. Edward and Margaret BoyceHenry and Jennie BrehautMartha Jo BreithauptBrian and Elizabeth BrittainAbram BuhlerDarryl and Donna BurtGordon Capern and Kelly DriscollAndrew and Julanne ClydeTerry Colgan and Donna JezChris CrawfordRobert and Gayle CroninJohn and Lotte DavisEstate of Christine SharpEstate of John Thomas SheaGwynneth EvansGerald Fairhead

Nancy FitchRichard FletcherCatherine FowlerMark and Maryann GaskinLaurence Goldberg and Diane SpivakPeter and Jill GoodmanScott and Krystyne GriffinStephen and Mary HafnerJames HarbellJulia HollandJette and Peter JamesBal KakariaStephanie Keeley-BuntingIan KingArthur and Sonia LabattThomas LaneClive and Susan LonsdaleR. Theodore LutzDiane MacDiarmid and Ian MacDonaldLaura MacFeetersMary Ann MacKenzie

Jennifer MazinLinda McCainSandy McFaddenJane McGillivraySheila McKinlayKaryn McLean Tom and Brenda MoffattJohn and Gloria MorrisonAndré NdikuyezeRobert NeishMary NixonMary K NixonJeff Pentland and Astrid GuttmanSid PreeceTim and Frances PricePhilip ReidGretchen RoeddeAlanna Rondi and Allen GarsonPaul RosenElaine RoyerLindsay Ryerson

Peter SacksManjit SidhuBecky SigmonPeter and Ailsa SinclairSuresh Singh and Nicole KozielStan SmithJamie StorrowChuck ThompsonKeith and Tanja ThomsonWill and Sydney TivilukAlan and Susan TorrieChris and Anne Twigge-MoleceyBlair VoyvodicGarnet WardBryce WheatonGrant WilliamsDenise YoungMargaret Zeidler

Airlie FoundationAthletes for AfricaUNIFOR - CAW Social Justice FundK. M. Hunter Charitable FoundationThe Blossom Foundation

The Charles & Rita Field-Marsham FoundationThe John Nixon Memorial FundThe Norman and Margaret Jewison Charitable FoundationThe Toronto Community FoundationUnited Way of Greater Toronto

United Way of the Lower MainlandUnited Way of Ottawa

A la Carte KitchenAcqua Fine FoodsAeroplan CanadaAG Hair CosmeticsAskari Custom TravelBarrick Gold CorporationBuron Holdings LtdCanso Investment Counsel LtdCapilano Golf ResortCarbonfree TechnologyChatters Canada Ltd

Chem Chem Lodge - TanzaniaDaniel et Daniel Event Creation and CateringDynalife DxElements Event ManagementFairmont Resorts & HotelHemlock Printers LtdManulife FinancialMarsh Canada Ltd.Mind Concepts Morneau ShepellNewport Private Wealth

Northleaf Capital Partners Canada LtdPlatinum Group MetalsPolson PierPropeller CommunicationsSilversmith Brewing CompanyStikeman Elliott LLPThe Globe and MailThe Oyster Bay Hotel TanzaniaTorys LLPWines of South Africa

Your support makes our work possible.

Major Gift Donors

Foundations

Corporations

A heartfelt thank you to the Government of Canada, individual Canadians, foundations and corporations who generously supported better health for Africa between January 1, 2013 and December 31, 2013.

FUNDS DISTRIBUTED TO PROJECTS IN AFRICA

EXPENDITURES

Government of CanadaAmref Health Africa in Canada acknowledges the contributions of the Government of Canada through the Department of Foreign Affairs, Trade and Development (DFATD), which contributed $2.3 million (2011 to 2014) to train community health workers in four countries, and $2.25 million (2012 to 2015) to improve the health of moms and babies in South Omo, Ethiopia.

Health for AfricaThis group of dedicated donors contributes monthly to better health in Africa. Special thanks to these supporters who are making a lasting difference all year long. To join our monthly Health for Africa program, visit www. amrefcanada.org/donate/ or call our office at (416) 961-6981, toll-free 1-888-318-4442.

www.amrefcanada.org

Amref Health Africa in Canada489 College Street West

Suite 403Toronto, Ontario

M6G 1A5

www.amrefcanada.org