Annual Report

HOSPICES OF HOPEMISSIONTo improve quality of lifefor patients with aterminal or life-limitingillness in Romania andsurrounding countries byincreasing provision andaccess to palliative careservices and training.

HOSPICES OF HOPEVISIONIs of a future wherepatients with a terminalor life-limiting illness areable to live and die withdignity as respectedand valued members oftheir society.

FACTSAT A GLANCE

PIONEER OF HOSPICE CARE IN SOUTH EAST EUROPEPrior to 1989, there was no specialist care available for patients with a terminal or life-limiting illness in this region. Now, the hospice movement is steadily growing.

“PALLIATIVE CARE BEACON”Hospice Casa Sperantei was declared a “Palliative Care Beacon” in S E Europe in 2003 by the Open Society Report “Transitions in End of Life Care”

INTERNATIONAL FOCUSWe now have partner charities in Romania, the Republic of Moldova and Serbia, and a sister charity in the USA. However, our educational work extends to many other countries in Central and Eastern Europe.

IMPACTIN FIGURES

11 people qualified in the first ever Masters in Palliative Care Programme in Romania

2,450 health care professionals attended palliative courses in our three training centres

3,500 patients now cared for annually by our partners in Romania, Republic of Moldova and Serbia

£4,000,000$6,520,000raised to date towards the new Bucharest Hospice Appeal

01 / Our Mission

02 / Messages

03 / Hospices of HopeNetwork

05 / New hospicesfor Bucharest

07 / Impact onpolicy

08 / Impact ondevelopment

09 / Impact in Serbia

10 / Impact inMoldova

11 / Impact onindividuals

13 / Summer tripsand volunteers

15 / Fundraising highlights

16 / Charity shops

17 / Income & expediture

18 / How you can help

Cover Photo:The Countess of Wessex meeting hospice patients in Bucharest, June 2013.

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Graham and Carolyn Perolls welcome the Royal Couple

“A highlight of the year was a visit by the Earl and Countess of Wessex to Bucharest. They attended a hospice luncheon and spoke to donors, sta� and patients. You will be moved to read further on about the young boy pictured on the front cover – the Countess was touched by his bravery and sense of humour in the face of overwhelming odds. Guests also had an opportunity to visit the new hospice building, which is now taking shape fast. We are tremendously grateful for your continued support as we endeavour to support the growth of the hospice movement in Romania, Serbia and Moldova.”

THANK YOU ON BEHALF OF ALL THE PATRONS, TRUSTEES AND STAFF OF HOSPICES OF HOPE

Graham Perolls O.B.E. Executive Director UK

Dr Ronna McHammond, Program Director USA

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Brian DavisChairman ofTrustees

“2012 was an exciting and busy time to take over as Chairman of Hospices of Hope as work commenced on the soon to be completed new Bucharest Hospice building. The provision of care for terminally ill patients continues to move forward in Romania, Serbia and Moldova and the surrounding region. More and more lives in these countries are touched each year by the work of our dedicated professional and support sta�. We are very grateful to the growing number of donors and volunteers who generously give of their time, money and other resources to support the work. Personally I am pleased we welcomed Emanuel Hospice as a country (network) partner having attended one of their early fundraising events in Oradea in 1999.”

THE HOSPICES OFHOPE NETWORK

THE HOSPICES OFHOPE NETWORK

ROMANIAHOSPICE Casa Speranteiwww.hospice.rosince 1992

SERBIABELhospicewww.belhospice.orgsince 2005

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Hospices of Hope is a charity registered in the UK and the USA with o�ces in Otford (near Sevenoaks, Kent), Edinburgh (Scotland) and Nyack (New York). It is dedicated to supporting the development of hospice/palliative care in Romania and surrounding countries by providing advocacy, technical support, education and training, and funding. We work through our country partners: currently Hospice Casa Sperantei, and Emanuel Hospice, Romania; BELhospice, Serbia; and Hospice Angelus, Republic of Moldova. Together we are striving to promote hospice / palliative care in the region.

We work with governments to improve legislation, widen access to services and medicines and increase the resources available to help all those su�ering from a terminal or life-limiting illness.

THE HOSPICES OFHOPE NETWORK

THE HOSPICES OFHOPE NETWORK

ROMANIAHospice Emanuelwww.emanuelhospice.orgsince 2013

MOLDOVAHOSPICE Angeluswww.hospice.mdsince 2008

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“After four years of fundraising, the dream has finally become a reality. The building is almost completed and after a month for “snagging” the builders will hand it over to the hospice in January 2014. Although, miraculously, the building itself is almost fully paid for, we still need to raise a further £853,000 / $1,390,390 to cover the equipment, training and first 9 months of running costs, as well as obtaining all the necessary permits before it can become fully

operational. We therefore expect the hospice to open in stages; starting with moving the home-care team and out-patient clinic from their current premises and finishing with the opening of the in-patient unit as soon as all the authorisations have been received and resources become available.

The hospice will have 15 beds for adults and 8 beds for children and young adults with cancer, a day care centre with sensory and therapy rooms, a reception area with co�ee

NEW HOSPICES

AlexandruPădureanuCEO Bucharest

At last - a brand new in-patient teaching hospice for adults and children with cancer

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FOR BUCHAREST

A new centre for children with life-limiting illnessesclose to Bucharest

shop, chapel, out-patient clinic and treatment rooms, a teaching centre and library, o�ces for home-care, fundraising and support services and rooms for family members to stay in.

We also managed to get the first building at Adunatii Copaceni finished in time to run the first summer camp for bereaved children and children with sick siblings or parents, in August 2013. The children loved this new venue which o�ers a great atmosphere, plenty of space and beautiful countryside. We look forward over the coming years, resources permitting, to developing the property into a Centre for children with life-limiting illnesses. The next phase will include a respite centre and accommodation for vulnerable families.

We are so grateful to all our supporters in the UK and USA for their help to get us this far.“

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Nicoleta MitreaDirector of Nurse Education and National Devleopment

“Change is possible and it happens with the help of open minded people. Developing a new profile for a profession like nursing has to go through many steps: individuals have to become aware of their own role and contribution towards the care of patients, models have to be established and voices need to be heard. Romania has changed a lot since the “revolution” in 1989, including the medical system. The inherited centralised system at that time assumed hierarchical subordination of one profession to another, for example nurses to doctors.

However, universities of nursing were established in 2002 and since then there has been a move towards establishing nursing as an autonomous profession, with palliative care leading the way. I have had the privilege of being involved in the hospice movement since 1997, starting as a children’s nurse at Hospice Casa Sperantei and going on to become Nursing Manager of the in adult in-patient unit and now Director of Nurse Education. I also had the opportunity to do an Advanced Palliative Care Diploma at Harvard University.”

CHANGING THE FACE OF NURSING IN ROMANIA, THE CONTRIBUTION OF PALLIATIVE CARE

IMPACT ON POLICY

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LOOKING BACK AND LOOKING FORWARD

Malina DumitrescuDirector of National Development Hospice Casa Sperantei

“The past 21 years have been a unique experience and a privilege for me personally. I have witnessed the growth of a small hospice team that started with Graham’s vision and enthusiasm for palliative care in 1992, into a mature team of over 150, sharing the same vision of a day when palliative care will be available wherever and whenever needed in Romania. We can confidently say we have brought relief of su�ering in over 15,000 patients’ families and planted the seed of palliative care in over 60 services throughout Romania following the Brasov model, but sadly we admit that they only cover less than 10% of the actual needs for care in the country. We proudly count over 14,000 professionals trained in our palliative care centres, but regret to see there are still so many places where patients have to su�er from unrelieved pain. We celebrate every new victory when health authorities, acknowledge the need for palliative care, then mourn over the endless political changes that make us start from scratch every so very often. Looking forward into the future is an incredible challenge for all of us: the hospice team, our patients and supporters. It means obstinacy in persuading authorities and professionals that our patients’ lives are only measurable in the present and that we are all given the privilege to relieve their su�ering. We cannot miss the chance to help them.”

/ON DEVELOPMENT OF SERVICES

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IMPACT IN SERBIA

• 272 patients cared for• 185 psycho-social and spiritual visits• 50 families attending group sessions• 1,000 health care professionals attended courses

“Thanks to your support we were able to significantly expand our organisation during the past year. In addition to our multi-disciplinary team, we also have 20 regular trained volunteers that are helping us. The Belgrade authorities have expressed their willingness to grant us a plot of land for a future in-patient hospice, which has always been our dream. We also continue to be part of an EU funded project which has seen more than 1,000 health care professionals attend lectures and seminars on palliative care, thus helping the concept to spread throughout Serbia. Our fundraising activities also grew this year and we had a record number of 280 supporters running in the Belgrade Marathon.”

Zoran PurkovicCEOBELhospiceSebia

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BELhospice at the Belgrade Marathon

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“2012 was another year of growth for the team at Hospice Angelus in Chisinau, Moldova. The paediatric team entered its second year and grew in confidence. They also saw more referrals of children with life-limiting illnesses other than cancer. The stoma bags that were donated by individuals and organisations in the UK were distributed to 630 patients. There is no other source of good quality stoma bags in Moldova. They make a huge di�erence to the quality of life of these patients. The

Ministry of Health continued its contract with Hospice Angelus, and provided 3% of the funds needed for the year. This amount is expected to grow in future. Other areas of fundraising in Chisinau also grew so that more than 50% of the funds required were generated in Moldova. The Annual Ball was a particular success, raising more than £20,000 / $32,600. Our special thanks go to our Country Manager, John McKellar, who has done such a superb job over the past 3 years.”

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James NiblettDeputy Director

IMPACT IN MOLDOVA

Hospice Angelus Doctor Olga, helping a stoma patient

• 851 Patients cared for• 4766 Home visits• 101 Child Patients• 79,000 Stoma Bags Distributed• More than 50% of funding was generated in Moldova

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IMPACT ONINDIVIDUALS

Vali is 8 years old. At the age of 16 months, Vali was diagnosed with NF which a�ects the development of nerve cell tissues, causing tumours which became cancerous. After the initial shock, his parents sought help for Vali both in in Israel and Romania but doctors were reluctant to operate on him. Finally a children’s hospital in the north of

Romania agreed to remove the tumours around the optic nerve. Sadly the surgery resulted in Vali losing his sight completely. As well as su�ering physically, Vali’s family life has been very di�cult. His parents separated as his Dad has a second family in Israel and moved back there. Vali’s mother had to cope on her own looking after the children in very di�cult emotional and financial circumstances. Vali’s symptoms worsened so the family moved to Bucharest to be closer to hospitals and specialist help. The doctors decided to insert a shunt into Vali’s skull which meant the family had to sell their car to a�ord this. Vali’s health continued to decline and this year he underwent surgery 8 times. It was at this stage the Hospice team became involved in providing palliative care. At first Vali was very shy but he quickly became very close to the members of the Hospice team. The family's financial situation continues to be very di�cult. Their only income is a carers allowance paid by the government for cancer patients which is about £30 / $48,90 a week. Vali’s mother struggles to feed the children properly. Their apartment is very small and unsuitable for Vali’s needs. Sadly Vali’s recent blood tests have given cause for concern and his condition has started to deteriorate again. Vali is very special to us because of his kindness and love that he shows to his family and our Hospice team members. Vali represents for us a life lesson, telling us that it

doesn’t matter how long you live, or how old you are, or even if you are able to see or not, what really matters is how you choose to live, either in the light or in the dark, far away from God. We think of him as our angel and we hope that God will watch over Vali and his family and help us to continue looking after them in the best possible way.

Vali and his mother meeting the Earl of Wessex

Vali's Story by Flori Baltag, Senior Children’s Nurse

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HOSPICE STORIESNenad’s story by Graham Perolls

“When I visited Nenad during my last visit to Belgrade in October 2013, I knew that his “goodbye” meant goodbye. He squeezed my hand, looked straight and meaningfully into my eyes and said nothing – he didn’t need to. I was therefore not surprised when I received a phone-call a few days later to say that he had died. Nenad was just 27 and when I met him two years previously I felt I could immediately relate to him. He had kidney cancer and was paralysed due to spinal secondaries, just like my father had su�ered many years before. His social situation could not have been sadder – his father had died, his mother was struggling with mental health problems and his brother was in prison for drug o�ences. Yet, despite all this, he was one of the most cheerful and positive people you could ever wish to meet. He lived just round the corner to our hospice centre in Belgrade, and I really enjoyed visiting him every time I was in Belgrade. He so appreciated the care of the team, especially his nurse Maja, doctor Snezana and social worker Mickey and they had all become his “family”. It took him a long time for him to come to terms with his diagnosis but on one visit he told me that he knew he would not recover and that his life was now in God’s hands.”

Nenad with Graham Perolls

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SUMMER TRIPSAND VOLUNTEERS

“This summer I spent an amazing 5 weeks in Romania leading and volunteering at the hospice summer trips. This was actually my 7th year, but I must say that this summer was a particular favourite! We had a total of 4 trips including 2 clubs for the patients and 2 camps for children who have, or have had a close family cared for by Hospice Casa Sperantei. In total 115 children benefited from these free activities run by English volunteers with the help of the Romanian team. At the end of August we made history by organising the first Bucharest Summer Camp at our newly donated Children’s Centre at Adunatii Copaceni. We had such a wonderful week with 17 children who had all been bereaved. The week included morning exercise (at 8am!!), team games, project work on our theme ‘The Oscars’, art & craft, choir, zumba & lots of parties! Henry who is a youth worker from Oxford organised our evening lessons with great team games and also an inspirational message from the bible. The children really loved listening to the stories about Peter and enjoyed acting them out. “

Anna PerollsFundraising & Communications Manager

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First summer camp for bereaved children and children with sick siblings or parents atAdunatii Copaceni

August 2013

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FUNDRAISINGHIGHLIGHTS

“Fundraising across our group of charities takes on many di�erent forms, from gala ballet evenings to marathons, charity shops to grant writing, quizzes to Balls. The most encouraging thing is that every year, more money comes from the countries we work in. Although the concept of fundraising is still relatively new, our fundraising teams do a great job in coming up with new ideas. Fundraising is always an uphill struggle and the year ended very appropriately with more than 600 people running up the 34 stories of Romania’s tallest building – the Rai�eisen Bank tower, raising more than £20,000 / $32,600 in sponsorship.”

Alex BacheUK O�ce Manager

Dr Ronna McHammond, Program Director USA SkyRun, Bucharest Ballet Gala with Alina Cojocaru, London

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CHARITY SHOPSWe now have 19 charity shops in the UK (15 in the South-East and 4 in Scotland). Our latest shop, opened in 2013, is at Woodhatch, near Reigate. We are enormously grateful to all our sta�, volunteers and customers who help us to raise such an important amount towards our work.

“Fall Concerto” organised by the Mara Society in New York

Charity Ball in Moldova. Graham Perolls and Dr Valeriu Isac withPrincess Marina Sturdza and First Lady of Moldova

Alexandru Tomescu (violin) and Matei Varga (piano)

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INCOME AND EXPENDITURECONSOLIDATED FINANCIAL DATA FOR HOSPICES OF HOPE NETWORK - 2012

2012 Income by country - Total £ 2,922,898 / $ 4,764,323.74

UK

Romania

Serbia

Moldova

USA

50.7%

44.6%

2.0%

2.1%

0.6%

2012 Expenditure by type - Total £ 2,913,764 / $ 4,749,435.32

Expenditure £ 274,342 / $ 447,177.46

Hospice Care

Advocacy

Education

Technical Assistance

Fundraising

64.4%

8.4%

6.0%

6,.9%

14.3%

Income £ 1,008,892 / $ 1,644,493.96

Bucharest HOSPICE Appeal

“The above figures are a consolidation of the 5 partner charities in the Hospices of Hope Network. The income for the group has grown significantly compared with 2011. Total income in 2012 was £2.92 m / $4.76 m compared with £2.56 m / $4.17 m in 2011. The income and expenditure related to the Bucharest Hospice Capital Appeal are shown separately, as these funds are restricted. The audited accounts for Hospices of Hope, and for any of the partner charities are available on request.”

James Niblett ACA DChAFinance Director

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HOW YOU CAN HELPWould you be able to commit to a regular standing order? This is the most helpful way of donating as it enables us to plan ahead. You only need to fill in a form at www.hospicesofhope.co.uk and send it to us. We can also claim Gift Aid if applicable.

Would you or your company consider becoming a founder member of the new hospice in Bucharest for a minimum donation of £10,000 / $16,300. Your name will be included on the hospice founders’ plaque in the entrance lobby and you will be making a unique and lasting contribution to the people of Bucharest.

Why not join a summer trip in 2014 and be part of something that can be truly life-changing

Bucharest Holiday Club: 19th to 28th June

Seaside Club: Thursday 26th June to 6th

Brasov Holiday Club: 24th July to 3rd August

Brasov Summer Camp: 31st July to 10th August

Bucharest Summer Camp: 14th to 24th August

Would you commit to praying for our patients, their families and our sta� who care for them? We will send you our regular prayer letter on request.

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Would you consider volunteering for Hospices of Hope in our New York, Edinburgh or Otford o�ces or in one of our charity shops?

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Buy some bricks for the New Bucharest HOSPICEjustgiving.com/Bucharest-Hospice-Buy-a-Brickfirstgiving.com/fundraiser/Bucharest-Hospice/buy-a-brick

DO YOU HAVE ANYBirthdays? Anniversaries? Celebrations? COMING UP? 18

www.hospicesofhope.co.uk

EXECUTIVE DIRECTORGraham Perolls O.B.E.

DEPUTY DIRECTORJames Niblett ACA

UK BOARD OF TRUSTEES

Brian DaviesChairman

Dr Mary Baines OBEFergus CassMarilyn BoggustDr Jo Hockley OBEAvril JacksonMihai RadoiAndrea EvansTrevor SnuggsDr Simon Pennell

Hospices of Hope UK(Head Office)Registered Office11 High Street, Otford, Kent, TN14 5PG, UKT. +44 (0)1959 525110F. +44 (0)1959 525013office@hospicesofhope.co.uk

USA BOARD OF TRUSTEES

Julianne PaunescuChairman

Claiborne BlevinsDr. Stephen ConnorDiane GerzewitzEileen HerzogGraham Perolls OBEJennifer SarteauJeremy Taglieri

Hospices of Hope USA29 Dickinson Avenue, Nyack, 10960, New YorkT. +1 (0)845 512 8661hohinc@optonline.net

PATRONS

The Duchess of NorfolkDame Marion Roe DBEDigby, Lord Jones of Birmingham Kt.Serban Cantacuzino CBEPrincess Marina SturdzaAndrew Bache CMGGordon MacKinlay OBESir George IacobescuAlina Cojocaru

Hospices of Hope SCOTLANDOffice 1,260 Gorgie Road, Edinburgh, EH11 2PP, UKT. +44 (0)775 189 6014lillah@hospicesofhope.co.uk

REGISTERED CHARITY NUMBERSEngland and Wales - 1088475Scotland - SC040117USA - 13-4194283 501(C)3

Hospice Casa Speranței ROMANIAStr. Sitei Nr.17A, 500074, BraşovT. +40 268 474 405F. +40 268 474 467hospice@hospice.ro

Hospice Emanuel ROMANIAStr. Redutei Nr.1A, 410061,T. +40 259 475 222M. +40 722 848 741office@emanuelhospice.org

Hospice Angelus MOLDOVAAlexei Mateevici Street, 46Chişinău, MD-2009, Republica MoldovaT. (+373) 22 925315F. (+373) 22 244860info@hospiceangelus.md

BELhospice SERBIA72 – 74 Dalmatinska Street.11000 Belgrade, SerbiaT. +381 11 30 38 074F: +381 11 33 43 311office@belhospice.org

CONTACT DETAILSFOR OUR COUNTRYPARTNERS

USA DIRECTORDr. Ronna McHammond