It's the effect that counts

The DAHW Deutsche Lepra- und Tuberkulosehilfe, e.V. was very successful in carrying out its mission. Again in 2012, the mission which is rooted in the statutes and is financed by many thousands of people in Germany, Austria, the Czech Republic and elsewhere, has spurred its volunteers and full-time employees on to top performance. Our ability to bring sustainable aid and support to the needy via our effective, reliable structures - frequently under very difficult conditions - has not gone unremarked by other relief organisations and institutions for emergency aid and development cooperation. For example, we received additional funds amounting to millions to solve tasks together and to contribute towards a positive change in the fate of needy people affected by leprosy, tuberculosis or other neglected diseases and also by disabilities.

We continue to work, concentrating on our vision of a “world in which not one single person suffers from leprosy, tuberculosis and other poverty-related diseases and their consequences, such as disability and exclusion.”

It’s the effect that counts!

From the global point of view neither leprosy nor tuberculosis has changed drastically. The burden of disease is still just as high for leprosy. According to information from the World Health Organisation (WHO) in 2011 more than 230,000 people contracted leprosy. Compared to 2010 numbers have risen a little. If we want to realise our vision for DAHW, we must insist that the number of new cases must be reduced. Unfortunately, we frequently find that - faced with inadequate state funding - the national health authorities in our partner countries are unable or unwilling to support leprosy work in their own countries. Our mere presence and commitment often has the effect that the state provides them with financial means and human resources. In that case sustainable and effective work means a long-term presence and advocacy for the people affected by leprosy who would not otherwise be heard and would be unable to demand state aid.

Tuberculosis doctor, Dr. Chris Schmotzer with her medical team at the hospital in Rawalpindi / Pakistan. Photo: DAHW

This is how we work: As a relief organisation - an NGO (Non-Government Organisation) - it is our mission to give aid directly to people in need who are affected by leprosy and tuberculosis. To this end we deploy both our own employees on the spot and partner organisations who take care of the needy with financial support from DAHW. By way of example we can name some of our partners: the Marie-Adelaide-Leprosy Centre (MALC), of which Dr. Ruth Pfau is the director in Karachi/Pakistan, Aid to Leprosy Patients (ALP), directed by Dr. Chris Schmotzer in Rawalpindi/Pakistan, or the Buluba Leprosy Hospital of which Dr. Elizabeth Nionzima in Buluba/Uganda is the director. In the partner organisations, together and at previously defined intervals, we monitor whether the agreed effect is indeed achieved for the afflicted persons and whether the donated money has been used effectively.

Reinforcement of national structures

Besides direct relief, wherever possible we try to strengthen those national structures which are responsible for regular and sustainable leprosy work, for example by means of training and support in the form of human resources. This support is a means of creating improvements in the leprosy work which will also affect the future and which raises our political influence as a civil society organisation with regard to claiming human rights for those people for whom we campaign.

It is the top priority of the medical staff to reach the people and inform them about health hazards. Photo: Boixadós / DAHW

It is our declared objective not just to speak for these people, but to enable the people we support to demand their rights themselves. Involving the people who are affected by leprosy and tuberculosis in all the planning work and projects is a fundamental prerequisite for effective, sustainable work. Targeted stabilisation of communities of interest for independent representation of the needs of these groups of persons enhances the sustainability of national structures.

Future funding and donation development

DAHW has always been a relief organisation based on the commitment of many faithful voluntary supporters. In recent years we have discovered that it has not been possible to close the gaps left behind by our volunteers of many years standing, who have had to withdraw due to their age, by engaging the same number of young, committed people. This is certainly also due to a change in our society in which long-term volunteer work has tangibly lost some of its attractiveness.

The “Medical Advisory Team” at the DAHW headquarters in Würzburg (from left): Dr. Joseph Chukwu, Dr. Pieter de Koning, Dr. Srinivasan and Dr. Joseph Kawuma. Photo: Mathiasch / DAHW

However, we have also discovered that by making special efforts the remaining DAHW volunteers have been able to make good a major part of the reduction in support. Personally, I think that DAHW has the best volunteers in the whole of Germany. After all, by contrast with volunteers working in a regional sports club, for example, they can only perceive the success of their efforts indirectly. And nevertheless, they give all they have year in and year out to help those who have been struck down by leprosy, tuberculosis or some other disease or disability stemming from poverty.

Despite her age, leprosy doctor Dr. Ruth Pfau works tirelessly. Photo: von Wiedersperg / DAHW

Thanks to the commitment of the Public Relations and Fundraising department, in 2012 we received a very respectable amount of donations. Although donations in Germany dropped almost by five percent in 2012, according to information given by the Deutscher Spendenrat (German donations council), we suffered a significantly smaller drop in donations of just two per cent. And this was balanced out by higher income from inheritances and institutional sponsors such as the Austrian Leprosy Relief Organisation, Likvidace Leprosy in the Czech Republic, Miserior or “the Carol Singers” in Aachen, a children’s relief organisation. The virtually unchanged project expenditure meant we were almost able to achieve a balanced budget.

Risks

Nevertheless, the members of staff agree in their assumption that it is hard to stop the downward trend regarding private donations. This trend applies to almost all relief organisations throughout Germany and to the other leprosy relief organisations all over the world. Therefore, we are increasingly looking to institutional sponsors who wish to make use of the good work done by DAHW, its competent staff and its decades of experience, to invest their own funds purposefully and efficiently in our mission. In order to be well equipped for the future in this respect, in 2012 we realigned the structure of the projects department. In addition, we started to introduce an internationally approved accounting system which will make secure documentation of the funds used and control in the relevant countries and in Würzburg considerably easier. The plan is to have converted all 13 DAHW national offices to the system by December 2013.

Leprosy involves more than just identifying new cases; it also means taking care of many old patients. Here at Buluba Hospital in Uganda. Photo: Einberger / DAHW

In the new departmental structure, quality assurance for our work and knowledge management - which has been an across-the-board responsibility of all staff in the project department - has now been assigned to a special competence team. Equally, in future the national offices will receive support from a separate competence team in Würzburg when applying to institutional sponsors for funds. The Project Development and Fund Allocation departments will remain and so will the Programme Development with medical and social experts to co-ordinate the development of expertise.

Our proven experts in the national office who are experiencing the current developments and new challenges directly will now be far more involved in the development of strategies and in important decisions at DAHW. The members of the so-called “Medical Advisory Team” established in October 2012 are Dr. Joseph Kawuma (medical advisor at DAHW in Uganda), Dr. Joseph Chukwu (DAHW medical advisor in Nigeria), Dr. Pieter de Koning (DAHW medical advisor in Liberia) and Dr. Srinivasan (national DAHW medical coordinator in India). This team advises the management and the Management Board on strategic decisions and important medical matters. One of the results after the deliberations in October 2012 was an urgent appeal addressed to the Management Board and the management to invest significantly and effectively in research into how leprosy is transmitted.

Acknowledgement

In December 2012 an article in the financial journal “Capital” stressed that the work of DAHW, its development and objectives are represented very well and transparently. The journal had commissioned two independent analytical companies to scrutinise the 50 largest charities in Germany. For this purpose the information published by the organisations was analysed and undercover tests were undertaken. To our great delight DAHW was among the “Top Ten”.

Equipping DAHW for the future: Give young donors an understanding of poverty-related diseases.Photo: Ludwig / DAHW

And it was not only the frankness with which information is handled which received praise from the public. Above all it was the commitment of the people who work so hard in the field for people with leprosy and tuberculosis. In November 2012 Dr. Ruth Pfau was awarded the coveted German TV award, BAMBI in the “Silent Heroes” category. In her moving speech she made it clear to the audience that we are not always aware that here in Europe we live in “paradise” compared to many poor people in countries in the southern hemisphere.

Challenges

One of the greatest challenges, besides securing income for the project work, is the search for suitable staff in Germany and the project countries. The vast amount of specialist knowledge required of our experts today at headquarters in Germany makes the search for good staff difficult. Just a few of the requirements: finding one's bearings in different cultures, mastering several foreign languages, coordinating tasks and solutions across several continents and many countries, expertise in financial management as well as having one’s own experience from years abroad and proof of commitment as a volunteer. The list of expectations is just about never-ending and each requirement is in itself completely different and at the same time at a high level. This is because today we no longer aspire to “be doing” all the work of DAHW from Würzburg; instead we want to enable the national experts in the respective countries to support and treat the people independently and at a very high level of quality.

Voluntary commitment: Every year in November the group in Würzburg organises a big bazaar to support DAHW. In 2012 they were able to hand over EUR 15,000 to DAHW.Photo: Hövekenmeier / DAHW

That requires a great deal of patience and empathy as well as being prepared to work together with the colleagues from the partner countries to find solutions which are acceptable locally, but nevertheless satisfy our global quality requirements.

These problems also apply in a similar way to our staff abroad. Luckily, in past years DAHW has repeatedly succeeded in finding excellent staff and experts in the partner countries who have fought for a long time to achieve the DAHW objectives in their home countries. I would like to mention Dr. Joseph Kawuma in Uganda, Dr. Joseph Chukwu in Nigeria, Ato Ahmed in Ethiopia and Antoinette Fergusson in Sierra Leone by way of example for all our staff in the partner countries. In past years these members of staff have maintained the support for people suffering from leprosy and tuberculosis, in some cases under extremely difficult conditions. However, today the demand for these highly qualified, reliable specialists with high ideals is rising and it is becoming increasingly difficult to acquire new staff with the same high standards for long-term work at DAHW.

Prospects and key operational aspects in 2013

After 56 years as tenants, DAHW will be building new headquarters in Würzburg in the coming year. This has been made possible by the donation of part of a plot on the condition that we will build on it and use it ourselves. Financially it is also advantageous because in the years to come DAHW will save large sums on rent and heating costs.

Their work is increasingly focusing on persons with disabilities. DAHW is working out a global CBR strategy for the project countries. Photo: Hövekenmeier / DAHW

DAHW will give more support to research on Buruli in Togo. Furthermore, it will establish a joint research pool together with the ILEP partner organisation, American Leprosy Missions (ALM) and with the Netherlands Leprosy Relief (NLR) and provide it with a financial basis to facilitate support for more research into leprosy in the future.

In June several social workers from the project countries prepared the future Community-Based Rehabilitation (CBR) strategy of DAHW. This approach enables persons with disabilities to take part in social life. DAHW has already been working in a similar way for many years for people who suffer from disabilities caused by leprosy. It wants to open up these projects for CBR in the future.

Following the International Leprosy Congress in Brussels in September, the DAHW doctors will meet in Würzburg. Dr. Joseph Kawuma, head DAHW doctor in Uganda and Chairman of the Technical Advisory Group of the WHO, will undertake to co-ordinate this work. Here too the issue is future strategies in the project countries, so it means that the expertise from the projects is very important.