DAHW German Leprosy and TB Relief Association supported people in need of help in 28 countries in 2010. The Association contributed significantly to people suffering from the diseases of poverty leprosy and tuberculosis having access to quick diagnosis and treatment. Emergency measures for the victims of the flood in Pakistan were a focus in the second half of the year.
In 2010, DAHW started a discussion about its future mandate. At a Future Conference, members of the Association, the Board, volunteers and employees, donors as well as experts from the project countries discussed DAHW's main emphasis for the future. In this context, the core mandates of leprosy and tuberculosis were confirmed. In addition, "neglected diseases" were confirmed as a sub-mandate and disability was incorporated as a new focal point for DAHW's work. Due to the large number of unsolved questions, particularly regarding leprosy, DAHW will also support more research projects.
Last year, DAHW committed to a mission statement which states, "Our vision is a world where nobody suffers from leprosy, tuberculosis and other diseases of poverty and their consequences like disability or exclusion".
Humanitarian help
The flood of the century in Pakistan last August deprived millions of people of their livelihood. DAHW reacted immediately. As DAHW had proved in the past that it is able to support the people in Pakistan quickly and effectively, donors trusted DAHW and its long-standing on-site partners: Dr. Ruth Pfau and her team in the Marie Adelaide Leprosy Centre (MALC) in Karachi in the South of the country and Dr. Chris Schmotzer with her organisation Aid for Leprosy Patients (ALP) in Rawalpindi in the North of Pakistan.
In emergencies, we particularly turn our attention to people with disabilities, chronic diseases and families who have lost their main breadwinner. Approximately 900 local helpers supported the flood victims at times. We reached more than 200,000 people with food parcels, drinking water, tents, plastic mats, bedding and other supporting measures. Reconstruction will continue in 2011 and 2012 as well.
Programmes and projects
In 2010, DAHW has supported religious and non-governmental initiatives, training centres and patients' associations with approximately half of its funds; the remaining 50 per cent were used to strengthen national programmes to fight leprosy, tuberculosis and Buruli Ulcer.
In Ethiopia, India, Columbia, Nigeria, Senegal and Tanzania, DAHW partners have extended the services for people with disabilities to a community-based rehabilitation. The new guidelines passed by the World Health Organisation (WHO) regarding this topic are very helpful in this context.
Last year, the decision made in 2009 to discontinue support for Argentina, Ecuador, Kenya, Syria, China, Cambodia and Thailand was implemented. In contrast to what had been planned, support for Afghanistan will continue. The 256 projects are distributed as follows:
110 projects in Africa, 99 in Asia, 32 in Latin America as well as 15 supraregional projects for research and training.
Quality assurance
To improve the quality of project work, a concept has been developed to work out how to reduce the number of patients who discontinue their treatment with antibiotics prematurely. In particular, patients suffering from tuberculosis have to take their medicine regularly until they have fully recovered as dangerous resistances can otherwise develop and the medicine becomes ineffective.
The framework for quality assurance based on the model of the European Foundation for Quality Management (EFQM) and developed in 2010 was complemented with one chapter on safety. This includes safety measures against criminal acts or armed conflicts, but also road traffic or ensuring the treatment of patients in case project activities have to be discontinued suddenly for whatever reason.
Furthermore, the guidelines concerning the tasks of the country offices were revised to add co-financing and local fund raising.
Communication
The fact that we provided prompt and continuous information via letters, via the Internet and via traditional media (newspaper, radio, TV) about flood relief in Pakistan, motivated many donors to donate much more than they usually would have been prepared to. We are very thankful for their great trust. We are particularly happy that so many people - in addition to their contributions to flood relief - have continued to donate to DAHW's "everyday work", i.e. the Association's medical and social work.
We have started to report more on the impact of this support and want to continue to extend this reporting. In particular in the context of appeals for donations, we want to increase the information provided on the phone by getting in touch personally with many donors. In 2010, we have for the first time integrated "apps“, applications for smart phones, into our appeals for donations and are thus also extending our Internet presence in the field of social networks.
Public relations
Our support for flood victims in Pakistan triggered a great press response. The measures implemented by Dr. Ruth Pfau and Dr. Schmotzer were described as examples of successful support in newspaper articles, on the radio and on TV. This motivated our donors, but also people who had not supported us previously.
The different events of our voluntary groups and supporters also triggered a very positive press response. Action groups, church parishes, women's associations and schools once again organised numerous sales, concerts or sponsored charity runs and donated their profits to our project work.
Monitoring of impact
To be better able to measure the impact our work is having, 13 German associations, including DAHW and 30 southern organisations have teamed up to form the initiative NGO-Ideas. Suitable instruments are to be worked out together with the affected section of the population to be able to record effects and side effects.
It is also important that the actual determination of project success is carried out by those affected - after all they are the main beneficiaries of the projects and are to be put in a position to check if the projects have the desired effect. In regular workshops, the organisations exchange their experience; a workshop of this kind took place in July 2010 in Coimbatore in southern India.
Human Resources Development
Last year, DAHW employed 41 full-time employees (not counting apprentices).
DAHW's structure in Germany did not change significantly in 2010. Flood relief in Pakistan was also accomplished without increasing the number of personnel, which was very strenuous from time to time. A colleague's maternity leave was "bridged" through an internal redistribution of tasks.
The country offices in Thailand and Pakistan (our project work continues!) were closed a while ago as planned. Our medical adviser, Dr. Pieter de Koning, who stopped working in Würzburg at the end of August 2010, will go to Libya for three years, starting in September 2011 and will support our local partner's team there in the fight against leprosy.
At the end of the year, we extended our team by one additional full-time position to support volunteers. The volunteers' support continues to be an important pillar of DAHW's success.
Annual results
Compared to the two previous years, both income and project expenditure increased significantly. Both figures increased by a double-digit percentage, which also has to do with humanitarian aid provided in Pakistan.
The overall project volume increased from 10.7 million Euro (2009) to 12.8 million, an increase of approximately 20%. The extraordinary commitment of employees and volunteers made this significant increase possible.
The fact that DAHW still showed a deficit of 521,682.12 Euro in 2010, results from the high provision of 2.5 million Euro for the donation fund for Pakistan. These are funds for Pakistan to be used after the flood, which were not intended for emergency measures but for reconstruction and which will be used in 2011/2012. They have been deducted from the income of 2010 and have been placed in a special fund.
Despite the unforeseeable supporting measures for Pakistan, DAHW has thus still come very close to its aim of a balanced budget. Compared to the previous year, project expenditure has risen by 2.2 million Euro.
Voluntary work
In 2010 as well, volunteers created a recognisable image for DAHW in cities and communities. In action groups, church parishes, with the Kolping family and in schools, they reported on the situation of people who suffer from leprosy or tuberculosis and described the effects of our help. Volunteers also collected donations for flood relief in Pakistan with the help of different activities.
Last year, representatives from Ethiopia, Brazil, Pakistan, Senegal and Tanzania toured Germany on behalf of DAHW and gave talks, very frequently at events that had been organised by volunteers.
During Advent season, more than 60 bazaars took place, to which approximately 1,200 volunteers and helpers contributed. Approximately 25,000 people visited these bazaars.
In November 2010, the interactive volunteer map with the function "where can I find volunteers in my vicinity" was launched on the website www.dahw.de.
Co-financing
In the year under review, income increased significantly through co-financing - both in the headquarters in Würzburg and directly in the project countries. Overall, the sum almost doubled from roughly 900,000 Euro (2009) to 1.8 million Euro in 2010.
We owe this development to the outstanding performance of the country offices. This increase was achieved in India, Nigeria and Ethiopia, which had already successfully accessed co-financing before.
As a partner of the association Bündnis Entwicklung Hilft (BEH), we received funds from this association for emergency aid and for reconstruction in Pakistan in 2010 for the first time.
Chances and Risks
Neither leprosy nor tuberculosis represent a health issue in Germany. Furthermore, the number of new leprosy cases worldwide was declining over many years; it has now levelled out at approximately 250,000 per year. Paradoxically, the success in the fight against leprosy today complicates the attempt to maintain people's attention on this particularly stigmatising disease and to maintain a certain level of knowledge about diagnosis and treatment.
This enhances the risk of a downward trend in the development of income from donations for the core mandates. Quality, innovation (disability, research) and the possibility of co-financing are thus becoming increasingly important criteria for the allocation of new project funds.
When it comes to co-financing, it is important to take into consideration that the predominant share of these third party funds come from the US Government. This carries the risk that these tasks cannot be implemented or carried out in the event of political changes. Authorised funds from global financing instruments such as the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) are only paid if the country - in this case Nigeria - achieves an overall positive evaluation in the implementation of all authorised funds. These are factors which DAHW cannot influence.
Outlook
Reconstruction after the flood catastrophe in Pakistan is one of our biggest challenges for 2011/2012.
For the first time, a strategic overall plan for the work in the following three years will be stipulated in 2011. We have planned roughly the same amount of project expenditure - excluding funds for the reconstruction of Pakistan - as in the last fiscal year 2010.
Based on our medium-term financial planning, we expect a balanced budget for 2011.
Operational key aspects in 2011
Leprosy
- extending surveys of contacts in order to find new patients as early as possible
- setting up referral centres in priority countries.
TB
- Filling gaps created by national health care systems to contain the spread of the disease
- Improving therapy adherence, also in patients with multi-drug resistant TB
People with disabilities/CBR
- Developing a concept for the sub-mandate disability
- New projects in 4-5 countries, also for general disability
Research
- Compiling a concept
- Academic advisory council, standardised forms, international networking
Last year, DAHW strengthened its profile as a competent and reputable medical-social relief association and it will continue this path in 2011. We are thankful for the trust our donors, volunteers and funding agencies and finally our patients put in us. To us, this trust is an incentive and an obligation.
Burkard Kömm, Chief Executive Officer
