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Together in the fight against TB and leprosy
Ann
ual r
epor
t 201
7
Pre
face
04
Wha
t doe
s D
amie
n Fo
unda
tion
do?
06
We
trea
t thr
ee d
isea
ses
07Th
ey a
re D
amie
n Fo
unda
tion
08
Look
ing
back
at 2
017
11
Med
ical
aid
14
Rai
sing
aw
aren
ess
and
info
rmin
g 18
Act
ive
scre
enin
g 22
Pho
to-r
epor
tage
Gui
nea
26Te
chni
cal a
nd fi
nanc
ial s
uppo
rt 3
0
Car
e af
ter c
ure
34Tr
aini
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8S
cien
tifi
c re
sear
ch 4
0A
net
wor
k of
vol
unte
ers
44M
ake
som
e no
ise!
46
Don
ator
s 48
Fina
ncia
l rep
ort 5
0N
umbe
r of p
atie
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52O
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ams
54G
loss
ary
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2
DAMIEN FOUNDATION
Damien Foundation is a non-governmental
organisation that provides medical and
social aid in sixteen countries. Since it was
founded in 1964, Damien Foundation has
made a difference in the fight against leprosy.
Tuberculosis was added to the list in the 1970s
and leishmaniasis in 1994 with projects in Latin
America. Pioneers such as Damien, Dr Frans
Hemerijckx, Dr Claire Vellut and Raoul Follereau
continue to inspire the day-to-day work of
Damien Foundation.
Damien Foundation, June 2018
You can find information on our 2017 projects in
this report and on our website:
actiondamien.be
2
DAMIEN FOUNDATION
© L
AYLA
AER
TS
Pre
face
04
Wha
t doe
s D
amie
n Fo
unda
tion
do?
06
We
trea
t thr
ee d
isea
ses
07Th
ey a
re D
amie
n Fo
unda
tion
08
Look
ing
back
at 2
017
11
Med
ical
aid
14
Rai
sing
aw
aren
ess
and
info
rmin
g 18
Act
ive
scre
enin
g 22
Pho
to-r
epor
tage
Gui
nea
26Te
chni
cal a
nd fi
nanc
ial s
uppo
rt 3
0
Car
e af
ter c
ure
34Tr
aini
ng 3
8S
cien
tifi
c re
sear
ch 4
0A
net
wor
k of
vol
unte
ers
44M
ake
som
e no
ise!
46
Don
ator
s 48
Fina
ncia
l rep
ort 5
0N
umbe
r of p
atie
nts
52O
ur te
ams
54G
loss
ary
56
54 5
DAMIEN FOUNDATIONPR
EFAC
E
Damien Foundation’s teams on the ground:
an enrichment for the future
Damien Foundation has, over the years,
accumulated a great deal of expertise in
the fight against leprosy and tuberculosis.
However, that would never have been pos-
sible without the commitment, insight and
professionalism of our teams on the ground.
From Dr Frans Hemerijckx, founder of the
‘the clinics under the trees’, to Dr Armand
Van Deun, founder and linchpin of the short-
course regimen for multidrug-resistant
tuberculosis*. Year after year, our staff
strive to find new and improved ways of
treating and curing those affected.
And, as you will read in this annual report,
our battle goes doggedly on. In 2017, leprosy
was still present in eleven of the sixteen
project countries. Thanks to the financial
support of the international community,
leprosy is in decline today. But the challeng-
es remain huge. And the number of patients
is still disquieting.
In 2017, we drew up a strategic plan for
2018-2027. A plan with ambitious objectives,
but with skilled staff these are certainly
attainable. Damien Foundation relies on its
human capital: on doctors, nurses, labo-
ratory technicians, logistics and financial
staff, drivers and directors, but also on its
volunteers and donors. Because all these
different profiles have one common goal:
providing high-quality services to all those
our campaigns are aimed at.
In the last few months I have been out in
the field where I was able to see for myself
the relevance and importance of our
activities. I met an incredible number of
people who dedicate themselves every day
to saving lives, despite the serious risk of
contamination from TB. All of them wished
for the same thing: more technical and
financial resources with which to help their
fellow citizens. We possess considerable
resources, but not yet enough. As a result,
we were forced in 2017 to suspend several
interventions, leaving thousands of people
without quality TB services. That’s painful,
very painful. But we are keeping our spirits
up. By searching for more efficient ways of
working and new funding sources, we will
be able to resume our activities again in
the future.
Every time I meet Belgian volunteers or
attend World Leprosy Day I realise how
fantastic and generous Belgians are,
54 5
DAMIEN FOUNDATIONFOREW
ORDANNUAL REPORT 2017
despite the difficult times they may be facing
themselves.
Everyone does their bit to help
Damien Foundation in their own way, but
always with the same enthusiasm. Jozef De
Veuster would be proud of the inspiration he
still provides to many.
Every patient we could not save. Every child
we were unable to prevent from becoming
disabled. We owe it to them to give 100% of
our effort. That’s why your help and commit-
ment are more essential to us than ever.
I thank you warmly and sincerely.
Alex Jaucot
Managing Director
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DAMIEN FOUNDATIONW
HAT
DOES
DAM
IEN
FOUN
DATI
ON D
O?
Medical aid p. 14
Scientific research p. 40
Raising awareness and informing p. 18
Technical and financial support p. 30
Care after cure p. 34
Active screening p. 22
Training p. 38
Damien Foundation is active in 16 countries.
What does Damien Foundation do? In 2017 Damien Foundation treated 214,016 persons affected
by leprosy, tuberculosis or leishmaniasis
How?
AfricaBurundiThe ComorosDR Congo Guinea
MozambiqueNigerNigeriaRwanda Senegal
AsiaBangladeshIndiaNepal
EuropeBelgium
Latin AmericaBoliviaGuatemalaNicaragua
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DAMIEN FOUNDATIONW
E TREAT THREE DISEASESANNUAL REPORT 2017
LeprosyInfectious disease that
is not fatal but can cause
severe deformity and
disability for life, such as
claw hand and foot drop.
Where? Predominantly in Asia
and Africa
Who? Populations in extreme
poverty are most at risk
Occurrence?1 diagnosis every
2 minutes
Treatment success
Fatality?Not fatal
TuberculosisDeadliest infectious
disease globally. Affects
the lungs primarily but
can also affect other
parts of the body such
as the spinal column
(Pott’s disease).
Where? In all parts of the world
Who? 25% of the global
population has latent
tuberculosis*
Occurrence?20 diagnoses per minute
Treatment success
Fatality?3 per minute
LeishmaniasisParasitic disease* caused
by the sting of an infect-
ed sand fly. There are 4
forms of leishmaniasis:
cutaneous and mucocu-
taneous (forms that we
treat), visceral and dermal
leishmaniasis.
Where? Present in one out of
every two countries
Who? More than a billion people
are at risk
Occurrence?2 diagnoses per minute
Treatment success
Fatality?3 per day
We treat three diseases
98 9
DAMIEN FOUNDATIONTH
EY A
RE D
AMIE
N FO
UNDA
TION
They are Damien Foundation
© A
RCHI
VES
DAMI
EN F
OUND
ATIO
N
A logistics worker in Guinea
who transports medicines to
the TB clinic. A leprosy surgeon
in India who gives a better future
to patients on his operating
table. A volunteer in Bolivia who
alerts people to the dangers of
leishmaniasis.
Each of them fights leprosy, TB
and leishmaniasis in their own
way. And every link in this chain
is equally essential. That’s why
we are giving all of these peo-
ple, Damien Foundation’s staff,
a prominent place in this annual
report. We want to thank them for
their hard work and show others
who the people working behind
the scenes are.
Together we are Damien Foundation.
98 9
DAMIEN FOUNDATIONTHEY ARE DAMIEN FOUNDATION
ANNUAL REPORT 2017
In numbers
members of staff
volunteers
local employeesexpats
femalemale
Globally,
Damien Foundation
counts:
consisting of:
>
© O
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© O
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© J
EAN
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TEAU
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DAMIEN FOUNDATIONTH
EY A
RE D
AMIE
N AC
TION
Joshnara Begum Project Director, Damien Foundation Mymensingh TB & Leprosy Control Project Bangladesh
Joshnara is the only female
project director working for
Damien Foundation today.
“I started working for Damien Foun-
dation in 1992 as a secretary. I was
18 years old and needed money to
support my family. I soon visited a hos-
pital for TB and leprosy patients. I saw
many very sick people. Staring into the
distance with a hopeless look in their
eyes. At that moment I knew what I
wanted to do with my life: help them.”
Thanks to her good work, dedication
and additional training, Joshnara
became the first female project
director in 2014. © Rifat H
asan D
ipro
We work almost exclusively with local personnel.
We employ only8 expats worldwide.
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DAMIEN FOUNDATIONLOOKING BACK AT 2017
ANNUAL REPORT 2017
Looking back at 2017 Since september 2017,
Damien Foundation officially has two new project countries: Senegal and
Nepal. Two countries where we will also
be combating leprosy and tuberculosis
from now on.
NepalNepal has more than 28 million inhabit-
ants, with 42% of them under 18 years
old. Almost 30% of the population lives
below the poverty line. The country’s
geography forms another challenge.
Remote areas, hard-to-reach health
centres, a lag in development... the ideal
breeding ground for diseases such as
leprosy and tuberculosis.
In 2016, 34,000 people were diagnosed
with TB in Nepal. For leprosy, there were
3000 diagnoses. However, this is merely
the tip of the iceberg.
Since 2017, Damien Foundation has
focused on 25 districts in the centre and
far west of the country and, in doing so,
reaches over 3 million people.
© J
EAN
PLAT
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DAMIEN FOUNDATIONLO
OKIN
G BA
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17
SenegalOf the 15.4 million people in this country, 40% live
below the poverty line. Furthermore, the govern-
ment budget for healthcare is a mere 8%, well
below the suggested 15%.
Senegal has 14 regions, but we found the need to
be greatest in Dakar, Diourbel, Kaolack and Thiès.
In 2016, Dakar and Thiès were home to 60% of
the people affected by multidrug-resistant tuber-
culosis (MDR-TB)*. According to the WHO*, Senegal
has 20,000 TB patients. Prior to our intervention,
the country detected 66% of this estimated number
of patients. We hope to see this figure increase.
In the case of leprosy, providing high-quality care
continues to be challenging. In 20141, only 59%
of those affected by the infectious form, multi-
bacillary leprosy*, completed their treatment. A
troubling figure, especially given the knowledge
that treatment ensures recovery and prevents
the patient from developing lifelong disfigurement.
10% of those affected are children, which indicates
active infection.
Damien Foundation wants to improve access to
high-quality healthcare for the whole population.
How? Through efficient early detection and by
providing high-quality services.
[1] We took cohort* data of 2014 into account for this because the method used for the calculation of the 2015 cohort indicator is not reliable enough. We are currently working on improving the data for leprosy in Senegal, together with the National Lep-rosy Programme (PNEL) and other ILEP partner members.
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DAMIEN FOUNDATIONRUBRIEK
ANNUAL REPORT 2017
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BAC
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DAMIEN FOUNDATIONME
DICA
L AI
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© L
AYLA
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[photo above] Makhissa developed MDR-TB when she was only 8 months old. It was her grandmother, Salimatou, who took care of her.
Medical aid healing hands
Doctors, surgeons, nurses, physiotherapists and other
medical staff make every effort to cure patients.
Diagnosis and treatment Employees screen patients, diagnose conditions, initiate
treatment and monitor progress. The intake of medi-
cation is monitored by medical staff, but also often by
volunteers and family members. In 2017, DOTS workers*
also provided monitoring of the treatment of TB patients.
• In 2017,
Damien Foundation
traced and treated
16,500 leprosy patients,
192,255 TB patients
and 5261 leishmaniasis
patients in the project
countries. In addition,
2456 persons with
multidrug-resistant TB
(MDR-TB)* began their
treatment.
• Bolivia is the first pro-
ject country where all
3 diseases were traced
and treated in 2017.
• In Maradi, Niger, one of
the two regions where
Damien Foundation is
active, the proposed
objective was achieved:
86% of the TB patients
recovered.
• Damien Foundation
detected 17,455
TB patients in
Mozambique in 2017.
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DAMIEN FOUNDATIONRUBRIEK
ANNUAL REPORT 2017
© L
AYLA
AER
TS
GuineaCLOSE-UP
Makhissa was 8 months old when she developed multidrug-resistant TB. She was infected by her mother, Maimouna, who died of the disease a few months later. She had no father either, as he had died in a motorbike accident. It was Makhissa’s grandmother, Salimatou, who brought her up from then on. The young girl was one of the first peo-ple in Guinea who received the short-course regimen for MDR-TB. She stayed in hospi-tal for the first four months as she received an injec-tion every day. Makhissa’s grandmother did not leave her side for a minute. In April 2017, Makhissa finally took her last dose of medicine. Her treatment was complete. Today, Makhissa is a happy little girl who likes nothing better than playing.
1716 17
DAMIEN FOUNDATIONME
DICA
L AI
D
© LAYLA AERTS
Jacob Camara, 33is a logistics worker with
Damien Foundation in Guinea.
Once a month, he and his col-
league Francis go to the market
where they purchase food for
TB patients. They distribute this
at the Tombolia health centre
in Conakry.
“During the course of their treat-
ment, every patient receives rice,
oil and smoked fish every month.
In 2017, 69 patients received these
food parcels.”
Nutritional supportTB medicines are very harsh. Patients
must eat well to ensure their body can
handle the medication. Damien Foundation
therefore provides nutritional support for
the most vulnerable TB patients in the
project countries. These are often
malnourished and poor patients,
MDR-TB patients or patients who also
suffer from HIV or diabetes. This enables
them to obtain sufficient nutrition during
their treatment.
TB patients received nutritional support in 2017 in India
Leprosy surgery*
Damien Foundation also employs a number
of leprosy surgeons. They perform surgical
interventions on leprosy patients when
necessary.
TB patients in Guatemala were provided with this help
patients in Bolivia were given food parcels
• In India, 7 leprosy surgeons were
employed in 2017. Together they
performed 449 operations.
• In the Democratic Republic of Congo
(DRC), 72 operations were performed in
leprosy patients.
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DAMIEN FOUNDATIONMEDICAL AID
ANNUAL REPORT 2017
India CLOSE UP
Vani was 15 when she was diagnosed with
leprosy. She completed her treatment but
still developed a claw hand. Going to school
was no longer an option: she couldn’t hold
a pen. She went to a Damien Foundation
leprosy centre in Karnataka, Southern India,
where she underwent corrective surgery.
Her claw fingers were reset. She returned to
school in 2018.
Mobile clinics Many patients live in remote places. Access
to healthcare is not always a straightfor-
ward matter for them. Previously, mobile
clinics were used in various countries. This
enabled even those in the most remote
regions to receive care. In 2017, this form
is no longer prevalent in all countries.
The only genuinely mobile clinics active
now are in Nigeria. In other countries our
workers use a number of different means
to get to remote areas.
• In DRC, mini-campaigns to trace leprosy
are held. 625 leprosy patients were treat-
ed in this way in 2017.
• Damien Foundation also holds
mini-detection campaigns for leprosy in
Sofala, Mozambique. In the past year, they
found 100 new patients in comparison to
80 prior to the start of the campaigns.
• In the Comoros, Damien Foundation uses
a mobile X-ray for dermatological and
respiratory consultations in villages. They
also deploy mobile pharmacies which
distribute vitamins and medication in
order to counteract the side effects of the
medicines.
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DAMIEN FOUNDATIONRA
ISIN
G AW
AREN
ESS
AND
INFO
RMIN
G
Raising awareness & informing from village to village
Leprosy and TB are centuries-old diseases, but still
unfamiliar to a great many people. Not only does this
create a stigma, people also often don’t know that
they can recover, or how.
This is why Damien Foundation invests in raising awareness among and informing the populationPersons affected by leprosy and TB are excluded in
many countries. They lose their jobs and income and are
shunned by their families. This often means that once
cured, they are unable to escape the poverty spiral.
This is why we always invest in raising awareness
among and informing the population. How is the dis-
ease transmitted? What are the symptoms? What can
you do to recover? Where can you get a diagnosis and
treatment? We dispel misconceptions and prejudices.
And vulnerable groups learn to identify the diseases
and deal with them. In this way, people with symptoms
know where and how to find treatment. And in doing so, even people who are not ill can play a role in detecting and curing those affected. Medical staff
must also be properly informed. Not only to diagnose
and treat the patients, but they must also ensure
that the disease is brought under control so that new
infections are kept to a minimum. © T
IM D
IRVE
N
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DAMIEN FOUNDATIONRAISING AW
ARENESS AND INFORMINGANNUAL REPORT 2017
• In Rwanda,
Damien Foundation
ran 8 campaigns in
2017 around active
screening*, each
time preceded by
awareness-raising
activities around
the symptoms
of leprosy.
• Our teams in
Mozambique
detect most of
the TB patients in
Tete and Sofala.
They also treat
them and pro-
vide follow-up by
raising awareness
amongst their
families and teach-
ing them precau-
tionary measures.
• In Nicaragua in
2017, 8 recovered
persons were
employed in advis-
ing people on the
dangers of TB and
leishmaniasis.
“In Burundi, Damien Foundation reached agreements with
three radio broadcasters in Bujumbura, and two in the provinc-
es of Rumonge and Ngozi. A range of radio advertisements and
broadcasts were used to inform and raise awareness of leprosy
and TB among listeners.”
Dr Michel Sawadogo
Damien Foundation representative in Burundi
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DAMIEN FOUNDATIONRU
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“I want people with leprosy to smile again and feel important. It’s the only way to get rid of the stigma around the disease.” - Dr Sushil Koirala
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DAMIEN FOUNDATIONRAISING AW
ARENESS AND INFORMINGANNUAL REPORT 2017
© ROOS PAUWELS
© RAJESH
GURU
NG
Dr Sushil Koirala, ‘The Rose Doctor’ - Damien Foundation representative in Nepal
Dr Sushil tries to raise awareness among
people in a very special way. He hands ros-
es out to people affected by leprosy.
Her has already given out more than
25,000 roses, in all the colours of
the rainbow.
Aminat raises awareness amongst the people in Ibadan, Nigeria about the dangers of TB.
Aminat is a voluntary health worker. She
travels around areas of the city to trace
people with TB, but also to advise them
about the disease.
“I feel responsible and want everyone to
be well. I want to help fight the disease as
absolutely anyone can become infected.”
It was Aminat who traced Aïshat, a six-
year-old girl with TB. In doing so, she saved
her life.
“I tell parents that they must teach their
children to cover their noses if they see
someone coughing, or they might become
infected themselves.”
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DAMIEN FOUNDATIONAC
TIVE
SCR
EENI
NG
Active screening the women and men who track down the disease
A fast detection of the diseases reduces the risk
of catastrophic consequences. In the case of
leprosy, active screening has two goals: prevent-
ing lifelong disfigurement and breaking the chain
of infection. How do our teams do this? By initiat-
ing preventive treatments and monitoring people
living in close contact with leprosy patients.
Active screening of TB increases the chanc-
es of full recovery and reduces the risk of new
infections.
The search for patientsVolunteers, cured people and paid health workers
from Damien Foundation go from village to
village in the project countries. They each have
a different profile but the same common goal:
finding those affected. This is why they examine
people who live near to new patients and present
suspicious symptoms.
Mobile app as a resourceOpen Data Kit (ODK) is a free mobile application
that makes this active screening easier.
The app makes it possible to register
newly-traced patients and use that data
to map out endemic zones.
More than
people are diagnosed with leprosy every day
of them live in India
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DAMIEN FOUNDATIONACTIVE SCREENING
ANNUAL REPORT 2017
• Through active screen-
ing, Damien Foundation
detects 30% more
patients per year on
the Comoros.
• In Mozambique,
Damien Foundation
employs more than 360
volunteers. A number
of them are involved
in advising and raising
awareness among the
population.
• In Bangladesh, the num-
ber of active screening
campaigns for leprosy
was increased last year.
The result? 171 more
new leprosy patients
were traced, com-
pared to 2016.
• In 2017,
Damien Foundation
detected almost half
of all TB patients in
Nicaragua. In figures:
2,403 persons were
diagnosed with TB on
a national level, with
Damien Foundation
diagnosing 1,001 and
successfully treating
827 patients.
More than
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DAMIEN FOUNDATIONAC
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The Comoros CLOSE-UP
In the Comoros, our teams treat on
average 300 new leprosy patients
a year. In 2017 however, this num-
ber reached 429. Why?
Dr Younoussa Assoumani, repre-
sentative of Damien Foundation on
the Comoros, explains:
“We are detecting more and more
patients using this active screen-
ing. It’s a very important strategy,
especially as 1 patient in 3 is a child.
In 2017, 164 patients were children.
Another advantage is the preven-
tion of lifelong disability. Out of
the 429 traced persons, only 8 had
grade 2, or visible, disability.”
Akram Abdallah Baco, health worker on the Comoros, explains
how ODK works:
“I geolocalise the patient’s house.
The app automatically inputs the
GPS data. I then complete a ques-
tionnaire indicating the head of the
household and how many people
live there. We also insert a photo of
the ‘index case*’.”
Dr Epco Hasker has worked as an epidemiol-
ogist for Damien Foundation at the Institute
of Tropical Medicine (ITM) in Antwerp since
May 2017. There he performs research into
leishmaniasis, leprosy and sleeping sickness.
Together with an Indian colleague, he wrote
the manual for the use of ODK in the active
screening of patients. We asked him how this
application works:
“The principle is simple: you visit the patients
and screen people in their environment. You
input the results in the app, which also regis-
ters your geographical coordinates. You then
project this data onto a map or Google Earth.
This gives you a good idea of where to find
clusters of patients, which you can then use to
decide the extent to which you need to broad-
en any measures like screening and preventive
treatment.”
Following a successful pilot on the Comoros,
the application was first used to actively trace
patients in Conakry, Guinea in September
2017. Dr Nimer Ortuño Gutierrez, medi-
cal advisor to Damien Foundation, trained
the staff of Action Damien Guinée and their
partner, Programme National de la Lutte
contre la Tuberculose (PNLAT), in its use.
Volunteers also took part in this training.
© S
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DAMIEN FOUNDATIONACTIVE SCREENING
ANNUAL REPORT 2017
[photo above] Ibrahim Camara gives advice to a patient in Tombolia, a health centre in Conakry, Guinea.
[photo under] With a questionnaire and mobile phone in his hand, Akram Abdallah Baco (red t-shirt) heads to a family of which the oldest son was diagnosed with leprosy on the Comoros.
GuineaCLOSE-UP
Ibrahim Camara, 46, is a
volunteer in Tombolia, a
district of Conakry. He was
also trained in the use of
ODK in September 2017:
“I know everyone in the
neighbourhood. If someone
coughs or shows other
symptoms of TB, I take a
sputum sample to the lab.
If that person is shown
to be sick, I enter their
details in ODK. Then I use
another free app, Quan-
tum Geographic Informa-
tion System (QGIS). This
enables me to establish
endemic zones.”
These two applica-
tions should ultimately
bring about a reduction
in the number of new
infections.
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DAMIEN FOUNDATIONRU
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The many faces of tuberculosisguinea - project country since 2007photos by layla aerts
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DAMIEN FOUNDATION ANNUAL REPORT 2017
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DAMIEN FOUNDATION
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DAMIEN FOUNDATIONRUBRIEK
ANNUAL REPORT 2017
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DAMIEN FOUNDATIONTE
CHNI
CAL
AND
FINA
NCIA
L RE
PORT
Technical and financial support helping from A to Z
• Damien Foundation
helped the MDR-TB
programme in Gabon,
a country in which we
are not active, buying
second line drugs.
• Damien Foundation
Bangladesh provided
technical support in
the implementation
of the short-course
regimen for MDR-TB*
in Pakistan, Indone-sia and Myanmar, 3
countries in which we
are not active.
• And Action Damien
Niger helped the
Programme National de la Lutte contre la Tuberculose (PNLT)
in drafting guidelines
for the care of MDR-
TB patients.
Where required, we offer technical and financial support to
project countries. Sometimes even after having left a country.
Technical support Damien Foundation staff can also act as advisors for local staff.
They supervise and provide consultancy for example. On what?
Diagnoses, various therapies and treatment programmes,
treating complications etc. They also help to write strategic
plans and develop guidelines for leprosy, leishmaniasis and TB
control programmes, in consultation with national authorities.
There are also two medical advisors working in our Brussels
headquarters. In the past year they have visited such coun-
tries as Bolivia, the Comoros, DRC, India and Rwanda. They
observed, provided training, acted as an external eye, gave
advice and worked on new programme guidelines and other
documents with local teams.
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DAMIEN FOUNDATIONRUBRIEK
ANNUAL REPORT 2017
Financial supportDamien Foundation provides funding for the var-
ious programmes. This may be by paying salaries
or fees of medical staff not employed directly by
Damien Foundation. We also finance activities or
campaigns not run by Damien Foundation but by local
NGOs, for example.
Furthermore, we provide funding for the purchase
of off-road vehicles and motorbikes, medical and
laboratory materials*, medicines, air conditioners for
medicine storage facilities, etc.
• For instance, in 2017 major
active screening campaigns*
for leprosy took place in three
Indian states. The organiser
was the National Leprosy Eradication Programme.
Damien Foundation India
Trust supported this screen-
ing campaign financially.
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DAMIEN FOUNDATIONTE
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CAL
AND
FINA
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PPOR
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© AURORE GI
LSON
New health centresFinancial support is also provided for the reno-
vation and construction of various buildings in
the project countries. In the last year we have reno-
vated a new centre for the diagnosis and treatment
of TB patients in Boké, Guinea
Distributing materials We also distribute materials where necessary,
such as medicines and laboratory equipment.
Project BelgiumIn 2015, we started a project for homeless TB
patients in Brussels. We are supporting
BELTA-TBnet* (umbrella organisation of VRGT
and FARES) who provide free treatment for all
TB patients in Belgium. Damien Foundation sup-
ports this programme by providing accommo-
dation for patients throughout their treatment,
distributing social cheques with which to buy
food and clothing and paying for transportation
to and from hospital.
• The first and only centre in Nigeria for the treat-
ment of persons with extensively drug-resistant
tuberculosis* (XDR-TB) was built this year. The
first centre for reconstructive surgery* for lep-
rosy patients was also built.
• Guatemala saw a new tuberculosis centre being
established in Escuintla, the region with the
highest incidence* of TB patients in the country.
• Damien Foundation Nepal aims to build two new
centres for MDR-TB and one for leprosy in 2018.
“Aid is not only needed during
emergencies. Support is also required afterwards. And
Damien Foundation is strong in that area.
However, logistical support continues to be challenging in the
DRC. It’s a very big country and therefore we have to cover vast
distances. ”
Luc Malingreau logistical worker with
Damien Foundation in the Democratic Republic of Congo
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DAMIEN FOUNDATIONRUBRIEK
ANNUAL REPORT 2017
© IS
ADOR
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DAMIEN FOUNDATIONCA
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CUR
E
Care after cure
[photo] Lagos, Nigeria - August 2017: 89 children of leprosy patients received new school equipment.
Our help does not end when a
person is cured from the dis-
ease. Our vision is broader.
Patients are often shunned
during their illness and
stigmatised. Many lose their
jobs, income and families.
Some are not even allowed to
send their children to school.
These people continue to live
in poverty and uncertainty
even after recovery. This is
why Damien Foundation is
investing in Care After cure*,
to give recovered patients and
their families their dignity and
autonomy back.
Looking to the futureIt’s often not just the patient
that suffers, but their
whole family. That’s why
Damien Foundation enabled
200 children of affected per-
sons to go to school in 2017.
We also make sure patients and
recovered persons are able to
develop independently in an
economic sense. We give them
training, material with which to
start a business, some goats
or chickens, etc. We want them
to be able to look after them-
selves and their families after
recovery. Sometimes we will
also support a person in their
immediate environment.
Wound care and self-care* Damien Foundation treats
the wounds of patients and
teaches them self-care. If
leprosy is not traced and
treated in time, there is a
strong chance that the patient
will develop disfigurements
or injuries. For example, feet
and hands become numb
and patients are not able
to notice when they step
on sharp objects which can
cause wounds.
3534 35
DAMIEN FOUNDATIONCARE AFTER CURE
ANNUAL REPORT 2017
• In India, we renovated
and built 33 new homes
for leprosy patients.
• 18 houses were built in
Guatemala.
• In Rwanda, 401 per-
sons and their families
were signed up to a
health service.
• And in Burundi, 180 leprosy patients and
their families received
clothing, food, soap and
school materials.
• In Bangladesh 1,986 leprosy patients took
part in self-care in 2017.
2,094 pairs of leprosy
shoes were distributed.
• In Rwanda, 74 patients
received vaseline and
chloramine to help care
for wounds. 47 people
were given leprosy
shoes and one cou-
ple was each given a
pair of crutches when
they both had one leg
amputated.
© A
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DAMIEN FOUNDATIONCA
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E
Live from Nicaragua: Dr Toon Bongaerts
If we could describe Dr
Toon Bongaerts with one
word it would be ‘com-
mitted’. Toon has worked
for Damien Foundation in
Nicaragua since 2002. He
has fought on behalf of
the most vulnerable peo-
ple there for 16 years.
“I am responsible for
the coordination of the
projects in Latin America,
but I’m also very active on
the ground in Nicaragua. I
coordinate training courses
for staff, deal with patients
with complications, and
together with their families
work out how to gear our
support to their needs.”
This urge to safeguard
the welfare of others
has ultimately led to
the founding of the NGO
Prosalud. As a Nicara-
guan NGO and partner
of Damien Foundation,
Prosalud monitors
the proper assimilation
and continuity of health
programmes by various
NGOs in the country.
Toon arrived in Nicaragua
in 1984 and has seen a
number of changes since
then. First and foremost,
politically: the decen-
tralisation of healthcare
opened up new possibil-
ities for people like him
who dedicated their lives
to this care. There was
also a significant shift
in mentality, though:
numerous people started
volunteering to promote
access to healthcare in
villages and raising aware-
ness among others. Some
people who had recovered
from TB even became
genuine activists. These
days they tell people of
their road to recovery and
encourage others to seek
help too. They give hope
and encourage patients to
complete their treatment.
“The support of Damien
Foundation is increasingly
focused on the social,
psychological and
economic aspects.
The most vulnerable
patients get support from
A to Z. We hand out food
parcels, help put people on
a path to financial secu-
rity and so on. The result?
Greater self-confidence,
which in turn brings higher
recovery rates. Damien
Foundation makes sure
that patients can reclaim
their positions in society.”
© J
EAN
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[photo] A stove with volcanic bricks was given to a family in Nicaragua to avoid their house from filling up with polluted smoke.
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DAMIEN FOUNDATIONCARE AFTER CURE
ANNUAL REPORT 2017
Bernardina, 41, from
Chichigalpa in north-west
Nicaragua, is one of them:
• After six months of
treatment, Bernardina
was declared cured
in August 2017. But in
order to support her
economically, she was given a bike by Damien Foundation and stocks of pastries, which she sold in her community. Bernardina used the
proceeds to buy 2 pigs and 42 chickens.
However, Toon goes a
step further. He looks at
the specific needs of each
individual and tries to fulfil
them as well as possible:
“I noticed that some houses
in Nicaragua were often
full of smoke from cook-
ing. Children and babies
were playing in houses and
breathing that polluted air
all day long. We developed
a new kind of stove made
from volcanic bricks.” • 467 people in Nicaragua were given post-treatment
care thanks to a Care after cure project
• In 2017, Damien Foundation provided additional
support after recovery to 481 people in Guatemala,
564 in Rwanda and 1,188 in Burundi.
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DAMIEN FOUNDATIONTR
AINI
NG
We encourage training… This is how we enable over 1,000 colleagues around
the world to provide the best services to people
affected by leprosy and TB. We train volunteers to
identify leprosy, TB and leishmaniasis and detect it in
their communities. But we also make sure that labo-
ratory workers can identify the diseases under their
microscopes. We train medical staff so that they rec-
ognise clinical symptoms. And we ensure that their
knowledge and skills are kept up-to-date regarding
new developments and requirements in their fields.
• In Senegal, 76 warehouse
workers were trained in
managing and storing TB
medicines.
• Representatives of
Damien Foundation Nigeria went to Bangladesh in 2017,
where they received training
on the short-course regimen
for MDR-TB* from colleagues
from Damien Foundation
Bangladesh.
• Action Damien Burundi
trained 90 carers in active
screening.
© T
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DAMIEN FOUNDATIONTRAINING
ANNUAL REPORT 2017
but also knowledge -sharing We encourage our staff to share their
knowledge with colleagues in other
countries.
On 29 and 30 May 2017, we welcomed in
Brussels representatives and medical
advisors from Bangladesh, Burundi, DRC,
Guinea, India, Niger, Nigeria and Nicaragua
for a two-day workshop. The programme
included the quality of healthcare and
intervention strategies for MDR-TB and
XDR-TB* in the project countries.
International conferences In 2017, Damien Foundation took part in
various international medical congresses:
• 10th European Congress on Tropical Medicine and International Health (ECTMIH) October 2017 | Antwerp
• World Leishmaniasis Congress May 2017 |Toledo, Spain
• The 48th Union World Conference on Lung Health October 2017 | Guadalajara, Mexico
© L
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DAMIEN FOUNDATIONSC
IENT
IFIC
RES
EARC
H
We invest in scientific research
Of course, competent staff are
essential to fighting leprosy, TB
and leishmaniasis. But we also
need good tools and technolo-
gies for high-quality screening
and treatment. For this reason,
Damien Foundation places a great
deal of importance on operational
research.
GeneXpert*: 90 minutes to trace multidrug-resistant tuberculosis* (MDR-TB) In 2010, the WHO* approved
GeneXpert for the diagnosis of
MDR-TB. In 90 minutes, this tool
uses molecular biology to detect
resistance to rifampicin, one of
the most important medicines for
TB. Damien Foundation encour-
ages the use of this machine in all
project countries.
• In 2017 the GeneXpert
was introduced in
Senegal and Bolivia.
[photo] Thanks to the GeneXpert technology, TB is diagnosed 90% faster in Bolivia.
© N
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[photo] Dr Nimer Ortuñu Gutierrez visits a lab in Thiès after the start of our new project in Senegal.
4140 41
DAMIEN FOUNDATIONSCIENTIFIC RESEARCH
ANNUAL REPORT 2017
Cochabamba, BoliviaCLOSE-UP
The third most affected region by
TB in Bolivia.
Dr Nimer Ortuño Gutierrez,medical advisor at
Damien Foundation:
“In Cochabamba 1,500 people are
diagnosed with TB every year. 1%
of those are found to suffer from
MDR-TB, which is a very low number.
There’s a reason for that: the test
for detecting MDR-TB is in La Paz, a
six-hour drive from Cochabamba.
That’s why it took 100 days to trace
MDR-TB in the region! It’s quicker
with GeneXpert, and now MDR-TB is
traced in 9 days.”
The short-course regimen for MDR-TB: implemented in more and more project countries Dr Armand Van Deun, working at the time for
Damien Foundation, was at the basis of the short-
course regimen for MDR-TB. This therapy is much
shorter, cheaper, more efficient and has fewer side
effects than the old treatment. The recovery rate is
also more than 84%, whereas for the old treatment
it was only 54%. The WHO has been recommending
the short-course regimen since May 2016. Since
then, 35 countries have implemented this treatment.
Niger had already implemented the short-course
regimen for MDR-TB in 2008. Nine years on,
the recovery rate is a spectacular 88%.
More and more project countries are starting to
use the short-course regimen. This is partly due
to Dr Alberto Piubello, medical advisor to Action
Damien Niger and consultant at The Union*. He gave
training courses in 2017 on the implementation of
the short-course regimen to our colleagues in Nepal
and Nigeria.
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4342 43
DAMIEN FOUNDATIONRU
BRIE
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© A
LEX
JAUC
OT
[photo] Attahé, 60 years, became a volontary microscopist after having followed one of Damien Foundation’s trainings in Maradi, Niger. Twice a year he receives a premium with which he can meet the needs of his family.
4342 43
DAMIEN FOUNDATIONSCIENTIFIC RESEARCH
ANNUAL REPORT 2017
Research funded by Damien Foundation
Completed in 2017
• The study into an alternative protocol for the treatment and monitoring of susceptible and multidrug-resistant tuberculosis | In collaboration with the Institute of Tropical Medicine, Antwerp (ITM).
Started in 2017
• Better understanding of the high incidence of leprosy
on the Comoros, despite the efficient battle fought
there | ITM
• The importance of initial resistance to isoniazid to the
results of a standard treatment for tuberculosis and
the tracing of this through molecular tests (line-probe
assays) | ITM
• Real-time confirmation by PCR* of the presence of the
mycobacterium leprae to simplify the diagnosis of lep-
rosy in endemic countries | ITM and Fiocruz (research
centre in Brazil)
• Tendency towards resistance to fluoroquinolones in
persons with MDR-TB at Damien Foundation Bang-
ladesh | ITM
• Tendency towards resistance to fluoroquinolones in
new TB patients and an increased resistance towards
other TB medicines | ITM
• The treatment has
been progressively
implemented in multiple
regions of the
DRC over the past year.
Nigeria, Nepal and Senegal also started
using the
short-course
regimen in 2017.
• In Guinea, we treated
165 MDR-TB patients
with the short-course
regimen in the past
year. A record!
• Dr Bassirou, rep-
resentative of
Damien Foundation in
Niger, treated 22 more
people with MDR-TB in
the past year than was
budgeted for. In total, 72
patients with MDR-TB
started their treatment
in Niger in 2017.
Their names are Michel,
Jessica, Françoise,
Myriam, Bart or Marie-
Jeanne. They live
in Louvain, Mortsel,
Namur or Mons. They
are students, teachers,
pensioners or simply
touched by the many
stories. There is no
such thing as the
‘typical volunteer’.
But they do all have
one common goal:
mobilising Belgium.
4544 45
DAMIEN FOUNDATIONAN
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ENSI
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OLUN
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K
Thousands gave their time on 27, 28 and 29 January 2017. They walked the streets, gathered
in front of supermarkets and sold pens in
shopping centres. From Diksmuide to Virton and
from Kortrijk to Welkenraedt. Our volunteers
acted as spokespersons for everyone affected by
leprosy and TB.
Damien Foundation is also an extensive volunteer network
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DAMIEN FOUNDATIONAN EXTENSIVE VOLUNTEER NETW
ORKANNUAL REPORT 2017
For Jessica, who is a teacher at a college in Binche, a great deal of organisation precedes the campaign weekend. From her headquarters, prettily clad in the Damien Foundation colours, Jessica organises her teams.
“I make a list of the shops
we can sell in and split my
students up into pairs,
each doing a three-hour
shift. They are so keen to
do this they even ask for
second shifts. Sometimes
I have to ring around all
the bakeries to ask if we
can still sell in front of
their shops.”
Why did you become a volunteer with Damien Foundation?
“I was moved by the work
of Damien ever since I was
a kid. As an adult, I helped
the college in Binche with
their annual marker sale.
So when I was asked to
take the organisation of
this event upon me, I didn’t
hesitate. Afterwards, I
went on a trip to India with
Damien Foundation. An
experience that marked
me as a person and
motivated me to become a
volunteer.”
Johnny Ronaldo, 83 years old, has long been a volunteer for Damien Foundation in Muizen. In 2017, he organised the renowned door-to-door collection in the town for the 49th time.
“We started the collection
campaign in Muizen
together with Frans
Schroons and the mayor at
the time in 1968. Frans was
the first person in Muizen
with a computer, so he
took on the administrative
tasks for all those
years. I took care of
the practical side.”
Why did you set out on this adventure in 1968?
“I’ve always admired
Damien. But I used to
think there was no cure
for leprosy. When I got to
know Damien Foundation,
I found out that there
actually are medicines
available. I decided then
to tread in Damien’s
footsteps and help leprosy
patients.”
Ready for the 50th edition in 2018?
“Yes, but I’m afraid 2018
may be my last year of
campaigning... my health
takes priority. And I had to
promise my wife (laughs).”
© LEO DE NIJN
4746 47
DAMIEN FOUNDATIONMA
KE S
OME
NOIS
E
In the media It was Sophie Pen-
deville, godmother of
the francophone side of
Damien Foundation in 2017,
who gave the start signal for
the campaign on the Munt-
plein in Brussels on 27
January 2017. The campaign
was given plenty of media
attention on both French and
Dutch speaking sides.
Our campaign was also a
social media success
under the hashtags
#maaklawaai and #faisonsdubruit. With
various YouTube and
Facebook videos, famous
faces like Marc Hermans and
Fred Janin supported us by
literally making noise. Alex
Germys, one of Belgium’s
newest electropop sensa-
tions, used the sound of a
rattle to create a new beat.
We used the song in our TV
adverts. Every time the ad
appeared on TV, viewers
could ‘Shazam’ the music and
download it for free.
Make some noise!2017 campaign
During medieval times, leprosy patients would
warn of their approach with bells or rattles.
Luckily, those days are over. But in 2017
Damien Foundation decided to make noise once
more to show the fight against leprosy and TB is
not yet over. We rattled against the indifference
towards the diseases that is still prevalent today.
But we didn’t have to make all that noise by
ourselves. We were able to count on numerous
schools and famous faces to help us rattle!
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DAMIEN FOUNDATIONMAKE SOME NOISE
ANNUAL REPORT 2017
In school We create educational mate-
rial every year in order to alert
young people to the importance
of access to healthcare. This
year, India was our campaign
country and we created two
films: “Abishek’s Day” (1st to 3rd
years) and “Sujeet and Nishu”
(4th year to 2nd secondary year).
In them, youngsters aged 10,
15 and 16 are confronted with
leprosy or tuberculosis. “Sujeet
and Nishu” was also broadcast
on television a number of times.
24 March: World TB Day Again in 2017, we held a cam-
paign against tuberculosis on
World Tuberculosis Day. Togeth-
er with the advertising agency
The Manifest, we developed
three Boomerang cards to raise
awareness among the Belgian
population. In total, 125,000
cards were given away in bars,
restaurants, cinemas etc.
throughout the country.
In numbers
10,000
607
€ 7,121
€ 15,626
€ 10,298
students let their rattles be heard at the start of the campaign
= the number of primary and secondary schools where Damien Foundation organised activities
collected by 120 volunteers at the Dour and Espreranzah! festivals
collected by 100 sellers at the entrances to various football and basketball stadiums in Flanders, Wallonia and Brussels
was collected at three concerts by Gospel for life in Liege, Maredsous and Leuze-en-Hainaut
4948 49
DAMIEN FOUNDATIONDO
NATO
RS
Donations In total, 15,951 donations of € 50 were made.
If you know us, you’ll know that that saves
15,951 lives.
Just like the volunteers, our donors come in all
shapes and sizes. For example, the 11-year-old Sarah decided to give her New Year’s money to
Damien Foundation.
“We had a school visit from someone from
Damien Foundation who gave us a presenta-
tion about leprosy. It was awful to hear the
stories and see the pictures. I decided then
to give the € 50 I received for the New Year to
Damien Foundation. In that way I could save a
human life.”
Schools Schools play a significant role in the running
of Damien Foundation. Time and time again,
they help by raising funds and setting up new
activities. In the past year, schools and their
staff on the committees raised € 1,466,588 for Damien Foundation.
Legacies39 persons included Damien Foundation in
their wills in 2017. This amounted to
€ 4,735,166. They all decided to keep on
fighting leprosy and TB even after they are no
longer with us.
Businesses In recent years we have entered into struc-
tural partnerships with a number of compa-
nies. In 2017 they gave a total of € 79,621 to
Damien Foundation.
Of course, Damien Foundation
would be nothing without the many
donors in Belgium who all help in
their own way to rid the world of TB
and leprosy.
Any financial help is a step in
the right direction. We consider
every gift to be extremely impor-
tant, whether large or small.
112,602 donations were made in
the past year, making a total of
€ 4,280,955. The highlight was
around our campaign weekend.
A total of € 1,028,916 was trans-
ferred between 20 January and
20 February.
Donorsin all shapes and sizes
4948 49
DAMIEN FOUNDATIONDONATORS
ANNUAL REPORT 2017
Business debate on Corporate Social Responsibility (CSR)CLOSE UP
On the
Damien Foundation
Day, 18 November 2017,
these major partners
were invited for a round
table talk with VRT jour-
nalist Ivan De Vadder.
Jo Benoît (Clovis Oncology), Dirk Vercruysse (D/M Vercruysse Interieu-rarchitecten), Jean-Noël Tilman (Tilman nv) and Bert Bogaerts (Avery Denisson) talked
about the importance of
Corporate Social
Responsibility, and why
Damien Foundation
was a perfect fit
for them.
“Social engagement
is currently a popular
phrase in the industry.
Business is about hard
figures and turning a
profit every year. But
there’s so much more
than that. Industry is
investing more and
more in social engage-
ment. They are trying to
motivate people to do
more than just their day-
to-day job.”
Bert Bogaerts, Avery Denisson
“I’m impressed by
the logistics, the way
of working, the way
everything is managed,
the way budgets are
handled. […] That’s one
of the reasons we chose
Damien Foundation.”
Dirk Vercruysse, D/M Vercruysse
Interieurarchitecten
“Damien Foundation is
Belgian. That
in itself is a good
reason to choose
Damien Foundation.
It’s the NGO in Belgium
that appeals most to the
imagination.”
Jean-Noël Tilman, Tilman nv
“Damien Foundation
invests in searching
for patients. To this
end they train nurses
and doctors. They also
treat and cure patients,
though care after the
treatment is also very
important. Not only for
the patient but also their
environment.”
Jo Benoît, Clovis Oncology
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DAMIEN FOUNDATIONFI
NANC
IAL
REPO
RT
Financial report
Balance
Assets 2017 2016
Fixed assets € 2,328,102 € 2,280,696
Intangible assets € 34,080 € 27,655
Tangible assets € 2,292,899 € 2,251,918
Financial assets € 1,123 € 1,123
Current assets € 19,149,749 € 19,474,209
Receivables > 1 year € 1,330,632 € 314,186
Inventories and orders
in process
€ 707,727 € 591,808
Receivables < 1 year € 4,428,200 € 5,387,957
Cash investments € 7,478,164 € 9,239,361
Disposable assets € 5,031,760 € 3,635,844
Accruals € 173,266 € 305,053
Total assets € 21,477,851 € 21,754,905
Liabilities 2017 2016
Social funds € 20,321,361 € 21,054,053
Association funds
Starting capital € 61,973 € 61,973
Permanent resources € 6,738,799 € 6,738,799
Encumbered funds € 14,382,512 € 14,630,063
Transferred result -€ 861,923 -€ 376,782Provisions € 241,608 € 251,629Debts € 914,882 € 449,223
Payables < 1 year € 732,842 € 368,480
Accruals € 182,040 € 80,743
Total liabilities € 21,477,851 € 21,754,905
5150 51
DAMIEN FOUNDATIONFINANCIAL REPORT
ANNUAL REPORT 2017
Operating income
Expenditure
Own income from operations € 10,795,047 65,7%
Belgian public
Contribution from the Belgian public
(from 1/1 until 31/12/2017)
€ 6,059,881 36,9%
Legacies € 4,735,166 28,8%
Grants and joint-financing € 4,692,842 28,6%
Belgian government (DGD) € 4,504,812 27,4%
ILEP members € 120,000 0,7%
Regions, provinces and municipalities € 68,030 0,5%
Financial revenue € 455,215 2,8%
Miscellaneous € 482,342 2,9%
TOTAL € 16,425,446
Project expenses € 12,464,544 72,6%
Projects under direct supervision of Damien Foundation
Africa € 6,794,305
Asia € 3,332,801
America € 687,963
Transferred amount to the South -€ 133,180
Belgium € 60,000
Contribution to ILEP member projects € 72,150
Scientific support € 414,741
Projects and operational costs support € 111,132
Chantiers Damien (Construction projects) € 136,021
Administration of the Projects department € 988,611
Information and education € 433,822 2,5%
Fundraising € 1,606,908 9,4%
Administration of the Communications department
€ 1,187,856 6,9%
Administration and Finance department € 1,151,428 6,7%
Miscellaneous costs € 313,581 1,9%
TOTAL € 17,158,139
Direct donations and local campaigns
Project expenses
€ 6,059,881
€ 12,464,544
€ 4,735,166
€ 1,187,856
€ 4,504,812
€ 433,822
€ 120,000
€ 1,606,908
€ 68,030
€ 1,151,428
€ 455,215
€ 313,581
€ 482,342
Regions, Provinces and Municipalities
Administration and Finance department
Financial revenue
Miscellaneous costs
Miscellaneous
Legacies
Administration of the Communications dept.
Belgian government
Information and education
ILEP members
Fundraising
Number of patients
Leprosy
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DAMIEN FOUNDATIONNU
MBER
OF
PATI
ENTS
legend
Population covered
Patients who received
additional aid
Patients screened
and treated
Multidrug-resistant patients
who started treatment
during the year
Bangladesh 32,712,453 475 2,417
Bolivia 1,943,429 8 0
Burundi 10,400,939 400 1,138
The Comoros 828,147 429 102
DR Congo 39,413,762 2,303 4,994
India 108,627,063 12,472 10,605
Mozambique 4,873,779 88 58
Nepal 3,000,000
Nigeria 61,171,062 299 1,206
Rwanda 12,322,920 26 564
Senegal 15,256,346
TOTAL 290,549,900 16,500 21,084
Leishmaniasis
Tuberculosis
*Our projects in Senegal and Nepal started in 2017, therefore we do not yet have these numbers.
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DAMIEN FOUNDATIONNUMBER OF PATIENTS
ANNUAL REPORT 2017
Nicaragua 704,779 3,948 55
Guatemala 2,117,147 1,028 0
Bolivia 1,943,429 285 6
TOTAL 4,765,355 5,261 61
Bangladesh 28,700,552 25,633 211 4,184
Belgium 1,187,800 31
Bolivia 19,3,429 1,138 7 354
Burundi 10,400,939 7,862 50 50
The Comoros 828,147 128 0 0
DR Congo 40,899,665 82,801 519 461
Guatemala 6,511,408 1,670 58 481
Guinea 3,115,115 9,051 165 165
India 57,376,091 13,186 819 391
Mozambique 4,873,779 17,455 149 96
Nepal 3,000,000
Nicaragua 2,827,928 1,001 36 467
Niger 7,440,566 3,043 72 72
Nigeria 61,171,062 29,287 370 370
Senegal 15,256,346
TOTAL 245,532,827 192,255 2,456 7,122
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DAMIEN FOUNDATIONOU
R TE
AMS
Our teams
Africa Burundi Representative: Dr Michel SawadogoLocal partner: Ministry of Health and the Fight against AIDS Support to: National Leprosy and Tuberculosis Programme (PNILT) Expenses 2017: € 361,684Staff under local contract: 10*(*of which 1 expat)
The Comoros Representative: Dr Younoussa AssoumaniLocal partner: Ministry of HealthSupport to: National Leprosy and Tuberculosis Programme Expenses 2017: € 219,134Staff under local contract: 7Start project: 1979
Democratic Republic of CongoRepresentative: Dr Pamphile Lubamba (until April 2017), Dr Pierre Umba (as from May 2017)Local partners: Ministry of Health, provincial health divisions, health districts, local NGOsSupport to: National Programme for the Elimi-nation of Leprosy (PNEL) , National Tuberculosis Programme (PNT)Expenses 2017: € 4,370,651Staff under local contract: 43*(*of which 2 expats)Start project: 1964
GuineaRepresentative: Dr Souleymane Has-sane HarounaLocal partner: Ministry of Health Support to: National Tuberculosis Pro-gramme (PNLAT)Expenses 2017: € 368,870Staff under local contract: 7*(*of which 1 expat)Start project: 2007
MozambiqueRepresentative: Dr César ArroyoLocal partners: Ministry of Health, provincial health departments in Tete and Sofala Support to: National leprosy and tuberculosis programmes in Tete and Sofala Expenses 2017: € 201,446Staff under local contract: 51*(*of which 1 expat)Start project: 2004
Niger Representative: Dr Souleymane Mahama-dou BassirouLocal partner: Ministry of Health Support to: Tuberculosis Programme at central level and in the regions of Tillabéri and Zinder Expenses 2017: € 372,187Staff under local contract: 11Start project: 2007
Nigeria Representative: Dr Osman El TayebLocal partner: Ministry of Health Support to: National Tuberculosis and Leprosy Programme (NTBLCP)Expenses 2017: € 644,138Staff under local contract: 34*(*of which 1 expat)Start project: 1991
Rwanda Representative: Jean-Paul ZawadiLocal partners: Ministry of Health, Institute of HIV/AIDS, Disease Prevention and Control, Rwanda Biomedical Centre (RBC)Support to: Tuberculosis and Other Respirato-ry Diseases Division (TB & ORD)Expenses 2017: € 84,380Staff under local contract: 3Start project: 1964
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DAMIEN FOUNDATIONOUR TEAMS
ANNUAL REPORT 2017
SenegalRepresentative: Dr Gilbert BatistaLocal partner: Ministry of Health Support to: National Programme for the Elimi-nation of Leprosy (PNL), National Tuberculosis Programme (PNT)Expenses 2017: € 171,816Staff under local contract: 2Start project: 2017
AsiaBangladesh Representative: Dr Aung Kya Jai MaugLocal partner: Ministry of Health Support to: National leprosy and tuberculosis programme Expenses 2017: € 1,485,437Staff under local contract: 555*(*of which 1 expat) Start project:1972
IndiaRepresentative: Dr Mugudalabetta ShivakumarLocal partners: Ministry of Health, 10 local NGOsSupport to: National leprosy and tuberculosis programmes at district level (Andhra Pradesh, Bihar, Delhi, Karnataka, Kerala and Tamil Nadu), projects of local NGOs and self-man-aged projectsExpenses 2017: € 1,603,445Staff under local contract: 251Start project: 1964
Nepal Representative: Dr Sushil KoiralaLocal partners: Ministry of Health, Social Welfare CentreSupport to: National leprosy and tuberculosis programmes Expenses 2017: € 243,919Staff under local contract: 9Start project: 2017
EuropeBelgiumRepresentative: Luc ComhaireLocal partner: BELTA-TBnetSupport to: Tuberculosis programme in Brussels (homeless TB patients)Expenses 2017: € 60,000Start project: 2015
Latin AmericaBoliviaRepresentative: Maria Luisa Palacios VargasLocal partners: Ministry of Health, IIBISMED, Technical health school Support to: Tuberculosis, leishmaniasis and leprosy programme in CochabambaExpenses 2017: € 96,867 Staff under local contract: 3Start project: 2016
Guatemala Representative: Zoila BailónLocal partner: Ministry of Health Support to: National tuberculosis and leishmani-asis programmes Expenses 2017: € 270,570Staff under local contract: 7Start project: 1993
Nicaragua Representative: Dr Toon BongaertsLocal partners: Ministry of Health, Prosalud (local NGO)Support to: National tuberculosis and leishmani-asis programmes Expenses 2017: € 320,526Staff under local contract: 19*(*of which 1 expat)Start project: 1990
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OSSA
RY
Glossary
Active screening - Visiting and screening the en-vironment of a newly-diagnosed patient to verify whether anyone around them is also infected.
BELTA-TBnet (Belgian tuberculosis association) - An umbrella organisation of which FARES (Fonds des Affections Respiratoires) and the VRGT (Vlaamse Vereniging voor Respiratoire Ge-zondheidszorg en Tuberculosebestrijding) form part. BELTA-TBnet ensures that all TB patients in Belgium have access to adequate diagnosis and treatment without financial obstacles.
Care after cure - A strategy or activity aimed at the socio-economic reintegration of recovered patients. By providing training, accommodation, start-up capital or materials with which to start trading, for example, Damien Foundation aims to give these patients additional support. This ena-bles them to once again become part of society and provide for themselves.
Cohort - Medical definition: a group of patients who are followed in a study during a certain period of time.
DOTS (Directly Observed Treatment, Short-course) - The tuberculosis patient takes the medication under direct supervision. This approach, developed by the WHO, is required to prevent the patient from ending the treatment prematurely and developing multidrug-resistant tuberculosis. DOTS workers may be employed by Damien Foundation, although volunteers and family members of the patient may also act as DOTS worker.
Endemic - A disease is endemic if it stubbornly continues to exist in a particular region or among a particular section of the population.Extensively drug-resistant tuberculosis (or XDR-TB) - A form of tuberculosis that develops due to a resistance to medicines in the treatment
of multidrug-resistant tuberculosis (fluoro-quinolones). Older, less effective and more expensive medicines are then required.
First-line (medication, treatment) - Traditional medication that is prescribed as a first line. Second-line medication is used when treating resistant tuberculosis.
GeneXpert - A fast, compact machine that uses DNA analysis to determine whether a person is infected with TB and/or is resistant to the main TB medicine, rifampicin. The machine sends the results to a computer in 90 minutes. The technology is considerably more sensitive than the microscopic examination of sputum. It is the fastest and simplest way of establishing the sus-ceptibility to medicines. GeneXpert is not cur-rently available to everyone due to its high cost. One machine costs € 15,000 (ex. custom fees).
ILEP (International Federation of Anti-Leprosy Organisations) - ILEP was founded in 1966 as an international umbrella organisation of 13 NGOs that collectively work to combat leprosy. Togeth-er they are active in 66 countries.
Index case - The first person to be infected by a pathogen. Our teams use this term for the person who is first to be diagnosed with leprosy or tuberculosis in a family, in the scope of active screening.
Laboratory material - Necessary material with a limited shelf life that can be found in a laborato-ry. Examples include: slides for a microscope or small beakers for collecting sputum.
Latent tuberculosis - Form of tuberculosis in which a person may carry the TB bacteria but is not (yet) unwell. A quarter of the global popula-tion has latent tuberculosis. 5 to 15% of these will develop active tuberculosis during their lifetime. People with the following risk factors have a
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DAMIEN FOUNDATIONGLOSSARY
ANNUAL REPORT 2017
higher risk of becoming ill: undernourishment, smoking, alcohol addiction, HIV, diabetes and air pollution.
Leprosy surgery - Surgery performed on leprosy patients and recovered persons living with disfigurements. This may involve septic surgery where a limb requires amputation for example. Or it may mean reconstructive surgery to enable fingers to move again in the case of a flexible claw hand, for example, or feet in the case of foot drop. This form of surgery gives the patient a degree of mobility and eliminates the stigma around the disease.
Multibacillary leprosy - Infectious form of lep-rosy. A large number of bacilli are present in the patient’s body. 60% of all leprosy patients suffer from multibacillary leprosy. The other 40% suffer from paucibacillary leprosy; a less infectious form characterised by only a small number of bacilli.
Multi drug-resistant tuberculosis (or MDR-TB) - Form of tuberculosis in which the medicines rifampicin and isoniazid – the two main antimi-crobial agents in first-line treatment – no longer have an effect on the patient.
Parasitic disease - A disease that is transmitted to humans by a parasite, a vegetable or animal organism that feeds on a host. Leishmaniasis is transmitted in this way by an infected sand fly. PCR (Polymerase Chain Reaction) - A method of reproducing one or more parts from a small amount of DNA to provide sufficient material for analysis.
Prevalence - Number of existing cases in a pop-ulation at a certain moment. Not to be confused with incidence, which refers to the new cases determined during a certain period.
Self-care - Patients are capable of looking after their own wounds and therefore avoiding further complications. Self-care means they are less dependent on others.
Susceptible tuberculosis - Normal variant of tu-berculosis that responds to first-line treatment.
The Union (The International Union Against Tuberculosis and Lung Disease) - Founded in 1920, The Union was the first NGO to be recog-nised by the WHO on its creation in 1948. Since 2000, The Union has developed into a powerful, global network comprising five hundred experts in twelve offices around the world.
Village doctors - Person who has been trained in identifying certain diseases and sometimes in providing treatment. He or she does not neces-sarily have a medical background. In Bangladesh, Damien Foundation has been training village doctors for years, and they play an important role in tracing tuberculosis patients. In total, we have trained thousands of village doctors. They are sometimes referred to as health promoters or brigadiers.
WHO (World Health Organisation) - The World Health Organisation (WHO) is a public health body that is part of the United Nations (UN). It was founded in 1948. The WHO is directly dependent on the Economic and Social Council of the UN and is based in Geneva, Switzerland.
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ANNUAL REPORT 2017
Damien Foundation Board of Directors
(on 31 December 2017)
ChairmanXavier Ortegat
MembersHans De Beenhouwer
Alain De Clercq
Lieve Deckers
Guido Knops
Steven Osaer
Françoise Portaels
Jean-Pierre Schenkelaars
Martine Van den Berghe
Dirk Vercruysse
Published by Damien Foundation June 2018
BE05 0000 0000 7575Boulevard Léopold II 263, 1081 Brussels
Design by: Josworld.org
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Damien Foundation would like to thank the following partners:
• The governments of the countries in which we combat leprosy, TB and leishmaniasis.
• The Belgian government (at federal, regional, provincial and municipal levels), and in particular the development cooperation departments.
• All of our staff around the world.
• Our many loyal, generous donors.
• The thousands of volunteers in Belgium and every project country.
