FWAB 2015 Annual Report

2015 Annual ReportHealing Children,Healing Asia

Message from our Founder2015 was the year of another dream come true for me to identify and thank the selfless andfor me. Friends Without A Border opened a new dedicated team that continues to make thishospital in a new country…Lao Friends Hospital success possible. I begin by naming and thankingfor Children (LFHC)! our primary partner in Laos, the Lao Ministry of Health and Health Department of Luang Prabang.I am happy to report that LFHC is not only open, As most of you know, our model for LFHC isbut off to an amazing and successful start. As different from the model we used in Cambodia2015 came to a close, LFHC has successfully for Angkor Hospital for Children. LFHC is a free-opened its Inpatient and Outpatient Departments, standing and independent children’s hospital builtPharmacy, Laboratory, Radiology, and its around- on the campus of the Luang Prabang Provincialthe-clock Emergency Department. In addition, Hospital (LPPH). LFHC has essentially becomeworks are in progress for Outreach, including the Pediatric Department for LPPH. We haveHomecare and HIV programs so that we can designed LFHC not only as a center of compassionbring compassionate and international-standard and international medical excellence, but as aof primary healthcare to children throughout children’s hospital that will be locally sustainable.Northern Laos. The critical need for our hospital Our plan is to successfully integrate LFHC withinhas also been confirmed by a consistently 10 years to be managed by LPPH. The success ofincreasing number of children being treated at this fundamental goal requires close coordinationLFHC on a daily basis. The lives of many children and cooperation with LPPH and the Lao Ministryhave been saved. of Health, and I wish to thank the leadership at these institutions for the important role theyThe challenges faced in successfully opening LFHC have played in the opening of LFHC.are simply too numerous to mention. It is important

I would also like to thank the board of directors Needless to mention, there are many peopleand staff of Friends Without A Border New York responsible for the initial success of LFHC. Butand Friends Japan, who worked tirelessly alongside one important part of the team remains, andthe staff of LFHC. We are fortunate to have such it consists of the generous donors listed at thehighly-qualified and dedicated leadership that end of this Annual Report. Not only have youcontribute experience from working in pediatric given generously to create Lao Friends Hospitalhospitals and clinics from around the world. for Children, but you have trusted us to investUnder the leadership of our Executive Director those donations efficiently and effectively. WeDr. Cheri Nijssen-Jordan, the expat leadership appreciate the trust, and we hope you can seestaff has exceeded our expectations. Our Laotian through this Annual Report that your trust hasstaff is also quite impressive. The amount of work been well placed. We are always so excited andput in by these young doctors, nurses, technicians, gratified when our donors make the long trip toand support staff is something to be seen. Not Luang Prabang to visit our hospital. Many of youonly are they learning to provide compassionate attended our Grand Opening in early 2015, andand international-standard care to the children, others visited throughout the year. Please knowbut they spend many hours beyond their duty to that you are always welcome to see our stafflearn advanced medicine and nursing together treating every child as if their own child at LFHC.with learning English. I can already see them Lao Friends Hospital for Childrengrowing into the leaders of the future Lao could not be there without you.healthcare system, inheriting the spirit ofFriends Without A Border. Kenro Izu Founder and Honorary President

Message from our Chair2015 was another busy and productive year for As we approach the 20th anniversary of FriendsFriends Without A Border. We continued our Without A Border, there is much to celebrate. Withfinancial support for Angkor Hospital for Children the support of thousands of donors, medical(AHC) and The Lake Clinic (TLC) while opening and professionals, staff members, volunteers andgrowing Lao Friends Hospital for Children (LFHC). strategic partners, we have delivered compassionateOver the course of the year, LFHC grew from an care to millions of children in the Mekong Regionoutpatient only facility to a 24-hour facility that and high-quality training to thousands of medicalincluded Inpatient and Emergency Departments. professionals. As Chair of the Board of Directors ofWe strengthened our relationships with the local Friends Without A Border, I would like to expresscommunity and Lao government by developing a our heartfelt thanks to everyone who has madereputation for high-quality medical service and this possible.continuing to share information and best practices. The last year has also reminded us that thereIn the coming year, we look forward to building remains much work to be done. With familiesour Surgery and Neonatal Departments, as well traveling up to eight hours to receive care at LFHCas implementing partnerships with local medical and children arriving with advanced and previouslyschools to provide pediatric training for the next undiagnosed serious medical conditions, we aregeneration of Lao doctors, nurses and physician more aware than ever of the need for our services.assistants. These education initiatives combined We look forward to the continued support of oldwith the expansion of our Outreach Programs will friends and to engaging with new friends as we fulfillensure that Friends Without A Border will be able our mission of delivering the highest quality andto help even those children and families unable most compassionate care to the children ofto travel to LFHC. Cambodia and Laos. Matthew Magenheim Chair of the Board of Directors 2

Friends Without a Border • 2015 Annual ReportMessage from theExecutive Director of LFHCLao Friends Hospital for Children is now a reality. record system. This system will allow not only clinicalThis Annual Report shares some of the successes documentation, but will assist in monitoring andand challenges of the first year of operations. As the evaluation for research and operational management.management team reviewed the goals that FriendsWithout A Border aspired to when designing the Additional site commissioning will continue in 2016hospital, the full LFHC team took a great deal of with Operating Theatre preparation for the surgicalpride in bringing such a special concept to life. program as well as opening a newborn unit toLFHC is now delivering care, free of charge, to any expand inpatient care to include infants under 28child in Northern Laos who needs it. days of life. The ultimate plan of integration of our children’s hospital into the fabric of the Lao MinistryThe doors to the hospital opened on February 12th, of Health has been taken very seriously by the2015 for outpatient consultation and treatments. team. Every decision was made using a lens ofThe numbers of visits in outpatients doubled those sustainability in the Lao environment of future andpreviously seen at the Luang Prabang Provincial vetted with our Lao Ministry of Health partners.Hospital (LPPH). The pace continued as the Inpa- The collaboration has been very successful!tient Department opened in August followed by theEmergency Department in November. As of Decem- As a final comment to this summary of LFHC’s firstber 31, LFHC treated over 10,000 children from the year, we want to tell the story of one of our patients.ages of 1 day up to 15 years. These children came A small 4-month-old baby came in looking very blue,from every district in the province of Luang Prabang not breathing well, and his heart was about to stop.as well as 8 other provinces (out of 17) in Laos. The LFHC Lao and expatriate team provided oxy- gen, breathing support, thiamine, supportive medi-The LFHC team numbered over 60 Lao staff includ- cations, IV fluids, antibiotics, nursing care, cuddling,ing nurses, doctors, x-ray technicians, laboratory and a lot of parental counselling and teaching. Thetechnicians, pharmacists, sterilization technician, team were very proud to discharge this baby homephysiotherapy, administrative personnel, security, with his smiling parents a few days later. The careFriends Visitor Center staff, and infection control provided to this small child was second to none in& cleaning staff. They are actively engaged in the world, and it was provided here at Lao Friendsproviding services as well as taking English lessons Hospital for Children. This story is one of many thatand continuing their clinical curriculum. Almost 100 already dot the short history of a growing, caringexpat volunteers from around the world helped to place with a mission statement that “every childprovide high quality service and teaching. Both staff has the right to a healthy and loving life.” A veryand volunteers alike added flavour and an enthusi- heartfelt thanks is extending from the LFHC staff toasm that echoed the mission of providing compas- all of our donors, partners and supporters for yoursionate quality care to the children of Northern Laos. help in bringing this dream to life!A significant highlight for operations was the Cheri L. D. Nijssen-Jordan, MD FRCPC FAAP MBAimplementation of an Electronic Medical Record Executive Director, Lao Friends Hospital for Childrenutilizing OpenMRS, an open source IT medical 3

FriendsWithout A BorderEvery child has the right to a healthy and loving life.We accomplish this by providing high-quality and compassionatemedical care to the children of Southeast Asia; by creating community healtheducation programs; and by training local healthcare professionals. 4

Friends Without a Border • 2015 Annual ReportFriends EventsNew York Gala Channapha Khomvongsa, Friends, symbolizing our belief Executive Director and Founder that “Art Can Make a Difference,”Our Annual Spring Gala of Legacies of War. The tireless and has raised over $2 millioncelebrates Friends Without A efforts of Channapha and since 1997. The 18th AnnualBorder and honors those with her team have helped raise Friends Photography Auctiontremendous dedication to our awareness about unexploded was held on October 6th in Newwork. The theme of the 2015 ordinance remaining from the York City. Over 250 photographyGala, “Realizing the Dream,” Vietnam War-era bombing of enthusiasts joined Friends tocommemorated the Grand Laos. As a result of their work, bid on over 150 pieces byOpening of Lao Friends countless lives have been photographers around theHospital for Children. The saved and devastating injuries globe. Friends inaugurated theGala runs concurrently with the have been avoided. Friends Best Artist of the Year Award byCambodian and Laotian New also recognized Gregory presenting this honor to ElliottYear and is a festive evening Wakabayashi along with George Erwitt, a renowned Magnumdedicated to celebrating and Dori-Ann Stubos for their photographer whose iconicSoutheast Asian culture, with many years of dedication and images are widely recognized.delicious food, live and silent support with the Best Friend of With prints from artists likeauctions, and a market of Friends Award. Annie Leibovitz, Steve McCurry,unique Asian-inspired gifts. Richard Misrach, DaidoOver 200 guests attended the Friends Photography Moriyama, and Hiroshi13th Annual Friends Gala in Auction Sugimoto, the event raisedApril and helped raise over over $170,000 for children’s$270,000 to support healthcare The Annual Friends Photography healthcare.programs in Cambodia and Laos. Auction is the signature event ofFriends was proud to presentits highest honor, the fourthHealing Asia Award, to 5

Friends in the CommunityFriends expresses our with Khmer-style dance and Airway Pressure (CPAP) machinesincere gratitude to the music. On December 9th, com- for Lao Friends Hospital formany supporters around mittee members Dr. and Mrs. Children - used for prematurethe world who organized Samrang Kchao visited AHC and births or babies born withcreative initiatives to support presented a check on behalf of breathing problems.our cause and help children all the FoF supporters.across Southeast Asia.Here are some of them. Diana’s Ice SkatingFriends of Friends Diana Cheung and the Asian Pacific American Medical StudentOn October 10th, Friends of Association (APAMSA) hostedFriends (FoF) New York held their an ice skating fundraiser forannual fundraiser for the 16th LFHC, with over 136 studentsyear.  The Cambodian-American from the NYIT College ofsupporters of Friends were Osteopathic Medicine indelighted to raise over $16,000 attendance. Diana and thefor Angkor Hospital for Children group raised enough money towhile having a fun-filled event purchase a Continuous Positive 6

Friends Without a Border • 2015 Annual ReportBerger Family’s Run Luang Prabang Volunteers Half MarathonAdri Berger, Luang Prabang- We are so grateful for thebased videographer who More than 500 participants took tremendous support we receivecreates great footage for to the streets of Luang Prabang from our volunteer community.Friends, and co-owner of the on October 18 in the run that Over 150 volunteers helpedBig Tree Café, is a big advocate has been voted among Asia’s us with events, mailings, officeof LFHC in the local community. top destination runs by CNN. duties, and outreach in 2015.Adri took his support even An unexpected shower did Thank you to each and everyfurther to his homeland of not dampen the enthusiasm of one of our amazing helpers!The Netherlands, where his the runners from 23 countries,extended family participated in who made their way past thea marathon to raise money for Mekong and Nam Khan rivers,LFHC. More than ten members beautiful temples, and markets.of his family visited LFHC over The runners raised over $60,000the summer and presented a for three Lao charities: a girls’symbolic check to the hospital. hygiene program, a literacy organization, and Lao Friends Hospital for Children. 7

Lao Friends Hospitalfor ChildrenImproving children’s health and survival is a top priority in Laos. Many years ofconflict and widespread poverty have stalled health care development, and poorpublic infrastructure combined with high mountainous terrain present a constantbarrier for children and families to access high-quality health care. Among themost crucial of these challenges is a lack of health workers in Laos. 8

Friends Without a Border • 2015 Annual ReportWith 62.6% of the population Treatment hospitals, as well as otherunder the age of 18, and an hospitals in the city and fromaverage population age of 20.7 Throughout 2015, the clinical other provinces.years, children are the most team delivered care to increas-vulnerable and affected popula- ing numbers of children with The opening of the Emergencytion by these challenges. It is dedication, smiles, and a caring, Department (ED) in Novembercommon for children to suffer compassionate attitude. LFHC marked the start of 24/7 care forfrom preventable and treatable implemented a phased opening; all children, including newborns,diseases such as malaria, with provision of care starting medical, surgical, and traumapneumonia and diarrhea. The with the Outpatient Department victims. An average of 10prevalence of malnutrition is (OPD). 47 children were seen emergency patients per day arehigh, and rates of immunization on opening day - since then, a treated for a variety of illnesses,are low. Approximately 74 out range from 30 to 90 outpatients with infectious diseasesof every 1,000 children born were seen each day by our accounting for over 80% ofwill not live to see their fifth Lao medical staff, alongside patient presenting illness.birthday. These astounding mentorship of our international Diagnoses also included sea-statistics are what brought medical volunteers. sonal illnesses such as typhoidFriends to the region. and dengue fever; as well as With increased training and malnutrition, Thalassemia, andFriends remains committed to capacity, the doctors and nurses nephrotic syndrome (kidneymeeting these challenges and were ready for the next mile- diseases). The most commonlydelivering evidence-based care stone: the Inpatient Department prescribed medicationsthrough the successful model (IPD). On August 11, the IPD dispensed by the pharmacyimplemented in Cambodia: admitted its first patient: a included Vitamin B1, folic acid,Treatment + Education + young girl named Yong Wa multivitamins, zinc, and Tylenol.Prevention. with typhoid fever requiring IV therapy. She came from a poorLFHC was inaugurated on Hmong family with 21 childrenFebruary 11. who traveled 8 hours by bus to receive treatment. On the first day there were 17 inpatients, and the department has since consistently been at capacity. LFHC has seen an increasing number of referrals from district 9

The Laboratory focused on The Diagnostic Imaging (patient archiving system) whichsimple tests like a CBC (hemo- Department opened in May, allowed images to be uploadedglobin test) and rapid tests to with help from RAD-AID and stored rather than needingtreat frequently seen diseases International, who sent a to print films. This technologysuch as malaria, HIV, strepto- radiologist, an ultrasound enabled reading of the informa-coccus, dengue, and typhoid. technician, and a radiology tion anywhere over the hospital’sThese tests provided immediate technician to LFHC. They network, plus easy transmissionresults and helped direct care in were able to set up the digital to outside consultants.the appropriate way. The staff radiology machine as well asbecame more proficient in read- teach in both ultrasound and LFHC was awarded the TEAMing blood smears, gram stains x-ray modalities to the new Lao Grant (Training, Economicand malaria tests, and also x-ray technician. The teaching Empowerment, Assistivecompleted the training for HIV from RAD-AID volunteers was Technology, Medical Rehabilita-testing. In total, 2,609 laboratory instrumental to the ability to tion) as a sub grant from USAID.tests were completed, with 13% provide high quality diagnostics. The grant allowed LFHC toleading to a diagnosis of den- An additional highlight for the develop its Therapy Programgue fever and 4% diagnosed year was the installation of PACS and employ a local Laowith malaria. education professional. The play therapist will be instrumental in Meet Sith, a 14-month-old boy from Xayaboury creating a neurodevelopmental Patient Province in northern Laos. Sith is the youngest of screening tool and measuring Story five siblings and the son of rice farmers. Brought cognitive stimulation and gross motor development. into LFHC by his parents, he was tired, weak, andirritable. A blood test showed that his hemoglobin level, ameasure of red blood cells, was dangerously low—less than1/3 the level that is usually considered “low.” Sith suffers fromThalassemia, a genetic red blood cell disorder extremely com-mon in Laos. Children with Thalassemia require routine bloodtransfusions, frequently as often as every month. Sith receiveda blood transfusion and food supplementation to bring himback to health, and was sent home in a few daystime with renewed energy. He will need to makethe 3 hour journey from his home to LFHC everyfew months to make sure that he maintains ahealthy red blood cell count. We look forward toseeing him back! 10

Friends Without a Border • 2015 Annual ReportThe Baseline Medical Survey LFHC Patients(BMS) conducted by Dr. JeffMeaselle, started in 2014 and Agecontinued research and analysisthroughout 2015. The BMS is 30% 18% 27% 25%among the most comprehensive Under 1 year 1-2 years 2-5 years Over 5 yearschild health studies conducted old old old oldin Luang Prabang. A total of630 households were surveyed, Genderproducing health data on morethan 900 children ages 0-to-5 46% 54%years. The BMS focused on Male Femaledeveloping an accurate pictureof children’s health in the EthnicityProvince, in particular children’sphysical growth rates, immuni- 67% 17% 16%zation status, general health Lao Khmu Hmongstatus, rates of communicableand non-communicable disease, Districtsoral health, nutritional status,familial reproductive health 74% 7%practices, and maternal perinatal Luang Prabang Chomphethealth status. The collection of 6%both biological and survey data Common Pak Ouhas helped to prioritize medical Diagnoses 54% 4%services at LFHC, and will Xiengngeunprovide a baseline from which Infectious Diesease 9%to gage the impact of LFHC Othergoing forward. The BMS alsoprovides LFHC staff the oppor- 35%tunity to collaborate on health Otherresearch and to develop grant 5%proposals with government and MalnutritionNGO partners. 3% Thalassemia/anemia 1% Epilepsy 1% Renal conditions 1% Injury 11

In preparation for the opening Education Workshop at Angkor Hospitalof the Operating Theatre in for Children. Nurses were2016, LFHC welcomed various LFHC’s education pillar focuses trained on combining clinicalinternational medical profes- on patient education, medical information with the essentialssionals, including teams from education, English-language of pediatric care, and alsoGermany and Singapore, as well education, and community completed an Emergencyas U.S. Board Member, Dr. Tim health education. The primary Triage Assessment and TreatmentWeiner. The surgeons worked emphasis was with patients (ETAT) course in preparation forhard to increase the capacity of and their family members, and the inpatient and emergencythe Lao staff through training ensuring that educators consid- department openings. Ratherand education on everything ered family dynamics, housing than delivering care accordingfrom anesthesia, operations, environments, village resources, to an arbitrary set of calcula-and pre- and post-operative and other influential factors. tions, the medical team wascare. Our collaboration with Patient education is given daily encouraged to think of thethe Luang Prabang Provincial to patients’ families including patient holistically, and toHospital (LPPH) was essential, nutrition, vaccinations, breast- understand the disease foras LFHC began to take on the feeding support, oral health, which they were givingpost-operative care for surgical family planning, and disease- medication. These ideas werepatients from LPPH. In addi- specific information. warmly welcomed and helpedtion, two of our Lao nurses genuinely foster a sense of com-underwent a 5-month training Ongoing medical education passionate care in the hospital.at Angkor Hospital for Children for Lao staff included a seven-on anesthesiology. We couldn’t module program following The team also undertookbe any happier to see our two World Health Organization English-language classes taughthospitals working together! (WHO) guidelines. There were by an ESL-certified and native four opportunities for staff to English speaker. Our medical attend continuing education library continued to grow, allow- workshops, including a Capacity ing the staff to consistently learn Building and Health Education new skills and further develop their English. Improving the lan- guage skills of our doctors and nurses is a component of our capacity-building and sustain- able approach to medical care: it allows each and every practi- tioner to become international medical professionals. 12

LFHC 2015by the Numbers 10,800 252 over 50 115Total patient visits Patients admitted Post-operative patients Homecare patients 805 2,609 67,806 11 Lab tests X-rays and ultra- performed Total medications dispensed Lao doctorssounds performed 21 less than 1day to 61 days Length of stayLao nurses 13

Prevention to involve a holistic approach launch an “Integrated Pediatric to support autonomy and HIV/AIDS Care Program” atOur Outreach Program is independence of both patients LFHC. Four clinical staff traineddesigned to care for children and families, while providing as HIV counselors, and the teamwho may not have access to needed medical care for conducted homecare visits formedical services, and to teach children diagnosed with ill- 4 HIV positive patients. Projectpreventative health to local nesses such as cerebral palsy, activities support improvedLao communities. The LFHC developmental delays, and quality of life as well as prolon-Outreach Program has three congenital heart disease. gation of life.components: a Homecareproject; HIV/AIDS care, and The HIV Project aimed to The Model Village project isa Model Village project. integrate all HIV-related care designed as a community into one pediatric facility with approach to providing healthHomecare focused on regularly pre- and post-test counseling, care, with a major emphasisvisiting chronically ill patients, treatment, homecare visits, and on prevention and education.and provided services to 116 prevention education. The team Three “Health Promotion Days”children and their families in 9 worked closely with the Center in the village provided neededdistricts across Luang Prabang for HIV/AIDS and STIs in Vien- immunizations and healthProvince. Care was designed tiane, as well as Luang Prabang education, covering hand wash- Provincial Hospital’s HIV clinic to ing, nutrition, food hygiene, personal hygiene, head lice, and Bapphavadee was admitted to LFHC with a severe growth and development. The Patient case of typhoid fever. Typhoid fever is spread Model Village is led by LFHC’s Story through contaminated water, and most often affects overarching goal to promote empowerment and autonomy, children from rural villages with poor sanitation rather than complacency.systems. It is one of the many infectious diseases we deal withat LFHC that are rarely, if ever, seen in the developed world. Our PartnersPatients with dengue fever, malaria, hepatitis, and parasiticworms are unfortunately common sights at LFHC. Bapphavadee Through the support of ourreceived a heavy dosage of antibiotics and generous partners, we receivedsupportive care to bring down her fever and treat life-saving medicine and equip-her headache and diarrhea. After nearly a week ment that allowed us to con-in the Inpatient Department, she started feeling tinue expanding LFHC to carebetter and was sent home within a few days. for more children in Laos. Our partners included Direct Relief International, Vitamin Angels, Rotary Club Australia, RAD-AID 14

Friends Without a Border • 2015 Annual ReportInternational, and the United LFHC Volunteers and IT Technicians. We extendStates Agency for International our sincere gratitude to everyDevelopment (USAID). Establishing a sound volunteer volunteer for donating their program at LFHC was a fun- time, talent, and knowledge toIn addition, a partnership with damental part of the hospital’s Lao Friends Hospital for Children.the local branch of the Swiss success. In 2015, we welcomedRed Cross (SRC) was initiated at medical and non-medical volun- Friends Visitor Centerthe start of Outreach program- teers from across the world thatming. Other coordination were essential in helping lay The Friends Visitor Center (FVC)on HIV/AIDS care, homecare the groundwork for the future opened in September 2014nursing visits, and the Model success of LFHC. 85 volunteers in downtown Luang PrabangVillage project was held with came from 4 continents and 8 as a way to spread awarenessa variety of governmental and countries, including Australia, of LFHC and the health carenon-governmental organiza- Canada, Germany, India, Japan, situation in Laos among touriststions, including Korean Inter- Myanmar, the United Kingdom, and the general public. The firstnational Cooperation Agency and the United States. Each and floor contains information on(KOICA), Save the Children, the every volunteer brought with our programs, souvenirs, andLuang Prabang Provincial Health them a strong commitment to an informative film about ourDepartment, the Luang Prabang teaching our Lao staff and build- project; while the second floorDistrict Hospital, and local ing LFHC’s capacity. They came houses photography and arthealth centers. from professions such as nurses, related to Lao culture - all doctors, surgeons, pharmacists, available for donation with physical therapists, radiologists, proceeds going toward patient English teachers, and biomedical care at LFHC.Europe Asia North FVC also plays an integral role America in community engagement. The 9 17 third floor is open to the local 48 community for various events, U.K. such as yoga classes, while the Germany Canada rooftop provides an incred- U.S.A. ible view of Luang Prabang for receptions or special occasions.2015 Volunteers at LFHC Australia The FVC staff also works to India increase outreach by visiting Japan hotels and businesses to Myanmar introduce LFHC to international New Zealand tourists or Luang Prabang locals. 15

Angkor Hospitalfor Children 16

Friends Without a Border • 2015 Annual ReportOpened in 1999 with just an tensive Care Unit was renovated AHC 2015 by the numbersOutpatient Department, to provide more patient privacyAngkor Hospital for Children and reduce in-hospital infec- 132,133(AHC) has developed into an tions. AHC is one of only a fewinternationally recognized hospitals with a standardised Outpatient Departmentpediatric teaching hospital. As Intensive Care Unit, and the onlythe Cambodian staff continues hospital in Cambodia with a 3,411to elevate the standard of Neonatal Intensive Care Unit.pediatric care in Cambodia, Inpatient Departmentthe Outpatient Department AHC aims to provide highhas gone from seeing 20,000 quality, compassionate care to 27,035patients a year to 132,000 in all Cambodian children regard-2015. AHC now provides Out- less of their ability to pay. For Emergency Roompatient, Inpatient, Emergency/ patients who cannot afford toIntensive Care, Cardiac and pay, AHC provides free health- 880other surgical services, Physio- care, as well as food support,therapy, Social Work, HIV, Eye round-trip transportation Intensive Care UnitCancer, and Neonatal Care, in reimbursement and a safe spaceaddition to ancillary services for their families to stay during 27,190including an on-site laboratory treatment. Through their strongand a wide variety of medical network of referral partners, Satellite Cliniceducational programs. In 2014, AHC is able to refer patients tothe Outpatient Department was other facilities should they be >186,000renovated to accommodate the more convenient or should theyincrease in patients, and in early require services that AHC does Total Treatments2015 the Emergency Room/In- not provide, such as routine vaccinations, which are provided Top Diagnoses: at no cost by the Cambodian Lower respiratory infection, government. upper respiratory infection, sepsis, and gastroenteritis. AHC became independent in 2013 and is now staffed by For more information, visit 98 percent Cambodians. www.angkorhospital.org 17

The Lake Clinic 18

Founded in 2007 by former meat, vegetables and rice, the initiated by one of TLC’sExecutive Director of AHC, children ranked vegetables the cooks, Si Sathya, an avid homeJon Morgan, The Lake highest—they learn quickly!— gardener. From just a couple ofClinic (TLC) provides medical with fish at the bottom. bottles filled with local soil, shecare and health education to expanded the idea from justfamilies living in remote and To bring these lessons home, basil and chili, to local spinachisolated areas on the Tonle Sap TLC started a “bottle garden” and green onions along withLake and its tributaries in project with the school children, mint and even tomatoes.Cambodia. TLC is the onlysustained hope of medical care TLC 2015 by the numbers 1,951for these families; other medicalcare centers are over 70 miles 4,843 Immunizations providedby boat. TLC has continued togrow and now includes 5 float- Pediatric patients treateding clinics (in 5 of 9 villages) anda small “fleet” of boats provid- 7,152 55ing transport and support fortwo clinical teams. Each team, General medicine provided Home care visitscomposed of an all Cambodianstaff, makes rounds every single 488 44day, providing medicine andeducation, and creating strong Antenatal care patients Referralsbonds in the local community. 705 120In 2015, TLC focused on theidea that “nutrition is key,” and Dental patients Birth spacingvillage health volunteers visitedlocal schools to encourage 211 1,172these ideas among local schoolchildren. In the village of Pek Eye care patients Visual acuity exams forChikrey, children learned the school childrenbasics of nutrition by describingfood as either “body building For more information, visit www.lakeclinic.orgfood,” “body maintenancefood,” or “body energy food.”When asked to prioritize theirfood tastes between fish, 19

Health Statistics CAMBODIA U.S.*All data from World Bank, 2013-2015 15,328,136 318,857,056 LAOSTOTAL 6,689,300POPULATIONPOPULATION 35% 32% 19%0-14 YEARS $1,600 $1,020 $55,200 7/1,000birthsGNI Per Capita(current US$)ATLAS METHODUnder 5 67/1,000births 29/1,000birthsMortality RateMaternal 197/100,000births 161/100,000births 14/100,000birthsMortality RatioBirths Attended 42% 74% 99%by skilled $32 $76 $9,146MEDICAL staff 20Health ExpenditurePer Capita(current US$)

Friends Without a Border • 2015 Annual ReportStatement of Activitiesand Changes in Net Assets for 2015 (Unaudited) Temporarily 2015 2014 Unrestricted restricted Total TotalREVENUE $ 1,760,291 $ 703,268 2,463,559 1,697,643Contributions – –Government contract grants – Special events 594,955 456,215Less: direct expenses 594,955 (222,311) (187,097)Patient income, fees etc. Sales (222,311) – –Collection boxes 37,488 4,482Investment income – 1,024Other income 4,131 1,602Net assets released from restrictions 37,488 1,477 2,284 92 5Total revenue 4,131 – – EXPENSES 1,477 2,881,583 1,974,794Program servicesAHC & TLC support 2,284 364,392 350,402LFHC 1,232,897 492,270Program development 451,011 (451,011) 17,209 4,500Total program services 2,629,326 252,257 1,614,498 847,172Supporting services 364,392 217,389 202,928Fundraising 1,232,897 177,863 162,232Management and general 395,252 365,160 17,209 2,009,750 1,212,332Total supporting services 871,833 762,462 1,614,498 – 1,800,394 1,037,932Total expenses 2,672,227 1,800,394Change in net assets 217,389 Net assets at beginning of year 177,863 Net asset at end of year 395,252 – 2,009,750 – 619,576 252,257 248,228 1,552,166 2,171,742 500,485 2% 85% 9% 62%Other Income Grants & Management & LFHC Contributions Program 13% GeneralSpecial Events 11% Fundraising 18% AHC & TLC ProgramsSources of Revenue in 2015 How Resources Were Spent in 2015 21

SupportersThe work of Friends Without A Border would not be possible without our generousdonors. From all of us at Friends, we would like to extend our deep gratitude to allour caring supporters all over the world. We apologize for any omissions or errors aswe acknowledge the following individuals and organizations that made significantcontributions in 2015. 22

Friends Without a Border • 2015 Annual Report$100,000+ Marily Mearns Jean A. BriggsSimon Franks Microsoft Matching Gifts Program Sheri BrooksHartmut & Ayako Giesecke Dany & Mark Ramsay Steve & Suzanne BrownEdward Stone Muhit Rahman Alexis & Steven BurakoffAndrew Wolff Stamos Capital Partners Kristen CampanaMija Yang Ungar Foundation Paul & Helaine Cantor Willie & Mika Chang$50,000+ $5,000+ Nieves B. & Alex S. ChanthasotoBuild Cambodia Carlos Belmonte Charities Aid Foundation Roberto Camacho Nerou N. Cheng (Ed & Laurie Bachrach) Barry & Naomi Cohen Diana CheungNina & John Cassils Jeff & Carla Cole Foundation, Inc. Jae Chun Darryl Goveas & Valerie Chow Dan & Sally Connolly$25,000+ Foto Care Ellen & Richard CookAsia Brokers Asset Managers RJ Hutton Charitable Trust William Cottingham George Kanas Jeffrey Cunard & Mariko Ikehara Charity Ltd. David Kronn Pushpak Damodar & Salina MaharajThe Shemesh Joester Foundation Philip Lajaunie Malcolm DanielDavid & Joan Pritchard Bernard Liberman Aaron DayPua Foundation Celia Morrissette Ellen DodgeWorld of Children Award Susan Rafte Walter & Caroline Dueger Nirit Resnick Tom Finke$10,000+ The Shelley & Donald Rubin Andrea FranchiniAvenue Capital Michael FreebornThe Big Wood Foundation Foundation Friendship With Cambodia Jake & Ewi Shafran Juliana Gamino (Marjorie & Michael Stern) Traloun Song Michael GilmoreCaroline & Jorge Camuñas Jane Tjian Lucy GoldmanDavid & Tamana Chang Ayako H. Weissman Marty & Kathy GoossenGary Cornell Howard & Ellen GreenbergThe Derfner Foundation $1,000+ Don & Joy HaleyRobert Ellis & Jane Bernstein Ronald & Judith Ablow Lee & Mary HamiltonSeiichi & Maho Fukuyama John Andresen Omar HansrodEstate of Lino Gobbi Marsha Askins Patrick HoganCorey S. Goodman & Michael Astendig Steven Holl & Solance Fabiao Ben Baccash The Honickman Foundation Marcia Barinaga Tony & Gay Barclay Horizon KineticsGreater Houston Community Susan Barrett International Society for Hazel Bercholz Foundation Terry Best Children with CancerKurt Forrest Foundation Stephana BottomMonica Rich & Rod KosannWilly & Eileen MaMichael & Carolyn Rossip MalcolmThe Marshall Family Foundation Inc 23

Helen Jessup Elizabeth Pritchard Won Chong Trading Inc.Melissa Jones Matthew & Elizabeth Quigley Asaf YogevBrice Karsh Joseph Rokacz Beverley ZabriskiePhonesouda Khamvongsa William RogersDavid Kistenbroker Travis & Julie Rushing Local SupportersGera-Lind Kolarik Kathryn Salisbury AmantakaDavid Krestin Sidney & Janet Sass Apsara HotelVarun Kumar Aileen Brody Schiro Belmond La Residence Phou VaoHal Kussick Kylie Schuyler Luang Prabang International AirportKen & Rosalind Landis Karen & Douglas Seidman Luang Prabang View HotelLang Foundation Trust Bob Shaye Ma Te SaiCorina Larkin Allan Silverstein Sala Prabang HotelJennie Lebowitz Francoise Simon Sofitel Luang PrabangVeronique Lee David & Kathryn Snell Sonphao Japanese RestaurantDavid & Pia Ledy Diane Steiner Trails of Indochina CompanyWilliam & Stephanie Lemke St. Thomas Aquinas Parish, Xiengthong Victoria Hotel (Palace)Olivier Letessier 3 Nagas by M GalleryBrian Li St. John Church & Student CenterMatthew H. Magenheim Jayashree Srinivasan In-Kind Donors ($1,000+)Steven B. Malkenson Jasmine & Mark Swope William AbranowiczPatrick Maloney Harumi Tai Alberta Health ServicesBarbara & Fred Marcus Daisuke Takahashi Mariette P. AllenAndrew Massat David & Sylvia Teitelbaum Fund Inc. Altour InternationalGeorge McClintock Miwako Tezuka Avenue Capital Management II, LPSiobhan McNally & Mark Liponis Craig Tooman & Jillian Crawford Rachel BarlowJohn Meditz Francois Turner & Robyn BeecheBruno Mejean Adri BergerKendall Messick & Paulette Wilson Marie-Michele Desfosses Big Brother MouseEdward Messikian Julian Tyacke & Kristiane Traffa Phil BorgesNippon Steel U.S.A., Inc. Wing Tsan & Mieko Wong Campbelltown Hospital, SydneyChris O’Connell Paul & Sylvie Vaccari Canadian Society of RegisteredGary O’Connor Kathy Valko & Alexander CookMichael O’Connor & Susan Leon Louis & Kimiko Vigden Orthopeadic TechnologistsNouanenith & Bob Paiva Gregory & Teresa Wakabayashi (Calgary Chapter)David Park Jeffrey Waltcher & Timely Rain William CarterRobert Pascoe Atsuko Watanabe Paul and Gabriel ChaleffScott Pearson Audrey Weaver & Michael Vogan Alisa Eva ChazaniRebecca Perrin & Michael Gulas Barbara & Frank Weiner Nerou N. ChengTatiana Pouschine Jack Weiner Commerce Graphics Timothy M. Weiner Ellie Davies Steven Williamson Margo Davis 24

Friends Without a Border • 2015 Annual ReportDominic DeFrancis Hiroyuki Matsuoka Kai StuhtMonica Denevan Steve McCurry Hiroshi SugimotoDeonne Dersch-Mills Siobhan McNally Jasmine SwopeDirect Relief International Amanda Means Eric TaubmanCeline Drean Barbara Mensch The Children’s Hospital atSteve Dunning Marilee MinerEdgewood College Daniel Mintz Westmead, SydneyAshley Emmerton Richard Misrach Charles TraubBrian English Daido Moriyama Brian TsengElliott Erwitt Marvin Newman Richard TuschmanEstate of James Karales Stefano Nicolini Setthy UngMillie Falcaro Cheri Nijssen-Jordan Carolyn UsherTom Finke Hank O’Neal Vitamin AngelsFrank Fournier Wendy Paton Lisa WalshDaniel Glico Ed Pfizenmaier Hiroshi WatanabeHoward Greenberg Sue Phim William WegmanHakujyuji Co.,ltd José Picayo Timothy WeinerRose Hartman Andy Plager Susanne WernerHerb Ritts Foundation Robert Polidori Greg WrightEikoh Hosoe RAD-AID International George S. ZimbelKenro & Yumiko Izu Beatrix ReinhardtStephen Joester Dave & Marnie Rickards LFHC Co-FoundersBill Kane Saul Robbins Act Against AIDSMichael Kenna Sheila Rock 「THE VARIETY」Laura Labelle and Aimee DeLeon Michael Sabo Ed Bachrach &Michael Lang Sand & StoriesPhilippe E. Laumont Tomoko Sawada Laurie Bachrach, MDLe Sen Boutique Hotel Robert Schaefer Nina & John Cassils, MDAnnie Leibovitz Leanne Schanzer David & Tamana ChangSaul Leiter Foundation Scheinbaum & Russek Ltd. Drs. Jay J. & B. Hyun ChoiElaine Ling Ken Schles Edward E. Stone FoundationLiverpool Hospital, Sydney Peter Serling Franks Family Foundation Michael Shapiro Hartmut & Ayako Giesecke Christophe Lunn Saschy Singh Houryuji in honor ofJenny Lynn Alex SmithEllen Kaplowitz South Austral Pty Ltd Houmyo SaitoRob Kinmonth Jonathan & Marci Spector Kenro & Yumiko IzuKunSik Harvey Stein Yollanda Cheung &Masatomo Kuriya Peter SteinhauerMichael Maher Rupert Christopher Li Nakayama Shingosho-shu Gratitude Campaign Fund 25

How you can help 26

Friends Without a Border • 2015 Annual ReportEvery single day, children die Heal a Child, Save a Life Give the Gift of Stockfrom preventable diseases andtreatable illnesses such as Give a gift to support our efforts Donating stock or mutual fundsmalnutrition, pneumonia, and to provide international-quality to Friends Without A Border is adiarrhea, simply because they and compassionate healthcare tax-wise approach for caring fordon’t have access to medical to the children of Southeast children in need. Making a giftcare. Our holistic model of Asia. Make an instant, secure, of securities is simple and offers“Treatment + Education + and tax-deductible donation a number of valuable financialPrevention” ensures that online by visiting www.fwab. benefits. We encourage youyour support not only treats org/donate, or give us a call to consult your personal taxchildren in need, but promotes at 212.691.0909, or by mail to advisor to evaluate your bestlong-term and sustainable Friends Without A Border. options when making a dona-development. tion of securities. Honor a Loved One Start a Fundraiser Honor someone special with a tribute gift, a donation made Celebrating a birthday, wed- in someone else’s name. Your ding, or other big event? We tribute gift can be in honor of, can assist in organizing com- or in memory of, a friend, family munity events from bake-offs member, colleague, loved one, to bike races. Simply start or just someone special. Your a fundraiser on Crowdrise, honoree will receive a personal- GoFundMe, or FirstGiving, and ized letter introducing them to select Friends Without A Border the children that their gift was as your charity of choice. able to impact. Friends Without A Border Create a Lasting Legacy 1123 Broadway, Suite 1210 Consider including Friends in New York, NY 10010 your estate plans. A gift to Tel: 212.691.0909 Friends Without A Border in your Fax: 212.337.8052 will or living trust allows you to retain assets during your lifetime, email: [email protected] minimize estate taxes, and is a lasting investment in advancing www.fwab.org our mission and ability to respond to future challenges. 27

Board / staff 28

Goodwill Ambassador Friends Without A Border Lao Friends HospitalYo-Yo Ma (2016) New York for Children Executive DirectorBoard Chief Operating Officer Cheri L. D. Nijssen-Jordan, MDRonald D. Ablow, MD FRCPC FAAP MBADavid Chang Akiko AraiNerou Cheng, CPA Medical DirectorKenro Izu, Development & Events Manager Siobhan McNally, MD Founder and Honorary President Juan Carlos Uribe Vega Deputy DirectorStephen JoesterPhilippe Lajaunie Donor Relations Jennifer BrownMatthew Magenheim, Chair AssociateMichael Malcolm Medical EducationTina Patterson Stephanie Lowry DirectorDavid J. PritchardJonathan Spector, MD MPH 1123 Broadway, Suite 1210 Michael Maher, MDMichael Stern New York, NY 10010Timothy M. Weiner, MD Tel: 212.691.0909 Director of NursingAyako Weissman Fax: 212.337.8052 email: [email protected] Jessica Dwyer, RNMedical Advisors www.fwab.orgDavid L. Pugatch, MD Clinical OutreachCharles F. Craft, DDS Friends Without A Border Coordinator JapanYoung Ambassadors 1-7-5-203 Shimo Meguro Kazumi Akao, RNDiana Cheung (2016) Meguro-ku, TokyoTodd Joseph (2016) 153-0064 Japan Director of Tel: 81.(0)3.6421.7903 Administration Fax: 81.(0)3.5722.2060 www.fwab.jp Rodney Miller Located on the grounds of the Luang Prabang Provincial Hospital P.O. Box 873, Luang Prabang, Lao PDR Tel and Fax: 856.(0)71.254.247 email: [email protected] credits: Adri Berger, Diana Cheung,Shigemi Hirano, Geoff Ridenour,Paul Wager, Ellen Wallop, Bryan Watt

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