2022 Annual Report & Accounts

What we do and why

In this report, we describe our activity during the second full year of the coronavirus pandemic. As UNICEF observes, this global crisis has had a lifelong impact on many children in the poorest countries, 'who risk being among its biggest victims'. In addition, millions of children have been displaced this year in new or renewed conflicts. Over 1 million children have fled Afghanistan and 5.2 million have been displaced by the war in Ukraine (3 million inside the country and 2.2 million outside it), which began in February 2022. Gazan children experienced two weeks of intense bombardment in May 2021. In Syria and Yemen, there is now a fragile peace, but living conditions in those countries continue to deteriorate. Many children are growing up without the basic security they need to develop, learn, and grow into capable adults. So the work we do to repair the impact of trauma is needed more than ever.

We are enormously proud this year to have updated our materials and tools and continued training local people working with traumatised children, both online and once again face-to-face. This report provides detail of all we have achieved thanks to all our donors, and growing team of committed and highly professional volunteers listed in section 1. In addition to the one-to-one Children’s Accelerated Trauma Technique (CATT), we have delivered our anxiety and resilience (A&R) group training programme, and Children & War’s Teaching for Recovery Technique, to people working in areas of ongoing instability or conflict. We have also delivered PTSD Awareness training to community leaders in order to enhance wider understanding of the impact on children and reduce the stigma associated with their troubled behaviours. Recently, we have also published online a guidance paper on how to support refugee children as they arrive in new communities. Once our materials have been translated and delivered in Polish (work now in progress), we will have trained counsellors working in five out of the top six countries hosting refugee children (Türkiye, Colombia, Uganda, Pakistan, and Poland).

Don’t forget: we can’t change what has happened, but we can – and do – change what happens next. By healing young minds, we give them another chance at a normal life.

Reference and administration details

Charity name and details

Luna Children’s Charity, working name: Action for Child Trauma International. Registered Charitable Incorporated Organisation (CIO) in England & Wales, Number 1272010

Registered address: 184 Medstead Road, Beech, Alton, Hampshire GU34 4AJ

Website: www.actinternational.org.uk

Facebook: www.facebook.com/ActionChildTraumaInternational

Twitter: https://twitter.com/LunaChildren

Charity trustees

Victoria Burch (Clinical Lead Trustee)
Stella Charman (Chair)
Jenny Cuffe
Dr Yara Fardous
Anne Feeney
Brenda Graham (Safeguarding Lead)
Saif Ghauri (Treasurer)
Philip Sarell

Officers

Fahed Al-Oqaili – Middle East Operations Manager
Elias Byaruhanga - Uganda Operations Manager & Senior Trainer

Specialist volunteers this year

Armenian translators – Narine Abrahamyan & Lilit Karapetian
Fundraisers:
Tom Anson
Rosemarie Ghazaros
Penny Jeffcoat
Amy Pope & family
Psychology assistant – Lily Holland
Website & IT support – Hector Riley & Glenn Adams
DT advisor – Kim Eakers
Journalist – Jessie Williams

Interns

Zara Bracegirdle – University of Sussex, General Operations Assistant from October 2021
Ruby Turok-Squire – University of Warwick, General Operations Assistant to September 2021

UK-based trainers active this year

Maria Chambers
Anna Kalin
Pippa Barow

Spanish trainers active this year

Almudena Garcia Perea
Pilu Rivas Lobo

Uganda-based trainers active this year

Sister Florence Achulo
Syson Katushabe
Candia Umar
Timona Asua

Middle-East based trainers active this year

Dr Ghalia Al Asha
Fahed Al Oqaili
Mohammed El Sharef
Haitham Shamiah

Governance and management

This year we have succeeded in resuming overseas trips as travel restrictions eased, and in the early part of 2022 managed to fulfil all the training commitments to partner organisations, which had been postponed as a result of the pandemic. Our training model has adapted well to new conditions, but need for child trauma training and support has rocketed. So, although we are financially sound at the current scale, trustees are anxious for growth in 2022/23 that will enable us to expand activity to meet increasing demand from many agencies working directly with children. As a consequence, we have begun to focus on raising our profile and publicising what we do more widely, with evidence of its effectiveness, in order to gain recognition and attract partnerships and funding for the future. This initiative led by trustee Jenny Cuffe is explained further in section 4.6, and Section 5 provides a more detailed overview of our financial position at the end of March 2022.

From 1st December 2021 Dr Carlotta Raby released the CATT licence which we have held exclusively for 7 years,so that any organisation is now able to train people to use the protocol. Technically this means we have lost our ‘unique selling point’ but in practice no other organisation has the ability or experience to train overseas, and we gain greater flexibility over whom we can train and how, as well as control of our charging policy. Trustees, however, agreed to maintain the same high quality standards required by the licence and to continue to promote the humanitarian and right-based principles upon which Dr Raby designed CATT in 2005.

This year we recruited a new trustee, Simon Stewart, to help us improve our online presence and with responsibility for digital transformation, which he undertakes in a paid role for the Samaritans. Our trustee recruitment process is painstaking and takes several months, so he was not formally appointed until June 2022, thus does not appear in the trustee list in section 1. At the same time Philip Sarell, who has been a Trustee since the early days of Luna Children’s Charity, retired with our very grateful thanks for all his support over the past 13 years. He made an invaluable contribution to the early development and subsequent sustainability of this small organisation. ACT International relies heavily on its trustees and specialist volunteers to lead and undertake the key tasks and obligations of running an effective and competent charity. Additional capacity this year was once again provided by interns. In the autumn, Zara Bracegirdle took over the general support role of Operations Assistant from Ruby Turok-Squire who left us to become a barrister specialising in family law and children’s rights. Tom Anson, another Sussex University masters student, contributed over the summer in a fundraising role. In February 2022 Zara accompanied the CATT training team to Colombia and remained there until May in order to gain valuable overseas experience. This enabled her to gain a place for 2023 on the Global Mental Health MSc course at King’s College London. We thank all four of them and wish them well. We cannot offer payment to our interns, but we do support their career development as best we can. Without their input and those of all our volunteers, ACT International simply would not exist.

Objectives and activities

ACT International exists to advance the rights, education and health of children and young people affected by conflict and trauma. Formally, its objectives are:

The advancement of education and preservation of good health of children and young people affected by conflict and/or trauma
To advance the education of the public in children and young people’s rights in part, but not exclusively, under the UN Convention of the Rights of the Child

In the past ACT International’s charitable objectives have been primarily achieved through the delivery of training in the Children’s Accelerated Trauma Technique (CATT). However, over the past three years we have been broadening our activities so that we now fulfil our purpose through a wider range of training, both online and in person, and by supporting people working with children affected by conflict and/or trauma. These activities are:

Training of people working with children in their communities, both in person and online:

Children’s Accelerated Trauma Technique (CATT) created by Dr Carlotta Raby
Anxiety and Resilience Programme (A&R) compiled by Victoria Burch
Teaching for Recovery Technique (TRT) developed by Children & War Foundation
PTSD Awareness: bespoke training to meet needs of local culture or experience
Safeguarding, based on Keeping Children Safe guidance for relief and development charities, and integrated into all our training as appropriate to the local culture or context.

Special projects offering wider support in areas of particular need or for specific types of children (e.g. trafficked girls cared for by the Bishop Asili Community Development Foundation).

Supporting individuals who work unaided or in isolation, in areas of need (e.g. Alhagie Camara for the Gambia).

Developing materials for use with children (eg Tortu the Very Worried Tortoise by Victoria Burch) in specific contexts, or to support good practice.

The Trustees confirm that they have complied with their duty, under section 4 of the Charities Act 2011 to have regard to the Charity Commission’s guidance and regulations on public benefit and that the public benefit requirement has informed the activities of the Charity in the year to March 31st 2022.

Achievements and performance

CATT training and follow-up

CATT Counsellors Conference in Kampala

This conference was originally planned for May 2020 but could not be held due to the coronavirus pandemic. However, as restrictions on movement began to be lifted at the end of 2021 we started planning for it to take place at last, in May 2022. We are delighted that a successful conference has taken place but as it fell outside the period covered by this Annual Report, it will be reported on in full next year.

CATT training in the Gambia

Our first post-pandemic overseas CATT training trip took place in February 2022. This was organised and planned with our in-country partner WAYAS Counselling & Psychotherapy Service, led by Director Alhagie Camara. The experienced training team included Elias Byaruhanga from Uganda, in addition to Maria Chambers from the UK. The trip resulted in the award of 18 CATT certificates to counsellors from a variety of local NGOs and Government agencies, presented to them by the Minister of Women, Children and Social Welfare. Follow-up supervision is being co-ordinated by WAYAS. There was also a wider purpose to the trip, in terms of promoting WAYAS and mental health service development within The Gambia. Members of the team accompanied Alhagie to a meeting at the National Human Rights Commission, and visited the country’s single mental hospital, Tanka Tanka, plus a Government-run children’s shelter. The trip was completed slightly over its £10,000 budget and at a cost of £560 per CATT certificate awarded, and was a more expensive one than our usual training courses in Africa. The reason is that training partner WAYAS had no resources of its own to contribute, as well as increased costs of travel due to the pandemic. We hope to return in 2023 to run a second course and provide trainer training to those counsellors who have been able to use CATT effectively.

CRESS CATT team

We reported last year on the setting up by CRESS (Christian Relief and Education for South Sudan) of a specialist CATT team working with South Sudanese refugees in northern Uganda. This year we continued to support the work of the team by providing £1,000 to supplement CRESS funding. Over the year, the CATT counsellors supported 611 children and young people and carried out an extensive programme of trauma and emotional health awareness across the refugee settlements, which are now home to around 950,000 people. You can read more about the work of the team on the CRESS website here.

We trained two of the team as CATT trainers in September 2021, and three attended the CATT counsellors’ conference in Kampala in May 2022 where they received their certificates and made a tremendous contribution due to their extensive experience of treating child trauma.

CATT training in Colombia

In February 2022, we were finally able to follow up on the online training delivered last year by sending a team of three Spanish-speaking trainers to Colombia. The trip was organised and partially funded by Children Change Colombia (CCC), with which we have developed an excellent partnership. The course took place in Bogota, but the 20 participants came from all over the country and are now using their skills to help children in a wide range of challenging and life-threatening situations. Follow-up supervision is being provided by CCC with support from our two Spanish trainers. Once again, we hope they can return in 2023 to run a second course and provide trainer training to those counsellors who have been able to use CATT effectively over the past year. The total cost of the trip was under £3,000 thanks to input from CCC, so £150 per CATT certificate awarded.

Training for International Rescue Committee staff in Arua, Uganda

In December 2021, a last-minute request for CATT training was received by senior trainer Candia Umar in Arua, Uganda from the local representative of IRC (International Rescue Committee). It was possible to give immediate consent to this as the terms of our Licence Agreement no longer applied, and IRC were able to fund all costs with the exception of one trainer. A total of 11 certificates were awarded, and one counsellor attended the conference in Kampala in May. We are delighted to have had the opportunity to train for such a large and well-respected international organisation.

CATT trainer training

Crucial to the sustainability of our training model is our ability to train local CATT counsellors, who are using the technique effectively to instruct others to use it too. As part of the protocol, they also learn about the importance of children’s rights and psychoeducation, thus promoting child protection and reducing stigma in their communities. However, our inability to travel during lockdown left us with a backlog of people willing and qualified to train as CATT trainers, so we designed an online approach incorporating four two-hour theory sessions taught over two days, with some homework, followed by supervised local teaching practice. This took place for our two Gazan CATT counsellors in August 2021, and five Uganda counsellors based in two locations in September. It was also an opportunity to update two Ugandan trainers who had not used their CATT training skills for several years. Online teaching was delivered by Stella Charman and Brenda Graham at zero cost, and was supported by Dr Ghalia Al Asha, Umar Candia and Elias Byaruhanga. We are delighted to have added seven new CATT trainers to our international network, now totalling 28 accredited CATT trainers.

Anxiety & Resilience Programme Training

Middle East

Our Anxiety and Resilience (A&R) Programme, designed for children in challenging post-conflict or post-disaster settings by our Clinical Trustee Victoria Burch, has now become an important part of our overall training 'offer' and is much easier than CATT to deliver online. It takes 15 hours, usually spread over three days and has primarily been delivered in Arabic by senior trainer Dr Ghalia Al Asha with the support of Fahed Al Oqaili, Director of the Altakaful Charitable Foundation in Jordan. This programme was delivered to staff of Altakaful (13 participants from 3 centres in Jordan) in June and later in the year to teachers in Yemen. Finally, for the year covered by this report, training was given in February to staff of the Hope Revival Organisation (20 participants from 2 centres) in Jordan. We have received feedback from all those trained, who have been able to apply at least some of the techniques they have learned to help children in their care. Whilst online training enables us to reach people who are unable to travel or living in inaccessible, dangerous areas, it is prone to internet connectivity problems and face-to-face training is inevitably more engaging and ultimately effective. So we are delighted that Dr Ghalia and Fahed have been able to begin in-person training again in 2022-23, which will be reported on next year.

The Yemen

At the time of writing there is a fragile peace in the Yemen, but children in this country remain threatened by famine and the return of hostilities. Thanks to our partnership with Canadian NGO ‘Bridges to Peace and Solidarity’ led by the indefatigable Dr Kawkab Alwadeai, we have been able to build on the success of the pilot in Yemen in March last year. A&R was rolled out to two more provinces in the Yemen (Aden and Hadramout) in October, with training attended by 30 teachers and mental health workers. A&R training for the Yemen has been supported and funded by our partners IMET2000 and the British Yemeni Society with incountry input from HSA Charitable Foundation. An introductory session was also run for 15 staff from Al Wahda Milat School in the Yemen on behalf of the Tamdeen Youth Foundation.In the forthcoming year we plan to further develop our support for Kawkab’s work on behalf of her home country, and have sponsored her to make an awareness-raising video in Arabic about anxiety and mental health issues among children. A previous video which she made about addiction and mental health had over 100,000 views on Facebook.

Armenia

Following the war between Armenia and Azerbaijan in Nagorno-Karabakh/Artsakh in September 2020, the focus of our partner charity, the Yerevan Children’s Center, turned to supporting Armenian children who were victims of the conflict and now live with its consequences. As reported last year, we put CATT training on hold and instead provided funding for two of the Center’s psychologists to translate and deliver A&R training. At the time of writing, we are making plans for this to take place before the end of 2022.

Teaching for Recovery Technique (TRT)/Children and War Manual: Colombia

In April and May, our three Spanish trainers each delivered a 14-hour online TRT training course. 25 staff of NGOs supported by Children Change Colombia (CCC) were trained remotely. They provided very positive feedback but were keen to receive further training in person once the pandemic had abated. The course and basic materials, including a manual, were developed by the Children & War Foundation, but considerable time was spent by the training team in preparing a set of colourful slides (now shared with Children & War) to support the training programme. It is aimed at groups of children, e.g., in classroom settings, to learn skills and techniques to help them deal with their experiences and to decrease their chances of needing specialist treatment. The objective of the course was to give the participants the tools to provide care for children enduring the psychological effects of disastrous events.

Following the training, candidates for in-person CATT training were identified and, thanks to the fundraising efforts of intern Zara Bracegirdle, two of the team (Almudena Garcia Perez and Pilu Rivas Lobo) travelled to Colombia in February/March 2023, accompanied by Zara, to deliver CATT training. We report on this course in section 4.14 above.

Special Projects

Gaza Child Trauma Clinic

The Gaza Child Trauma clinic is a joint project with IMET 2000 and Firefly International. This year has been a traumatic one for the people of Gaza, beginning with 11 days of bombardment in May 2021 which destroyed many buildings and infrastructure, including our clinic in the Adam Center on the 7th Floor of Al Jawhara Tower. Thankfully, our staff Mohammed El Sharef and Haitham Shamiah survived with their families, and all clinical data saved in electronic form was preserved. Following the bombardment, the clinic was relocated thanks to the generosity of IMET and Firefly supporters, and all children previously treated were reassessed, with only two requiring further intervention.

An analysis was undertaken of data from 69 children treated by the clinic in 2019-20, which showed that CATT significantly reduced trauma symptom severity in children and young people experiencing cumulative and ongoing stressors from conflict, violence, and associated socio-economic instability, including those with chronic symptoms. Limited data from a small follow-up group indicated that CATT may increase children and young people’s psychological resilience and mitigate the impact of further traumas. Further information about this study is downloadable from our website here.

Despite deteriorating living conditions and spasmodic recurrences in conflict, the clinic has grown over the year thanks to additional investment by IMET and Firefly, and now employs two part-time psychologists (who have been trained to use CATT) with the input of a psychiatrist (also now CATT trained). It continues to provide trauma awareness-raising and education events, receives a steady flow of referrals for PTSD treatment, including from Médecins sans Frontières and the Ma’an Development Centre, and has been visited by the International Red Cross. This growth would not have been possible had it not been for the commitment and funding of the service by IMET and Firefly. As a small training charity, this goes beyond our capacity and in January 2022 we withdrew from operational responsibility for the service. However, we continue to provide trauma training and clinical supervision via Dr Ghalia Al Asha, and to advise the Project Team.

The Friends of Butabika Children's Ward

After coronavirus travel restrictions were lifted in Uganda, Dismas Lwagula was able to return to the children's ward at Butabika Hospital where he volunteers for four days per week, supporting the staff team with activities for the children. The Friends' Project continued to fund his expenses throughout the year (£900) and also sent £300 in December for a Christmas present of games and toys to be kept on the ward. Elias Byaruhanga has also kept in close touch with Reverend Dismas Besigye of St Luke's Chapel, which is formally our 'partner' for this work. Elias has visited the ward on several occasions and reported back to us on the staffing situation, raising ongoing concerns about safeguarding. Trustees Stella Charman and Brenda Graham attended the East London/Butabika Link meeting in July to inform them of these concerns, which were raised with the Hospital Director and are an ongoing item on the Link meeting agenda. Unfortunately, Rev Dismas is planning his retirement in early 2023 and we are currently seeking an alternative mechanism for ensuring regular monitoring of the ward and support for Dismas Lwagula, as well as a Project Manager for this work. More positively, Dismas Lwagula has been privately funded to attend the two-year CAMHS Diploma course in the PCO School at Butabika Hospital, beginning in August 2021. So he is developing his skills and knowledge which can be used on the ward in future to supplement the clinical team there, and we plan to increase ongoing funding for him, in recognition of this.

Bishop Asili Community Development Foundation

Over the past year, Sister Florence has continued to focus her work on children (mainly young women and girls) who have been abused or trafficked, living in the local community. In April, Elias Byaruhanga visited Lira to support her and her colleagues, offer consultation and advice on individual children, and assess their overall needs. Trustees approved a special grant of £625 which was spent on a variety of educational activities, including school fees and training in practical skills to enable them to support themselves. Elias returned with Syson Katushabe in October to help Sister Florence run a PTSD Awareness course for the local community, which included a workshop on sexual violence and its effect on the mental health of families and children. It was attended by 20 people at a cost of £2,800. The key objective was to equip them with the ability to recognize PTSD and refer children to the right people for help. As a consequence, a number of them have requested CATT training and we hope to deliver a course in the Autumn of 2022 (currently being planned). Afterwards, we received the following e-mail from the Director of the Centre for Adolescent Reproductive Health in Lira. He and some of his staff attended the training. He told us:

‘I was glad to attend your training workshop on post-traumatic stress disorder. I was amazed to share my experience of being a child soldier and a rebel commander. That day I as well learn a lot on how stress can be solved. Therefore, I feel inspired to do more for the affected children in northern Uganda.’

Fundraising

Once again, we had relatively low expectations of fundraising during the pandemic but are delighted to report that this year has been our most successful one ever, with nearly £35k income achieved. None of this has come in as a result of grant bids, despite several being submitted. Primarily, it was the result of the great generosity of faithful regular donors, and some magnificent individual initiatives (see below), which have greatly increased the proportion of our income from these sources from 20% to 46%, and for which we are enormously grateful. We have also benefitted from the ongoing hard work and support of volunteer Penny Jeffcoat with all our fundraising efforts.

At the end of November 2021, the Virgin Money Giving platform closed and we transferred to CAF Donate. All regular donors were contacted and asked to transfer their giving. Thanks go to Treasurer Saif Ghauri and IT consultant Glenn Adams for making this seamless transition.

Donations from corporate sponsors, charitable and grant-giving foundations

£5,000 Joan Ainslie Trust
£2,000 Marine House at Beer Art Gallery
£5,000 De Brye Charitable Trust
£2,000 Chartwell Industries Ltd/Cripps Foundation
£2,250 IMET 2000
£2,000 British Yemeni Society

Online campaigns and fundraising events

£3,000 raised by Michael Coates’s Thames 26 Endurance Swim
£1321 raised by Pippa Gray & others for the Gambia
£1,650 Stephen Riley & Victoria Burch’s wedding
£1,500 raised by Tom Anson,Zara Bracegirdle with help from Amy Pope & family (pub night and Brighton marathon)

Individual donors

£1,025 from Rosemarie Ghazaros for profile-raising
£7,400 from miscellaneous donations made by individuals, including Neil Appleyard, Una & Alex Henderson, Ian Tegner and Yvonne North, and others who prefer to remain anonymous

Funding sources (%) year ended March 2022
Funding source	amount	%
Charitable Trusts/Foundations/Corporates	14,000	40%
Other charities	4,250	12%
Campaigns & events	7,471	22%
Individual donations	8,444	24%
Income from activities/interest/refunds	428	1%
TOTAL	34,593	100%

Communications & profile-raising

In August, a subgroup of three trustees met with Rosemarie Ghazaros to think about our communications strategy. Following discussion, it was agreed that a profile-raising strategy was primarily required, to ensure that more people and organisations know about the work of ACT International and specifically fundraisers, philanthropists and potential partners. Our work is relevant to many of the issues people are concerned about, i.e., children in conflict, peace building, natural disasters, refugees, mental health, prevention of terrorism, the impact of COVID-19 and disease. We agreed that our strategy needed to extend beyond the website and social media to traditional media and that we should be proactive in responding to events in the news. This approach was subsequently approved by the Board and we recruited a young freelance journalist, Jessie Williams, who volunteered to visit Armenia. Her excellent article was published online in Open Democracy, and resulted in some social media attention and a spike in visits to our website in November. Link to the article.

In November, Toria Burch ran a session for the Consortium for Street Children’s Annual Network Forum which also contributed to the surge of visits to the website. As a result, we were approached by UK & Ugandan charity SALVE (Support and Love via Education) which cares for rescued street children. They requested training which was scheduled in May, and will be reported on in next year’s report.

Following the Russian invasion of Ukraine, Toria was interviewed about the impact of the war on children by a reporter for Devex (the media platform for the global development community). She also put together some guidance, with the assistance of Anna Kalin and Ghalia Al Asha, about how to support children in the days and weeks after conflict. It is downloadable from the website and we are working on the translation of our materials into Polish and Ukrainian.

Website and social media

The website had 2.8K unique visitors this year - a 12% increase on last year. Our largest source of traffic remains direct visits. We have seen a 75% increase in traffic from Google but a 90% decrease in traffic from Facebook. “Trauma international” and “international children’s charities” were the search terms giving us the largest number of search impressions though the clickthrough rates for these were low relative to other search terms. Our average position in google search results was low for these terms compared to more focused terms like “catt training”, “childhood trauma charities”, “stella charman”, “carlotta raby” and “meet tortu”, which all had significantly higher clickthrough rates, placing us on the first page of google results.

Geographically, the proportion of our traffic coming from the UK decreased and the amount of US traffic doubled. The rest of our traffic is distributed globally, with increases in the Gambia, Uganda, and Palestine, though fairly small numbers from each.

With the support of Simon Stewart, our new trustee who has been tasked with reviewing our digital and online profile, we are currently looking at opportunities for driving more traffic to the website and assessing the effectiveness of our social media. Through Facebook, we reach 800 people and have 300 followers on Twitter. Pippa Barlow is now managing the closed Facebook group, and invitations have recently been sent to all who attended the Kampala conference or who had recently been training to use CATT. This group currently has 73 members. Yara Fardous has set up the Arabic group which both CATT and A&R trainees can join, and she is in the process of setting up an Instagram account.

Quality Assurance & Research

COVID-19 and associated lockdowns have caused so many hardships across the world this year, but the development of technology for remote training has been a definite benefit for ACT International. Over the year our clinical lead Victoria Burch has attended online conferences and webinars which would have been impossible to travel to in person, allowing some very current research and the experience of world experts in psychological trauma to be incorporated swiftly into our training programmes.

CATT course update

Re-writing and updating our CATT course was a major focus of the first few months of the year. The aims were to update the content in line with current research and best practice, simplify the language to make it easier to translate and use internationally, and to build in features which would enable the course to be taught online if necessary. The updated material was critiqued and approved by our lead trainers in the UK, Uganda, and the Middle East, all of whom now have the updated slide pack. After discussion, we have agreed that while theoretical aspects of CATT can be taught safely online, the practical part of the course should be delivered through face-to-face training wherever possible, to assure quality and safety for both trainees and the children whom they treat.

Uganda

Whilst awaiting our postponed clinical conference (section 4.1.1), improved IT access enabled several online supervision discussions with trainer/counsellors in remote areas of Uganda with questions about clinical practice. We plan to increase informal online meetings which are valued by all participants. The first pre- and post-treatment data from the CRESS CATT team who work with traumatised children in the settlement areas and camps for South Sudanese refugees, demonstrated that CATT is an appropriate tool for use by people who may themselves have had limited access to formal education, and showed how effective it is in freeing children from symptoms of trauma in this difficult setting. We look forward to reviewing more pre- and post-treatment data and case stories next year.

Gaza

In May 2021, The Children’s Trauma Clinic in Gaza was tragically destroyed during 11 days of bombardment. Mercifully no one was hurt, but all written records were lost. That the clinic was able to open again only two weeks later (in temporary accommodation) was due to the swift action of IMET2000 and Firefly International, the dedication of the two clinicians, and also to excellent online record keeping. This is so important both for keeping track of patients and for audit. The clinicians contacted all families whose children had been treated for trauma previously at the clinic. Remarkably only two of these children had signs of trauma despite high levels of trauma experienced by people in Gaza generally after the bombardment. This demonstrated, better than any research study, the impact of CATT on building children’s resilience to cope with further adversity, and confirmed our view of its appropriateness for traumatised children in areas of ongoing and intermittent conflict.

Anxiety and Resilience Programme – Pilot Study

This new manualized group course was written after discussion about the needs of Syrian refugee children and families with UOSSM, a partner organization based in Turkey. It was designed for counsellors, teachers, or others who support stressed and anxious children in areas affected by violence, conflict, or disaster. After online training by our senior Arabic trainer for the Middle East, Dr Ghalia Al Asha, UOSSM ran a pilot study for the programme with 12 groups of displaced children and teenagers. Many of the children have lost a parent as well as their home, and all face ongoing hardship and adversity due to the war. Feedback from the trainers indicated that the programme was very well received by children and their parents. The children’s scores on a short anxiety assessment carried out before and after the course were analysed by ACT International assistant psychologist Lily Holland, and were shown to be significantly lower after the course. We are very grateful to UOSSM for field-testing the programme and providing such useful feedback, which led to some adjustments to the material before its use in other countries. Feedback from trainees in Yemen and in Jordan led to further minor adjustments for online training.

Supervision

Supervision for new trainees in any mental health programme is essential for maintaining quality and safe, effective practice. Dr Ghalia Al Asha has provided online supervision to the Gaza CATT clinicians, and also to Anxiety and Resilience trainees in Yemen and the Middle East for the first six months after their training course while they become familiar with using the materials. We are hoping to find another experienced Arabic-speaking mental health professional to join us to help with training in this area. Elias Byaruhanga and Umar Candia provide regular supervision to counsellors in the refugee settlements in Uganda. All newly-trained counsellors are invited to join our private Facebook groups in English and Arabic where they can obtain useful new material and information, and share any issues of concern in a confidential online space.

Future Plans

Building networks of trainers and counsellors who can work together in their own language helps to ensure our courses are appropriate for different conditions and settings. Through our cascade model, we have grown a robust network of people who train, supervise, and provide consultation in Uganda. The Ugandan trainers also lead or participate in training in other countries in the region, where their knowledge of local situations helps to make our training culturally acceptable as well as clinically effective. We have a small but strong team within the Middle East operating in Arabic. We aim to build and further develop these networks, and our teams of trainers working in Spanish and Armenian.

Safeguarding

ACTI safeguarding activity covered four key areas of work this year:

In May 2021 the Gaza Child Trauma Clinic team and Safeguarding lead trustee Brenda Graham were finalising the clinic safeguarding policy when the clinic was destroyed and had to relocate after the Israeli bombardment. However, the work they had done on creating a safe environment for children, and safe recruitment of staff and volunteers, meant they could set up swiftly in a new building and take on more staff.
In April and November 2021 Elias Byaruhanga, Uganda Operations manager, visited Butabika Children’s Ward and noted the ongoing under-staffing and continuing difficulty with resettlement of children back to their families and community due to under-resourcing of social work. His concerns about poor staffing levels and few resources for children were reported by the Safeguarding Officer Brenda Graham to East London/Butabika Link and have been raised with the Hospital Director. Safeguarding on the ward will now be a standing agenda item for the Link at its regular meetings.
CATT training trips to the Gambia and Colombia finally took place in February 2022. As part of planning our first trips to these countries we exchanged safeguarding policies with WAYAS (Gambia) and Children Change Colombia and learned more about the risks faced by children they work with. In Colombia, street children live chaotic, dangerous lives, at risk of physical harm, neglect and exploitation. In the Gambia children experience and witness domestic abuse and sexual violence within their home and community. A whole day of training for the Gambian participants in February 2022 was dedicated to safeguarding. Discussions about safeguarding are part of CATT training and always reveal the professional and political challenges our CATT counsellors face every day.
In March 2022 our ACTI Safeguarding Children Policy was updated, agreed by trustees and is now available for all to view via the website

Apart from ongoing concerns about the Butabika Children’s ward, no other incidents have been reported to the Safeguarding Officer this year. We continue as an active member of Keeping Children Safe.

Financial Review

The overall economic climate during the year remained challenging with the continued fallout of COVID-19 and the commencement of Russian aggression on the sovereign state of Ukraine in February 2022. The effects of war, global inflation, future waves of COVID-19, China’s economic slowdown, and supply-chain disruptions are the top risks right now, according to a recent Dun & Bradstreet analysis of global business risks. We need to add to this the impact of climate change and the rise of geopolitical unrest leading to divisions and causing further misery and suffering to those disadvantaged.

ACT International, despite these challenges, has been supported by its core funders and harnessed the efforts of individual fund-raising initiatives to generate close to £35,000 and apply these funds across countries. At the end of 2021, the Board of trustees set an ambitious and stretched programme for 2021/22. The operational team[s] have shown tremendous resilience by mobilising and delivering strategic programmes on site. They continue to explore and reach out to provide a better future and hope for the children. Our liquidity year on year remained on level pegging. During the period, due to fund-raising efforts and the generosity of our donors, the trustees secured nearly £35,000 during the year ended 31st March 2022.

Looking forward, the trustees remain positive despite the back-to-back challenging times. With elevated levels of inflation and the cost-of-living implications, this could be a 3–5-year cycle and will impact the sector. Invariably the greatest impact will be borne by those who are vulnerable across the globe. Our focus and priority will remain on optimising the aim and objectives of ACT International.

17% Uganda: all training & Operations Manager
7% Yemen
3% Armenia CATT training
9% Bishop Asili Foundation Special project
3% Cress partnerships
6% Colombia
3% Friends of Butabika Children's Ward
13% Middle East: all training, Gaza clinic & Regional Manager
3% Profile-raising
7% Project Support & development
30% The Gambia Special project

Annual accounts

Income and Expenditure Statement for the year ended 31st March 2022

		£	£
		2022	2021
Incoming resources
	Restricted funds	11,251	5,446
	General funds	23,340	15,359
Total donations		34,590	20,805
Other income		3	19
Total incoming resources		34,593	20,824
Resources expended
Programme activities:	Restricted Funds	14,055	6,507
Programme activities:	General Funds	18,975	5,100
Project support & development		2,148	1,970
Fundraising support & marketing			423
Total cost of charitable activities		35,601	13,577
Net surplus/(deficit) for the year		(1,008)	7,247

Balance Sheet as at 31st March 2022

	£	£
	2022	2021
Fixed assets		-
Prepayments	2,624	3,036
Cash at bank and in hand	25,757	26,462
Current assets	20,369	28,381
Accruals		301
Current liabilities		301
Net assets	28,080	29,498
Restricted reserves	4,235	7,039
Unrestricted reserves	23,845	22,459
Total funds	28,080	29,498