Chemotherapy in Swaziland Let S Make It Happen

ANNUAL REPORT 2008

“Chemotherapy in Swaziland let’s Make it Happen”

April 2008 TABLE OF CONTENTS Page 2 Table of Contents Page 3 SBCN, Mission, vision values and ethics

The history of the SBCN.

Message from Vice Chairperson of the Executive Board

SBCN Executive Board members in pictures

Message from the Executive Director

Awareness Creation & Public Education

Clinic report

Monitoring & Evaluation

SBCN in pictures & local donors

Summary Midterm review

‘My life with Breast Cancer - Nomsa’s story

Financial statements SBCN’S VISION AND MISSION STATEMENTS

Vision

To be an efficient and effective provider of breast cancer services in Swaziland in collaboration with strategic partners.

Mission Statement

The mission of the Swaziland Breast Cancer Network is to assist in improving the survival rates of people directly affected by breast cancer in Swaziland through awareness, education, destigmatisation and advocacy, leading to early detection, diagnosis and treatment of the disease. In carrying out this mission, the Network works through strategic alliances – including health institutions , professionals, and associated organisations – and also provides support and counselling services.

Value statements

In carrying out the objectives of the SBCN, a non-profit making organisation, the organisation and its members subscribe to the following values and ethics:

1.1Voluntarism – we will offer our time and resources generously 1.2Confidentiality – we will keep in confidence all personal information disclosed to us in the course of our work 1.3Empowerment of clients to make informed choices and decisions 5.4. Transparency and accountability – We will conduct ourselves at all times in a professional and ethical manner. Openness and honesty are hallmarks in our transaction of business

1.4 Respect and dignity of clients - We demonstrate fairness, consistency and compassion in our interactions with others 1.5Equity and inclusiveness – we will involve our strategic partners and members in all our programme implementation

Aim & Objectives

The main aims and objectives of the Swaziland Breast Cancer Network are:

a. To raise awareness of all aspects related to breast cancer including the increasing incidence of this disease, promotion of self-examination, annual medical examination and the importance of early diagnosis and treatment. b. To build capacity of service providers and clients through information, education and training on breast cancer related issues. c. To work closely with stakeholders to assist in establishing efficient and effective channels of referrals and to be aware of trends in breast cancer incidence and survival rates on an on- going basis. d. To provide breast cancer counselling and a support network for those affected directly and indirectly by breast cancer. e. To mobilise resources to support the activities of the Network. f. To Increase and manage the membership base of the Network.

History of the SBCN The Swaziland Breast Cancer Network (SBCN) is the brainchild of four women in Mbabane who were directly and, or indirectly affected by breast cancer. This was after realising that new cases of breast cancer were on the increase yet there was little or no information and support for survivors. Yet breast cancer if detected early can be successfully treated and eliminated. These four women are still actively involved in the work of the Network and they are:  Maggie Hall  Gcinile Buthelezi  Peggy Bidé  Diorobo Daffé Major Milestones for the year under review 1. Launch of the second breast cancer clinic in Manzini in partnership with the Manzini City Council 2. Placement of three Development Workers two by Skillshare International and one by Australian Volunteers International 3. In August 2008, the Network moved to its new premises on 24 JSM Matsebula Street, Queensgate, and Mbabane (next to CANGO offices). These premises are being rented out from the Co-ordinating Assembly of Non- Governmental Organisations. 4. Training of nurses on chemotherapy 5. Carrying out a mid term review 6. Strategic review and induction of the new Executive Board Message from the Vice-Chairperson Maggie Hall.

The year 2008 was a time of consolidation and expansion for the Swaziland Breast Cancer Network (SBCN). Rising to challenge of increasing rates of breast cancer, SBCN displayed determination and commitment in raising awareness of the disease and strategies for early detection within urban and rural areas of Swaziland. To support this endeavour, a second Breast Care Clinic was opened in May 2008 at the Manzini City Council. Work to raise awareness and promote early detection and diagnosis of breast cancer must be accompanied by effective and accessible treatments. The 2008 SBCN theme “Chemotherapy: Let’s Make It Happen”, saw much work being done to lay the foundation for the introduction of chemotherapy to Swaziland.

Throughout 2008, advancements were also made in the area of governance. In particular, a formal election process saw a restructuring of the Board of Management; the new Board possessing a strong and diverse range of professional skills. An independent consultant (Salile Consulting) was appointed to take the new Board through an induction exercise and formal review of the SBCN 2007 – 2010 Strategic Plan. Review of the Strategic Plan is to be undertaken annually as part of the Network’s on-going monitoring and evaluation procedures.

In the second half of the year a mid-term review was carried out by an independent consultant from LCC Capital to assess the depth and breadth of the work of SBCN, and propose recommendations of the way forward. This process highlighted a need to review the content of the SBCN constitution, as the Network grows and diversifies. Fiscal management was also independently reviewed, and continues to be transformed in a process of continuous quality improvement.

We at SBCN are committed to reduce the morbidity and mortality associated with breast cancer, and offer support to affected individuals and their families. It is with sincere gratitude that we acknowledge and thank the numerous individuals – SBCN staff, health professionals, volunteers and breast cancer survivors, and organizations – our major funder WK Kellogg Foundation, the Harrison Cooper Foundation, the Ministry of Health and Social Welfare, Mbabane Government Hospital, Manzini City Council and numerous others who are mentioned throughout the following pages, that played a part in assisting us to realize this vision during 2008. As we look toward 2009, it is with continued enthusiasm that, in collaboration with the Ministry of Health and Social Welfare and key stakeholders, we can continue make a positive difference in breast cancer detection and management, and make a positive contribution to the health of the Swazi population. SBCN EXECUTIVE BOARD MEMBERS

Dr. Ruth Tshabalala Nomvula Ntombini- Member

Eudosia Andoh - Treasurer

Betsy Kummer – Secretary Anne Smyth- Member Fikile Dlamini – Member Overview of 2008 by the Executive Director – Thobile Dlamini

It gives me great pleasure to present to our members and stakeholders yet another annual report detailing the successes and shortfalls of the Network. The year like the previous one has seen the work of the Network grow from strength to strength. In the area of program administration, the Network was able to recruit and place three officers to implement work plan activities: a Project Officer, a Clinic Coordinator and a Clinical Research Monitoring & Evaluation Officer. With this growth the Network was required to source larger office space. New premises have been secured and we continue to outsource our financial management support as previous year. Our efforts in awareness creation were highly successful and enhanced by partnerships with numerous stakeholders including the Ministry of Health (MOH). Collaborations resulted in activities including a series of workshops targeted to educate Rural Health Motivators working at “grass-root” level. Appreciation goes to our volunteers Lindile Mabuza, Basize Dlamini & Doreen Magongo. Significant work was also undertaken over the course of the year on national radio, television and in print media. A nurse training workshop in chemotherapy management was held. Counseling training was undertaken by three breast cancer survivors, with the help of Reach for Recovery, a South African-based organization. A range of awareness creation material was also developed and printed in both SiSwati and English, and distributed in numerous ways to the general public. Our most notable achievement in the area of mobilizing support and counseling for patients was the successful launch and operation of our second regional breast care clinic. Partnerships were forged with the Manzini municipality who provided a fully furnished consulting room and a nurse. The government hospital (where the first clinic is located) also agreed to allow its doctors to manage this second breast care clinic. The SBCN provides continued clinic support with the presence of the Clinic Coordinator. During 2008, a total of 1813 patients were screened by doctors at these breast care clinics. In collaboration with Lancet laboratories, SBCN also facilitated the collection of 135 fine needle aspirations (FNA), 17% (n=23) of which resulted in a breast cancer diagnosis. We also continued efforts to obtain chemotherapy treatment for our patients. Inroads in this area include the training of 14 nurses in chemotherapy management, and significant reductions in the time taken to diagnose and refer patients for cancer treatment. Several collaborative meetings were held in 2008 to foster our partnership with government public health units. Particular areas of focus were Non Communicable Diseases (NCD) and Sexual Reproductive Health (SRH). These meetings highlighted the lack of government infrastructure to manage cancer-related illness, while enabling the timely sharing of information and facilitating submission of a proposal paper to establish the first oncology unit in Swaziland. Finally, 2008 saw the implementation of improved monthly tracking of service statistics, as well as data on patient profiles, and referral sources. The Network also undertook a study to assess the level of awareness on breast and cervical cancer among rural women in two of the four regions in the country. The study was sanctioned by the Ethics committee in the Ministry of Health and will continue in 2009 to cover all four regions. An independent consultant (LCC Capital) was appointed to conduct a midterm review (MTR) of work undertaken during this one and half year project period of institutionalizing the Network. We were able to achieve most of our planned activities for the year. This is despite the fact that a suitable Clinic Coordinator was not recruited until October. Work achieved during 2008 has greatly improved the visibility of the Network in the eyes of the public, and also in the view of major stakeholders. In conclusion, I invite you all to continue giving the Network your support and constructive criticism; we are here to serve the nation hence we aim to continually improve our services to meet your needs.

Thank you.

Volunteers Lindile Mabuza & Basize Dlamini conducted the RHM trainings Programmes- Public Health Policy & Education

The main objective of this programme component is to augment the levels of knowledge about breast health and breast cancer as well as promote and urge people to do self-breast examinations because early detection of any malignant tumour assists in early vigorous treatment options. Activities undertaken in this regard include radio programmes, newspaper articles, IEC material development training workshops and seminars.

Radio programmes – Three pre-recorded programmes were aired with the assistance of the Health Education Unit. two of these were slotted on the live prime time program ( Current Affairs)

Television- Swazi T.V offered the Network six prime slots on the Kusile breakfast show during the month of October to educate and publicise activities and services available for cancer sufferers and those indirectly affected. Furthermore, the Network was featured on Face the Nation, a live- programme, where viewers had the chance to call and ask questions from the panel.

Times Group Of Newspapers – As has become the norm, the Times of Swaziland provided the Network with its unwavering support by donating space in the paper for the Network to submit weekly articles on breast cancer and notifications on upcoming events.

Training workshops and Awareness Creation The Network with the assistance of a team comprising of three volunteers including a breast cancer survivor conducted trainings in the Lubombo and Shiselweni regions. These sessions were preceded by a mini survey to assess the depth of knowledge on breast cancer and cervical cancer. This survey had the blessing of the Ethics. The table below illustrates the number of workshops and awareness seminars held by the Organization:

Training Dates Workshop Title Participants Venue 16-18 June 2008 Breast Cancer Nurses Training on Mbabane Awareness Chemotherapy Government Hospital Training Dates Workshop Title Participants Venue 12 July 2008 Coffee Morning Invited guests and The Mountain Inn the general public 23 July 2008 Breast cancer (BC) Rural Health Gege Inkhundla awareness Motivators (RHMs) 11 August 2008 BC awareness RHMs Maplotini- Lavumisa 12 August 2008 BC awareness RHMs Hosea Mtsambama Inkhundla 14 August 2008 BC awareness RHMs Sandleni & Sigwe Tinkhundla 15 August2008 BC awareness RHMs Somtongo & Matsanjeni 18 August 2008 BC awareness RHMs Kaphunga & Nkwene 3 October 2008 BC awareness New RHMs Singwe Inkhundla Shiselweni 8 October 2008 BC awareness Staff members CONCO 20 October 2008 BC awareness RHMs and Hlane and Malindza market Malindza women 21 & 22 October BC awareness RHMs Lomahasha 1 2008 & 2 23 & 24 October Breast cancer RHMs Lugongolweni 1 & 2008 awareness 2 24 October2008 BC awareness Siteki Agriculture Siteki Agriculture Staff Premises 24 October 2008 BC awareness Lubombo Clinic Lubombo Clinic( of support staff note and was encouraging was the male attendance 25 & 27 October BC awareness RHMs Tikhuba 1 & 2 Training dates Workshop Title Participants Venue 28 October 2008 BC awareness RHMs Mpolonjeni 29 & 30 October BC awareness RHMs Dvokodvweni 1 & 2 2008 17,18,19 BC awareness RHMs Siphofaneni 1,2 & 3 November 2008 20 November 2008 BC awareness RHMs Lubulini 24 November 2008 BREAST CANCER RHMs Nkilongo awareness 25 & 26 November Breast cancer RHMs Sithobela 1 & 2 2008 awareness

Awareness Creation and Promotional Material

The following items were developed for distribution during the awareness sessions:

Items Quantity Event Message T-shirt 120 Manzini clinic Clinic days and launch times T-shirt & caps 20 each Sibebe Challenge Breast Cancer Crusaders Bandana 200 October launch Key rings 50 Promotional Network contacts Lanyards 150 Promotional Network contacts Stickers 28,500 Launch in October SBCN contacts and clinic times Bandanas 300 Jane King Promotional Memorial Run (JKMR) Water bottles 500 JKMR Promotional Posters 100 JKMR Promotional

Pamphlets 5,000 Breast health in the Educational local language Pamphlets 1,000 Cervical Cancer Educational Documentary 20 About the Network Promotional

The Network was also requested by the following companies to educate and examine their staff members; CONCO Ltd, Cadbury Swaziland, Royal Swaziland Sugar Company, UN Agencies, Swaziland Water Services Corporation and CMAC. Last year, the Network launched its October breast cancer awareness activities in collaboration with CANGO at Msunduza. This was a detour from the usual criterion used and it created an avenue for the Network to reach a marginalized group (the elderly).

A section of the elderly during the launch at Msunduza hall.

RHM’s at Hosea Inkhundla Shiselweni region RHM’s at Mantambe, standing is Nomkhosi Dlamini volunteer

Teresa Rehmeyer- Clinic Coordinator (Oncology Nurse). Clinic Project It should be stated that the clinic (in room 4) at the Mbabane Government Hospital (MGH) continues to operate very well. Furthermore, of note was the opening of a clinic at the Manzini City Council on the 14th of May.

Whilst this achievement is highly commendable, there is still a huge disparity in treatment accessibility. Even though government provides funds for clients requiring treatment, these are not sufficient to cover for the expenses incurred. The Network therefore, finds it a prerogative to advocate and lobby government to localize treatment, thus reducing the gross inconvenience of ill patients travelling long distances, and in a majority of cases using public transport.

1814 clients is the combined total number of clients observed in the clinics.

Below is a table showing the number of clients seen in the past year: Month Attendance Referred for FNA FNA’s CA Confirmed Conducted January 70 18 2 2 February 67 13 March 43 3 April 77 41 38 4 May 81 53 June 152 20 July 131 6 37 2 August 91 14 September 88 5 October 679 29 November 195 13 58 11 December 140 10 Total 1814 227 135 19  About 57% of the referred clients came back for the FNA test.  About 19% of those who had the FNA were diagnosed with cancer of the breast.  Currently the only available treatment for patients is surgery and this is only one of three treatment procedures required for these clients. There is need to continue to lobby the Government for the inclusion of chemotherapy and radiotherapy in the country. Monitoring and Evaluation Monitoring and evaluation is an integral part of program implementation. Systems are put in place to assess the impact and effectiveness of program delivery and ensure quality health care and continuous service improvement.

During 2008, monitoring and evaluation activities run by SBCN included:

 Collection of data from over 1400 rural women and RHMs on the level of awareness of breast and cervical cancer risks and treatments; database analysis, and presentation of this data in abstract format.  Collection of demographic and clinical data on all patients attending the SBCN breast care clinics; database analysis, and subsequent monthly and annual statistical and qualitative reports.  Collection of data on the incidence of breast cancer in Swaziland, and constant review of MOHSW health registry data.  The development of operational manuals for all data collection and database construction, and educational programs.  Site visits during rural awareness and education sessions.  On-going staff training.  Scheduled review meetings.  Collection of data on the reach and extent of media and educational activities.

Dr. Susan Colles (Dietician)

It is difficult to articulate the impact the awareness through media has created without undertaking a detailed study, however at face value, we are aware through the clinic attendance form (revised in September 2008) that media is a leading awareness raiser. The table below lists reported patient referral sources. # Activity/Information Source No. of Percentage people 1 Radio programmes 176 40% 2 Newspapers & articles (The Times, Sunday Times, 103 23% Observer, Kaleidoscope, The Nation) 3 TV programmes (Kusile, Face the Nation) 54 12% 4 SBCN Office/Breast Clinics 35 9% 5 Other organizations (mainly FLAS, CMAC, Mbabane 33 7% City Council) 6 Msunduza launch 12 3% 7 Hospital 4 1% 8 Family/ Friends 24 5% TOTAL 441 100%

A training evaluation tool has been designed and is implemented at the end of each training session, below is some of the comments we have received from participants.

SBCN THROUGH THE LENS

The youngest runner Jane King at the CANGO open day Memorial fun run.

Nurses trained on Chemotherapy At Mbabane Govt. Hospital Annual Meeting at the council chambers Practical chemotherapy training Dr Jacobus & Dr Alcedes @ one of theDoctors meetings

Donors and Supporters The Network expresses its gratitude to all individuals and companies who supported and or participated in their 2008 activities, especially the following in no particular order:

The Times of Swaziland Vision Care Joy Forsyth-Thompson The Rotary Club Mbabane Mbuluzi Municipality of Mbabane Adderley Hotel MTN Swaziland Bridget Polly Cara Breero Indigo Hair Salon The Mall Management Hotel Express Steve Hall Mbabane Traffic Police Health Education Unit Standard Bank (Swaziland) SBCN Members SBIS The Nation Magazine Nimue Skin Technology Mbabane Govt. Hospital staff The Tums George Hotel Webster Print (Pty) Ltd Harvey World Travel Agencies The Central Bank of Swaziland CMAC – Conciliation Mediation & Arbitration Commission. The Mountain Inn Manzini City Council Executive Summary

The Swaziland Breast Cancer Network is a non-profit making, donor-funded organization that is established and guided by a constitution. In 2007, pushed by the demand and need for structured coordination and management of activities, the Network established a secretariat by engaging the services of an Executive Director. To date the network employs four other staff members including; a clinics coordinator, research and evaluation officer, a project officer and a receptionist (see Table 1).

The Network has developed and implemented 3 strategic plans, 2001 – 2003, 2005 – 2007, 2008 – 2011. Each strategic plan had action plans that were aimed at achieving specified key objectives responsive to the needs of the target beneficiaries and these have evolved over time. Currently the target beneficiaries are women from adolescence to menopause, but are extended to involve all of the community, including men.

In 2007, WK Kellogg Foundation provided grant funding covering a period of two years to the Network for various activities of the Network aligned to the promotion of breast cancer awareness in Swaziland.

In direct reference thereto, the Network decided to undertake a mid-term review of the grant and introspection by engaging external parties, for impartiality, to assess the impact and achievements of the grant. The aim of the mid-term review is to assess for the Network, donors and stakeholders the effectiveness, efficiency and the impact that the Network had achieved during the period under review.

When conducting the mid-term review, the consultants obtained and conducted a detailed review of all relevant documents including: SBCN Constitution, audited financial statements, memorandum of association and articles of incorporation, strategic plans, work-plans, reports, statistics, promotional and advertising items, news paper articles published, and further conducted selected interviews with Network Board, staff, stakeholders. In Swaziland, breast cancer is largely perceived as a women’s disease. This is naturally so given the vast majority of breast cancer cases among women. In Swaziland, additional social factors such as the lack of empowerment of women, poor self-opinions and lack of opportunity or ability to take responsibility for one’s health all contribute to late presentation for cancer diagnoses.

Laudably, the SBCN is also contributing to a shift in perceptions, highlighting that breast cancer can affect anyone. The more males that become educated and aware of the disease, the more men can begin to encourage their partners to take the disease seriously and undergo routine checkup.

The Network has made significant strides in ensuring the participation and involvement in its activities of breast cancer survivors. This helps in building a supportive environment for breast cancer programs, including the reduction of possible stigma and fear of the unknown.

The institutionalization of the Network through the establishment of the secretariat in 2007 has resulted in a mix of both challenges and successes. The premises have been deemed appropriate and suitable to meet the current physical needs of the Network. Patients are now able to identify with an organization whose operational premises are known, and can approach it when interventions are sought. The transition of the delegation of administrative functions from the board to the secretariat has thus far been handled fairly well

The network has employed four professionals namely: Executive Director, Project Officer, Clinics Coordinator and a Research and Evaluation Officer.

Findings The Network over the period under review continued to abide by the provisions of the constitution. The annual general meeting and board meetings were held as scheduled.

It was discovered that all board minutes are not signed yet pertinent resolutions including those with a financial impact are adopted. The financial activities of the Network were successfully audited by PriceWaterhouseCoopers. A review of audited financial statements revealed that there is compliance to: accurate recording of transactions, auditors did not find any material transactions that would lead to a qualified opinion.

The Network continues to employ all forms of information dissemination through electronic, audio and newsprint which includes the two media houses, the Times of Swaziland and Observer and the Nation Magazine. In total 17 articles were published. In furtherance the Network has successfully launched a website.

The work undertaken by the Network during the months of October each year is highly commended. A lot of material is produced and articles are published in all popular media streams and the success of the awareness during this month is also evidenced by the number of males that wear the pink ribbon.

A total of 54,457 promotional and awareness items were developed and distributed nationwide, however the real impact of the IEC material could not be ascertained since a survey was not undertaken.

A total of four fund raising activities were successfully undertaken by the Network wherein branded materials were sold.

A review of the programs undertaken shows that all media houses were used during the period under review. Of 17 articles, 13 were published by the Times of Swaziland; the lion’s share at 75%.

In 2007 thirteen workshops were conducted for; doctors, nurses, health teams, media and students. A total of 985 rural health motivators were trained with the aim of taking the services to the people including dissemination of information, education and support. A surface review of services provided reveals that key services are still unavailable in the regions with the exception of Mbabane and Manzini clinics resulting in the conclusion that the decentralization process is still faced with challenges.

The Network has played a satisfactory role in engaging Government on areas surrounding policy development, implementation, promoting “on-the-ground” operations, service delivery on breast cancer interventions and institutional framework.

Recommendations It is recommended that the Network should consider, through a staggered process, to move toward positioning itself as a Cancer Association of Swaziland.

In furtherance to the immediately above recommendation, it is recommended as a matter of urgency, that the Network should engage consultants to review the Memorandum and Articles of Association and cause amendments to be effected as per the findings stated herein, to ensure compliance with the Networks’ constitution.

It is recommended that the minutes of the Board must show the start and end times for each meeting held, and that once adopted the minutes are signed by the chairperson and secretary.

It is recommended that the Network intensifies efforts to educate the public on the fact that breast cancer also affects the male population.

It is recommended that breast cancer awareness implementation work plan should be spread right through the year, with each month allocated a theme.

It is further recommended that efforts must be intensified to take advantage of national events and activities on the calendar to further create breast cancer awareness. It is further recommended that the Network should develop a program for celebrating the October Breast Cancer Awareness month circulated among the four regions of the country.

To compliment the current monitoring and evaluation tools in use, it is recommended that the Network secure funding for a nationwide IEC impact assessment survey.

It is recommended that the Network intensifies discussions with Government and potential donors on the need to secure breast cancer mobile clinics to provide basic diagnosis, counselling and advisory services.

It is recommended that the Network should engage Government to allocate permanent staff to the breast cancer clinics who can therefore rotate in clinics countrywide, rendering diagnosis, counselling and advisory services.

Overall Evaluation Rating The consultants were required after conducting a mid-term review to rate each programme outcome /objective under the following: highly satisfactory, satisfactory, less than satisfactory, highly unsatisfactory. The rating was concluded as follows:

Activity Description Performance Rating Institutionalization of SBCN Highly Satisfactory Achievements of the Grant Highly Satisfactory Promotion of breast cancer awareness Highly Satisfactory Decentralization of services Satisfactory Contribution toward policy dialogue Satisfactory Overall Effectiveness Satisfactory My life with breast cancer Nomsa’s story

In late 2005 Nomsa Msibi (41) started experiencing back pains but she ignored this feeling until 2006 when she went to see a doctor to be examined. After a medical check up at the Mbabane Government Hospital it was discovered that the pain was in fact caused by a lump in her left breast. She was later admitted at the hospital where the lump was removed and tested for cancer. “Luckily I was counselled and taken care of which made me feel better,” said Msibi.

She had to wait for over two months for her results to come back from the Central laboratory. Its system was not computerized, thus delaying the release of results. This also meant that treatment could not commence as it depended on the outcome of the results. But the waiting felt too long and Msibi decided to fetch the results herself from the Central Laboratory.

Eventually came the shocking news that changed Nomsa’s life forever. Her worst fears were confirmed when the results verified that she had breast cancer.

“Even though breast cancer runs in my family, I never thought I could have it,” she said. “I had lost a cousin who died after a breast cancer operation.”

Nomsa then underwent radiotherapy treatment which was due to be completed in December 2007 when the doctors discovered another lump in the same breast just a month before she was to finish treatment. She had a Fine Needle Assessment test done to determine if the lump was cancerous, and unfortunately the results confirmed that it was. “Early this year I had a mastectomy (complete removal of the breast) done, and have had to wear a breast prosthesis ever since” explained Msibi.

Although Nomsa has to face the reality of having one breast, she has survived the disease and continues to fight it until her chemotherapy treatment is completed. She is a living example that breast cancer can be controlled if it is discovered and treated early. SWAZILAND BREAST CANCER NETWORK Financial Statements for the year ended 31 December 2008 SWAZILAND BREAST CANCER NETWORK

ANNUAL FINANCIAL STATEMENTS for the year ended 31 December 2008

CONTENTS Pages

Statement of Executive Board’s responsibility 1

Qualified report of the independent auditors 2 - 3

Executive Board report 4

Income statement 5

Balance sheet 6

Statement of changes in equity 7

Cash flow statement 8

Summary of accounting policies 9 - 17

Notes to the annual financial statements 18 - 21

Detailed income and expenditure statement Annexure 1 Page 1

SWAZILAND BREAST CANCER NETWORK

STATEMENT OF EXECUTIVE BOARD’S RESPONSIBILITY for the year ended 31 December 2008

The Executive Board is responsible for the preparation, integrity and fair presentation of the financial statements of Swaziland Breast Cancer Network. The financial statements presented on pages 4 to 21 have been prepared in accordance with Swaziland and International Financial Reporting Standards, and include amounts based on judgements and estimates made by management.

The Executive Board is also responsible for the network’s system of internal financial control. These are designed to provide reasonable, but not absolute assurance as to the reliability of the financial statements, and to adequately safeguard, verify and maintain accountability of the assets, and to prevent and detect misstatement and loss. Nothing has come to the attention of the Executive Board to indicate that any material breakdown in the functioning of these controls, procedures and system has occurred during the year under review.

The going concern basis has been adopted in preparing the financial statements. The Executive Board have no reason to believe that the network will not be a going concern in the foreseeable future based on forecasts and available cash resources. These financial statements support the viability of the network.

The financial statements have been audited by the independent accounting firm, PricewaterhouseCoopers, which was given unrestricted access to all financial records and related data, including minutes of all meetings of the Executive Board. The Executive Board believe that all representations made to the independent auditors during their audit are valid and appropriate. PricewaterhouseCoopers’ audit report is presented on pages 2 - 3.

The Executive Board confirm that the annual financial statements set out on pages 4 to 21 were approved by the Executive Board and are signed on its behalf by:-

CHAIRPERSON DATE

TREASURER DATE Page 2

SWAZILAND BREAST CANCER NETWORK Page 2

QUALIFIED REPORT OF THE INDEPENDENT AUDITORS TO THE MEMBERS OF SWAZILAND BREAST CANCER NETWORK

We have audited the annual financial statements of Swaziland Breast Cancer Network, which comprise the Executive Board report, the balance sheet as at 31 December 2008, the income statement, the statement of changes in equity, the cash flow statement for the year then ended, and a summary of significant accounting policies and other explanatory notes, as set out on pages 4 to 21.

Directors’ Responsibility for the Financial Statements The Executive Board is responsible for the preparation and fair presentation of these financial statements in accordance with Swaziland and International Financial Reporting Standards and in the manner required by the Company’s Act of 1912. This responsibility includes: designing, implementing and maintaining internal control relevant to the preparation and fair presentation of financial statements that are free from material misstatement, whether due to fraud or error; selecting and applying appropriate accounting policies; and making accounting estimates that are reasonable in the circumstances.

Auditor’s Responsibility Our responsibility is to express an opinion on these financial statements based on our audit. We conducted our audit in accordance with International Standards on Auditing. Those standards require that we comply with ethical requirements and plan and perform the audit to obtain reasonable assurance whether the financial statements are free from material misstatement.

An audit involves performing procedures to obtain audit evidence about the amounts and disclosures in the financial statements. The procedures selected depend on the auditor’s judgement, including the assessment of the risks of material misstatement of the financial statements, whether due to fraud or error. In making those risk assessments, the auditor considers internal control relevant to the entity’s preparation and fair presentation of the financial statements in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the entity’s internal control. An audit also includes evaluating the appropriateness of accounting policies used and the reasonableness of accounting estimates made by the Executive Board, as well as evaluating the overall presentation of the financial statements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our audit opinion.

Basis for qualification In common with similar organizations, it is not feasible for the Network to institute accounting controls over cash collections from offerings prior to the initial entry of the collections in the accounting records. Accordingly it was impracticable for us to extend our examination beyond the receipts actually recorded.

Qualified Opinion In our opinion, except for the effects of adjustments, if any, as might have been determined to be necessary had we been able to satisfy ourselves as to the completeness of income, the financial statements present fairly, in all material respects, the financial position of the Network as of 31 December 2008 and of their financial performance and their cash flows for the year then ended in accordance with Swaziland and International Financial Reporting Standards and in the manner required by the Companies Act of 1912. Page 3

Supplementary schedule The supplementary schedule set out on Annexure 1 does not form part of the financial statements and is presented as additional information. We have not audited this schedule and accordingly we do not express an opinion on it.

PricewaterhouseCoopers Partner: Paul Lewis Chartered Accountant (Swaziland) Date REPORT OF THE EXECUTIVE BOARD for the year ended 31 December 2008

The Executive Board has pleasure in presenting their report for the period ended 31 December 2008.

Nature of the Network’s business

The Swaziland Breast Cancer Network was established in 2001.

The Swaziland Breast Cancer Network is an organisation responding to the incidence of breast cancer in Swaziland by raising awareness about breast cancer including the promotion of self – examination and the importance of early diagnosis and treatment.

State of the Network’s affairs

The network’s affairs are fully disclosed in the attached financial statements.

Executive Board Members

Dr Ruth Tshabalala – Chairperson Margaret Hall – Vice Chairperson Annie Symthe - Member Eudosia Andoh - Treasurer Fikile Dlamini - Member Nomvula Ntombini - Member Elizabeth Kummer - Secretary Thobile Dlamini – Executive Director

Share capital

There were no changes in the authorised or issued share capital during the period under review. The shareholders (with 1 share of E1 each) are as follows:

P Bide E Andoh M Hall

Going concern

The Executive Board believes that the Network will be a going concern in the year ahead.

Auditors

PricewaterhouseCoopers MTN Office Park Karl Grant Street Mbabane, Swaziland Page 5

INCOME STATEMENT for the year ended 31 December 2008

Note 2008 2007 E E

Grant income 1 1 076 514 600 790

Amortisation of grant received 11 47 237 16 575

Ticket sales 29 440 6 075

Other operating income 21 167 15 200

Finance income 12 73 648 15 202

Employee benefit expenses (413 623) (238 547)

Skillshare International Swaziland Management fees (30 020) (101 812)

Depreciation 4 (55 607) (19 108)

Other operating expenses ______(668 700) ______(290 354) Surplus before taxation 80 057 4 021

Taxation 2 ______- ______-

Surplus for the year ______80 057 ______4 021

5 Page 6

BALANCE SHEET As at 31 December 2008

2008 2007 Notes E E

ASSETS

Non current assets Property, plant and equipment 4 ______268 984 ______129 923

Current assets Receivables 6 226 226 Cash and cash equivalents 3 ______385 789 ______442 264 386 015 442 490 Total assets ______654 999 572 413 ______

EQUITY AND LIABILITIES

Capital and reserves Share capital 7 3 3 Accumulated surplus 210 509 130 452 Special funds 9 ______15 462 ______15 462

______225 974 ______145 917

Non-current liabilities 11 260 620 121 518 Property, plant and equipment fund ______

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Current liabilities Deferred grant income 10 108 210 304 978 Accounts and other payables 5 ______60 195 ______-

168 405 304 978 Total current liabilities ______

Total equity and liabilities ______654 999 ______572 413

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STATEMENT OF CHANGES IN EQUITY for the year ended 31 December 2008

Share Accumulated Special capital surplus funds Total E E E E

Balance at 1 January 2007 3 130 452 15 462 145 917

Surplus for the year ______- ______80 057 ______- ______80 057

Balance at 31 December 2008 ______3 ______210 509 ______15 462 ______225 974

Balance at 1 January 2007 3 125 053 16 840 141 896

Transfer from special funds - 1 378 (1 378) -

Surplus for the year ______- ______4 021 ______- ______4 021

Balance at 31 December 2007 ______3 ______130 452 ______15 462 ______145 917

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CASH FLOW STATEMENT for the year ended 31 December 2008

Notes 2008 2007 E E

Cash flow from operating activities

Cash generated from operations 8 ______117 043 ______3 354

Net cash generated by operating activities ______117 043 ______3 354 Cash flow from investing activities

Purchase of property, plant and equipment 4 ______(194 669) ______(138 093)

Net cash outflow from investing activities ______(194 669) ______(138 093)

Cash flow from financing activities

Grant received net of amount utilised to finance operations ______21 151 ______376 366

Net cash inflow from financing activities ______21 151 ______376 366

Net movement in cash and cash equivalent ______(56 475) ______241 627

Movement in cash and cash equivalents

At beginning of period 442 264 200 637

Movement during the period ______(56 475) ______241 627

At end of period 3 ______385 789 ______442 264

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SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES for the year ended 31 December 2008

The principal accounting policies adopted in the preparation of these financial statements are set out below:

1. Basis of preparation

The financial statements of Swaziland Breast Cancer Network have been prepared in accordance with Swaziland and International Financial Reporting Standards. They have been prepared under the historical cost convention, as modified by the revaluation of land and buildings, available-for-sale financial assets, and financial assets and financial liabilities (including derivative instruments) at fair value through profit or loss.

The preparation of financial statements in conformity with Swaziland and International Financial Reporting Standards requires the use of certain critical accounting estimates. It also requires management to exercise its judgement in the process of applying the organization’s accounting policies.

(a) Interpretations effective in 2008

. IFRIC 14, ‘IAS 19 – The limit on a defined benefit asset, minimum funding requirements and their interaction’, provides guidance on assessing the limit in IAS 19 on the amount of the surplus that can be recognised as an asset. It also explains how the pension asset or liability may be affected by a statutory or contractual minimum funding requirement. This interpretation does not have any impact on the organization’s financial statements, as the organization only has a defined contribution plan and is not subject to any minimum funding requirements.

. IFRIC 11, ‘IFRS 2 – Company and treasury share transactions’, provides guidance on whether share-based transactions involving treasury shares or involving company entities (for example, options over a parent’s shares) should be accounted for as equity-settled or cash-settled share-based payment transactions in the stand-alone accounts of the parent and organization companies. This interpretation does not have an impact on the organization’s financial statements. (b) Standards and amendments early adopted by the organization

There were no standards and amendments to standards that were early adopted by the organization during the financial under review.

(c) Interpretations effective in 2008 but not relevant

The following interpretation to published standards is mandatory for accounting periods beginning on or after 1 January 2008 but is not relevant to the organization’s operations:

. IFRIC 12, ‘Service concession arrangements’

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SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (continued) for the year ended 31 December 2008

1. Basis of preparation (continued)

(d) Standards, amendments and interpretations to existing standards that are not yet effective and have not been early adopted by the organization

The following standards and amendments to existing standards have been published and are mandatory for the organization’s accounting periods beginning on or after 1 January 2009 or later periods, but the organization has not early adopted them:

. IAS 23 (Amendment), ‘Borrowing costs’ (effective from 1 January 2009). The amendment requires an entity to capitalise borrowing costs directly attributable to the acquisition, construction or production of a qualifying asset (one that takes a substantial period of time to get ready for use or sale) as part of the cost of that asset. The option of immediately expensing those borrowing costs will be removed. The organization will apply IAS 23 (Amendment) retrospectively from 1 January 2009 but is currently not applicable to the organization as there are no qualifying assets.

. IAS 1 (Revised), ‘Presentation of financial statements’ (effective from 1 January 2009). The revised standard will prohibit the presentation of items of income and expenses (that is, ‘non-owner changes in equity’) in the statement of changes in equity, requiring ‘non-owner changes in equity’ to be presented separately from owner changes in equity. All non-owner changes in equity will be required to be shown in a performance statement, but entities can choose whether to present one performance statement (the statement of comprehensive income) or two statements (the income statement and statement of comprehensive income). Where entities restate or reclassify comparative information, they will be required to present a restated balance sheet as at the beginning comparative period in addition to the current requirement to present balance sheets at the end of the current period and comparative period. The organization will apply IAS 1 (Revised) from 1 January 2009. It is likely that both the income statement and statement of comprehensive income will be presented as performance statements.

. IFRS 1 (Amendment) ‘First time adoption of IFRS’, and IAS 27 ‘Consolidated and separate financial statements’ (effective from 1 January 2009). The amended standard allows first-time adopters to use a deemed cost of either fair value or the carrying amount under previous accounting practice to measure the initial cost of investments in subsidiaries, jointly controlled entities and associates in the separate financial statements. The amendment also removes the definition of the cost method from IAS 27 and replaces it with a requirement to present dividends as income in the separate financial statements of the investor. This amendment and the new standard will not have any impact on the organization’s financial statements.

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(d) Standards, amendments and interpretations to existing standards that are not yet effective and have not been early adopted by the organization (continued)

. IFRS 5 (Amendment), ‘Non-current assets held-for-sale and discontinued operations’ (and consequential amendment to IFRS 1, ‘First-time adoption’) (effective from 1 July 2009). The amendment is part of the IASB’s annual improvements project published in May 2008. The amendment clarifies that all of a subsidiary’s assets and liabilities are classified as held for sale if a partial disposal sale plan results in loss of control. Relevant disclosure should be made for this subsidiary if the definition of a discontinued operation is met. A consequential amendment to IFRS 1 states that these amendments are applied prospectively from the date of transition to IFRSs. This amendment is not expected to have any impact on the organization’s financial statements.

. IAS 23 (Amendment), ‘Borrowing costs’ (effective from 1 January 2009). The amendment is part of the IASB’s annual improvements project published in May 2008. The definition of borrowing costs has been amended so that interest expense is calculated using the effective interest method defined in IAS 39 ‘Financial instruments: Recognition and measurement’. This eliminates the inconsistency of terms between IAS 39 and IAS 23. The organization will apply the IAS 23 (Amendment) prospectively to the capitalisation of borrowing costs on qualifying assets from 1 January 2009. This amendment is not expected to have any impact on the organization’s financial statements.

. IAS 36 (Amendment), ‘Impairment of assets’ (effective from 1 January 2009). The amendment is part of the IASB’s annual improvements project published in May 2008. Where fair value less costs to sell is calculated on the basis of discounted cash flows, disclosures equivalent to those for value-in-use calculation should be made. The organization will apply the IAS 28 (Amendment) and provide the required disclosure where applicable for impairment tests from 1 January 2009.

. IAS 19 (Amendment), ‘Employee benefits’ (effective from 1 January 2009). The amendment is part of the IASB’s annual improvements project published in May 2008.

– The amendment clarifies that a plan amendment that results in a change in the extent to which benefit promises are affected by future salary increases is a curtailment, while an amendment that changes benefits attributable to past service gives rise to a negative past service cost if it results in a reduction in the present value of the defined benefit obligation

– The definition of return on plan assets has been amended to state that plan administration costs are deducted in the calculation of return on plan assets only to the extent that such costs have been excluded from measurement of the defined benefit obligation.

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– The distinction between short term and long term employee benefits will be based on whether benefits are due to be settled within or after 12 months of employee service being rendered.

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– IAS 37, ‘Provisions, contingent liabilities and contingent assets, requires contingent liabilities to be disclosed, not recognised. IAS 19 has been amended to be consistent.

This amendment is not expected to have any impact on the organization’s financial statements.

. IAS 39 (Amendment), ‘Financial instruments: Recognition and measurement’ (effective from 1 January 2009). The amendment is part of the IASB’s annual improvements project published in May 2008.

– This amendment clarifies that it is possible for there to be movements into and out of the fair value through profit or loss category where a derivative commences or ceases to qualify as a hedging instrument in cash flow or net investment hedge.

– The definition of financial asset or financial liability at fair value through profit or loss as it relates to items that are held for trading is also amended. This clarifies that a financial asset or liability that is part of a portfolio of financial instruments managed together with evidence of an actual recent pattern of short-term profittaking is included in such a portfolio on initial recognition.

– The current guidance on designating and documenting hedges states that a hedging instrument needs to involve a party external to the reporting entity and cites a segment as an example of a reporting entity. This means that in order for hedge accounting to be applied at segment level, the requirements for hedge accounting are currently required to be met by the applicable segment. The amendment removes the example of a segment so that the guidance is consistent with IFRS 8, ‘Operating segments’, which requires disclosure for segments to be based on information reported to the chief operating decision-maker. Currently, for segment reporting purposes, each subsidiary designates contracts with organization treasury as fair value or cash flow hedges so that the hedges are reported in the segment to which the hedged items relate. This is consistent with the information viewed by the chief operating decision-maker. See note 3.1 for further details.

– After the amendment is effective, the hedge will continue to be reflected in the segment to which the hedged items relate (and information provided to the chief operating decision-maker), but the organization will not formally document and test this relationship.

– When remeasuring the carrying amount of a debt instrument on cessation of fair value hedge accounting, the amendment clarifies that a revised effective interest rate (calculated at the date fair value hedge accounting ceases) are used.

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The organization will apply the IAS 39 (Amendment) from 1 January 2009. It is not expected to have an impact on the organization’s income statement.

. IAS 1 (Amendment), ‘Presentation of financial statements’ (effective from 1 January 2009). The amendment is part of the IASB’s annual improvements project published in May 2008. The amendment clarifies that some rather than all financial assets and liabilities classified as held for trading in accordance with IAS 39, ‘Financial instruments: Recognition and measurement’ are examples of current assets and liabilities respectively. The organization will apply the IAS 39 (Amendment) from 1 January 2009. It is not expected to have an impact on the organization’s financial statements.

. There are a number of minor amendments to IFRS 7, ‘Financial instruments: Disclosures’, IAS 8, ‘Accounting policies, changes in accounting estimates and errors’, IAS 10, ‘Events after the reporting period’, IAS 18, ‘Revenue’ and IAS 34, ‘Interim financial reporting’, which are part of the IASB’s annual improvements project published in May 2008 (not addressed above). These amendments are unlikely to have an impact on the organization’s accounts and have therefore not been analysed in detail.

. IAS 20 (Amendment), ‘Accounting for government grants and disclosure of government assistance’ (effective from 1 January 2009). The benefit of a below market rate government loan is measured as the difference between the carrying amount in accordance with IAS 39, ‘Financial instruments: Recognition and measurement’, and the proceeds received with the benefit accounted for in accordance with IAS 20. The amendment will not have an impact on the organization’s operations as there are no loans received or other grants from the government.

. The minor amendments to IAS 20 ‘Accounting for government grants and disclosure of government assistance’, which are part of the IASB’s annual improvements project published in May 2008 (not addressed above). These amendments will not have an impact on the organization’s operations as described above.

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(e) Interpretations and amendments to existing standards that are not yet effective and not relevant for the organization’s operations

The following interpretations and amendments to existing standards have been published and are mandatory for the organization’s accounting periods beginning on or after 1 January 2009 or later periods but are not relevant for the organization’s operations:

. IFRIC 13, ‘Customer loyalty programmes’ (effective from1 July 2008). IFRIC 13 clarifies that where goods or services are sold together with a customer loyalty incentive (for example, loyalty points or free products), the arrangement is a multiple element arrangement, and the consideration receivable from the customer is allocated between the components of the arrangement using fair values. IFRIC 13 is not relevant to the organization’s operations because none of the organization’s companies operate any loyalty programmes.

. IAS 16 (Amendment), ‘Property, plant and equipment’ (and consequential amendment to IAS 7, ‘Statement of cash flows’) (effective from 1 January 2009). The amendment is part of the IASB’s annual improvements project published in May 2008. Entities whose ordinary activities comprise renting and subsequently selling assets present proceeds from the sale of those assets as revenue and should transfer the carrying amount of the asset to inventories when the asset becomes held for sale. A consequential amendment to IAS 7 states that cash flows arising from purchase, rental and sale of those assets are classified as cash flows from operating activities. The amendment will not have an impact on the organization’s operations because the organization’s ordinary activities do not comprise renting and subsequently selling assets.

. IAS 27 (Amendment), ‘Consolidated and separate financial statements’ (effective from 1 January 2009). The amendment is part of the IASB’s annual improvements project published in May 2008. Where an investment in a subsidiary that is accounted for under IAS 39, ‘Financial instruments: recognition and measurement’, is classified as held for sale under IFRS 5, ‘Non-current assets held-for-sale and discontinued operations’, IAS 39 would continue to be applied. The amendment will not have an impact on the organization’s financial statements.

. IAS 28 (Amendment), ‘Investments in associates’ (and consequential amendments to IAS 32, ‘Financial Instruments: Presentation’ and IFRS 7, ‘Financial instruments: Disclosures’) (effective from 1 January 2009). The amendment is part of the IASB’s annual improvements project published in May 2008. Where an investment in associate is accounted for in accordance with IAS 39 ‘Financial instruments: recognition and measurement’, only certain rather than all disclosure requirements in IAS 28 need to be made in addition to disclosures required by IAS 32, ‘Financial Instruments: Presentation’ and IFRS 7 ‘Financial Instruments: Disclosures’. The amendment will not have an impact on the organization’s financial statements.

. IAS 29 (Amendment), ‘Financial reporting in hyperinflationary economies’ (effective from 1 January 2009). The amendment is part of the IASB’s annual improvements

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project published in May 2008. The guidance has been amended to reflect the fact that a number of assets and liabilities are measured at fair value rather than historical cost. The amendment will not have an impact on the organization’s financial statement.

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(e) Interpretations and amendments to existing standards that are not yet effective and not relevant for the organization’s operations (continued)

. IAS 31 (Amendment), ‘Interests in joint ventures’ (and consequential amendments to IAS 32 and IFRS 7) (effective from 1 January 2009). The amendment is part of the IASB’s annual improvements project published in May 2008. Where an investment in joint venture is accounted for in accordance with IAS 39, only certain rather than all disclosure requirements in IAS 31 need to be made in addition to disclosures required by IAS 32, ‘Financial instruments: Presentation’, and IFRS 7 ‘Financial instruments: Disclosures’. The amendment will not have an impact on the organization’s operations as there are no interests held in joint ventures.

. IAS 38 (Amendment), ‘Intangible assets’ (effective from 1 January 2009). The amendment is part of the IASB’s annual improvements project published in May 2008. The amendment deletes the wording that states that there is ‘rarely, if ever’ support for use of a method that results in a lower rate of amortisation than the straight-line method. The amendment will not have an impact on the organization’s operations, as the organization currently does not have intangible assets.

. IAS 40 (Amendment), ‘Investment property’ (and consequential amendments to IAS 16) (effective from 1 January 2009). The amendment is part of the IASB’s annual improvements project published in May 2008. Property that is under construction or development for future use as investment property is within the scope of IAS 40. Where the fair value model is applied, such property is, therefore, measured at fair value. However, where fair value of investment property under construction is not reliably measurable, the property is measured at cost until the earlier of the date construction is completed and the date at which fair value becomes reliably measurable. The amendment will not have an impact on the organization’s operations, as there are no investment properties that are held by the organization.

. IAS 41 (Amendment), ‘Agriculture’ (effective from 1 January 2009). The amendment is part of the IASB’s annual improvements project published in May 2008. It requires the use of a market-based discount rate where fair value calculations are based on discounted cash flows and the removal of the prohibition on taking into account biological transformation when calculating fair value. This amendment is not applicable to the organization’s operations.

. The minor amendments to IAS 29, ‘Financial reporting in hyperinflationary economies’, IAS 40, ‘Investment property’, and IAS 41, ‘Agriculture’, which are part of the IASB’s annual improvements project published in May 2008 (not addressed above). These amendments will not have an impact on the organization’s operations as described above.

. IFRIC 15, ‘Agreements for construction of real estates’ (effective from 1 January 2009). The interpretation clarifies whether IAS 18, ‘Revenue’, or IAS 11, ‘Construction contracts’, should be applied to particular transactions. It is likely to result in IAS 18 being applied to a wider range of transactions. IFRIC 15 is not

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relevant to the organization’s operations as all revenue transactions are accounted for under IAS 18 and not IAS 11.

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2. Financial instruments

Financial instruments carried on the balance sheet include cash and bank balances and trade creditors. The particular recognition methods adopted are disclosed in the individual policy statements associated with each item.

3. Grants income, donations and interest

Grant and donations are recognised in the income and expenditure account so as to match them with the expenditure towards which they are intended to contribute. To the extent that grants and donations are made as a contribution towards specific expenditure on fixed assets, they are recognised over the expected useful economic lives of the related assets.

Interest income is recognised on a time proportionate basis using effective yield to maturity.

4. Cash and cash equivalents

Cash and cash equivalents are carried in the balance sheet at cost. For the purpose of the cash flow statement, cash and cash equivalents comprise cash on hand, deposits held at call with banks, other short term highly liquid investments with original maturities of three months or less, and bank overdrafts. In the balance sheet bank overdrafts are included in borrowings in current liabilities.

5. Provisions

Provisions are recognised when the network has a present legal or constructive obligation as a result of past events, it is probable that an outflow of resources will be required to settle the obligation, and a reliable estimate of the amount can be made. Where the network expects a provision to be reimbursed, for example under an insurance contract, the reimbursement is recognised as a separate asset but only when the reimbursement is virtually certain.

6. Trade payables

Trade payables are carried at fair value of the consideration to be paid in future for goods or services that have been received or supplied and invoiced or formally agreed with the supplier.

7. Trade receivables

Trade receivables are recognised initially at fair value and subsequently measured at amortised cost using the effective interest method, less provision for impairment. A provision for impairment of trade receivables is established when there is objective evidence that the organization will not be able to collect all amounts due according to the original terms of receivables. The amount of the provision is the difference between the asset’s carrying amount and the present value of estimated future cash flows, discounted at the effective interest rate. The amount of the provision is recognised in the income statement.

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ACCOUNTING POLICIES (continued) for the year ended 31 December 2008

8. Property, plant and equipment

Property, plant and equipment is initially recorded at cost and depreciation is calculated on the reducing balance basis by reference to the expected useful lives of the assets concerned. The principle annual rates used for this purpose are:

Motor vehicle 25% Plant and machinery 10% Office machine and equipment 10% Furniture and fittings 5% Computer equipment 33.3%

9. Comparatives

Where necessary, comparative figures have been adjusted to conform with changes in presentation in the current year.

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NOTES TO THE FINANCIAL STATEMENTS for the year ended 31 December 2008

2008 2007 E E 1 Grant income

Analysis of grant income: Kellogg Foundation Fund (note 10.2) 1 044 955 565 395 Harrison Cooper Foundation Fund (note 10.1) ______31 579 ______35 395 _

______1 076 514 ______600 790 _

2 Taxation

The Network is exempt from normal tax in terms of section 12(1)(a)(viii) of the Income Tax Order, 1975, as amended.

3 Cash and cash equivalents

African Alliance 323 557 203 100 Nedbank call account 42 791 229 067 Nedbank current account 19 133 9 783 Cash on hand ______308 ______314 _

______385 789 ______442 264 _

4 Property, plant and equipment

Other Motor Computer Office Furniture fixed Vehicle Equipme Equipme & fittings assets Total nt nt E E E E E Year ended 31 December 2008 Opening net book value 105 000 16 698 7 146 1 078 - 129 922 Additions 122 526 29 025 36 338 5 014 1 766 194 669 Depreciation charge ______(42 737) ______(11 074) ______(1 568) ______(179) ______(49) ______(55 607) _ _ _ _

Closing net book value ______184 789 ______34 649 ______41 916 ______5 913 ______1 717 ______268 984 _ _ _ _

At 31 December 2008 Cost 242 526 53 555 44 213 6 183 1 766 348 244 Accumulated depreciation ______(57 737) ______(18 906) ______(2 297) ______(270) ______(49) ______(79 260) _ _ _ _

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Closing net book value ______184 789 ______34 649 ______41 916 ______5 913 ______1 717 ______268 984 _ _ _ _

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NOTES TO THE FINANCIAL STATEMENTS (continued) for the year ended 31 December 2008

4 Property, plant and equipment (continued)

0ther Computer Office Motor Furniture Fixed Equipment furniture Vehicle & fittings assets Total E E E E E E Year ended 31 December 2007 Opening net book amount 6 505 3 298 - 1 135 - 10 938 Additions 13 734 4 359 120 000 - - 138 093 Depreciation charge ______(3 540) ______(511) ______(15 000) ______(57) ______(19 108) ______

Closing net book amount ______16 699 ______7 146 ______105 000 ______1 078 ______- ______129 923 ______

At 31 December 2007 Cost 24 531 7 875 120 000 1 169 - 153 575 Accumulated depreciation ______(7 832) ______(729) ______(15 000) ______(91) ______- ______(23 652) ______

Net carrying amount ______16 699 ______7 146 ______105 000 ______1 078 ______- ______129 923 ______

2008 2007 E E 5 Accounts and other payable

Skillshare Swaziland management fee 30 020 - Accruals ______30 175 ______-

______60 195 ______-

6 Receivables

Shareholders’ loan 3 3 Staff loan ______223 ______223

______226 ______226

The receivables are unsecured, interest free and there are no fixed terms of repayment.

7 Share capital

Authorised: 1 000 ordinary shares of E1 each ______1 000 ______1 000 Issued:

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3 ordinary shares of E1 each: ______3 ______3

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2008 2007 E E 8 Reconciliation of cash flows generated from operations

Surplus for the year 80 057 4 021 Amortisation of grant received (47 237) (16 575) Grant income recognised (31 579) - Depreciation ______55 607 ______19 108 56 848 6 554 Changes in working capital

Decrease in receivables - 90 Increase/(decrease) in accounts payable ______60 195 ______(3 290)

Cash generated from operating activities ______117 043 ______3 354

9 Special Funds

Gay Thom Memorial Fund 12 690 12 690 Duncan Little Memorial Fund ______2 772 ______2 772

______15 462 ______15 462

10 Deferred grant income

Harrison Cooper (note 10.1) 6 556 160 035 Kellogg (note 10.2) ______101 654 ______144 943

______108 210 ______304 978

10.1 Grant received from Harrison Cooper Foundation Fund:

Balance at beginning of year 160 035 66 705 Received during the year - 128 725 Purchase of motor vehicle (121 900) - Recognised in the income statement ______(31 579) ______(35 395)

Balance at end of year ______6 556 ______160 035

The Network entered into a grant agreement with Harrison Cooper Foundation Fund. The grant is for the network to continue work of improving the survival rates of people directly affected by breast cancer through awareness, education, and advocacy campaign. The amount of this grant is US$ Nil (2007 US$ 19 977) and the period of performance under this agreement is 31 August 2008.

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2008 2007 E E

10.2 Grants received from W K Kellogg Foundation

Balance at beginning of year 144 943 - Purchase of assets (64 439) (138 093) Received during the year 1 066 085 848 431 Recognised in the income statement ______(1 044 935) ______(565 395)

The Network has entered into programme grant agreement with W K Kellogg Foundation to continue to be an efficient provider of information, education, communication, guidance, support and counselling on breast cancer in all regions of the country by building and strengthening Institutional Systems and capacities. The amount of this agreement is US$ 395 000 to be disbursed over a period from 1 November 2006 to 31 December 2009.

11 Property, plant and equipment fund

Balance at beginning of year 121 518 - Purchase of assets 186 339 138 093 Grants amortised ______(47 237) ______(16 575)

The above represents fixed assets purchased through the Kellogg Foundation Funds. The grant is recognised over the expected useful economic lives of the related assets.

12 Interest received

African Alliance ______73 648 ______15 200

______73 648 ______15 200

NCOME AND EXPENDITURE STATEMENT for the year ended 31 December 2008

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2008 2007

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E E INCOME Amortisation of grant received 47 237 16 575 Coffee morning raffle 19 586 - Harrison Cooper foundation fund 31 579 35 395 Interest received 73 648 3 938 Jane King Run tickets, aprons, t-shirts 29 440 5 120 Kellogg Funds 1 044 935 565 395 October donors 882 15 200 Other donors 400 8 384 Ribbon sales - 615 Subscriptions 300 340 Sundry income ______- ______2 880

______1 248 007 ______653 842 EXPENDITURE Advertising and promotions 75 813 Bank Charges 10 752 5 370 Computer expenses - 220 Client support 22 384 13 064 Depreciation 55 607 19 108 Duncan Little Memorial Fund Expenses - 1 378 General expenses 1 455 1 295 IEC Materials 9 195 15 750 Insurance - - Kellogg expenses 601 293 238 785 October awareness 7 960 8 659 Office expenses 13 791 2 389 Printing and stationery - 442 Rent 36 500 - Ribbon purchases - - Salaries – SBCN - 13 750 Salaries – Kellogg 413 623 224 797 Security 1 445 - Skillshare International Swaziland management fees 30 020 101 812 Subscription fees 250 700 Tea and cleaning - 649 Telephone and fax 21 132 840 Training expenses ______- ______-

______1 167 950 ______649 821

SURPLUS OF INCOME OVER EXPENDITURE ______80 057 ______4 021

This statement does not form part of the financial statements and is presented as supplementary information.