Hope Walks Annual Report - Fiscal Year 2024

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Great Strides F Y 2 024 AN N UA L R E P OR T

Message From the President and Co-Founder

We knew it all along We have been helping children born with clubfoot get the treatment they need for quite a while. Since becoming an independent organization in June 2019, we have enrolled more than 36,000 children in clubfoot treatment worldwide.

Would we still be doing what we are doing if we only had a hunch that our work with God’s provision and donor support was making a positive difference?

Hardly. We see real outcomes when children learn to walk on straight feet. We see lives transformed. Relationships mended. Families brought to Christ.

A new peer-reviewed working paper from the Kellogg Institute for International Studies at the University of Notre Dame confirms what we knew deep down.

It validates that your support of our ministry makes a difference. The findings conclude that early clubfoot intervention impacts the physical mobility of a child (not surprising) but also positively impacts other areas of human flourishing, including mental health, social inclusion, education and religious faith. It is the first study to examine clubfoot treatment's holistic outcomes.

Specifically, the study’s authors researched our program in Ethiopia. You can read more about the results on page 9.

On the Cover:

Daricson walks free from clubfoot today in Honduras. His family is grateful for donor support.

The study’s findings may be a mic-drop moment, but without access to treatment, children lose the benefits of renewed physical and mental well-being.

Hope Walks has a bold vision of countries taking responsibility for the care and treatment of clubfoot. To this end, we are dedicated to training more healthcare professionals in our countries and raising awareness so families know treatment is available.

This fiscal year we made great strides toward a world with more children treated for clubfoot, but the battle is far from won. We look forward to continuing the fight with you.

In Hope,

Scott Reichenbach

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OUR APPROACH Physical ® Clubfoot is treatable, especially with early intervention within the first six months. Hope Walks uses the globally accepted process of casts and braces known as the Ponseti method. Medical professionals straighten feet using an average of four to eight weekly casts.

Then, a child wears braces, mostly at night, until age five. The entire process costs $500 on average.

Spiritual We share the love of Christ to our families and treat them with the respect they deserve. Our parent advisors guide them by educating them, praying and sharing the gospel.

200,000 annual clubfoot births.

Clubfoot is one of the most common birth conditions, with an estimated 200,000 children born with it each year.

Almost 90% of cases are in low- and middle-income countries where access to treatment is difficult.

Partnerships Hope Walks does not have its own facilities or medical staff. We partner with public hospitals and each country’s national health administration to set up treatment centers within the existing healthcare system. This approach keeps overhead low, allowing us to expand precious resources further for a more significant impact.

A treatable condition turns into a lifetime disability.

With limited access to treatment or knowledge about solutions, thousands of babies become adults with clubfoot.

At this point, treatment solutions are minimal, expensive and less effective.

What was once a treatable condition turns into a life-altering disability.

Training We train hundreds of national medical staff annually on the Ponseti method and proper diagnosis. These individuals know the language and culture.

Each person trained strengthens the national health system and creates opportunities for a consistent countrywide approach to clubfoot treatment.

DEFINING THE PROBLEM

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HOPE WALKS ANNUAL REPORT

Program Model Our program model includes six pillars that guide our organization. Building on each other, this system allows us to scale sustainable clubfoot treatment programs so the national health system is strengthened and more children and families are served.

Partnerships We create local, national, and international partnerships to promote advocacy, resource mobilization, integration, and longevity.

National Program Management National staff working through a locally registered organization provide leadership for each country's program.

Each team works within appropriate cultural norms and within the national healthcare structure.

Data-driven Outcomes Our reporting system allows us to monitor program effectiveness, strengthen accountability and track Key Performance Indicators.

SYSTEMS SCALABLE SUSTAINABLE

Christ-centered Holistic Care We integrate local Christian parent advisors in each partner clubfoot clinic to educate families on clubfoot, promote treatment adherence, and build relationships to meet the family’s psychosocial needs and share the love of Christ.

Access to Early Quality Treatment Working within the national health system, we integrate access to early quality treatment for all children through a nationwide network of fully staffed and equipped partner clubfoot clinics.

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Training & Awareness We invest in training national medical providers, brace makers, program staff, and parent advisors while raising awareness by educating the public and healthcare community about clubfoot, its treatment, and where to find care.

Mission TO GLORIFY GOD AND FREE CHILDREN AND FAMILIES FROM THE PHYSICAL, EMOTIONAL AND ECONOMIC BURDEN OF CLUBFOOT.

Vision THAT EVERY CHILD AND FAMILY WILL WALK FREE FROM CLUBFOOT AND ENCOUNTER THE LOVE OF CHRIST.

Core Belief WE BELIEVE THAT GOD LOVES AND VALUES ALL HIS CHILDREN, AND THAT THROUGH THIS MINISTRY GOD WILL BE GLORIFIED.

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Reflecting on

Your Impact in FY24 W H AT W E N T W E L L ? i We served more than 16,500 children (newly enrolled and ongoing treatment) i Several new foundations partnered with Hope Walks, further demonstrating God’s ongoing provision. i There is increased awareness of clubfoot and a growing interest in rehabilitation services. Hope Walks is now a member of the World Health Organization’s (WHO) World Rehabilitation Alliance, and we are partnering with the Clinton Health Access Initiative in Ethiopia to increase access to care for children as part of a larger grant from LEGO to create a world of play.

W H AT W E R E T H E C H A L L E N G E S ? i We moved to all electronic reporting from all our clinics. This year, we digitally registered every child in our data collection system. This is the first year we have relied solely on electronic individual patient reporting. As everyone who has had to transition from paper to digital reporting on a smartphone realizes, this is a challenging change to make, particularly with a less computer-savvy workforce. i Conflict in several countries has hindered our ability to provide treatment, especially in Haiti and Ethiopia.

Sadly, we had to suspend our work entirely in Sudan, which is facing a major humanitarian crisis. i It is a global reality that prices continue to rise. We have seen increases in the plaster of Paris used for the casting process. Other costs have also risen, including the leather and metal used in brace production.

WHERE ARE WE HEADED?

Systems

Hope Walks supports a network of national clubfoot programs through standard procedures and processes to implement Hope Walks’ mission.

Scalable

Our proven program model is built on six pillars designed to effectively implement and expand clubfoot care and services to a nation.

Sustainability

With time and an aligned strategy, the countries and communities where we serve will become self-sufficient in providing families with access to holistic clubfoot care with limited outside support.

HOPE WALKS ANNUAL REPORT

Training is Key There are thousands of excellent medical professionals in our 15 countries. These individuals are there; they speak the language and know the customs and culture better than any outsider. We take advantage of this available resource by teaching them how to treat clubfoot using the Ponseti method. They, in turn, can train and teach others.

It’s a win-win scenario that allows us to leverage our knowledge and expand the clubfoot program's reach.

In FY24 19,081 PEOPLE TRAINED IN E A R LY D E T E C T I O N A N D R E F E R R A L

53 PEOPLE TRAINED IN COUNSELING

237 CLINICIANS TRAINED IN THE PONSETI METHOD

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Training in Three Categories WE OFFER DIFFERENT TYPES OF TRAINING TO MEET THE NEEDS OF VARIOUS PEOPLE Early Detection and Referral (EDR) Many medical professionals, church leaders, and community leaders will never need to use the Ponseti method. However, their understanding of clubfoot is invaluable for raising awareness and directing families whose children have clubfoot to proper treatment. Midwives, for example, are great resources to educate a mother when the child is born to calm her fears and let her know help is available.

Clubfoot Early Detection & Adherence (CEDA) Other individuals, such as parent advisors, need more detailed training on clubfoot without the need for medical training. This thorough

understanding of clubfoot helps them educate families throughout the process. They also encounter challenging situations that require counseling skills and a strong knowledge of Biblical teaching.

ACT training We offer both basic and advanced courses for medical professionals who will use the Ponseti method with children born with clubfoot. Every family wants the best for their child. Therefore, we adhere to the highest standards to ensure children not only walk free from clubfoot but can lead happy and productive lives.

Academic

Proof

A study, several years in the making, was released showing the overall impact of clubfoot treatment on five categories of human flourishing, including physical mobility, mental health, social inclusion, education and religious faith.

The results were first reported in a peer-reviewed working paper from the Kellogg Institute for International Studies at the University of Notre Dame. After studying 564 families impacted by clubfoot from Hope Walks’ clubfoot program in Ethiopia, the authors found that untreated clubfoot results in a significant decline in human flourishing, and conversely, early use of the Ponseti method realizes “large and significant impacts” across all the identified facets of human flourishing. Overall, the study’s authors estimate that early treatment of clubfoot restores between 71-82% of human flourishing lost to untreated clubfoot.

Your Impact New Children Enrolled FY24 - 8,701 FY23 - 8,436 FY22 - 7,211

Children Receiving First Brace FY 24 - 6,878 FY 23 - 6,563 FY 22 - 5,707

Clinic Visits FY 24 - 103,920 FY 23 - 102,823 FY 22 - 90,037

Counseling Sessions FY24 - 92,364

When treatment is delayed, children often require surgery.

Not only is surgical intervention more expensive, but the study also found the results are not as positive as those of children treated using the Ponseti method.

Home Visits

The study also investigated barriers to clubfoot treatment, including lack of knowledge about available treatment, cost, and understanding that clubfoot is treatable. Our programs at Hope Walks are all designed to address these barriers specifically.

PHONE CALLS

The study concluded these barriers suggest a primarily informational challenge, and if society addresses these hurdles, the volume of this “substantively life-changing intervention might be significantly increased.”

FY24 - 1,632 FY23 - 2,030 FY22 - 1,602

FY 24 - 46,724

LOCAL church connections FY 24 - 926

Faith expressions FY 24 - 772

Read more details of the study at hopewalks.org/nr-clubfoot-study or scan the QR code.

All children served FY 24 - 16,606

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Where will be in 2030?

you

FINANCES FISCAL YEAR 2024 STATEMENT OF FINANCIAL POSITION JUNE 30, 2024 (INDEPENDENT AUDIT)

None of us know exactly where we’ll

Cash

be in 2030, but Hope Walks has a vision

Grants & Pledges receivable

$80,000

for children born with the treatable

Prepaid expenses and other assets

$141,810

condition of clubfoot. We are part of a

Furniture and Equipment

$134,872

global movement to see more children treated for clubfoot by 2030. Dozens of organizations have joined with the Global Clubfoot Initiative (GCI), of which Hope Walks is a founding member, and its RunFree2030 campaign.

$1,823,653

Total Assets:

$2,180,335

Liabilities

$205,587

Net Assets

$1,974,748

Without donor restrictions:

$1,654,140

With donor restrictions:

$320,608

TOTAL LIABILITIES & NET ASSETS

$2,180,335

During World Clubfoot Day, June 3, 2024, GCI relaunched RunFree2030 with revised goals and strategies.

Strategic objectives include:

i Access — All low- and middleincome countries within the RunFree2030 strategy will have national clubfoot programs with comprehensive clubfoot care available to all babies. i Quality — High-quality clubfoot treatment will be provided according to evidence-based protocols. i Integration — Clubfoot programs will be integrated within national health systems for long-term sustainability.

FISCAL YEAR 2025 BUDGET

Family Outreach & Counseling

$814,619

Medical Care & Treatment

$1,202,354

Monitoring & Evaluation

$383,466

Sensitizations & Awareness

$138,768

Clubfoot Program Operations

$764,871

Total Program Expenses:

$3,304,078

US Fundraising & Admin

$931,350

TOTAL

$4,235,428

What will 2030 look like?

Hope Walks is working with dozens of

2020

2021

2022

2023

2024

other clubfoot organizations to ensure

$2,035,947

$2,698,226

$3,104,126

$3,812,254

$4,210,294

that more children can walk, run and

5,445

6,432

7,211

8,436

8,701

play free of disability.

Revenue

Children Enrolled

HOPE WALKS ANNUAL REPORT

Transforming Lives, Amplifying Impact Investing in Hope Walks’ clubfoot program is more than a contribution; it’s a transformative act that changes lives and creates enduring value.

In FY24, Hope Walks invested $4.29m to provide life-changing clubfoot treatment, enabling 6,855 children across 15 countries to achieve correction and reach the bracing stage with feet in correct alignment. This investment doesn’t just represent immediate medical interventions— it embodies a generational impact.

The outcome of our work generated a net present benefit of $55.42m** for children treated and their communities. With your support, we see a staggering return on investment measure of $13.84 for every dollar invested, fulfilling our mission to free children from the physical and economic burden of clubfoot and enabling Program Activity $3,368,700*

them to pursue education, careers, and a future filled with opportunity. The ripple effect of early clubfoot treatment strengthens communities, enhances productivity, and builds hope for families who once faced the despair of untreated disability.

Your partnership with Hope Walks enables a scalable, high-impact program with proven results that will have a transformational societal impact for generations. Together, we can amplify this success and bring the gift of mobility to even more children, empowering them to live full, independent lives. Join us in walking alongside these children and their families toward a brighter, healthier future.

Invest in Hope Walks. Change lives.

Create lasting impact.

Fundraising $672,503

78%

16%

FY 2024

*Hope Walks is built on partnerships, and our finances reflect that reality. We are grateful for solid relationships with Ministries of Health and local healthcare providers who provide the dedicated space and overhead to facilitate care and partner with our staff to raise awareness and ensure quality outcomes. This year, this represents a gift-in-kind contribution of more than $192,000 from the various government health ministries with whom we partner. **Visit hopewalks.org/lifetime_impact to see how we calculate net present benefit.

6%

Admin $251,631

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Nandi and Lwazi

Why we support Hope Walks Nandi and her husband were expecting a child a few months into marriage. They were thrilled, but doctors told them their child would be born with clubfoot. To their relief, their son Lwazi was not born with this birth defect. Instead of turning toward anger at the misdiagnosis, they decided to use the experience to help others.

“Through prayer, I felt guided to focus on helping those affected by clubfoot. I made contributions to several such organizations, but [Hope Walks] stood out to me. I appreciate how your organization integrates faith and prayer with medical treatment and your transparent communication about your projects.”

“When I think on my ways, I turn my feet to your

Nandi Makubalo Mission Support Coordinator The English Church Ostend Bruges Belgium

testimonies.”

Psalm 119:59 ESV

Global Footprint Niger 315 14%

Haiti 80 16%

Honduras 104 28%

Sudan 83 4%

Burkina Faso 296 24%

Dominican Republic 233 70%

New patients enrolled in FY24 Percent of new clubfoot births in FY24 accessing treatment through Hope Walks (a small percent may

Ghana 347 24%

Ethiopia 2,557 44%

Rawanda 451 91%

Kenya 1,366 68%

DRC 1,039 16%

Burundi 417 72% Malawi 535 58%

Zambia 425 43%

Mozambique 453 27%

access treatment through a private option or another program)

“This cause touches our hearts because you can really see the love of Christ being shown in a tangible way. The Hope Walks staff build a bond with the families throughout their journey, which builds trust and relationship, and in turn, the staff can share the love of Jesus with them. Hope Walks changes both their physical and spiritual lives, leaving an eternal impact.”

SONYA & BILL ROBERTS Members of The Clubfoot Crew

Bill (far left) and Sonya (far right) visit a family during a recent trip to Kenya.

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Lives you’ve impacted Esdras in Honduras His name means “help from the divine.” His parents gave him this name because Roxana had difficulty getting pregnant, and they believed this little boy was a miracle from God. When doctors told her Esdras would be born with clubfoot, she became angry with God but still believed he would provide another miracle for her son.

Working as a preschool teacher, Roxana had little financial resources and assumed she would never be able to afford treatment. But then she found out about Hope Walks and its free treatment option.

“I SAW A MIRACLE IN MY SON WHEN THEY REMOVED HIS THIRD CAST. I THOUGHT, YES, GOD FULFILLED MY WISHES, AND GOD FULFILLED MY PRAYERS.” - ROXANA -

Scan the QR code to watch Esdras’ story and an adorable video of him marching in a parade on straight feet.

Herminia in Mozambique No one noticed anything wrong with Herminia’s feet when she was born, even the medical professionals who helped with the delivery. It was not until Herminia’s grandmother saw a problem with her foot while bathing the little girl.

Her mother, Sandra, returned to the hospital, but after receiving little satisfaction, she looked for other options. That’s what led her to the Hope Walks partner clinic at Maputo Central Hospital.

“I AM VERY HAPPY AND DEEPLY GRATEFUL FOR THE WAY WE ARE TREATED AND FOR SEEING MY DAUGHTER HEALED. THE COUNSELING WAS POSITIVE AND SPIRITUALLY EDUCATIONAL, AS WE FELT THE PRESENCE OF GOD DURING PRAYERS, AND THIS RENEWED MY FAITH.” - SANDRA 14

HOPE WALKS ANNUAL REPORT

Habsa in Niger Sadia and Issa saw how people with disabilities are often treated in society. They usually struggle to meet their basic needs, and others look down on them. This was all the motivation these parents needed to help their daughter Habsa when she was born with clubfoot.

But still, the road was difficult. Sadia and Issa struggled with the shame they felt even though they knew they did nothing to cause Habsa’s clubfoot and that the condition was treatable. A Hope Walks parent advisor counseled the family through their emotions and guided them through their journey.

"I AM VERY HAPPY TO SEE HER HEALED, AND I CAN ONLY THANK GOD. WE HAVE LEARNED A LOT, AND NOW WE WILL IN TURN RAISE AWARENESS AMONG OTHERS.” - ISSA -

Sarahi in Honduras Overcome with emotion, Nolvin left the hospital after his daughter Sarahi was born with clubfoot. He went to his home village to be consoled by his aunt. Her advice to have faith in God and trust Him was enough for him to find courage.

Living in an extremely remote mountain village with no paved roads and steep hills, Nolvin and his wife Brenda could not imagine how Sarahi would be able to survive. Even getting to the closest clinic was a 45 minute walk before reaching the main road where they could find public transportation.

Hope Walks donors supported Sarahi’s treatment process and now she is free from the burden of clubfoot.

Scan the QR code to watch Sarahi's story.

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caption

WHO WE ARE Hope Walks is a group driven by dignity and compassion for vulnerable children and their families, committed to ending the treatable condition of clubfoot through local health partners, and showing the love of Christ with tangible actions, not just empty words.

F Y 24 B OA R D O F D I R EC TO R S

Tom Free Eric Gokcen, MD Leron Lehman, Chairman John Mitchell Kevin Nderitu Marlise Streitmatter Don Waardenburg, Secretary Natalie Weakly James Welch, Treasurer

Follow us on social media at HopeWalksOrg.

400 Main St., Suite C York Springs, PA 17372 hopewalks.org