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Annual Report 2018

Download the annual report 2018 as a PDF here. All basic information will be found in the document.

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Corporate social responsibility

The AO is proud to be a good corporate citizen in all geographies where it has a presence. Locally, and globally, the AO has a positive impact on patients, the health care sector, and communities.

From energy-saving initiatives at its headquarters in Davos (Switzerland), to projects in Malawi, and targeted initiatives in key locations across the world, the AO remains driven by its founders' passion for improving lives.

2011-2018 AO Foundation CEO Rolf Jeker looks at the highlights of the AO's CSR activities in 2018

The AO Alliance Foundation was established in December 2014 to strengthen the AO's engagement in low- and middle-income countries (LMIC). Health care professionals in these countries face particular challenges, including lack of equipment (C-arms, surgical instruments, and implants), patients who reach hospitals after the golden hour for optimum treatment, insufficient time in the operating room, and lack of continuing education opportunities. AO Alliance works to address these needs.

AO Alliance
has since its establishment:
organised 304 courses
trained 13,452 surgeons and        operating room personnel (ORP)
sponsored 170 fellowships in sub-Saharan Africa and Asia.

AO Alliance is the AO's largest CSR project, and is its most significant financial contribution to the care of the injured in LMIC. Trauma victims in high-income countries (HIC) usually get medical help within minutes of an accident. Trauma victims in low-income countries can wait hours, or days, for adequate treatment—due to local infrastructure and the availability of qualified health care.

Each country has different needs, but these needs usually amount to the 4Ss: staff, stuff, systems, and structure. The AO has the reputational and financial strength to act as an advocate and raise awareness for the current silent epidemic of injuries in low-income countries.

Going where the need is greatest

In 2018, AO Alliance: 

  • secured an additional 1.5 million USD for projects in the next financial year (2019)
  • completed the first phase of its flagship program, Fracture Solutions for Africa and Asia, delivering 100 courses and training 4,120 health care professionals in 24 sub-Saharan African countries and in seven low-income countries in Asia
  • successfully partnered with Coalition for Dialogue in Africa (CoDA) to raise awareness about the silent epidemic of injuries in sub-Saharan Africa, developing a resolution that will be considered by the African Union Commission (AUC) in 2019
  • developed additional activities to be implemented with AO Clinical Divisions in select LMICs in 2019
  • delivered a white paper, At Breaking Point: Understanding the impact of musculoskeletal injuries in low- and middle-income countries, with the Economist Intelligence Unit, looking at the care of musculoskeletal injuries in LMICs, released in 2018
  • began construction on the Lilongwe Institute of Orthopedics and Neurosurgery (LION), due to open in 2021
  • received an honorary award for its contribution and support for development in orthopedics in Myanmar. Dr Claude Martin jr. was presented with the award by Permanent Secretary of the Ministry of Health and Sports Dr Thar Htun Kyaw in November 2018. This recognizes the role AO Alliance has played over the past five years in developing the National Roadmap for Trauma Care in the country.

Foundation stone laying ceremony at the Lilongwe Institute of Orthopedics and Neurosurgery (LION)

This focus is shared by the AO's Clinical Divisions. In 2018 the AOTrauma Europe and Southern Africa Board decided that LMIC need additional focus and set themselves the goal of building an AO community among surgeons in selected countries which can carry out AO activities that are locally sustainable and managed centrally.

Per diem donations in 2018
31,500 CHF in donations
50% to AO Alliance
25% to ARGO
25% to additional projects in Malawi

Safeguarding health worldwide

The AO offsets a portion of the carbon footprint created by the travel of its surgeons and staff by supporting work in Malawi to renovate old boreholes. This means that people (mainly women and children) who had to walk for hours to get dirty and unsafe water now benefit from clean water supplies closer to where they live. It also delivers carbon saving, as they no longer need to boil the water before they use it, thus reducing deforestation and the production of carbon dioxide (CO2).

In looking to maximize the local impact of this AO CSR project in a way that corresponds to the AO's broader goals and identity, the decision was taken to renovate health centers in Malawi, together with local partners, in a three phased approach—covering three clinics in three years from 2017-2019.

In 2018, the AO supported First Climate and its Malawi-based partner United Purpose on the second project in the Dowa district, completing much-needed reconstruction and renovation work on Dowa District Hospital, which serves 850,000 people. This included providing a new solar-based reticulated water system, backup solar-powered lighting for some of the hospital wards and operating theaters, and backup solar energy for ventilators on-site.

The hospital is now clean. The guardians don't have to go to the rivers to wash and clean any more. 
Eliza Mabulasa, Bimphi Village, Traditional Authority Msakambewa, Dowa, Malawi

These measures have a direct impact on patients. Eliza Mabulasa, Bimphi Village, Traditional Authority Msakambewa, Dowa, Malawi said: "I was referred to this hospital from Mponela. My colleagues were sorry for me because of the water problem. To my surprise we have a tap stand from a solar-powered borehole that has running water throughout. The hospital is now clean. The guardians don't have to go to the rivers to wash and clean anymore. I will go back with a different, wonderful, story."

The installation of solar-powered lighting means that pregnant women no longer need to bring candles with them to provide light for the medical teams on duty when they are giving birth.

Our pregnant women and guardians have dignity now because of the guardian shelter.
Senior Village Head, Dzoole


Thanks to the additional money donated by AO faculty through their per diems, the AO expanded planned renovations at the Dzoole Health Center, which serves 50,000 and was part of the first phase of this project in 2017. Senior Village Head at Dzoole said: "I am speechless, the joy in my life is beyond words. Our Health Center is now a haven. We have running water and electricity even at the hospital, as well as at the staff houses. Other centers lack this. Our pregnant women and guardians have dignity now because of the guardian shelter."

The AO built new shelters, provided a new antenatal bed, mattress, and solar power. "The new shelter has a big sleeping quarter, a kitchen, and a laundry. What an honor that has been put to all the women of TA Dzoole," said Esnart Harold, Samuel Village, Traditional Authority, Dzoole, Dowa, Malawi. The impact is felt by patients and doctors: lighting, electricity, and ventilation machines all help improve patient outcomes day and night. The community benefits as these improved conditions mean these locations are more appealing places to work, helping retain talented professionals and thus raising the standards of care available to people in these areas.

Rehabilitation in disasters and conflicts

The AO is actively engaged in bringing excellence in orthopedic treatment and education to areas affected by natural or man-made disasters, and conflict zones.

©William Daniels, Handicap International

The AO Strategy Fund's 12-month Early Rehabilitation During Disasters and Conflicts project was launched in 2018 and is due to yield a clinical guide and suite of resources for health care professionals working in these difficult situations.

This project will offer both resources that can be used in an emergency and in preparation for emergency situations in disaster-prone areas. By focusing on the needs of clinicians in these areas the AO Strategy Fund aims to help reduce the inequality of care that affects their patients.

AO Foundation CEO 2011-2018 Rolf Jeker on the first 60 years of the AO's impact

More on CSR at AO in 2018

Play Safe with Sisimpur

AO Center: leading the way in energy efficiency

Fracture Solutions for Africa and Asia