2014 ANNUAL REPORT
SPOON Foundation is the first and only organization worldwide dedicated to transforming nutrition and feeding for children in orphanages and foster care, and those with disabilities.
A WORLD WHERE ALL CHILDREN ARE VALUED AND NOURISHED 2014 was a year of unprecedented global expansion for SPOON. While deepening our work in India, Kazakhstan, Tajikistan, China and Vietnam, we entered Russia and Mongolia for the first time, soaring over geographic boundaries to reach more children, many times against the odds. SPOON grew a lot this year. And so did many deserving children, thanks to your support and partnership.
Our financials reflect a unique investment in 2014 towards building SPOON’s administration and fundraising capacity, positioning us to launch and expand more life-saving programs in the years ahead. The following pages are evidence of the thoughtful, powerful difference we are making together. With hope and gratitude,
With each road traveled, we’ve met children deprived of their basic human rights and needs, all because they were born into bodies affected by disability and/ or to parents unable to care for them. We have witnessed communities and wellintentioned caregivers do harm during feedings, simply because of a lack of basic knowledge. In response, we have educated and equipped these caregivers with the tools they need to provide safe, nourishing care. We have watched anemia rates plummet, growth charts take off, and mealtimes become opportunities to feed children’s development.
Cindy Kaplan, Co-Founder and Executive Director
HI G H LI GH TS O F 2 0 1 4
ADVANCING NUTRITION Around the world we have seen children in orphanages suffering from malnutrition at rates far higher than their peers living with families, compromising their growth, health and brain development. This malnutrition is often easy to prevent and treat, yet most orphanages lack the knowledge and resources to do so. SPOON has created a practical, evidencebased solution to this problem: the NSS: Nutrition Screening System™. The NSS provides a standardized way to measure, track, and promote growth and essential nutrition for children in low-resource settings. It can be easily implemented in low-resource settings to measure and track children’s growth and nutritional status, flagging those who are high risk and triaging them with appropriate care. In 2014, we field-tested this tool in a variety of settings, Teaching caregivers how to test for anemia in Guangxi Zhuang Autonomous Region, China PLACES & PARTNERS:
Tajikistan Partners: Vibrant Village, Handicap International, HealthProm Sites: Dushanbe and northern region
with life-changing results for many children. India Partner: Holt International Sites: Pune and Bangalore
China Partner: Holt International Sites: Nanning and Changchun
Vietnam Partner: Holt International Sites: Hanoi, Dong Nai, Ben Tre, Khanh Hoa, and Binh Duong
SPOTLIGHT ON INDIA
When we began our work in India in 2013 with our partner Holt International, our initial assessments at two orphanages turned up surprisingly dire results: at one site, 30% of the children were anemic; at the second, 45% of the children were anemic. For children like the ones we met in India— already vulnerable due to their institutionalized status—anemia can complicate underlying health conditions, compromising their ability to learn, grow and ward off infection. Anemia also robs children of their energy and the vitality they need to engage with their environment and to form essential relationships with caregivers and potential adoptive or foster families.
In 2014, we equipped our India partners with SPOON’s NSS and trained them on nutrition basics, such as pairing vitamin C with iron supplements and delaying the introduction of cow and buffalo milk for infants (which can lead to iron bleeds). Within six months of introducing SPOON’s NSS in orphanages and care centers for foster families, the incidence of anemia dropped to less than 10% at one site and 0% at the second. Not only did local staff become experts in administering these programs at their orphanages, they have begun spreading these tools and their impact to other orphanages and community care centers.
ADVANCING FEEDING PRACTICES We have come to realize that how children are fed is as, if not more, important as what they are fed. This is especially true for young children and those with disabilities who rely on their caregivers to feed them, and the importance is amplified in group settings (i.e., orphanages). We have repeatedly observed mealtimes that are void of the caregiver-child interaction that is so critical to healthy growth and development. Even more concerning are the harrowing feeding practices we have witnessed across countries and institutions (i.e., rapid feeding and feeding children with disabilities lying down), causing preventable health complications and premature death. In 2014, PLACES & PARTNERS: India Partner: Holt International Sites: Pune and Bangalore
Kazakhstan Partners: Kazakhstan Ministry of Health Sites: Almaty Oblast
we created a one-of-a-kind solution for assessing and optimizing feeding practices, SPOON’s SAFE: Short Assessment of Feeding Environments™. SPOON’s SAFE provides a quick snapshot of a child’s positioning, bottle-feeding, spoon-feeding, cup drinking, and self-feeding, and coaches caregivers on practical adjustments they can make to promote safe, nurturing feeding. The global health community and partners on the ground have embraced it as the first-ever tool of its kind.
Mongolia Partners: World Vision International Sites: Ulaanbaatar
Demonstrating using an adaptive cup in Almaty, Kazakhstan Russia Partners: Firefly and Carlson Family Foundation Sites: Moscow
Tajikistan Partners: Vibrant Village, Handicap International, HealthProm Sites: Dushanbe and northern region
Vietnam Partner: Holt International Sites: Hanoi, Dong Nai, and Binh Duong
SPOTLIGHT ON RUSSIA
In the past several years, there has been exciting movement globally to end institutionalization of children. Yet, under-nourished and unhealthy children may not be removed from orphanages and selected for adoption or reunification with local families. In Russia, many parents who do bring these children home are ill-equipped to manage their care. In the past 10 years, Russian families have returned over 9,000 children to baby homes. To break the cycle of institutionalization, it is critical to address malnutrition for children in orphanages and to train parents caring for post-institutionalized children on their unique needs and risks, including nutritional deficits and feeding challenges. Very fortunately for SPOON and for the nearly 700,000 children in Russia’s baby homes, support from the Carlson Family Foundation made it possible to launch a program in Russia this year. Given current sensitivities in US-Russia relations, this program was executed through our exceptional RU-based colleagues, Drs. Svyatoslav Dovbnya (Slava) and Tatiana Morozova (Tanya). Tanya and Slava traveled to the U.S. to be trained by our team on the SAFE, and then incorporated the tool into a comprehensive pilot training for caregivers and directors in baby homes in the Moscow metro region in December. The training participants were very enthusiastic and are eager for further trainings and tools. We were pleased by the effectiveness of using the train-the-trainer methodology to scale to additional sites in Russia and beyond. Plans are now underway to expand this training to reach greater numbers of deserving children throughout the country.
Tanya and Slava leading a feeding training
2014 represented a year of infrastructure building and growth for SPOON, allowing us to invest more heavily in our programs for years to come. SOURCES OF REVENUE: Individual Contributions
FINANCIAL SUMMARY Assets: Cash and cash equivalents Accounts & Grants Receivable Prepaid Expenses & Insurance Furniture and Equipment
225,157 204,524 6,355 9,439
Net Total Assets
LIABILITIES AND NET ASSETS
Contracts Earned Income
Liabilities: Total Liabilities
In Kind Contributions Other Income
EXPENSE ALLOCATION: Total Programs International Programs Domestic Programs Program Development G&A* Fundraising*
Net Assets: Total Unrestricted Net Assets Total Temporarily Restricted Net Assets
Total Net Assets
Total Liabilities and Net Assets
Notes: SPOON undergoes an annual audit conducted by an independent firm. Figures above are based upon the report of McDonald Jacobs. *In 2014, SPOON’s Board of Trustees and staff made a strategic decision to invest in infrastructure and fundraising in order to create a sustainable foundation for program growth in years to come. As a result, G&A and Fundraising expenses for 2014 are proportionately higher than in prior years and to what we aspire to moving forward.
Revenue: Individual Contributions Foundation Grants Contracts Earned Income In Kind Contributions Corporate Contributions Other Income Investment Income Unrealized Gain/Loss Investments
Amount 316,648 237,087 228,787 31,066 18,293 1,288 201 (3,553)
Expenses: Total Programs Domestic Programs International Programs Program Development G&A Fundraising
409,737 55,554 298,681 55,502 119,129 98,370
Change in Net Assets
OUR TEAM STAFF Cindy R. Kaplan, MS | Co-founder and Executive Director Mishelle Rudzinski, MA, CCC-SLP | Co-Founder and Feeding & Disability Specialist Emily Brod, MBA | Director of Finance & Operations Sophie Hawkins | Administration & Outreach Coordinator Zeina Makhoul, PhD, RD | Nutrition Scientist Kerry Norton, MPH | Tammy Teske, MBA | Director of Programs Brita Johnson | Special Advisor (through March 2014) Monica Czapla, MPH | Director of Programs (through April 2014) Kate Ward, MPH | Training Specialist (through October 2014) Raushan Amanzhanova | Director of SPOON Foundation Central Asia Assel Mussagaliyeva | Monitoring & Evaluation Coordinator, SPOON Foundation Central Asia
BOARD OF TRUSTEES John Ordway, JD | Chair Jeff Erlich, MA | Vice-Chair and Treasurer Judith Shank, MD | Secretary Martha Deevy, MBA John Himes, PhD, MPH Dana E. Johnson, MD, PhD Cindy R. Kaplan, MS Michele Meyer, MBA Dara J. Royer Mishelle Rudzinski, MA, CCC-SLP Almaz Sharman, MD, PhD (2012-2014)
MEDICAL ADVISORY BOARD
VOLUNTEERS, INTERNS, AND PRO BONO SUPPORT
Julian Davies, MD Philip A. Fisher, PhD Michael Georgieff, MD Mary Hearst, PhD, MPH John Himes, PhD, MPH Dana E. Johnson, MD, PhD Maria Kroupina, PhD Brad Miller, MD Paula Rabaey, MS, OTR/L Katja Rowell, MD Almaz Sharman, MD, PhD
Georgia Canaan Amy Colville Pip Denhart Dana DuVivier Laura Grieser Daniel Hawkins Bill Hines Jake Hyman
Laura Koch Jaime Macintosh Marisa Meltebeke, Davis Wright Tremaine
Carol Noonan, Davis Wright Tremaine
Ashley Paquin Emily Payne
Allen Poole Erin Porter Liz Stapf Lisa Steenson Amie Wexler Nada Wheelock Beth Williamson Kerry Wright
SPOON Staff and Board of Trustees
OREGON ADVISORS Jeremy Barnicle, MPA Matthew De Galan Chris DeMars, MPH Gun Denhart Philip A. Fisher, PhD Tobey Fitch
Dana Hargunani, MD, MPH, FAAP Dan Lauer Julia Plowman
David Pollock, MBA David Sawyer Keith Thomajan Photography by Bill Hines, KazPhoto
SPOON is fueled by donors from 40 states and 7 countries.
Our donors make our work possible, helping change the lives of thousands of children worldwide. In 2014, over 500 individual donors contributed more than 38% of our total revenue. The remaining reflects meaningful investments from foundations, corporations, contracts and gifts in kind. Thank you! SPOON is a Proud Member of: InterAction Joint Council on International Children’s Services Nonprofit Association of Oregon UNICEF Global Partnership on Children with Disabilities Institutional Donors and Partners: Ashoka Boehringer Ingelheim Carlson Family Foundation Firefly International General Mills Inc.
General Mills Foundation George Family Foundation Handicap International HealthProm Holt International Children’s Services The Jay & Rose Phillips Family Foundation of Minnesota Joint Council for International Children’s Services
Kazapalooza Koerner Camera Systems M.J. Murdock Charitable Trust Maybelle Clark Macdonald Fund Nancy & Richard Silverman Charitable Foundation Oregon Department of Human Services Rogers Family Foundation
SOHUM Foundation University of Oregon Vibrant Village Foundation The Waitte Foundation Wheeler Foundation World Vision
US States with Donors
Countries home to Donors:
United States (see map)
United Arab Emirates
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Cover Image: Jilin province, China