Cardiovascular Speciality Hospital/Dar es Salaam/Tz

This will be branch hospital, 50 beds total, aiming at diagnosing and treating heart disease patient based on private business in East Africa.

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I'm an experienced cardiovascular surgeon and cardiac sonographer, healthcare businessman as well. I opened up branch hospitals two times before in 2000 and 2016 in Turkey.
I opened a sole proprietorship company for the same purpose in East Africa for this time.
It is my area of expertise to establish and manage heart units turnkey. I will also operate the hospital afterwards, manage as a CEO, work as a physician as well in 2025.
Please find the attached files explaining the project shortly.
I need average 2 mio as a whole\ to start out the hospital in Spring 2025.
Thank you,
Mehmet Ugur Es, MD

1. BRIEF INVESTMENT FEASIBILITY:
This project proposes building a specialized heart hospital in Dar es Salaam, Tanzania. 
Why this location was chosen:
Dar es Salaam's Advantages:
Large Population: With a population of around 7 million, Dar es Salaam offers a substantial patient base.
Vibrant Economy: The city's thriving economy indicates a strong demand for healthcare services.
Strategic Location: Situated in close proximity to Kenya, Uganda, and Rwanda, Dar es Salaam facilitates patient transfers from neighboring countries,serving overall 200 mio people total.
Inadequate Existing Healthcare:
Limited Services: While Dar es Salaam has three cardiac hospitals, including KIKWETE Heart Hospital and two private facilities, their services are considered inadequate.
High Costs of Overseas Treatment: Many patients travel to India for cardiac care, incurring significant expenses for flights, accommodation, and medical procedures, often exceeding $10,000 to $15,000 per patient.
Accessibility Issues: Not all patients can afford or undertake overseas travel for treatment.
Projected Success:
Full Capacity within a Year: We are confident that our hospital will reach full capacity, filling all 50 beds, within the first year of operation.
Robust Treatment Volume: We anticipate performing around 10 coronary angiography, stenting, and pacing procedures daily, along with 2 open-heart surgeries each day at the end of first year.
Expansion Plans:
Regional Outreach: Our hospital's advertising and promotion department will collaborate with local cardiologists in Kampala, Nairobi, Mombasa, and other surrounding areas to expand our reach and serve a wider patient population.
Charitable Foundation: A foundation established within the hospital will strive to raise funds for underprivileged patients. This initiative will enable the provision of free or subsidized treatment for a select number of patients, particularly children.
Overall, the chosen location of Dar es Salaam presents a compelling opportunity for our specialized cardiac hospital to address the unmet healthcare needs of the region. Our strategic approach, coupled with our commitment to providing high-quality, accessible care, positions us to achieve sustainable success and make a positive impact on the lives of numerous patients.
Here's a breakdown of the key aspects:
Hospital Features:
Location: Dar es Salaam, Tanzania
Type: Single-branch facility with a 3,500-4000 square meters closed area
Amenities: Parking lot, stretcher elevators, ICUs bedside vacuum and oxygen systems, Central climatization, generators etc.
Bed Capacity: 50 beds total
20 beds dedicated to intensive care and emergency services
30 private rooms
Focus: Comprehensive cardiac care for adults and children, including pediatric heart surgery
Financial Investment:
***The estimated total investment for this project is approximately 2 million USD (US Dollars). 
Here's a breakdown of the major costs:
Building Renovation & Medical Systems plus generator supply: 
       100,000 USD 
Ambulance:                                                                                            100.000 USD
Medical Equipment & Instruments:
Cardiology:
Coronary Angiography & Cath Lab:                                                 600,000 USD
Intensive Care Unit Equipments,ECG Defibrillator :                       75,000 USD
Echo 2 packages plus one TEE facility  & Stress Test, Holter Devices,other outpatient facilities :                                                                          150,000 USD

Heart Surgery:
2 Operating Rooms Equipment (including 2 Anesthesia devices, Operating tables, Heart Lung machines, Heater Cooler, IABP,Surgical hand instruments Defibrillator with internal spoons, temporary pacemakers,stainless steel cabinets and tables,  etc.):                                                                250,000 USD
Cautery, patient blankets, Surgical Hand Instruments & 3 month surgical disposable supplies:                                                                          125,000 USD
Intensive Care Unit Equipment including auomated ICU beds,bedside monitors and ventilators,crash carts etc. :                                   125,000 USD
Other Expenses:
Patient Rooms & Furniture:                                                               50,000 USD
Laboratory equipments & Blood Storage Equipments,kits etc: 75,000 USD
Portable X.ray machine:        40.000 USD
Non-medical Furnishings & Early stage Supplies:                          50,000 USD
Kitchen,Prsonel Dining Hall, meeting rooms,seminar saloon, Morg, Fire escape etc.                                                                                              50.000 USD
Initial Working Capital for 6 months: (for supplies and operational costs):
                                                                                                               250.000 USD
Human Resources: The hospital will initially employ 30 staff members in 6 months, with plans to expand to 80 stuff within the first year.

2.Financial projections for average 6 months of the first year after start.up: 

A.Monthly Expenses:
A.1. Hospital Rent                                                                           15.000 USD
Rent: Preferred Building Characteristics:
Central Location: The desired building should be situated in the city center, ensuring easy accessibility for patients and staff.
Parking Availability: The building should have adequate parking facilities to accommodate both patients and visitors.
Conversion Potential: The building should possess the structural integrity and layout that can be readily transformed into a functional hospital. This could include repurposing an existing 3-star hotel or a similar structure,say.
Renovation Ease: The building should be relatively easy to renovate, repair, and remodel to meet the specific requirements of a hospital. This will expedite the transition process and minimize construction costs.
Lease Agreement Terms:
Lease Duration: The proposed lease term is 25 years, providing long-term stability and security for the hospital's operations.
Competitive Rent: Efforts will be made to secure a rental rate below the prevailing market rates, ensuring cost-effectiveness.
Legal Safeguards: A comprehensive lease agreement will be established, including a clause stipulating the hospital's designation on the building and land titles. This protects the hospital's rights and interests in the property.
Currency Stabilization: The lease amount will be denominated in US dollars to shield the hospital from potential fluctuations in local currency exchange rates.
Renovation Grace Period: A grace period will be negotiated to accommodate the renovation phase, allowing the hospital to focus on construction activities without incurring rental expenses during this initial period.
Capitalization of Renovations: The initial year's rent will be offset by the costs of any permanent renovations and investments made within the building. This aligns the financial interests of the landlord and tenant.
Termination Restrictions: The lease agreement will expressly prohibit the landlord from unilaterally terminating the lease without valid cause. In case of any disputes, the matter will be referred to the court for resolution.
Investment Protection: In the event of an unwarranted eviction by the landlord, the lease agreement will include a penalty clause requiring the landlord to compensate the hospital for the full amount of its investments in the property which is about 2 mio USD. 
Overall, the outlined preferences for the building and lease terms aim to establish a favorable environment for the successful operation of the hospital. The strategic approach to property selection and lease negotiation seeks to minimize risks, ensure cost-effectiveness, and protect the hospital's long-term interests.
A.2. Salaries                                                                                          50.000 USD
A.3. Amenities,facilities like Electricity, water, heating cooling etc.                                          5000 USD
A.4. Medical supplies, disposables,reusables, medications   10.000 USD
A.5. Cafe,restaurant diet meals etc                                                  5000 USD
A.6. Unexpected expenses                                                                 2000 USD
A.7.Loan payback after grace period                                            15.000 USD
A.8.Tax, consultancy payments                                                        5000 USD
A.9.Advertisements,seminars at hospital,visits,gifts etc.         5000 USD
***Average monthly expenses : 110-120.000 USD per month

B.Montly Incomes:
B.1. Outpatient:
Patient exams,15 patients per day= 300 USDX 25 weekdays      7.500USD
Echo 8 patient per day= 400 USD, 25 weekdays                          10.000 USD
Holter, Stress Test 5 patient per day 250 USD, 25 weekdays      6.250 USD
B.2. Inpatient,Emergency and ICU patients:
3 patients 3 nights stay per patient 225 USDx 25 weekdays        5.625 USD
5 patient blended (Emergency plus ICU) per day =1.000 USDX 25 weekdays       25.000 USD
B.3. Coronary Angiography:  3 patient per day, 1500 USD per day, 20 weekdays                                                                                                  30.000 USD
B.4.PTCA+Stent and Pacemaker procedures:
 2 patient per day,average 5000 USD, 20 weekdays                     100.000 USD
Surgery  5 patient per month, 5 patientX 4000 USD per patient 20.000 USD 
Average monthly  income: 180.000-200.000 USD
Please kindly note that "Financial projections for income and expenses have been developed for the initial six months. The statement conveys that the financial statements for the first 6 months were prepared with a cautious and conservative approach, assuming higher expenses and lower revenue and patient numbers. This approach is often used to mitigate potential risks and ensure that the financial statements are not overly optimistic. I mean "In preparing the financial statements for the first 6 months, a conservative approach was adopted. Expenses were overestimated, while revenue and patient numbers were minimized." These projections may vary by plus or minus five percent."
All  in all, over the first 10 years of operation, the hospital anticipates generating a net profit of approximately USD 15 million, with an average annual net profit of USD 1 million during the first 5 years and USD 2 million per year during the subsequent 5 years. This projection accounts for taxes and considers early investments and subsequent depreciation. Under the most conservative scenario, the net profit is estimated to be at least USD 12 million in the first decade.
Detailed Breakdown:
Year 1-5: Average annual net profit of USD 1 million
Year 6-10: Average annual net profit of USD 2 million
Total 10-Year Net Profit: USD 15 million (excluding taxes)
Minimum Projected Net Profit: USD 12 million (considering taxes and early investments)
Key Assumptions:
Steady growth in patient volume and revenue
Effective cost management and optimization
Favorable market conditions and reimbursement rates
These financial projections are based on current assumptions and estimates and may vary depending on actual market conditions, operational performance, and unforeseen circumstances.

3. Operating  Company
CARDIOCARE BUSINESS
Business Name / Nom commercial
1000379944
Business Identification Number / Numéro d’identification d’entreprise
Registrant: / Personne enregistrée:
MEHMET UGUR ES
Sole Proprietor / Propriétaire unique
4. Resume
Mehmet Ugur ES, MD
490 Paul Metivier Dr. Ottawa, ON K2J 0A9, Canada
+1 (343) 777-2600
[email protected]
February 15, 2024
OBJECTIVE To use my medical, surgical, and supervisory experiences at a
heart specified hospital targeting East African people in four countries as Uganda, Kenya, Rwanda and Tanzania.
EDUCATION
Izmir Ataturk High School, High School Diploma, 1977-1980
Ege University School of Medicine, Izmir/Turkey Bachelor of Medicine,
1980-1986
General Practice Medicine 1987, Government Hospital, Bilecik/Turkey
Cardiovascular Surgery Residency, 1987-1992 Kosuyolu Cardiology and
Research Hospital, Istanbul/Turkey
Consultant Cardiovascular Surgeon, 1992-1998 Dr. Siyami Ersek Cardiac
Hospital, Istanbul/Turkey
ECFMG Certificate-1990
English for Academic Purposes- Algonquin College/Ottawa/ON/CA -2021
ICAS, WES Certificates 2020,2021
Addictions and Mental Health Program-Algonquin College/Ottawa/ON/CA,
2021-2022 (For research purpose in postoperative cardiac patients and their
families)
Diagnostic Cardiac Sonography Program-Algonquin College/Ottawa/ON/CA,
1
2023-
(For academic and research purposes in postoperative cardiac patients, still
continues)
Membership of Medical Council of Canada and Physiciansapply.Ca
Canadian Cardiovascular Society Membership 2021-continues.
PROFESSIONAL EXPERIENCE
In all of the following hospitals named below since 1998, I have been the chief
surgeon who had established and started, and sometimes maintained
cardiovascular surgery activities on consultant basis:
1998-2001 Private Istanbul Cardiology Hospital, Istanbul/Turkey, Chief Physician
& Senior Consultant Cardiovascular Surgeon,
2001-2005 Private Shifa Hospital, Tekirdag/Turkey Senior Consultant
Cardiovascular Surgeon,
2005-2008 Private Central Hospital, Izmir/Turkey Chief of Surgery, Senior
Consultant
Cardiovascular Surgeon,
2008-2014 Private Omur Hospital, Kayseri/Turkey Senior Consultant
Cardiovascular Surgeon
2011-2014 Maltepe University Faculty of Medicine, Istanbul/Turkey Senior
Consultant Visiting Cardiovascular Surgeon and Lecturer
2012-2014 Private Rentip Hospital, Bursa/Turkey Senior Consultant
Cardiovascular Surgeon & Chief Medical Officer
2014-2016 Spitali i Zemres Tirane/Albania & Istanbul Medicine Hospital,
2
Pristhine/Kosovo
Senior Consultant Cardiovascular Surgeon
2016- 2019 Medical Park Group Hospitals, Tokat and Elazig provinces/Turkey
Worked as chief medical director at different hospitals, total spanning of 3 years.
BUSINESS EXPERIENCE
Project for Cardio-check Outpatient Heart Clinic, CEO, 1995
Safak Hospital, outsourcing of Department of Invasive Cardiology and
Cardiovascular Surgery, 1998
Istanbul Private Cardiology Hospital, CEO, Shareholder, Head physician, 2001
Horizon and Cardioren Co. Medical Disposable Manufacturing and Market
affairs, 2013-2019
VOLUNTARY ACTIVITIES
Humanitarian aid after the 2005 Earthquake, Hyderabad/Pakistan,
Cardiology Center and Cath lab Investment, 2005, Dakar/Senegal.
Military Hospital Eye Surgery Department investment, Nyala-Darfur/Sudan, 2008
LANGUAGES
Turkish native, English advanced
COMPUTER
Microsoft Office Apple Macintosh
TRAINING & CONFERENCES
TOEFL Certificate
ECFMG Certificate
3
Turkish Cardiovascular Surgeons Board Certificate
Albanian and Kosovo Certificate of Cardiovascular Surgery
Annual Meeting of Angiology – Toronto-Canada 1990
Other many national and international conferences, nearly 50 national and
international
scientific papers and articles.
REFERENCES
Associate Prof, Alper Aydin, MD, Electrophysiologist, Ottawa Heart Institute,
Ottawa/ Canada
Dr. K.M. Cherian, Institute of Cardio-Vascular Diseases, Director, Chennai/India
Prof. Dr. Unal Acikel, Head of Cardiovascular ad Thoracic Surgery Department
at 9 September Unv. Hospital – Izmir/Turkey
Prof. Dr. Cevat Yakut, Head of Kosuyolu Cardiology and Research Hospital –
Istanbul/ Turkey
Prof. Dr. Denyan Mansuroglu, Head of Cardiovascular Surgery GOP Research
Hospital affiliated Yeniyuzyil Uni., Istanbul/Turkey
Prof. Dr. Mustafa GULER, Head of Cardiovascular Surgery Bahcesehir
University Medicalpark Goztepe Hospital Istanbul/Turkey
Prof. Dr. Rahmi ZEYBEK Cardiovascular Surgeon in Chief, Central Hospital,
Izmir/Turkey
Prof. Dr. Roland Xhaxho, Head, Cardiac Anesthesiologist, Spitali i Zemres,
Tirane-Albania



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