Following a competitive tender, Astaldi S.p.A. (“Astaldi”) and Türkerler İnşaat (“Turkerler Construction”) consortium (the “Consortium”) was officially awarded for the Project on October 18, 2011. Accordingly, Ankara Etlik Hastane Sağlık Hizmetleri İşletme Yatırım Anonim Şirketi (the “Project Company”), has been established by the Consortium. The shareholders of the Project Company are Astaldi, Astaldi Concessioni S.r.l. (“Astaldi Concessions”), Turkeler Construction, Türkerler Holding, and Türker Gayrimenkul Geliştirme ve Yatırım İnşaat (“Turkerler Real Estate”).

Astaldi is an Italy-based construction company providing general contracting and project finance, including developing major civil and industrial public works. Astaldi is a publicly-listed company on the Milan Stock Exchange with over 9,500 employees and operations in 25 countries. Through its subsidiary Astaldi Concessions, the Company is engaged in the operation of car parks, motorways and healthcare projects, among others. Astaldi and Astaldi Concessions have an aggregated 51% stake in the Project Company.

Turkerler Construction is a Turkish construction company with diversified activities in natural gas, renewable energy, mass transportation, environmental and infrastructure projects and industrial facilities projects. The parent company, Turkerler Holding is privately-owned by Kazim Turker and his family, with origins in the textile sector. Turkerler Construction, Turkerler Holding and Turkerler Real Estate have an aggregated 49% stake in the Project Company.

The total project cost is expected to be approximately EUR 1.2 billion. The proposed IFC investment will be in the form of a EUR 75 million A loan for IFC’s own account and mobilization of a B loan to be syndicated to commercial banks.

88.02 million (USD)

Product Line	IFC Investment (million USD)
Risk Management	3.0
Guarantee
Loan	85.02
Equity

* These investment figures are indicative

The Project will be located in Etlik, a neighborhood in Yenimahalle district of Ankara, Turkey.

(i) The proposed project will improve infrastructure for public health services in Ankara, especially in underserved specialized areas of oncology, cardiovascular surgery.
(ii) Successful financing and implementation of this flagship project under the program is expected to lead the way for the rest of the projects in the program, most of which being focused on second tier cities.
(iii) Additionally, the proposed project will have a demonstration effect in the region and for other sectors (e.g. education), where PPP models are being investigated as an alternative to improving social infrastructure, and are expected to follow the example of the Turkish healthcare PPP Program

Through the proposed project, IFC will:
(i) Provide long-term financing required for the Project''s feasibility
(ii) Provide healthcare investment, healthcare PPP and general project finance expertise and help imporve bankability aspects of the Project, which will be reflected in the Turkish healthcare PPP program
(iii) Set precendent by supporting the flagship project in a high profile public private partnership program in healthcare, one of the first of its kind in emerging markets

The Etlik, Ankara project is part of the wider Turkish health PPP Program (Kayseri Health (#31029) and Adana Health (#34358) for which IFC has a mandate on financing). The project involves construction of new hospital facilities on land that is to be provided by Ministry of Health (MoH) and which does not involve physical or economic displacement. The campus once built will have total of 3,566 bed capacity.



Based on a review of available project information, key project related environmental health and safety (EHS) aspects are life and fire safety risks and adequacy of emergency preparedness and response for such large campus; other important aspects seismic risk consideration in building design, construction related EHS impacts and adequacy of the environmental and social management system; implementation of good hospital management practices; workers’ health and safety, including training and housekeeping; disinfection, sterilization, and hygiene; high fresh air requirements and good lighting, hospital solid waste and effluent treatment and disposal; hazardous materials management; opportunities for energy conservation and efficiency as well as waste minimization; community health, safety and security. The core health services will be provided by MoH and support services will be outsourced based on detailed specifications provided by MoH. Construction, maintenance and facilities management of the Campus will be undertaken by the company. Thus, the overall environmental, health, safety and social management systems to identify, assess, and manage key E&S risks and impacts during the construction and operation in compliance with IFC Performance Standards may be split between the public and private partners.



IFC’s review did not identify impacts related to:

PS6: Biodiversity Conservation and Sustainable Management of Living Natural Resources, due to the Project being developed in a large residential area of Ankara and involving no biodiversity impacts. PS7: Indigenous Peoples, as there are no Indigenous Peoples in the project area. PS8: Cultural Heritage, although a small tumulus is on the site, no significant impacts regarding cultural assets is anticipated for this Project.



While the risks and impacts associated with the construction and operation of medical facilities are site specific, largely reversible and readily addressed through known mitigation measures, this investment is categorized as A based upon the diversity and size of the project.

Please refer to the related Environmental and Social Review Summary (ESRS) document for this project.

Please refer to the Environmental and Social Action Plan (ESAP) tab in the related Environmental and Social Review Summary (ESRS) document for this project.