The Public Sector is expected to be diluted post-placement from 51% to 33%. Strategic investors include the Cleveland Clinic and Elaj Medical Company (KSA), a network of specialized medical centers with locations in London, Cairo, KSA and GCCs. Other new investors include Dr. Fahed Khater, the chairman of CarePlus, an Egyptian medical insurance company, a Greek investor, Mr. Contominas. SEDCO, a Saudi strategic investor for DAF’s expansion of outpatient clinics in KSA and the Gulf is undertaking its due diligence and may subscribe for additional shares (in addition to the private palacement). This will further dilute the public sector.

Total project cost is estimated at $26 million and the proposed IFC investment is $4 million equity/quasi equity and a partial credit guarantee of up to 40% of DAF’s existing debt.

4.17 million (USD)

Product Line	IFC Investment (million USD)
Risk Management
Guarantee
Loan
Equity	4.17

* These investment figures are indicative

The expansion of the additional 26 beds of Dal Al Fouad Hospital will be on the campus of the Hospital which is located in the 6th of October City. The Hospital will acquire an existing property in Nasr City Cairo with a view to developing a new facility at that location. The location is excellent being in the heart of a very large residential area with a two main road frontage. The new facility currently only occupies around one third of it.

Improving Quality Care: The project will assist a prime healthcare provider to expand its quality services, especially in tertiary healthcare services which are much needed in Egypt and the region. Enhancement of Existing Capacity: DAF will be acquiring a majority stake in the Arab International Hospital (AIH), located in East Cairo and will improve the quality of services in an area where such services are needed. The impact on the neighboring community is expected to be substantial as DAF’s ownership control of AIH and the planned upgrades are expected to raise the quality of services at this hospital and improve its services in a very populated area. Dar Al Fouad employs about 250 doctors and about the same number of nurses. While DAF has no problem attracting high quality and dedicated doctors to their staff, the hospital does experience some shortage in nursing and other skilled support staff. Typically for DAF, the hospital has adopted a forward thinking strategy to deal with these shortages – approaches include a very active career development program based on training and upgrading of skills, excellent salaries and benefits, and the opportunity and challenges associated with working in an environment dedicated to quality and first rate healthcare. Employees undergo pre-employment medicals as well as regular medicals each year. DAF has also developed an effective community program including the Charity Society (formed in 1999) which focuses on congenital cardiac problems in children (about 40 operations performed in the last 5 years). DAF provides training in the development and implementation of Mass Disaster Plans and is working with the Ministry of Tourism, Government of Egypt, in developing and implementing a plan to monitor food safety in Egyptian hotels. Dar al Fouad Hospital will adopt the same quality and performance standards for all their operations in Egypt and elsewhere in the Gulf Region. IFC’s role as part of this Project will be to contribute to facilitating private ownership of DAF. IFC’s equity will also provide a stamp of approval and will enhance the Company’s potential IPO. Finally, IFC’s senior debt contribution whether as direct lender or partial guarantor, will help to extend current maturities of existing loans.

This is a category B project according to IFC’s Procedures for Environmental and Social Review of Projects because a limited number of specific environmental and social impacts may result which can be avoided or mitigated by adhering to generally recognized performance standards, guidelines or design criteria. The review of this project consisted of appraising technical, environmental, health and safety, as well as social and community information submitted by the project sponsor as well as a site visit to the existing hospital facilities in the 6th of October city. The following potential environment, health and safety (EHS) and social/community impacts of the projects were analyzed:

- The compliance of Dar Al Fouad Hospital’s existing and new facilities with Egyptian and IFC EHS requirements;
- The commitment of Dar al Fouad Hospital to quality and efficiency and to EHS performance including international certifications; and
- Labor, community and social issues.

Based on the above information, IFC concludes that the proposed project will meet the applicable Egyptian and IFC environment and social policies and the environmental, health and safety guidelines.
Location of environmental documents in locally affected community
The translated ERS will be available upon request at Dar Al Fouad Hospital (26 July St., the Touristic Zone, 6th of October City, Giza, 12568 Egypt. It will also be published in the company’s website (http://www.DarAlFouad.org). An advertisement in a local newspaper will inform the local community of the availability of the ERS.