PROJECT REPORT
(As Prepared by Dr Satadal Saha & his Team)

Background :

In India the ushering of free market economy and introduction of modern medical facilities has increased the cost of medical treatment manifolds. The Governmental arrangement falls far short of the need. The high tech hospitals are being set up to cater the need of the rich who may not constitute even 20% of the population, the bottom 80% can hardly afford the bare minimum health care facility because of ever increasing cost of medical treatment. In this situation it is voluntary organizations that can provide some relief to the great mass living below poverty line. With this objective in view AROGYA SANDHAN SANTOSHPUR was established in 1998 (Registered in 1999).

The initial objective of providing free medical treatment to the children of poor families has been widened in short time to extend the following medical support at free of cost or at negligible cost to cover a wider spectrum of socially and financially weaker section of the society :

• Adoption of villages inhabited by economically downtrodden and tribal people for medical care and other welfare.
• Adoption of schools for immunization, awareness and treatment.
• Organizing health awareness, immunization and treatment camps in remote rural areas.
• Established charitable Child Health Centre at Santoshpur to offer immunization and treatment with medicines for street children and other financially disadvantaged children with their mother and people of weaker sections.
• An extension counter of this health center has recently opened at Helen Keller Deaf School, Mukundapur, near Calcutta for medical care of students.
• For elderly people, 8 to 10 micro/pheco eye surgery is arranged free of cost every month.
• Disbursement of regular monthly financial aid to thellassemic children for their blood transfusion and treatment.
• Creation of Blood Donors’ Bank for thellassemic children and other emergency patients.

Experience of last few years in the above mentioned diverse voluntary healthcare services and our increasing exposure to the economically weaker section has revealed that medical facilities to these people are inadequate or beyond their means and requires urgent attention. Commercialization of medical services has further increased their problems.

AROGYA SANDHAN established a clinic for children to be run by a group of socially dedicated people with a core team of doctors. It has now been resolved to upgrade this existing Child health centre to “CHILDREN HOSPITAL”. But a stand-alone charitable pediatric hospital, given our social realities is not a sustainable proposition unless it is strongly supported by large annual grants, which is unlikely to flow. To maintain the primary objective of treating children, this hospital should be a Gynecology (including obstetrics) and Pediatric hospital. There is a demand for safe, quality and affordable gynecological and maternity services aimed at social classes 3 & 4 in and around Kolkata.

A well equipped clinical and pathological laboratory along with a pharmacy catering to the need of both charitable cause as well as to the general public is expected to generate adequate surplus to meet the shortfall in running the proposed hospital.

In this background AROGYA SANDHAN proposes and decides to establish a “Mother and Child Care Hospital” in the vicinity of its existing charitable clinic and in the South-eastern fringe of Kolkata.

MOTTO :

To offer excellent comprehensive medical services at a very reasonable rate with overall professional approach and service but without profit motive and to reserve 30% bed for patients from down trodden section at free of cost. It is designed to have a comprehensive child and mother care centre with special emphasis on the following areas:

• Preventive aspects of pediatric diseases,
• Thellassemic children,
• Mentally retarded children,
• Autistic children,
• Child psychology, psychiatry and guidance,
• Juvenile HIV,
• Secondary level care in the entire spectrum of G&O and pediatric/neo-natal services including laparoscopic surgery.

Proposal :

A. Construction of 100 bed Hospital with a mix of 70 (G&O) and 30 (Pediatric NICU) with all required provisions of:

• Outdoor facilities,
• Pathological laboratory
• Clinical laboratory
• Pharmacy

B. Phase wise Schedule of Construction of hospital project will be as under :

COST :

Estimated Cost of the Project app. is Rs 545 lacs ( as given in Annexure - 1) equivalent to $1.16 million (as given in Annexure – 2). The cost has been assessed based on practical and accumulated experience of others involved in the execution and running of similar sized hospitals.

Land :

Arogya Sandhan has already received few offers for land both as a giftas well as in commercial terms. A final decision with regard to the land of around 2000 sq.mtr offered as gift is under active consideration.

EXECUTIVE SUMMARY :

It will be a self-sustaining hospital, where the profit, if any, will be used entirely for future growth & expansion of the hospital. The hospital is intended to serve the financially disadvantaged people primarily.

· A stand-alone Pediatric hospital, given our societal realities, is not a sustainable proposition unless it is strongly supported by large annual grants. That is unlikely to flow. To maintain the primary objective of treating children, this should be a Gynaecology (including Obstetrics) and Pediatrics hospital along with facilities for pharmacy, clinical and pathological laboratory. There is a demand for safe, quality and affordable gynecological and maternity services aimed at social classes 3 & 4 in and around Kolkata. The revenue from this side is expected to support the Pediatric and Neonatal services, which take a much longer time, if ever, to break even. This will be the first project of its kind in Kolkata and that will offer a significant marketing advantage.

· A 100 beds hospital is recommended with a mix of 70 (G. & O.) and 30 (Paed. & NICU). The bed break-up includes an HDU and Neonatal ICU (Level 3), but no ICU as such.

· The hospital will provide Secondary level care in the entire spectrum of G. & O. and Pediatric/Neonatal services including Laperoscopic surgery. It will strengthen the concept of safe and mother-oriented delivery systems in maternity.

· The hospital is expected to be completed in three phases spanning over a period of 42 months. The 1st phase with comprise of outdoor facilities, laboratories and pharmacy.

· The basis for the figures given in the Summary Project Report has been practical experience and accumulated experience of others involved in the execution and running of similar size hospitals.

· Projected Occupancy figures are conservative.

· Gross Realisation per bed per month has been the basis for calculating Revenue. This is based on the historical evidence of other hospitals in and around Kolkata and can be considered fairly accurate.

· Expenditure calculation has been based on actual figures from other hospitals and we are convinced that it is difficult to have much margin in that area.

· The hospital is expected to take at least 3 years to stabilize its operation. Shortfall in cash generation during this period if any will be met either by increasing occupancy figures which is a distinct possibility with appropriate effort towards creating a client base even before the hospital starts, or through donations from our friends and well wishers.

· Equity: Debt ratio has been taken at 1:1. Term Loan interest rate has been considered at 15% on quarterly reducing balance. The repayment period has been considered as 1-year moratorium and 5 years principal repayment.

· We envisage utilizing at least 80% of equity fund before availing of Loan. Interest has been capitalized in the Project Cost (see Preliminary & Preoperative expenses).

· Our assessment of Working Capital requirement is around Rs. 40 lacs.

· We have done Sensitivity Analysis and we feel it is a good project to proceed with.

Our aim is to provide mother and child health services as an integrated package of preventive and curative measures on the principles of equity, greater co-ordination, and community participation at lowest possible affordable price because by improving the health of mothers and children, we contribute to the health of general population and build up the health of the nation.

Project Cost

For Further clarifications you may please contact :

E-mail : arogyasandhan@hotmail.com

Telephone : Office-(033)24161465 Dr. Manjusri Chatterjee 033-24166603(R)
                  Niranjan Biswas 033-24161499/ Mobile 9331031650