Introduction:

Al-Buraihy Hospital Group is among the earliest private hospital the non profit which emerged in the nineties. The first hospital established in Taiz was in 1991 with the capacity of 70 beds, followed by Al-Buraihy Center For diseases Ear, Nose and Throat Aden 1997, which expanded to a hospital in 2000,then Alburaihy Center emergency in Lahj Governorate.

Introduction:

Al-Buraihy Hospital Group is among the earliest private hospital the non profit which emerged in the nineties. The first hospital established in Taiz was in 1991 with the capacity of 70 beds, followed by Al-Buraihy Center For diseases Ear, Nose and Throat Aden 1997, which expanded to a hospital in 2000,then Alburaihy Center emergency in Lahj Governorate.

in 2005 Which is almost free and serves as a group of villages living in the margins of society and suffers from different diseases and different Pandemic .

The objective of establishing these hospitals has been and will be the shortage in providing health services in Government Hospitals, while the population progressively increasing in the main cities  as the number of Government Hospitals are the same, and their services are continuously retrogressing. Hence come the idea of establishing private health utilities.

Especially the non-profit is rare that our services go beyond charity medical services in hospital to contribute to the country with facilities and charities In cases of disasters and Pandemic.

The second main reason: to enable health cadres with high and medium certificate to receive training in as healthy proper learning circumstances as possible. The practical health approach has been sharply diverted from the proper direction reflecting on experiences of trainees in future.

The third main reason: Provision of job opportunities for more than one thousand five hundred families.

However, our medical services in all these utilities were limited to providing first aid carrying small and medium operations and according to the possibilities of large operations.

This never meets only 20% of the services needed by citizens. There are group of diagnostic and therapeutic services which we are unable to provide, and patient has one of this choice, either  to travel abroad or surrender to fate.

From here came the idea of establishing a medical institution.

First: market research

Health services in Yemen:
1 - the area of health facilities:
Despite the developments in the health sector, both in easing medical facilities or in the field of workforce Or to the improvement and expansion of immunization programs Aumajal development and improvement of medical services and preventive and curative, but Yemen is still among

As the number of public and private hospitals to (268) Hospital at the end of 2004, compared to 75 in the hospital in 1992 and the number of health centers (370) in the center in 1992 that reached to the center in 1261 in 2004
The number of the family including the family of the private sector in 8150 in 1992 to 23350 beds in 2004.

2 - Agreement in the health sector

Yemen has given the state of the health sector for special attention and worked on the financing of reaching agreement on the health sector in 1997 increased by 3% of total public spending at a rate of 2.1 of GDP compared to 7.3% of total public spending at a rate of 3.1% of GDP in the year 2003 as the per capita total expenditure on health has not evolved significantly It rose from 608 riyals in the year 1997 to 1536 rials in the year 2003 and this amount is very low compared to other countries.

3- private sector investment in the health sector:

.Private sector investment has a significant development after the blessed unity in 1990, where statistics show that the number of Medical facilities and private establishments reached 4000 in 2004, including 94 hospitals, 345 clinics, 100 medical center, 615 Laboratory, 267 Status and dental clinics teeth .1164 medical clinic, 1288 clinic previews / 62 radiology center Where the spread of investment in this sector without regulations controls certain set of infrastructure investment in this sector, the most prominent engineering and technical constraints and staff and the mechanism by which the organization of the private medical sector.

Also emerged as the role of the private sector through the provision of appropriate health services and the opening sections of different disciplines, easing the government-owned hospitals from the pressure of the patients increased in addition to easing the burden of traveling abroad due to the availability potential in this sector, but the majority of private hospitals is Public hospitals is not available where the specialized nature This is confirmed by that many patients travel to some Arab countries like Egypt and Jordan in search of specialized hospitals in the provision of curative services, but that after the guidance Recent guidance of His Excellency the President of the Republic should be directed opening of the medical private  sector specialist divisions were opened in some hospitals and the use of qualified cadres and remarkable competence and expertise at the local, regional and global.

And therefore call specialists from outside Yemen to conduct operations to ease the difficult burden on the patients that also provides for the state treasury large sums of foreign currency due to travel for treatment outside the home and through those provided by the private medical sector has become the industry Plays a role, service and social and developmental as well as he has become an important sector and complementary to the governmental sector.

The most important indicators of population demographic :

Statement	Count	appreciation	appreciation	appreciation
				Total resident population
The resident population by type
				Male
				Female
Resident population by urban situation
				Urban
				Outskirts
Estimates of the number of families in urban as the case may
				Urban
				Outskirts
Estimates of the number of urban housing as the case
				Urban
				Outskirts

Idea of the project components

the previous level of health service needs of the population in Yemen note to health services Especially with the increase in population and also to increase health awareness, mostly by the proliferation of different media and Hence came the idea of a modern hospital provides sophisticated health services and more specialized, but rely on previous experience the project owner and the hospital Able to handle (300) beds consist of the following centers

1- Emergency Center accommodates groups of people resulting from disasters that occur from time to time to provide the Centre contingent of ambulances equipped with equipment for various injuries and her crews qualification.

2- Center for the treatment of burns and plastic.

3- Cardiac disease center (diagnostic and open heart operation).

4- Centre for Nephrology (fragment stones ultrasound, dialysis, kidney transplant).

5- Centre for Blood Diseases.

6- Centre for Oncology (surgical, chemical, radiological)

7- Center for laser surgery.

8- Surgery Center different Endoscope

9 - Center for Infertility and IVF.

It  will consist of three operating rooms - intensive care capacity (20) Beds - Care Children( ten incubators ) - sections diagnostic assistance(x- ray, laboratory, pharmacy )- physiotherapy.

Phase II: construction of the building back to an area of 700 m and will include six floors will be devoted latter role staff accommodation.

Third Phase: Building Construction College of Medicine and Pharmacy, Nursing and accessories of housing for students from other cities, and playgrounds and others, has started the dialogue with the President of the Free Zone On this stage.

place of the hospital: Reasons for choosing the city of Aden, the headquarters of the medical institution is:

- Location, It is considered crucial for patients from eight Governorates: (Hadhramout, Al-Mahrah,Taiz, Shabwah, Abian, Lahj and Dhala, in addition to Aden Governorate).
- Obtaining land area of ten thousand km 2 with the building ready, and rehabilitation for him to the hospital, which gave us of the free zone in Aden.
- Lack of medical services and the aforementioned finally found them did not meet the minimum medical standards.

Geography and climate:

Aden economic and commercial capital of the Republic of Yemen and the Yemen and the gaps in the gate located on the southern coast of the Arabian Sea (Gulf of Aden) near the Strait of Bab AlMandab- the main entrance to the Red Sea - at the intersection of Asia with the continent of Africa and the capital city of Aden at the site of a compromise between the East and West.

the city of Aden, lying directly above the sun twice a year within the virtual movement of the sun between the tropics because of its astronomical ,We note that the temperature rises in summer and winter to be warm in Julythe average temperature between( 24.5 ) minimum and (40.5) at the most, while the up average temperatures in January between (18.6) and minimum (31,6), Rate and pressure of the city of Aden in the summer at least, where in July, up to (1002.1) millibars, while increasing the proportion of rates in the winter, up in January (1015.4) millibars.

Pricing policy for the hospital services and to identify revenue :

Have been adopted in the level of income of the Yemeni people and when the adoption of pricing policy for the hospital, As well as experience generated operating result medical units and the level of service provided and the summarize following are the most important element in determining the prices of medical services provided:

- Open the operating room and anesthesia around (355) $ for a time.
- Emergency around ( 13 ) $ per patient.
- The cost of the detection of a single patient (13 $)
- Revenue of medicines (pharmacy) per day ( 148 $)
- Accommodation per room about ( 45 $) per day
- Revenue Laboratory (1,181$) per day.

Second: The technical study

- Components and basic elements of the hospital:

Can be divided into elements hospital functionally into four main sections:

1 - Nursing Services: are those services provided by nurses to patients living in the dormitories, and doctors located in this section on an ongoing basis for diagnosis and treatment procedure, And the Department of Nursing is the section devoted to the establishment of inpatients in the hospital and is the provision of health services as well as some recreational activities which also provides treatment to patients, which includes drug screening and follow-up and treatment., so this section is the most important sections of the hospital and it needs the best guidance and to link appropriately with the main entrance .

2- Sections, detection and treatment:

The section includes patient rooms in addition to rooms nurses & bathrooms and divided into wards depending on the type of disease, associated with this section reception and outpatient clinics and Operations Division is a major and is also associated with the administration, stores and kitchen.

3-Administrative Services: includes the services of remedial management - management services and non-therapeutic.

4- General Services: Pharmacy - the morgue - the kitchen - laundry - sterilization - General Stores - Personnel Services - Green areas - parking lots.

considerations in the design :

Have been adopted, the basic considerations in the redesign of the building to serve as rehabilitation hospital, including:

-The human dimension in the design :With the development of treatment methods had to be a similar development in the planning and design of hospitals Something that has been taken into account when preparing designs for the hospital design is given to the patient a sense of safety and comfort, both in internal been achieved by a lot of way architectural and natural colors and measure masses and sizes.
- Flexibility: The design allows the hospital with enough flexibility to change and switch the use of empty space as needed this was done using the flexible Module clips allow a change of internal spaces to accommodate a variety of activities were also choose the method suitable for electrical and mechanical installations to fit the space when you use it.
- Susceptibility to stretch: the taking into account that some sections in the hospital need to be extended and expanded to the design has been prepared and are aware of the process of expansion in the spaces in the future and designed to rehabilitate the building So as to allow for this Extensions be horizontal, with the formation projections Walt allows horizontal extension.
- Stages of implementation and construction: Due to the high costs of construction of hospitals and the difficulties of funding to the hospitals have become established in a phased manner is necessary in order to advantage from the first stage to be done to provide the necessary support to the remaining stages.

It is also taken care to some of the considerations in the design of portlets.

* There is a ramp for the disabled and the elderly in a way to enter

* There is a main entrance for pedestrians and cars.

*Ambulance entrance has a room to check arrivals and a waiting room

*Connected to the service entrance of the yard to unload the servicing needs of the kitchen and laundry and admitted.

Motion Paths of horizontal and vertical:

Design paths of horizontal and vertical movement so as to serve the various regions in addition to all of: the sick, the guest  - Doctors, nurses and technicians - materials and sterile medical instruments - contaminated material and non-clean - files and medical reports

These tracks have been designed so that items are not link to any cross-section of another department to avoid transmission of infection and obstruction of work in other sections and paths of movement designed to allow an extension of the hospital operations without hindering.

System with the availability of fire insurance as well as escape route in case of fire.

Investment cost of the project

First: The equipment and medical equipment:

estimated total cost of this item

AMOUNT	UNIT PRICE	QTY	ITEM
40000	40000	(1)	LAPROSCOPE
20000	20000	(1)	ERCP
800000	800000	(1)	MRI
400000	400000	(1)	CT- SCAN
500000	500000	(1)	ANGIOGRAPHY
60000	60000	(1)	MAMOGRAPHY
160000	40000	(4)	VENTILATOR FOR ADULT
160000	40000	(4)	VENTILATOR FOR INFAT
60000	30000	(2)	MECROSCOPE (ARTHROSCOP)
70000	70000	1))	C- ARM
75000	5000	(15)	ICU MONITER
36000	18000	(2)	GASTROSCOPE
10000	10000	(1)	COLONOSCOPE
6000	6000	1))	AUDIOMETRY FOR  CHILDREN
180000	180000	(1)	X-RAY (500 MA) DIGITAL
60000	30000	2))	X- RAY (100 MA ) متحركة
22000	22000	1))	ENDOSCOPIC SCLEROTHEAPY         AND BAND LIGATION
56000	28000	2))	GASOMETRY
36000	18000	(2)	BRONCOSCOPY FLAXBAL
75000	15000	5))	OPERATION TABLE ( HYDROLIC )
12000	12000	(1)	OPERATION TABLE FOR ORTHOPEDIC OP.
16000	8000	2))	DELIVERY CHAIR
160000	32000	5))	ANASTHETIC  MACHIN
50000	10000	5))	CUOTARY
16000	4000	(4)	PORTABLE LIGHT SOURCE
32000	8000	(4)	LIGHT SOURCE (FIXED )
18000	3000	(6)	STERELIZED LAMP
10000	1000	10))	DRUG TABLE
6000	1000	(6)	TABLE( STEEL ) FOR OPERATION INSTRUMENT
18000	3000	(6)	ECG
60000	60000	1))	ULTRASOUND + ECHOCARDIOGRAPHY
8000	8000	(1)	INSTRUMET FOR TONSILECTOMY  OPERATION
4000	4000	(1)	INSTRUMET FOR SEPTOPLASTY OPERATION
20000	20000	(1)	CBC جهاز
10000	10000	(1)	(SCREEN ARTER3000) BIOCHEITY
2000	2000	(1)	WATER BATH
4000	1000	(4)	MICROSCOPE
8000	8000	(1)	REFRIGRATE FOR SOLUTIOS
12000	12000	(1)	REFRIGRATE FOR  BLOOD BANK
9000	3000	(3)	INCUBATORS FOR CULTURES
2000	1000	(2)	DIGITAL CENTER FUGE
20000	20000	(1)	ELIZA
2000	2000	(1)	ROTATRY
2000	2000	(1)	SHWKER FOR B.BAGS
39000	39000	(1)	COPAS
18000	18000	(1)	ELCTROLIT 9180
6000	6000	(1)	GLYCATED HB (HB A,C)
28000	28000	(1)	A25 BIOSYSTEM
10000	10000	(1)	COAT – RON (COAGULATION FACTORS )
16000	8000	(2)	DENTAL CHAIR WITH HIS INSTRUMENTS
10000	5000	(2)	BABY SECTION
20000	2000	(10)	LAPRATOMY MINOR SET
40000	5000	(8)	INSTRUMENT  FOR ORTHOPEDIC OPERATION
40000	10000	(4)	Ped.warmar
30000	10000	(3)	Ped. Warmer with ventilator
300.000	300.000	(1)	Device Cardiac Catheterization &care
10000	2500	(4)	Sterilization units
3894000			Total

Second: furniture and medical equipment: The cost of this item about (10 388) million dollars, according to the following items:

AMOUNT	UNIT PRICE	QTY	ITEM
100000	5000	(20)	VOLVE MOUNTED PANLE FOR ICU
300.000	2000	(150)	VOLVE MOUNTED PANLE FOR PATIENT ROOM
75000	500	(150)	DREIP STAND
750000	5000	(150)	PATIENT BEDS
10000	1000	(10)	OFFICE FOR DOCTORS
10000	1000	(10)	CHECK BEDS
225000	1500	(150)	COMEDINO
120.000	120.000	(1)	Pharmacy
13875000			TOTAL

Third: Cars: The cost of this item about 20380 million dollars, according to the following items:

AMOUNT	UNIT PRICE	QTY	ITEM
150.0000	300000	(5)	AMBULANCE
880.000	440000	(2)	AMBULANCE SPECAILY FOR CARDIAC CASSES
2380000			Total

Fourth: The cost of rehabilitating the building and construction: estimated cost of the item 20100 million dollars, according to the following items

AMOUNT	UNIT PRICE	QTY	ITEM
2.100.000	300	م27000	Total area of the building in two phases
2.100.000			Total

V / other equipment: The cost of this item about 918 thousand dollars in accordance with the following items

AMOUNT	UNIT PRICE	QTY	ITEM
10000	10000	(1)	Telephone network
300.000	150.000	(2)	Energy system, central air-conditioning
300.000	150.000	(2)	GENERAL MOTORS 500KW
16000	8000	(2)	WASHER MASHINE
12000	6000	(2)	IRON
180000	60000	(3)	Hospital left (15 persons)
10000	10000	(1)	Cafeteria & restaurant
40000	40000	(1)	Computer network
50.000	50.000	(1)	section morgue
918000			Total

VI: furniture and office equipment: The cost of this item about 100 thousand  dollars:

AMOUNT	UNIT PRICE	QTY	ITEM
100.000	100.000		Furniture & office equipment
100.000			Total

Administrative structure of the hospital: Takes into account the administrative structure of the hospital covers the activities of the hospital in order to achieve full performance with a message suited to the hospital:

 

Third: the study of financial

Investment Costs: As a conclusion of a technical study of the project, the expected investment costs of the project is about (10780)million dollars

AMOUNT	ITEM	NO
2100	the cost of rehabilitation of the building and new construction	1
3894	Equipment and medical equipment	2
1388	Furniture and medical equipment	3
2380	Cars	4
100	Furniture and office equipment	5
918	Other equipment	6
10780	Total	7

Operating costs :According to data available as a result of past experience in hospital management, it is expected that the annual operating cost of approximately (1.010) million dollar and distributed on the following:

Operating costs :

AMOUNT	ITEM
24000	Annual rental
44500	Maintenance expenses
107000	Water and electricity
648000	Wages and salaries of medical staff
15000	Marketing costs
838500	Total

Administrative costs:

AMOUNT	ITEM
20000	Office supplies and stationery
22000	Public relations and hospitality
9000	Cleaning expenses
120000	Salaries of administrators
171000	Total

Annual depreciation:

is calculated according to the annual depreciation rates shown in the table following:

Annual depreciation	Rate of depreciation	Investment cost	ITEM
105	5%	2100	the cost of rehabilitation of the building and new construction
779	20%	3894	Equipment and medical equipment
139	10%	1388	Furniture and medical equipment
476	20%	2380	Cars
10	10%	100	Furniture and office equipment
138	15%	918	Other equipment
1647		10780	Total

: Revenue

In accordance with the conclusion of marketing studies income is expected to run at about 30 705 million dollar

Revenue per thousand	ITEM
1280	Operations (open the operating room and anesthesia)
240	Emergency
640	accommodation
480	Clinics
640	Pharmacy
425	Laboratory
3705	Total

List of annual income:

Will prepare a list of the annual income of the project during the first five years and in accordance with the following assumptions :

Increase the annual expenditure rate of 10% Increase revenue by 5%

Revenue per thousand

Total	5	4	3	2	1	ITEM
20472	4503	4289	4085	3890	3705	Revenue
5123	1229	1117	1015	923	839	expenses
15349	3274	3172	3070	2967	2866	Net operating profit
1045	251	228	207	188	171	Administrative expenses
8235	1647	1647	1647	1647	1647	depreciation
6069	1376	1297	1216	1132	1048	Net Profit

Statement of Cash Flows:

Will prepare a list of project cash flows project during the first five years and in accordance with the following assumptions:

Increase the annual expenditure rate of 10%

Increase revenue by 5%

5	4	3	2	1	Construction
-Cash inflows
					10780	Finance
4503	4289	4085	3890	3705		-Operating income
4503	4289	4085	3890	3705	10780	-Cash inflows
Cash outflows
					10780	- Investment costs
1229	1117	1015	923	839		Operating expenses
251	228	207	188	171		Administrative expenses
1480	1345	1222	1111	1010	10780	Cash outflows
3023	2944	2863	2779	2695	0	Net cash flows
14304	11281	8337	5474	2695	0	Cumulative net cash flows

- Indicators of feasibility of the project

1 - Period of recovery of investments : Estimated payback period of recovery of the head of the amount invested about 3 years and 10 months and this period is relatively short periods to cover.

2-The present value of net cash flows :Reliance on a discount rate of 7.5%, the highest rate of return calculated on the U.S. dollar currency loans currently in banks The net present value estimated at 747 000 dollars were calculated in accordance with the following schedule is clear from this that the project is to achieve net cash flow plus investment costs Using the present value of cash flow using a discount factor of 7,5%, and this was positive indicators for the project.

the current value of net cash flow	the discount rate	Net cash flow	Year
10780	1	10780	Construction
2507	0.9302	2695	First
2405	0.8653	2779	Second
2305	0.8050	2863	Third
2204	0.7488	2944	Fourth
2106	0.6966	3023	Fifth
+747			Net present value

Internal rate of return of the project:

Internal rate of return for the project is about 10% was calculated according to the following schedule:

the current value of net cash flow	the discount rate	Net cash flow	Year
10780	1	10780	Construction
2449	0.9089	2695	First
2296	0.8261	2779	Second
2150	0.7509	2863	Third
2009	0.6825	2944	Fourth
1876	0.6204	3023	Fifth
0			Net present value

This is the rate of the high rates if what has to take into account the interest rate on dollar deposits, which is about 0.5% to 9.5%

The results of the feasibility study:

Clear that the chances of success of the project is positive and for the following reasons:

1-Last demand for the product subject of the study due to the low level of medical services in Yemen in general and the project site Aden city particular.

2 - Last representatives of government support to facilitate the procedures and for the awareness of government for Project Services.

3- the availability of medical expertise to the hospital.

4-Provide medical services unique to the project in question.

5 - level of equipment and medical equipment next to the professional level has been carefully planned project.

6-Positive financial results of the project, including :

*Short payback period of investments planned the project, estimated at about 3 years and 10 months.

* project achieved a positive result of the current value of the net cash flows generated from the operation of the project.

*The project achieved the internal rate of return of 10%, higher than the rates of return on deposits in foreign currency by about 9.5%.

All of this, the project is successful, God willing,