total hospitality ltd Management discussions

Industry Structure and Developments:

From 1999 to 2006 South Africa (SA) has seen a 67% rise in deaths owing to chronic kidney disease (CKD), and the prevention of this condition remains an important priority. Type 2 diabetes mellitus, HIV infectants, hypertensions, BP > 140/90 mmHg and smoking. are the dominant diseases associated with end-stage kidney disease (ESKD), particularly in black ethnic groups.

We are in the process of setting up dialysis centres for acute and chronic renal dialysis services through our proposed network of ten nos. most-modern state-of-the-art Dialysis Centres in Africa, stand-alone or with existing facilities of a large hospital. In each centre, we propose to install 10 nos. dialysis machines including 2 nos. exclusively reserved for HCV, HIV & Hep B patients. These centres will consists of dialysis machines, fowler beds, cardiac table, crash cart, defibrillators, multi-para monitors, weighing scale, air-conditioners & fridges, individual television for each bed, reverse osmosis plant 1000 LPH, with 2 nos. storage tanks of 10,000 litres capacity each, CCTV cameras etc. The company has initially identified Rwanda, Uganda, Zambia & Ethiopia for setting-up these 10 dialysis centres. Our strategy is to expand its footprint in order to widen access to, and meet the growing demand for such services and is busy developing several additional facilities that will open in coming years.

These specialised services assist patients in renal failure who require out-patient based chronic renal dialysis or home based peritoneal dialysis; or acute renal dialysis in hospital. We aim to standardise and provide quality services and will focus on improving the clinical outcomes and the quality of lives of all our patients.

Hemodialysis centers provide medical treatment for end-stage renal disease (ESRD) caused primarily by the chronic diseases of diabetes and/or hypertension (high blood pressure). There is an increasing need for hemodialysis centers as people live longer and more people develop the diseases that lead to kidney (renal) failure. Additionally, medical advances have enabled dialysis patients to live longer on dialysis. In most urban areas, hemodialysis centers provide the patient with needed services that are easily accessible with minimal travel time.

Opportunities, Threats, Outlook, Risk and Concerns:

Kidney disease has been defined primarily in terms of end-stage renal disease (ESRD), i.e., kidney failure requiring dialysis or kidney transplantation. Recently, however, the disease has been redefined as chronic kidney disease (CKD), a progressive condition that culminates in ESRD and that often can be effectively treated in its earlier stages; prevention is now a realistic possibility. Clinical interventions at earlier stages of CKD can effectively slow, stop, or, in some cases, reverse the progress to ESRD.

In second phase, the Company may explore other countries in Africa & West Asia. The Company is in the process of appointing a competent experienced consultants, who will be responsible for setting-up the entire operations of the centres which include layout design, area modifications, beds allocation, build & construction of waiting area, utility room, store design, nursing & administration stations, purchase & installation of equipment, provide manpower planning, protocol & quality implementation.

Dialysis centers are expected to perform well, due to the inelastic demand for their services, especially in Africa where there is lack of facilities for healthcare. The majority of dialysis patients are covered under Medicare, threatening profitability of the Company. As patients use medicare as their primary insurer, repayments to dialysis centers will slow. Apart from that, foreign exchange fluctuations, country and political risks are also a major threat.

Segment-wise or Product-wise performance, Discussion on Financial Performance with respect to Operational Performance:

The estimated cost of per dialysis session is more than 5 times compare to India. The estimated total capital outlay of this project is US$ 3.00 million equivalent to INR 200 million, which will financed through deferred credits on equipment, equity contribution by the Promoters and a Mauritius based Private Equity Company.

Internal Control Systems and their Adequacy:

The Company has proper internal control system and systems are adequate to safeguard the assets of the Company.

Material Developments in Human Resources / Industrial Relations Front, including number of people employed:

The Company is still in the stage of setting up most-modern state-of-the-art Dialysis Centres in Africa, stand-alone or with existing facilities of a large Hospital, and therefore, the Board will comment on the Material developments in Human Resources / Industrial Relations front, including number of people to be employed in the coming year as the Company is in the process of appointing a competent experienced consultants, who will be responsible for setting-up the entire operations of the centres which include layout design, area modifications, beds allocation, build & construction of waiting area, utility room, store design, nursing & administration stations, purchase & installation of equipment, provide manpower planning, protocol & quality implementation.

		On behalf of the Board
	Divya Seengal	Siddharth Seengal
	Managing Director	Director
	DIN: 00507943	DIN:02182275
04/08/2017	Australia	Gurgaon