Crystal Thorpe (CT) has issued a privately place 2 year note in conjunction with First National Bank to finance the construction of a general hospital in Lagos. This loan is meant to set the stage for new health care services in Nigeria and take advantage of favorable policies and financing incentives. Afreximbank is a project guarantor and is expected to secure bondholders fixed returns 2 years from the date of issue. Target returns are 12% per annum.

1. Hospital Construction Bond
Crystal Thorpe: Healthcare Project
Investing in Nigeria Diaspora Symposium
Presented by Ms Ugonna Ogueri, MD
London, United Kingdom
March 2014

2. Table of Content
• Introduction to The Crystal Thorpe Project
• The Investment Case
• The Nigerian Economy
• Healthcare Industry in Nigeria
• Presentation of the Company and Parties to the Project
• Business Model and Strategy
• Governance Arrangement
• Environment and Social Impact
• Funding Plan
• Revenue Model
• Healthcare Investment Opportunity
• Risk Analysis

3. Important Notice
Crystal Thorpe accepts responsibility for the information contained in this
presentation and to the best of its knowledge has taken reasonable care to
ensure that such is the case, such information is in accordance with the facts
and does not omit anything likely to affect the import of such information.
The presentation is a summarised version of information related to the
transaction described, and should be used in conjunction with, the more
detailed information, including the Summary Terms and Conditions of the
Financing, appearing elsewhere in our Information Memorandum. Reference
is made to “Risk Factors” for a discussion of certain issues that should be
considered in evaluating participating in the financing described herein. All
capitalised terms used in this presentation that are used in the Project
Documents or the Financing Documents are qualified by the meanings given
to such term in the applicable Project Document or Financing Document.

4. Crystal Thorpe is a holding company incorporated in the UK and Nigeria to acquire,
develop and manage healthcare facilities in Nigeria.
This project involves the purchase of X Hospital Ltd and the acquisition of run-down
facilities in Lagos and Abuja that will be transformed into two hospitals and four
polyclinics (the “project”) over a roll-out period.
The project is estimated at N9.8 billion or US$62.48 million, implemented in two
phases spreading over a 3-year period: -
❑ Phase 1: involves the purchase of X Hospital Ltd; the construction and
development of 1 specialist hospital and 1 polyclinic in Lagos;
❑ Phase 2: involves the acquisition of 1 hospital and 2 polyclinics in Abuja.
Introduction to Hospital Project

5. Pent up demand for healthcare services in Nigeria with inadequate supply:
Nigerians spend around US$1-2 billion annually for healthcare in foreign hospitals, according to the
government with orthopedics, cancer and cardiac diseases, accounting for a significant proportion.
The supply deficit of healthcare in Nigeria is a strong and positive credit factor.
The healthcare industry in Nigeria presents opportunities for consolidation:
Nigeria has few investor-led healthcare groups in the country. The industry lacks the scale and scope
economies because of the sole proprietorship structure, which also determines the quality of services,
returns on investment, corporate and clinical governance standards.
Penetration rate for healthcare insurance is set to double over the next 3-5 years:
3.3 million individuals out of a population of 150 million people, have signed on to medical schemes,
according to NHIS. The penetration rate for health insurance in Nigeria is projected to grow to 6
percent, over the next 3-5 years, reducing out-of-pocket payments.
Strong Health Tourism opportunities and PPP arrangement with the government
Nigeria can become a hub for West Africa as centers of excellence are built and Crystal Thorpe is also
partnering with both state and federal government via the option of offering its services to the public
sector via long-term contracts.
Investment case

6. Estimated population (millions) 15.22
Estimated population growth rate (%) 1.93
Age structure (as a % of population):
- 0 to 14 years 40.9
- 15 - 64 years 55.9
- 65 years and over 3.1
Source: Central Bank of Nigeria Monthly/Quarterly Reports 2009/2010; EIU Country Report for Nigeria, 2009/2010.
Nominal GDP & real growth rate, 2005-2010 Key demographic information
Key economic indicators
The Nigerian Economy

7. Nigeria has the biggest healthcare market in Africa with a population of around 165
million people growing at approx. 2 percent per annum
Government hospitals accounts for a large share of Nigeria’s hospital market but
are grossly under-funded with poor quality
65 percent of healthcare is done in Private cottage-style Hospitals with inadequate
capacity to meet the growing demand. The Private Sector Industry is very
fragmented with several sole doctor-owned facilities
Nigerians spent $2 bln in Foreign Hospitals last year on Medical Tourism for Heart,
Cancer, Kidney, Orthopedics and major Surgeries in the Americas, Dubai, Europe,
India and South Africa
Healthcare Industry in Nigeria

8. Nigeria Africa av.
Physician density 3 2
Nurse and midwife density 17 11
Community health workers 9 n/a
Hospital beds (2002 – 08) 5 10
Workforce and Facilities 2000 – 07 (per 10,000 population)
Nigeria has more
doctors than average
in Africa but less
Hospital beds and a
growing disease
burden
Healthcare expenditure per capita in emerging economies
Nigerian Healthcare Industry

9. Nigeria’s disease burden
350,000 new cancer cases every year

10. Key Drivers of Demand for Private Healthcare in Nigeria
•Increase in Population Growth Rate
Nigeria’s population is projected to grow at an annual average of 2 percent to reach 217 million
people by 2025, from 167 million in 2012. Nigeria has a youthful population with around 43
percent of its people less than 15 years of age and 3 percent above 65 years.
•Rapid Urbanization and Emerging Middle Class
Rapid urbanization and rising income levels have led to changing lifestyle and stress levels
which has contributed to rising levels of diseases such as coronary heart disease, diabetes,
hypertension and cancer.
•Increasing Awareness of Available Healthcare Options and Insurance Penetration
Penetration rate for health insurance in Nigeria is projected to grow to 6 percent over the next
3-5 years, from 3.23 percent currently, according to industry experts and executives as more
people sign up to medical schemes and large hospital networks develop.
•High Disease Burden
Africa has 25 percent of global disease burden according to the IFC’s health in Africa report
2007 with a very high incidence of disease. Nigeria suffers from a high burden of diseases
particularly women and children health and Malaria. Nigeria’s population suffers from diseases
associated with both developing and developed countries.
Healthcare in Nigeria

11. Key Competition within the Private Healthcare in Nigeria
Small clinics which are mostly out-patient clinics set up by individual doctor or a group of
doctors. Our polyclinics is positioned to play in this market, in order to grow our customer
network, acts as day-centers and referral clinics and create brand awareness.
The government-owned hospitals which provides sub-standard healthcare to the general
public. Our business model includes providing services to the government under a Public
Private Partnership arrangement or long-term supply contracts.
Competition from other facilities which include Lagoon Hospitals; Reddington and Eko
Hospital. Nigeria has 167 million people with only about 4-main hospitals located in
Lagos with different specialties
Customers travelling abroad for services especially those that travel to India and North
Africa. Our aim is to provide services that will match those obtained in Europe and
America, thereby attract some of the patients going abroad at the moment
Healthcare Industry in Nigeria

12. Crystal Thorpe is a company registered in the UK and Nigeria to acquire, develop
and manage healthcare services within the sub-Saharan African continent.
The Company will engage in the acquisition, construction, re-provision and
management of hospitals and clinics with the objective of turning them into
world-class healthcare centers. Our acquisition targets are run-down facilities;
facilities were succession planning is not in place or proprietors are in distress.
To begin with, Crystal Thorpe will purchase X Hospital Ltd, Lagos and expand its
operation together with two additional run-down facilities in Lagos in need of
modernization. We have advanced acquisition negotiations with the owners. The
facilities are situated in locations that supports stable customer base and possess
location advantage. After reconstruction, the acquired facilities will be
transformed into:
I. Specialist Hospitals
II. Polyclinics – acts as days centers and feeders to the Specialist Hospitals
III. Pharmacy Services
IV. Diagnostic Services
Parties to Crystal Thorpe Project

13. Other parties to the Project
American Hospital
Management
Siemens AG
Iroko Securities
London
Costain West
Africa
MANSAG
AHMC supports Crystal Thorpe in bringing global best practices and
training to healthcare service delivery and management to
facilities in Nigeria
Siemens Medical AG provides Crystal Thorpe with latest imaging
and diagnostic solutions for its hospitals and facilities
Crystal Thorpe has partnered with Costain to procure the hospitals
and polyclinics under a design/build FIDIC form of contract. Costain
has over 60-years experience in Nigeria.
Medical Association of Nigerians across Great Britain. Crystal
Thorpe has a partnership with MANSAG to bring back Nigerian
doctors and nurses.
Iroko is a UK-based investment bank supporting Crystal Thorpe’s
financing activities and hospital development

14. Support services
-HR
-Finance
-IT
-Legal
-Estates and Facilities
•Polyclinics
•Pharmacy
• Diagnostics and
Laboratory services
Crystal Thorpe
Hospital
• Gynecology
• General Medicine
• Oncology services
• Pediatrics
• Heart disease/Stroke
• Neurology
• Internal Medicine
• Urology
• Diabetes
Health Plan and
Partnerships with
HMOs
CT will operate a HUB and SPOKE model linking each unit with electronic medical
records and AHMC as the hospital manager
Business Structure

15. Analysis of target market
The target market for CT facilities are – the growing middle class and upper middle
class in Nigeria, middle and upper middle class from other West African countries,
expatriates in Nigeria and surrounding countries and dependants of Nigerians in
Diaspora. The target market mentioned above can be classified as below:
• High Income Nigerians: defined as those with annual disposable incomes of
US$5,000 or more (the top 2 percent of households, by income).
• Upper Middle Income Nigerians: those with annual disposable incomes between
US$1,750 and US$5,000 more (the top 17 percent of households by income –
excluding high income Nigerians).
• Affluent Expatriates: foreign nationals who are either 1) tourists and/or 2)
employees of Nigerian based firms. Incomes rank with those of upper income
Nigerians.
• Affluent West Africans: upper income citizens of one of four high income West
African countries (Ghana, Cameroon, Sierra Leone, or Liberia). Incomes are
commensurate with those of upper income Nigerians.

16. Marketing Strategy
Cost and Inventory
Management
Revenue Strategy
We will leverage on X Hospital’s existing HMO and corporate
clients to roll-out its network. Crystal Thorpe and AHMC has made
initial contacts with some foreign missions in Nigeria and oil firms
and will extend our reach to cover telecom and power companies
AHMC has a database of healthcare executives that will benefit
Crystal Thorpe. We also have strong links with Nigerian doctors
and Nurses in Diaspora and at home. X Hospital currently has 15
doctors and over 50 nurses.
We will leverage on X Hospital’s existing supplier relationship and
economies of scale to maintain/manage our input cost and the cost
of service provision. Economies of scale will help drive cost
optimization
HR Strategy
Crystal Thorpe has indications of interest with health insurance to
sign re-imbursement agreements. We will aim for contractual
arrangements with customers in order to support a smooth running
of operations and our debt service obligations. Pre-paid health
plans will also form a key part of our revenue strategy
Key operating strategies

17. Customer Care Payment for Consultation
Triage Nurse Payment for Blood Test
Payment for X-ray or
scans required by
doctor
Doctor
Deposit on
admission
Discharge
Admission status
reviewed daily
Admission
Referral to another
CT service
Crystal Thorpe Care Pathway

18. Our expansion project will be implemented in two phases:
Phase 1:
I. Renovate of new specialist hospital in Lagos
II.Upgrade X Hospital Ltd
III.Renovate polyclinic in Lagos
IV.Installation of medical equipment
Specialist hospital renovation will last 15-18 months while polyclinic
renovation will take up to six months. We will require to pay for the
purchase of medical equipment in month 12.
Phase 2: Commences end of 2016/2017
I.Construction of specialist hospital in Abuja
II.Renovation of two polyclinics
III.Installation of medical equipment
Indicative Implementation Plan

19. Crystal Thorpe Nigeria Board
of Directors
Audit Committee
Clinical Governance and
Quality Committee
Capital Investment
Committee
Executive Management Team
(AHMC)
Remuneration
Committee
Workforce Board
Business Management
Board
Finance Performance
Board
Clinical Effectiveness
Board
Governance Structure and
Accountabilities line

20. Environmental and Social Impact Analysis
CT is a socially responsible organisation and will uphold high standards of business ethics in
compliance with local and international law. CT has an anti-corruption policy in place and
will not accept or solicit bribes as part of its business practices. We are an equal opportunity
employer and will not discriminate based on gender, religion and ethnicity or disability.
Impact Analysis:
CT expansion has a strong social impact and a positive return for investors. The fundamental
aim of our organization is to grow its business and ensure that investments deliver strong
social and financial returns, whilst addressing some of the most pressing healthcare needs in
sub-Saharan Africa, particularly Nigeria through the delivery of efficient, quality healthcare
services and innovative products to the population.
CT service strategy is to deliver care across the healthcare pyramid. The company believes
that in order to deliver quality care to the bottom of the pyramid, it needs to deliver care
quality care to the higher-income segment of the population.
For maximum impact, CT will target women and children, the elderly population and male
youths with low skills employed in the formal and informal sector and majority of whom live
on less than US$2–US$5 a day.
Crystal Thorpe Impact Analysis

21. CT will provide access to healthcare for the bottom of pyramid population, treating at
least two thousand two hundred (2,200) patients each year, which will include access to
latest diagnostic equipment, clinical personnel, and specialist consultants within a modern
healthcare environment.
For particular type of services e.g. women that require caesarean section during child-
birth (presently a common cause of death in pregnancy for majority of women in sub-
Saharan Africa and Nigeria in particular) and treating children born with jaundice.
Nigeria has growing episodes of cancer amongst its population, according to its cancer
registry in the country. No doubt a high proportion of these episodes will be among the
bottom of the pyramid segment of the population. CT will promote awareness and in
some cases free diagnosis and treatment for this section of the population.
Through our relationships with the HMOs we will enhance access to healthcare for low-
level staff with basic coverage on the HMO scheme. We will identify and screen bottom of
the pyramid patients for service needs through our agreements with HMOs and referrals
from government hospitals. CT will monitor service delivery and outcomes using its clinical
records system and also capture data which will include demography, diagnosis and cost
of service delivery.
Social Impact – Service delivery

22. Over the last 20 years, Nigeria and sub-Saharan African countries have suffered from brain drain in the
healthcare sector. We will create an environment to provide employment for Africans in Diaspora who want
to come back home to provide quality healthcare service to people in Africa.
By attracting these specialists back home, they will support the development of local clinical staff which will
help bridge the skills gap in the sector, thereby addressing the quality of healthcare issues on the continent
while also reducing the high disease burden in Africa. The bottom of the pyramid patients will benefit from
the expertise that otherwise would have been available only to the higher-income segment of the
population.
Job creation is fundamental to CT strategy. We are an equal opportunity employer will source a proportion
of our staff from the local communities where we operate, thus enhancing income levels and adding value to
the society.
CT will employ around three hundred (450) medical and non-medical personnel at full capacity, of which
eight to ten percent of workers will be auxiliary staff i.e. bottom of the pyramid segment of the community,
for example care assistants, cleaners, security staff, and drivers. Also our partnership with global equipment
manufacturer Siemens will help develop a technical workforce on how to operate complex medical
equipment which is not sufficient in Nigeria.
Our business plan has factored in systems to attract, train, support and retain our workforce. Provisions have
been made within our financial model for staff training and development. CT will uphold high standards in
business ethics and comply with local and international law.
Workforce Impact

23. CT is conscious of the impact of its business on the environment and
will manage such impact through the adherence to the internationally
acclaimed BRE Environmental Assessment Method (BREEAM). We are
aware of the IFC standards on Environment, Health, and Safety
Guidelines for Healthcare Facilities and have incorporated them into
our business planning. We are committed to minimizing the impact of
our activities on the environment.
We propose to reduce carbon emissions from our facilities by applying
energy efficient design principles and implementing an energy
management strategy. We will use a mix of energy sources for
electricity and power generation. For example, our design strategy and
building technology are focused on the use of renewable energy which
will cut energy cost and reduce carbon emission. While our waste
management policy will ensure that we manage and dispose medical
waste responsibly.
Environmental Impact

24. Phase 1 Phase 2
Period 2013-2015 2016
Naira (mln) US$ (mln) Naira (mln) US$ (mln)
Equity & Subordinated Debt 1,648 10.48 2,228 14.17
Debt 3,844 24.45 2,103 13.38
Total 5,492 34.93 4,331 27.55
• Phase 1: the acquisition of X Hospital and the construction and
development of 1 specialist hospital and 1 clinic in Lagos;
• Phase 2: the acquisition of 1 hospital and 2 clinics in Abuja.
CT proposes to fund the project by splitting the debt financing into:
1. The financing of the construction and payment of the cash
consideration to X Hospital
2. The financing of the operation and refinancing of (1).
3. The financing of each phase will be systematically refinanced as
stated in (2).
The Funding Plan

25. Phase 1 Phase 2
Naira
(in millions)
US$
(in millions)
Naira US$ Naira US$
Mezzanine Debt (third party investor)* 1,627 10.35 831 5.29 796 5.06
Contribution of Services Providers
(Costain West Africa and the land seller
via subordinated debt)
837 5.32 349 2.22 488 3.10
CT X Hospital Ltd 365 2.32 349 2.22 16
Mezzanine Debt/Equity
The X Family
1,047 6.66 119 0.76 928* 5.90
TOTAL 3,876 24.65 1,648 10.49 2,228 14.17
Mezzanine debt providers for US$ 5.29 mln include during the construction phase for
Phase 1:
* Homestrings Investment
* Xplico Insurance Company
Summary of the Equity Financing

26. Phase 1
Naira
(in millions)
US$
(in millions)
Construction Facility 3.838 24.45
Total 3.838 24.45
Refinancing amount* 4.589 29.23
* Amount includes refinancing for the construction facility and mezzanine providers during
the construction phase in Phase 1
* Crystal Thorpe has funding support from two international banks
Summary of Phase 1 Financing

27. *An LC will be opened to place purchase order with Siemens which will be issued by Ecobank
Nigeria in Phase 1. Siemens will paid in month 12 during the construction period.
The Use of Proceeds

28. Proposed financing structure

29. Selected Periods 2015 Year 1 2016 Year 2 2017 Year 3
(in million US$) (in million US$) (in million US$)
Total Revenues 12.44 14.96 24.58
Reimbursement or
payments from
Insurances Schemes
5.22 42% 6.28 42% 10.32 42%
Corporate 3.48 28%] 5.24 35% 8.60 35%
Individuals (out of
pocket payment)
9.74 30% 3.44 23% 5.66 23%
Selected Performance Data (US$ million) 2015 2016 2017 2018 2019 2020
Revenues 12.44 14.96 24.58 29.41 31.19 34.33
EBITDA 2.40 4.11 6.90 8.39 9.40 9.92
Income Before Tax: (1.71) (1.24) (0.2) (0.8) 1.75 3.62
Projected distribution of revenues
by source of payments

30. (% of Gross Revenue)
General Medical Services 27%
Emergency Medical Services 3%
Maternal and Childcare Services 5%
Diagnostic Services 19%
Specialised Services 5%
Polyclinics 5%
Pharmacy Services 29%
Other Services 7%
(% of Gross Revenue)
Cost of Goods Sold* 22%
Overheads 9%
Staff Costs 28%
Costs of Provision of Care (Year 1)
• Pharmaceutical products are the largest items.
Projected revenue distribution by
service (Year 1)

31. We are pleased to invite prospective investors to participate in the equity
and mezzanine financing in the Crystal Thorpe hospital project to the
tune of up to US$8 million.
Equity and Mezzanine investment: up to US$8 million
Use of Proceeds
•Medical equipment
•Construction
Investment Opportunity:

32. Key Risk Factors
The following are the principal risk factors that may adversely affect the debt service performance of
CT. However, the probability of occurrence of those risk events is considered very low.
Completion Risk
This is the risk that the two hospitals and four clinics are not built on time and within budget. The
reason why the technical risk is considered low because Costain West Africa, the contractor, has an
established track record of executing a wide range of building and civil engineering projects in
Nigeria.
There is also an alignment of interest between Costain West Africa, the sponsor and the funding
providers. By subscribing the subordinated debt issued by CT, it is the interest of Costain West Africa
that the construction is finalized within the time limit as this affects its overall return. Costain West
Africa will more easily find a solution to potential problems as the failure to do so will adversely affect
its position as investor in the project.
Under the design and build contract, Costain West Africa will issue a completion bond via Ecobank
Nigeria for the contract sum, mitigating the risk of completion. Hence there is no risk of cost overrun
as the contract is a fixed price contract. All unforeseen risks related to the sites are born by Costain
West Africa. Appropriate insurance cover will be taken by Costain West Africa and CT in order to
reduce and manage risks.

33. Hospital Management Risk
This is the risk that the running of the hospitals and polyclinics does not deliver a good quality of
support services which itself may result in a poor delivery of quality of care.
Under a management and service agreement, AHMC will be responsible for managing the
hospital and polyclinic facilities. The company is a professional healthcare manager.
It focuses on the admission, management and development of world class hospitals and
healthcare system. It is very active in Latin America where it manages six hospitals, in Africa and
in India. Through its network of hospitals, AHMC is able to deliver scale economies not available
to stand alone hospitals.
Through the partnership with CT, AHMC will take a small equity stake in CT and will subordinate
some of its performance fees to interest due to senior lenders. This partnership arrangement
creates a strong alignment of interest between AHMC, CT and the lenders.
AHMC is involved with CT in the construction management, namely the design and development
and equipment planning. It is working with CT on the preparation of the business plan, financial
analysis and projections, the determination of the scope of services and on staff planning. It will
also be involved in the pre-operation and commissioning of the hospitals and polyclinics.

34. Operational Risk
This is the risk that the quality of care is not provided due to the (i) lack of personnel or staff, (ii)
lack of funding and (iii) lack of equipment.
• Staff Risk
It is acknowledged that in Nigeria, there is a shortage of trained health workers. CT and AHMC
are aware of this situation. AHMC intends to leverage its network to address CT’s staffing
requirement. In addition, the management and service agreement have provisions for
recruitment, training and supervision of CT’s employees.
CT’s believes staffing risk will be mitigated further through attractive remuneration, conducive
work environment, good medical facilities and equipment.
• Lack of Funding
The financing transaction described above covers the CAPEX and working capital
requirements of the project.
• Lack of Equipment
CT understands the need for complex medical equipment to ensure quality and modern
medical services. The equipment will be purchased from Siemens AG, a major manufacturer in
the health industry. The equipment will support clinicians to make diagnosis and treat complex
medical conditions. CT and Siemens AG will put in place a maintenance agreement to ensure
that the equipment is optimized.

35. Reimbursements or Payments under Private and Public Insurances and Corporate
Schemes
CT business model is geared towards offering its services to patients covered by insurance
schemes and corporate schemes with strong credit standing. Public sector counterparty risk will
be covered through insurance policies taken with providers of political risk cover.
Regulatory Risk
The risk is that the federal government, the state governments or the local governments introduce
rules that may have an adverse effect on CT business.
Rules may target quality standards, insurance schemes, pricing of pharmaceuticals and medical
products to name just a few examples.
CT intends to support the improvement of healthcare service delivery during its operation and
pursue quality enhancing initiatives.

36. AHMC Global Experience

39. VIP Hospital

41. How can you get involved?
• Invest
– access the deal and make a commitment
Homestrings.com/VehiclePreview/a03F0000009uUc3IAE
• Promote
– Your own project, fund or bond on Homestrings
• Participate
– Diaspora Investment Symposium
– Investing in East Africa, July - London

42. Contacts
• Eric V. Guichard – Founder and CEO
eric@homestrings.com
service@homestrings.com
• Ugonna Ogueri – Crystal Thorpe
Ugonna.Ogueri@crystalthorpe.org
• Web: www.Homestrings.com
• @Homestrings & facebook.com/Homestrings